Country Project (Angola)

Abstract

The countries all over the world are inhabited by people who have different cultures that define them. The countries also have their health systems that have been put in place by several stakeholders to ensure that all the people in the country live healthy lives. Angola is a country that is located on the west-coast country of south-central Africa. It has several minerals and petroleum reserves, and it is one of the fastest growing economies in the world although the growth of its economy is largely uneven. According to the report by WHO, Angola has a life expectancy of 60.3 for male, 64.9 for females and 62.6 average. The culture of Angola is hugely influenced by the Portuguese possibly because they colonized the country then imparted most of their ideas on the people living in the country. The main language spoken in the country is Portuguese and the main religion is the Roman Catholic Christianity. The culture was mostly Bantu but was mixed with the Portuguese culture after they were colonized. The native communities in the country also have their own diverse culture that affects the way they lead their lives in the country. The local dialects include Ovimbundu, Ambundu, Bakongo, Chokwe, Ovambo and other peoples. This paper is an assessment of the people that live in Angola, their culture as well as their healthcare system.

Introduction of Angola

            Angola is a country that is located on the west-coast country of south-central Africa. It is the seventh country in Africa on the basis of size and it is bordered by the Democratic Republic of Congo to the North, Namibia to the south, Zambia to the east and the Atlantic Ocean to the west. Its capital city is called Luanda and it has an exclave province that of Cabinda which borders the democratic republic of Congo and the Republic of Congo. It has several minerals and petroleum reserves, and it is one of the fastest growing economies in the world although the growth of its economy is largely uneven (Tvedten, 2018). The country is made up of somewhat sterile and sparsely watered coastal plain that extends inwards for a distance of between 50 to 160 kilometers (Tvedten, 2018). Angola has a belt of mountains and hills which is parallel to the coastline. There is a plateau behind the belt which shows the interesting landforms that are found in the country as well as a beautiful landscape with a high aesthetic value. The county experiences alternating dry and rainy seasons meaning that the people can practice agriculture. A microclimate is created on the coastal side of the country by the Benguela sea current creating the same climate like the one that is found in Baja California or Peru. The southern part of the country towards the capital city is semi-arid. The country has a short rainy season that lasts from February to April. The winters are mild whereas the summers are hot. The northern part of the country has a cool, dry season. The prevailing winds in the country have a big influence on the climate of the country. The winds include S.W., W and S.S.W monsoon winds. Angola has a beautiful terrain which consists of four principle natural regions namely the arid coastal lowland, green hills, and mountains, high plateau as well as the rising inland from the coast into a great escarpment (Gerald, 1978). Angola has a population of 31,027,869 as of Thursday, September 30, 2018 at 05:25pm, according to the latest estimates from the United Nations, which represents 0.4% of the world’s population. The country ranks 46 on the list of countries by population. The population density of the country stands at 24 people per square kilometer. 37.6% of the people in the country live in the urban centers. The median age of the people is 16.5 years (“Angola Population (2018) – Worldometers,” n.d.). According to the report by WHO, Angola has a life expectancy of 60.3 for male, 64.9 for females and 62.6 average and has a birth rate of 5.69 births per woman as per the census that took place in the year 2016 (WHO, 2018).

Angola has had problems with their environment which have been aggravated by the war that has gone on in the county for 30 years. The main problems in the country include the abuse of land, the loss of forests, desertification and impure water. The environmental problems have been the course of some of the diseases that affect the people in the country. The productivity of the land has continuously been threatened by desertification. The forests are declining at a high rate hence the forest cover may be depleted if the urgency is not taken up to control the logging and the destruction of the forests. The adverse environmental conditions have led to the decline of the health of the citizens in the country (Tvedten, 2018). The health of the people is highly dependent on the environment which they live in. The country is found in the tropics means that many of the people in the country suffer from the tropical diseases such as malaria. The environment in the country is conducive for the spread and the thriving of the Plasmodium parasite.

Health indicators in Angola

            The country has a total population of 31,027,869 people who are distributed throughout the country. Gross national income per capita of the country is 6. The data on the probability of the people in Angola dying before attaining five years old is higher compared to the rich and the developed countries. The government spends approximately 239 billion US dollars which is a lot and could be used for performing other tasks if the health of the people in the country was okay (“Angola – Under-five mortality rate (2016) – knoema,” n.d.). The health of people is very delicate, and more efforts are required if the people in the country have to be healthy. 3.3% of the gross domestic product in Angola is spent on the taking care of the health of the citizens in the country. The diseases that cause more deaths in the country include Tuberculosis, malaria as well as the non-communicable diseases. The diseases are more severe in the people living with HIV and Aids in the country. Angola has a large population of people living with HIV and AIDS. It was estimated that 280,000 people were living with HIV/AIDS in Angola (WHO, 2018). HIV/AIDS is not only a problem for Angola but it is a problem that affects the whole world. HIV can be transmitted from Angola to the United States of America hence it is a global concern. The visitors coming to Angola are also likely to suffer from malaria hence there is a need to address the health concern in the country. In the year 37.4% of the children in Angola breastfeed exclusively for the first six months of their lives from 2015 to 2016 (“Angola – Under-five mortality rate (2016) – knoema,” n.d.). The number is still low meaning that there is need to conduct campaigns that will increase the number of the children who undergo exclusive breastfeeding because the breast milk is important for the growth and the health of the children. 64% of the country underwent immunization in the year 2016 according to the survey that was conducted by the world health organization (“Angola – Under-five mortality rate (2016) – knoema,” n.d.). The total government expenditure on health in Angola is 5% of all the money that the government spends on the projects in the country in the year 2014 (Segagni Lusignani et al., 2013). The neonatal mortality rate averaged at 29.3 for every 1000 live births. The under five-year mortality rate was 82.5 for every 1000 live births in the country in the year 2016. The infant mortality rate is 54.6 in the year of 2016. Life expectancy in Angola is 61.5 years. (“Angola – Under-five mortality rate (2016) – knoema,” n.d.).

This graph shows how the mortality rate for under five-year-old has been decreased over the years.

The healthcare system in Angola

            The health of the people in Angola is rated as one of the worse in the world. Only a small fraction of the population receives medical attention meaning that there is a lot to be done to ensure that the people in the country enjoy healthy lives in the society which they live in. From the year 1975 to the year 1992, the country recorded 300000 civilian war-related deaths (Segagni Lusignani et al., 2013). The overall deaths in the country are estimated at 240 people per 1000 in the year 2002. The country also recorded 3.9 per 100 HIV prevalenc (Segagni Lusignani et al., 2013)e. According to the USAID, the government of Angola has not been successful in the development of an effective healthcare system as a result of the civil war that rocked the country for 27 years. USAID estimates that 1 million people were killed as a result of the Civil war, 4.5 million people were displaced and 450000 moved out of the country as refugees (Segagni Lusignani et al., 2013). The government has been unable to promote the programs that could lead to the improvement of the health care system in the country due to the lack of infrastructure and the slowness of the country to urbanize. The government has therefore been unable to address the basic needs of the people in the country. Most of the people are therefore not able to access health care in the country (Segagni Lusignani et al., 2013). The government has made some improvements in the health care system of the county ever since the time of civil war. However, there are still problems in the health sector. The healthcare system in Angola is made up of the public and private services. The law of Angola demands that the public health services which include primary to the most specialized ones should be available at no cost. However, one big problem that bedevils the public healthcare system in Angola is the fact that there is a shortage of doctors, nurses, medicine, primary healthcare personnel as well as the inadequate training of the personnel hence affecting service delivery in the hospitals. The healthcare system also lacks an effective computerized information management system hence it is not easy for the healthcare personnel to track the medical history of the patients. It is therefore hard to offer efficient medical services to the people in the country. The majority in the country do not have access to the healthcare and pharmaceutical services. The best quality healthcare services are offered in the major cities which includes the capital city of Luanda and the other cities such as Benguela/Lobito, Lubango and Huambo (Segagni Lusignani et al., 2013). It is challenging for the people who live in the villages to find effective medical care because they have to move to the cities to get the services. The infrastructure is also poor, which makes it hard for the people to get the emergency services on time. Most of the upper and the middle class in Angola depend on the public health care services which are provided at a fee. Four major private clinics are located in Luanda which includes Sagrada Esperança, Girassol, Multiperil, and the Luanda Medical Center. The country also has small, numerous private clinics which offer the healthcare services at a fee. The high-class individuals travel to the other countries such as Namibia, South Africa, and Europe for complex healthcare services (Segagni Lusignani et al., 2013).

This figure shows how the health system delay in weeks in Angola. There are about 279 patients who have been suffering from late health diagnosis for about two weeks while 106 patients suffering from late health diagnosis for more than two weeks (Segagni Lusignani et al., 2013).

Healthcare financing

The increased cost in the medical care has restricted the higher and medium classes from getting healthcare internationally. The major diseases that cause concern in the healthcare industry include tuberculosis, malaria, infectious and parasitic diseases, rabies, cholera, sickle cell anemia as well as the respiratory and diarrheal diseases. The efforts by the world health organization have been used to deal with the crisis in the healthcare. The government of Angola came up with a budget of $1.87 billion to cater for the healthcare in the country (Hilhorst & Serrano, 2010). The government does the financing of the public health in the country. On the other hand, the middle class pays for their healthcare by visiting the public healthcare centers. Angola is less dependent on donor funding to support their healthcare compared to the other sub-Saharan countries. Two-thirds of the health care funding comes from government expenditure whereas the private financial sources finance the remaining third. The government income comes from the value added tax, income tax and the trade of the natural resources such as the minerals. The funding that the government provides for the healthcare organization is set to go down due to the expected decline in revenue coming from oil exports. Pooling is another method that is used in healthcare financing in Angola. Many insurance companies are found in Luanda, offering health policy. A person’s healthcare is therefore financed by the money that has been pooled by the insurance companies. Public and private organizations provide healthcare coverage for their employees. The Non-governmental organizations also provide health care funding for the people in the society (Hilhorst & Serrano, 2010).

Comparison between the United States of America and Angola

(Mikkelsen-Lopez, Wyss, & De Savigny, 2011).

The health problems that are faced by Angola

1. Inadequate infrastructure

The main problem that is faced by the country is the challenge of infrastructure which is a major challenge that affects the other developing countries in the world. The healthcare system in Angola also has a problem in dealing with the emergency situations that affect the people in the country. One of the biggest challenges is the fact that the infrastructure that should aid transport makes the transportation of the clients from one place to the other to be very challenging. It is challenging for the people who live in the villages to find effective medical care because they have to move to the cities to get the services. The problem is common in all the developing countries.

2. Shortage of staff

The healthcare system in Angola is also suffering from the shortage of staff hence crippling the healthcare sector. There is a global shortage of the healthcare personnel which means that Angola should not be blamed for facing the problem.

3. Lack of capacity to effectively handle the major diseases

The major diseases that cause concern in the healthcare industry include tuberculosis, malaria, infectious and parasitic diseases, rabies, cholera, sickle cell anemia as well as the respiratory and diarrheal diseases. The diseases are also common in the United States of America (Mikkelsen-Lopez, Wyss, & De Savigny, 2011).

Factors contributing to the healthcare problems in Angola

The lifestyle of the people contributes to the increase in the prevalence of diseases such as Cholera in Angola. Many people do not value the practice of washing hands before and after visiting the toilets or before they take meals. Some of the people do not vaccinate their dogs which is the reason why people suffer from rabies within the country. Some of the traditional cultures such as initiation ceremonies are blamed for the increase in the incidences of HIV/AIDS within the country. The country is facing problems with regards to funding healthcare meaning that many people will not get access to health care because of financial challenges. Most of the people in the country are also not able to afford efficient healthcare because of the financial challenges. The health problems are also influenced by the inability of the people to get to the healthcare facilities on time (Mikkelsen-Lopez, Wyss, & De Savigny, 2011).

How the healthcare problems pose a threat to the healthcare of the United States of America.

            Some of the diseases such as rabies, cholera, tuberculosis, malaria, infectious and parasitic diseases, and some respiratory diseases are very contagious hence they can affect Americans that visit the country. America may also decide to give funding to help in the healthcare initiatives which show how the country is affected by the health situation in Angola. The United States of America is affected both directly and indirectly. The United States of America will also be affected because they fund some of the research and development initiatives that help in the development of the medicines to the diseases that the people suffer in the country. The United States and the all the other countries are also concerned about the Ebola virus that has affected people in the West African region, some of which are neighbors to Angola (Hilhorst & Serrano, 2010).

How the healthcare system in Angola is equipped to deal with the healthcare challenges

The healthcare system in Angola is equipped to deal with the problems in healthcare. The government is doing the best to upgrade the roads so that dealing with the emergencies will be much easier. The government is also extending the hospital facilities to the remote areas of the country to ensure that all the people benefit from the healthcare services. The government of Angola also improves the funding of the health care services so that they can have enough money to pay the staff employed in the healthcare system. The government is also investing in the campaigns that are aimed at telling the people the importance of leading good lifestyles hence protecting themselves from diseases (Hilhorst & Serrano, 2010).

Recommendations

It is recommended that the government improves the infrastructure especially the transport network so that the patients can be taken to the hospital in a faster way hence saving their lives. It is also recommended that the government builds hospitals in the villages to ensure that the health care services get to all the people within the country. The government should also emphasize immunization especially for the disease that can be prevented by the intervention. Diseases such as rabies could be prevented if the government insisted that the people should immunize their dogs. It is also recommended that the government increases the number of the health care personnel so that the services will be provided efficiently to the patients. It is also recommended that the government spreads a campaign that insists on people leading healthy lifestyles that will enable them to lead healthy lives (Mikkelsen-Lopez, Wyss, & De Savigny, 2011).

References

Angola Population (2018) – Worldometers. (n.d.). Retrieved from http://www.worldometers.info/world-population/angola-population/

Angola – Under-five mortality rate (2016) – Knoema. (n.d.). Retrieved from https://knoema.com/atlas/Angola/Child-mortality-rate

Gerald, J. B. (1978). Angola under the Portuguese : the myth and the reality. London: Heinemann.

Hilhorst, D., & Serrano, M. (2010). The humanitarian arena in Angola, 1975-2008. Disasters, 34, S183-S201. doi:10.1111/j.1467-7717.2010.01153.x

Mikkelsen-Lopez, I., Wyss, K., & De Savigny, D. (2011). An approach to addressing governance from a health system framework perspective. BMC International Health and Human Rights, 11(1). doi:10.1186/1472-698x-11-13

Segagni Lusignani, L., Quaglio, G., Atzori, A., Nsuka, J., Grainger, R., Da Conceiçao Palma, M., … Manenti, F. (2013). Factors associated with patient and health care system delay in diagnosis for tuberculosis in the province of Luanda, Angola. BMC Infectious Diseases, 13(1). doi:10.1186/1471-2334-13-168

Tvedten, I. (2018). Angola: Struggle for Peace and Reconstruction. Boulder: Routledge.

WHO. (2018). Angola. Retrieved from http://www.who.int/countries/ago/en/