Health
USAID/Angola's 2006-2009 Strategy Statement identified weak governance as a key source of fragility, because shortfalls in governance limit economic opportunity and access to basic services. This weakness is exacerbated by the limited and/or inadequate institutional, infrastructural, and human capacity faced by Angolan institutions, be they public sector, private non-extractive industry enterprises or NGOs. As a result, access to basic services, such as health care and electricity are inadequate, inaccessible or even nonexistent for large parts of the population. Government inability to meet the basic needs of many of its people, combined with other factors such as lack of economic opportunity, rapid urbanization, and large numbers of youth without work, education, or services contribute to fragility.
USAID's new Service Delivery strategic objective is part of an integrated program that seeks impact at the people level, over the short-term, to relieve the immediate sources of fragility; and impact on systemic reform, over the longer-term, to transform fragility to stability. To facilitate people-level impact, USAID will provide assistance at the community level of governance; to facilitate systemic reform, USAID will support efforts at the central level of governance. To the extent possible, because it will be critical to both the people-level and the systemic reform efforts, USAID will seek to fortify the bridge between the community and the central level of governance by strengthening systems at the provincial and municipal levels of governance as well. In this and the other two strategic objectives, key actors will include the Government, civil society, and the private sector.
USAID aims to expand access to health care and electricity in the short-term, and improve the responsiveness of national providers of health care and electricity over the longer-term, by increasing the providers' technical capacity and promoting systemic reform in the health and electrical energy sectors. The USAID approach integrates our strategic objectives in service delivery, economic growth and governance reform. The electricity program is designed to contribute to the restructuring of the electricity sector and, in the process, improve service delivery, increase opportunity for micro, small and medium enterprise development and strengthen governance by improving the quality of dialogue between government and civil society. It will focus on electricity service provision and community participation surrounding electricity service provision. The program will build and extend the Luanda Urban Rehabilitation and micro-Enterprise Project (LURE), initially funded by DFID, and which has, up to this point, focused on improvement of water, sanitation and micro credit services. The USAID program will extend LURE's efforts to establish solid, well- run community groups that will be able to achieve individual and community goals. It will include a specific component for electricity service provision as part of the participatory community development process. Electricity service provision is a logical addition to the existing community work and will provide another concrete entry point for reinforcing participatory democracy. The result will be increased access to electricity for affected communities for social services and productive uses through community participation in the electricity decisions that affect their lives.
To improve service delivery efforts In the health sector, USAID is (a) implementing the President's Malaria Initiative (PMI) to significantly reduce the incidence, morbidity and mortality of malaria in Angola; (b) supporting interventions to curb the spread and mitigate the impact of HIV/AIDS and other infectious diseases (such as Tuberculosis); (c) reinforcing reproductive health efforts; and (d) helping put in place the systems necessary to improve health care delivery over the long term. This final point of systems strengthening actually is the underlying foundation for our strategic focus, since it integrates with our efforts to advance governance reform, building up the capacity of the Government of Angola to effectively address service delivery needs of Angolans, with increased transparency and accountability, participation and institutional capability.
USAID's service delivery in health program addresses key health problems - primarily reproductive health, HIV/AIDS prevention and malaria - through three main technical approaches: expanding delivery and improving quality of non-clinical services in key municipalities of three provinces; improving health systems that affect access and quality, particularly pharmaceutical logistics, health worker supervision and performance monitoring, to influence budget priorities and availabilities nationwide; and introducing community outreach and local participation in health decision-making.
USAID is working to improve civil society's ability to address service delivery deficiencies, initially health care and electricity needs, through linkages between line ministries and public sector entities at the central, provincial and municipal levels, civil society organizations, and community mobilization efforts with community-based groups and organizations. USAID will seek new corporate partnerships to expand the reach and leverage USG resources for service delivery.
The health program focuses on the key health problems in Angola: malaria, reproductive health, HIV/AIDS, other selected infectious diseases - particularly polio, and health systems improvements to enhance potential for long-term sustainability.
