In their joint staff advisory note on the second annual progress report of Guinea-Bissau's poverty reduction strategy paper (PRSP), the IMF and World Bank teams note that the country has made progress with respect to most indicators covering education and health. The teams base their assessment on figures obtained from the Multiple Indicators Cluster Survey (MICS) conducted by the UN Children's Fund (UNICEF) in 2010. According to the survey, primary school enrolment rates rose from 42% in 2000 to 45% in 2006, subsequently increasing to 65% in 2010. A similar trend is observed in gender equality in education, with the ratio of girls' to boys' enrolment expanding from 0.67 in 2000 to 0.83 in 2006 and to 0.94 in 2010. Linked to this trend, the illiteracy rate among women of 15-24 years has decreased significantly, from 83% in 2000 to 72% in 2006 and to 61% in 2010. In the health sector, the results have also been impressive, with child mortality falling from 223 deaths per 1,000 births in 2006 to 155 in 2010. Infant mortality followed the same pattern, falling from 138 deaths per 1,000 births in 2006 to 104 in 2010. Finally, the cholera awareness and prevention programme led by the national health authorities and their non-governmental organisation (NGO) partners has been effective, insofar as there have been no new outbreaks in either 2009 or 2010.

The IMF-World Bank report attributes these improvements to a broadening in access to social services-due, in turn, to reforms carried out by the government, backed up by the contribution of NGOs and the private sector, as well as demand-side developments. The IMF-World Bank teams point, in particular, to the elimination of school fees and the introduction of school feeding programmes in most primary schools, which had a major impact on enrolment rates, notably on girls' enrolment in rural areas. Large-scale vaccination campaigns, effective distribution of bed nets and improvements in health facilities also had positive effects with regard to infant mortality and maternity services. The joint staff advisory note underlines, in particular, that an incentive premium for healthcare workers operating in isolated rural areas, retroactive to 2009, had been paid in full and that these incentives had been formally incorporated into pay scales.

While the IMF and World Bank teams paint a positive picture in overall terms, they also note that political instability has repeatedly compromised the ability of successive governments to provide essential public goods and services and has contributed to the exodus of qualified personnel. Political discontinuity has also weakened government ownership of the PRSP process and promoted inconsistency in government actions. The teams therefore emphasise the need for improved political stability, together with ongoing support from development partners.