Angolas State of Health - Essay Example

? Adult and Child Mortality Rates in Angola Introduction Angola is situated along the western shoreline of Sub-Sahara Africa. Withan area of more than one million square kilometers, Angola is one of Africa’s largest nations. The country had a populace of approximately 19 million people based on the most recent census. Being a resource rich nation, Angola has been experiencing significant economic development since the end of the civil war in the year 2002, at an estimated 16 percent annual growth. Even though the nation has immense wealth, it continues to lag behind globally in regard to health, socio-economic and infrastructural development (UNICEF, 2008). Selection of Angola for this analytical study was based on the fact that, the nation has the necessary resources to improve its healthcare system, yet it is one among several African nations with the highest rates of mortality and morbidity. The country also experiences acute shortage of human resources in the health sector, especially nurses. This research paper attempts to give insight into the current state of Angola’s health system, by considering responsible government institutions, healthcare delivery, nursing education and accreditation, and roles that nurses can play to aid in improvement of the country’s health outcomes. Government Angola is a republic, meaning that its government is chosen by the electorate. The country currently has a stable executive government framework. The president is usually a leader of the coalition or party that gets the highest number of votes in the National Assembly (NA) elections. The president heads the executive branch of government and he or she may serve one or two five-year terms. It is also the president who nominates provincial governors. These governors then elect district administrators for further devolution of resources (UNICEF, 2008). State of Health Angola’s state of health is currently among the worst around the world, as shown by high infant mortality rate at about 154 deaths for every 1,000 newly born babies, and a mortality rate of 260 deaths for every 1,000 kids under the age of five. The country also has a diminished life expectancy of 40 years (USAID, 2010). These shocking statistics are attributable to widespread prevalence of malaria, acute respiratory diseases like pneumonia, diarrheal diseases like cholera, malnutrition and tetanus, coupled with inadequate access to healthcare. The high rate of mortality in Angola is accentuated by the nation’s lack of properly trained healthcare professionals and infrastructure damaged during the civil war. Another significant fact to denote is the high maternal mortality rate, estimated to be 1,700 for every 100,000 births (WHO, 2010). This exceedingly high proportion can be attributed to prevalence of malaria and hepatitis, among other pregnancy-linked conditions which are left untreated. Angola is also facing several communicable ailments like sleeping sickness, tuberculosis and leprosy. Nonetheless, malaria is the greatest cause of mortality in the country, with approximately 35 percent of reported annual deaths being as a result of this disease (Costa Mendes et al., 2013). Culture and Traditional Medicine In Angola, adoption of traditional medicine and healing practices can be traced back about four millennia. The fundamental assertion that underlies traditional medicine in the country is that, it developed from   experimental observation of the manner in which man reacted to certain environmental triggers. Traditional medicine is no longer extensively practiced in Angola due to adoption of modern medicine and because about 56 percent of the populace lives in urban areas. However, people in rural areas still believe in traditional medicine and many consume purported healing portions (Connor, Averbug & Miralles, 2010). Healthcare System and Delivery Healthcare service delivery in Angola faces acute human resource issues, especially shortage and lack of qualification among care providers. There are also widespread cases of essential medical supplies’ stock-outs and unequal financing of recurrent healthcare costs. However, the country’s healthcare system has made significant improvements, with coverage of fundamental services increasing from 30 percent in 2005 to 42 percent in 2011. The public financing of primary care health facilities also improved during this duration, enabling Angolans to gain better access to such facilities following their construction and renovation. The government continues to make attempts at delivering quality healthcare service by advancing clinical standards and accrediting health facilities (Froystad, Maestad & Villamil, 2011). Governmental Health-Related Agencies Angolan healthcare system is largely managed by governmental institutions even though private institutions have recently been approved to institute necessary checks and keep propelling the system toward betterment. These government institutions include the National Health Services (NHS), which was created in 1975 following the country’s independence. This umbrella organization supports free and universal primary healthcare for Angolans. The other significant governing establishment is Ministry of Health Services in Angola (MINSA), which is committed to improving primary healthcare services and guaranteeing their availability especially for the poor (Sjursen, 2012). Healthcare Personnel As mentioned, human resource issues make up major constraints for Angola’s healthcare system. These mainly include few clinical skills among staff and inadequately serviced rural areas (Connor et al., 2010). There is also a shortage of doctors, nurses and health workers at the community level, and limited number of medical schools. Even though the number of doctors in public facilities has tripled since 2005, and new medical schools established, staffing remains a challenge in Angola. For instance, there is only one doctor and about 63 nurses per 10,000 patients. Vertical programming of healthcare management and inadequacy of finances for recurring costs, significantly inhibit training and supervision of primary healthcare staff, ultimately limiting chances to address Angola’s medical problems and enhance efficiencies (Marchi-Alves et al., 2013). Angola Nursing Education System Most training functions for nurses and other health staff fall under the authority of MINSA. Angola’s basic level nurses must have reached the eighth grade and undergone nursing training for two years (Connor et al., 2010). In contrast, nurses at the intermediate level must have attained 12th grade education and four years of training. MINSA recently approved nursing programs in the newly established universities, adding to the only extant intermediate-level school of nursing. Even though the newly added universities bring about a significant improvement to nursing in Angola, the present programs are still of questionable quality. This is because the universities are understaffed, diminishing their teaching capacity and resources are inadequate. Further, teaching aides are limited and the current curriculum is rather weak (Kaplan et al., 2013). Although Angola has collaboration agreements with medical training institutions in Portugal, Cuba and Brazil, their impact and scale of contribution is not clear (Marchi-Alves et al., 2013). Nursing Associations There are two main nursing associations in Angola. These include International Council of Nurses (ICN) and the National Nurses Association of Angola (NNAA). Both share similar interests such as defending the interests of Angolan Nurses and the nursing profession in general and promoting quality nursing. The two also seek to lobby for professional development of Angolan nurses, in order to increase their capacity to avail quality nursing services, which uphold the population’s humanity. Health Priorities Given the high rates of child and maternal mortality, the country’s first priority should be to reinforce its health system’s capacity to provide quality health services for mothers and their children. Since this capacity is inhibited by inadequacy of health professionals and lack of skills among those available, the next step would be to increase and equip medical, nursing and health training institutions, in order to develop workers’ skills (USAID, 2010). Angola should also make significant attempts to create integrated health programmes for children of all ages. The government of this country must also strengthen the capacity of medical facilities to develop and manage strategies that promote healthy living and disease prevention. This would involve ensuring that health facilities have adequate supplies to avoid stock-outs. The government must also strengthen the ministry of health’s capacity to monitor infectious disease, in order to enhance emergency readiness and ability to respond. Angolan health system stakeholders must work in unison, launching campaigns for sanitary conditions to avoid diarrheal ailments and advocating for use of mosquito nets among all people. It would also be necessary for the government through MINSA to reinforce social protection and health financing through establishment of strong financial and management systems. This would make it possible to identify key inefficiencies and execute relevant mitigation measures thus accounting for all resources availed to the health system. The Angolan Government must restructure, upgrade and streamline the deplorable state of its health workforce by improving training programs and institutions. Further, the established universities should strive to create graduate nursing programs to make it possible for Angolan nurses to pursue higher academic qualifications. Finally, nurses must be recognized as principal elements in the qualitative development of healthcare in Angola through proper accreditation channels (WHO, 2010). Nursing Implications Nurses can actively advocate for improvement of training programs that cater for their academic and professional advancement. Once given this opportunity to gain additional experience, nurses can use the acquired skills to work effectively within integrated treatment programmes. This would enable them to take good care of mothers and their babies thus contributing toward reduced maternal and child mortality. Being in direct contact with patients, nurses can train patients and other people in the community on how to maintain hygiene, in order to avoid communicable diseases. Nurses can also be on the front in advocating for use of malaria prevention measures, among other disease avoidance strategies. References Connor, C., Averbug, D., & Miralles, M. (2010). Angola Health System Assessment 2010. Bethesda, MD: Health Systems 20/20, Abt Associates Inc. Costa Mendes, I. et al. (2013). Healthcare context and nursing workforce in a main city of Angola. International Nursing Review, 11, 37–44. Froystad, M. Maestad, O., & Villamil, N. (2011). Health Services in Angola: Availability, Quality and Utilization. Chr. Michelsen Institute (CMI) Report. Retrieved from http://www.cmi.no/publications/file/4319-health-services-in-angola.pdf Kaplan, A., Dominis, S., Palen, J., & Quain, E. (2013). Human resource governance: what does governance mean for the health workforce in low- and middle-income countries? Human Resource Health, 11, 6-13. Kinfu, Y., Dal Poz, M., Mercer, H., & Evans, D. (2009). The health worker shortage in Africa: are enough physicians and nurse being trained? Bull World Health Organ, 11, 161–244. Marchi-Alves, L. et al. (2013). Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions. Human Resource Health, 11, 33-49. Sjursen, H. (2012). Angola Health Survey: Opportunities to Reduce Maternal and Newborn Mortality. Angola Brief, 2(3): 1-4. UNICEF. (2008). UNICEF Humanitarian Action: Angola. Retrieved from http://www.unicef.org/har08/files/har08_Angola_countrychapter.pdf USAID. (2010). Angola Health System Assessment 2010. Retrieved from http://www.healthsystems2020.org/files/2616_file_Angola_HSA_Report_Final_7_9_2010.pdf WHO. (2010). Angola: Factsheets of Health Statistics 2008. Retrieved from http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=7064&Itemid=2593 Read More