HEALTHCARE SCENARIO OF ANGOLA
Are you planning to build or restructure or venture in any healthcare venture in Angola? Looking for information about the major healthcare players in government, private diagnostic centers that are available in Angola? Are you looking to find out which part of the cities is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario of Angola.
This is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on Hospaccx.India@gmail.com or you can visit our website on https://hospaccxconsulting.com/
INTRODUCTION
Angola is an upper-middle income country of 28.8 million inhabitants that is 63 percent urban.
The population is by gender, 47.3 percent male and 52.7 percent female. According to the 2014 Angolan Census, the Angolan population is very young with 65 percent of the population under 24 years.
Angola’s healthcare system is comprised of public and private services. As Per Angolan law, public health services, from primary care to specialized services, are available at no cost. However, the public system suffers from shortages of doctors, medicines, nurses, primary health care workers, as well as inadequate training and a lack of a computerized information management system to efficiently track historical records of patients. As a result, access to healthcare services and to pharmaceuticals for the majority of the population is limited. The best quality health services are found in Luanda and in the other major cities of Benguela, Lobito, Lubango and Huambo.
Most middle and upper middle class Angolans use private healthcare services that generally offer higher quality and fee-based care. Four major private clinics are located in Luanda: Girassol (affiliated with state oil company Sonangol), Sagrada Esperança (affiliated with the state diamond company Endiama), Multiperfil (affiliated with the Presidency), and the Luanda Medical Center. Numerous small private clinics are also available. Professional and upper class Angolans typically travel to Namibia, South Africa, Cuba, Spain and Portugal for more complex medical treatments. However, such international health travel has become more difficult due to increased costs with the local currency devaluation and severe restrictions on foreign exchange.
The lack of sufficient pharmaceuticals and medical supplies in the Angolan market due to government budget challenges and foreign exchange delays is significant and is negatively impacting patient health. As the Angolan budget recovers, most likely linked to the global oil market, there will be a need for restocking medical supplies both by the private and public healthcare sectors.
STATISTICS OF ANGOLA
| Total population (2016) | 28,813,000 |
| GNI per capita (PPP international) | 6,770 |
| Life expectancy at birth m/f (2016) | 60/65 |
| Probability of dying under five (per 1000 live births (2018) | 77 |
| Probability of dying between 15 and 60 years m/f (per 1 000 population, 2016) | 275/202 |
| Total expenditure on health per capita (Intl $, 2014) | 239 |
| Total expenditure on health as % of GDP (2014) | 3.3 |
HEALTH EXPENDITURE
Angola is less dependent on donor funding for health than other sub-Saharan African countries, with external resources comprising only 3.4% of total health expenditure (THE) compared to the regional average of 22%. Out-of-pocket (OOP) expenditures as a percentage of THE have gradually decreased. In 2015, THE per capita reached US$267. Although public financing for primary care faced a growth rate of 415% from 2000 to 2005, government health spending as a percentage of general government expenditure remains relatively low, at 7.7%—below the average of 11.4% for upper middle-income countries (UMICs).
Since 2008, public primary care facilities have not charged user fees, but funding to replace this revenue has been uneven. The public payroll system functions reliably; however, one of the major challenges remaining is to finance non-salary recurrent costs (drugs, water, fuel, and supplies); such financing remains inconsistent and often inadequate due to poor funding for health from the central level and insufficient allocation, planning, and spending at sub national levels.
About 60% of the government’s health budget is used to cover hospital services. In the private sector and secondary/tertiary levels of the public sector, contracting is on the basis of fee-for-service (FFS). Insurance companies pay on an FFS basis through their contracted hospitals. Angola has poor oversight systems, and many unregulated private providers that deploy poorly skilled human resources and quality of care have emerged.
Angola has a generalized HIV epidemic, with an estimated prevalence of 2.4% (ages 15–49).
HIV accounts for 8.6% of all deaths in the country, whereas the total AIDS expenditure (TAE) accounts for just 0.88% of THE in Angola.
SOCIO-ECONOMIC OVERVIEW
Despite significant progress on macroeconomic stability and structural reforms, Angola is still suffering the effects of lower oil prices and production levels, with an estimated gross domestic product (GDP) contraction around 1.2% in 2018. The oil sector accounts for one-third of GDP and more than 90% of exports. The transformation of a state-led oil economy to a private-sector-led growth model is a complex and long-term process and the oil sector will continue to play an important role during this transition period.
The government has delivered on several key reforms since taking office in 2017. Two laws that are essential to enhance private sector-led growth and competitiveness have been approved: the private investment law and the antitrust law, followed by the creation of a competition authority. The government took first steps to reform public utilities, utility tariffs and subsidies, and to privatize or liquidate some state-owned companies by creating IGAPE – the state-owned enterprise (SOE) oversight agency. The government also established a social protection registry to protect the most vulnerable from the reforms.
Macroeconomic stability has been restored and maintained through a more flexible exchange rate regime, restrictive monetary policy, and fiscal consolidation. The reform program is supported by a three-year Extended Arrangement Under the Extended Fund Facility (EFF) from the International Monetary Fund ($3.7 billion) and a programmatic series of Development Policy Financing (DPF) from the World Bank ($500 million).
The policy response since late 2017 has been adequate and effective in reducing domestic imbalances. The Banco Nacional de Angola (BNA) adopted a restrictive monetary policy to anchor inflation and to offset the impact of the exchange rate devaluation; however, the tight monetary policy stance has been relaxed somewhat in 2019 with interest rate cuts in January and May to stimulate economic activity. Inflation remains high but continued to decline from 18.6% at end-2018 to 17.2% in July 2019, reflecting weak economic activity and muted exchange rate pass-through.
The authorities are actively addressing financial sector vulnerabilities. The BNA increased minimum capital requirements for banks, which led to the closure of three banks.
Nonperforming loans (NPLs) remain high at 28% of total gross loans; but they are concentrated in Banco de Poupança e Crédito (BPC), whose restructuring is part of the IMF EFF program.
HEALTH SYSTEM
- The health system is organized in three levels, corresponding to the administrative division of the country:
- The private sector includes around 200 health establishments, seven supply centers and 42 private pharmacies.
- The health system is under-resourced. More than 50% of the population does not have access to health services. The quality of available health services and their coverage are both severely limited. Public health programmes are overstretched. Health service users have to pay substantial charges.
- Nationwide, there is one health center per 25,000 persons, one pharmacy per 22,500 persons, one maternity bed per 577 births and one pediatric bed per 13,540 children under 15 years of age. The ratios vary depending on the region and very populous areas such as Maradi, Tahoua, Zinder and Tillaberi are the least covered.
The main health sector priorities include:
- Health infrastructure rehabilitation at the Primary Health Care level in return and resettlement areas, and expanded provincial health services providing the Minimum Health Care Package (MHCP);
- Gradual re-directing of funds to PHC programmes;
- Provision of outreach services for hard-to-reach populations, increasing accessibility to the MHCP;
- Reinforcement of STIs case management, providing voluntary and confidential testing for STIs and counselling, and health education for HIV/AIDS;
- Support to the Ministry of Health and Provincial Health Directorates in partnership-building, coordination and monitoring;
- Training (particularly in-service) directed at restructuring, upgrading, and streamlining the dilapidated workforce, a precondition to the redeployment of available staff and to the improvement of the quality of care, and provision of support to the integration of former UNITA health workers into the national health system;
- Strengthening of management and financial systems (including information), to identify main inefficiencies and inequalities, correct them, and attract additional resources.
HELATH INFRASTRUCTURE
Most Angolans, expats and tourists must pay for private treatment, as public healthcare is not easily accessible. The standard in public hospitals and clinics is very low with regards to cleanliness, availability of medication and medical centres, and provision of basic services
Public healthcare
Public health services are very limited in Angola. It is more than likely that you will end up having to visit a private hospital. There are very few qualified doctors, and few hospitals or clinics in Angola. Combined with a poor infrastructure, the Angolan Ministry of Health, MINSA, faces a difficult job to improve primary, secondary and tertiary care.
Private healthcare
Private healthcare is expensive in Angola and will expect to pay upfront in cash for any treatments in a medical center. For major medical care such as surgery, many expats will either return home or go to South Africa to receive treatment. If you have a medical issue prior to arrival in Angola, it is important to bring the medication with you in the original packaging in case any problem arises. There are local private hospitals scattered across Luanda, though there are very few located outside of the city.
Angolans will pay $80- $150 USD for basic malaria treatment and $200- $300 USD for a more complex malaria or typhoid fever treatment. The high infant and maternal mortality rates show that hospitals in Angola do not offer the same quality care that you are used to back home.
CHALLENGES IN HEALTHCARE
Lack of government funding and health care reforms has led to Angola having the second highest mortality rate among children worldwide. The leading causes of death among children in Angola include malaria, malnutrition, pneumonia, and meningitis. HIV/AIDS and infectious diseases, particularly polio and tuberculosis, continue to threaten the sustainability of this developing nation.
BURDEN OF DISEASES:
The above figure explains the percentage of total deaths caused by various diseases in Angola. Influenza and pneumonia that is 30% (total deaths 45,062 per 100,000 populations). Least number of deaths has occurred due to prostate cancer that is 1% (total deaths 800 per 100,000 populations).
MAJOR HOSPITALS IN ANGOLA
Centro Evangélico de Medicina do Lubango (CEML):
The hospital is 55 bedded hospital and has 7 doctors and 42 nurses. The phase 1 comprises of X-rays, ultrasounds, basic labs and supplemental oxygen. Phase 2 comprises of diagnosis, treatments, surgery and training.
Chiulo Missionary Hospital:
The Missionary Catholic Hospital of Chiulo, situated in the Ombadja Municipality in Angola is the referral health facility for approximately 306.550 persons. The hospital has a capacity of 234 beds and consists of pediatrics, gynecology, vaccination, surgery, ophthalmology, internal medicine, emergency room and physiology departments. In 2018, the hospital received 33’021 outpatient visits, 7325 antenatal care visits, took care of 1200 deliveries of which 49 were done by caesarean sections, provided 15128 vaccinations and took care of 4451 patients admitted for care of which 303 were malnourished children.
Hospital
Hospital de Kalukembe represents one of CHSC’s greatest staffing needs. It has an inpatient capacity of around 200 beds. It is located at Huila, Caluquemge, Angola, some 230 kilometers or 140 miles northwest of the city of Lubango, The inpatient wards include: Pediatrics, maternity, men’s, women’s and the ICU. Kalukembe is the only protestant mission hospital to survive the 27 year civil war in Angola.
Luanda Medical Center, Angola
Specialties:
- Operating rooms
- Specialty consultation
- Outpatient Emergency
- Imaging
- Laboratory analysis
- Specialized cardiology unit, etc
Clinica Girassol Luanda, Angola
Specialties:
- Medical oncology
- Cardiology
- Neurology
- Nephrology
- Obstetrics and gynecology
- Radiation oncology, etc
MAJOR DIAGNOSTIC CENTERS
- Global Diagnostic
- Cemedic
- MD clinic Angola
- FISIOGASPAR Angola
CONCLUSION
Angola healthcare has continuously taken measures to excel in the healthcare industry. Public and private sector is working to achieve the goals in health care industry. There should be a focus on improving, renewing and developing the performance of the health sector which should neither be optional to the administration nor voluntary, but, in the current situation, are necessary for the survival of the health system.
It is the superficial and macro level study for more details kindly contact Hospaccx Healthcare business consulting Pvt. ltd on Hospaccx.India@gmail.com or you can visit our website https://hospaccxconsulting.com/
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