Having emerged from more than 30 years of civil war, Angola has made substantial progress in economic and political terms and achieved significant progresses. The country’s infrastructure is noticeably improved, and its economy was rebounding quickly due to its vast oil wealth, but this progress has decreased with the crisis the country is facing due to decreasing oil prices.
Despite these successes achieved, Angola is actually in the 148 position in the UN’s Human Development Index, meaning that the country remains in the lowest quintile. The county 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, because women lack access to and understanding of modern contraceptives. Only 12% of women of reproductive age are using a modern contraceptive method. Access to safe drinking water and sanitation is still limited to roughly 50% of Angolans. 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% of diseases reported by the Ministry of Health 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 products on the market, including the long-lasting insecticide treated net, (LLIN) Jóia, the water treatment pills, Certeza, and the Legal and Sensual condoms. Tem Mais network of pharmacies was launched in 2014 and aims to provide accurate and affordable malaria rapid diagnostic testing and treatment of confirmed positive cases of malaria. PSI/Angola is currently launching different products and services related to family planning: IUD insertions in a quality-assured women’s health network of clinics, and third generation contraceptive pills, among others.
PSI/Angola estimates that in 2015, its products and services helped avert 387,044 DALYs, including, by health area:
- 330,235 Malaria DALYs
- 31, 292 HIV DALYs
- 19,424 RH DALYs
- 6,093 WASH DALYs
PSI/Angola’s family planning programs also provided 58,112 couple-years of protection.
PSI/Angola’s 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.
The PSI malaria treatment and prevention program is supported by USAID/President’s Malaria Initiative (PMI) and ExxonMobil. It is conducted in close cooperation with the 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, which is 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. In 2015/2016, Benguela and Uíge provinces received this intervention. The results are as follows:
- Zaire: reached 373,977 beneficiaries and distributed 175,196 LLIN
- Kwanza Norte: reached 311,635 beneficiaries and distributed 185,600 LLIN
- Malange: reached 1,072,239 beneficiaries and distributed 568,442 LLIN
- Bié: reached 1,589,223 beneficiaries and distributed 876,226 LLIN
- Huambo: reached 1,537,273 beneficiaries and distributed 1,015,457 LLIN
- Uíge: reached 1,159,731 beneficiaries and distributed 650,000 LLIN
- Benguela: reached 1,937,252 beneficiaries and distributed 1,089,431 LLIN
The Tem Mais neighborhood pharmacy network was launched by PSI/Angola with the support of its partner, The MENTOR Initiative, in Huambo province, April 2014. In September 2015 the program was expanded to Uíge province. Tem Mais brings affordable and accurate malaria rapid diagnostic tests (RDT) 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 was launched with the support of USAID and ExxonMobil.
Tem Mais network has proven results:
- 74 pharmacies belonging to the network (43 in Huambo and 31 in Uíge).
- 154 technicians trained in mRDT and malaria treatment.
- 131,750 mRDTs sold.
- 153,911 ACTs sold.
- Children under five representing 33% of clientele.
Behavior Change Communication on Net Use
A behavior change communication (BCC) campaign supported the previous investments in free distribution with the goal to increase the consistent use of LLIN for pregnant women and children under five years old. The campaign objectives were to increase knowledge of malaria transmission and prevention methods, as well as perception of severity and susceptibility for pregnant women and children under five. This BCC campaign was implemented in four provinces: Bié, Huambo, Benguela and Uíge. More than 300,000 people were reached through interpersonal communication activities.
In March 2008, PSI launched a new health intervention that 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.
In 2016, 10,680,040 Certeza pills 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. Thirteen years later, LEGAL is now synonymous with ‘condom’ and is Angola’s national condom brand. Since LEGAL’s introduction into the Angolan market, more than 115 million condoms have been sold.
In 2004, PSI added a second branded male condom, Sensual, which is available as Sensual Sensitivo, Sensual Saliências and Sensual Sabores – in scented strawberry, mint and chocolate. A new scented extension and a special edition will be launched in 2017.
In 2016, total sales of Sensual were 4,801,135 condoms.
PSI has also produced numerous behavior change campaigns and materials and has provided technical assistance and training to over 20 national partner nongovernmental organizations. It has successfully implemented community-based interpersonal communications (IPC) 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.
- U.S. Agency for International Development (USAID)
- The Global Fund to Fight AIDS, Tuberculosis and Malaria
- Ministry of Foreign Affairs of the Netherlands
- President’s Emergency Plan for AIDS Relief (PEPFAR)
- President’s Malaria Initiative (PMI)
- United Nations Children’s Fund (UNICEF)
- Government of Angola
- Angola multi-lateral and bi-lateral partners
- Multiple international, national and community based organizations operating in Angola
- Women’s Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.
- 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.