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This article discusses the current situation of child health in Angola, highlighting the higher mortality rates compared to developed countries. It explores the causes of child mortality and the challenges faced in addressing this issue, including poverty, limited access to clean water, and inadequate healthcare resources. The article also emphasizes the importance of prioritizing primary care and implementing an integrated approach to improve child health in Angola.
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CHILD HEALTH IN ANGOLA Luis Bernardino March 2013
CHILD HEALTHTHE SITUATION IN LESS DEVELOPED VERSUS DEVELOPED COUNTRIES • 1. Highermorbility/mortality(Quantity) Perinatal mortality (nº dead 1st week/1000 NB alive ordead) Neonatal mortality (nº dead 1st month /1000 NB) –( M < 1M) Infantmortality (nº dead 1st year /1000 NB) (M < 1 Y) Mortality >5 (nº deadfirstfiveyears/ 1000 NB) (M < 5 Y) 2.Different causes ofdeath(Quality)
MORTALITY, QUANTITY * Levesl& Trends in ChildMortality, 2011 Report UNICEf, WHO, WORLD BANK, UN.NATIONS,DESA/ Pop. Div.
MORTALITY (Quality) 10 more frequent causes ofchilddeath in Sweeden na Nigeria( 1990)
CAUSES OF ILNESS LESS DEVELOPED COUNTRIES DEVELOPED COUNTRIES Genoma Genoma Environment Environment
THE UNDERDEVELOPMENT CYCLE POVERTY POPULATION/ RESOURCES GAP POOR EDUCATION FOOD INSECURITY UNHEATHY HABITAT HIGH NATALITY INFECTION HIGH MORTALITY < 5 YEARS MALNUTRITION
http://www.infoescola.com/geografia/paises-mais-pobres-do-mundo/http://www.infoescola.com/geografia/paises-mais-pobres-do-mundo/
HOUSE : AVERAGE NUMBER OF PEOPLE PER SLEEPING ROOM Source : IBEP, 2011
Houseswithsanitaryfacilities Source : IBEP, 2011
ACCESS TO CLEAN WATER Fromappropriatesources No treatmentofinappropiatesources Source : IBEP, 2011
Vacination * WHO Report 2012 ** PopulationWelfareSurvey (IBEP), 2011
CAUSES OF DEATH IN 1992 CHILDREN IN THE PEDIATRIC HOSPITAL OF LUANDA IN 2012
Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000 TheLancet, Volume 329, nº 2161, Pages 2151 - 2161, 9 June 2012
CAUSES OF DEATH INCHILDREN IN THE WORLD IN 2010. (TheLancet, 2012, 379: 2155)
SEVERE ANEMIA = TRANFUSIONSNumberof cases Pediatric Hospital, 2010
ANGOLA : HOW NEAR THE 4TH MILENIUM DEVELOPMENT GOAL? What sould be done?
THE ATTEMPTS: • 1978 :ALMA ATA AND HEALTH FOR ALL IN 2000 – THE STRATEGY OF PRIMARY CARE • 2000 : THE MILENIUM OBJECTIVES GOALS
THE UNDERDEVELOPMENT CYCLE POVERTY OVERPOPULATION/ RESOURCES GAP POOR EDUCATION FOOD INSECURITY UNHEATHY HABITAT HIGH NATALITY INFECTION HIGH MORTALITY < 5 YEARS MALNUTRITION
INTEGRATED APPROACH TO REVERT THE POVERTY CYCLE Estrategydefined in 1978 in Alma Ata
MILENIUM DEVELOPMENT GOALS (New York, 2000) 4 th OBJECTIVE REDUCE BY 2/3 FROM 1990 TO 2015 THE MORTALITY OF CHILDREN AGED 0 TO 5 YEARS Indicators • Mortality rate up to 5 yeard (M < 5) • Infantil mortalily (M < 1) • Percentageofchildrenlessthanoneyearimmunizedagainstmeasles
ThemilestonesofMortality < 5 in Angola, 1990 – 2012WHO Data ?
EDUCATION HEALTH NATIONAL BUDGET Higherexpence UnversityTerciaryCare Technical Provincial & Municipal traningHospitals Primary & HealthCenters SecondaryCommunitycareLowerexpense BUT HEALTH STRATEGY IN ANGOLA DOES NOT PRIORATIZE PRIMARY CARE 1. The budget of health is below the level advised 2. Theexpenses are atthe top levelsofEducationandHealth, ratherthanon basic services
ANGOLA • STRONG AND WEAK POINTS TO REACH THE 4TH MILENIUM GOALS • STRENTGHTS • RICHESS IM MINERAL, AGRICULTURE • WATER AND SEA RESOURCES • POPULATION RELATIVELY SMALL, PER • CAPITA PRODUCT INCREASING IN THE LAST YEARS NATIONAL GDP WorldBank PERCAPITA INCOME CIA WorldFactsBook 2012 • PEACE SINCE 2001
ANGOLA • STRONG AND WEAK POINTS TO REACH THE 4TH MILENIUM GOALS • WEAKNESSES • UNEQUAL INCOME DISTRIBUTION • STATE BUDGET FAVOURING THE HIGHER QUINTILE OF THE POPULATION • HEALTH STRATEGY SUFERING FROM SAME APPROACH IN INVESTMENT, NOTWITHSTANDING THE RECENT POLICY OF “MUNICIPALIZATION” (BIG HOSPITALS VERSUS HEALTH CENTERS; SUPRESSION OF BASIC CATEGORIES ON NURSING, TRAINING DOCTORS VS. NURSES , ETC.)
The basic unity to execute primarychild/maternal care • Components • IMCI • Prenatalcare • Vaccines • Nutritionsurveillance • Handing TB & ARV drugs • RESOURCES • Local actors • Basic training • Lowcosts • Quickimplementation • Sustainability