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ABSTRACT
We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs’ function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid.
Acknowledgement
We are grateful to research assistant Neida Vicente for support in the field.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1. Millennium Development Goals (MDGs) 4: Reduce child mortality; MDG 5: Improve maternal health; MDG 6: Combat HIV, Malaria and other diseases and MDG 8: Develop a global partnership for development.
2. The CORE (Child Survival Cooperation and Resource) group of NGOs is a Group of NGOs and donors that works on specific issues like polio or HIV/AIDS.