Guinea-Bissau meets many, if not all,criteria that characterize health systems in fragile states.The country’s health system faces persistent challengesrelated to low public spending, poor infrastructure,inadequate supply of health workers, inadequate clinical andmanagerial training systems, malfunctioning referral system,non-operational health-information systems, weak governanceand inadequate management capacity and systems (such asbudgeting, public financial management and human resourcesmanagement). Public spending accounts for about 20 percentof total health spending and is mostly used to pay staffsalaries, while donors finance nearly 90 percent of therecurrent costs of the sector, including medicines and othercritical health inputs. This report provides a comprehensivediagnostic of the health service delivery system inGuinea-Bissau. It explores quality of care,workload/productivity and absenteeism. A service deliveryindicators (SDI) survey was implemented to cover these andother key aspects of the health system for which no datawere available in Guinea-Bissau (such as public expendituretracking survey). The report provides an extensive analysisof the data and links it to other analytical and operationalwork under implementation in the country.
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