Advance Africa's Angola Program: Interventions, Results, and   Lessons Learned in a Post-Conflict Setting, 2004 - 2005
Publisher: http://pdf.usaid.gov/pdf_docs
Published: 2005
Number of pages: 45
Table of contents: title: Angola has been in a state of civil war for the last 40 years, during which time the; title: health system’s infrastructure was destroyed. Huambo Province was the center the; title: majority of the fighting during the war, as it was home to the UNITA separatist party; title: leader Jonas Savimbi. In 2002, a peace agreement was signed between the; title: government and the UNITA party. In this post conflict setting, where internal; title: infrastructures have been destroyed and poverty levels have skyrocketed, the maternal; title: morality and infant mortality rates are some of highest in the world. To combat these; title: issues Advance Africa focused on revitalizing the health system in the Huambo; title: province.; title: Advance Africa at the request of the of the Ministry of Health and USAID/Angola; title: mission, was asked to assist MINSA in the development of a comprehensive Family; title: Planning (FP) strategic approach to support the family planning component that exists; title: in the document entitled “The National Reproductive Health Plan (2002-2007)”. With; title: the collaboration and full involvement of the Ministry of Health (MINSA) and the; title: National Direction of Public Health (DNSP), a plan was prepared in order to improve; title: Reproductive Health/ Family Planning (RH/FP) services. The objectives and activities; title: of such a plan were designed to improve the health of women and men of reproductive; title: age through quality prenatal services, birth attendance, family planning, treatment and; title: education about sexually transmitted diseases (STI) and HIV/AIDS.; title: Activities began in 8 out of the 11 municipalities in Huambo Province, through; title: rehabilitation and renovation of 17 of the 32 Health Centers in the province. They also; title: included training for municipal health directors, health center directors and health; title: technicians.  Training consisted of FP, behavior change and communication (BCC),; title: leadership, improvement in service delivery, and supervision and monitoring. At the; title: community level, training was also provided to Traditional Birth Attendants (TBA) and; title: Village Health Committees (VHC), as well as for journalists. Large groups of people; title: were targeted for training and sensitization in order to create a strong core group, for; title: transmitting clear messages on the benefits of birth spacing and to clarify any; title: misperceptions about FP. Prior to the intervention, in general, the Angolan people were; title: still convinced that FP was synonymous with not having children.; title: Advance Africa staff worked with the community to give them a feeling of; title: empowerment over their own lives which was  especially critical in the post conflict; title: setting. For example the community was involved in the rehabilitation of the health; title: centers. Their participation in the process developed a sense of ownership over the; title: Health Centers (HC) and the services they would provide.; title: At same time, health technicians and mobilizers presented lectures every day in the; title: services areas of HCs. A theater group, which was created as another community; title: outreach tool, was also part of the Advance Africa team. The theater group presented; title: skits spreading the project’s key messages in diverse places such as churches,; title: markets, universities, military and police units, schools, refugees camps for internally; title: displaced populations (IDPs), government and private institutions, and at many events; title: and holiday celebrations. Advance Africa also produced radio messages carried out in; title: Portuguese as well as in Umbundo (the local language). Another radio program “O; title: medico em sua casa” (The doctor in your house) which has been an ongoing program; title: in Huambo for the last eight years was presented and directed by an Advance Africa; title: employee and also helped to spread the main ideas of the project.; title: During the projects short stay in Angola there was an outstanding increase in the; title: number of users of FP methods, from 13,730 (FY2003) at the beginning, 54,382; title: (FY2004) to 90,742 (2005) at the end; with a stable increase in the number of returning; title: cases.; title: One of the most important program achievements was the exceptional rates of male; title: involvement in the decision making and acceptance of practicing FP. By the end of the; title: project, it had become common to observe men accompanying their wives to the FP; title: consultation. Knowledge about FP methods and birth spacing dramatically increased; title: among males in Huambo. Military and police units as well as other male dominated; title: groups received weekly lectures on RH/FP services, the benefits of birth spacing and; title: free condoms.; title: Many debates took place about gender based violence which has been a problem in; title: Angola, as well as alcoholism. Both practices are closely related to the number of; title: rapes and unplanned pregnancies in Huambo.; title: Finally, Advance Africa developed client feedback interviews, to determine users’; title: opinions and initiated home to home visits covering a radius of 1.5 miles from the; title: health centers. This motivated health technicians to go outside of the centers to; title: practice community mobilization and made the clients and community feel as though; title: they were the most important part of the project.