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Health in Angola

Health in Angola is rated among the worst in the world. Only a fraction of the population receives even rudimentary medical attention.

From 1975 to 1992, there were 300,000 civil war-related deaths. The overall death rate was estimated at 240 per 1,000 in 2002.

The HIV/AIDS prevalence was 3.90 per 100 adults in 2003. As of 2004, there were approximately 240,000 people living with HIV/AIDS in the country. There were an estimated 521,000 deaths from AIDS in 2003.

Health infrastructure

The National Health Service is run by the Ministry of Health, the Provincial Governments which run Provincial Hospitals and the Municipal Administrations which run Municipal Hospitals, Health Care Units and Posts. The Municipal Administrations are leading the primary healthcare network. Services are free, but very limited in rural areas. Medicine is regulated by the General Health Inspection and the National Directorate of Health which manage the National List of Essential Medicines. Medicinal products are regulated by the National Pricing System. Tendering for medical products is run by the Centralized Medicine Purchase Authority which also distributes medicine.[1]

History

USAID reported that the Angolan government has not had much success in developing an effective health care system since the end of the 27-year-long Angolan Civil War in 2002. According to USAID, during the War as many as 1 million people were killed, 4.5 million people became internally displaced, and 450,000 fled the country as refugees.[2] Due to lack of infrastructure and rapid urbanization, the government has been unable to promote programs that effectively address some of the basic needs of the people. Health care is not available in much of the country.[2]

Some improvements were made after the end of the Civil War. According to UNICEF reports in 2005, 2% of the nation's public expenditures were allotted to health care. That number increased after 2005. Larger problems include the shortage of doctors, the destruction of health care facilities throughout the country, and disparities between rural and urban primary care availability.[3] Public spending on health decreased after 2014.

Census data reported by the CIA reveals that Angola has very few physicians to attend to the medical needs of its population. It is estimated that there are about 0.08 physicians per 1,000 people in Angola.[4] Due to the length of the Angolan Civil War, nearly an entire generation of Angolans was not given the opportunity to receive any education. This has led to a dramatic decrease of health workers and added to the poor maternal health problem. In response to the shortage of health workers, Cuban physicians are currently working in the country to improve health overall, as well as to focus on improving maternal health.[5]

The health care system has felt the social effects of the War. Due to the large number of people who were unable to receive an education during the War, today, educated medical personnel, administrators, and other needed positions in the governmental system are not able to be filled. The population of Angola has lost nearly an entire generation of educated personnel. This education gap has repercussions that have been felt throughout the society and especially in the health field.

As of 2012, 54% of the population had access to an improved water source and 60% had access to improved/shared sanitation.

In September 2014, the Angolan Institute for Cancer Control (IACC) was created by presidential decree, and it will integrate the National Health Service in Angola.[6] The purpose of this new center is to ensure the health and medical care in oncology, policy implementation, programs and plans for prevention and specialized treatment.[7] This cancer institute will be assumed as a reference institution in the central and southern regions of Africa.[8]

Health status

Life expectancy

The 2014 CIA estimated average life expectancy in Angola was 51 years.[9]

Period Life expectancy in
Years
Period Life expectancy in
Years
1950–1955 31.4 1985–1990 41.5
1955–1960 32.5 1990–1995 42.2
1960–1965 34.1 1995–2000 44.7
1965–1970 36.0 2000–2005 50.0
1970–1975 38.1 2005–2010 55.6
1975–1980 40.0 2010–2015 60.2
1980–1985 40.9

Source: UN World Population Prospects[10]

Endemic diseases

Angola lies in the yellow fever endemic zone. Cholera incidence is low.

Malaria

Malaria in Angola is very prevalent in the northern part of the country due to the climate and appears more seasonally in the south. The majority of the population lives in the northern areas, in cities such as Lunada. Malaria is a huge concern for maternal health, contributing about 25 percent of the total maternal mortality alone. In 2009, UNICEF, NMCP, WHO, and other organizations partnered together in an effort to reduce the malaria burden.[11]

In 2008, the President of the United States Obama announced the Global Health Initiatives. One of these Initiatives includes the Malaria Operational Plan, which is a program that allocates funds to be used in order to improve health in Angola and other African countries afflicted with malaria. In Angola, the Malaria Operational Plan was implemented to decrease the number of women suffering from malaria and improve maternal health. Angola was one of the first countries to receive aid and to have programs implemented to reduce the risk of malaria, as well as increase the number of healthy pregnancies.[11]

Infectious diseases

Due to Angola's location, the climate is ideal for many tropical diseases. Angola has a narrow coastal plain that rises into a high plateau in the country's interior. Rain forests are prevalent in the north, and in the south, the land is dry. The CIA reports that malaria and schistosomiasis are prevalent in the country.[4]

These diseases and others, such as tuberculosis and especially HIV/Aids, increase the complications and dangers faced by women during pregnancy.[12] The incidence of tuberculosis in 1999 was 271 per 100,000 people.

In 2014, Angola launched a national vaccination campaign against measles, extended to every child under ten years old in all 18 provinces in the country.[13] The measure is part of the Strategic Plan for the Elimination of Measles 2014–2020 created by the Angolan Ministry of Health which includes strengthening routine immunization, proper dealing with measles cases, national campaigns, introducing a second dose of vaccination in the national routine vaccination calendar and active epidemiological surveillance for measles. This campaign took place together with the vaccination against polio and vitamin A supplementation.[14]

HIV/AIDS in Angola

Angola has a large HIV/AIDS infected population. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated adult prevalence at the end of 2003 at 3.9% – over 420,000 infected people. Angola's 27-year civil war (1975–2002), deterred the spread of HIV by making large portions of the country inaccessible. Angola was thus cut off from most contact with neighboring countries that had higher HIV infection rates. With the end of the war, transportation routes and communication are reopening, therefore enabling a greater potential for the spread of HIV/AIDS. Current statistics indicate that the border provinces, especially certain areas bordering Namibia and the Democratic Republic of the Congo, currently have higher prevalence than the rest of the country.[15]

Unhealthy individuals and populations pose a higher risk of infections when exposed to pathogens. Sexually transmitted diseases, including HIV/AIDS, are no exception to this rule. Stillwaggon states that many of the populations in Sub-Saharan Africa have a high prevalence of malnutrition, malaria, parasite infections, and schistosomiasis. These health conditions increase an individual's susceptibility of contracting HIV/AIDS. In that region, social conditions also play a major role in HIV transmission. Poverty, inadequate nutrition, unclean water, poor sanitation, and unsafe health care all play a major role in the prevalence of AIDS.[16]

Maternal health

Angola represents one of the highest maternal death rates in the world.[12] Results vary, but the estimated maternal mortality ratio (MMR) toward the end of the Civil War was between 1,281-1,500 maternal deaths to 100,000 live births.[17] Despite the improvements that have been made, the Human Development Index for 2011 shows a poor level of maternal health in Angola. A high level of adolescent fertility and low use of contraceptives for women of all ages was reported. This is observed by the high total fertility rate. These factors contribute to an elevated risk of health problems during pregnancy and childbirth.[18]

In 2004 the infant mortality was estimated at 187.49 per 1,000 live births, the highest in the world. Immunization rates for one-year-old children in 1999 were estimated at 22% for diphtheria, pertussis, and tetanus and 46% for measles. Malnutrition affected an estimated 53% of children under five years of age as of 1989.

References

  1. ^ "Pricing & Reimbursement- Angola". Lexology. 16 November 2018. Retrieved 25 December 2018.
  2. ^ a b [www.usaid.gov]. Accessed April 10, 2012
  3. ^ [www.unicef.org]. Accessed April 30, 2012.
  4. ^ a b CIA Factbook April 9, 2012
  5. ^ [www.youtube.com]. Accessed 9, 2012
  6. ^ Novo instituto oncológico de Angola quer ser referência em África, Notícias ao Minuto (Source: Lusa Agency), September 9, 2014
  7. ^ Novo instituto oncológico de Angola quer ser referência em África, Diário Digital (Source: Lusa Agency), September 9, 2014
  8. ^ Novo instituto oncológico angolano quer ser instituição de referência no continente, Ver Angola, September 11, 2014
  9. ^ "CIA - The World Factbook Life Expectancy". Cia.gov. Retrieved 2014-06-24.
  10. ^ "World Population Prospects – Population Division – United Nations". Retrieved 2017-07-15.
  11. ^ a b USAID. Angola Malaria Report. President's Malaria Initiative. Angola. 2011.
  12. ^ a b Jacobsen, Kathryn. Introduction to Global Health. Jones and Bartlett Publishers,2008.
  13. ^ Over 30,000 Children Vaccinated Against Measles in Huíla, All Africa, September 30, 2014
  14. ^ Angola lança vacinação nacional contra sarampo, Notícias ao Minuto (Source: Lusa Agency), September 18, 2014
  15. ^ "Health Profile: Angola" Archived 2008-08-16 at the Wayback Machine. USAID (December 2004). This article incorporates text from this source, which is in the public domain.
  16. ^ Stillwaggon, Eileen. Feminist Economics. Race, Sex, and the Neglected Risks for Women and Girls in Sub-Sahara Africa. 2008.
  17. ^ Pettersson, Karne. Christensson, Kyllike. Freitas, Engracia da Gloria Gomes de. Johansson, Eva. Adaptation of health care seeking behavior during childbirth: Focus group discussions with women living in the suburban areas of Luanda, Angola. Health Care for Women International, 2004. Accessed April 9, 2012
  18. ^ Human Development Report 2011 Tables. Human development statistical annex