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Please provide data on the structure of the healthcare system in Angola. Include information and statistics on the number of hospitals, breakdown of hospitals, healthcare coverage/insurance, setup (Private vrs Public), and key stakeholders.
Hi there! Thank you for your request to provide data on the structure of the healthcare system Angola, including information and statistics on the number of hospitals, breakdown of hospitals, healthcare coverage/insurance, setup (private versus public), and the key stakeholders. The short version is that, using a number of sources, particularly Export.gov's "Healthcare Technologies Resource Guide A Reference for U.S. Exporters 2017," I have found relevant information on the overall healthcare system structure in Angola, including information on the number of hospitals and other medical services, whether private or public, as well as key stakeholders, such as Luanda Medical Center, Mecofarma, Exxon Mobil and BP Angola. Below is a deep dive into my research and methodology.
METHODOLOGY
To fulfill your request, I first examined the links you provided in the "What have you already found?" section, and thereafter, I used Google and Wonder's resources database as my primary research tools. Using various searches, I found several news articles, government websites, industry-related websites, and reports that provided the information requested. The most important of these resources is Export.gov's "Healthcare Technologies Resource Guide A Reference for U.S. Exporters 2017."
SECTIONS:
A. HEALTHCARE CONCERNS IN ANGOLA
B. HEALTHCARE FINANCING
C. HEALTH COVERAGE/INSURANCE
D. HEALTHCARE SERVICE DELIVERY
E. HUMAN HEALTHCARE RESOURCES
F. HEALTHCARE PRODUCTS & TECHNOLOGIES
G. CURRENT HEALTHCARE SYSTEM GOALS
In the above listed sections, I have attempted to thoroughly address the various aspects of your request. Where information is missing, or may seem deficient, this is due my not having found any publicly available information on the subject.
A. HEALTHCARE CONCERNS IN ANGOLA
1. The 2017 World Report by Human Rights Watch states the Angolan government faced significant challenge in meeting the healthcare needs of its population due to its healthcare budget cuts, citing child mortality rate (one of the highest in the world) because children represented the majority of the 3000 malaria-related deaths in the first quarter of 2016. These deaths might have been prevented if the government had managed to maintain an adequate supply of basic malaria medications. This was also compounded by the fact that the government ran out of yellow fever medications and other medications and medical items (e.g. gloves, syringes) as well.
2 Beyond malaria and yellow fever, there are number of other healthcare concerns in Angola, including:
- Typhoid
- Tuberculosis
- Infectious diseases
- Parasitic diseases
- Respiratory diseases
- Diarrheal diseases
- Cholera
- Rabies
- Measles
- Sickle cell anemia
- Chronic non-communicable diseases.
3. Other healthcare issues that impact the system include the fertility rate due the fact that women give birth an average of 6.3 times, and inadequate services (0.1 hospital beds per 1000 people)
B. HEALTHCARE FINANCING
1. Public
a. Financing healthcare represents 5.3% (US$2.1 billion) of the Angolan federal budget (2016). Although the government has increased its budget in recent years, the fall in oil prices (40% lower than 2 years prior) had a devastating impact on healthcare--Angola is the second largest African exporter of oil (approximately 53% of Angola's revenue comes from exporting crude oil) .
b. The US government, through USAID, also provides support to Angola, particularly in treatment and prevention for HIV/AIDS and malaria (through the President's Malaria Initiative program, the country also receives treatments and products related to preventing and curing malaria), expanding family planning services and providing excellent reproductive health care services. Through the President's Emergency Plan for AIDS Relief program, Angola also receives aid in caring for children who are either orphans or are in situations that may compromise their health.
2. Private
C. HEALTH COVERAGE/INSURANCE
- Healthcare spending is approximately US$355 per capita annually, of this 67% comes from public healthcare services, while the remaining 33% is from private healthcare services, which is paid for by individuals, employers or through private health insurance. For individuals who choose private healthcare services, approximately 73% of their expenses is paid out-of-pocket. Insurance companies, however, relatively new to Angola (since 2009) and are not well-regulated.
- The Insurance Information Institute states that nonlife insurance premiums (includes health insurance) in Angola generated US$838 million in revenue. Although dated (2013), the Institute lists the following companies as leading nonlife insurance companies:
- ENSA
- AAA Seguros
- GA
- Global Seguros
- Nossa Senhora da Paz Hospital
- A Mundial Seguros
- Garantia
- Tranguilidade
- Triunfal Seguros
- Confiança
D. HEALTHCARE SERVICE DELIVERY
1. Public Health Services
Although Angola's law allows for free healthcare services, general and specialized) to all, a number of Angolans, expatriates, and tourists choose to use private healthcare services. The reason is due to the low hygienic standards, difficulty accessing medical centers, poorly qualified medical professionals, and insufficient supplies of medications.
In addition, for major medical care, many citizens and residents choose to travel abroad for treatment to countries like Cuba, Spain, Portugal and South Africa--for citizens, the government has been subsidizing the expenses of what has been termed "patient evacuation." The government hopes to reduce the number of subsidies by 50%.
Regarding the number of public hospitals and medical centers, I have not found sufficient data. However, MedPages currently has 87 public hospitals and 184 public clinics in Angola listed on its website. It has been noted that better medical care can be found in the following cities: Luanda, Benguela, Lobito, Lubango and Huambo.
2. Private Health Services
There are significant number of private medical establishments in Angola. However, I have not found any conclusive data about the exact number. This is likely due to the fact that many of these establishments are small. However, MedPages currently has 31 private hospital and 37 private clinics listed on its website, the majority of which are in Luanda. Located in Luanda, the four major private clinics in Angola are
1. Girassol (associated with Sonangol, a state oil company),
2. Sagrada Esperança (associated with Endiama, a state diamond company),
3. Multiperfil (associated with the Presidency), and
4. Luanda Medical Center.
In addition to the private clinics listed above, the American Embassy in Angola also lists the following: Alvalade, Climed, Espirito Santo, Medigroup, Cligest, Cemedic, Horon, and Clidopa. These private clinics offer the following:
- General Practitioners,
- Specialist Physicians-Internists,
- Ear, Nose, Throat Specialists,
- Neurologists,
- Neurosurgeons,
- Obstetrics/Gynecologist,
- Ophthalmologists,
- Cardiologists,
- Flight Medical Specialists,
- Gastroenterologists,
- Pediatricians
3. Pharmacies
MedPages shows that there are 14 public hospital-based pharmacies, 43 private hospital-based pharmacies, and 1,398 retail pharmacies, the majority of which are located in Luanda. The following are 5 major pharmacies are: Mecofarma, Moniz Silva, Novassol, Central, and Mediang.
- Angolan Institute for Cancer Control
- Lwini Foundation for neurosurgery and hydrocephaly treatment (Luanda)
E. HUMAN HEALTHCARE RESOURCES
- There are approximately 3,700 doctors (0.08 doctors per 1,000 inhabitants), half of which were supplied by the Cuban government, 34,300 nurses (0.01 midwives per 1,000 inhabitants), and 6,400 diagnostic and therapeutic technicians. In addition, Angola has also sent hundreds of medical students to Cuba for training. Still, Angola faces a challenge in retaining its foreign doctors due to the lowering income.
F. HEALTHCARE PRODUCTS & TECHNOLOGIES
1. Pharmaceuticals
Angola relies heavily on importing medications and medical devices because the country does not yet have an adequate pharmaceutical industry. The imports primarily come from the following countries: India, Portugal, and China, representing a total of 221 importers and distributors. Lower-cost medications are unregulated and are typically imported from distributors in China and India. Such medications are likely to be sold outside of the major urban areas, while fully registered, higher quality medications can be found in urban areas.
At the national level, there is the publicly- and privately-funded company Nova Angomédica, which produces the following product types: anti-inflammatories, anti-allergic, anti-anemic, antimalarial, saline solutions, ointments, anti-tuberculosis, and analgesic.
Although prices vary, medications and medical devices can be acquired through local pharmacies (branded medications and devices), private clinics (typically branded medications and devices), and public hospitals (typically generic medications and devices).
Related Institutions: The National Institute for Consumer Protection, and the National Direction for Medicines and Equipment (Ministry of Health).
2. Telemedicine
Some healthcare services have started to implement telemedicine services with the intention of providing outreach services in rural communities. This plan, however, has been challenged by decreased government spending and the limited and/or inconsistent internet availability in poorer communities.
- Girassol
- Pediatric Hospital David Bernardino
- Nossa Senhora da Paz Hospital
- Luanda Medical Center
G. CURRENT HEALTHCARE SYSTEM GOALS
- Updating the system's infrastructure and increasing the number of facilities, particularly remote areas and in urban areas that have not received adequate services,
- Providing more training opportunities for healthcare professionals, and
- Investing more in disease prevention.
The government's National Development Plan for 2013-17 and its National Health Strategic Plan for 2012-25 had anticipated that the government would be able to invest US$5.2 billion annually towards improving its healthcare system. However, they have not been able to achieve budget goal over the past 2 years (US$2 billion in 2015 and 2016).
CONCLUSION
To wrap it up, using a number of sources, particularly Export.gov's "Healthcare Technologies Resource Guide A Reference for U.S. Exporters 2017," I have found relevant information on the overall healthcare system structure in Angola, including information on the number of hospitals and other medical services, whether private or public, as well as key stakeholders, such as Luanda Medical Center, Mecofarma, Exxon Mobil and BP Angola. The Resources sections provides supplementary news articles and websites that you may provide you with additional insights. Thanks for using Wonder! Please, let me know if we can help with anything else!