Transforming Health For All in Angola

By Dr. Paulo R P Souza, chief of party of HFA, PSI/Angola

In Angola, nearly two decades of peace and robust economic growth has led to huge progress in the management of the country’s national health system. Building on years of bilateral collaboration, USAID launched Projecto de Saúde Para Todos (Health For All, or HFA) in early 2017 as a new, collaborative program to support the government’s efforts to increase quality health service delivery in Angola.

The five-year USD 63 million grant is being implemented by PSI in partnership with Rede Mulher Angola, TechnoSaúde, Tropical Health, Management Sciences for Health and The MENTOR Initiative. The project will deliver a package of health interventions bringing malaria, HIV/AIDS and family planning services in select municipalities and provinces throughout the country.

Angola’s healthcare system has rapidly expanded in the last 15 years to reach over 46% of the population. However, the recent economic slump due to falling oil prices – the driving force behind the country’s transformation – threatens progress already made in the health sector. “Through HFA, USAID aims at strengthening the government capacity to improve the health sector, and complementing government initiatives and other donors like the Global Fund in these three health areas,” said Anya Fedorova, PSI/Angola country representative.   

Despite significant reduction in incidence rates – almost 40% decline in the number of cases between 2006 and 2011 – malaria remains one of the biggest killers in Angola. PSI and partners will operate in 24 municipalities across six provinces to improve access to and use of bed nets, scale up the intermittent malaria preventive treatment for pregnant women, and work with providers to combat drug resistance through effective use of diagnosis and treatment kits.

HFA also join the government’s efforts to maintain the country’s relatively low HIV prevalence (2 to 3%). Taking effect in Luanda and possibly two additional provinces, the project will seek to develop sustainable models for providing high-quality HIV/AIDS prevention, care, support and treatment services.

In line with the national goal of reducing maternal and child mortality, HFA will work in Luanda and Huambo provinces to strengthen and expand access to and create demand for family planning services. This will be accomplished through behavior change approaches, building provider capacity and fostering an enabling environment that support comprehensive reproductive health services for women, couples and youth.

Moving beyond partnerships as usual, HFA will focus on fostering the capacity of national, municipal and provincial governments to plan, fund, monitor and supervise improved health programs. This includes creating more public private partnerships to bring together the resources and expertise from both the public and private sectors.

“The spirit of Health For All is about nurturing local ownership and leadership not only from the government but other in-country stakeholders as well,” explains Dr. Paulo Proto de Souza, HFA chief of party, PSI/Angola. “The project aims to transfer 30% of resources, including key personnel, to local partners by the end of Year 3.”

Building on USAID’s ten principles of engaging local systems, HFA will directly engage government, civil society, private sector and beneficiary partners in three phases of implementation:

  • Co-diagnosis of fundamental barriers. Working with health system leaders and change agents, HFA will leverage local knowledge to map health systems with the goal to understand the challenges and unpack their root causes.
  • Co-design of solutions to strengthen health systems. Interventions will be developed in close collaboration with the government and local stakeholders for high impact, flexible, country-specific interventions and health system reforms.
  • Co-implementation of proven intervention. From the onset, HFA will work with the Ministry of Health and local partners to co-design a phased program approach, establish annual and transition planning, quarterly progress reviews and accountability checks as well as stepping stones for effective transition.

“The vision is to gradually transition program implementation to local stakeholders over the life of the project,” says Anya Fedorova. “Ultimately, this will transform Health For All interventions into measurable and sustainable outcomes beyond program end.”

 

The contents are the responsibility of Population Services International and do not necessarily reflect the views of USAID or the United States Government.