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

USAID has 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.^[1] 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, specifically, is not available for many of the people in the country.^[1]

Some improvements have been made regarding the health care system in Angola since the end of the Civil War. However, many problems continue to exist. According to UNICEF reports in 2005, 2 percent of the nation’s public expenditures were allotted to health care. That number has increased since 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.^[2]

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.^[3] 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.^[4]

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.^[5] 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.^[6] This cancer institute will be assumed as a reference institution in the central and southern regions of Africa.^[7]

Health status

Life expectancy

The 2014 CIA estimated average life expectancy in Angola was 51 years.^[8]

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.^[9]

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.^[9]

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 shistosomiasis are prevalent in the country.^[3]

These diseases and others, such as tuberculosis and especially HIV/Aids, increase the complications and dangers faced by women during pregnancy. ^[10] 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.^[11] 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.^[12]

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. ^[13]

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.^[14]

Maternal health

Angola represents one of the highest maternal death rates in the world.^[15] 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.^[16] 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.^[17]

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