Cablegate: Information Regarding United Nations Fund For


DE RUEHGT #0822/01 2392157
R 272157Z AUG 09




E.O. 12958: N/A


With USG funding in FY 2009 to UNFPA the USG in Guatemala sees
an excellent opportunity for a more constructive collaboration
between USAID and UNFPA. Greater initiative by UNFPA to
engage USAID both as a donor to and partner with UNFPA will
facilitate greater commitment among those working in
reproductive health and family planning. The USG program in
Guatemala implemented by USAID welcomes the opportunity to
coordinate with UNFPA to make programs more effective and
efficient. There are several technical areas in which both
programs overlap. By UNFPA more vigorously coordinating its
efforts, duplication of efforts can be avoided and synergies
amplified contributing to potentially significant results.

The current host government leadership in Guatemala in the
area of family planning and contraceptive security has been
deficient. Internal forces and organizational change are
forcing a potential transformation of the family planning and
reproductive health program. The Ministry of Health's (MOH)
determination to buy contraceptives in the private market, at
much higher prices than those offered by UNFPA will likely
result in the MOH buying less and spending more, leaving a
large unmet need for contraceptive supplies. Family planning
is widely recognized by technical experts worldwide as one
of the most cost-effective measures to improve the health
status of women and children.

To many of those working in the area of reproductive health
and family planning, the key principles for supporting
coordinated, country-driven action adopted some years ago by
donors fighting the HIV/AIDS pandemic would serve as a
potential model. This kind of approach fosters
complementarities and efficiency among the donors and between
donors and host governments. The USG in Guatemala urges
strong UNFPA leadership to address the challenge to establish
a framework for effective coordination among multilateral and
bilateral donors, non-governmental organizations (NGOs) and
host government.


USG Response to UNFPA Draft Country Program

The USG in Guatemala was asked to respond to specific points
regarding the UNFPA Draft Country Program. The following are
the questions and responses to matters specified in the
original action request cable.

1. What is the extent to which the host government supports
the program financially or politically?

Current host government laws, policies and priorities serve as
the foundation for the proposed program. The Population and
Social Development Law and the Universal Access to Family
Planning Law serve as the platform for the proposed
components. Furthermore, a year ago, President Colom declared
reduction of maternal mortality as one of his administration's
priorities. This declaration is captured in the national
health plan submitted by the Ministry of Health. The host
government provides financial support to the program; however
the funds are insufficient to meet the population needs and
program gaps.

2. How is the UNFPA program coordinated with other host
government programs, NGOs and other donors?

Currently, the UNFPA program has an agreement with the MOH
implemented by an office at the Ministry called the
Reproductive Health Unit, with UNFPA staff based in the unit.
However, the MOH has not provided the required leadership and
coordination among the different internal units is limited.
UNFPA has worked with a number of other host government
entities in addition to the MOH such as the Presidential
Qentities in addition to the MOH such as the Presidential
Secretariat for Planning and Programming and, the Presidential
Secretariat for Women among others. UNFPA has also been
active in regards to coordination with other donors and NGOs
such as with the local International Planned Parenthood
Federation (IPPF) affiliate, Asociacion Pro Bienestar de la
Familia (APROFAM).

3. What is the geographical extent of the program?

Although it is not completely clear in the Draft Country
Program document, our interpretation is that the program is
planned to have nationwide coverage.

4. Observations on how the program can be monitored and
evaluated, adequacy of proposed performance measurements, the
strategic fit of the program within larger development goals,
and other technical matters.

Designing and implementing a monitoring and evaluation
component into the program, including: a baseline, mid-term
review and a final evaluation would be the best approach to
evaluate the program and monitor its implementation. If
properly managed, the program could contribute to improve
important development goals, such as to reduce maternal and
child mortality. The UNFPA program could also contribute to
improve quality of services and contraceptive coverage. The
proposal, however, only broadly defines the technical
approach. In order to properly judge the technical approach
of the UNFPA program, it would be necessary to receive more
detailed information rather than general statements. The
proposal would be strengthened if it included critical
indicators such as maternal mortality ratio and
infant/neonatal mortality rate, both of which are essential to
measure impact of the proposed program. These are vital
indicators monitored by the host government and help inform
programming for the USG maternal and child health program.


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