Angola’s economic and social infrastructure was devastated by 27 years of civil war. Since 2002, Angola’s health system has faced immense challenges and currently only serves 45% of the population.
The decrease in global oil prices has had a deleterious effect on national revenue which, in turn, has had a negative impact on all national budgets. The underfunded Ministry of Health (MoH) is reliant on aid for purchasing basic basic drugs and other support. Angola is one of the most challenging countries for INGOs to work in. However, in 2002, MENTOR set up a partnership with the MoH and has since been working to address the challenges posed by malaria, the most common cause of suffering and death in Angola. In 2012, the work was extended to tackle the huge burden of neglected tropical diseases (NTDs).
Neglected Tropical Diseases (NTDs)
Every year, millions suffer from devastating, yet preventable, NTDs such as soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis and onchocerciasis. These diseases are often associated with the inadequate water supplies, sanitation and hygiene found in the poorest areas. NTDs lead to increased poverty and even poorer health, hindering socio-economic development on a massive scale. However, most NTDs can be prevented and treated relatively easily through the mass administration of donated drugs.
Building on results from the successful malaria programmes in Angola from 2002 to date, MENTOR is now supporting the implementation of school and community based mass drug administration in six Angolan provinces: Huambo, Uige, Zaire, Bie, Kuando Kubando and Cuanza Sul.
Basic sanitation and access to clean water are necessities, yet the results of surveys performed amongst students between April and June 2015 clearly show that these necessities are severely lacking:
- 71% had no access to improved water supply.
- 57% defecated in the bush rather than in latrines.
- 83% in Huambo and Uige had no hand-washing facilities at school.
- 93% in Zaire had no hand-washing facilities at school.
School WASH programmes were successfully set up in Huambo, Zaire and Uige between April and June 2015 with support from The END Fund. The WASH programme encompasses work on hygiene practices among school children, waste management and equipment for making tippy-taps (basic sanitation installation for hand washing). So far, over 2034 schools have been provided with WASH equipment and the teachers have been trained in techniques to improve school based hygiene and hand-washing across the three provinces. The teachers’ enthusiasm for the training programme has been very motivating for the trainers and MENTOR.
MENTOR operates as an official partner to the provincial health department in all provinces and has supported WHO-funded disease mapping in 2015 and 2016. In the province of Bie, this mapping identified high prevalence of onchocerciasis, a disease that causes significant disability and blindness. In 2016, MENTOR started delivering community based mass drug administrations (MDAs) to prevent and treat onchocerciasis and lymphatic filariasis in disease prevalent municipalities in Uige, Zaire, Kuando Kubango and Bie provinces.
The last thirteen years have seen measurable progress with investments in the construction of new health facilities and medical schools for doctors, nurses and technical staff. MENTOR has been working with the MoH and other partners to build effective malaria diagnostic and treatment capacity in some of the worst affected provinces. Overall, significant advances in malaria control have been achieved in the country, but huge challenges still remain.
With World Learning, supported by USAID, MENTOR has been assisting the public sector across the northern provinces of Zaire and Uige, providing a strong platform for sustainable outcomes in malaria case management. MENTOR has been training health workers to diagnose and treat malaria cases more effectively and improving the ability of laboratories to diagnose malaria. In 2015, MENTOR trained nearly 2,000 health workers and laboratory technicians in malaria case management in Zaire, Huambo and Uige. MENTOR is improving medical supply chains and the quality of treatment prescription practice. Although this work is part of a programme due to close at the end of 2016, MENTOR hopes to be able to continue supporting the national Malaria Control programme in the future.
With the support of ExxonMobil, MENTOR has been reducing morbidity and mortality due to malaria in the most vulnerable groups of people in communities across Zaire and Uige provinces. During the project period, 122 community leaders were trained on malaria control at the community level. During 2016, 69 community health workers (CHWs) were selected and trained on home management of diarrhea and malnutrition and in the prevention of neglected tropical diseases. Alongside awareness-raising for malaria and other hygiene-related communicable diseases in the community, community health workers have actively participated in the yellow fever campaign in both provinces in the course of 2016.
During the year 2016, CHWs reached a total of 1,258,343 people through health educational activities during 9,092 sessions. Among the people affected, there are 546,575 women including 40, 961 pregnant women, 314, 607 men and 397,161 young people. Most recently the CHWs have been trained in measuring malnutrition, and in recording and referring case as they appear, in addition to teaching communities and about malaria symptoms, treatment and avoidance.
The Way Forward
As the Angolan health infrastructure adapts in order to cope with the effects of economic changes caused by the oil crisis, MENTOR remains at the forefront of control activities for neglected tropical diseases and malaria, implementing strategies that involve stakeholders from local to national level. Fundamentally, MENTOR is working with national level actors to influence policy changes and implementation of recommended strategies in NTDs, malaria, school hygiene and WASH.
MENTOR will continue to work to reduce the disease burden of the vulnerable populations in the provinces where it operates, and to seek opportunities and new partnerships to help improve health outcomes for the most excluded populations.
Last updated 27/10/2016