Having emerged from more than 30 years of civil war, Angola has achieved significant progress in the last decade. The country’s infrastructure is noticeably improved, and its economy has rebounded quickly due to its vast oil wealth. Angola now has an estimated GDP per capita of $6,500 growing at an annual rate of 8.4 percent – one of the highest growth rates in the world.
Despite these successes, Angola has lagged behind on its social welfare indicators and still has one of the highest child mortality rates in the world. Its maternal mortality ratio is also above average, even among other developing countries. The primary causes of morbidity and mortality continue to be infectious diseases including malaria, respiratory infections, diarrhea, tuberculosis and measles – all of which accounted for 96 percent of diseases reported by the Ministry of Health (MOH) in 2011.
PSI/Angola was established in 2000, initially to work on HIV/AIDS prevention and later broadened its scope to include malaria and diarrheal disease prevention in 2004. In coordination with the Angolan Ministry of Health and many other partners, PSI/Angola is increasing access to essential health commodities and implementing targeted behavior change communications. By leveraging commercial and community distribution channels, PSI/Angola complements public sector distribution efforts and contributes to increasing coverage levels.
PSI Angola has several brands on the market, including the LLIN Jóia, the water treating pills Certeza, and the Legal and Sensual condoms. Recently, PSI Angola launched Tem Mais a network of pharmacies to provide accurate and affordable malaria rapid diagnostic testing and treatment of confirmed positive cases of malaria.
PSI Angola comprehensive malaria prevention and treatment program includes:
- Free distribution of long lasting insecticidal nets (LLIN).
- Sales of socially marketed insecticide treated mosquito net branded Jóia.
- Provision of malaria rapid diagnostic tests (mRDT) and treatment of confirmed cases with ACT (Coartem) through a Tem Mais pharmacy network.
- All activities are accompanied by mass media and interpersonal behavior change communication campaign.
PSI malaria treatment and prevention program is supported by USAID/PMI and ExxonMobil and is conducted in close cooperation with national malaria control program (NMCP) and the provincial health directorates.
Long-Lasting Insecticide Treated Nets (LLIN)
The NMCP has the strategic objective to reach universal coverage of nets in Angola. Through free distribution, PSI is increasing access to LLIN, a critical step in helping families protect themselves from malaria. In 2013, PSI Angola, together with other implementing partners conducted the distribution of LLIN in the provinces of Zaire, Kwanza Norte and Malange. In 2014, PSI Angola assumed leadership of the distribution of LLIN in Bié and Huambo provinces. The results are as follows:
- Zaire – Reached 373,977 beneficiaries and distributed 175,196 LLIN
- Kwanza Norte – 311,635 beneficiaries and 185,600 LLIN
- Malange – 1,160,312 beneficiaries and 610,389 LLIN (reached universal coverage)
- Bié – 1,570,551 beneficiaries and 865,402 LLIN (reached universal coverage)
Tem Mais Pharmacy Network
The Tem Mais neighborhood pharmacy network was launched by PSI Angola with the support of its partner The MENTOR Initiave in Huambo province in April 2014. Tem Mais brings affordable and accurate malaria rapid diagnostic tests and treatment directly to communities, saving precious time and adding convenience. All Tem Mais pharmacies are trained and authorized by the provincial health authorities to perform the RDT and administer ACT treatment. Tem Mais is supported by USAID and ExxonMobil.
In the first five months, the Tem Mais network has proven results:
- 50 established locations in Huambo province.
- 100 technicians certified in Rapid Diagnostic Tests.
- 360 lives saved.
- 4,226 unnecessary treatments avoided.
- 9,876 clients served.
- 53,072 community members reached.
Behavior Change Communication on Net Use
Scheduled to begin in 2015, this campaign will support the previous investments in free distribution with the goal to increase the consistent use of LLIN for pregnant women and children under 5 years old. The campaign objectives are to increase knowledge of malaria transmission and prevention methods as well as perception of severity and susceptibility for pregnant women and children under five.
In March 2008, PSI launched a new health intervention which aims to reduce diarrheal disease among children under five via a highly effective, easy-to-use and affordable point-of-use water treatment product called Certeza. This simple and robust technology was created by the U.S. Centers for Disease Control and Prevention in the late 1990s and has been brought to scale by PSI in more than 23 countries. In 2010, Certeza got a new look with an updated logo and label. Aquatabs water purification tablets, to be locally named Certeza Comprimidos para Água, were launched at the beginning of 2011, providing a different option for water treatment. Capitã Certeza (bottom right picture) is the superhero that protects from waterborne illnesses; the Capitã has become famous overnight with little girls playing the superhero role in playgrounds and kindergartens everywhere.
Between October 2013 and September 2014: 10,261,820 Aquatabs water purification tablets were sold.
PSI started its HIV/AIDS prevention program in 2000 by promoting risk-reduction and safer sexual behaviors.
In 2001, USAID and PSI introduced a subsidized condom targeting low income youth in Angola called LEGAL. 13 years later, LEGAL is now synonymous with condom and is Angola’s national condom brand. Since LEGAL’s introduction into the Angolan market, 110,976,866 condoms have been sold, which means:
- 8,500 lives saved.
- 11,290 HIV infections prevented.
- 340,000 unintended pregnancies prevented.
The brand is widely recognized by consumers, particularly among its target group – youth. Sales are coupled with strong awareness campaigns about HIV transmission and unplanned pregnancies, and about other benefits of condom use.
In 2004, PSI added a second branded male condom, Sensual, which is available as Sensual Sensitivo, Sensual Saliências and Sensual Sabores – flavored strawberry, mint and chocolate. In last fiscal year (October 2013 to September 2014), the quantities sold were:
- Sensual Sensitivo: 370,116.
- Sensual Saliências: 467,532.
- Sensual Strawberry: 590,544.
- Sensual Mint: 567,792.
- Sensual Chocolate: 554.436.
PSI has also produced numerous behavior change campaigns and materials and has provided technical assistance and training to over 20 national partner nongovernmental organizations in implementing community-based interpersonal communications activities with high-risk groups such as sex workers, truckers, police and youth. These activities add to long-term sustainability and health impact by creating capacity in local organizations to design and manage their own projects. To this end, many of PSI’s NGO partners now receive donor grants directly.
Since FY 2011, PSI/Angola has been working with Key Populations program providing the PEPFAR- and WHO-recommended elements of a core package of HIV-related services for female sex workers, male clients of sex workers, and truckers—and, through these primary target populations, their main categories of sex partners—with a combination prevention approach. Specific elements of the core package of services will vary target population and HIV status, and will seek to: improve self-efficacy and skills to reduce risk of HIV acquisition and transmission through behavior change communication; create demand for HIV-related services in the public sector; and, provide referrals and linkages to MARP friendly public sector providers in targeted intervention areas.
Notable achievements to date include:
- 41,181 sex workers reached in individual or small group activities; and 18,396 were received HIV counseling and testing.
- 936 MSM reached in individual or small group activities.
- Scale up of interpersonal communication and referrals to services for sex workers, clients, and MSM in PROACTIVO regions.
- Pilot of MSM peer led outreach in Luanda.
- Training to provide capacity, knowledge and skills to health care workers to improve health outcomes of MSM; there were 260 healthcare workers trained in five provinces.
- Development of communication and information leaflets for MSM outreach activities services.
- Development of draft national outreach communication manual for service provision to key population groups – sex workers and MSM.
- 2,371,412 male and female condoms were distributed
- Government of Angola
- Angola multi-lateral and bi-lateral partners
- Multiple international, national and community based organizations operating in Angola
- Towards Subsidized Malaria Rapid Diagnostic Tests. Lessons Learned from Programmes to Subsidise Artemisinin-Based Combination Therapies in the Private Sector: a Review
Private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. A subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.
- Knowledge, Empowerment and Positive Social Norms as Drivers of Consistent Condom Use among Female Sex Workers in Angola
This presentation discusses a study with aimed to identify factors associated with consistent condom use among female sex workers (FSWs) with all their clients during the last month prior to the survey. The results inform evidence based programs aiming at reducing HIV risks among FSWs.
- Effectiveness of IPC and TV Ads on HIV Risk Reduction Behaviors Among FSW in Angola
Angola is a country in reconstruction after 30 years of war, that presumably limited the spread of HIV in the country. The program at hand included IPC activities such as promoting condom and lube use, referral to HIV testing, and reducing discrimination against key populations. Additionally, TV ads promoted condom use.
- Factors Associated with Consistent Condom Use with Non-Marital Partners among Truck Drivers and Assistants in Angola
In Angola, truck drivers are separated from their families for long periods of time, traveling through areas of high HIV prevalence and frequently reporting paying for sex in non-marital relationships. HIV prevalence among this population is 4%, twice that of men of the same age in the general population (UNAIDS, 2008). In 2013, PSI/Angola conducted a study to identify factors associated with consistent condom use among truck drivers and their assistants with non-marital female partners. This presentation reviews that study.
- 2012 Mid Year Region and Country Dashboards, East Africa
Mid-year East Africa region and country impact dashboards for 2012
- 2011 Region and Country Dashboards, Eastern Africa
Eastern Africa region and country impact dashboards for 2011
- Healthy Lives: Superheroes Protect Angolan Children
- PSI/Angola Safe Water Program
In order to reduce child mortality due to diarrhea, PSI/Angola launched Certeza, a point-of-use water treatment product, in April 2008.
- “Trust is Principal Barrier to Condom Use”
PSI researchers found that trust in one’s partner is the main reason for not using condoms with a marital or regular partner in Africa, and dislike of condoms is the most important reason for not using them with a casual partner, in what is apparently the first multi-country study of barriers to condom use.
- Gender and Relationship Differences in Condom Use among 15-24-year-olds in Angola
The sexual behavior of young people in Angola will play a major role in the future spread of HIV, yet few young people use condoms consistently, and reported rates of condom use are low. This study aimed to identify predictors of consistent condom use by gender and determinants of condom use at last intercourse by type of relationship.