Assessment of Reproductive Health for IDPs
Angola, February 15-28, 2001
Conclusions
and Recommendations
The main difference between the local population and IDPs is that locals are much more aware of RH and are, therefore, more likely to seek out available RH services. Most IDPs are from very rural areas where there were no health services so they are unaccustomed to seeking out services. Therefore, much outreach, awareness raising and education needs to be done with the IDPs.
IDPs need far more blood transfusions than the local populations. The needs for IDP transfusion are primarily anemia, gunshot wounds, landmine accidents and surgeries such as cesarean sections. A family member typically provides blood but many IDPs do not have family members available to provide a donation. The hospital will not turn an IDP away if a family member cannot donate the needed blood supply, but the delay in finding a volunteer donor can be life threatening.
Biggest problems: 1) STDs (prevention, diagnosis, treatment) - many people self diagnose and self treat buying medicines in the market (that may or may not be the right treatment for their STD) or by traditional means that can be very harmful; 2) emergency obstetrics - women come too late with complications, deliveries take place in unclean conditions, no neonatal tetanus.
Greatest needs: 1) reconstruction and re-supply of the health facilities destroyed in heavy fighting (e.g., Kuito, 2) improve referrals, 3) family planning/contraceptives, 4) more ambulances/adequate transport options, 5) qualified/trained professionals, and 6) essential drugs.
Recommendations for improvement of RH services:
- Awareness and education - IDPs from very rural areas have never
had information about reproductive health or access to reproductive
health services. They need and want to be made aware of the services
they can and should be accessing. Awareness activities should
include men, women and adolescents. Radio is a viable medium to
promote awareness and education in all the provincial capitals.
Food for Work programs are being used to support agricultural
programs in Angola so perhaps a similar programs could support
the work of a community health worker program. Additionally, awareness
and education activities could be conducted in collaboration with
food distribution as so many IDPs are dependent upon the WFP food
deliveries and take part in the distribution.
- Targeted services for adolescents - 45% of Angola's population
is under 15 years of age. As in any country, young people
represent the future. To neglect the significant needs of young
people for health, education and psychosocial services will result
in a bleak future.
- Supplies and equipment - Luena, Moxico has a lovely new maternity
but no drugs, contraceptives or even simple equipment like stethoscopes
or forceps, stock outs, no transport/ambulances. There is a great
need to strengthen the logistics system for timely distribution
of supplies and equipment.
- Training - staff in health posts and TBAs want and need to be
better trained. · More financial support and technical assistance
is needed by the local NGOs in order to build local capacities.
Based on a recent Refugees International (RI) assessment of the
response to refugee and IDP conditions in Angola, RI recommends
expanded donor support in Angola because "Sensible investments
now could end the need for aid later." 15
- The Angolan government needs to allocate more resources to health and education. This is one of the richest countries in the world in natural resources and yet the government has only committed 5.5% of its budget to health. We were told that so far this commitment is on paper only and that the actual contribution will likely be much less. Regardless, 5.5% does not come close to meeting the needs of Angolans for health services. It is quite discouraging for international NGOs to maintain or increase the social services they are providing to the Angolan people (including IDPs) when there is no reciprocal effort being made by the government.
15. Refugees International, Angola: New Efforts To Build Local Capacity, April 2001.
