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Annex 2.4 Page4 of 6

2000; and (III) to increase the prevalence of contraceptive use from 4.4% to 60% by the year 2005.

15.    To achieve the objectives defined above, the Goverament of tiurkina Faso has the honor to request the support of your institution in implementing a Health and Nutrition Deve!opment Project (PDSN) aimed at: (i) improving the coverage, quality and utilization of the basie health services offered to the Burkinabe population; (ii) enhancing the nutritional status of such vulnerable groups as children, pregnant women, breastfeeding mothers, and women of childbearing age; (iii) developing the national capacity needed to achieve sustainable control of endemic parasitic diseases; and flv) strengthening the institutional management capacity of the central departments of the Ministry of Health.

16.    Improvements in the coverage, ąuality and utilization of basie health services offered to the Burkinabe population will result from the following actions: (i) strengthening the health system pyramid; (ii) rationalizing Staff use and promoting staff development; (iii) decentralizing the public health system; and (iv) strengthening the procurement system for supplies of generic essential drugs.

17.    Enhancing the nutritional status of at-risk groups (children, pregnant or breastfeeding women, and women of childbearing age) will require micronutrient supplementation and development of a sustainable, long-term nutritional policy.

18.    The control and continuous surveillance of parasitic and endemic diseases will reąuire a strengthening of the technical services responsible for epidemiological surveillance, detection and treatment of cases of trypanosomiasis, onchocerciasis and dracunculiasis. Great importance will be attached to the mobilization of the target groups through IEC.

19.    Strengthening the institutional management capacity of the Ministry of Health will entail technical and financial support for the following departments: the Directorate of Administrative and Financial Affairs, the Directorate of Studies and Planning, the Directorate of Preventive Medicine, and the Directorate of Pharmaceutical Services.

20.    Implementation of this Project will serve to strengthen the Primary Health Care rehabilita-tion strategy adopted by the Burkinabe Goveroment in Juty 1993. The principal recommendation of this strategy, which is based on the “Bamako Initiative" approach, is to restructure the peripheral health facilities so as to revitalize them and ensure they can provide permanent, good-ąuality care. The cornerstone of this restructuring is the establishment of fonctioning health distriets.

21.    Reorganization of the health system will reąuire the upgrading and construction of new facilities, the assignment of medical and paramedical staff to the peripheral health stations, and implementation of an appropriate policy for the supply and distribution of generic essential drugs.

22.    Over the next 10 years the Government has planned the construction of fifty-three (53) health distriets centered around the Regional Hospital Centers (CHRs) and the Medical Centers with Surgical Units (CMAs). Fifteen (15) of these distriets are already in place, ten (10) are under construction, and sixteen (16) about to begin operations. Moreover, the program for the