World Food Programme Angola Senior Project and Optional Rotation June 5, 2006 – August 4, 2006 Cathy Hsu
Overview Introduction to Angola Current situation in Angola WFP Angola’s SMI program Projects done in Angola Senior project: Focus groups with women Side project: Data analysis Side project: Community nutrition assessment Conclusions
Introduction to Angola Colonized by the Portuguese Independence in 1975 Quickly followed by a civil war Cease-fire in 2002
Current situation in Angola Rich with diamonds, oil, and fertile land 70% of population under the poverty line 4 million people displaced from the war Heavily mined country interior Devastated infrastructure: transportation, sanitation, education, health systems
Maternal and Child Health in Angola Maternal mortality: 1850/100000 Hemorrhaging Malarial and iron-deficiency anemia Infant mortality: 150/1000 Malaria Vaccine preventable diseases Vitamin A deficiency Reduce by increasing attendance of women at prenatal and postpartum health care.
Saude Materno Infantil (SMI)Maternal and Child Health Distribute food rations to women attending prenatal and postpartum health centers Goals To reduce maternal and infant mortality through increased usage of health services To improve the nutrition status of pregnant and lactating women and infants
SMI Rations provided: Corn-soy blend, fortified maize meal, vitamin A fortified oil, iodized salt Two areas Rural Huambo Peri-urban Viana
1. Senior Project: Focus Groups Conduct focus groups with pregnant women at health centers implementing SMI 8 focus groups 4 in Huambo 4 in Viana 2 small 2 large 2 small 2 large
Methods Received IRB approval from Medford Social Sciences At each health center 6-8 women were recruited to participate All women were orally consented Asked questions regarding: Health care access Health care quality Food rations
Preliminary results All women believe that prenatal care is very important for a good pregnancy outcome. Women in semi-urban areas have more sources for health information than women in rural areas. Women make health center choices based on quality of health care provided. Quality of care suffers from inadequate medication supply. Adequate transportation is a barrier to health care access.
Preliminary Results Knowledge of the importance of mosquito nets has not translated into the practice of using mosquito nets. All women breastfeed for 1-2 years, but knowledge and practice of exclusive breastfeeding varies. Food rations are not a universally motivating component of the program. Most women spend less money the month that they receive the rations.
2. Side project: Data analysis Data from Government of Angola survey 214 children under five Huambo province Nutritional, household, health information Software used Epi-Info for stratified frequency and means WHO Anthro 2005 for z-score calculations ArcView for chloropleth maps of data
Results Average household size: 5.5 Average prenatal consults: 5.1 7% of children were wasted 28% of children were underweight 60% of children were stunted 73% of children received vitamin A 55% of children received measles vaccine
3. Side project: Nutrition assessment UNITA community of displaced people WFP Angola to continue or end assistance Conduct an assessment of nutrition status of children under five 57 Children Weight, height, MUAC History of sickness, vitamin A, measles vacc Clinical indicators of severe malnutrition
Results Wasted: 10% Underweight: 18% Stunting: 26% 32% had diarrhea in past 2 weeks 33% had ARI in past 2 weeks 93% had measles vacc and vitamin A No children had edema, Bitot spots, cheilosis, angular stomatitis
In conclusion… Focus groups
Follow-up for qualitative analysis
Follow up with Field Exchange publication
Discuss with WFP Angola possible changes and improvements to SMI program or implications for future programs
Submitted analysis and graphics to GSA
Discussed results and use in future
Submitted analysis to FAM and Dep. Country Director