Angola health system assessment

Type Report
Title Angola health system assessment
Publication (Day/Month/Year) 2005
Publisher USAID/Angola
Country/State USA/Angola
At the request of the U.S. Agency for International Development (USAID)/Angola, a team performed an assessment of the Angolan health system in August 2005. The purpose of the health system assessment is to inform the Mission's development of a new health program for 2006-2011. To conduct the assessment, the team tested a new health systems assessment approach developed as part of the global Mainstreaming Health Systems Strengthening Initiative of USAID's Office of Health, Infectious Disease and Nutrition. The team found several weaknesses including a lack of human and institutional capacity and supervision; and insufficient public health financing of basic inputs for service delivery (e.g., supplies, drugs, equipment, electricity, potable water) contributing to user fees being charged by some public facilities. Strengths included the quantity of nurses, Ministry of Health and donor plans to increase staff capacity, the dedication of public sector health staff at multiple levels, implementation of some quality guidelines (IMCI and maternal health); and public-private partnerships in health. Angola currently presents some windows of opportunity because it is in a post-war transition period; Angolans are open to change and anxious for improvement; the young population (60 percent of Angolans are under the age of 18) has a shorter memory of the war; elections promised for 2006; Angola's long-term economic outlook is very positive; and other donor investments in health system strengthening are in progress or planned (European Union, U.N. Development Programme/Global Fund, World Bank) with convergence of goals and strategies. On the other hand, Angola faces certain threats, including the risk that elections in 2006 could generate a flurry of facility construction that is not part of a rational plan or part of the health budget for recurrent costs. The country's cost structure is exceptionally high. The team's recommendations for health system strengthening activities are consistent with the Mission's proposed strategy statement, Africa Bureau's new Strategic Framework (in which Angola is classified as a fragile state), and other donor initiatives. The team's findings and recommendations were presented at a stakeholder workshop where participants worked in small groups to review and provide

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