CHILD HEALTH IN ANGOLA Luis Bernardino March 2013
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CHILD HEALTH IN ANGOLA Luis Bernardino March 2013
description
CHILD HEALTH IN ANGOLA Luis Bernardino March 2013 . CHILD HEALTH THE SITUATION IN LESS DEVELOPED VERSUS DEVELOPED COUNTRIES. 1 . Higher morbility / mortality ( Quantity ) Perinatal mortality (nº dead 1st week /1000 NB alive or dead ) - PowerPoint PPT Presentation
Transcript of CHILD HEALTH IN ANGOLA Luis Bernardino March 2013
CHILD HEALTH IN ANGOLALuis Bernardino
March2013
CHILD HEALTHTHE SITUATION IN LESS DEVELOPED VERSUS
DEVELOPED COUNTRIES
• 1. Higher morbility/mortality (Quantity) Perinatal mortality (nº dead 1st week/1000 NB alive or dead) Neonatal mortality (nº dead 1st month /1000 NB) –( M < 1M)
Infant mortality (nº dead 1st year /1000 NB) (M < 1 Y) Mortality >5 (nº dead first five years/ 1000 NB) (M < 5 Y)
2. Different causes of death (Quality)
MORTALITY, QUANTITY *
Levesl & Trends in Child Mortality, 2011 ReportUNICEf, WHO, WORLD BANK, UN.NATIONS,DESA/ Pop. Div.
Best figures among more developed countries
The more unfavourable figures
Country Mort.<1M Mort.<1A Mort.<5A Country Mort.<1M Mort.<1A Mort.<5A
Japan 1 2 3 Burkina Faso
28 93 176
Luxembourg 1 2 3 Chad 41 99 173
Finland 2 2 3 Rep.DemCongo
46 112 170
Sweden 2 3 3 Haiti 20 70 165
Norway 2 3 3 Angola 45 98 161
MORTALITY (Quality)10 more frequent causes of child death in Sweeden na Nigeria( 1990)
SWEDEN NIGERIA
1.Delivery trauma;asphyxia 1. Pneumonia
2. Other neonatal conditions 2. Other neonatal conditions
3. Congenital malformations 3. Malaria
4. Accidents (no trafic) 4. Diarrhoea
5. Trafic accidents 5. Other ilness
6. Other ilness 6. Cause not known
7. Neoplasia 7. Measles
8. Pneumonia 8. Other infectious and parasitic infections
9. Influenza 9. Delivery trauma; asphyxia
10. Diarrhoea 10. Anemia
Environment
GenomaGenoma
Environment
CAUSES OF ILNESS
LESS DEVELOPED COUNTRIES DEVELOPED COUNTRIES
THE UNDERDEVELOPMENT CYCLE
POVERTY
FOOD INSECURITY
POOR EDUCATION
UNHEATHY HABITAT
INFECTIONHIGH
MORTALITY < 5 YEARS
HIGH NATALITY
MALNUTRITION
POPULATION/ RESOURCES GAP
http://www.infoescola.com/geografia/paises-mais-pobres-do-mundo/
Fonte : Wilkipedia.org
HOUSE : AVERAGE NUMBER OF PEOPLE PER SLEEPING ROOM
National 2.9Urban 2.7Rural 3.0
Source : IBEP, 2011
Houses with sanitary facilities
Urban 74.5 10.3 evacuate out
doors
Rural 28.4 63.5 evacuate out
doors
Source : IBEP, 2011
ACCESS TO CLEAN WATER
National 42%Urban 57.9%Rural 22.8%
National 65.9Urbano 46.4
Rural 89.5
From appropriate sources
No treatment of inappropiate sources
Source : IBEP, 2011
VacinationOfficial figures, 2010 * Measles 93%
DPT 3 91%Hib B 3 91%
National survey 2008- 2009 **
Children immunized with BCG,DPT,Polio, MeaslesWith vaccination card 21.1%Information from mother 7.9%
* WHO Report 2012** Population Welfare Survey (IBEP), 2011
5%
20%
19%
14%
11%1%
2%
5%
6%
1%
8%
3% 7% Anemia Aguda
DRA
Malária Complicada
Malnutrição Grave
Sepis Neonatal
Tuberculose
Drepanocitose
Diarreia Aguda
Hipóxia Perinat
Celulite
Prematuridade
Cardiopatias
Meningite
CAUSES OF DEATH IN 1992 CHILDREN IN THE PEDIATRIC HOSPITAL OF LUANDA IN 2012
Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000
The Lancet, Volume 329, nº 2161, Pages 2151 - 2161, 9 June 2012
CAUSES OF DEATH INCHILDREN IN THE WORLD IN 2010. (The Lancet, 2012, 379: 2155)
A2000 A2001 A2002 A2003 A2004 A2005 A2006 A2007 A2008 A2009 A20100
10
20
30
40
50
60
70
80
90
100
Inte
rnad
os
PEDIATRIC HOSPITALDaily Emergencies admitted, 2000-2010
MONTHLY ADMISSIONS FOR MALARIA2010Malaria 2010
0
100
200
300
400
500
600
700
800
900
1000
Meses
Freq
uênc
ia
Casos 283 267 364 490 941 747 455 230 201 218 330 420
Obitos 27 31 27 27 76 56 32 18 18 12 28 26
1º 2º 3º 4º 5º 6º 7º 8º 9º 10º 11º 12º
SEVERE ANEMIA = TRANFUSIONSNumber of cases Pediatric Hospital, 2010
Anemia severa 2010
0
200
400
600
800
1000
1200
1400
Meses
Freq
uênc
ia
Casos 558 539 728 693 1169 986 718 499 471 568 645 780
Obitos 6 8 9 17 23 15 21 8 5 6 7 20
1º 2º 3º 4º 5º 6º 7º 8º 9º 10º 11º 12º
ADMISSION EMERGENCY WARD PEDIATRIC HOSPITALMay, 2011
A2000 A2001 A2002 A2003 A2004 A2005 A2006 A2007 A2008 A2009 A20100
2
4
6
8
10
12
14
16
Hospital Pediátrico David BernardinoDaily deaths,2000 - 2010
Óbi
tos
ANGOLA : HOW NEAR THE 4TH MILENIUM DEVELOPMENT GOAL?What sould be done?
THE ATTEMPTS: 1978 :ALMA ATA AND HEALTH FOR ALL IN 2000 – THE STRATEGY OF PRIMARY CARE
2000 : THE MILENIUM OBJECTIVES GOALS
THE UNDERDEVELOPMENT CYCLE
POVERTY
FOOD INSECURITY
POOR EDUCATION
UNHEATHY HABITAT
INFECTIONHIGH
MORTALITY < 5 YEARS
HIGH NATALITY
MALNUTRITION
OVERPOPULATION/ RESOURCES GAP
INTEGRATED APPROACH TO REVERT THE POVERTY CYCLEEstrategy defined in 1978 in Alma Ata
The Problem The ReactionPoverty DevelopmentUnhealty environmente SanitationFood insecurityMalnutrition
Nutritional surveillanceEducation
Ignorance Education – general, healthEmphasis on mothers
Infection ImmunizationEducation (hygine)
High natality Family planningAccess to healthcare Heath Centers
Community agents
INSTRUMENTS TO DELIVER HEALTH- ITS COMPONENTS
NUTRITIONAL REHABILITATION
EPI
HEALTH EDUCATIONCOMUNITY HEALTH
WORKERS
PROGRAMSIMCI
MALARIATUBERCULOSIS
SIDA
MILENIUM DEVELOPMENT GOALS (New York, 2000)4 th OBJECTIVE
REDUCE BY 2/3 FROM 1990 TO 2015 THE MORTALITY OF CHILDREN AGED 0 TO 5 YEARS
Indicators• Mortality rate up to 5 yeard (M < 5)• Infantil mortalily (M < 1)• Percentage of children less than one year immunized against
measles
The milestones of Mortality < 5 in Angola, 1990 – 2012WHO Data
A 1990 A 2000 A 2010 A 20150
50
100
150
200
250
300
243
200
161
81
?
EDUCATION HEALTH NATIONAL BUDGET Higher expenceUnversity Terciary Care
Technical Provincial & Municipal traning Hospitals
Primary & Health Centers Secondary Community care Lower expense
BUT HEALTH STRATEGY IN ANGOLA DOES NOT PRIORATIZE PRIMARY CARE
1. The budget of health is below the level advised2. The expenses are at the top levels of Education and Health, rather than on basic services
ANGOLA STRONG AND WEAK POINTS TO REACH THE 4TH MILENIUM GOALS STRENTGHTS RICHESS IM MINERAL, AGRICULTURE WATER AND SEA RESOURCES
POPULATION RELATIVELY SMALL, PER CAPITA PRODUCT INCREASING IN THE LAST YEARS
ANGOLA 6.ooo
Congo Brazaville 4.600
Cabo Verde 4.000
Guiné Bissau 1.200
Moçambique 1.100
NATIONAL GDPWorld Bank
PERCAPITA INCOMECIA World Facts Book 2012
PEACE SINCE 2001
ANGOLA STRONG AND WEAK POINTS TO REACH THE 4TH MILENIUM GOALS
WEAKNESSES
UNEQUAL INCOME DISTRIBUTION
STATE BUDGET FAVOURING THE HIGHER QUINTILE OF THE POPULATION
HEALTH STRATEGY SUFERING FROM SAME APPROACH IN INVESTMENT, NOTWITHSTANDING THE RECENT POLICY OF “MUNICIPALIZATION” (BIG HOSPITALS VERSUS HEALTH CENTERS; SUPRESSION OF BASIC CATEGORIES ON NURSING, TRAINING DOCTORS VS. NURSES , ETC.)
1ST ED. 1973
The basic unity to execute primary child/maternal care
Components• IMCI• Prenatal care• Vaccines • Nutrition surveillance• Handing TB & ARV
drugs
• RESOURCES• Local actors• Basic training• Low costs• Quick implementation• Sustainability
CAN THE POLITICIANS STRAIGHTEN THAT QUICKLY FOR US?
