During the 1980s and 1990s, the population in Guinea nearly doubled. The health care system worked to expand coverage to more people, but the structure was disorganized, relied heavily on international agencies, and failed to improve health for the population. The Ministry of Health in Guinea realized that its health reforms would not result in improved, much less sustained health unless the capacity of the public health system and of the communities it served was developed so that they themselves could implement an integrated approach. MSH assisted in this development by increasing access to health services by strengthening the access to, quality of, and demand for services in the project's target area.