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Annex 2.4 Page 3 of 6

social problem in Burkina Faso. Moreover, these activities face many obstacles in the field due to the inadeąuacy of Information, education and communication on population issues.

9. Although it has increased significantly over the last six years (growing by an average of 9.74% a year), the share of govemment budget resources allocated to the health sector still falls short of WHO's 10% guideline. It represented 6.11% of the central govemment budget between 1990 and 1993. A major role is therefore played by foreign aid in financing investments in this sector.

10.    As for the private sector, it is underdeveloped, except for private practitioners in the pharmaceutical sector. In the latter area, the private sector Controls 95% of the country's supply of medical drugs. The population at large cannot afford these medications, almost all of which are very expsnsive specialty drugs.

11.    In summary, the health situation of Burkina Faso is characterized by: 0) the persistence of endemic/epidemic diseases, compounded by the rapid spread of AIDS; (ii) the persistence of protein-energy malnutrition and other nutritional deficiencies; (iii) the inadequacy of infirastructure facilities in the sector; (iv) a shortage of qualified medical and paramedical personnel and their uneven distribution between urban and rural areas; (v) the underutilization of health facDities by the population; (vi) the lack of targeted informational, educational and communication programs; (vii) the Iow level of fmancial and physical resources; (viii) the unhealthiness of the environment, the lack of basie sewerage facilities and of potable water supply; and (ix) the high cost of care and lack of access to medication, for both geographical and financial reasons.

12.    To address this unsatisfactory health situation, the Govemment of Burkina Faso has adopted a morę coherent health policy which is based on the expansion of basie health services through the "Bamako Initiative“ approach and which dovetails with the country's overall development strategy. The Govemment's aim is to respond to the population's growing demand for health services while assuring optimum coverage of expressed needs and mobilizing all available resources for this purpose. To address the country's many health problems, the Burkina Govemment has adopted the Primary Health Care strategy, whose aim is to meet the people's health needs in a spirit of equity, self-responsibility and intersectoral collaboration.

13.    The Govemment has accordingly set as objectives: (i) to improve health coverage (by decentralizing the sector's infirastructure); (ii) to improve the quality of health service delivery; (iii) to ensure that medical drugs are available throughout the national territory and to all social strata at affordable prices; (iv) to strengthen the coverage of the EPI, MCH, FP and anti-diarrheal programs by combining them according to Primary Health Care principles; (v) to ensure that basie, continuing and specialized training is provided for health personnel; (vi) to make greater use of traditional medical practices and remedies; (vii) to encourage private sector involvement in meeting health needs; (viii)to strengthen the pardcipation of individuals and communities in managing health problems, in keeping with the principle of accountability; and (ix) to promote the search for a better way to organize health services.

14.    The thrust of these objectives is to achieve the following goals: (i) to lower the crude infant mortality ratę from 134 to 70 and the crude mortality ratę from 17.5 to 14 by the year 2005; (i>) to halve the ratę of severe and moderate malnutrition in children under 5 by the year