Issue overview
Angola’s civil war which ended in 2002 after lasting 27 years, severely affected the health and nutrition of the population, particularly women and children. The child mortality rate is the third highest in the world. At 260 deaths for every 1,000 live births, one out of every four children dies before their fifth birthday. The maternal mortality rate is also one of the highest in the world, estimated at 1,700 deaths for every 100,000 live births. These deaths tend to be concentrated in poor and densely populated urban areas and in rural areas without access to health services. Medically, the main reasons for maternal death are haemorrhage complications of abortion, toxaemia septicaemia and obstructed labour. Malaria is the largest single cause of child morbidity and mortality in Angola and the greatest public health problem. Annually 1.4 to 2 million cases are reported nationwide, and in 2002 66% of the reported cases were among children under 5 years of age. Anti-malaria treatment is not always available in the health network and is not standardized in all health units. Additionally, despite important promotion and education campaigns, a large majority of the public does not use mosquito nets. The 2001 Multiple Indicator Cluster Survey (MICS) found that nationally only 10% of children under five slept under a mosquito net and only 2% used a net treated with insecticide.
Malnutrition isn't over Poor nutrition is also a major cause of the high levels of child morbidity and mortality. Forty five percent of under-fives, it is regarded as an associated cause in two out of three deaths in this age group. Worsening household poverty and food insecurity continue to contribute to the extremely high rates of wasting among children that were reported in several areas both during the war and following the ceasefire. The MICS revealed that 31% of children under five were underweight and 6.2% were acutely malnourished. Other main causes of child mortality are acute respiratory infections, diarrhoeal diseases and vaccine preventable diseases. Immunization coverage is increasing, although only 47% of one-year-olds are fully immunized. Rates of acute diarrhoeal diseases are high, due in part to inadequate access to safe water and sanitation services, particularly in rural areas where some 60 per cent of households lack access to safe drinking water and 75 per cent do not use sanitary means of excreta disposal.
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