Angola: The State Of Health And Healthcare System - Term Paper Example

Angola: The State Of Health And Healthcare System Introduction: Angola Angola has recently ended its forty years of civil war that heavily damaged its economic infrastructure, according to the World Health Organization's (WHO) report in 2005. This war inevitably affected the state's healthcare system and delivery too (WHO, 2005). This paper aims to provide a brief country profile for Angola and to describe its state of health, healthcare system and delivery, health priorities, and nursing implications. Location/Geography Angola is located in the Southwestern region of Africa. Around its borders are Namibia, the two Congos, and Zambia. Its terrain consists of agricultural highlands, with a large savanna in the east and south; and rain forest strips in the north and the enclave of Cabinda (U.S. Department of State, 2011). Angola has a tropical climate. Population According to the WHO (2011), the total population of Angola is 18,498,000. Its main ethnic groups are: “ Ovimbundu 37%, Kimbundu 25%, Bakongo 13%, mixed racial 2%, European 1%” (U.S. Department of State, 2011). Around 17% of its population are children 5 years old and below. Approximately 42% live in the rural areas. The official language in Angola is Portuguese and the Portuguese compose the largest non-Angolan population. Government Angola has a republic government system. A new constitution was enacted on February 5, 2010 and three days after, President dos Santos established a new government. The new constitution made a party list system where citizens can vote for a party, instead of a single candidate, and the president will be the head of the winning party’s list (U.S. Department of State, 2011). It created a new office of the vice president, and removed the position of the prime minister. The next presidential and parliamentary elections are projected to occur in 2012. Economy Angola is rich in oil, gas, and diamonds, but remains in the lower rings of 10% of numerous socioeconomic indicators (U.S. Department of State, 2011). GDP growth in 2009 did not improve, though higher GDP projections are expected for the coming years (U.S. Department of State, 2011). An estimation of Angola’s oil reserves showed it to range from 9.5 billion to 13.5 billion barrels (U.S. Department of State, 2011). Crude oil composed around 50% of Angola's GDP, as well as 95% of its exports, and 72% of government revenues in 2010 (U.S. Department of State, 2011). Angola also generates 40,000 bpd of locally refined oil. State of Health in Angola Key Determinants of Health Angola ranks 160th in the UNDP Human Development Index (WHO, 2005, p.1). The main determinants of health are the financial resources of the country, the availability of healthcare professionals, access to healthcare delivery centers, and the continuing effects of decades of war (WHO, 2005, p.1). Key Health Status Indicators Life expectancy in Angola is 40 years. Angola has one of the highest infant and under-five mortality rates, which are approximated to reach 195 and 265 per 1,000 live births per year respectively (WHO, 2005, p.1). The primary causes of mortality are malaria, acute respiratory and diarrheal diseases, tetanus and malnutrition (WHO, 2005, p.1). The maternal mortality rate is around 1,700 per 100,000 live births (WHO, 2005, p.1). This significantly high rate is connected to common pregnancy-related conditions that are not immediately and sufficiently treated, since less than 30% of deliveries are done in healthcare institutions, which means that more than 70% are done at homes and other conditions where risks are higher (WHO, 2005, p.1).Malaria and hepatitis have been also found to be correlated with maternal mortality (WHO, 2005, p.1). Despite the high maternal mortality rate, Angola's fertility rate is 6.8 and currently is the world's second highest fertility rate (WHO, 2005, p.1). Burden of Disease The country suffers from a high burden of communicable diseases, primarily “malaria, tuberculosis, sleeping sickness, onchocerciasis, leprosy and diarrheal and respiratory diseases” (WHO, 2005, p.1). Malaria is Angola's leading cause of morbidity and mortality and poses a large threat to the whole population, specifically children under five and pregnant women (WHO, 2005, p.1). Malaria causes “35% of all cases and 70% of all deaths” in yearly reports (approximated at 35,000) affect under-five children (WHO, 2005, p.1). In addition, from October 2004 and July 2005, Angola suffered from the biggest outbreak of Marburg haemorrhagic fever that took the lives of 329 out of 374 people who had been affected (CFR 88%) (WHO, 2005, p.1). Chronic malnutrition rates reach the rates of 40 to 50% (WHO, 2005, p.2). The WHO estimated that roughly 45% of children under five have not reached the right height level and more than 30% are also underweight (WHO, 2005, p.2). HIV/AIDS is also a concern, with an infection rate of 3.9 % (WHO, 2005, p.2). Culture/Traditional Medicine Though Angola has modern medicine and hospitals, Angolan communities continue to significantly rely on traditional healers for their health care (Oyebade, 2007, p.138). Numerous Angolans depend on traditional healers called kimbanda to perform healing ceremonies, where all forms of illnesses could be cured, such as fever and stomach aches, as well as more complicated diseases or health problems, such as sterility and mental disorders (Oyebade, 2007, p.138). Traditional healing emphasizes purifying and cleansing human bodies, so that illnesses could be removed (Oyebade, 2007, p.138). Treatment usually involves chants and natural medicine that is made of boiled root, stems, and leaves (Oyebade, 2007, p.138). Traditional healers also complete healing through chanting, which concerns communing with the spirits in the other world (Oyebade, 2007, p.138). Healing rituals could be done either in secret or in the open, depending on the illness and the traditions of the people (Oyebade, 2007, p.138). Some rituals even require community or family participation to complete the cleansing process (Oyebade, 2007, p.138). Healthcare System and Delivery Due to numerous decades of under-financing and transferring of national capacities to other social sectors, reconstruction of the healthcare system in Angola remains difficult and complex (WHO, 2005, p.2). Grave inequalities exist in resource allocation and health services provision across the country (WHO, 2005, p.2). In fact, merely 2% of public expenditure is invested on health (WHO, 2005, p.2). Expansive infrastructure destruction (65% of peripheral health units) demands significant investment (WHO, 2005, p.2). Approximately greater than 50% of public health expenditure is given to referral and central facilities (WHO, 2005, p.2). Access to health care is severely curtailed to 30 or 40% of the population and many people have to walk far to reach them (WHO, 2005, p.2). Health service coverage also relies on external support and restrained to cities and towns where the private sector has not been regulated (WHO, 2005, p.2). Workforce inequity is pervasive with 70% of doctors located in the capital, while there is a shortage of nurses and primary health care workers (WHO, 2005, p.2). Around 5 physicians are only available per 100,000 people (WHO, 2005, p.2). Governmental Health-Related Agencies, Health Regulatory Organizations and Nursing Organizations The Ministry of Health is primary public provider of health care in Angola. The country greatly relied on international and private relief organizations, such as USAID, WHO, and UNICEF (Collelo, 1991; USAID, n.d.). Government health programs also failed to reach majority of the population (Collelo, 1991). The country also heavily depended on foreign medical assistance, since Angolan medical schools provided slow instruction and there was lack of education and training for different healthcare workers that the country needed (Collelo, 1991). Health Priorities The main health priorities are the following: 1) Strengthening the ability of the health system to deliver quality mother and child health services and improving the skills of health professionals (WHO, 2005, p.2). 2) Advancing a comprehensive health program for infant child and adolescents (WHO, 2005, p.2). 3) Improving the capability in developing and managing health promotion strategies (WHO, 2005, p.2). 4) Reinforcing the capacity of the Ministry of Health in surveying and monitoring communicable diseases and for emergency preparedness and response (WHO, 2005, p.2). 5) Promoting HIV/AIDS prevention and control (WHO, 2005, p.2). 6) Enhancing health financing and social protection by reinforcing management and financial systems so that inefficiencies can be identified and removed (WHO, 2005, p.2). 7) Training more healthcare professionals and spreading them across the country (WHO, 2005, p.2). Nursing Implications Angola's healthcare concerns implies the following for nurses: 1) There is a need to increase training for local nurses to augment nurse shortage; 2) The government should tie up with international nursing organizations to recruit foreign nurses for the meantime, as the state trains new nurses; 3) Nurses need to improve knowledge of and sensitivity to cultural practices and beliefs to attain legitimacy, especially in areas where Angolans highly value and practice traditional healing and medicine; and 4) Nurses have to be prepared to handle maternity and childhood diseases, since they are prevalent in Angola. Conclusion Angola requires a wide-scale improvement of its healthcare system and delivery. Its primary diseases are malaria, tuberculosis, sleeping sickness, onchocerciasis, leprosy and diarrheal and respiratory diseases. Nurses are in shortage and there is a need to work with international nursing organizations to augment them. Nurses should be prepared of handling maternity and childhood diseases, since they are pervasive in Angola. References Oyebade, A. (2007). Culture and Customs of Angola. Connecticut: Greenwood Publishing. U.S. AID. (no date). Angola. Retrieved from http://www.usaid.gov/ao/essential_services.html U.S. Department of State. (2011). Angola. Retrieved from http://www.state.gov/r/pa/ei/bgn/6619.htm Collelo, T., ed. (1991). Health and Welfare. In Angola: A Country Study. Washington: GPO for the Library of Congress. U.S. Library of Congress. Retrieved from http://countrystudies.us/angola/83.htm World Health Organization. (2005). Angola. Health Action in Crises. Retrieved from http://www.who.int/hac/crises/ago/background/Angola_Dec05.pdf World Health Organization. (2011). Angola. Countries. Retrieved from http://www.who.int/countries/ago/en/ Read More