Assessment of Reproductive Health for IDPs
Angola, February 15-28, 2001
Huambo
Huambo is Angola's second largest city, and was an
industrial center in the past. Currently, the many large factories
sit roofless and empty outside the city center. The economy is at
a standstill, in large part because transport of raw and finished
materials by road is impossible and air transport is far too expensive.
As is the case in other towns, renovated buildings house NGO offices;
the physical effects of offensives on the town, notably a 30-day
siege several years ago, are visible in the semi-destroyed buildings
used as homes and commercial sites.
Maternal/Newborn Care
The provincial hospital in Huambo is a spotlessly clean facility managed by an energetic Angolan physician. The hospital handled 2,270 deliveries in 2000, 12% (264) of which were cesareans. The maternity wards were clean, though bed frames were rusty and in bad repair and many lacked mattresses. Simple incubators were available for infants; low birth weight is reportedly a problem.
It is notable that 29% (661) of the women delivering at the hospital
in 2000 were 14-19 years old. This group made up the largest single
5-year age group, and the number decreased steadily as age increased.
The staff were not sure why this was the case but it would appear
that there is a perception among the population that young women
should deliver in the hospital but that it was not as important
that older women do so.
Family Planning
Antenatal care is offered at the hospital, as it is in some of the health centers in the province. All complications, or problems of any kind, are referred to the hospital. Family Planning The hospital is virtually the only source of family planning services in the province. For example, Sao Pedro Government Health Center, another site visited, has not provided family planning since 1998. The staff there report that women (and men) are indeed interested in family planning and that they refer them to the hospital, a distance too far to walk.
At the hospital, all methods except male sterilization are offered - this includes female condoms and emergency contraception. There were 2,843 family planning consultations in 2000, with 822 new acceptors. Almost half of new acceptors adopted the pill and 21% accepted condoms. Besides problems with stock-outs of supplies, there was some concern among staff that injectables are not appropriate for younger women interested in spacing since the return to fertility is longer than with other methods. They reportedly use injections primarily for older women who want to stop having children.
The staff does not actively promote family planning in deference
to what they identify as the conservative population they serve.
They fear that any bad publicity will harm the program.
STDs/HIV/AIDS
STD treatment is done in the family planning clinic. The most common
infections are gonorrhea and cervicitis, though overall the numbers
of clients seen is low. As with family planning, the staff recognizes
the need for community education and outreach but fear a negative
reaction from the conservative population.
Sexual and Gender-Based Violence
When asked about rape and other forms of sexual violence, the hospital staff reported that it is common, and due mainly to the social dissolution brought on by conflict. The perception was that sexual violence is, in fact, so common that adults rarely bother to report it and this explained why they saw few adult patients in the hospital. The cases of sexual violence they see tend to be in children, for whom families might seek care in order to collect evidence. The staff cited a recent case of a 3-year old girl brought in for this purpose. Since pregnancy is not a concern for the very young patients they see, emergency contraception was not seen by the staff as a service relevant to rape survivors.
