Unlocking Women’s and Girls’ Potential 1 The status of women and girls relative to men and boys in Guinea UNLOCKING WOMEN’S AND GIRLS’ POTENTIAL The status of women and girls relative to men and boys in Guinea © 2022 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved. This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. All queries on rights and licenses should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; e-mail: pubrights@worldbank.org. ABSTRACT Evidence shows that Guinean women and girls face important barriers across all dimensions of well-being that prevent them from having access to opportunities on an equal footing with men. The poor agency of women and girls, as reflected in the high prevalence of dis- criminatory legal and social norms, translates into gaps in health, education, employment, and entrepreneurship, ultimately undermining their capacity to fulfill their potential and imposing important societal costs. This report presents a summary of the key challenges fac- ing Guinean women and girls relative to men and boys. The report has a particular focus on early family formation, a common phenomenon in the country with important implications for girls’ and women’s well-being and opportunities in life. On the basis of this diagnostic and a review of evidence of what works, the report proposes some strategic lines of action to address the existing constraints and effectively empower Guinean women. CONTENTS Acknowledgments  5 Child marriage 44 Abbreviations 6 Adolescent pregnancy 46 Chapter 1. Introduction 7 Strategic direction 3: Reduce child marriage and teenage pregnancy 47 Context and rationale  8 Chapter 5. Employ: Women’s Economic Objective and framework of the assessment 10 Opportunities in Guinea 51 Overview  12 Labor market outcomes  52 Chapter 2. Educate: The Status of Girls’ Education in Entrepreneurship and access to assets and Guinea  23 finance 59 Gaps in enrollment and attainment 24 Poverty  64 Reasons for not attending school 26 Strategic direction 4: Improve women’s Barriers facing girls 26 economic empowerment and access to quality employment 66 Strategic direction 1: Assist girls in attaining primary and secondary education 28 Chapter 6. Increase Women’s and Girls’ Voice and Agency 73 Chapter 3. Enhance Access to Health Services: The Status of Women’s Health in Guinea  31 Decision-making 74 Maternal mortality 32 Gender-based violence  76 Access to maternal health services  32 Social norms  79 Contraceptive use 34 Strategic direction 5: Promote women´s participation in decision-making, and prevent Female genital mutilation/cutting 35 GBV  83 Strategic direction 2: Enhance access to maternal Chapter 7. Conclusions 89 and sexual and reproductive health services, and eradicate FGM/C  39 Appendix A. Entry Points for Legal Reform to Expand Women’s Empowerment in Guinea 92 Chapter 4. Postpone family formation: Child marriage and adolescent pregnancy 43 Bibliography 94 Early family formation in Guinea  44 ACKNOWLEDGMENTS This report was prepared by a team composed of Carmen de Paz (Consultant), Alina Mykytyshyn (Consultant), and Didier Alia (Consultant), edited by Honora Mara and led by Miriam Muller (Social Scientist) under the guidance of Johan Mistiaen (Practice Manager). The team is grate- ful for the valuable feedback and contributions of Andrea Coppola (Program Leader), Gabriela Inchauste (Lead Economist), Aissatou Ouedraogou (Economist), Susana Sanchez (Senior Econ- omist) and Paula Tavares (Legal and Gender Specialist). This work was supported through the Gender Data for Policy work program funded by the Hewlett Foundation. ABBREVIATIONS DHS – Demographic and Health Survey FGM/C – female genital mutilation / cutting FLFP – female labor force participation GBV – gender-based violence GDP – gross domestic product IPV – intimate partner violence MICS – Multiple Indicator Cluster Surveys MMR – maternal mortality rate Unlocking Women’s and Girls’ Potential 7 The status of women and girls relative to men and boys in Guinea CHAPTER 1. INTRODUCTION Unlocking Women’s and Girls’ Potential 8 The status of women and girls relative to men and boys in Guinea Context and rationale child marriage contributes to higher levels of maternal mortality, adolescent pregnancy, and childbirth-related Despite being resource rich, Guinea remains one of the complications (Azevedo et al. 2012; Klugman et al. 2014; poorest countries of the world, as well as one of the most UNICEF 2008b; WHO 2014). In addition, IPV, one of the gender unequal. Guinea holds vast natural resources, in- most extreme manifestations of poor agency, results in cluding land and mining. Yet 44 percent of the population macroeconomic losses (Raghavendra et al. 2019), reduc- was poor in 2018, and that rate was over 55 percent in es women’s labor productivity (Duvvury et al. 2013), and rural areas (where 80 percent of the country’s 5.3 million negatively affects children’s physical health, as well as people live). The Ebola crisis and COVID-19 pandemic their school attendance and performance, thus contrib- have further exacerbated poverty and inequality in the uting to the intergenerational transmission of poverty country. Although the country managed to reduce pov- (Anand, Desmond Marques, and Fuje 2012). erty from 49 percent in 2014 to 44 percent in 2018, the COVID-19 pandemic alone may have offset much of this Promoting gender equality is not only a moral imperative positive progress—it has been estimated that poverty in- but also economically beneficial for societies. It has been cidence increased by 4 percentage points in 2020 (World estimated, for instance, that equal labor participation of Bank 2021b). The unfolding food price crisis is likely to women and men would add US$12 trillion—11 percent— worsen this trend. Among the 191 countries featured in to the 2025 annual global gross domestic product, or GDP the United Nations Development Program Gender In- (Woetzel et al. 2015). In addition, eliminating barriers that equality Index for 2021, Guinea ranked 182, as one of the prevent women from working in certain occupations and countries in the world with rampant gender inequality. owning assets can lead to increases in output per worker Customary and religious practices such as child marriage, by from 3 percent to as much as 25 percent across coun- female genital mutilation/cutting (FGM/C), and polygamy tries (Cuberes and Teignier 2011). According to estima- remain concerningly widespread and signal the very poor tions by the Food and Agriculture Organization of the status of women and girls in Guinean society. United Nations, if women worldwide had the same ac- cess to productive resources as men, they could increase Limited women’s decision-making, voice, and choice are yields on their farms by 20–30 percent and raise total ag- associated with, among others, a higher risk of poverty, ricultural output by 2.5–4.0 percent. Gains in agricultur- health complications, infant mortality, and lower quali- al production alone could lift 100 million to 150 million ty of life (World Bank 2012a). Women who marry as chil- people out of hunger (World Bank 2014). On the contrary, dren, for instance, are less likely than those who marry inequality in economic participation may produce large in adulthood to complete secondary education (Nguyen economic and social losses, and trigger negative individ- and Wodon 2015), have less capacity to invest in their chil- ual outcomes across different dimensions of welfare. A dren’s health and nutrition (Pfeiffer, Gloyd, and Li 2001), recent study in a sample of developing countries estimat- receive lower earnings later in life (Male and Wodon 2018), ed the short- and long-run income losses stemming from and are more vulnerable to experiencing intimate part- gender inequality in labor markets to be 16.0 and 17.5 ner violence (IPV) (Clark, Bruce, and Dude 2006; Tenko- percent, respectively (Cuberes and Teignier 2016). rang 2019). Additionally, global evidence indicates that Unlocking Women’s and Girls’ Potential 9 The status of women and girls relative to men and boys in Guinea Recent evidence from Guinea shows that closing gender 1.1). Moreover, a reduction in the agricultural productiv- gaps in education, health, and economic participation ity gap—through, for instance, granting women and men in the country could have large positive effects for the equal access to productive assets and landownership as national economy. Increasing women’s labor productiv- well as improving women’s decision-making and mana- ity by closing gaps in education has been estimated to gerial roles—is envisioned to accelerate per capita GDP lead to an increase in GDP per capita of 2.3 percent; a growth and result in a 1 percent higher GDP per capita in reduction in fertility leading to a higher accumulation of 2035. The combination of all those scenarios is expected capital could translate into an 8 percent higher GDP per to have a significant impact on the national economy, capita relative to the baseline projection by 2035 (table resulting in a 10 percent increase in GDP per capita. TABLE 1.1. ECONOMIC BENEFITS OF GENDER EQUALITY: COMPUTABLE GENERAL EQUILIBRIUM RESULTS, GUINEA Percentage points above baseline for Percent above baseline in 2035 for Scenario GDP growth GDP per capita growth GDP growth GDP per capita growth 1. Closing education gap 0.14 0.13 2.27 2.27 2. Reducing fertility 0.28 0.46 4.67 7.97 3. Reducing agricultural productivity gap 0.06 0.06 1.03 1.03 4. Combined scenario (1, 2, and 3) 0.40 0.58 6.80 10.16 Source: World Bank 2019a. As access to opportunities expands for women, so do from more spending on food and education (Doss 1996; chances improve for the next generation. The enhanced Hoddinott and Haddad 1995; Thomas 1997). Additional- financial, nutritional, economic, and decision-making ly, women typically reinvest a much greater part of their status of women is associated with lower infant mortality earnings in their families and communities than men rates, better dietary habits, and higher chances for their do, thereby spreading wealth, creating a springboard children to attain education (Allendorf 2007; Andrabi, for families to move out of poverty, and creating a pos- Das, and Khwaja 2011; Dumas and Lambert 2011; Thom- itive impact on future development (Idowu 2019). This as, Strauss, and Henriques 1990). Evidence from coun- is particularly relevant in a country where 38 percent of tries as varied as Brazil, China, India, South Africa, and children are engaged in work, 38 percent of school-age the United Kingdom shows that when women control a children are out of school,1 30 percent of children under higher share of household income—either through their 5 are stunted, and over 10 percent of children die before own earnings or through cash transfers—children benefit they turn 9 years old.2 1 Based on data from Save the Children. 2 Based on data from the World Bank, World Development Indicators. Unlocking Women’s and Girls’ Potential 10 The status of women and girls relative to men and boys in Guinea The already vulnerable position of Guinean women a disproportionate effect on women. Poverty increased worsened as a result of the Ebola outbreak in 2013. The as a result of Ebola in 2014–15. Although the recent eco- closure of borders due to the outbreak severely disrupt- nomic acceleration experienced by the country may have ed the livelihoods of women involved in cross-border partly helped reverse this trend, the more recent impact trade with neighboring countries. Moreover, the Ebola of the COVID-19 pandemic on economic activity and the crisis disproportionally affected women because of the projected halt in economic growth could have led to an increased demand for unpaid care for the sick, which increase of 4 percentage points in the poverty rate in 2020 also made women more prone to infections and pov- (World Bank 2021b). It is likely that a large share of those erty (UNDP 2015). Similarly, the Ebola outbreak led to affected would be female. Indeed, a growing body of new the closure of health care facilities in affected countries, data confirms that more women than men globally have resulting in the decreased use of contraception and shouldered a larger share of the negative economic im- higher risks of birth complications and maternal death pacts of COVID-19 and lost their income-generating activ- (African Development World Group 2014). For example, ities (for example, Bundervoet, Dávalos, and Garci 2021; it is estimated that the Ebola outbreak led to a 75-per- Center on Gender Equity and Health 2020; Cucagna and centage-point increase in maternal mortality in West Romero 2021; Kugler et al. 2021). The COVID-19 pandem- Africa (Mullan 2015). Moreover, evidence also indicates ic has also increased the hours of unpaid domestic work that, because of increased poverty, school closures, and performed by women and raised the incidence rates of lack of economic opportunities, girls spent more time GBV, including IPV and child marriage (Cookson et al. with men, which resulted in increased pregnancies and 2020; Perez-Vincent et al. 2020; UNICEF 2021c). In the school dropout rates (Rasul et al. 2020). Finally, some ev- specific case of Africa, evidence from the Ebola outbreak idence indicates that the breakdown in law and policing and the COVID-19 pandemic, for instance, indicates that caused by the Ebola lockdown may have exposed wom- female-led (micro and small) businesses tended to suffer en in Guinea, Liberia, and Sierra Leone to increased gen- more than those owned by males, experiencing a high- der-based violence (GBV) and sexual exploitation (African er rate of closure (Cookson et al. 2020; Koroknay-Palicz, Development World Group 2014). 2016; World Bank 2020b). As with the Ebola outbreak, the COVID-19 pandemic Objective and framework of the has likely brought similar negative impacts on women assessment and girls (de Paz et al. 2020; de Paz et al. 2021). The di- verse challenges that Guinean women face across all di- This assessment aims to shed light on the challenges mensions of well-being and agency make it difficult for and barriers faced by women and girls relative to men them to access economic opportunities and participate and boys in Guinea. For that purpose, it takes up the in society on an equal footing with men. Moreover, the concept of women’s capacity to fulfill their potential as recent Ebola and COVID-19 crises are likely to have had a function of the following objectives: educate, enhance Unlocking Women’s and Girls’ Potential 11 The status of women and girls relative to men and boys in Guinea (access to health services), employ, and increase agen- The assessment is based on three main inputs: (1) a di- cy (figure 1.1). The analysis has a particular focus on the agnosis of the existing gender gaps in Guinea across the impacts of early family formation, which appears to be a main dimensions of welfare; (2) an analysis of legal and significant trend with relevant implications in the coun- policy barriers by Women, Business and the Law; and try. This framework largely builds on the dimensions in (3) a review of successful practices and interventions to the 2012 World Development Report on gender equality close gender gaps in the relevant areas (see box 1.1). The and development (World Bank 2012a). On that basis, this report is organized as follows. This chapter introduces report identifies key emerging issues for women and girls the rationale and conceptual framework for the report. in the country and recommends areas of strategic actions Chapters 2 through 6 cover the different areas highlight- to empower them and improve their access to economic ed, identifying the distinctive challenges and emerging opportunity along those dimensions (see table 1.2 in the risks for women and girls in Guinea, and proposing stra- next section). tegic areas of intervention including legal and policy re- forms. Chapter 7 concludes. FIGURE 1.1. FRAMEWORK TO EMPOWER WOMEN AND ADOLESCENT GIRLS IN GUINEA Strengthen policy and legal frameworks ENHANCE ACCESS POSTPONE FAMILY EDUCATE to HEALTH FORMATION EMPLOY INCREASE AGENCY Increase girls' access Particularly Eradicate child Equalize access to Eliminate to quality education reproductive and marriage and economic discriminatory formal in safe environments, maternal health adolescent opportunities and institutions, reducing gender gaps services, decreasing pregnancy. provide incentives for harmonize customary in enrolment and MMR and eradicating women and young and statutory laws, attainment at all FGM/C. girls, in the form of reduce the incidence levels. high quality and and provide an productivity jobs, adequate response to access to assets and GBV and promote entreprensurship and change social norms. social protection. Source: World Bank. Note: FGM/C = female genital mutilation/cutting; GBV = gender-based violence; MMR = maternal mortality rate. Unlocking Women’s and Girls’ Potential 12 The status of women and girls relative to men and boys in Guinea Box 1.1. Sources of data for the analysis The following data sources or databases are used for the purpose of analysis in this report: • Guinea Demographic and Health Surveys (National Institute of Statistics 2012 and 2018) • Harmonized Survey on Household Living Conditions (National Institute of Statistics 2018-2019) • National Survey on Gender-Based Violence in Guinea (UNFPA 2017) • Poverty Assessment Survey (World Bank 2012) • Women, Business, and the Law database (2022) • World Bank, World Development Indicators • World Bank, Gender Statistics database • Afrobarometer databaser • International Labour Organization Department of Statistics, ILOSTAT database • G20 Financial inclusion Indicators Overview maternal mortality, especially among rural and poorer population groups, related to the widespread practice of The assessment finds that Guinean women and girls face FGM/C. Maternal deaths account for as much as 28 per- disadvantages across different dimensions of well-be- cent of all female deaths in Guinea. Among women aged ing when compared to men and boys in the country. 20–24 and 15–19, this share is even higher: 35.3 percent Investments in Guinean women’s and girls’ human en- and 41.0 percent, respectively. dowments including education and health are skewed relative to those of boys and men. This disparity marks Gaps in health and education translate into substantial an unequal departing point in life that will shape their disparities in access to economic opportunity. Women life-long opportunities differently across a variety of out- are not only less likely to participate in the labor mar- comes. Differences in education results are particularly ket than men but also, when they do participate, dispro- stark, with girls showing systematically (and increasingly) portionately engaged in informal and low-quality and lower enrollment and attendance levels than boys. For low-productivity work, which ultimately translates into example, only 22.0 percent of girls, compared to 32.2 lower lifetime incomes and heightened risks of falling percent of boys, attended secondary school in 2018 (ta- into or remaining in poverty. Labor market participation, ble 1.2). At the same time, the health of Guinean women wage employment rates, entrepreneurship, and access appears to be seriously compromised by the high risk of to productive assets are much poorer among Guinean Unlocking Women’s and Girls’ Potential 13 The status of women and girls relative to men and boys in Guinea women than men. Women are also overrepresented in to compromise the ability of many Guinean girls and self-employment and unpaid family care activities. As young women to attain an adequate education, as well as such, they lack access to formal social protection and their health outcomes, and therefore their opportunities see their productivity undermined by discriminatory in- for engaging in productive activities later in life. Gender stitutions that weaken their capacity to make decisions, and social norms and expectations are key in family for- placing the burden of household work and caregiving on mation processes and decisions. Indeed, both phenom- them and leading to early family formation. For example, ena are mostly driven by the prevailing patriarchal value 90 percent of women compared to 86 percent of men are system and gender roles that constrain Guinean women’s underemployed, and 95.0 percent of women compared capacity to make decisions and participate in public life. to 83.3 percent of men are engaged in vulnerable work. In Child marriage is not fully prohibited by law in the coun- addition, women spend on average 15.4 hours per week try, and customary laws and social norms most often do on unpaid domestic work—compared to 5.2 hours spent not leave any other option for girls but to marry and have by men. All these pervasive gender gaps remain a drag on children at a very young age. Guinea’s long-term development. The observed differences are largely explained by the Family formation is initiated early in Guinea, as shown poor agency of Guinean women and girls. The deci- by the high incidence of child marriage and adolescent sion-making capacity of women in public spheres, which pregnancy in the country. Guinea is among the 10 coun- can be proxied by their presence in democratic institu- tries with the highest prevalence of child marriage world- tions, remains particularly low in Guinea, signaling the wide. Only Chad, the Central African Republic, and Niger persistence of weak agency4 among women in the coun- have higher prevalence rates of child marriage among try. Moreover, Guinea has a high prevalence of and wide women aged 20–24 (UNICEF 2022). Likewise, the ado- social tolerance for GBV. Indeed, about 63 percent of lescent fertility rate in Guinea is high and significantly women have experienced IPV at least once in their lives, above the average for Sub-Saharan Africa: 133.36 births and between 40 percent and 58 percent of respondents per 1,000 women aged 15–19 in Guinea compared to (depending on the survey) justify wife-beating. Girls’ and 101.1 in Sub-Saharan Africa3 (World Development Indi- women’s weak decision-making capacity, their burden of cators 2018). This high rate undermines the education, household work and caregiving, and early family forma- health, and economic opportunity outcomes of affected tion result in a cycle that perpetuates inequality across women, and therefore poverty reduction efforts. Family generations. The coexistence of customary, religious, and formation patterns, and especially the age of marriage, statutory law systems makes the situation even more largely shape women’s transition from school into labor challenging. Afrobarometer results show clear patriar- markets or economic activity more broadly, determining chal social norms and gender roles. For example, almost their opportunities to make a living and be independent. 50 percent of respondents reported they believe that, in Child marriage, early pregnancies, and FGM/C are likely times of job scarcity, men should have priority. 3 Based on 2018 data from World Bank, World Development Indicators. 4 Agency refers to the capacity to make decisions on one´s life independently, and to act on them. Poor agency can translate into inefficient decisions concerning investments in the accumulation of endowments ultimately operating as a constraint for women´s economic participation and productivity. Unlocking Women’s and Girls’ Potential 14 The status of women and girls relative to men and boys in Guinea TABLE 1.2. AT A GLANCE: EMERGING PRIORITY ISSUES FOR WOMEN AND ADOLESCENT GIRLS IN GUINEA Educate Enhance Access to Health Employ Increase agency • Large (and growing) • Maternal deaths account for 28 • Labor force participation among • Despite recent efforts to increase gender gaps in percent of all female deaths women aged 15–64 is lower than women´s representation in enrollment and in Guinea: among women men’s and has decreased over time. politics, the share of women in attainment persist: aged 20–24 and 15–19, this democratic institutions remains 22.0 percent of girls share is higher: 35.3 percent • The quality of women’s jobs is also comparatively low: only 17 and 32.2 percent of and 41.0 percent, respectively. lower than that of men: 90 percent of percent of seats were held boys attend secondary women versus 86 percent of men are by women in the Guinean school (2018). • In addition, women have low underemployed; 95 percent of women parliament in 2020. access to adequate maternal compared to 83.3 percent of men • Significantly more and sexual and reproductive engage in vulnerable work. • Women’s decision-making girls than boys health services: only 55 capacity in the household is also remain out of school. percent of deliveries were • Women are overrepresented in poor: 59 percent of women attended by a skilled health unpaid family work: they spend 15.4 report that their husband/ • Financial barriers are professional (2018). Rural and hours on unpaid domestic work per partner alone makes decisions the most cited reason poor women have the lowest week, compared to 5.2 hours by men. about the women’s health. for both boys and girls rates. not to attend school, • Women account for half of the total • The country has a high incidence along with distance • Only 10.9 percent of women self-employed and for most workers of GBV: about 63 percent of or lack of facilities. aged 15–49 used some in agriculture, livestock, fishing, and women have experienced IPV at For girls, simply being method of contraception (11 mining. least once in their lives. a girl and the refusal percent for those aged 15–24). • Gender gaps in access to productive of families are also • Traditional patriarchal norms • About 94.5 percent of assets (land and livestock ownership, are entrenched: between important. finance, and IT) persist. Guinean women aged 15–49 40 percent and 58 percent of • Rural girls have the have suffered FGM/C (2018). • Patriarchal social norms explain these respondents (depending on lowest outcomes. trends. Women also face several legal survey) justify wife-beating; • Strong patriarchal social almost 50 percent believe that, in • Traditional and norms and customary restrictions to economic participation. times of job scarcity, men should patriarchal norms practices play a key role in • Poverty appears to be high in female- get priority. and customary laws explaining all these trends. only households, among girls and play a key role in young women aged 0–14 and elderly • Formal institutions often reflect keeping girls out of women age 65+. Income level and and reinforce the prevalence of school. poverty are associated with child discriminatory social norms, marriage and adolescent pregnancy. with customary law—which • Violence in schools sometimes supersedes statutory operates as a law—adding special complexity deterrent. to the situation. Postpone family formation: eradicate child marriage, and decrease adolescent pregnancy • The high prevalence • Adolescent pregnancy rates • Although early family formation does • The incidence of child marriage of child marriage and remain high. not deter women from working, the is high: as many as 24.9 percent adolescent pregnancy jobs available for girls and young and 49.4 percent of all women are contributes to existing • Maternal mortality is one women who marry and become married by age 15 and by age 19, gaps in education. of the most dramatic effects mothers by age 18 are often informal respectively (INS 2020). of the high incidence of and poorly paid. child marriage, teenage pregnancy, and FGM/C. Source: World Bank. Note: FGM/C = female genital mutilation/cutting; IPV = intimate partner violence; IT = information technology. Unlocking Women’s and Girls’ Potential 15 The status of women and girls relative to men and boys in Guinea The analysis in this assessment indicates that—in order with the health integrity of women coming before for Guinean women and girls to improve their status, cultural and religious beliefs and practices, will well-being, and opportunities relative to men and boys— be necessary. investments in women’s health, education, employment, and entrepreneurship outcomes need to be promoted, • Strategic direction 3: Eradicating child mar- and their agency greatly improved. Five priority strategic riage and adolescent pregnancy. One of the directions can be identified for the reform agenda ahead, most daunting challenges preventing Guinean based on the analysis of gaps and barriers presented women and the overall society from fully devel- here, the global evidence on what works to close gen- oping to their potential is the high prevalence of der gaps across different dimensions, and the potential early family formation. Child marriage and teen- impact of the selected options on various development age pregnancy continue to be widespread prac- outcomes. tices rooted in customary and traditional views and values that continue to relegate women to • Strategic direction 1: Assist girls in attaining second-class citizens. Ending these adverse prac- primary and secondary education. Encouraging tices will be crucial for women to access opportu- girls to attain primary and secondary education nities on an equal footing with men. Doing so will will be necessary to maximize the opportunities require a large-scale change in social norms and available to girls relative to boys in Guinea as they the institutions that continue to validate them. move into adulthood, and to prevent early fam- ily formation. For this purpose, specific policies • Strategic direction 4: Improve women’s eco- aimed at removing physical and financial barriers nomic empowerment and access to quality and at facilitating access will be necessary. Ensur- employment. Guinean women face important ing that services are gender-sensitive will also be barriers to access economic opportunities, which important, as will improving the perceived value render them economically dependent and lessen of education for girls and empowering them to their autonomy and status in the household and pursue it to higher levels. society. More specifically, their capacity to en- gage in productive activities will largely depend • Strategic direction 2: Improve health-related on the availability of support in balancing the ex- outcomes of women and girls. Improving the isting demands on their time, targeted activation health outcomes of Guinean women and young policies, access to safe infrastructure, adequate girls is also required in order to optimize human skills development, and access to productive capital investments and women’s and girls’ en- assets. These developments are especially im- gagement in productive activities. For that pur- portant in the agricultural sector, where most pose, addressing the high prevalence of maternal Guinean women work. mortality and FGM/C will be crucial. Ensuring access to adequate health services that are af- • Strategic direction 5: Promote women’s par- fordable as well as to related knowledge and in- ticipation in decision-making, and prevent all formation will be instrumental in this endeavor. forms of GBV. Women’s capacity to unlock their A societal change in the perception of priorities, potential remains limited by social norms and Unlocking Women’s and Girls’ Potential 16 The status of women and girls relative to men and boys in Guinea beliefs that exclude them from decision-mak- Table 1.3 summarizes the main barriers, possible strate- ing in public and private spheres, and constrain gic directions, policy recommendations, and interven- their capacity to make decisions even on their tions for women’s and girls’ empowerment in Guinea own health. The adoption of affirmative actions presented throughout the different chapters. They focus to encourage female representation in politics on areas where gender gaps/barriers are most significant needs to be accompanied by measures that en- according to the assessment presented here, across all sure effective enforcement and change. Efforts the dimensions discussed. The key areas and interven- should prioritize preventing and diminishing the tions described have been selected on the basis of their high prevalence of all forms of GBV, some of the potential to lead to meaningful changes in the lives of most extreme manifestations of the poor agency young girls and women, and of likely synergies. The de- of women and girls in Guinea. scriptions of these strategic directions and suggested ar- eas of interventions in this section highlight evidence on what has worked in Sub-Saharan Africa5 and elsewhere to advance girls’ empowerment. 5 As part of the Gender Data for Policy program, a review of impact evaluation studies was conducted to collect evidence on what works to close gender gaps in the context of Sub-Saharan Africa. The review comprised impact evaluation studies, which assessed interven- tions, focusing on adolescent girls and women, and aimed at narrowing gender gaps. Interventions consisted of those in the dimen- sions of (1) agriculture, (2) education and skills, (3) labor and entrepreneurship, (4) finance, (5) land ownership and access to assets, (6) sexual and reproductive health and child marriage, and (7) GBV and FGM/C. The search included briefs, published papers, and working papers from 2000 onward, published on the World Bank’s Open Knowledge Repository and the International Initiative for Impact Evalu- ation’s Evidence Hub. The selected studies were limited to studies estimating causal impacts, either through experimental or quasi-ex- perimental methods. Of a total of 460 studies identified, 162 studies were selected and reviewed. Unlocking Women’s and Girls’ Potential 17 The status of women and girls relative to men and boys in Guinea TABLE 1.3. STRATEGIC DIRECTIONS AND AREAS OF INTERVENTIONS FOR EMPOWERMENT OF WOMEN AND ADOLESCENT GIRLS IN GUINEA (Potential) barriers Policy recommendations Interventions Strategic direction 1: Assist girls in attaining primary and secondary education Main gaps: large and persistent discrepancies in enrollment and attainment between girls and boys at all levels Lack of schools and school- • Improve availability and access to • Build new schools, especially in remote relevant infrastructure education. areas. • Expand school-relevant infrastructure such as roads, sanitation, or water facilities. Lack of girl-friendly schools • Make school facilities and • Provide facilities for menstrual hygiene infrastructure gender sensitive. management at schools. • Prevent school-based GBV and • Improve the presence of female teachers. address its consequences. • Provide gender-related training of staff. • Develop and implement a comprehensive educational institution-based GBV prevention strategy. • Institute anti-sexual harassment policies. • Incorporate gender sensitization in school- based programs. • Deliver services for survivors. Financial constraints and poverty • Lift direct and indirect financial • Eliminate fees or provide school subsidies constraints to facilitate access to (directly to school managers or parents of primary and secondary schooling. daughters). • Provide scholarships and grants. • Provide conditional cash transfers. • Provide material or in-kind support, such as food aid. Negative social norms around • Promote positive social norm • Conduct community-mobilization programs girls’ education change around girls’ education. with parents. • Eliminate gender bias in the educational curriculum. • Provide life skills and mentorship programs. Lack of agency among girls • Empower and support girls and • Institute comprehensive approaches to equip young women to pursue education. adolescent girls with life and technical skills. • Develop regulations and policies that allow married and pregnant women to return to schools without facing discrimination or stigmatization. Unlocking Women’s and Girls’ Potential 18 The status of women and girls relative to men and boys in Guinea (Potential) barriers Policy recommendations Interventions Strategic direction 2: Improve health-related outcomes of women and girls Main gaps: poor health outcomes of women and young girls manifested in high MMR and almost universal FGM/C High rate of teenage pregnancy • Reduce teenage pregnancy and • See strategic direction 3. FGM/C. Financial constraints to access • Lift financial constraints for • Provide adequate funding to health care fee health services vulnerable women. exemption program for children under five and pregnant women. Lack of knowledge/information/ • Encourage expectant mothers to • Conduct information and awareness-raising women´s empowerment and seek professional medical support efforts. patriarchal social norms before, during, and after pregnancy. • Develop and implement strategies for male engagement. • Conduct community-based interventions. • Provide conditional cash transfers. Inadequate supply of sexual, • Improve availability and access to • Expand and improve quality of health care reproductive, and maternal maternal and SRH services. infrastructure (including WASH facilities). services • Ensure gender-sensitive service • Offer provider incentives. provision. • Implement standardized procedures, protocols, and manuals of care . • Provide professional training for health care practitioners. • Set up functioning mechanisms for monitoring and evaluation. • Expand access to frontline health care providers as alternative mechanism, such as trained nursing assistants and community- based health workers. Weak enforcement of legislation • Ensure the proper application of • Strengthen training of all service providers prohibiting FGM/C the law. and authorities involved. Social norms that encourage the • Facilitate a social norm change • Engage communities in a dialogue around practice of FGM/C around intentions, beliefs, and consequences of FGM/C. attitudes toward the practice of FGM/C. • Train health care professionals to recognize symptoms of FGM/C and treat its consequences. • Gender sensitize health care professionals on the harms of FGM/C. • Engage parents (and especially mothers) in dialogue about the harms of FGM/C. Unlocking Women’s and Girls’ Potential 19 The status of women and girls relative to men and boys in Guinea (Potential) barriers Policy recommendations Interventions High prevalence of patriarchal • Mobilize all actors affected. • Integrate the issue within the curricula of social norms schools, universities, and training centers. • Mobilize communities, with a special focus on fathers and their families (sisters). • Raise awareness through mass information campaigns. Lack of agency among girls and • Empower girls and young women • Provide legal and other types of support to young women to understand and stand up for girls. their rights. Strategic direction 3: Eradicate child marriage and teenage pregnancy Main gaps: fourth-highest child marriage rate in the world and high associated prevalence of teenage pregnancy Legal and enforcement gaps • Institute legal reform prohibiting • Set the legal age of marriage at 18 for both and lack of coherence between child marriage. boys and girls, and eliminate all exceptions. statutory and customary law • Build capacity for enforcement. • Establish adequate sanctions, and make sure that institutions in charge are ready to apply • Harmonize customary law and them and protect girls effectively . practices with statutory law (on the basis of provisions in international mechanisms). Patriarchal social norms • Encourage social norm changes • Conduct awareness-raising campaigns and among girls, families, and edutainment. communities. • Conduct community sensitizing and mobilization, engaging men and religious leaders. • Expand sexual and reproductive education in school. Lack of education and agency • Empower girls and women. • Enforce laws regarding compulsory among young women education. • Offer incentives for adolescents to continue education (see strategic direction 4 • Provide social empowerment programs + economic empowerment + education for girls and adolescents. Lack of access to reproductive • Improve demand and supply • Expand sexual and reproductive health/ and sexual health and family of adequate health and family family planning infrastructures, and improve planning planning services. their quality. • Ensure gender/youth sensitivity of services. • Promote access to contraception. Poverty and deprivation • Improve livelihoods, and provide • Provide cash transfer/ microcredit/ loan safety nets for vulnerable families. programs. • Implement alternative livelihood programs. Unlocking Women’s and Girls’ Potential 20 The status of women and girls relative to men and boys in Guinea (Potential) barriers Policy recommendations Interventions Strategic direction 4: Improve women’s economic empowerment and access to quality employment Main gaps: comparatively low FLFP and employment, informal and vulnerable nature of work, inadequate access to productive assets, and heightened vulnerability to poverty Prevalence of formal and • Enact legal reforms. • Amend discriminatory legislation, and enact informal discriminatory norms that preserve equality in employment institutions • Shift social norms and attitudes and access to assets. toward women’s work outside of the household. • Legislate against sexual harassment in public spaces and at work. • Enact family-friendly policies. • Conduct community mobilization programs. • Conduct educational campaigns. • Conduct economic empowerment programs. • Reform maternity leave, and set up paternity/ parental leave. Skills mismatch between supply • Improve the skills of female • Develop TVET systems and technical skills for and demand workers, making skills more STEM. responsive to industry needs and increasing workers’ productivity. • Improve the connections between education and private sectors. • Focus on foundational skills. • Provide training and skills development programs for women entrepreneurs, with a focus on mining and farming sectors. Lack of adequate infrastructure • Provide adequate infrastructure • Invest in safe transportation infrastructure. and services and public services. • Provide culturally adapted childcare services • Promote targeted employment (mobile creches). programs. • Provide targeted job creation interventions. • Conduct training for entrepreneurs. • Conduct social and economic empowerment programs for self-employed women. • Provide temporary employment schemes, such as public work programs. Lack of access to productive • Ensure equal opportunity access to • Implement land registration and assets land rights and landownership. formalization programs. • Improve access to finance by • Encourage co-titling. women. • Improve access to financial products + training. • Provide financial technology solutions. Unlocking Women’s and Girls’ Potential 21 The status of women and girls relative to men and boys in Guinea (Potential) barriers Policy recommendations Interventions Lack of or inadequate access to • Ensure access to social protection • Explore and consider options to extend social protection mechanisms. social security to informal sector workers, for example, through universal minimum • Expand access to family-friendly pensions. policies to workers in informal sector. • Reform the law to recognize nonmonetary marital contributions. • Provide child cash transfers “Plus” for vulnerable families. Strategic direction 5: Promote women’s participation in decision-making, and prevent GBV Main gaps: low representation in democratic institutions and decision-making capacity at the household level, and high prevalence of GBV Formal and informal institutions • Find necessary agreements for legal • Conduct awareness-raising and advocacy preventing equal representation procedures conducive to making efforts among all parties involved and the of women in politics the law on parity operational. general population to make the law a reality. • Address adverse party dynamics • Put into place adequate enforcement and and political violence. monitoring mechanisms. • At party level, remove registration fees for women or provide additional free airtime and billboards, and oblige governing bodies to implement annual capacity and leadership programs for women and to have female quotas. • Establish institutions such as a female leadership institute or a commission for the monitoring of the implementation of the law. • Legally prohibit political violence against women, provide mechanisms for women’s protection, and adequately prosecute these cases. • Recognize the importance of women’s CSOs. Discriminatory legislation and • Eliminate discriminatory norms. • Reform laws in order to adjust norms that legislation that provides legal legitimize gender discrimination in the areas basis for adverse practices in civil • Harmonize customary and of divorce, marriage, and inheritance. or family law statutory provisions (on the basis of international instruments and • Promote gender sensitization for officials and human rights). general population. • Ensure enforcement of statutory • Promote the role of the judiciary in laws when conflict emerges. harmonization efforts. • Support women’s rights movements and CSOs. Unlocking Women’s and Girls’ Potential 22 The status of women and girls relative to men and boys in Guinea (Potential) barriers Policy recommendations Interventions Legal gaps in the area of GBV • Enact stand-alone legislation that • Draft and enact a comprehensive law on GBV. comprehensively addresses this phenomenon. Insufficient protection and • Enable access to justice and GBV • Conduct gender-sensitive training of response services to GBV care services for survivors. professionals. survivors • Ensure functioning mechanisms and protocols on the duties of police, court officials, and social workers. • Improve service delivery for GBV survivors including psychosocial support, shelters, or hotlines. • Ensure representation of women in courts, the police, and health care services. • Set up specialized protection services that are sensitive to gender and GBV issues. • Explore one-stop centers for integrated services and support. Harmful patriarchal, traditional • Reduce women’s vulnerability • Provide alternative livelihoods/conditional and cultural practices—in to GBV through economic cash transfer/other financial incentives particular, high acceptance of and empowerment. + behavioral component (cash “Plus” tolerance rates for IPV programs). • Promote behavior and social norms change on GBV. • Conduct community mobilization programs. • Raise awareness among young • Conduct awareness-raising campaigns. people of different forms of GBV and gender norms. • Conduct school-based interventions. • Keep girls in school (see strategic • Conduct gender sensitization. direction 1). • Provide life skills training. • Socially empower young girls and • Provide vocational and livelihoods skills adolescents with information, training. skills, and support networks. • Conduct adolescent girl programs (skill building + mentorship + safe spaces). Source: World Bank. Note: CSO = civil society organization; FGM/C = female genital mutilation/cutting; MMR = maternal mortality rate; SRH = sexual and reproductive health; STEM = science, technology, engineering, and mathematics; TVET = technical and vocational education and training; WASH = water, sanitation, and hygiene. Unlocking Women’s and Girls’ Potential 23 The status of women and girls relative to men and boys in Guinea CHAPTER 2. EDUCATE: THE STATUS OF GIRLS’ EDUCATION IN GUINEA Unlocking Women’s and Girls’ Potential 24 The status of women and girls relative to men and boys in Guinea Gaps in enrollment and attainment At the same time, a significant gap in secondary school enrollment persists between boys and girls. Between Large (and often growing) gender gaps in enrollment and 2012 and 2018, net secondary enrollment increased by attainment—to the advantage of boys—can be observed 1.0 percentage point for boys and decreased by 2.6 per- in Guinea. Net primary education enrollment rates have centage points for girls (figure 2.1). As of 2018, only 22.0 increased steadily since 1994, with more boys than girls percent of girls and 32.2 percent of boys were attending attending primary school for the entire period. Between secondary school. Primary and secondary education en- 2012 and 2018, primary enrollment rates grew from 55.5 rollment rates are significantly higher in urban than in percent to 62.0 percent among girls and from 60.1 per- rural areas for both girls and boys. Rural girls have the cent to 66.9 percent among boys, deepening the enroll- lowest levels of primary and secondary school enroll- ment gap by 0.3 percentage point (Guinea EHCVM 2018). ment (Guinea EHCVM 2018). FIGURE 2.1. TRENDS IN FEMALE AND MALE NET EDUCATIONAL ENROLLMENT IN GUINEA, 2000–18 (PERCENT) 80 70 68,8 60,1 66,9 60 62 50 52,7 56,9 55,5 40 38 30,6 31,2 30 32,2 20 23 24,6 22 15,9 10 9,2 0 2000 2005 2012 2018 Male primary Male secondary Female primary Female secondary Source: World Bank, World Development Indicators. Overall educational attainment levels remain very low middle wealth quintile, and 54.8 percent from the rich- for both women and men in Guinea: 74.3 percent of est one. Moreover, although almost no women from the women and 55.8 percent of men aged 15+ have not at- poorest wealth quintile have postsecondary education, tained any education. Both rates are significantly high- 9.2 percent of women from the richest wealth group do er in rural than in urban areas (87.9 percent of women (Guinea EHCVM 2018). Importantly, a positive trend can and 71.6 percent of men aged 15+). The level of educa- be observed when comparing younger against older age tional attainment increases with wealth quintile. About groups: whereas 91.2 percent of women aged 45–49 have 89.9 percent of women from the poorest households no formal education, the same figure stands at 50.6 per- have no education, compared to 77.3 percent from the cent among women aged 15–19 (figure 2.2). Unlocking Women’s and Girls’ Potential 25 The status of women and girls relative to men and boys in Guinea FIGURE 2.2. HIGHEST LEVEL OF EDUCATION ATTAINED BY GUINEAN WOMEN IN 2018, BY AGE (PERCENT) 100 90 80 70 60 50 85,8 89,2 91,2 40 76,0 70,0 30 63,1 50,6 20 10 0 15-19 20-24 25-29 30-34 35-39 40-44 45-49 No education Primary Secondary Postsecondary Source: Guinea EHCVM 2018. Significantly more girls than boys remain out of primary time frame. In 2018, 35.3 percent of girls and 30.3 per- and secondary school. The share of young women aged cent of boys were out of primary school, and 55.5 percent 13–18 out of school increased in the period 2012–18 of girls and 35.9 percent of boys were out of secondary from 51.2 percent to 55.5 percent, with rates significant- school (figure 2.3). School dropout levels are negatively ly higher in rural (71.0 percent) than in urban (34.8 per- correlated with household income, with dropout levels cent) areas (Guinea EHCVM 2018). On the contrary, the decreasing among higher wealth quintiles. However, and proportion of out-of-school girls and boys aged 7–12 across income groups, it is always girls who are dispro- and young men aged 13–18 have decreased in the same portionately affected. FIGURE 2.3. SHARE OF GUINEAN YOUTH OUT OF SCHOOL, 2012 AND 2018 (PERCENT) a. 2012 b. 2018 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 Male Female Male Female Male Female Male Female (7-12) (7-12) (13-18) (13-18) (7-12) (7-12) (13-18) (13-18) Total Urban Rural Source: Guinea EHCVM 2018. Unlocking Women’s and Girls’ Potential 26 The status of women and girls relative to men and boys in Guinea Reasons for not attending school residing in rural areas and having limited resources place a higher value on the education of boys than of girls. The Reasons for not attending school differ for boys and girls. motivation is driven by the persistence of traditional In 2018, the main reason for not attending school for both views on women’s role in the household, as well as by girls and boys of all ages was the lack of financial resourc- challenges related to school attendance (Coleman 2017). es, with more boys than girls citing this as the key barrier. For example, sexual harassment and abuse are very im- Boys (22.5 percent) are more likely than girls (19.4 per- portant concerns for parents when sending their children cent) to leave school because of refusal by their families, to school (Tuwor and Soussou 2008). Guinea has no laws but only at the primary education level. At the secondary tackling gender-based violence and sexual harassment in level, that tendency reverses, affecting 26.3 percent of educational institutions, which fails to protect girls from young women and 22.2 percent of young men. Distance violence in schools (Bouchama et al. 2018). or lack of facilities appears to be an important barrier: in 2018, 18.0 percent of Guinean girls and 19.1 percent of In particular, early family formation is likely to explain to boys aged 7–12 and 9.8 percent of girls and 7.9 percent a large extent the gender gaps observed in education- of boys aged 13–18 did not attend school because they al attainment in Guinea. Child marriage is strongly and had no school nearby or the school was too far away. Pri- negatively correlated with school enrollment and educa- mary school dropout rates are generally low, with slight- tional attainment, leading to higher risks of school drop- ly more boys (1.3 percent) than girls (0.9 percent) being out and, consequently, limiting women’s employment affected. At the level of secondary education, however, opportunities later in life. There is a strong association school dropout rates are much higher among both boys between the level of education attained and child mar- (9.8 percent) and girls (8.2 percent). Finally, 6.0 percent of riage. Only 2.4 percent of married young women of any girls aged 7–12 and 7.4 percent aged 13–18 did not attend age remain in school (Guinea EHCVM 2018). Marrying at school in 2018 simply because of “being a girl” (Guinea 15–17 years of age strongly hinders the completion of EHCVM 2018; see box 2.1). secondary education, and marrying before the age of 15 can prevent girls from completing their primary school- Barriers facing girls ing (Male and Wodon 2016). Girls’ education is, in turn, one of the most effective deterrents of child marriage. Guinean law provides for equal opportunities for men According to analysis of data, about 53 percent of wom- and women in education, although in practice women’s en with no education6 were married before the age of access to schooling is challenged by social and cultural 18 in Guinea, compared to only 20 percent of those who norms, traditions, and gender roles. Women’s access to had completed lower-secondary education. Adolescent education in Guinea is limited by early marriages, long fertility also reduces the number of schooling years for hours of unpaid domestic work, and caregiving—espe- girls, often preventing them from completing their edu- cially in rural areas (Coleman 2017). Traditional and cus- cation. Consequently, adolescent fertility can translate tomary laws discriminate against women and sometimes into more limited income-generating opportunities later take precedence over formal law, again particularly in ru- in life (WHO 2020). ral areas (Bertelsmann Stiftung 2018). Guinean families 6 Defined as 0 years of education. Unlocking Women’s and Girls’ Potential 27 The status of women and girls relative to men and boys in Guinea Box 2.1. Why are investments in girls’ primary and secondary education a priority for Guinea? Large gender gaps exist in access to education in Guinea at all levels. Enrollment and at- tainment rates are systematically higher among boys than girls, and significantly more girls than boys remain out of primary and secondary school. As of 2018, only 62 percent and 22 percent of girls and 67 percent and 32 percent of boys were attending prima- ry and secondary school, respectively. Despite existing legal provisions on equality of opportunity with regard to education, patriarchal and cultural norms, traditions, and gender roles in practice prevent many girls from accessing education on a par with boys. Indeed, one of the main reasons reported by Guinean girls for not attending school is simply “being a girl.” In addition to early marriages, long hours of unpaid domestic work and caregiving operate as particular barriers for girls relative to boys, especially in rural areas. The lack of adequate facilities in their vicinity and the associated costs of attend- ing schools are some additional key barriers identified that keep girls out of education. The prevalence of sexual harassment in schools also prevents parents from enrolling their daughters. A large body of international evidence shows the positive impacts of education, not only for affected girls and their future prospects in life, but also for their families, commu- nities, and entire societies. Indeed, investing in girls’ education has been labeled “the world’s best investment” (Sperling and Winthrop 2015). Educating girls frees them to raise their aspirations and unlocks their potential to achieve those aspirations. On av- erage, women who have a secondary education are more likely to work, and they earn almost twice as much as those with no education (World Bank 2018). The benefits of ed- ucation can also transmit across generations because more-educated people have few- er children and provide their children with better health care and education (World Bank 2012a). All these factors combined can help lift households, communities, and countries out of poverty. Indeed, the “limited educational opportunities for girls, and barriers to completing 12 years of education, cost countries between US$15 trillion and $30 trillion in lost lifetime productivity and earnings” (World Bank 2018). Another challenge observed in Guinea and multiple other percent of schools in Guinea have no drinking water sup- countries in Sub-Saharan Africa is the absence of water, ply, with the proportion being particularly high in rural sanitation, and hygiene facilities in schools. According areas, at 74 percent (WHO and UNICEF 2022). Moreover, to the World Health Organization and United Nations 62 percent of schools have no hygiene facilities. Slight- Children’s Fund Joint Monitoring Program’s report, 47 ly more than half of all Guinean schools (52 percent) Unlocking Women’s and Girls’ Potential 28 The status of women and girls relative to men and boys in Guinea provide basic sanitation services, although 17 percent negatively affecting their school attendance and comple- of schools do not have any sanitation facilities on their tion (Coleman 2017). The availability and accessibility of premises (figure 2.4). This lack can be an important im- adequate water, sanitation, and hygiene infrastructure at pediment to girls’ school attainment: without appro- schools is associated with girls’ higher school enrollment priate infrastructure and sanitary facilities at schools, and attendance (Freeman et al. 2012). adolescent girls may stay home during menstruation, FIGURE 2.4. PROPORTION OF SCHOOLS IN GUINEA WITH WASH FACILITIES (PERCENT) Hygiene Sanitation Drinking water 0 20 40 60 80 100 No service Limited service Basic service Insufficient service Source: WHO and UNICEF 2022. Note: WASH = water, sanitation, and hygiene. Strategic direction 1: Assist girls in sanitation facilities at school help to improve girls’ en- attaining primary and secondary rollment and attendance rates, as well as their test scores education (Andrabi, Das, and Khwaja 2013; Kazianga et al. 2013; Mu- ralidharan and Prakash 2017; World Bank 2016). General interventions such as building new schools and improving school-relevant infrastructure are proven Additionally, making service provision more gender-sen- to bring positive impacts for all students and for girls sitive could go a long way toward increasing the cover- in particular. As shown by Evans and Yuan (2019), who age of education services among girls. For example, Kano reviewed evidence from 270 educational interventions State, Nigeria, expanded access for girls at the junior-sec- from 177 studies, general interventions for enhancing ondary school level through the upgrade of single-sex schooling outcomes deliver the same positive gains for girls’ schools and the provision of separate toilet facili- girls as do interventions targeted specifically toward ties for girls at coeducational schools (World Bank 2016). girls. On the basis of the existing global evidence, build- In the case of Guinea, it has been reported that, with a ing new schools (particularly in rural and remote areas), slight improvement in sanitation in schools from 1997 to providing safe transportation, and improving water and 2002, enrollment rates for girls increased by 17 percent. Unlocking Women’s and Girls’ Potential 29 The status of women and girls relative to men and boys in Guinea However, many schools still lack proper separate toilets and production of youth groups, which have shown pos- for boys and girls or facilities that ensure privacy (Sero- itive effects for those engaged (UNICEF 2010). dy 2018). The Guinean government has recently reported the improvement of water and sanitation services and Closing existing gaps will require lifting the financial con- the construction of schools aiming to provide second straints to access for many vulnerable Guinean girls. In chances for out-of-school girls (Government of Ghana the face of limited household budgets, and given patri- 2019). archal norms as well as other barriers to girls’ schooling, Guinean families tend to give precedence to the educa- Ensuring the presence of female teachers or providing tion of boys over that of girls. Removing financial con- gender-related training to educational staff (with a spe- straints through school grants, vouchers, subsidies, and cial focus on gender-based violence), are also relevant scholarships can encourage families to keep their daugh- policy options in this regard (Coleman 2017). There is a ters in school. Eliminating primary school fees in Ethiopia strong correlation between the number of female stu- (Chicoine 2021) and Uganda (Keats 2018), for instance, dents and the number of female teachers in schools. Ev- increased the percentage of girls’ school primary enroll- idence from Sub-Saharan Africa, in particular, indicates ment and had positive effects on the likelihood of com- that girls are more likely to enroll in schools where there pleting secondary school. A scholarship program aimed are female teachers (Haugen et al. 2014). In 2017, less at girls translated into an increase in enrollment in Niger than half of Guinea’s primary school teachers and only (Giacobino et al. 2022). Economic incentives in the form 30 percent of secondary teachers were female (Coleman of conditional cash transfers can also be effective in pro- 2017). Having a female teacher not only makes young moting female enrollment (Akresh, De Walque and Ka- girls feel safe in the classroom but also gives them a pos- zianga 2013; Baird et al. 2014; Blimpo et al. 2016; Hallfors itive role model. et al. 2015; Koumassa, Olapade, and Wantchekon 2020). A comprehensive educational institution-based preven- Similarly, programs that aim to increase the perceived tion strategy and effective interventions would be re- value of education of girls relative to that of boys can quired to mitigate sexual violence in schools, including be effective in changing current social and cultural anti-sexual harassment policies, gender sensitization in norms and increasing girls’ presence in schools as well school-based programs, and service delivery for survi- as their completion. As noted previously, one of the ma- vors. Ghana and Kenya have already implemented this jor challenges Guinean girls face in accessing education, type of policy with positive impacts (Beninger 2013). In especially at higher levels, is the prevailing notion that Ghana, for instance, the Stop Violence against Girls in girls are meant to be wives and mothers, and that the Schools campaign has helped to raise awareness of the education of boys is therefore more valuable. However, types of violence experienced by girls and how violence according to recent estimations, the economic returns interferes with their right to education. Under the same to education generally tend to be higher among girls in campaign, girls’ clubs have been established, providing Africa: each additional year of schooling raises a man’s safe and supporting environments for girls and opportu- earnings by 11 percent and a woman’s earnings by 14 nities to advocate for violence-free schools. Sensitization percent (Montenegro and Patrinos 2014). efforts have been deployed through comic book training Unlocking Women’s and Girls’ Potential 30 The status of women and girls relative to men and boys in Guinea Shifting social norms and beliefs around the role of girls for adolescent girls, for instance in Ethiopia (Erulkar and relative to boys, and educating parents and communities Muthengi 2009) and South Africa (Branson and Byker about the importance and potential returns of education 2018). There is also growing evidence, for instance from for girls, is required in Guinea. Sensitization campaigns Liberia, that comprehensive approaches to equip ado- with parents offer particular promise in this regard. One lescent girls with life and technical skills can translate such program deployed in pilot areas in Guinea to raise into an increase in their years of completed education awareness among parents, educators, and community (Koroknay-Palicz 2016). The Sahel Women’s Empow- leaders about the value of girls’ education through ed- erment and Demographic Dividend project,7 operating ucation promoters (promoteurs éducatifs) was associ- across six Western African countries, represents a major ated with an increase in the number of girls enrolled in effort in this area. Investing in girls’ education and keep- primary education and with declines in gender gaps in ing girls in school are the first objectives of the project, enrollment (USAID 1999). The Guinean government has to be achieved through a variety of specific interventions also carried out some sensitization programs in commu- that, overall, aim to empower participant girls. The proj- nities of the prefectures of Koroussa and Dinguiraye on ect has already shown important positive impacts on the the importance of girls’ schooling and on gender-based rate of retention of girls in secondary schools. In addition violence (Government of Guinea 2019). to these programs, regulations and policies that allow married and pregnant women to return to school with- Empowering girls and young women to continue pursu- out facing discrimination or stigmatization need to be in ing education is similarly important. There are various place and be adequately enforced. This consideration examples of interventions that have raised the educa- is especially important given the relevant contribution tional attainment of participants by combining educa- of these phenomena to explaining higher dropout rates tional components and social empowerment programs among girls in Guinea. 7 For more information, see the project’s home page (https://projects.worldbank.org/en/projects-operations/project-detail/ P150080?lang=en). Unlocking Women’s and Girls’ Potential 31 The status of women and girls relative to men and boys in Guinea CHAPTER 3. ENHANCE ACCESS TO HEALTH SERVICES: THE STATUS OF WOMEN’S HEALTH IN GUINEA Unlocking Women’s and Girls’ Potential 32 The status of women and girls relative to men and boys in Guinea Maternal mortality al. 2020). Early family formation also has very negative effects on newborn health (World Bank 2018).9 In the case of Guinea, maternal mortality is, without doubt, one of the most dramatic negative effects of the Access to maternal health services high incidence of child marriage, adolescent pregnancy, and female genital mutilation/cutting (FGM/C). Progress The lack of access to adequate maternal services ap- in reducing maternal mortality in Guinea has been slow pears to underlie these trends. Only 35 percent of preg- and inconsistent over the past decades. In 2017, the ac- nant women in Guinea had at least four antenatal care tual maternal mortality rate (MMR) was 576 deaths per visits, and only 55 percent of deliveries were attended 100,000 live births (figure 3.1), above the regional aver- by a skilled health professional (Ministry of Planning age of 534 for Sub-Saharan Africa, making Guinea the and International Cooperation 2018). Only 27 percent of country with the 13th-highest MMR in the world. The rate women in the poorest households had their birth attend- is still above those registered in many comparator coun- ed by a skilled professional compared to 97 percent of tries, including Benin (397), Burkina Faso (320), Ghana women from high-income households (UNICEF 2019b). (302), Senegal (315), and Togo (396). Moreover, mater- 8 Additionally, postnatal care within the first two days after nal death is still one of the main causes of death among birth was provided to only 52 percent of newborns in ru- Guinean women, especially among female adolescents ral areas, compared to 87 percent in urban areas. Access and in rural areas. Maternal deaths account for as much to antenatal and postnatal care increases among women as 28 percent of all female deaths in Guinea; this share is with at least some education (UNICEF 2019b). Moreover, even higher among women aged 15–19 (41 percent) and the COVID-19 outbreak negatively affected first antenatal 20–24 (35.3 percent; World Bank 2019a, 2022a). There are visits and tetanus vaccination coverage among pregnant strong regional disparities in MMRs. According to the last women (World Bank 2022a). Insufficient or poor obstet- Guinea General Population and Housing Census (2014), ric health services, lack of access to health care facilities MMR is highest in Labé (888) and Faranah (806), and low- or of skilled professionals, and gaps in sexual and repro- est in Kankan (407) and Conakry (508). Child marriage is ductive health education are some of the main drivers of linked to maternal deaths through early pregnancy and maternal mortality (Jansen et al. 2014; Lee et al. 2012; childbirth; child marriage can lead to increases in total Ntoimo et al. 2018; World Bank 2019a). In particular, fertility of between 13 percent and 35 percent (World there is a documented association between maternal Bank 2018). There is a proven link between FGM/C and mortality and the number of health care facilities or of maternal mortality, with the more extreme forms of FG- medical personnel available (Okonofua et al. 2018; Zhao M/C amplifying the risks of maternal death and labor et al. 2020). delivery complications (Banks et al. 2006; Okagbue et 8 Similar MMRs are observed in Côte D’Ivoire (617) and The Gambia (597), and even higher ones in Guinea-Bissau (667) and Liberia (661). Mauritania (766), Nigeria (917), and Sierra Leone (1,120) have the highest levels of maternal mortality in the West African region. From UNICEF’s “Maternal mortality” data (https://data.unicef.org/topic/maternal-health/maternal-mortality/). 9 Being born to a mother younger than 18 increases the risk of under-five mortality by 3–7 percent. It has been estimated that, overall, if child marriage were ended between 2016 and 2030, more than 2 million children could survive beyond the age of five, 3.6 million could avoid stunting, and 140,000 children’s lives could be saved on average every year. Reducing early childbirth would lead to a 0.2–0.6 percent decline in under-five mortality in Guinea. Unlocking Women’s and Girls’ Potential 33 The status of women and girls relative to men and boys in Guinea FIGURE 3.1. CHANGE IN MATERNAL MORTALITY RATES, GUINEA AND SUB-SAHARAN AFRICA, 2006–17 (MATERNAL DEATHS PER 100,000 LIVE BIRTHS) 1.200 1.000 800 600 400 200 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Guinea SSA Source: World Bank, World Development Indicators. Note: SSA = Sub-Saharan Africa. The availability of quality maternal health services ap- the situations of medical emergency (Bohren et al. 2019). pears to be inadequate in the country. In 2017, only 62 A 2017 study looking at the mistreatment of women percent of health facilities offered obstetric care, 20 during childbirth in Guinea suggested that women and percent neonatal care, and 40 percent childhood immu- health care providers believe that mistreatment is justi- nization services (Ministry of Health 2017). A recent as- fiable under certain circumstances, such as when wom- sessment of maternal and neonatal services in Guinea en cry out or are noncompliant with providers’ demands concludes that the quality, both technical and nontech- (Balde et al. 2017). A key bottleneck to the delivery of ser- nical (interpersonal) and organizational, remains weak vices is the shortage of sufficiently skilled health workers (Hatem, Halabi-Nassif, and Maroun 2018). Because of and of commodities, particularly at the community level the lack of health care facilities and medical personnel (World Bank 2015b). in their area, many women in Guinea might therefore opt for home delivery, which became particularly urgent after This problem is further compounded by the prevalence the Ebola outbreak (Ahinkorah 2020; World Bank 2015b). of unequal gender norms and the lack of gender-sensi- Care protocols are not always followed, with pregnant tive services and infrastructure. In a recent study, respon- women often reporting they experienced some form of dents listed lack of financial means, the distance from physical abuse, verbal abuse, or stigma or discrimination the health facilities, and the lack of means of transpor- (39.4 percent), according to a community survey from tation as barriers to the management of complications Guinea (Bohren et al. 2019). Additionally, women often during pregnancy and childbirth in Guinea. The same report that medical interventions are performed without study showed that women´s knowledge and attitudes their consent, which might also be linked to the lack of about obstetric complications were not adequate (Bal- protocols of obtaining patients’ complaints, especially in de et al. 2021). In addition, Guinean women experience Unlocking Women’s and Girls’ Potential 34 The status of women and girls relative to men and boys in Guinea limitations on their physical mobility, often requiring exemptions in the face of restrictive economic and health their husbands’ permission before leaving the home. service conditions or because of discretionary criteria In addition, only 59 percent of Guinean women report (Nanda 2002). making decisions about their own health. The scarcity of female doctors affects women’s use of health services Contraceptive use given cultural and religious norms stigmatizing any con- tact between women and male health professionals. Contraceptive use remains very low in Guinea, also Women are reluctant to consult male doctors regarding among adolescent girls. Although contraceptive use has sexual and reproductive health, often turning instead to increased steadily over the past three decades in Guin- traditional care providers (Groggel, Sow, and Gnimas- ea, it is still very low in comparison with use in other sou 2020). And, even where health centers are available, Sub-Saharan African countries: in 2018, 10.9 percent of many of them lack basic services. According to one re- women aged 15–49 used at least some method of contra- port, 64 percent of Guinean hospitals nationwide have ception compared to 24.2 percent in Burkina Faso, 29.2 no drinking water facilities, and 27 percent have no san- percent in Ghana, and 32.2 percent in Uganda.10 The use itation services (WHO and UNICEF 2022). of contraception in urban areas is nearly twice as high as in rural ones (15.5 percent versus 8.4 percent; figure High out-of-pocket costs and the lack of universal health 3.2). Although the use of contraception increased from coverage lead many Guinean people to forgo health care 7.2 percent in 1999 to 11.4 percent in 2018 among ado- even when they need it (World Bank Group 2021). In lescent girls and young women (aged 15–24), the level many instances, payment schemes (sometimes in-kind) remains very low. Indeed, 20 percent of females in this are demanded for statutory services that are supposed age group reported having an unmet need for family to be free, with a disproportionate impact on women and planning in 2018. Urban adolescents and young wom- girls (Groggel, Sow, and Gnimassou 2020). A recent study en in the middle and richer wealth categories are more shows that low socioeconomic status and inadequate ex- likely to use modern methods than those in the poorer posure to media can be key predictors of home delivery quintiles (Sidibé et al. 2020). In addition, sexual and re- among childbearing women in Guinea (Ahinkorah 2020). productive health education, proven to be an effective Evidence from Sub-Saharan African countries including method for reducing adolescent fertility in other regions, Ghana, Kenya, Uganda, Zambia, and Zimbabwe sug- has not generally been provided in the country (Alzúa gests that, although overall women may be exempted and Velázquez 2017). The government, however, reports from formal fees, they must often make informal pay- having integrated sexual education into the educational ments because providers have no incentive to apply such curriculum (Government of Guinea 2019). 10 Based on data from UNICEF’s State of the World’s Children and Childinfo, the United Nations Population Division’s World Contraceptive Use, and household surveys including Demographic and Health Surveys (for Guinea, the 2018 survey) and Multiple Indicator Cluster Surveys. Unlocking Women’s and Girls’ Potential 35 The status of women and girls relative to men and boys in Guinea FIGURE 3.2. USE OF CONTRACEPTION BY GUINEAN WOMEN IN URBAN AND RURAL AREAS (PERCENT) Modern contraception Total contraception No contraception use 0 10 20 30 40 50 60 70 80 90 100 Urban Rural Source: Guinea EHCVM 2018 Contraceptive use trends are related to patriarchal social of religious beliefs and traditional social norms. These norms around masculinity that prevent women and men norms prohibit sexual intercourse outside of wedlock, from practicing appropriate health-seeking behaviors re- which deters young women from seeking family plan- lated to family planning. Traditional and religious norms ning and sexual and reproductive health services. Only that value large families with multiple wives and children 51 percent of women compared to 77 percent of men inhibit the use of family planning, and therefore correlate think it is justified for women to procure condoms and with unmet needs for it (Groggel, Sow, and Gnimassou demand their use when aware that their husband or part- 2020). Still, it is largely women who make the decision to ner has a sexually transmitted disease. Women´s limited use (or not use) contraception. Among women who use control over income and the required expenditures for contraception, 66 percent made the decision themselves. these services also operate as barriers (Groggel, Sow, and In 20 percent of cases, women made the decision jointly Gnimassou 2020). with their partners or husbands; 15 percent of women reported that their partner or husband made the deci- Female genital mutilation/cutting sion for them. Among women not using contraception, the role of the partner in decision-making was higher, at Finally, Guinea has one of the highest rates of FGM/C 20 percent. By distancing boys and men from the domain globally, with the practice remaining broadly accept- of sexual and reproductive health, society and the health ed—and expected—in society and pressure to undergo care system tend to excuse them from responsibility, re- this practice growing for young Guinean girls. As many inforcing the idea that it is only a female concern. as 94.5 percent of Guinean women aged 15–49 have un- dergone FGM/C as of 2018.11 There has been only a very Among young women, lack of information combined small decrease (by 4.1 percentage points) in the preva- with stigmatization about sexual activity outside of lence rates of FGM/C in Guinea since 1999.12 As a result, marriage prevent the use of contraception in Guinea. the country has the highest rate of FGM/C in all Sub-Sa- Sexuality in general remains taboo in Guinea, because haran Africa, followed by Mali (88.6 percent), Sierra Leone 11 Based on 2018 data from World Bank, World Development Indicators. 12 Based on data from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and other surveys. Unlocking Women’s and Girls’ Potential 36 The status of women and girls relative to men and boys in Guinea (83.0 percent), and The Gambia (75.7 percent) (figure reinforced by social pressure, stigmatization, and ostra- 3.3).13 Because the practice remains broadly accepted, it cism in cases of noncompliance (Barry 2019). The risk of does not depend on the mother’s level of education or being excluded from community activities and denied the family’s religious affiliation (Yoder, Abderrahim, and support and marriage possibilities can outweigh the Zhuzhuni 2004). health risks associated with FGM/C, leading many girls to request it themselves (Johansen et al. 2013; UNICEF Marking girls’ transition to adulthood, FGM/C in Guin- 2013). Indeed, in 2012, 76 percent of women and girls ea is practiced out of respect for ancestral customs and wanted the practice to continue—up from 65 percent in to restrain women’s sexuality to safeguard the family’s 1999 (UNICEF 2013). honor (Doucet et al. 2020). Submission to this norm is FIGURE 3.3. THE PREVALENCE OF FGM/C IN SUB-SAHARAN AFRICAN COUNTRIES, WOMEN AGED 15–49 (PERCENT) 100 94,5 88,6 90 83 80 75,7 70 66,6 60 50 44,9 44,4 38,4 36,7 40 30 23,3 19,5 20 9,2 10 0 0 Guinea Malí Sierra Leone Gambia, The Mauritiana Guinea-Bissau Liberia Chad Côte d’Ivoire Senegal Nigeria Benin Togo Source: World Bank, World Development Indicators. Note: Data for Guinea, Mali and Nigeria are from 2018. Data for Benin are from 2014. Data for Chad, Guinea-Bissau, Senegal, and Sierra Leone are from 2019. Data for Côte d´Ivoire are from 2016. Data for The Gambia and Liberia are from 2020. Data for Mauri- tania are from 2015. Data for Togo are from 2017. FGM/C = female genital mutilation and cutting. 13 Based on data from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and other surveys. Unlocking Women’s and Girls’ Potential 37 The status of women and girls relative to men and boys in Guinea Efforts to curtail this practice have so far had unintend- of the Law/010/2000/AN of July 2000 on Reproductive ed effects, which rendered the efforts unsuccessful. Nu- Health and Articles 406-410 of the Children’s Code of merous awareness campaigns by the government and 2008, and the General Secretariat of Religious Affairs is- national and international partners on the health risks sued a fatwa (religious ruling) prohibiting its practice in of the practice, as well as the introduction of legal sanc- Guinea (Thomson Reuters Foundation 2018). Since 2016 tions against FGM/C, have likely encouraged the increas- FGM/C is also prohibited under the Criminal Code (Law ing medicalization of excision and may have contributed No. 2016/059/AN) (Art 259), with the maximum penalty to the perception that, in a medical setting, FGM/C is au- applied when practiced “in a public or private health thorized and presents no risk (Plan International 2006). structure and facilitated by a person belonging to the A 2012 study indicated a trend toward greater medical- paramedical or medical staff, in particular doctors, nurs- ization of FGM/C in Guinea: although 79 percent of wom- es, midwives and technicians.” In 2019, the Child Code en aged 15–49 were excised by traditional practitioners, (Law no. /2019/0059/AN) added provisions against FG- the proportion fell to 66 percent among girls aged 0–14 M/C. The law requires all paramedical and medical staff (UNICEF 2013). Health personnel, mainly midwives, were to report known or attempted cases of FGM/C performed increasingly involved, despite the 2010 decree prohibit- on a child to authorities (Art. 779). Nevertheless, the Con- ing the practice of FGM/C in public or private health in- stitution of Guinea neither explicitly refers to FGM/C nor stitutions. At the same time, and because of fear of legal prohibits it as a harmful practice. At the same time, the sanctions, practicing FGM/C shifted from large celebra- current law does not criminalize the cross-border exer- tions to private settings (Plan International 2006). cise of FGM/C. There is also little evidence to prove that prosecution of FGM/C takes place on a regular basis. De- In recent years, Guinea has strengthened the national spite some recent cases of prosecution of medical staff legislation prohibiting FGM/C in medical settings and who performed FGM/C (Balde and Granier 2021), most by medical staff, although certain gaps persist and en- cases are often left unreported and perpetrators unpun- forcement remains weak (Thomson Reuters Foundation ished (Barbière 2017). 2018). FGM/C was already prohibited under Article 13 Unlocking Women’s and Girls’ Potential 38 The status of women and girls relative to men and boys in Guinea Box 3.1. Why are investments in women´s health a priority for Guinea? Maternal mortality is the main cause of death among women in Guinea—especially younger women. The high incidence of maternal mortality relates to the widespread phenomena of teenage pregnancy (see discussion in the chapter) and female genital mutilation/cutting (FGM/C). In addition, Guinean women lack access to adequate health services. In 2018, only 50 percent of pregnant women were assisted by skilled staff and only 11 percent of women used some contraceptive method. Access to health services is even lower among rural and poor women. Different constraints combine to prevent Guinean women from receiving the attention they need, including hidden costs, lack of infrastructure and quality service provision, and the scarcity of female staff. Beyond the individual tragedy that it represents for the mother and the family, the costs of maternal mortality are multiple and far-reaching. There is evidence from Sub-Saha- ran African countries that children born to mothers who died during birth face higher risks of death and health problems, have poorer educational outcomes, and experience other negative consequences throughout their lives. These negative consequences are especially true for girls, in the form of child marriage, early childbearing, and increased risk of maternal mortality and morbidity, among others. In addition, maternal death can bring financial instability, increasing the vulnerability of the household and exacerbat- ing its lack of access to basic necessities (Miller and Belizán 2015). Ultimately, maternal deaths have very negative implications for the entire society and the economy. It has been estimated for instance that the 147,741 deaths that occurred in 45 countries in the African region in 2010 resulted in a total nonhealth gross domestic product loss of US$4.5 billion (Kirigia et al. 2014). In addition to the above-mentioned factors, FGM/C, a concerningly common phenom- enon in Guinea, contributes to the maternal mortality rate. In 2018, as many as 94.5 percent of Guinean women aged 15–49 had undergone FGM/C. Strong patriarchal so- cial norms and customary practices underlie these trends. Social pressure on women is high: they face ostracism and stigmatization if they resist excision. FGM/C is not only a violation of women’s human rights but also a major health and economic concern. A 2017 report on gender-based violence found that 20 percent of girls and women who experienced FGM suffer from several health problems (UNFPA 2017). As highlighted ear- lier, FGM/C is also associated with a higher risk of maternal death (Banks et al. 2006; Unlocking Women’s and Girls’ Potential 39 The status of women and girls relative to men and boys in Guinea Box 3.1. Why are investments in women´s health a priority for Guinea? (continued) Okagbue et al. 2020). According to a 1999 survey, the most frequent health complica- tion after FGM/C is bleeding (30.9 percent), followed by problems with urination (16.8 percent), infection (12.4 percent), slow healing (10.2 percent), and swelling (4.4 percent) (Yoder, Abderrahim, and Zhuzhuni 2004). Additionally, the health complications associ- ated with FGM/C eventually reduce women’s labor participation, employment opportu- nities, and civic activities, imposing a high cost on society and overall development. Ac- cording to World Health Organization estimations, the economic costs of FGM/C-related health complications in Guinea in 2018 are as much as US$4 million. Strategic direction 2: Enhance Guinea also has made important efforts in this area, in access to maternal and sexual and collaboration with other international development part- reproductive health services, and ners and the World Bank Group (see, for instance, World eradicate FGM/C Bank 2015b). For example, the government has put in place a Strategic Plan for Maternal Health 2016–20. Like- Making the reduction of MMR a political priority is a pre- ly as a result of these efforts, maternal outcomes have requisite to improve maternal health across countries. improved over the last decade. Continuing and reinforc- Lack of attention to and insufficient funding for mater- ing these initiatives will be necessary to ensure that this nal health care facilities are direct outcomes of the fail- recent positive progress continues. ure by many countries to recognize maternal health as an important development matter. Acknowledging it Encouraging expectant mothers to seek professional as a political priority provides an opportunity to shift medical support before, during, and after pregnancy, attitudes toward maternal health care services and en- and continuing to improve the availability and quality courage more women to seek professional advice and of maternal health services for Guinean women, will be guidance (box 3.1). For example, the Health Transfor- required moving forward. Opportune, appropriate, and mation Program in Turkey has reformed the funding of affordable care can help to detect early symptoms of po- health care institutions and paid more attention to the tentially dangerous conditions and prevent the risks of performance of maternal health services, resulting in a pregnancy complications, as well as prevent neonatal drastic decrease in MMR in one decade (Prata et al. 2010). and maternal mortality. Developing and implementing It will also likely bring about improved performance and policies for the protection of expectant mothers—specifi- capacities of health care institutions, better investments cally targeting and encouraging them to use professional in infrastructure, higher attention to women’s health con- health care services before, during, and after pregnan- ditions, and improved qualifications of maternal health cy—are central to the reduction of maternal mortality. providers at large. In recent years, the government of Doing so would likely require strengthening the existing Unlocking Women’s and Girls’ Potential 40 The status of women and girls relative to men and boys in Guinea institutional capacity; implementing standardized proce- reducing fees for maternal health care services or pro- dures, protocols, and manuals of care; providing profes- viding women with financial incentives to seek medical sional training for health care practitioners; and setting support is an effective approach to increase the percent- up functioning mechanisms for monitoring and evalua- age of attended births and reduce the rates of newborn tion, among others. Investments in infrastructure, staff, and maternal mortality (Alfonso et al. 2015; Basinga et al. and supply provision would also contribute to improving 2011; Johri et al. 2014; Rasella et al. 2021). Guinea’s Min- access among vulnerable women, especially those living istry of Health implemented a health care fee exemption in remote areas (Groggel, Sow, and Gnimassou 2020). In- program for children under five and pregnant women, deed, the lack of fiscal space to absorb adequate staff which encompasses prenatal care and delivery services, or provide centers with the necessary commodities and including caesarean sections. However, lack of funding, supplies has been identified as a key supply-side barrier, among other factors, has hampered the effectiveness especially in rural areas (World Bank 2015b). of this program. As part of the overall health budget in- crease, greater funding should be allocated to this excep- It is important to acknowledge the crucial role that social tional program (World Bank 2022a). norms and gender dynamics play to this effect in Guin- ea. In particular, gender-sensitive service provision—in- Expanding access to frontline health care providers offers cluding adequate availability of female staff—will be key an alternative strategy for addressing the lack of access given the stigma that women, and especially adolescent to adequate maternal health care. One strategy to facil- girls, face for being in contact with a male professional. itate easy access to maternal health care is to delegate Attitudes of health care providers and managers can some of the clinical tasks from higher-level health provid- present an obstacle to women’s access to gender-sensi- ers to mid- or lower-level providers, including communi- tive health services and diminish the quality of existing ty-based health workers and traditional birth attendants. provision. Community-level development and health Making medical care more widely available for women actors in Guinea do not receive gender-related training, might have positive effects on the actual use of profes- which represents a missed opportunity. Because the men sional support during and after pregnancy. That was the in the family often make health decisions for women, it case, for example, in Indonesia, where the Bidam Di Desa will be similarly important to promote strategies for male (village midwife) program, which trained midwives and engagement. Information and awareness-raising efforts deployed them to rural areas throughout the country, can play a key role in promoting health-enhancing norms has significantly increased the proportion of attended among the population (Groggel, Sow, and Gnimassou births (Ensor et al. 2008). Equipping frontline health care 2020). providers with up-to-date medical knowledge and tech- nologies is another way to facilitate women’s access to Lifting financial constraints for vulnerable women will professional care and allow them to seek immediate ad- be necessary to ensure that the required maternal vice in the event of an emergency. In Guinea, physicians, health services are available and accessible regardless midwives, and nurses are few and largely employed in of income. Ensuring a broader affordability of maternal urban areas, whereas the majority of the population liv- health care services to women through policy and/or le- ing in rural parts of the country depends on nursing as- gal mechanisms can bring a positive change to mater- sistance and community health workers with inadequate nal and newborn health. Global evidence confirms that training (World Bank 2015b). Unlocking Women’s and Girls’ Potential 41 The status of women and girls relative to men and boys in Guinea Ensuring the proper application of the law and disci- of religious leaders in the current efforts to decrease plinary measures to health professionals involved is a this practice. In addition, it has implemented a training first step in addressing Guinea’s extremely high rate of program on the topic in health schools (Government of FGM/C. The persistence of FGM/C in Guinea is in large part Ghana 2019). It is important to continue pursuing and due to an absence of vigorous action by judicial author- strengthening these efforts. The main priority focus for ities to ensure its prevention and eradication. However, successful strategies is on stopping the practice from punitive application of the law will not in itself be suffi- being a dominant social norm. Achieving this goal will cient to alter this widespread practice. Regional studies require a combination of measures targeted toward all demonstrate that, although necessary, laws require so- actors involved, including prohibiting public messages cial legitimacy to be effective (box 3.2). Law enforcement in favor of the practice; mobilizing all actors affected, personnel may have limited knowledge about these laws with a special focus on fathers and their families (sis- or a conflict of interest, whereby they may continue to ters); strengthening training of all service providers and support the practice to uphold community traditions. authorities involved; integrating the issue within the Inherent conflicts between formal laws prohibiting FG- curricula of schools, universities, and training centers; M/C and local and regional religion and customs, also providing legal and other types of support to girls; mo- recognized as sources of law, will need to be addressed bilizing and raising awareness in communities; devel- (Groggel, Sow, and Gnimassou 2020). oping mass information campaigns; and empowering girls and young women to understand and stand up for International practices show that large-scale abandon- their rights. Adequate approaches also include the en- ment of FGM/C requires holistic and community-led gagement of community and religious leaders, targeted approaches. The government of Guinea has adopted a activities with cutters and health care professionals, and National Strategy and a road map for the period 2019–23 work with peer groups (Babalola et al. 2006; Chege et al. to curtail this practice. It has also commissioned an an- 2004; Diop et al. 2004; Easton, Miles, and Monkman 2002; thropological study to better understand the drivers of Ouoba et al. 2004). this practice in the country and is promoting engagement Unlocking Women’s and Girls’ Potential 42 The status of women and girls relative to men and boys in Guinea Box 3.2. What works to eliminate FGM/C and address its consequences? Community mobilization programs. The TOSTAN program in Senegal offered a basic educational curriculum of four modules: hygiene, problem solving, women’s health, and human rights. During the program, participants shared their learning with peers and family members and raised awareness among other community members and neighboring villages in their locality. Together, participants and members of the com- mittee also organized community mobilization activities, motivating people living in those villages to join in the process to change local harmful norms. The evaluation of TOSTAN shows that the program has a positive impact on attitudes to and knowledge on female genital mutilation/cutting (FGM/C). The proportion of women who thought it was necessary to practice FGM/C decreased significantly in the intervention group im- mediately after the program, and this trend continued one year later (from 70 percent initially, to 21 percent after the program, and to 15 percent a year later). Awareness of at least two consequences of FGM/C significantly increased among both men (11 percent to 83 percent) and women (7 percent to 83 percent), and after the intervention more than half of women who did not participate could mention at least two of the dangers of FGM/C. Knowledge of at least two reasons for not cutting girls went from 8 percent at the baseline to 77 percent immediately after the intervention among participants and to 50 percent among nonparticipants (Diop et al. 2004). Communication outreach and awareness raising. A communication intervention in Nigeria, called Ndukaku, was delivered at three community levels: the hamlet (or vil- lage) level, local government area level, and state level. It consisted of multimedia ac- tivities (for example, newspaper columns, radio call-in shows), development of action plans to improve women’s situation, and community meetings. The impact evaluation of the program shows that it had a significant positive effect on intentions, beliefs, atti- tudes, and knowledge regarding FGM/C in all participating communities. For example, in Enugu, the intention not to perform FGM/C on their daughters has strongly increased among both women (from 59 to 76 percent) and men (from 53 to 73 percent) after the program. The level of disapproval of FGM/C has also increased among participating men (from 67 to 77 percent) and women (from 63 to 88 percent). Likewise, the percentage of individuals who believed that there were benefits to FGM/C was strongly lower at the end of the program than at the baseline (from 42 to 25 percent among women; from 47 to 24 percent among men; Babalola 2006). Unlocking Women’s and Girls’ Potential 43 The status of women and girls relative to men and boys in Guinea CHAPTER 4. POSTPONE FAMILY FORMATION: CHILD MARRIAGE AND ADOLESCENT PREGNANCY Unlocking Women’s and Girls’ Potential 44 The status of women and girls relative to men and boys in Guinea Early family formation in Guinea trends are even more pronounced in rural areas of the country, where 79.7 percent of girls are married before The onset of family formation occurs at a very early age they reach 19 years old compared to only 9.7 percent of for most Guinean girls and young women. Whereas the men (Guinea EHCVM 2018). A similar (and related) pat- largest share of men marries between the ages of 20 tern can be identified with regard to age at first birth: and 29 years (70.2 percent), as many as 24.9 percent of 10.6 percent of Guinean women are under 15 years old women are married by age 15 and 49.4 percent at ages when they have their first child, 26.6 percent are between 16–19 (figure 4.1). Indeed, the average age at first mar- 14 16 and 19 years old, and 29 percent between 20 and 24. riage among Guinean men is 25.7, almost eight years old- (Guinea EHCVM 2018). er than that observed for women (18 years old). These FIGURE 4.1. PROPORTION OF POPULATION BY AGE AT FIRST MARRIAGE IN GUINEA, 2018 (PERCENT) 60 50 40 30 20 10 0 Under 15 16-19 20-24 25-29 30-34 35+ Male Female Source: Guinea EHCVM 2018. Child marriage (61 percent), Chad (61 percent), Mali (54 percent), Mo- zambique (53 percent), Burkina Faso (52 percent), South According to UNICEF, Guinea is among the 10 countries Sudan (52 percent), and Bangladesh (51 percent) have with the highest prevalence rates of child marriage world- higher prevalence rates of child marriage among women wide. Only Niger (76 percent), Central African Republic aged 20–24 than Guinea (47 percent) (figure 4.2). 14 This report uses the data on child/early marriage from the Harmonized Survey on Household Living Standards (Guinea EHCVM 2018), which measures the proportion of all women who have been married by age 15 and between the ages of 16–19. For the purposes of comparison with other countries, the standardized definition of child marriage is applied in accordance with the Demographic and Health Surveys. These surveys measure the proportion of women aged 20–24 who have been married by age 15 and by age 18. Unlocking Women’s and Girls’ Potential 45 The status of women and girls relative to men and boys in Guinea FIGURE 4.2. COUNTRIES WITH THE HIGHEST RATES OF CHILD MARRIAGE, WOMEN AGED 20–24 (PERCENT) 100 80 60 40 20 0 Niger Central African Republic Chad Mali Mozambique Burkina Faso South Sudan Bangladesh Guinea Nigeria Malawi Ethiopia Married by age 15 Married by age 18 Sources: Bangladesh Multiple Indicator Cluster Survey (MICS), 2019; Burkina Faso Demographic and Health Survey (DHS), 2010; Chad MICS, 2019; Central African Republic MICS, 2018–19; Ethiopia DHS, 2016; Guinea DHS, 2018; Malawi DHS, 2015; Mali DHS, 2018; Mozambique Inquérito de Indicadores de Imunização, Malária e HIV/SIDA (AIS) 2015; Niger DHS, 2012; South Sudan House- hold and Health Survey Second Round 2010. UNICEF Data Warehouse. According to the Guinea EHCVM 2018, a quarter of all burden and an opportunity to get financial or material women (24.9 percent) in Guinea were married before remuneration (UNFPA 2012). Early and forced marriag- the age of 15, while nearly half of all women (49.4 per- es are also often justified on the basis of saving families cent) were married by age 19. Moreover, those shares from having to cover the costs of raising their female chil- have not changed much during the past decade. In 2012, dren to adulthood (Groggel, Sow, and Gnimassou 2020). 21.3 percent of women were married before the age of 15 The prevalence of early marriage as a coping mecha- and 51.7 percent women were married by age 19 (Guinea nism against poverty and insecurity tends to rise during EHCVM 2018). The incidence of early marriage is higher natural disasters and humanitarian crises—for instance in rural than in urban areas, with significant disparities during the Ebola outbreak (Villegas et al. 2021). Other across regions. The highest mean age at first marriage studies, however, indicate that parents report the eco- for women is observed in Conakry (19.7 years) and the nomic aspects not to be as relevant (Animata.com 2021). lowest in Labé (16.8 years). There is also a correlation between the wealth quintile and the mean age at first Child marriage in Guinea is the result of socio-cultural marriage, with the mean age highest among high-income norms, beliefs, and perceptions of gender roles. Some households (Guinea EHCVM 2018). studies indicate that parents generally report the inten- tion of protecting the dignity of their daughters and the Evidence on the role of family socioeconomic back- honor of the family at the onset of puberty, when girls ground as a driving factor of child marriage remains un- could become pregnant, as the main motivation to marry clear. Some studies have highlighted poverty as a major them early (Animata.com 2021). The role of mother and driving factor of early marriage in Guinea, because, for wife is central in the Guinean family, significantly limiting some families, girls are perceived as both an economic other options and role models for girls. Being a mother Unlocking Women’s and Girls’ Potential 46 The status of women and girls relative to men and boys in Guinea and wife increases the social inclusion and respect of faith, permits the refusal of a forced marriage, girls and women and grants them wider opportunities to engage women often find it impossible to avoid because of high in social life, which might explain the motivation of girls pressure exerted by the family and their own lack of de- who marry early (Efevberaa and Farmer 2021). There is cision-making power (Canada: Immigration and Refugee also evidence that many early marriages occur because Board of Canada 2015). of pressure from the family (Efevberaa Farmer 2021). Re- fusing to marry constitutes a challenge to parental au- Adolescent pregnancy thority, which results in the girl’s rejection by her family and being forced to leave the family home (Groggel, Sow, Similarly, adolescent pregnancy is a very common phe- and Gnimassou 2020). nomenon in Guinea, especially among rural and poorer populations. Adolescent fertility levels in Guinea have Guinean law does not explicitly prohibit the marriage of decreased over the past 25 years, but the figures are underage individuals. The legal age of marriage in Guin- still extremely high. In 2020, Guinea’s adolescent fertility ea is 17 for women and 18 for men (Civil Code, Article rate was clearly above the average for Sub-Saharan Afri- 280). However, marriages of individuals below the offi- ca: 129.51 births per 1,000 women aged 15–19 in Guinea cial marriage age can take place with permission from compared to 98.03 in Sub-Saharan Africa (figure 4.3). As the Ministry of Justice. Anyone under the age of 21 needs of 2018, 2.0 percent of Guinean adolescent girls aged 15 the consent of their father or the head of the family to had given birth, 2.1 percent had been pregnant, and 4.1 marry. Additionally, when the age difference between percent had already started their reproductive life (Guin- the spouses exceeds 30 years, the marriage can take ea DHS 2018). The shares increase for all three catego- place only with authorization by the Minister of Interior ries among 16-year-old girls (10.5 percent, 5.7 percent, (Civil Code, Article 284). Forced marriage is officially pro- and 16.2 percent, respectively). There is a large disparity hibited by Article 268 of the Guinean Children’s Code of in adolescent fertility rates between urban and rural ar- 2008 and is penalized with imprisonment of one to three eas: in urban areas, 13.8 percent of adolescent girls aged months and a fine of 50,000 to 100,000 Guinean francs. 15–19 had given birth in contrast to 27.1 percent in rural Guinea’s Civil Code recognizes only civil marriage, mean- areas. This phenomenon also decreases steadily with ing that the civil ceremony must occur before any reli- wealth: 11.1 percent of adolescent girls from the highest gious or customary marriage celebration; however, this wealth quintile had given birth in contrast to 30.9 per- requirement is rarely followed (LandInfo 2011). Although cent of girls from the lowest wealth quintile (Guinea DHS customary law, which is based on the law of the Muslim 2018). Unlocking Women’s and Girls’ Potential 47 The status of women and girls relative to men and boys in Guinea FIGURE 4.3. ADOLESCENT FERTILITY RATE: NUMBER OF BIRTHS TO WOMEN AGED 15–19, GUINEA AND SUB-SAHARAN AFRICA, 2006–18 200 150 100 50 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Guinea SSA Source: World Bank, World Development Indicators. Note: SSA = Sub-Saharan Africa. Legal reforms setting the legal age for marriage at 18 or higher and eliminating parental or judicial exceptions are a necessary (although insufficient) first step to erad- Strategic direction 3: Reduce child icate child marriage (Wodon et al. 2017). Guinea belongs marriage and teenage pregnancy to the 18 Sub-Saharan African countries (out of a total of 43) that still have a discriminatory minimum age for Previous and current efforts to curtail child marriage and marriage—17 for girls and 18 for boys. In addition, Guin- adolescent pregnancy need to be upscaled or strength- ean legislation includes exceptions to the minimum ages ened in order to see effective results on the ground (box (Svanemyr et al. 2013). Reforming the law to prohibit the 4.1). In 2018 the Guinean government committed to de- marriage of girls under 18 in all cases—or establishing velop a socio-anthropological study on the issue that adequate safeguards to ensure that exceptions are not could help illuminate the factors that perpetuate this used to force girls into marriage—is therefore a basic nec- practice in the country (Government of Guinea 2019). essary measure (UNICEF 2020). However, the literature Better understanding the drivers and dynamics around shows no correlation between legislation prohibiting the this phenomenon in Guinea is a first necessary step to practice and child marriage rates; legislation prohibiting adequately inform policies addressing it. The govern- this practice is often inconsistent with customary or reli- ment also announced the preparation and deployment gious laws that legitimize it, which requires harmoniza- of a National Strategy and Action Plan to Eliminate Child tion efforts (Svanemyr et al. 2013). Marriage, with the objective of reducing by 15 percent the incidence of marriage of individuals under 18 by 2023 Kenya offers an example of a strong institutional frame- (Government of Guinea 2019). The Strategy and Action work to prevent child marriage. The country has made sig- Plan 2021–25, elaborated with the assistance of UNICEF, nificant progress in harmonizing child-related laws with was presented and launched at the beginning of 2021. international standards. It was one of the first countries in The budgetary allocation amounts to US$15 million Sub-Saharan Africa to come up with a consolidated chil- (Koundouno 2021). Good practices from successful in- dren’s statute, and to establish a separate and specialized terventions in the region can be useful for the adequate justice system for children. To follow up on the imple- development of these and other similar future efforts. mentation of child-related laws, the government set up an independent coordinating organ for children’s rights, the National Council for Children’s Services (Odala 2013). Unlocking Women’s and Girls’ Potential 48 The status of women and girls relative to men and boys in Guinea Box 4.1. Why is eradicating child marriage and adolescent pregnancy a priority for Guinea? Guinea exhibits a concerningly high rate of child marriage and adolescent pregnancy. A quarter of all women (24.9 percent) in the country were married before the age of 15, and nearly half of all women (49.4 percent) were married at ages 16–19 (Guinea EHCVM 2018). Guinea’s child marriage rate is one of the highest in the world, with only Chad, the Central African Republic, and Niger having higher rates. In 2018, the adolescent fer- tility rate was clearly above the average for Sub-Saharan Africa: 133.36 births per 1,000 women aged 15–19 compared to 101.10 births. Both phenomena are disproportionately more common in rural areas than in urban areas and among women from a lower so- cioeconomic background. They are also both related to the high prevalence of strongly rooted and very patriarchal social norms and religious customs. Such norms and cus- toms inflict widely accepted and severe forms of violence on women and relegate them to a submissive position to men very early in life. Early family formation has many very negative effects for women and societies, signifi- cantly limiting economic opportunities for women over the long term and ultimate- ly compromising shared prosperity and poverty reduction efforts. Child brides are at greater risk of experiencing poor health outcomes, early pregnancy and childbearing, and maternal mortality; they are also more likely to drop out of school, with life-long impacts on their capacity to engage in productive activities and their exposure to pov- erty (Hindin and Fatusi 2009; Wodon et al. 2017). Marrying before age 18 also increases a woman’s odds of experiencing intimate partner violence by 22 percent (World Bank 2014a). These dynamics also affect women’s children and households, as well as com- munities and entire societies (Wodon et al. 2017). Overall, if child marriage had ended in 2015, the global economy could have saved US$566 billion by 2030 (Wodon et al. 2017). Adolescent mothers also face higher maternal mortality and higher risks of complica- tions related to pregnancy and childbirth than do older mothers (Azevedo et al. 2012; Klugman et al. 2014; UNICEF 2008a; WHO 2014); are less likely than their female peers to finish secondary education (Bethelon and Kruger 2012); and are more likely to have lower labor force participation and earnings. Research also finds that negative effects carry over into the next generation (Azevedo et al. 2012; Hoffman and Maynard 2008). Unlocking Women’s and Girls’ Potential 49 The status of women and girls relative to men and boys in Guinea Implementation and enforcement of laws on child mar- adolescent pregnancy rates. In addition, the provision of riage across Africa experience several common problems. adolescent-friendly health services in schools and health These problems include weak judicial systems, lack of care centers and the initiation of adolescent empower- effective monitoring mechanisms, a poor understanding ment programs could have a positive impact in this area of the laws, lack of adequate training, poor coordination (Yakubu and Salisu 2018). Interventions should aim to between relevant government ministries, lack of a clear engage and mobilize parents, communities, and leaders delegation of responsibilities to specific authorities, and in activities to share information, raise awareness, and lack of guidelines on how to handle child marriage cases change behavior in order to shift adverse beliefs. They (UNICEF 2020). should also aim to empower girls and their families eco- nomically and socially though alternative livelihood pro- Different approaches exist to ensure enforcement of the grams, conditional cash transfers, and other financial minimum age of marriage. The main approach involves incentives. Lesotho offers a relevant example in this area, criminalization of the practice, which, although sending because the country managed to curtail child marriage the clear message that child marriage is illegal, can also through community engagement efforts (Maepe 2020). have unintended negative impacts on families, leading to an increase in informal unions (UNICEF 2020). The One of the most promising ways of reducing child mar- enactment and enforcement of this type of legislation riage and adolescent fertility is to keep girls in school. must therefore be carefully designed in order to keep This means that all efforts directed at the objective of the practice from going underground (Svanemyr et al. keeping girls in school would indirectly contribute to 2013). To ensure adequate enforcement of laws, all ac- curtailing this adverse practice (World Bank 2022a). In tors involved—especially police and judiciary officers, the Guinean case, existing laws and regulations related local government representatives, and community lead- to the schooling of children should be enforced. For ex- ers—need to be trained, while efforts should be made to ample, education in the country is officially compulsory communicate the details of the law, and to strengthen for 6 years for all children between the ages of 7 and 12 the capacity of law enforcement bodies. The marriage (World Development Indicators, UNESCO Institute for registration process should also require that both parties Statistics 2020). Some of the programs aimed at helping list their birth dates to ensure that the parties are of legal girls to complete primary and secondary education also age to be married; for that, a functioning civil registra- demonstrate important spillover effects on teenage fertil- tion system producing official documentation of births ity, early marriage, and socioeconomic welfare. A subsidy and marriages plays a crucial role (Hanmer and Elefante program in Kenya (see chapter 5 and strategic direction 2016; Svanemyr et al. 2013). 4), for instance, delayed the onset of girls’ fertility, with adolescent pregnancy rates falling from 16 percent to 13 Legal reforms must be accompanied by a wide range of percent within three years (Duflo, Dupas, and Kremer policies and interventions aimed at addressing the root 2015). At the same time, the elimination of primary causes of these practices (Wodon et al. 2017; UNICEF school fees in Ethiopia and Uganda led to delays in child- 2020). A recent review of the determinants of teenage bearing and reduced teenage pregnancy (Chicoine 2021; pregnancy in Sub-Saharan Africa finds that communi- Keats 2018). Similarly, a cash transfer program for girls’ ty sensitization, comprehensive sexual education, and schooling in Malawi decreased the incidence of teenage ensuring girls enroll and stay in school could reduce pregnancy by 34 percent (Baird et al. 2014). Unlocking Women’s and Girls’ Potential 50 The status of women and girls relative to men and boys in Guinea Community-based adolescent empowerment programs and increased the use of contraception (Dupas, Huillery, can foster multiple dimensions of human capital accu- and Seban 2018). Similarly, a media campaign in South mulation by offering girls and young women alternative Africa on sex, HIV, sexuality, and gender relations has de- uses of their time. These types of programs show im- layed early childbearing by 1.2 years on average (Bran- portant positive impacts on changing girls’ beliefs and son and Byker 2018). An intervention in South Africa that acceptance of specific forms of gender-based violence, provided 12 weekly lessons using a variety of interactive including child marriage, as well as on reducing teen- activities16 led to significantly healthier attitudes toward age pregnancy, as shown by the experience in Ethiopia sexual and reproductive health (Taylor et al. 2014). (Erulkar and Muthengi 2009) or South Sudan (World Bank 2013). Early results of the South Sudan Adolescent Girls Focused efforts to promote access to contraception Initiative, which provides safe spaces for girls and young methods among young people can also help to reduce women to receive training and to socialize, suggest pos- adolescent fertility. A complex intervention in Tanzania itive impacts on behavioral change with regard to ear- enabling community-based condom promotion and dis- ly pregnancy.15 Participants in the Empowerment and tribution, for and by youth, supplemented by in-school Livelihood for Adolescents program in Uganda, which sexual and reproductive health education and the provi- offered adolescent girls vocational and life skills training sion of youth-friendly sexual and reproductive health ser- and a safe space to meet and socialize with other ado- vices, had positive impacts on participants’ knowledge lescent girls, were also 26 percent less likely than non- about pregnancy prevention and use of contraception participants to have a child (Bandiera et al. 2020). The (Doyle et al. 2011). A similar intervention in Uganda pro- same intervention in Sierra Leone has decreased teenage vided youth-friendly services, including information, ed- pregnancies outside of wedlock by 7.5 percentage points ucation and communication on sexual and reproductive (Bandiera et al. 2018). health, counseling, and distribution of contraception. It led to a significant increase in the age at first intercourse Moreover, awareness campaigns on sexual and reproduc- and a decrease in the probability of pregnancy in the par- tive health and family planning can show very positive ticipating communities (Asingwire et al. 2019). However, effects (World Bank 2022a). Overall, increased knowledge there is also evidence that the mere provision of contra- about sexual and reproductive health is effective in de- ceptive methods may increase usage among recipients creasing the incidence of early pregnancy and childbear- but not necessarily reduce the rate of births (Ashraf, Field, ing. A regular anti-HIV training in Cameroon combined and Leight 2013). More evidence is needed to determine with a component on contraceptive use (video, training the effectiveness of this method to reduce adolescent session) has reduced the incidence of early pregnancy fertility. 15 The interventions offered at the clubs include demand-driven skills training, financial literacy training, life skills training, and access to savings clubs and microcredit. For more on the World Bank’s Adolescent Girls Initiative, go to https://www.worldbank.org/en/pro- grams/adolescent-girls-initiative. 16 Including role plays, small and large group discussions, debates, and viewing of videos made especially for the discussions with stu- dents. Unlocking Women’s and Girls’ Potential 51 The status of women and girls relative to men and boys in Guinea CHAPTER 5. EMPLOY: WOMEN’S ECONOMIC OPPORTUNITIES IN GUINEA Unlocking Women’s and Girls’ Potential 52 The status of women and girls relative to men and boys in Guinea Labor market outcomes As economies advance and household income increases, the family “buys” back women’s time for home produc- Female labor force participation (FLFP) in Guinea is rel- tion, such as care for children and the elderly. This pat- atively high, given that, as with other low-income coun- tern, together with the exclusion of women from manual tries, large numbers of women tend to engage in work jobs because of social stigma and discrimination, con- at family farms and household enterprises. The relation- tributes to the decline in the FLFP in countries with high- ship between FLFP and development is U-shaped. At an er gross domestic product per capita. It is only at a higher extremely low level of income and higher levels of pov- level of income and with women’s education that gender erty, where most African countries including Guinea fall, gaps in labor markets start to close (Woldemichael 2020; women are expected to contribute to the family income. figure 5.1). FIGURE 5.1. THE RELATIONSHIP BETWEEN GDP PER CAPITA AND FLFP IN AFRICA 90 80 70 Guinea 60 50 40 30 20 10 0 0 25 50 75 100 Source: World Bank, World Development Indicators. Adapted from Woldemichael 2020. Note: FLFP = female labor force participation; GDP = gross domestic product. Guinean women participate in the labor force to a low- over 80 percent in 2018, was exceptionally high even for er extent than men do. FLFP, at 56.3 percent in 2018, is African standards. Still, overall labor force participation slightly lower in Guinea than the average in the Sub-Sa- of women in Guinea is strongly below that of men, which haran Africa region (61.0 percent) but significantly higher was estimated at 76.1 percent (Guinea EHCVM 2018). La- than in other regional peers such as Côte d’Ivoire (45.0 bor force participation increases among both men and percent), Mauritania (28.0 percent), Nigeria (49.0 per- women with wealth quintile (figure 5.2).17 cent), and Senegal (47.5 percent). FLFP in rural areas, at 17 Because of the incomparability of the latest Harmonized Survey on Household Living Standards (2018) with previous surveys, it is not possible to estimate trends in FLFP over years. Unlocking Women’s and Girls’ Potential 53 The status of women and girls relative to men and boys in Guinea FIGURE 5.2. LABOR FORCE PARTICIPATION RATES IN GUINEA, BY GENDER, 2018 (PERCENT) b. By wealth quintile 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 Total Urban Rural Q1 Q2 Q3 Q4 Q5 Male Female Source: Guinea EHCVM 2018. Individuals with children (both men and women) have hand, evidence from Guinea suggests that married wom- a higher likelihood of participating in the labor market. en, who most usually have children, are also more like- The more children women and men have, the higher ly to be economically active. Also, individuals active in the participation rate: 96.2 percent of men and 69.6 per- the labor market are more likely to have the means to cent of women with more than four children are active, start a family, including having more children. Hence, twice the share registered among those without children the relationship between the number of children in the (figure 5.3). On the one hand, the number of children in household and FLFP may reflect a simple correlation the household may drive FLFP up, because it generates rather than a causal effect—meaning that the number of additional financial and material pressure. On the other children is not necessarily a driving factor of higher FLFP. FIGURE 5.3. LABOR FORCE PARTICIPATION RATES AND NUMBER OF CHILDREN IN GUINEA, BY GENDER, 2018 (PERCENT) 100 80 60 40 20 0 No child One child 2-3 children More than 4 Male Female Source: Guinea EHCVM 2018. Unlocking Women’s and Girls’ Potential 54 The status of women and girls relative to men and boys in Guinea Child marriage and early pregnancy can also be con- earlier may place pressure on women to enter the labor ducive to women’s participation in the labor force. Ac- force, participation is not higher among women who cording to the Guinea EHCVM 2018, women who married had their first child as adolescents; on the contrary, it when they were 30–34 show the highest labor force par- increases with age at first child up to the 30-to-34-year- ticipation rates (73.4 percent), followed by women who old group (64.8 percent compared to 61.7 percent among married before 15 years of age (64.1 percent). Most wom- women who got pregnant before they turned 15). In this en who married before they were 15 years old appear to case, the differences in the type of employment are not work on the family farm (61.6 percent) or to own a non- so marked, except for the share who work as managers farm enterprise (33.2 percent); only 2.3 percent work as of a plot, which tends to increase with age at first child, nonfarm wage earners (compared to 13.8 percent among and ownership of a nonfarm enterprise, which decreases those who married after 35) (table 5.1). With regard to (table 5.2). pregnancy, and against the perception that having a child TABLE 5.1. FEMALE LABOR FORCE PARTICIPATION AND TYPE OF EMPLOYMENT IN GUINEA, BY AGE AT FIRST MARRIAGE All married Under 15 16–19 20–24 25–29 30–34 35+ Labor force participation 61.2 64.1 59.4 61.3 61.6 73.4 60.8 Agricultural activities Works as a manager of a plot 14.4 22.5 12.2 11.8 7.8 5.5 11.0 Works as a livestock keeper 25.8 32.2 25.2 23.3 14.4 11.7 9.0 Works on the family farm 49.5 61.6 49.6 40.1 29.8 27.7 38.3 Works as a paid agricultural worker 0.3 0.3 0.2 0.4 0.0 0.0 0.0 Nonagricultural activities Works as a nonfarm wage earner 2.3 0.4 1.8 3.4 9.7 13.1 13.8 Owns a nonfarm enterprise 33.2 29.5 32.9 37.5 37.9 42.2 22.9 Owns a formal nonfarm enterprise 0.7 0.5 0.5 1.1 2.4 1.4 0.0 Owns an upper-tier informal 23.4 18.6 22.9 28.9 29.0 36.6 10.3 nonfarm enterprise Owns a lower-tier informal 9.2 10.4 9.5 7.5 6.5 4.2 12.6 nonfarm enterprise Source: Guinea EHCVM 2018 Unlocking Women’s and Girls’ Potential 55 The status of women and girls relative to men and boys in Guinea TABLE 5.2. FEMALE LABOR FORCE PARTICIPATION AND TYPE OF EMPLOYMENT IN GUINEA, BY AGE AT FIRST CHILD All Under 15 16–19 20–24 25–29 30–34 35+ Labor force participation 62.7 61.7 60.9 62.5 65.5 64.8 62.2 Agricultural activities Works as a manager of a plot 13.4 9.1 10.9 10.7 15.4 21.4 23.9 Works as a livestock keeper 25.8 22.1 23.7 21.4 29.3 31.8 39.4 Works on the family farm 49.4 52.3 49.5 46.0 47.5 54.4 55.5 Works as a paid agricultural worker 0.3 0.1 0.1 0.2 0.7 0.2 0.4 Nonagricultural activities Works as a nonfarm wage earner 2.4 1.7 2.2 2.2 3.7 2.6 2.1 Owns a nonfarm enterprise 36.2 39.4 36.0 38.9 36.1 33.2 26.0 Owns a formal nonfarm enterprise 0.8 0.9 0.7 0.7 1.1 0.8 0.6 Owns an upper-tier informal 25.5 27.5 24.1 27.0 26.1 24.6 21.2 nonfarm enterprise Owns a lower-tier informal 9.9 11.1 11.2 11.1 8.9 7.8 4.3 nonfarm enterprise Source: Guinea EHCVM 2018. Many of the jobs available to women can be character- Guinean women are also overrepresented in unpaid do- ized as vulnerable, seasonal, informal, and/or occasional. mestic work. Guinean women spend an average of 15.4 Over 95 percent of female employment was considered hours on unpaid domestic work per week in contrast to vulnerable in 2019, compared to 83.3 percent of male 5.2 hours spent by men (Guinea EHCVM 2018) (figure 5.4). employment—both rates significantly higher than the The gap is similar in urban and rural areas. In addition, average in the Sub-Saharan Africa region (80.1 percent women are more likely than men to be engaged in unpaid among women and 67.2 percent among men in 2019).18 work outside the home, especially in agriculture. For ex- Many women in Guinea are employed informally or sea- ample, evidence suggests that women who contribute sonally. About 75 percent of female employees in agricul- to the cultivation of male family members’ cash crops ture, farming, and fishing are seasonal workers; and 37.1 are often not paid for that work (Groggel, Sow, and Gn- percent of all female workers are employed on a seasonal imassou 2020). The disparity in the number of hours of basis (Guinea EHCVM 2018). domestic work persists across generations, with the gap 18 Based on World Bank, World Development Indicators and modeled International Labour Organization estimations. Unlocking Women’s and Girls’ Potential 56 The status of women and girls relative to men and boys in Guinea becoming wider among younger age groups. In connec- (Bardasi and Wodon 2010). The rate of time poverty was tion with these trends, time poverty19 is higher among higher for women (24.7 percent) than for men (15.1 per- women than men in Guinea. In 2010, about 20.4 percent cent) and more substantial in rural (26.4 percent) than in of adults in Guinea were characterized as time poor urban areas (7.7 percent). FIGURE 5.4. AVERAGE HOURS SPENT ON DOMESTIC PER WEEK (UNPAID WORK) IN GUINEA, BY AGE AND GENDER, 2018 25 20 15 10 5 0 7-12 13-18 19-24 25-44 45-64 65+ Male Female Total Source: Guinea EHCVM 2018 Earning differentials between men and women persist, Even if, following the regional trend, family formation de- with employed married women facing a substantial dis- cisions do not inhibit women’s labor force participation advantage—especially in rural areas. Large gender wage in Guinea, they do affect employment on the intensive gaps have been identified in Guinea across sectors and margin. As seen above, being married or having children geographical areas, regardless of education level—with appears to increase the likelihood that a Guinean wom- the exception of the minority of women with university an will work. Indeed, child marriage prevalence rates degrees (Osorio and Wodon 2010). It is estimated that appear to be lower among nonworking women, which the raw gender pay gap in Guinea in 2012 was 50 percent suggests a positive correlation between child marriage (World Bank Group 2019a). Employees in the informal and labor participation (Male and Wodon 2016). Howev- sector earn 38–43 percent less than those in the formal er, high rates of labor force participation mask underly- sector in urban areas, with the reverse effect observed in ing challenges for women. Faced with childcare duties rural areas. This reversal may be related to the fact that and constraints on their time, women are often pushed most rural women who are employed on a permanent into forms of work that, while providing more flexibility contract are usually involved in low-skilled agricultural and being better adapted to the prevailing social norms, production with low wages (Osorio and Wodon 2010). render women more vulnerable (Chakravarty, Das, and 19 The time poor work 50 hours per week and belong to households that are poor or would become poor if the individuals were to reduce their working hours up to the time-poverty line. Unlocking Women’s and Girls’ Potential 57 The status of women and girls relative to men and boys in Guinea Vaillant 2017). Indeed, the jobs available to girls and exclusively by men: men constitute 98.8 percent of all young women who marry by the age of 18 are likely to employees in construction and 99.3 percent in trans- be of an informal nature and poorly paid (if paid at all), portation/communication. However, and against the hindering their chances of reaching economic and finan- trend observed in most countries, men are also overrep- cial stability. In addition, employed married women have resented in education and health (69.0 percent), and in much lower earnings than men, especially in rural areas other services (66.4 percent). At the same time, women of the country, which may reflect gender norms that ex- constitute a majority of employees in agriculture (54.6 pect men to be the main earners in the family and limit percent), livestock/fishing (58.2 percent), mining/indus- the range of work opportunities for women, or that put try (56.8 percent), and commerce (69.6 percent), sectors the burden of unpaid work on women. traditionally considered male. Between 2012 and 2018, a significant increase was observed in the share of women Women in Guinea are overrepresented in agriculture, working in livestock/fishing (by 23.6 percentage points) mining, and trade; however, men have more presence and mining/industry (by 15.9 percentage points). In all in traditionally female sectors such as health and edu- other employment sectors, however, the percentage of cation (figure 5.5). Occupational segregation is common women employees has dropped (Guinea EHCVM 2018). in Guinea. Indeed, some sectors are dominated nearly FIGURE 5.5. DISTRIBUTION OF EMPLOYMENT IN GUINEA, BY SECTOR AND GENDER, 2018 (PERCENT) Other services Education/health Transportation/communication Commerce Construction Mining/industry Livestock/fishing Agriculture 0 10 20 30 40 50 60 70 80 90 100 Male Female Source: Guinea EHCVM 2018. Guinean women’s large presence in agriculture may be that about 34 percent of adult females aged 15+ and 38 explained by a combination of factors including male percent of adult males reported having recently lived for migration and the Ebola crisis. Limited evidence from at least six months in a location different from their cur- Sub-Saharan Africa suggests that male out-migration rent location. In Conakry and other urban areas, more may amplify women’s workload in agriculture, forcing than one in three adults report themselves to be new- women to take up traditionally male farming tasks (FAO comers. This finding is consistent with expectations of 2011). In the case of Guinea, the household survey shows a fairly high rate of internal migration in Guinea (World Unlocking Women’s and Girls’ Potential 58 The status of women and girls relative to men and boys in Guinea Bank 2018). Among male rural-to-urban migrants, 40 in certain parts of the country.21 About 70 percent of percent list work as the reason for their relocation. Em- workers in the sector in the eastern region, for instance, ployment seems to play a much smaller role for female are believed to be women. Their activity is most usually rural-to-urban migrants, motivating just 9 percent of their concentrated in downstream and labor-intensive activi- relocations; most cite marriage or family as their main ties.22 Qualitative evidence, however, indicates that these reason for moving. More than two in three households female workers are among the most vulnerable groups (68 percent) receive some transfers from former house- affected by the extractive industry in Guinea. At the com- hold members or other relatives who may reside within pany level, they rarely reach managerial positions; at the Guinea or outside the country’s borders. In addition, it community level, their needs are rarely ascertained; and, is likely that the Ebola crisis, which resulted in the loss in the artisanal sector, their health, and that of their chil- of income-generating activities and decreased financial dren, is strongly affected by the use of harmful products security, intensified male work migration while increas- (Camara, Ngom, and Baudin Sanchez 2020). ing women’s involvement in agriculture. Moreover, the Ebola crisis interrupted many of the other economic ac- Women’s labor force participation and access to quali- tivities available to women, such as cross-border trade, ty employment in Guinea continue to face restriction by retail sales, and so on (UNDG 2015). Finally, food insecu- discriminatory formal and informal institutions. Guinea rity and the high levels of undernourishment registered is among the less than half of Sub-Saharan African coun- after the Ebola crisis may have pushed more women into tries where national labor laws still contain provisions agricultural activities (UNDG 2015). that restrict women’s access to employment in the same industries as men and to jobs deemed dangerous.23 Ac- Despite women’s major role in mining in Guinea, their cording to the 2021 Women, Business and the Law report working conditions are particularly poor. Mining is one (World Bank 2021c)women in Guinea cannot legally work of the most important economic sectors in Guinea, which in industrial sectors such as mining, construction, and fac- is a major global producer of bauxite, iron ore, gold, and tories—even when they are overrepresented in some of diamonds. The country possesses some of the world’s them, as they are in mining. Moreover, despite the fact that largest deposits of bauxite and iron. The sector accounts the labor code prohibits gender discrimination in hiring, in for 20 percent of gross domestic product, 80 percent of practice women still encounter discriminatory judgements foreign currency earnings, and 20–25 percent of govern- and practices, especially in rural areas (Groggel, Sow, and ment revenue.20 Women have traditionally been engaged Gnimassou 2020). Social norms and expectations toward in artisanal mining of gold and diamonds alongside men women’s roles in society also affect women’s economic 20 From the World Bank, Guinea Integrated Agricultural Development Project datasheet (https://documents1.worldbank.org/curated/ en/575631525731828125/pdf/Project-Information-Document-Integrated-Safeguards-Data-Sheet-Guinea-Integrated-Agricultural-Devel- opment-Project-GIADP-PDAIG-P164326.pdf). 21 From Centurion’s web page, “Guinea: Promoting Women and Artisanal Mining” (https://centurionlg.com/2020/09/10/guinea-promot- ing-women-and-artisanal-mining/). 22 From the United Nations Economic Commission for Africa, African Minerals Development Centre profile of Guinea (https://knowledge. uneca.org/asm/Guinea). 23 Of 48 countries in the region, 25 have already repealed restrictions on the industries women may work in, and 28 of the 48 countries have no restrictions on women working in dangerous occupations. Unlocking Women’s and Girls’ Potential 59 The status of women and girls relative to men and boys in Guinea participation. For example, some men see the economic women’s employment, as evidence from different coun- empowerment of their wives as a threat to their status as tries shows (Dobbs 2007; Martinez et al. 2020). Gen- family head and main breadwinner (Ammann 2016). der-based violence (GBV) on public transportation is a widespread phenomenon across countries, which may In addition, women’s exclusion from decent and formal lead many women to use it only at certain times or to employment may be related to their lack of marketable stop using it altogether (Gekoski et al. 2017). In addition, skills. A low level of marketable skills among youth is social and gender norms often operate as constraints on widely recognized as a major barrier to youth employ- women’s mobility. According to the 2018 Demographic ment in Africa. According to the World Bank Enterprise and Health Survey report, 83 percent of women (aged Survey, 18.2 percent of firms in the region identify an in- 15–49) agree with the statement that a husband is justi- adequately educated workforce as a major constraint to fied in beating his wife if she goes out without telling him operations. Young women attain less education on aver- (INS and ICF 2019). age than young men, putting them at a further disadvan- tage (Chakravarty, Das, and Vaillant 2017). Technical and Entrepreneurship and access to vocational education and training systems, in particular, assets and finance remain very poorly developed in Sub-Saharan Africa, and gender gaps in access persist. The few women enrolled The role of Guinean women in entrepreneurship remains remain systematically excluded from science, technolo- limited mostly to self-employment. In 2018, only 12 per- gy, engineering, and mathematics fields of study (Arias, cent of all formal business owners (with more than five Evans, and Santos 2019). Evidence from Guinea indicates employees) were women.24 In 2016, only 9 percent of firms that the skill level of the labor force is far from adequate to were (partially) owned by women, in contrast to 29 per- satisfy existing demands, because the education system cent on average in Sub-Saharan Africa and 25 percent in does not equip graduates to meet the needs of the labor low-income countries; only 6 percent of firms had a fe- market. Employers report difficulties finding workers with male top manager, which is significantly lower than the the skills they need. In addition, technical and vocation- average in Sub-Saharan Africa (14 percent) and in low-in- al training is underdeveloped relative to the needs of in- come countries in general (12 percent).25 Entrepreneur- dustry—particularly mining, construction, and agriculture ship for African women often comes more from necessity (World Bank 2015a). All these trends are likely to be more than choice, given the lack of wage job opportunities pronounced among women, whose access to education available and the prevailing social norms related to the and training remains more severely constrained. role of women relative to men in society. It is the only re- gion where women are more likely to be entrepreneurs Women’s participation in the labor market is also deter- than men, although again out of economic necessity rath- mined by the lack of transportation to get them to em- er than opportunity (World Bank 2019b). For example, ployment sites as well as the risk of experiencing sexual African women account for 58 percent of the continent’s harassment during the commute. Safe and convenient self-employed population (Copley, Decker, and Delavelle transportation connections and infrastructure can boost 2020). However, female-led businesses systematically 24 Data from the World Bank, World Development Indicators. 25 World Development Indicators. Unlocking Women’s and Girls’ Potential 60 The status of women and girls relative to men and boys in Guinea show lower performance (as reflected in profits) than largely relates to gaps in availability of productive assets those led my men (World Bank 2019b). This disparity such as machinery, vehicles, or land (figure 5.6). FIGURE 5.6. FEMALE AND MALE ASSET OWNERSHIP IN GUINEA, 2018 (PERCENT) 60 50 40 30 20 10 0 Land Machine Vehicle Furniture Male Female Source: Guinea EHCVM 2018 However, female self-employment26 remains high in areas, and women from the highest wealth quintiles are Guinea—even if lower than that of males—with urban more likely to be self-employed—with a reverse trend ob- and wealthier women more likely to be self-employed. served among men. Importantly, a sizeable proportion Although a larger share of men (68.1 percent) than of of these self-employed women and men are farmers, women (62.9 percent) was self-employed in Guinea in livestock keepers, or fisher(wo)men. Self-employment is 2018, women accounted for half of the total self-em- also associated with lower educational levels, older age, ployed workers in the country (Guinea EHCVM 2018). being married/widow/divorced, and having children, Both self-employment and working for family are con- among both men and women (Guinea EHCVM 2018). sidered vulnerable or insecure forms of employment because the lack of stability and financial security and Informal work and self-employment not only reduce the seasonal character of work allow employers to easily women’s financial and economic security but also bear exploit workers. Moreover, the existing legal protections important risks for women. Informal sector workers against gender discrimination in the workplace do not lack access to formal social protection mechanisms that apply to women who are self-employed or who work in provide a safety net in the face of shocks. To cover that informal settings (OECD 2014). Between 2012 and 2018, gap, workers most often rely on traditional mechanisms, the share of women who were self-employed decreased including community/family solidarity and tontines27 by 3.2 percentage points, whereas that of men increased (Toure 2017). Informal employment also increases the by 3.0 percentage points. Female self-employment is risks of experiencing sexual harassment and GBV in the higher in urban (71.2 percent) than in rural (59.3 percent) workplace (Groggel, Sow, and Gnimassou 2020). For 26 Self-employment as captured in the survey is very broad. Anyone in the labor force that is not working for someone else considers themselves as being ‘self-employed”. 27 Informal community-based savings systems or clubs through which members make regular contributions that they can withdraw in case of need. Unlocking Women’s and Girls’ Potential 61 The status of women and girls relative to men and boys in Guinea example, anecdotal evidence shows that women from entrepreneurship in Guinea. There was a pronounced urban areas working in the private sector often experi- increase in access to almost all assets between 2012 and ence sexual harassment but rarely report it because of 2018 for both men and women, although the gender gap the lack of law enforcement mechanisms and fear of re- in asset ownership is persistent and significant. Own- taliation, including loss of job or demotion (Groggel, Sow, ership of other assets is significantly lower among fe- and Gnimassou 2020). Similarly, increased risks of GBV— male-headed households across all regions. For example, including transactional sex, prostitution, and a practice 93.3 percent of male-headed compared to 85.5 percent known as foudoukoudouni —are documented in mining 28 of female-headed households had a mobile phone in communities where women are underrepresented and 2018; 25.6 percent of male-headed and only 2.0 percent underpaid (Groggel, Sow, and Gnimassou 2020). of female-headed households possessed a motorcycle (Guinea EHCVM 2018). Social norms regarding family formation and care con- stitute serious challenges for women’s entrepreneurship. Data further show pronounced differences in the way For example, women’s limited household decision-mak- men and women engage in financial services in Guinea. ing powers, which make women dependent on the deci- In 2018, only 2.6 percent of women (in contrast to 9.4 sions of their husbands, strongly decrease their chances percent of men) had access to a bank account in Guinea, of starting their own business. Additionally, women lack and 15.1 percent to mobile banking (compared to 32.9 the necessary time to dedicate to business setup and percent of men). A significantly higher percentage of men operation because of the number of hours they put into (54.5 percent) than women (32.9 percent) had access to unpaid domestic work and care (see figure 5.4). Social ex- mobile banking in urban settings, with the lowest ac- pectations and duties within the household limit the time cess to mobile accounts observed among rural women available to women to engage in financial and business (1.1 percent) (Guinea EHCVM 2018) (figures 5.7 and 5.8). opportunities. It appears that family pressure on women Moreover, only 24.0 percent of women aged 15+ own an entrepreneurs has significantly negative effects on busi- account at a financial institution or with a mobile money ness investment decisions. For instance, married women service provider, compared to 36.9 percent of men. The with family living nearby perform worse, whereas men figures remain largely below the Sub-Saharan African benefit from close family proximity (Fiala 2013). A study averages of 49.0 percent for women and 61.4 percent for from Ghana also shows that, to reinforce their husband’s men.29 Notably, between 2014 and 2017, the proportion responsibilities as a provider, women hid income and sav- of women who saved or borrowed to start, operate, or ex- ings, and sometimes explicitly limited business growth pand a farm or business increased, whereas that of men (Friedson-Ridenour and Pierotti 2018). decreased significantly (table 5.3). In these terms, Guinea performs better that the Sub-Saharan African average.30 As noted earlier, the lack of access to productive as- sets also acts as a major constraint to women´s 28 Short-term marriage. 29 Based on the 2021 data from World Bank, Global Findex Database (https://data.worldbank.org/indicator/FX.OWN.TOTL.FE.ZS?locations=ZG) 30 Based on 2014–17 data from World Bank, Global Financial Inclusion data set (https://databank.worldbank.org/source/global-finan- cial-inclusion). Unlocking Women’s and Girls’ Potential 62 The status of women and girls relative to men and boys in Guinea FIGURE 5.7. PROPORTION OF GUINEAN POPULATION FIGURE 5.8. PROPORTION OF GUINEAN POPULATION AGED 15+ WITH A BANK ACCOUNT, 2018 AGED 15+ WITH ACCESS TO MOBILE BANKING, 2018 (PERCENT) (PERCENT) 18 60 16 50 14 12 40 10 30 8 6 20 4 2 10 0 0 Total Urban Rural Total Urban Rural Male Female Male Female Source: Guinea EHCVM 2018. Source: Guinea EHCVM 2018. TABLE 5.3. PROPORTION OF INDIVIDUALS AGED 15+ WHO SAVED AND BORROWED TO START, OPERATE, OR EXPAND A FARM OR BUSINESS, BY GENDER, 2014–17 (PERCENT) Guinea Sub-Saharan Africa Saved to start, operate, or expand a farm or business (% age 15+) 2014 2017 2014 2017 Female 16.74 17.31 19.77 20.25 Male 21.04 14.73 25.56 26.29 Borrowed to start, operate, or expand a farm or business (% age 15+) Female 14.34 16.07 12.15 10.83 Male 18.75 12.71 13.45 12.37 Source: Based on 2014–17 data from World Bank, Global Financial Inclusion data set. Despite the key role that Guinean women play in agri- farm inputs like fertilizers, pesticides, and farming tools; culture, their access to land and other productive inputs support from extension services; and access to markets remains constrained. Even though women make up a and other factors essential to their productivity. In Guin- large share of Africa’s farmers, they tend to be locked ea, women are responsible for nearly 80 percent of the out of land ownership; access to credit and productive country’s food production. As seen before, 54.6 percent Unlocking Women’s and Girls’ Potential 63 The status of women and girls relative to men and boys in Guinea of all workers in the agricultural sector are women, and (figure 5.9). Instead, women obtain use rights to agricul- 62 percent of female employment corresponds to this tural land through their husbands and sons, and they are sector (Guinea EHCVM 2018). However, women control a usually dependent on those relationships to maintain very small share of resources, and men hold the main de- their rights of access to land (Clapp 1993; Fischer et al. cision-making power and the ownership of and access to 1995). At the same time, only 6.3 percent of female land- information, inputs, means of production, and technol- owners use fertilizers, half the usage registered among ogy. Indeed, men own 73 percent of the plots in Guinea, male landowners (12.9 percent). Importantly, however, as well as 84.5 percent of the total hectares. Similarly, the these data may not reflect the full reality in Guinea be- share of plots with legal documents owned by women, at cause the survey did not cover all plots operated and 22 percent, is much lower than the share owned by men owned by households.31 FIGURE 5.9. LAND OWNERSHIP IN GUINEA, BY GENDER (PERCENT) Total number of plots Total number of hectares Total number of plots with legal documents 0 10 20 30 40 50 60 70 80 90 Male Female Source: Guinea EHCVM 2018. Despite some positive legal developments, Guinean leg- countries in Sub-Saharan Africa, Guinea is one of only 14 islation still contains some discriminatory provisions that that treat surviving wives differently in inheritance rights obstruct women’s access and ownership of assets. Arti- than surviving husbands. Countries in the region that cle 695 of the Guinean Civil Code creates a disparity in provide for the most equitable treatment of surviving inheritance rights of surviving male and female spouses, husbands and wives include Burkina Faso, Gabon, and granting surviving husbands more rights than wives. Arti- Ghana. In Sub-Saharan Africa, 29 countries provide for cle 695 gives widows a one-eighth share of the husband’s the recognition of nonmonetary contributions, but Guin- estate if there are no children or second wives but has no ea currently lacks legislation recognizing nonmonetary such limit on the husband’s inheritance share. Among 48 marital contributions.32 31 Enumerators might have purposely limited themselves to plots with easy access, because it was not an agricultural survey. Also, collec- tive ownership of plots is common in Guinea and most West African countries and is not reflected here. 32 Nonmonetary contributions include unpaid work in the house such as childcare or household responsibilities. Because women are more likely to perform unpaid activities that benefit the household such as child or elderly care, they typically have fewer monetized contributions than men and therefore acquire fewer assets during marriage. Recognition of these nonmonetary contributions is im- portant upon the dissolution of marriage because it can grant women access to a share of marital property. Unlocking Women’s and Girls’ Potential 64 The status of women and girls relative to men and boys in Guinea Poverty observed among male adult households without chil- dren (3.7 percent). In comparison, female only adult Likely as a result of all the gaps mentioned previously, households without children show a much higher pover- women are more exposed to poverty and extreme pov- ty incidence (23.3 percent). Furthermore, when compar- erty in Guinea.33 Poverty incidence by household compo- ing poverty status by age, those most exposed to poverty sition is highest among adults of both sexes with four or are girls and young women aged 0–14 and elderly women more children (60.7 percent), followed by women-only aged 65+ (50.5 percent for each age group). The incidence households with children (54.5 percent) and households of poverty is also steadily higher among female-headed with adults of both sexes with one to three children (34.3 than male-headed households. percent) (figure 5.10). The lowest incidence of poverty is FIGURE 5.10. POVERTY IN GUINEA, BY HOUSEHOLD COMPOSITION 70 60,7 60 54,5 50 40 34,3 30,2 30 23,3 19,9 20 10 3,7 0 Male adults Female adults Adults Male(s) with Female(s) Adults Adults (both sexes) children with (both sexes) (both sexes) children +1-3children + 4+children Poverty incidence Population share (%) Source: World Bank staff calculations based on Guinea EHCVM 2018 33 In this analysis, poverty is defined as the percentage of the population whose total consumption (including food, rent, clothing, energy, health expenditures, and education) is below the poverty line estimated at GF 5,006,362 per capita per year. Extreme poverty is either (1) the percentage of the population living below the international poverty line of US$1.90 per capita per day, in 2011 purchasing power parity, or (2) the percentage of the population whose total consumption (including food, rent, clothing, energy, health expenditures, and education) is below the food poverty line. Unlocking Women’s and Girls’ Potential 65 The status of women and girls relative to men and boys in Guinea Box 5.1. Why is improving access to economic opportunities for women a priority for Guinea? Female labor force participation has decreased over the last 10 years in Guinea, reaching 56.3 percent in 2018, compared to 76.1 percent among men. This decrease has result- ed in a widening gender gap in labor market engagement. Employment rates are also lower among women than men (40.7 percent compared to 61.9 percent among men), while the quality of jobs available to women tends to be poor. Guinean women are over- represented in unpaid domestic work; seasonal, informal, and vulnerable employment; and self-employment. Occupational segregation relegates women to certain activities, (atypically) including agriculture, mining, fishery/livestock, and trade. In addition, wom- en tend to face special barriers to entrepreneurship, including lack of access to assets such as finance or land. Overall, their earnings (if any) tend to be lower and their access to social protection minimal, making them especially vulnerable to poverty. Having chil- dren increases women’s likelihood of participating in the labor force, and having chil- dren early appears to decrease the likelihood of being self-employed. As seen at the beginning of this report, the lack of gender equality in access to economic opportunity not only imposes a drag on women and girls but also represents massive economic costs for societies. In particular, estimations for Guinea show that increasing female labor productivity could result in a 10 percent higher gross domestic product per capita. Enhancing women’s economic opportunities can have not only a direct impact through women’s productive contributions to the economy but also an indirect one, by increasing educational attainment, improving women’s health outcomes, lowering fertility rates, accelerating the demographic transition, or improving women’s agency. Economic and financial independence expands the role of women in the household and society, which for instance can alleviate social pressure for early marriage and fertility (Chakravarty, Das, and Vaillant 2017). Having more control over financial resources in the household is also associated with an increase in the use of contraception (Black- stone 2017). Female economic autonomy plays a central role for women´s agency. For example, asset ownership is positively correlated with women’s work and decision-mak- ing in Guinea. In addition, women’s presence in businesses is associated with gains for companies: those with a gender-diverse workforce are 15 percent more likely to have financial returns above their respective national industry medians (Hunt, Layton, and Prince 2015). Unlocking Women’s and Girls’ Potential 66 The status of women and girls relative to men and boys in Guinea Strategic direction 4: Improve 619 of the new Civil Code, the default regime for marital women’s economic empowerment assets is separation of property, which makes women and access to quality employment particularly vulnerable in case of divorce.37 This legal gap could be addressed by introducing a provision mandat- Promoting women’s access to quality jobs offers a wide ing the equal or equitable division of marital property or variety of benefits not only for women themselves, but for the transfer of a lump sum to the stay-at-home spouse also for the societal and economic development at large based on nonmonetary contributions at the time of sepa- (box 5.1). One strategy to achieve this goal is to adjust the ration or divorce. Alternatively, a reform could introduce legal framework and eliminate any prohibition on female the setting of “full community, partial community or de- labor force participation. Some legal reforms to recognize ferred full or partial community” as the default marital the same rights to work between men and women are property regime through an amendment to Article 619 of pending in Guinea. Guinea’s national labor laws contain the Civil Code. In the last 10 years, three countries in the provisions that restrict women’s access to employment in region—The Gambia, Kenya, and Malawi—have enacted the same industries as men (Article 136.1 and Arrêté No. reforms in this area. 1392/MASE/DNTLS/90 du 15 Mai 1990, Art. 1, 3-6) and to jobs deemed dangerous (Code du Travail Article 231.5).34 However, it is not the existing gaps in formal institutions The current provisions in the Code du Travail along with that appear to be the main challenge faced by Guinean all implementing directives35 could be repealed or re- women in this area, but rather the high prevalence of placed through a legal amendment allowing men and informal patriarchal norms. Traditional beliefs and val- women to have access to the same jobs in all industries. ues make women and girls extremely vulnerable and Furthermore, an article could be added stating that men dependent on men in Guinea, confining women to the and women may work in all industries without discrim- household and the role of mothers and wives, undermin- ination on the basis of sex, encompassing all industries ing their decision-making capacity in public and private and all jobs. A good regional example of a reform in this spheres, and making them vulnerable to different forms area comes from South Sudan, which approved a new of GBV. Shifting social norms and attitudes toward wom- Labor Code in 2017.36 In addition, Guinea currently lacks en’s work outside the home is therefore a priority to facil- legislation recognizing nonmonetary marital contribu- itate women’s economic participation. Such a shift would tions, which include unpaid work in the house such as require a large-scale and long-term comprehensive strat- childcare or household responsibilities and are mostly egy across areas and levels. Such an effort could include shouldered by women. Moreover, according to Article dialogue and mobilization programs at the community 34 Article 136.1 of the Code du Travail specifically bars women from night work in factories, quarries, construction sites, and other indus- tries. Article 231.5 specifically allows for ministerial decrees to set out the nature of work women (and, specifically, pregnant women) may be prohibited from undertaking. 35 Specifically, Arrêté No. 1392/MASE/DNTLS/90 du 15 Mai 1990. 36 The New Labor Code, Act 64, 2017 states (Article 6, subsection 1): “No person shall discriminate, directly or indirectly, against an employee or job applicant in any work policy or practice.” Subsections 2–6 define this right in more detail, making it clear that blanket occupational or vocational exceptions to the prohibitions are prohibited. 37 Because women are more likely to perform unpaid activities that benefit the household, such as child or elderly care, they typically have fewer monetized contributions than men and therefore acquire fewer assets during marriage. Recognition of these nonmonetary contributions is important upon the dissolution of marriage because it can grant women access to a share of marital property. Unlocking Women’s and Girls’ Potential 67 The status of women and girls relative to men and boys in Guinea level, working with men and particularly religious lead- Sudan’s Labor Law provide good examples of paternity ers; educational campaigns or programs, for instance in leave reforms. schools, not only with students but also including the gender training of staff and gender-sensitive adaptations The adoption of family-friendly policies aimed at in- to the educational curriculum; and mass awareness-rais- formal sector workers will be especially crucial in the ing campaigns at the local or national level through TV or Guinean context. A majority of the Guinean labor force, radio programs, for instance. Economic empowerment particularly female workers, is engaged in informal interventions for women can also contribute to change work—often in the form of self-employment or unpaid the knowledge and aspirations of young women and family work—and therefore remains excluded from all girls, with spillover effects. forms of contributory social protection, including mater- nity leave. In this context, extending contributory social Family-friendly policies are a crucial tool to address the insurance and noncontributory social assistance mea- gender gaps and discriminatory practices resulting from sures to build universal social protection systems that the unbalanced distribution of responsibilities over the include informal workers and the children in their care household and children. Maternity leaves are central is a priority. In South Africa, for example, paid materni- for mothers to recover from childbirth and to be able to ty leave and benefits are available to wage workers in breastfeed children for the minimum time recommended sectors with high levels of informality, such as domestic for healthy development. Paternity and parental leaves and farm workers, through the Unemployment Insurance are also key for fathers to engage in childcare, to rebal- Fund (UNICEF 2021d). The government of Guinea can ance the distribution of responsibilities between men find ways to collaborate with informal workers and their and women, and for a better attachment between fathers organizations to include them in economic and social and children. However, Guinean law, Loi L/2014/072/ protection COVID-19 recovery packages. Universal cov- CNT du 10 Janvier 214, Art. 153.3, mandates that em- erage of child benefits could help reduce the vulnerabil- ployers pay for maternity leave benefits, which could act ity of low-income or disadvantaged families, addressing as a disincentive for employers in the private sector to inequality in how children are supported and cared for; hire women. The government of Guinea could consider and these programs could be linked with gender-trans- amending its current law by shifting responsibility for formative and child-sensitive “Plus” components that administering maternity leave benefits from employers support informal sector workers, parents/caregivers, and to the government. In Sub-Saharan Africa, the govern- families (UNICEF 2021d). ments of 18 countries—including Mali, Mauritania, and Tanzania—fully administer maternity leave benefits. Targeted social protection programs can help empower Guinea could do so through a compulsory social insur- women economically, while offering a safety net against ance scheme, employment reimbursement in full, public poverty and vulnerability. In some Sub-Saharan African funds, or a quasi-public entity that administers the full contexts, public works programs provide a safety net benefits. In addition, paid parental and paternity leave through temporary employment, while expanding ac- provisions could be introduced by adopting legislation cess to basic infrastructure such as school and health mandating the right to some form of paid parental leave centers and advancing green projects such as watershed either shared between the mother and father or as an management (World Bank 2022b). A recent experience individual entitlement. Recent amendments to South in this area in Guinea with support from the World Bank Unlocking Women’s and Girls’ Potential 68 The status of women and girls relative to men and boys in Guinea has been the Productive Safety Nets Project, which pro- that access to quality childcare can significantly benefit vided labor-intensive public works and cash transfers: women’s labor market participation, increase household 60 percent of beneficiaries were women (World Bank earnings, and bring strong economic value for the entire 2022b). Cash transfer programs can support women’s society and economy. Recent experiences from the re- empowerment while stimulating human capital–rele- gion, such as the provision of mobile childcare in Burkina vant investments in the household. In Africa, social safety Faso, can be of particular interest for the Guinean case.38 net programs predominately focusing on cash transfers Developing infrastructure and facilities for childcare that have shown enhanced interest in promoting gender are culturally adapted to the Guinean context should be equity (World Bank 2022b). Cash transfers offered to part of the broader policy dialogue on gender equality in ultra-poor households in northwest Nigeria had an im- the country. For that purpose, it would be important to mediate positive impact on household consumption understand the strategies that women use to overcome and on female employment and well-being (Papineni, the lack of support, as well as the existing societal prefer- Bastian, and Osinibi 2016). Impacts are reinforced with a ences. Qualitative evidence from other African countries “Plus” approach, for instance combining cash transfers suggests that, even in the context of weakening extended with productive inclusion. In Niger, for example, the na- family networks, such networks are still the main source tional social safety net program has improved women’s of support for working mothers. labor participation, revenues, and various dimensions of well-being by combining a lump-sum cash grant with a There is evidence that active labor market policies tend psychosocial intervention (Bance, Bermeo, and Kabem- to benefit women more than men. In particular, job coun- ba 2021; Bossuroy et al. 2021). Digital cash transfers pro- seling and work placement support programs can assist vide an opportunity to strengthen inclusion and access women to access quality employment. An intervention in to financial services. Ethiopia that supported and facilitated the job applica- tion process for young women seeking a production line Adequate infrastructure and public services including position at one of the factories increased the likelihood of childcare are also necessary to support women’s eco- getting a factory job by more than 50 percent and raised nomic participation. Unpaved and poorly maintained reported monthly income by nearly 30 percent (Abebe roads lead to the isolation of many rural areas during et al. 2020). A job counseling intervention in South Africa the rainy season, which hinders access to local markets that delivered a 90-minute career-counseling workshop, and to basic services, especially among women (World covering topics such as job search strategies, CV creation, Bank 2022a). Investments in infrastructure and trans- interview techniques, and access to information and re- portation are therefore central to facilitate access to sources for job search, was found to increase the number jobs and markets by women. At the same time, Guinean of job applications submitted by 15 percent, which trans- women spend substantially more time than men on un- lated into an increase in job offers (by 30 percent) and a paid household activities, which restricts the time they higher likelihood of employment (by 26 percent) (Abel, can spend on income-generating activities outside of Buehren, and Goldstein 2019). Training programs can the home. There is evidence from different countries 38 From the World Bank’s “Who We Are” web page (https://www.worldbank.org/en/news/feature/2021/03/08/enabling-women-to-work- and-their-children-to-blossom-the-double-success-story-of-mobile-childcare-units-in-burkina-faso). Unlocking Women’s and Girls’ Potential 69 The status of women and girls relative to men and boys in Guinea also be particularly effective in raising the future pros- an entrepreneurship training coupled with business pects of female participants. mentorship in Ethiopia for experienced businesswomen on marketing, record keeping, financial planning, and Targeted job creation interventions can be particularly stock control strongly increased participants’ sales and effective to encourage the presence of women in the profits (Bakhtiar, Bastian, and Goldstein 2021). Moreover, formal sector. These interventions can assist women the DOT ReachUp! training program in Ethiopia that of- entrepreneurs in particular to sustain their businesses fered an innovative approach to entrepreneurship devel- by supporting their financial, information technology, opment through a 120-hour course on basic technology and managerial skills. The potential impacts of business and business skills increased program participants’ prof- training are larger or more significant when the training its by 30 percent points, compared to those without the is carefully targeted (Bardasi et al. 2021). training (Alibhai et al. 2017a). A personal initiative train- ing program for entrepreneurs with a focus on teaching a Training and workshops that equip participants with mindset of self-starting behavior, innovation, goal setting, business-related skills and knowledge often lead to planning, and feedback cycles was particularly effective the adoption of new business practices and diversifica- for female-owned businesses, who saw their profits in- tion of firms’ activities. A business training in Tanzania, crease by 40 percentage points (Campos et al. 2018). A which aimed to strengthen the managerial and techni- program in Uganda, which combined a business skills cal skills of women entrepreneurs, led to the adoption training with an individual start-up and regular follow-up of new business practices among participants, although by trained community workers, increased participants’ with no further effect on sales or profits (Bardasi et al. sales, earnings, and assets ownership. The program had 2021). An entrepreneurship training in Kenya—which most impact on the entrepreneurs with the lowest initial offered business skills training, franchise-specific train- levels of capital and access to credit, which were mainly ing, start-up capital, and ongoing business mentoring for female-led businesses (Blattman et al. 2013). women—had large and significant impacts on the likeli- hood of being engaged in an income-generating activity. The transition from school to work among young women These effects are driven by a doubling of the likelihood needs to be eased by improving their competencies, such of being self-employed (Brudevold-Newman et al. 2017). as technical and life skills, in areas that offer special po- The Guinean government has for instance put into place tential. The Economic Empowerment of Adolescent Girls a program for female entrepreneurship and female au- and Young Women program in Liberia provided young tonomy, and has built, rehabilitated, and equipped 10 women with a six-month training in job skills targeted centers for the autonomy of women (Government of to sectors with high demand or business development, Guinea 2019). Combined programs aiming at both social coupled with career advising, mentorship, and job in- and economic empowerment could also help to increase termediation services. The program increased the em- the productivity and earnings of self-employed women ployment of participants by 47 percent and earnings by (World Bank 2022a). 80 percent (Adoho et al. 2014). Equipping young people with the relevant technical skills to take advantage of the Business training is often accompanied by follow-up ac- high penetration of digital technology can be an effec- tivities, such as mentorship, regular feedback sessions tive strategy for accelerating nonfarm business growth. with the trainers, or cash/in-kind support. For instance, For example, the Ninaweza program in Kenya provides Unlocking Women’s and Girls’ Potential 70 The status of women and girls relative to men and boys in Guinea young women with technical training in information and at developing noncognitive skills was associated with a communication technology, training in life skills, work more productive use of inputs and a 5-percentage-point experience through internships, and job placement sup- increase in the probability of adoption of the main cash port. Participants were 14 percent more likely to obtain a crop (Montalvao et al. 2017). In Ethiopia, the Rural Capac- job after completion and had higher earnings (Azevedo, ity Building Project, aimed at strengthening agricultural Davis, and Charles 2013). Girls and young women can, services and productivity through the delivery of a pro- however, face particular challenges in the posttraining fessional training with a gender-sensitive component, led period due to the lack of financial resources, high time to an increase in the adoption of high-value crop farming, use on domestic chores, and pressure from the family area of land cultivated, and economic participation of (Cho et al. 2013). household members, benefiting male- and female-head- ed households equally (Buehren et al. 2019). Couples’ Incipient initiatives along these lines have already been agricultural extension training led to increased women’s adopted by the Guinean government, although their management of cash crop tasks and involvement in ag- results remain unclear. Activities include setting up in- ricultural decisions in Côte d’Ivoire (World Bank 2020a). centives for young women to enter science, technology, The Guinean government has developed several training engineering, and mathematics fields of study; the or- programs for female farmers, for instance in the area of ganization of a forum on the employability of women; milk or honey production, in artisanal agriculture, cattle the development of a training program on information breeding, fertilization, fishing, and forestry (Government and communication technology targeted at women in of Guinea 2019). higher education and scientific research; and the estab- lishment of an excellency price for the best female re- Combined interventions, aiming to empower adolescent searchers/professors in science, technology, engineering, girls socially and economically, can increase the chances and mathematics fields of study (Government of Guin- of participating in the labor market and accessing paid ea 2019). These initiatives, when effective, should be employment. Participants of the Empowerment and strengthened and scaled up. Livelihood for Adolescents program in Uganda, which combined vocational and life skills trainings with a safe Interventions that aim to strengthen the technical and life space for adolescent girls, were 72 percent more likely skills of women farmers through training, social network- to be engaged in income-generating activities and re- ing, or extension services demonstrate promising effects ported self-employment earnings three times higher on agricultural productivity and incomes. An intervention than the original average (Bandiera et al. 2020). A similar in Uganda that paired female cotton farmers who had intervention, the Adolescent Girls Initiative in Rwanda, not previously met to stay in touch and share new agri- consisted of technical training for self-employment (in cultural information about recently adopted cash crops areas such as food processing, culinary arts, arts and significantly increased productivity for women farmers, crafts, and agri-business), psychosocial support, life raising their levels of agricultural knowledge—account- skills and business development training, and business ing for roughly 20 percent of the increase in yields (Vasi- mentorship. The results revealed a substantial increase laky 2013). Similarly, a training for female farmers aimed in nonfarm employment and waged employment among Unlocking Women’s and Girls’ Potential 71 The status of women and girls relative to men and boys in Guinea participants.39 In addition to employment outcomes, Mines (50 of them women) on the integration of women such programs have a wide range of positive impacts of in the mining sector, and the consolidation of the role of young women’s well-being, social networks, and mental women in artisanal mining (Government of Guinea 2019). health, which altogether increase the chances of eco- However, women miners still lack access to productive nomic and financial empowerment. assets and training, which undermines their productivi- ty. For example, female workers in mining generally rely The crucial role of women in the two most important on informal sources of funding, such as tontines and economic activities in the country, agriculture and min- community funds. In addition, their presence in mining ing, needs to be acknowledged and supported. Invest- technical careers is low because of misconceptions about ing in increasing the productivity of women farmers and mining conveyed by families from an early age. Because miners could deliver important economic gains for the of family pressures or prohibitive conditions, women also country. Acknowledging their important role in these refuse to participate in capacity-building activities and in activities will require strengthening efforts to encourage opportunities for financing or tendering (Camara, Ngom, and facilitate their presence in related decision-making and Baudin Sanchez 2020). spaces and specific organizations that promote and de- fend their rights, and efforts to improve their technical Programs that aim to increase access to productive re- competencies in these areas. Particular attention should sources among Guinean women in general, and women be paid to food-related manufacturing and services in- farmers in particular, are also required. Promoting the cluding the processing, packaging, transporting, storing, registration and formalization of land can help women to distributing, and retailing of food. According to the recent access finance and other necessary services, as shown by national household survey, 41 percent of nonfarm rural the experiences of Benin (Benhassine et al. 2015; Gold- enterprises in Guinea are situated in the food sector and stein et al. 2016), Ghana (Agyei-Holmes et al. 2020), Mala- women, found throughout the off-farm segments of the wi (Campos, Goldstein, and McKenzie 2004), and Rwanda food economy, play a large role in processing and retail- (Ali et al. 2015). In addition, encouraging the co-titling ing food.40 of land through targeted interventions such as the one deployed in Uganda (Cherchi et al. 2019) could be of With regard to women in mining, the government could particular interest for Guinea. Programs that provide continue the efforts already initiated and could be com- direct access to financial products combined with train- plement them with programs that effectively support fe- ing appear to have important positive effects for female male miners’ access to finance or training. The Guinean entrepreneurship. An intervention in Tanzania that pro- government has put into place important measures ac- moted the expansion of mobile savings accounts among knowledging the female presence in mining, including a women microentrepreneurs and provided them with policy of corporate social responsibility for companies to business-related training led to substantially higher mo- consider the concerns of women, a mining code that sim- bile savings, new businesses and products, more capital ilarly incorporates a gender angle in its deployment, the investment, more labor effort, and better business prac- capacity development of 65 managers in the Ministry for tices (Bastian et al. 2018). Financial technology solutions 39 For more on the World Bank’s Adolescent Girls Initiative, go to https://www.worldbank.org/en/programs/adolescent-girls-initiative. 40 Based on 2017 data from the Famine Early Warning Systems Network, FEWS NET Data Center (https://fews.net/data). Unlocking Women’s and Girls’ Potential 72 The status of women and girls relative to men and boys in Guinea can viably address the collateral constraint for women current support mechanisms; and the societal preferenc- borrowers and can work even in low-tech environments; es in this regard are some additional areas for which data however, financial institutions need to be ready to adopt and analysis (quantitative and qualitative) would help to such technologies (Alibhai et al. 2017b). The Guinean better identify the contextual factors that drive the labor government has already developed some initiatives in market outcomes of women in Guinea relative to men. this area, including the promotion of the constitution of At the same time, the existing data identify quite atypi- Mutuelles Financières des Femmes Africaines, a micro- cal trends in the labor market participation and employ- bank network of women for women, as well as structures ment of women that would be interesting to explore in at the rural and community level accessible to women further detail. These trends include the disproportionate and men (Government of Guinea 2019). participation of women in activities that are traditionally dominated by men (agriculture and mining), the concur- Important information gaps exist in the area of female rent high prevalence of female engagement in economic employment and entrepreneurship in Guinea, and those activities, and early family formation. All would allow for gaps need to be addressed. Data collection on women’s a better understanding of the status of Guinean women time use and needs, for instance, is needed. Their role in and their needs to access economic opportunities on an informal work; the barriers they face to participate in eco- equal footing with men. nomic activities, especially with regard to childcare; the Unlocking Women’s and Girls’ Potential 73 The status of women and girls relative to men and boys in Guinea CHAPTER 6. INCREASE WOMEN’S AND GIRLS’ VOICE AND AGENCY Unlocking Women’s and Girls’ Potential 74 The status of women and girls relative to men and boys in Guinea Decision-making Africa in 2020 (figure 6.1). In 2021, 31 percent of Guinean ministerial positions were held by women, above the Despite promising recent positive changes, the reported average of Western African countries. However, nearly progress in increasing women’s political participation in three-quarters of women ministers were allocated po- the country so far has been slow and insufficient. In the sitions in sectors that, although important, are often past decades, the number of women in Guinean repre- deemed “soft,” such as education, culture, or tourism. In sentative institutions, including the National Assembly addition, and despite the overall increase in the number and ministries, has slightly increased, even though the of women in leadership positions in government, only proportion of seats held by women in the Guinean parlia- 25 percent of those positions were in high-level roles ment is still significantly below the average in the region: (Faleme Conseil 2021). 16.7 percent in Guinea versus 24 percent in Sub-Saharan FIGURE 6.1. PROPORTION OF SEATS HELD BY WOMEN IN NATIONAL PARLIAMENTS (PERCENT) 30 25 25% 20 17% 15 10 5 0 2014 2015 2016 2017 2018 2019 2020 Guinea Sub-Saharan Africa Source: World Bank, World Development Indicators. Several legal reforms show a strong political will to in- March 2020 (UN Women 2021). The new law also foresees crease women’s participation in democratic institutions the alternation between women and men in lists in order in the country. The new (2019) Law of Parity has gone be- to promote the strict implementation of this provision. In yond the previous (2010) provision of a 30 percent quota addition, 5 percent of state funding for political parties in all candidacies for the General Assembly and in district is proportionally distributed to parties that have elected and town councils, establishing the necessity of adopt- women as members of parliament and in communal-mu- ing parity (50/50) in representation at the national and nicipal councils (UN Women 2022). Despite all these pro- subnational levels. The parity rule corresponds to Article visions, Guinea is still one of four countries where the 9 of the amended Constitution, which was approved by proportion of women in the lower houses of parliament the Constitutional Court and adopted by referendum in is the lowest in Sub-Saharan Africa (UN Women 2021). Unlocking Women’s and Girls’ Potential 75 The status of women and girls relative to men and boys in Guinea The enforcement of quotas in many Sub-Saharan Africa grounds that it was contrary to the principle of nondis- countries including Guinea has been traditionally under- crimination. Although the new norm has been made part mined by the absence of sanctions for noncompliance of the Constitution and has been approved by the Court (IDEA 2021). This element is a prerequisite for quotas and by referendum, resistance may still be observed; to be effective in raising effective participation (World a two-thirds majority and again an examination by the Bank 2014a). The lack of appropriate law enforcement Constitutional Court are required to amend the electoral has indeed hindered the success of the Guinean 30 per- law (UN Women 2021). cent quota, and parties not complying with the law have not faced any consequences (Ammann 2020). Experience Deeply rooted cultural, religious, and traditional ste- with parity laws shows that political parties are often reotypes around the role of women in society largely quite unwilling to implement parity if effective sanctions account for the difficulties to make parity in political cannot be imposed. However, the new Guinean law fore- representation a reality in Guinea. Indeed, social norms sees one of the most effective sanctions—the rejection of often reinforce the notion that men are better leaders the list by the Electoral Commission—although the party than women, limiting the capacity for women to aspire concerned may appeal to the competent court (UN Wom- to public roles (World Bank 2014a). Political parties are en 2021). themselves very patriarchal and male-dominated enti- ties (IDEA 2021). The role and visibility of female politi- Financial and safety concerns operate as additional bar- cians are often overlooked and underestimated in the riers to women’s entry into politics. In addition, in many Guinean system. For example, some male politicians still African countries including Guinea, political violence perpetuate the stereotype that women are not suitable presents particular barriers to women’s engagement and for leadership positions because of their lack of educa- political participation. For example, 64 percent of Guin- tion and “professionalism” (Ammann 2020). The very ean women are very concerned about political intimida- institutionalization of political parties in Guinea is by de- tion (IDEA 2021). Financial constraints also operate as a fault male led, excluding women from decision-making barrier to female participation in politics. and placing an additional burden on women to prove their qualifications and competence. As a result, despite Legal and political obstacles prevent the implementation the fact that women constitute the majority of the ordi- of the law of parity. Section 8 of the 2019 Law of Parity nary local party members, female politicians still have stipulates that it can enter into force only once the Elec- to fight for their representation and recognition in the toral Code has been amended and the parity rule has different commissions, committees, and leadership po- been enshrined therein. However, any reform of the Elec- sitions (Ammann 2020). toral Code, as organic law, requires a two-thirds majori- ty in Parliament and the approval by the Constitutional Women’s decision-making within the household also Court. Already in 2017, an attempt was made to change remains constrained. More than one-third (37 percent) the Electoral Code to implement the 30 percent quota, of women aged 15–49 do not participate in decisions which was rejected by the Constitutional Court on the on their own health care, major household purchases, Unlocking Women’s and Girls’ Potential 76 The status of women and girls relative to men and boys in Guinea and visiting family (Guinea DHS 2018). Moreover, many whereas in 2012 more than half of all women reported women report that their husband/partner alone makes that the above-mentioned decisions were made solely decisions about the women’s health (59 percent), about by their husband, in 2018 more women reported making major household purchases (51 percent), and about vis- decisions related to their health and visits to family and its to family or relatives (48 percent) (Guinea DHS 2018) relatives. The limited voice of women within households (figure 6.2). The share of women who report that major results from the combined influence of restricted access household decisions are made solely by their husbands to economic opportunities, gendered social norms, the is relatively higher than in other countries in the region. 41 insufficiency of legal provisions, and weak law enforce- However, some progress has been made in recent years: ment (World Bank 2012a). FIGURE 6.2. SHARE OF GUINEAN WOMEN AGED 15–49 WHO REPORT THAT THESE DECISIONS ARE MADE SOLELY BY THEIR HUSBAND, 2012 VS. 2018 (PERCENT) 51,6 Making large household purchases 51 57 Visits to family and relatives 47,9 65,7 Own health 59 0 10 20 30 40 50 60 70 2012 2018 Source: Guinea DHS 2012; 2018. Gender-based violence (60.5 percent) and women living in a union (55.0 percent) are most vulnerable to physical IPV. By age, young wom- The incidence of different forms of gender-based vio- en aged 15–24 and women aged 25–34 face the highest lence (GBV) is concerningly high in Guinea. More than risk of experiencing physical GBV (60.9 percent and 69.7 one in two women living (or having lived) in a union have percent, respectively). Women with no education are also been affected by GBV at least once during their married more vulnerable to GBV than those with at least some life (54.9 percent), and about 63 percent of women have level of educational attainment. Furthermore, nationally, experienced intimate partner violence (IPV) at least once nearly 29.3 percent of women have experienced at least in their lives (Republic of Guinea 2017). Single women one form of sexual violence since the age of 15, with the 41 For example, only 25.0 percent of women in Angola, 30.3 percent of women in Ghana, 32.0 percent in Malawi, and 26.0 percent in Ugan- da report that health-related decisions are made exclusively by their husbands. At the same time, decision-making around women’s health is exercised exclusively by men in 74.9 percent of households in Burkina Faso, 73.9 percent in Chad, 64.1 percent in Côte D’Ivoire, 80.0 percent in Mali, and 74.0 percent in Senegal. Data from the Angola Demographic and Health Survey (DHS) 2015–16, Burkina Faso DHS 2010, Chad DHS 2014-15, Côte D’Ivoire DHS 2011–12, Ghana DHS 2008, Guinea DHS 2018, Mali DHS 2018, Malawi DHS 2015, Sene- gal DHS 2017, and Uganda DHS 2016. Unlocking Women’s and Girls’ Potential 77 The status of women and girls relative to men and boys in Guinea share higher in urban (35.4 percent) than in rural (25.8 47 productive days of work per year (Vara-Horna 2015). percent) areas. In recent years several disturbing cases In the long term, GBV imposes a high economic cost on of sexual violence against very young girls and even tod- society, resulting in important gross domestic product dlers have been reported in the media, raising concerns (GDP) losses (UN Women 2016a).42 over this type of event (Amnesty International 2021; Chérif 2021; Diallo 2020; Guirassy 2022). A very high pro- Legal and policy gaps, poor enforcement and institution- portion of women reports experiencing psychological al capacity, and deeply entrenched cultural norms and violence, with rates higher in urban (76.8 percent) than practices continue to represent major obstacles to effec- in rural (62.5 percent) areas. Finally, women previously tive GBV prevention and response in Guinea. Some forms married (12.2 percent) or currently married (9.8 percent) of GBV can be prosecuted under the Criminal Code when experience the highest rates of economic violence (Re- classified as murder (Articles 282–89), rape (Article 321), public of Guinea 2017). indecent assault (Articles 322–25), or assault and battery (Articles 295–305). However, there is no standalone law GBV has serious adverse effects at the individual and so- that criminalizes domestic abuse or sexual harassment. cietal levels. It has severe impacts on individuals’ health The existing legislation also fails to include the obligation and well-being, including their physical health as well to provide restraining (also called “protective”) orders, as psychological trauma and stress, elevated risk of de- criminal penalties, and a definition of domestic violence pression, anxiety, and social isolation (Adamu and Adin- that includes physical, psychological, sexual, and eco- ew 2018). Women survivors of GBV may suffer reduced nomic/financial harm. High acceptance rates of GBV and ability to work, loss of wages, higher medical costs, job strong social stigma on seeking help and reporting cas- instability, lack of participation in regular activities, and es of IPV discourage women from accessing justice and limited ability to care for themselves and their children bringing their cases to court, which further undermines (IWPR 2017; WHO 2017). Some studies show negative any legislative efforts in the country. When survivors seek links between exposure to domestic violence and the justice, gaps in legislation and weak enforcement mech- school performance of children (IWPR 2017). Physical anisms make it improbable. Cultural and social norms and sexual violence increase the risk of miscarriages and view cases of GBV as family matters, and do not consid- infant mortality (Musa et al. 2019). In extreme cases, GBV er it acceptable for a wife to file a complaint against her results in the victim’s death. Beyond its physical impacts, husband. Many of these cases are thus settled informally GBV affects the human capital potential of survivors, re- (Groggel, Sow, and Gnimassou 2020). Indeed, Guinean ducing their labor market participation, civic activities, civil society organizations have recently come together to level of educational attainment, and participation in denounce the high rate of impunity of this type of crime decision-making. For example, a study from Peru has in the country and the various structural weaknesses of found that women victims of GBV lose between 43 and the criminal justice chain in some of the cases that have 42 The study from Ghana estimates that direct losses of GBV amount to 0.9 percent of annual GDP, because of the direct losses inflicted by GBV in the dimensions of work absenteeism, deteriorated labor productivity, and reduced household production and care work. (Raghavendra et al. 2019). Similarly, it is estimated that productivity and employment losses due to IPV constituted 1.2 percent of GDP in Uganda in 2011 (Duvvury et al. 2013). The study from Namibia reveals that losses from GBV reach 6 percent of national GDP, includ- ing costs associated with lost economic output, health services, legal aid, social welfare and personal costs, and other indirect costs (Breuer 2021). Unlocking Women’s and Girls’ Potential 78 The status of women and girls relative to men and boys in Guinea made it to the media. According to these organizations, norms). About 17.0 percent of men and 22.5 percent of GBV crimes in Guinea are rendered banal by the inaction women believe that rape within a couple does not exist, of justice institutions (Guineematin.com 2022). essentially justifying marital rape and sexual IPV (Repub- lic of Guinea 2017). Going out without the husband’s per- In Guinea, social acceptance of GBV, and IPV specifical- mission or neglecting children are considered by many as ly, is high among both men and women. Child abuse is justified reasons for committing IPV, with more women widely accepted by both men and women in Guinea, than men supporting these statements (table 6.1). These and to a higher degree than violence against women. On results show wide acceptance of and tolerance for IPV in average, 75 percent agree that teachers are allowed to Guinean society, potentially due to traditions and social hit children, and nearly 80 percent of respondents toler- norms that assert male dominance over women in mari- ate parents beating their children as part of upbringing. tal relationships. In contrast to women and children, men According to a 2016 survey on gender-based violence are culturally and socially protected from violence. Nei- in Guinea, nearly one in three adults (32.3 percent) ap- ther women nor men themselves accept violence against proves of verbal violence by the husband against his wife, men. Overall, only 10 percent of women and 5 percent of and about 40 percent tolerate physical violence (Repub- men accept the idea that a woman is entitled to insult lic of Guinea 2017). The share of people who justify wife her husband, and only 33 percent of men and 7 percent beating goes up to 58 percent in the Afrobarometer (Stat of women accept the idea that a woman is allowed to hit View International 2019)43 (see the next section on social her husband (Republic of Guinea 2017). TABLE 6.1. SHARE OF GUINEAN ADULTS WHO PARTIALLY OR TOTALLY AGREE WITH THE GIVEN STATEMENT, BY GENDER (PERCENT) Statements Men Women Total A man is entitled to insult his wife 25.4 38.9 32.3 A man is allowed to hit/beat his wife 33.4 45.5 39.6 A woman is entitled to insult her husband 4.5 10.7 7.7 A woman is allowed to hit/beat her husband 3.3 6.5 4.9 Rape within a couple does not exist 17.1 22.5 19.9 It is normal for a woman to report cases of IPV against her husband 28.8 24.3 26.5 It is normal for parents to forcibly marry their daughters 8.4 16.6 12.7 Source: Republic of Guinea 2017. 43 Enquête Afrobarometer Round 8 en Guinée, 2019 https://www.afrobarometer.org/wp-content/uploads/2022/02/afrobarometer_sor_ gui_r8_fr_2020-08-25.pdf Unlocking Women’s and Girls’ Potential 79 The status of women and girls relative to men and boys in Guinea Other barriers include service provision for female sur- The parallel existence of customary and religious laws vivors, limited data on GBV, and lack of information on with statutory law in Guinea creates confusion and of- women´s rights. As in many other Sub-Saharan African ten undermines women´s rights. Traditional laws often countries, Guinea’s health, psychosocial and protection supersede the formal legal framework. For example, the systems are constrained and lack a survivor-centered customary forms of levirate and sororate44 continue to be approach. Survivors indeed encounter barriers includ- practiced, preventing widows from receiving inheritance ing the financial cost of services, limitations in quality, entitlements. Customary practices prohibit women from and unclear and uncoordinated referral pathways. The inheriting land, which they can hold only on a usufruct confidentiality of patients in the health system is not ad- basis. Divorce laws generally favor men in awarding cus- equately protected, and health service providers are not tody and dividing communal assets, and legal testimony trained to respond to these cases. Constraints related to by women carries less weight than that of men (Grog- data collection, analysis, and sharing on GBV persist. GBV gel, Sow, and Gnimassou 2020). Traditionally, Guinean survivors’ limited awareness of their rights contributes to men have been responsible for communicating with au- perpetuating the impunity of perpetrators (Groggel, Sow, thorities, ensuring any legal or official proceedings, and and Gnimassou 2020). keeping the documents of all family members. This tra- dition is perceived as a mechanism for control within the Discriminatory laws reduce women’s decision-making household. Although women are allowed to register vital power in society and within households. The Civil and La- events, they are not empowered to do so, and in practice bor Codes still contain several discriminatory provisions. men always carry out registrations (Andreev 2019). For example, women may not remarry in the same way as men. In the Civil Code of Guinea, Articles 246, 336, and Social norms 337 stipulate that women can remarry only after a wait- ing period of 130 days before contracting a new marriage, Gender norms and beliefs in Guinea follow traditional but this stipulation does not apply to men. Over the past and conservative patterns dictating rigid roles for wom- decade several countries (Bolivia, Ecuador, Malta, and en, men, boys, and girls. Cultural beliefs construct “real Nicaragua) granted women the same rights to remarry men” to be the heads of the household, the breadwin- as men. In Sub-Saharan Africa, half of the countries in the ners who make decisions about the use of resources and region (24) give women and men equal rights to remarry. investments in the household (Ministère de l’Action So- Economies that follow international best practices in this ciale, de la Promotion Féminine et de l’Enfance 2015); area include Angola, Ghana, Nigeria, and Sierra Leone. notions of the “real woman” are conflated with submis- Rwanda recently (in 2020) reformed the legal framework siveness, pride, dignity, taking care of the family, and by removing the waiting period imposed on women to domestic duties (Ammann 2016). The prevalence of patri- remarry after divorce as well as the 300-day waiting pe- archal social norms is evident from the 2016–18 Afroba- riod for widows. rometer survey responses (Stat View International 2019). 44 Levirate involves the forced replacement of a deceased husband by his brother, and sororate involves the forced replacement of a deceased wife by her sister. Unlocking Women’s and Girls’ Potential 80 The status of women and girls relative to men and boys in Guinea For example, about half of respondents believe that responsibility for the household and children; 36 percent in times of job scarcity men should have priority and believe that women should not have the same rights as that it is better for families if women have the main men to own and inherit land (figure 6.3). FIGURE 6.3. GENDER-RELATED BELIEFS AND ATTITUDES IN GUINEA, 2016–18 (PERCENT) Women and men have equal chances to inherit land Women and men have equal chances to earn income Women and men have equal chances of getting a paid job Girls and boys have equal opportunities to get education It is justified for men to beat their wives It is better for a family if a woman has the main responsibility for taking care of the home and children Women should not have the same rights as men to own and inherit land When jobs are scarce, men should have more rights to a job Men make better political leaders than women and should be elected rather than women 0 10 20 30 40 50 60 70 80 90 100 Source: Afrobarometer 2018. The widespread nature of polygamy in the Guinean soci- that the first wife agrees to it (Diallo 2019). The share of ety additionally signals the entrenched nature of strongly individuals in polygamous households in Guinea is 26 patriarchal norms in the country, and the submission of percent—lower only than Burkina Faso, Mali, The Gam- women to men. The prevalence of polygamy—in the form bia, Niger, and Nigeria. The practice is more common of polygyny, when a man marries multiple women—in among Muslim households (Kramer 2020; figure 6.4). In Guinea is one of the highest in the world. Although pro- polygamous households, first wives are seen as the most hibited by civil law until the vote of the new civil code, powerful, and they can often exploit or even abuse the polygamy was still recognized under customary law and younger ones. In general, mothers-in-law are also able to religious practices, and legal restrictions were therefore exert control over the behavior of their new daughters- rarely enforced. The new Civil Code of 2019 legalized the in-law, particularly when it comes to household care and right of men to choose to be in a polygamous marriage— health-related behaviors (Groggel, Sow, and Gnimassou with a maximum of four wives and under the condition 2020). Unlocking Women’s and Girls’ Potential 81 The status of women and girls relative to men and boys in Guinea FIGURE 6.4. SHARE OF INDIVIDUALS LIVING IN POLYGAMOUS HOUSEHOLDS IN SUB-SAHARAN AFRICA, BY RELIGION (PERCENT) Burkina Faso Mali The Gambiat Niger Nigeria Guinea Guinea–Bissau Senegal Togo Chad Cameroon Côte d'Ivoire Benin Central African Republic Congo, Dem. Rep. 0 5 10 15 20 25 30 35 40 45 50 Total Muslim Folk Source: Kramer 2020. Unlocking Women’s and Girls’ Potential 82 The status of women and girls relative to men and boys in Guinea Box 6.1. Why are investments in women’s agency a priority for Guinea? As seen in the assessment, the agency of Guinean women, or their capacity to decide and act on their decisions, remains generally very poor. Indeed, it is the lack of female em- powerment in households, communities, and the entire Guinean society that explains to a large extent the observed gaps across all other dimensions of well-being. Poor agen- cy is for instance reflected in the low representation of women in politics compared to that of men (only 17 percent of seats in parliament are occupied by women), despite the existing political will and advanced legal framework; in their lack of capacity to make decisions within the household (three out of five women report that their husband/ partner alone makes decisions about the women’s health); and in the high incidence of the various forms of gender-based violence, or GBV (about 63 percent of women have experienced intimate partner violence at least once in their lifetime). The drivers of such poor agency include weak formal and informal institutions: (1) legal gaps with regard to women’s empowerment and the poor enforcement of the existing ones; and (2) clashing customary laws or practices shaped by patriarchal social norms that relegate women to second-class citizens. Improving women’s agency is crucial for shrinking gender disparities, advancing gen- der equality, and empowering women (Donald et al. 2020). Increased agency for wom- en leads to improvements in women’s welfare and that of their children (World Bank 2012a). On the contrary, limited decision-making power within families is associated with increased risks for women of experiencing intimate partner violence, higher vulner- ability to financial and economic dependence, reduced civil activities and educational attainment, and higher maternal and infant mortality (Hou and Ma 2013). An important expression of women’s agency is women’s political participation and their ability to fully engage in public life (Markham 2013). When more women are elected to office, policy making increasingly reflects the priorities of families, women, and exclud- ed groups (Chattopadhyay and Duflo 2004; Iyer et al. 2010; Klugman et al. 2014). Wom- en’s political participation results in tangible gains for democracy (Markham 2013). Unlocking Women’s and Girls’ Potential 83 The status of women and girls relative to men and boys in Guinea Box 6.1. Why are investments in women’s agency a priority for Guinea? (continued) GBV also can lead to large losses in terms of education, employment, and civic life for the women who experience it. There is evidence from various countries that episodes of GBV force women to lose time from paid work; therefore, GBV negatively affects businesses through reduced productivity, absenteeism and increased leave and sick days, and vic- tims exiting the workforce (IFC 2020; ILO 2021). Children also suffer the consequences of GBV in the family. Moreover, GBV entails important economic costs for society overall. The economic costs of lost productivity due to domestic violence conservatively range from 1.2 to 2.0 percent of gross domestic product across countries (WHO 2013). Strategic direction 5: Promote and individuals promoting this agenda could also be in- women´s participation in decision- strumental. In addition, attention must be paid to other making, and prevent GBV concurrent barriers to women’s political participation, such as constrained financial resources, political violence Improving women’s agency is essential for women’s targeted at women, and adverse party dynamics based ability to build human capital, access economic oppor- on deeply rooted patriarchal social norms and views tunities, ensure their children’s welfare, and exercise about the roles of Guinean women and their ability to decision-making in the home and in the society (box lead. The removal of registration fees for women, or the 6.1). Despite the clear legislative move toward promot- provision of additional free airtime and billboards, can ing female presence in Guinean political institutions, help raise potential financial barriers, while helping to further efforts will be required for that move to trans- promote female candidatures (UN Women 2021). In addi- late into larger numbers of women in politics. Given the tion, measures to start changing negative party dynamics past difficulties in implementing the 30 percent quota include stipulating the obligation of political parties to mandated by law, it remains to be seen whether the re- implement annual capacity and leadership programs for cently established parity provision will ever be effective. women, instituting female quotas for the governing bod- For that purpose, and for the law to be applicable, the ies of political parties, and establishing institutions such procedures required for the inclusion of this rule in the as a female leadership institute or a commission for the Electoral Code need to be completed—and the potential monitoring of the implementation of the law (UN Women resistance circumvented. Doing so will require informa- 2021). Ultimately, a large-scale change in the prevailing tion and awareness raising and advocacy efforts with social norms that tend to exclude women from public de- all agents involved. Support to women’s organizations cision-making spaces needs to take place in the country. Unlocking Women’s and Girls’ Potential 84 The status of women and girls relative to men and boys in Guinea Legal reforms that grant women equal rights to those in changing behavior and social norms, making violence of men in the family sphere are necessary to encourage against women unacceptable and encouraging reporting their decision-making capacity within the household. of such incidents (WHO 2009). In Sub-Saharan Africa, 31 Reforms introduced by the new Civil Code in 2019 elim- out of 48 countries—including Benin, Chad, Guinea-Bis- inate restrictions on women’s capacity to be head of sau, and Senegal—have laws specifically addressing do- household or to get a divorce in the same way as men mestic violence. It is critical that the law defines domestic (Articles 260, 287, and 305–19). Despite those reforms, violence as violence between spouses, within the family discrimination between men and women is still pres- or members of the same household, or in interpersonal ent in Guinean statutory law. Articles 246, 336, and 337 relationships; includes IPV; and provides for the neces- of the Civil Code would need to be repealed or replaced sary protection of women and members of the family, through an amendment allowing both men a women to as per international standards and good regional and remarry without limitations—or, at least, establishing the global practices. Implementation mechanisms should same limitations for both men and women. In addition, be put in place and key stakeholders well informed of an amendment to Article 695 of the Civil Code could be the new regulations to ensure strong implementation introduced to establish that, absent a legal will, both (by police, health sector, justice system, and so on). The spouses have equal rank and rights to inherit assets from legislation should include, at a minimum, the ability to deceased partners regardless of whether children exist. obtain restraining (also called “protective”) orders, crim- Importantly, polygamy (in the form of polygyny, when inal penalties, and a definition of domestic violence that a man can marry several women), which was common includes both physical and mental harm. Madagascar of- practice although prohibited by statutory law before the fers a good recent regional example of reform: in 2019, it 2019 Civil Code, has since become legal, allowing a man enacted Law No. 2019-008 on Combating Gender Based to have up to four wives when he states that choice in Violence. the celebration of his first marriage and the wife agrees. Customary laws need to be taken into account as a com- Implementing stand-alone legislation on criminalization ponent of the plurinational” legal framework. Statuto- of domestic violence is another important step toward ry laws granting equal rights to men and women and women’s empowerment and elimination of GBV. Glob- customary norms are often contradictory in Guinea, al evidence suggests that women who live in countries for instance with regard to inheritance rights, divorce, with domestic violence laws have 7 percent lower odds or registration of vital events. Indeed, even when dis- of experiencing violence compared with women living crimination in statutory law in the area of family is no in countries without such laws (Klugman et al. 2014). longer common, overall discrimination in institutions is Moreover, the granting of protection orders for survi- considered very high in the Organisation for Economic vors is associated with a small but significant reduction Co-operation and Development’s Social Institutions and in prevalence rates of domestic violence (Dowling et al. Gender Index for Guinea. Customary law, as a living body, 2018). Additionally, legislation can be a key instrument needs to develop over time, adjusting to new standards Unlocking Women’s and Girls’ Potential 85 The status of women and girls relative to men and boys in Guinea and needs, for instance to comply with human rights. Context, however, is critically important in determining Also, in the area of GBV and access to justice by women, the outcomes of collective agency, and changes in social the customary legal and justice system may often take norms often follow a slow, nonlinear trajectory. When precedence over statutory law, leading to the impunity treated with flexibility and within context, collective of perpetrators. Harmonization efforts between custom- action processes are vital contributors to efforts to pro- ary and statutory law are required. Many African consti- mote the agency and empowerment of women (Evans tutions recognize the validity of customary law without and Nambiar 2013). resolving the conflict between some of its provisions and human rights. In this regard, the Organisation for Strengthening the focus on GBV prevention will be nec- Economic Co-operation and Development recommends essary moving forward. The most obvious or possibly eliminating regulations that exempt customary law from immediate interventions with promising results (the legal prohibitions of discrimination, such as those includ- low-hanging fruit) would include the introduction of be- ed in constitutions (OECD 2021). Engaging with commu- havioral elements in economic empowerment or support nity and religious leaders in efforts to raise awareness programs (the “Plus” element), or of gender components and change social norms will also be necessary. in school-based programs covering GBV, romantic rela- tionships, or sexual and reproductive health (see box Over the last years, a number of initiatives focusing on 6.2). The former, as proven by the experience of South customary law developments have emerged, pointing to Africa and Tanzania, can reduce the risk of IPV among the important role of communities and judiciary institu- participant women; the latter, as shown by the PREPARE tions in this endeavor. Customary justice institutions are program in South Africa, can help to change mindsets best placed to develop customary law and therefore have and behaviors regarding GBV among young people. a crucial role to play in protecting human rights. Courts Short-term targeted interventions aimed at changing can also help in this effort, by ensuring that customary the behaviors of couples or parents can be effective in laws conform to international human rights instruments preventing some forms of GBV. Examples from the re- and contribute to the promotion of gender equality. gion include the Indashyikirwa program in Rwanda and Two recent groundbreaking decisions in Botswana and the REAL Fathers intervention in Uganda. Longer-term South Africa show how this could work (Ezer 2016; Fom- large-scale interventions that challenge social norms and bad 2014; Ndulo 2011). The South African Constitutional perceptions of GBV are also required. Community mobili- Court overturned the customary rule of male primogen- zation programs can be effective in reducing prevalence iture in a dispute as to whether a woman could succeed rates and promoting zero tolerance toward violence her late father as a tribal chief (Mireku 2010). In addition against women, as shown by the experience of TOSTAN in to the courts, women’s collective action, through self- Senegal and SASA! In Uganda. Meanwhile, when they are help groups, cooperatives, and associations, can also part of a broader set of interventions, media and edutain- play a key role in securing justice for women in the face ment campaigns can contribute to reducing prevalence of contradicting customary and statutory mechanisms. rates and tolerance of GBV. Unlocking Women’s and Girls’ Potential 86 The status of women and girls relative to men and boys in Guinea Box 6.2. What works to prevent GBV in Sub-Saharan Africa: International examples for Guinea Economic support and empowerment programs “Plus” and school-based interven- tions. The TEVAW program in Tanzania, which combined microfinance provision with a behavioral component, has shown positive impacts on intimate partner violence (IPV) and enhanced behavior among participant women (Messersmith et al. 2017). The MAI- SHA microfinance and training program, also in Tanzania, reduced women’s risk of ex- periencing physical and/or sexual IPV by a quarter, improved attitudes toward IPV, and increased women’s self-confidence (Kapiga et al. 2019). The Stepping-Stones and Creat- ing Futures intervention in South Africa—which combined livelihood (training on setting livelihood goals, coping with crises, saving and spending, getting and keeping jobs, and managing work expectations) and social empowerment (gender-based violence [GBV], sexual and reproductive health, communication skills, sexual behavior)—has also re- sulted in considerably less physical IPV and economic IPV perpetration by men (Gibbs et al. 2017). Nevertheless, more evidence from the region is needed to determine the effectiveness of combined social and economic empowerment interventions. A multi- component, school-based intervention in South Africa, PREPARE, has led to a reduction of IPV victimization and to the formation of safer intimate partnerships among adoles- cents (Matthews et al. 2017). Couple therapy and/or counseling and parenting interventions. IPV decreased among couples who participated in the intensive couple training within the Indash- yikirwa program in Rwanda (Stern and Heise 2019). The REAL Fathers intervention in Uganda, which combined a mentoring program for young fathers, awareness-raising activities, and community celebrations, led to the decrease of IPV and violence against children (Ashburn et al. 2017). Moreover, participants in the Ethiopian male norms ini- tiative showed increased support for gender equitable norms, and the program led to a decrease in the percentage of reported instances of IPV (Pulerwitz et al. 2015). Sever- al generations can benefit simultaneously from parenting interventions, because such interventions can reduce the likelihood that children will experience or perpetrate GBV later in life, therefore promoting a less violent society in general (Kerr-Wilson et al. 2020). Evidence indicates that programs that work only with men and boys are usually inef- fective in addressing GBV, because these programs often experience high dropout or offender attrition rates and sometimes have unintended negative consequences such Unlocking Women’s and Girls’ Potential 87 The status of women and girls relative to men and boys in Guinea Box 6.2. What works to prevent GBV in Sub-Saharan Africa: International examples for Guinea (continued) as the normalization of aggressive behaviors (Kerr-Wilson et al. 2020). The best known intervention in this field is the Transforming Masculinities program in the Democratic Republic of Congo, which aimed to engage and equip faith leaders to be catalysts and led to a substantially lower prevalence of physical and sexual IPV 28 months after base- line (Le Roux et al. 2019). Community mobilization interventions and media/edutainment campaigns. Such interventions most often target households or entire communities to foster a positive so- cial norm change. The evidence shows that such programs are most effective when they involve city or village residents and promote learning and attitude change through dia- logue and mobilization. The SASA! intervention in Uganda, which combined community mobilization activities with the training of professionals, led to a 64 percent reduction in the prevalence of children witnessing IPV in their homes and improved parent-child relationships (Kyegombe et al. 2014). The Unite for a Better Life program in Ethiopia used the traditional coffee ceremony to deliver a series of group-based sessions on root causes of IPV and gender stereotypes and unequal roles in the home. The program was effective in reducing men’s perpetration and women’s experience of physical and/or sexual IPV (Sharma et al. 2020). The community-based program TOSTAN in Senegal has contributed to the reduction of GBV among participating communities—from 86 per- cent to 27 percent (Diop et al. 2004). These interventions are also effective in reducing risk factors of GBV (e.g., substance abuse, limited women’s decision-making, etc.) and enhancing protective factors, such as better communication skills and decreased tol- erance towards GBV (Diop et al. 2004When part of a wider strategy, media campaigns and edutainment can help to boost social norm change around GBV. In Uganda, a mass video campaign significantly reduced the incidence of GBV, and the MTV series Shuga led to a reduction in men´s support for GBV (Banerjee et al. 2019). The protection of survivors and their access to key sup- health outcomes of GBV survivors and reduce the risk of port services also requires improvements. Institutional revictimization (Falb et al. 2014). Adequate referral sys- , including psycho- service delivery for survivors of GBV​ tems are crucial. In many cases, women GBV survivors re- social support, shelters, or hotlines, is required. There is fuse to seek justice or file legal complaints because they growing evidence that combined approaches to identify- fear stigma, isolation, revictimization, or pressure from ing and providing counseling to women experiencing IPV their families, and/or because they lack trust in law en- in health settings can be an effective strategy to improve forcement authorities. Lack of functioning mechanisms Unlocking Women’s and Girls’ Potential 88 The status of women and girls relative to men and boys in Guinea and protocols on the duties of police, court officials, and for formulating, implementing, and enforcing laws; and social workers further discourage survivors from report- their voices must be better interpreted in the justice sys- ing. Evidence from different countries shows that the tem. Reducing physical and financial barriers for wom- representation of women in courts, the police, or health en to access justice, improving awareness of their rights, care services can have a positive impact on help-seek- providing gender training to all staff involved, and setting ing and reporting of GBV (Miller and Segal 2019). Spe- up services only aimed at women survivors are alterna- cialized protection services that are sensitive to gender tive measures to be considered. All-women’s justice cen- and GBV issues can be more effective than those that do ters, for example, which mostly employ female officers not take these considerations into account. In addition, and where GBV survivors receive assistance in filing a one-stop centers for integrated services and support can complaint, have strongly increased the rates of reporting be effective in increasing women’s access and meeting of GBV, as shown by the experience of Ghana, South Afri- their needs. Women’s groups and collective action can ca, and Uganda (Kavanaugh, Sviatschi, and Trako 2018). play a pivotal role in building momentum for progressive reform. Strong women’s movements are associated with The Guinean government has already started to put into more comprehensive policies on violence against women place some of the measures highlighted here. It has es- (Klugman et al. 2014). tablished GBV centers in health services and special cells in police offices and research units at the national level. Justice systems need to be more responsive and acces- It has also created the Office for the Protection of Wom- sible to women’s needs. Improving women’s access to en and Girls, and started a training program for defense justice might encourage women to report cases of GBV and security forces. Similarly, a training curriculum on without the fear of being misunderstood or revictimized GBV has been integrated into the program for primary (World Bank 2012a). Even when GBV cases are brought and secondary education (Government of Guinea 2019). to court, numerous obstacles stand in the way of trans- These efforts should be assessed and, depending on parent and fair court proceedings. For example, efforts their results, deepened, modified, replicated, scaled to report GBV might lead to lengthy judicial proceedings, up, or complemented by other actions that can help to lawsuits that do not amount to the damages suffered, maximize positive impacts. An integrated comprehensive reliving trauma, or even bringing more attention to the strategy/action plan in this area would help to bring co- traumatic experience in the first place. Women need to be herence and systematization. better represented within the organizations responsible Unlocking Women’s and Girls’ Potential 89 The status of women and girls relative to men and boys in Guinea CHAPTER 7. CONCLUSIONS Unlocking Women’s and Girls’ Potential 90 The status of women and girls relative to men and boys in Guinea Gender equality is a key foundation of peaceful and sus- pregnancy, and female genital mutilation/cutting. In fact, tainable growth that contributes to poverty reduction the practice of female genital mutilation/cutting is nearly and shared prosperity. Although gender equality mat- universal in Guinea, which further compromises women’s ters on its own as a fundamental human right, efforts to health outcomes and bears important implications for promote women’s rights and well-being can also provide their well-being. gains for the entire Guinean society. Global and region- al evidence has consistently shown that empowering Lack of investment in human capital not only increases women and girls reduces poverty incidence and food in- risks of poverty among women but also strongly affects security (Mulugeta 2021), boosts economic growth and their potential to participate actively and productively in productivity (Aguirre et al. 2012), and enhances invest- economic opportunities. Guinean women participate in ments in children’s human capital (Allendorf 2007; An- the labor market to a lower extent than men, and over- drabi, Das, and Khwaja 2011; Dumas and Lambert 2011). all female labor force participation in Guinea remains Moreover, delaying child marriage and early pregnancy is lower that the Sub-Saharan African average. Even when associated with better health outcomes and employment women do participate in the labor market, the quality of opportunities, and lower risks of gender-based violence, employment available to them remains low. Most of the or GBV (Bergstrom and Özler 2021; Malhotra and Elnakib jobs available to women can be characterized as vulnera- 2021). Eliminating GBV and female genital mutilation/ ble, seasonal, informal, and/or occasional. Occupational cutting and improving women’s agency are also likely to segregation and earning differentials between men and bring macroeconomic benefits and prevent intergenera- women persist, further limiting women’s chances to en- tional poverty transmission (Rui and Nie 2021; Uzoama- gage in quality employment. Guinean women also ap- ka, Gerald, and Jude 2016; Wei et al. 2021). Particularly pear to be disadvantaged in access to and ownership of in Guinea, closing gender gaps in education and agricul- productive assets and finance. tural productivity and reducing fertility are estimated to have a significant impact on the national economy, Additionally, Guinean women experience many limita- resulting in up to a 10 percent increase in gross domes- tions with respect to their agency and encounter dif- tic product per capita by 2035 compared to the baseline ferent forms of GBV. Family formation occurs at a very (World Bank 2019a). early age for most Guinean women, and the country has one of the highest rates of child marriage worldwide. Guinean women and girls continue to have low potential Child marriage in Guinea is the result of socio-cultur- to realize their human capital in education and health. al norms, beliefs, and perceptions of gender roles; the Despite some progress in the past decades in primary practice bears important implications for the ways in and secondary enrollment rates among both girls and which women participate in the economic activities and boys, the overall rates of school completion remain con- exercise their agency. Early marriage increases women’s cerningly low, especially among rural girls and women. risks of encountering domestic violence, the incidence Girls are significantly more likely than boys to be out of of which is particularly high in Guinea. Finally, Guinean secondary school, often for gender-specific reasons. In women are largely constrained in their agency and bar- terms of health, Guinea has also one of the highest rates gaining powers, which is manifested in their exclusion of maternal mortality worldwide, which is likely linked from household decision-making and low representation to the high incidence of child marriage, adolescent in the political institutions. Unlocking Women’s and Girls’ Potential 91 The status of women and girls relative to men and boys in Guinea To narrow existing gender gaps, five strategic directions 5. Increase women’s and girls’ voice and agency and have been identified for Guinea. A set of recommenda- eliminate all forms of GBV. tions is provided for each strategic direction, based on the regional evidence of effective interventions and pro- In light of the multidimensional aspects of gender equal- grams. These strategic directions include a set of actions ity—and the existing disparities across endowments, to improve and strengthen the legal environment. The economic opportunities, and agency—it will be crucial five strategic directions are as follows: to initiate comprehensive, multisector efforts to address existing gender gaps. Those efforts will need to be in- 1. Improve the status of girls’ education. formed by existing regional evidence and data. For that 2. Enhance access to maternal, sexual, and repro- purpose, more efforts to collect, analyze, and dissemi- ductive health services. nate sex-disaggregated data are to be undertaken in or- 3. Postpone early family formation and adolescent der to inform and design relevant, evidence-based, and pregnancy. data-driven policies. 4. Improve women’s economic opportunities and access to quality employment. Unlocking Women’s and Girls’ Potential 92 The status of women and girls relative to men and boys in Guinea APPENDIX A. ENTRY POINTS FOR LEGAL REFORM TO EXPAND WOMEN’S EMPOWERMENT IN GUINEA Women, Business and the Law 2021 measures the laws Marriage indicators. The reforms recommended range and regulations across several areas that affect women’s from those designed to give women more choice in em- economic opportunities in 190 economies. From the ba- ployment decisions (by eliminating restrictions on the sics of movement in the community to the challenges of types of jobs they may have or the industries they may working, parenting, and retiring, the data offer objective work in) to making it less expensive for companies to and measurable benchmarks for global progress toward hire women (by pushing the cost of maternity leave from gender equality. Guinea has an overall Women, Business private employers to the state, and by enacting paternal and the Law score of 76.3 points, 5.3 points above the and parental leave policies). They also seek to improve Sub-Saharan Africa average of 71. Guinea outperforms legislation in areas affecting the financial well-being of 25 regional economies, ties 1 country (Seychelles), and women, by allowing them to inherit in the same way as is outperformed by 21 economies. men, by accounting for periods of childcare in the calcu- lation of pensions, and by allowing them to remarry in Guinea has opportunities to reform and close the gap the same way as men. Passing legislation that specifically with global leaders in four of the regulatory areas mea- addresses domestic violence is also recommended. See sured by Women, Business and the Law. Those four table A.1 for a more detailed discussion about reform op- areas are covered by the Pay, Assets, Parenthood, and portunities. Unlocking Women’s and Girls’ Potential 93 The status of women and girls relative to men and boys in Guinea TABLE A.1. REFORM OPPORTUNITIES FOR GUINEA, FROM WOMEN, BUSINESS AND THE LAW Entry points Recommended legal reforms Pay Does the law mandate equal remuneration for work of equal value? Yes Pay Can a woman work the same night hours as a man? Yes 1. Allow women access to employment Are women able to work in the same industries and in jobs deemed dangerous? No in all jobs and all sectors and industries. Assets Do men and women have equal ownership rights to immovable property? Yes Assets Do sons and daughters have equal rights to inherit assets from their parents? Yes 2. Grant spouses equal inheritance rights Do male and female surviving spouses have equal rights to inherit assets? No Does the law grant spouses equal administrative authority over assets during marriage? Yes 3. Provide for the valuation of nonmonetary contributions Does the law provide for valuation of nonmonetary contributions? No Parenthood Is paid leave of at least 14 weeks available to mothers?  Yes Parenthood Does the government pay 100% of maternity leave benefits?  No 4. Introduce legislation or amendments Is there paid leave available to fathers and parental leave?  No for maternity leave benefits to be fully paid by the government. Is the dismissal of pregnant workers prohibited? Yes 5. Introduce paid parental and paternity leave. Marriage Is a married woman not legally required to obey her husband? Yes Marriage Can a woman legally be “head of household” or in the same way as a man? Yes 6. Allow women to remarry in the same Can a woman obtain a divorce and remarry in the same way as a man?  No way as men. Is there legislation specifically addressing domestic violence? No 7. Draft, enact, and implement specific Is there a specialized court or procedure for cases of domestic violence? 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