Assessment of Reproductive Health for IDPs
Angola, February 15-28, 2001
General Health Services/Conditions
UNICEF considers Angola to be "the worst place in the world to
be a child," based on the extremely high rates of morbidity and
mortality among children under the age of five. 6
The Angolan government spends less than 2% of its national budget on
healthcare, and after years of neglect, the health system is in shambles.
The government has committed to increasing its health budget from 2%
to 5.5% but the increase has yet
to take effect and while a sign of progress, does not come close to
meeting the country's actual need for health services. The system includes
basic levels of care and services. A health post offers primary care
services, a health center has more advanced care, and hospitals are
where people are referred for specialized care and surgery. During our
visit, healthcare facilities at all levels were inadequately staffed
and lacked basic equipment and supplies.
Due to the war, many people have not been able to complete their education,
and trained medical health personnel are in short supply. Many doctors
have left the country, and others have relocated to the capital Luanda
in order to make more money in private practice. As a result, provincial
hospitals have a very difficult time hiring and retaining doctors. In
one hospital we visited, an Angolan doctor had just been hired, but
before his arrival, there had been no doctor in the entire province.
In another hospital, the only doctors were expatriate doctors employed
by an NGO. There are also shortages of trained midwives and other health
personnel. During our visit, many NGOs cited the lack of trained and
qualified health staff as a barrier to implementation of quality services.
The shortage of medical equipment and supplies is also a severe problem.
Health care workers at every healthcare facility we visited complained
of drug stock-outs and lack of equipment. The facilities that had any
medicines or equipment were being sponsored or supported by NGOs and
were not relying on the government health system for procurement.
In theory, health care should be accessible and affordable for all
Angolans, but the reality is quite different. Because government
staff are so underpaid, many government health workers do not come
to work or try to charge fees for their services. NGOs are only
able to work in stable and secure areas, so there are large parts
of the country where people are dependent on the government or UNITA
for services that may or may not be available. Almost all health
facilities in the four provincial capitals that we visited are supported
or run exclusively by international NGOs. A major concern of the
NGOs and some of the health providers is what will happen if these
NGOs pull out of Angola.
6. The Economist, January 11, 2001.
