Angola

World Health Organisation

Background

The World Health Organization (WHO) is operating in Angola since 15 May 1976. WHO country office is lead by an international Resident Representative, appointed by the regional director for Africa with official agreement from the government. The main role of WHO is to provide technical assistance to improve health situation in the country. Three years after the end of the civil war, on April 2004, WHO is fully committed to working very close with Angola in improving its health indicators, stands amongst the worst in the world. Currently, only 44,5 percent of the population is covered by health services. The maternal mortality rate in the country is estimated in 1850/100,000 per live births. In Luanda, the capital, only 62% of the pregnant women have access to health facilities. The mortality rate among children under 5 year-old is estimated in 250/1,000 live births, meaning that about 181.000 children are dying per year. For example, severe malnutrition affects about 45% of children under 5 years old.

The country is also vulnerable to the occurrence of epidemics. Due to poor sanitation and water supply systems in presence of shrunk and ill preventive programmes, including low routine immunization coverage, Angola has over the past years faced various outbreaks: poliomyelitis in 1999, with a total of 1,117 children affected; meningitis with 1263 cases with 152 deaths until October 2002 and Marburg with 318 deaths from October 2004 to 19 July 2005. Malaria also remains the main cause of morbidity, with 40 percent of the children dying in the first five years of life and one forth of maternal mortality associated to malaria conditions. The lethality rate in hospitals stands at between 15% and 30%. Malaria accounts for around 80% of the demand for care and 50% of the in-patients in health services. According to national reports, Acute Respiratory Diseases and Diarrhoeal Diseases are the 2 nd most causes of morbidity and mortality. All together, according to the recent assessment carried out in the provinces by MOH and partners, the three diseases account for approximately 70 percent of all causes of morbidity and 60 percent of all causes of mortality. Concerning Tuberculosis (TB) control, t he main challenge is to expand DOTS strategy to treat 85% of a total of 27,000 the TB patients registered in the country.

Factors such as the massive destruction of the health network, the deterioration of the socio-economic structures, the great population movements, and HIV/AIDS threat, are all at the root of worsening health status of the people in Angola. Some of these factors further explain the poor capacity of the services to detect and treat other chronic diseases, including Leprosy and Trypanosomiasis. However, the low level of HIV infection (2,8% among pregnant women), the end of the war and the high national and international commitment placed Angola in good to scale up rapid interventions to contain the spread of HIV/AIDS, such as information dissemination, education and disease prevention measures. According to official data, about 65% of the health units were destroyed during the war, especially in the peripheral areas. In the last 10 years, thanks to an high level commitment and very strong partnership and coordination, Angola achieved tremendous results in its Expanded Programme for Immunization (Polio, measles, tetanus, etc.). Concerning polio, for instance, Angola registered the last wild virus case on September 2001and, to date, no case has been reported. This was reached thanks to the strong political commitment and leadership of MOH, good organization by the national stakeholders both at the central and provincial level and the strong work done by the partners among WHO, UNICEF, Rotary International, USAID, CDC Atlanta, CORE, UK, the Netherlands, and NGOs in general are included.

Objectives:

• To strengthen Implementation of priority Health Programmes (Health Systems Development; Human Resources; Communicable Diseases Prevention and Control; Immunisation and vaccine development; Reproductive Health; Emergency and Humanitarian Action; Health Promotion; Communicable disease research; Food Safety; Nutrition; Health and environment; Child and adolescent health; Essential medicines; Essential health technologies; Policy making for health in development; Epidemic alert and response; Emergency preparedness and response;
• To support rehabilitation of the municipal health system in order to improve delivery of quality health services at national, provincial and municipal level;
• To strengthen HIV/AIDS control and surveillance activities to increase awareness and to stop the spread of this disease.
• To reinforce advocacy to include health in the national agenda for development and in the fight for poverty reduction;
• To promote sustainable livelihoods, good governance and decentralization.