Afrigather 
This opinion was first printed in Portuguese by Jornal de Angola, which model will be discovered here:
Dr Humphrey Karamagi, WHO Consultant in Angola
On 28 November 2023, Ministers of Well being and people liable for HIV/AIDS, along with senior authorities officers and well being companions within the SADC area, met in Luanda, Angola, to debate progress on the well being agenda within the area. This annual discussion board is essential for the SADC area, because it permits nations to study from one another and develop frequent options to the challenges they face within the well being sector.
This yr’s assembly was hosted by the Authorities of Angola, which has made vital progress that may be adopted by different SADC nations. As highlighted on 16 October 2023 by the Head of State, His Excellency João Manuel Gonçalves Lourenço, throughout his State of the Nation Tackle, Angola has seen vital enhancements in its capability to supply important well being providers. Since 2017, the nation has undertaken the development, enlargement, and rehabilitation of greater than 163 new well being items, 155 of that are for main care. In the identical interval, mattress capability has elevated from a minimal of 13,426 to 37,808. On the nationwide degree, the capability of specialised hemodialysis providers is being strengthened, at present out there in 10 provinces, in comparison with solely 3 provinces in 2017. Within the final parliamentary time period, the nation additionally recruited 41,093 well being professionals, together with docs, nurses, diagnostic and therapeutic technicians, and others, with 80% of the docs recruited being positioned within the municipalities of the provinces, rising the capability to supply well being providers on the deconcentrated degree of the well being sector. The outcomes of this funding are already being demonstrated. For instance, though malaria stays the main reason for sickness and demise, the variety of folks dying from malaria has been falling since 2017, by round 15 %. Moreover, on this similar interval, there was a 50 % enhance in diagnoses of non-communicable illnesses in main care.
This story is essential as a result of the nation is reaching it with restricted will increase within the funds out there for well being. Between 2017 and 2020, WHO/World Financial institution estimates present that present well being expenditure adjusted for buying energy remained between 180 and 200 {dollars} per particular person, with fixed values prevailing after adjusting for COVID-19 expenditure.
It’s due to this fact potential for nations within the SADC area to considerably enhance their well being service supply, even in conditions of restricted sources, by focusing succinctly and unwaveringly on a variety of well being outcomes.
The worldwide well being agenda is concentrated on reaching three outcomes: common well being protection – entry to and utilization of important well being providers; well being safety – safety from sudden disasters and emergency threats to well being; well being determinants – the safety of individuals in opposition to social, environmental, financial and safety dangers which will have an effect on their well being. Angola is making appreciable investments within the well being sector and different sectors which might be having an influence on all these outcomes. I’m highlighting right here FOUR examples of areas the place nations can focus to extend their capability to deal with their well being challenges inside useful resource constraints. These examples are usually not exhaustive, however they serve as an example the teachings we are able to study from one another.
Firstly, a worldwide concentrate on the event of well being service supply programs. It’s essential to concentrate on the entire system and never make the totally different areas compete with one another. By the use of instance, Angola is concentrating on funding on the nationwide, provincial, municipal, well being heart, and group ranges concurrently, with out prioritizing one to the detriment of the opposite. On the main care degree, the nation is specializing in the municipalization of well being providers, whereby the first well being care strategy is constructed round a considerably stronger main hospital within the municipality – one degree decrease than the province, which is the decentralized degree of governance.
Secondly, we have to develop and capitalize on particular person and group well being actions as a part of well being providers. At present, a whole lot of private care is at finest tolerated however usually discouraged. Nevertheless, it’s an integral a part of the care-seeking course of that folks start and finish their healthcare course of with some type of private care. Our group well being staff shouldn’t simply concentrate on bringing outlined providers to the group however must be seen as a way of harnessing and facilitating self-care actions which might be useful to the inhabitants. That is much more essential for populations the place entry to institutional well being providers is restricted, and the place native cures and options are used.
Thirdly, we have to higher combine our well being providers into international and nationwide priorities. The context through which well being providers are offered has a major influence on the flexibility to answer folks’s wants. As we speak, globalization, urbanization, and extra knowledgeable communities are shaping the way in which people work together with well being providers. The Well being Sector in Angola has undertaken initiatives to observe and reply to well being and well-being points that come up on social media and different public platforms, which helps to deal with the operational challenges arising from the care supply course of.
Fourthly, we have to maximize the potential of digital well being within the area. Most of the present initiatives can’t be scaled up, are too restricted in scope, are centered on knowledge extraction fairly than service provision, and are externally oriented. We have to develop options tailored to the present wants of the area, centered on bettering people’ entry to providers that might in any other case not be out there. For instance, the present well being infrastructure and the coaching carried out by the Angolan authorities have built-in digital telemedicine options to facilitate the trade of data and thus prolong the supply of important providers that might not usually exist.
These are some examples we are able to see in Angola. Different SADC nations even have examples they will share, notably in areas equivalent to resilience, high quality of care, and different areas for which options are being sought within the area. Though the well being challenges are many and complicated, there are answers that, by working collectively, will be overcome.
