Family planning has increased significantly in Upper Guinea, one of the most impoverished rural areas of the country. The contraceptive prevalence rate in Upper Guinea is now 6.9% compared to 2.9% in 1999. In Mandiana, a geographically isolated and socially and religiously conservative district in Upper Guinea, the rate has now reached 20%.

A grass-roots program trains volunteer village health workers to sell affordable contraceptives to their neighbors while giving out important health information, and to refer clients to the nearest health center when necessary. Service delivery has also improved both through policy development and the training of local health care providers. In addition, USAID’s marketing program makes contraceptive products available where public health facilities don’t exist through sales points such as bars, kiosks and pharmacies. Eliciting the support of local government, traditional, and religious leaders has also been a key to success in the Mandiana district.