Introduction

Guinea-Bissau faces significant challenges in building and sustaining human capital, which refers to the knowledge, skills, and health that people accumulate over their lives. These elements are critical for individuals to realize their potential and for countries to achieve long-term economic growth and poverty reduction. The country’s fragile political situation, recurring instability, and limited institutional capacity have constrained progress in social and economic development.

Human capital outcomes in Guinea-Bissau are among the lowest in the world. Children born in the country today are expected to be only a fraction as productive as they could be if they enjoyed full health and education. Low school completion rates, high child mortality, malnutrition, and poor learning outcomes are widespread, reflecting systemic weaknesses in service delivery and governance.

The Human Capital Review provides an in-depth assessment of the state of human capital in Guinea-Bissau, identifying key constraints across the life cycle, and examining the underlying systems that shape human capital outcomes. It also offers policy recommendations aimed at improving the efficiency, equity, and quality of human development investments.

The report’s focus on the life-cycle approach highlights the interconnectedness of interventions at different stages of life from early childhood to adulthood and the need for coordinated efforts across sectors such as health, education, nutrition, and social protection. By understanding the current state of human capital and the drivers behind it, policymakers and development partners can better prioritize and design interventions that will yield the greatest returns.

Assessing human capital across the life cycle in Guinea-Bissau

Human capital accumulation in Guinea-Bissau is constrained at every stage of the life cycle. From before birth through adulthood, children and youth face multiple barriers that limit their health, nutrition, and educational attainment. These deficits are cumulative, meaning disadvantages in early years tend to compound over time, making it harder to recover later in life.

Early childhood (0–5 years) 

Guinea-Bissau has one of the highest under-five mortality rates globally. Many of these deaths are preventable, caused by conditions such as malaria, diarrheal diseases, respiratory infections, and complications during birth. Chronic malnutrition is widespread; a large share of children under five are stunted, impairing their cognitive and physical development. Access to quality maternal and child health services is limited, with shortages of skilled health personnel, essential medicines, and functioning health facilities.

Early childhood development is further hindered by low rates of exclusive breastfeeding, poor dietary diversity, and inadequate access to safe water and sanitation. Stunting, anemia, and frequent illness reduce the ability of young children to thrive physically and mentally. Preschool enrollment is low, especially in rural areas, limiting children’s readiness for primary education. `

School-age children and adolescents (6–17 years) 

School participation declines sharply with age. While most children enroll in primary school, completion rates are low and many students are overage for their grade due to late entry or grade repetition. Quality of education is undermined by unqualified teachers, high absenteeism, poor infrastructure, and a lack of learning materials.

Learning outcomes are poor, with many students unable to achieve basic literacy and numeracy by the end of primary school. This “learning crisis” is more pronounced among children from poor households, rural areas, and girls who face cultural barriers and the risk of early marriage or pregnancy. Adolescents often leave school early to work, care for siblings, or marry, reducing their chances of acquiring the skills needed for productive employment.

Youth and young adults (18–24 years) 

Transition from school to work is challenging. Many young people leave school without adequate skills, and the labor market offers few formal employment opportunities. Most youth work in subsistence agriculture or informal sector jobs with low pay and poor working conditions.

Early childhood development is further hindered by low rates of exclusive breastfeeding, poor dietary diversity, and inadequate access to safe water and sanitation. Stunting, anemia, and frequent illness reduce the ability of young children to thrive physically and mentally. Preschool enrollment is low, especially in rural areas, limiting children’s readiness for primary education

Vocational and technical training opportunities are limited, often not aligned with labor market needs, and lack adequate resources. This mismatch between skills and job opportunities fuels underemployment and contributes to cycles of poverty.

Cumulative effects 

The deficits observed at each stage of the life cycle reinforce one another. Poor nutrition and health in early childhood lead to reduced cognitive capacity and lower school performance. Inadequate education limits opportunities in the labor market, while low incomes make it harder to invest in the next generation’s human capital. Breaking this cycle requires interventions that are coordinated across sectors and sustained over time.

Human development systems required to strengthen human capital

Strengthening human capital in Guinea-Bissau requires a systemic approach that addresses weaknesses in the delivery of health, education, nutrition, and social protection services. The quality and reach of these systems determine whether investments in human capital translate into real improvements in people’s lives.

Health system

The health system suffers from chronic underfunding, limited infrastructure, shortages of trained personnel, and weak supply chains for essential medicines and vaccines. Health facilities are unevenly distributed, with rural areas particularly underserved. Out-of-pocket costs remain a barrier to accessing care, especially for the poorest households.

Improving the health system requires sustained investments in primary health care, stronger governance, better planning and budgeting, and robust monitoring systems. Training and retaining skilled health workers, expanding access to essential medicines and equipment, and strengthening disease prevention programmes are critical steps. Integrating nutrition interventions into maternal and child health services is essential to tackle stunting and other forms of malnutrition.

Education system

The education system faces shortages of trained teachers, inadequate infrastructure, and low availability of teaching materials. Governance challenges and inefficiencies in resource allocation reduce the effectiveness of spending. Teacher absenteeism is common, and professional development opportunities are limited.

Improving education outcomes will require reforming teacher recruitment, training, and management; investing in safe and inclusive school infrastructure; and ensuring equitable access to learning materials. Curriculum reform and assessments are needed to improve learning quality, along with targeted interventions to keep girls in school and support children with disabilities.

Nutrition and food security

Malnutrition is both a health and a development challenge. Weak coordination among ministries, limited funding, and inadequate community-level services hinder progress. Many households lack access to diverse and nutritious foods, especially in rural areas.

Strengthening food security involves boosting agricultural productivity, improving market access, and promoting nutrition-sensitive agriculture. Social and behavior change campaigns can encourage breastfeeding, dietary diversity, and hygienic practices.

Social protection system 

Coverage of social protection programmes is low and benefits are often insufficient to lift households out of poverty. Administrative systems for identifying and enrolling beneficiaries are underdeveloped, and financing is largely donor-dependent.

Building a robust social protection system will require establishing a national registry of vulnerable households, expanding cash transfer programmes, and integrating social protection with health, education, and nutrition interventions. This can create a safety net that supports families while enabling them to invest in their children’s human capital.

Cross-cutting systems and governance 

Human capital outcomes are closely linked to governance and institutional capacity. Weak public financial management limits the ability to plan and execute effective programmes. Data systems are fragmented and often unreliable, making it difficult to monitor progress and adjust policies.

Strengthening governance means improving budget planning, increasing transparency and accountability, and building capacity for evidence-based policymaking. Better coordination across ministries and with development partners can ensure resources are used efficiently and interventions are aligned.

Key recommendations

Improving human capital in Guinea-Bissau requires a combination of urgent short-term actions and sustained long-term reforms. The following recommendations focus on interventions that can deliver the greatest impact across the life cycle and strengthen the systems that underpin human development.

– Invest early in child health and nutrition

• Expand access to quality maternal and child health services, especially in rural areas.

• Increase coverage of essential vaccinations and ensure uninterrupted supply chains for medicines and vaccines.

• Integrate nutrition services into primary health care, including screening for malnutrition, promotion of exclusive breastfeeding, and dietary counselling.
• Improve access to clean water and sanitation to reduce disease burden and malnutrition.

– Strengthen education quality and access

• Ensure universal access to pre-primary education to improve school readiness.

• Reduce repetition and dropout rates by addressing barriers such as school costs, distance, and gender-based constraints.

• Enhance teacher recruitment, training, and supervision, with a focus on child-centred and inclusive pedagogy.

• Provide adequate learning materials and improve school infrastructure, including safe sanitation facilities.
• Introduce regular learning assessments to monitor progress and guide curriculum reforms.

– Expand opportunities for youth and improve skills development

• Develop and expand vocational and technical training programmes aligned with labour market needs.

• Facilitate school-to-work transitions through apprenticeships, internships, and entrepreneurship support.
• Promote digital skills and access to technology to prepare youth for a changing job market.

– Build a comprehensive and inclusive social protection system

• Establish a national social registry to identify and target vulnerable households.

• Expand cash transfer programmes and link them with education, health, and nutrition services.
• Ensure predictable and sustainable financing for social protection to reduce dependence on external funding.

– Strengthen governance, financing, and data systems

• Increase domestic financing for health, education, and social protection, ensuring funds are allocated efficiently and equitably.

• Improve public financial management, transparency, and accountability to build trust and enhance service delivery.

• Strengthen national data systems to enable regular monitoring of human capital indicators and evidence-based policymaking.
• Foster coordination among government ministries, development partners, and civil society to align priorities and pool resources effectively.

– Adopt a life-cycle approach in policy design

• Integrate interventions across sectors and life stages to break the cycle of poor health, low education, and poverty.
• Ensure that policies and programmes are inclusive, addressing the needs of the most disadvantaged, including women, children with disabilities, and those in remote areas.

By implementing these recommendations, Guinea-Bissau can accelerate progress towards building a healthier, better-educated, and more productive population, laying the foundation for sustainable economic growth and poverty reduction.