Angola: Social inclusion and protection

Angola has a generalized HIV epidemic with an estimated prevalence of 2%. However, not everyone is affected in the same way. The prevalence of HIV is higher in urban environments (such as Luanda, home to almost 30% of Angolan population) and in southern and eastern provinces (such as Cunene and Moxico) that border countries with higher prevalences. Moreover, women are twice as likely to be infected with HIV than men. It is estimated that less than 50% of people living with HIV know their HIV status, mainly due to poor quality of care, stigma, and discrimination. 
The lack of access to HIV/AIDS-related health information and services (such as prenatal testing and consultations), faced by a significant portion of pregnant women living with HIV, are among the main reasons for HIV transmission in Angola. With an estimated Mother-to-Child HIV transmission rate of 26%, prevention of such transmissions is a priority to ensure an HIV/AIDS-free generation.
Born Free to Shine (Nascer Livre para Brilhar) project uses PIN’s mHealth mobile voice-messaging platform to support Angola's Operational Plan to reduce the Mother-to-Child transmission of HIV in Angola.  Among the strengths of the platform is the use of Interactive Voice Response (IVR) technology, which allows the barriers of illiteracy to be overcome, giving the program an advantage over SMS-based services and other similar technologies. In addition, the voice messages are created taking into account the context, cultural aspects, and national languages of the regions covered. With the technological support of UNITEL and in collaboration with local authorities and the campaign led by the First Lady of Angola, PIN will design a new package of voice messages on the prevention of Mother-to-Child HIV transmission. At least 3500 pregnant women and mothers with young children will receive voice messages from the Born Free to Shine package. In addition, at least 150 health technicians, 150 Traditional Birth Attendants and Community Health Agents, 42 provincial and municipal supervisors, and 48 representatives of CSOs active in the HIV sector will receive training in providing adequate care, counseling and monitoring to pregnant women and mothers of young children exposed to HIV.
Throughout the period 2022-2023 PIN will continue to contribute to the reduction of mother-to-child transmission of HIV in the target municipalities of Luanda, Cunene and Moxico Provinces, with the support of the mHealth Mobile Health Programme. The action will also continue to improve the capacity of health workers to provide appropriate care and counselling to mothers and children 0-24 months with particular focus on HIV-positive Mothers and Exposed Children.
 

First 2 confirmed cases of COVID-19 in Angola were announced on March 21 2020. By November the number grown to 13,451 reported cases, including 322 confirmed deaths[1]. The majority of cases are concentrated in Luanda, making it the province with the highest risk of community transmission. Given that proper hygiene etiquette, abiding by the measures put in place by the Government of Angola (such as self-isolation) and taking test when needed are effective ways to stop the spread of COVID-19 and minimize the infection risks, it is essential to ensure that vulnerable communities have access to the information. Furthermore, information on safe breastfeeding and correct infant feeding practices, as well as on how to access maternal, newborn and child health services (MNCH) during COVID-19 is equally important, since the pandemic has resulted in disruptions to health services worldwide. Additionally, study also shows that due to stronger innate immunity, children are better protected against SARS-CoV-2.[2]
Therefore, the intervention in Luanda Province aims to increase access to information on COVID-19 prevention, good hygiene and nutrition practices and access to MNCH services for the most vulnerable communities in the municipalities of Belas, Cazenga, Maianga, Sambizanga and Talatona. Community engagement is the key not only to spread credible information and fight rumors, but also for strengthening the connections between people living in the target communities and the health services, so that people can easily adhere to the protective measures.
PIN implements the action through a series of risk communication and community engagement activities in target institutions as well as through a community-led public awareness raising campaign using various communication channels including radio programs, theatre plays, community speakers and mobile messages. The project also enhances the sensitization on key nutritional aspects during COVID-19 and access to MNCH services in pandemic context through information disseminated by local influencers and the media.
The intervention is in line with the 2020 WHO Global Strategic Humanitarian Response Plan on COVID-19 by aiming to contain the spread of the COVID-19 pandemic. It contributes to achievement of overall objective of the Angolan National Contingency Plan for the Control of the Coronavirus Pandemic (Plano Nacional de Contingência Para o Controlo da Epidemia por Coronavírus) which aims to reduce the risk of coronavirus in Angola and its negative impact on the health of the population and the socio-economic sphere.
 

Following the first confirmed cases of Covid-19 in March 2020, the Ministry of Health of Angola declared a state of emergency, resulting in a nation-wide lockdown. Even though measures limiting people’s movement and social interaction have proven effective in containing the spread of Covid-19, they also have an enormous economic and social impact, especially on the most vulnerable segments of the Angolan society, and particularly on women and girls. Women are often involved in informal work, hold insecure jobs, and generally earn and save less money than men. More than 70% of Angolan women have a job in the informal economy, with the lockdown severely impacting women who earn their living as street vendors or market sellers. Because of this, women are most likely to lose their income and be exposed to increasing poverty. Moreover, women have generally lower access to reliable health information compared to men (only 6 out of 10 women in Angola are literate), which can, in the context of a pandemic, represent a matter of life and death. Also, economic and social distress coupled with social isolation and restrictions on movement exponentially increase Gender-Based Violence (GBV). Finally, school closures associated with the pandemic can also lead to girls dropping out and not returning to school, even after the crisis is over. 

As a response to these conditions, PIN is implementing a project comprising three parts. As an immediate measure to combat Covid-19, we focus on women’s access to health information. Using our mHealth platform to send life-saving voice messages to women and mobilizing our existing networks of Community Health Workers (CHWs) and Traditional Birth Attendants (TBAs), PIN will spread information on good hygiene practices, essential health services and other key messages for COVID-19 prevention and diagnosis. To protect women’s livelihoods, we will train 40 women in safer work practices, business management skills and alternative income-generating activities, such as hand-making of face masks, soap and handwashing stations. Through our Community Livelihoods Programme, we will provide financial support in the form of sub-grants to 8 local women-led organizations, businesses and entrepreneurs. The final part of the project will aim to increase the capacities of local women groups and civil society organizations so that they are able to advocate for Covid-19 response and recovery plans that address the specific impact of the pandemic on women. The intervention will concentrate on urban and peri-urban areas of the Huíla and Bié provinces where the risk of COVID-19 is much higher than in rural settings. 

In Angola, only 25% of children under the age of 5 have a Birth Registration certificate. The situation is even more critical in rural areas, where less than 13% of children are registered. This deprives the children of many rights, including the access to health and education systems. As a part of the initiative of the Angolan Ministry of Justice and Human Rights, PIN fostered community engagement and social mobilisation in 8 priority municipalities to support the efforts to register children, including emphasizing the responsibility of fathers to register their children. 
In partnership with UNICEF, PIN developed the Network Angola for Children with the aim of contributing to the protection of children’s rights. Agents of Change were key to achieve the project’s goals. They are leaders in their communities, and through their work on the project, they’ve also become the local source for questions about birth registration. They work together with traditional and religious leaders, association leaders, school principals and representatives of parents’ committees, among others, to ensure that the message about birth registration and responsible fatherhood reach as many people as possible. 
Health workers were also trained on key messages related to birth registration procedures and documentation, and on how to sensitize parents and caregivers to register their children. They disseminate the information in regular talks to the families in selected maternity wards and health centres, with the goal of increasing the number of children registered immediately after birth. 
The project also organized theatre sessions to inform and engage families, and conducted community talks known as ‘jangos’ to share and debate important topics with caregivers. The activities developed over 9 months have reached more than 26,000 people.

PIN’s programme FOCO was aimed at strengthening the capacities of civil society organizations and improving their dialogue with local authorities. Within a gender perspective, all activities also fostered gender equality and women’s empowerment.
The programme on gender and civil society was developing in Angola since 2013, when FOCO I project was first implemented in Bié province. The initiative created and implemented income-generating activities for women, in hopes of overall social and economic empowerment. As a part of the efforts of the Angolan Government in fulfilling its international commitments towards the protection of women and promotion of gender equality, the country enacted in 2011 a law on domestic violence (Law 25/11). The programme also focused on fostering networks of governmental and non-governmental institutions dealing with domestic violence, on developing awareness raising activities amongst women, young students and men, and on promotion and dissemination of the Law 25/11.
The efforts to promote gender equality continued as FOCO II, in Bié and Huíla provinces. The initiative supported the Social Protection Network for Victims of Domestic Violence of Bié and also intended to improve the response of the Children’s Network of Huíla in specific cases of domestic violence.
The empowerment of young women was the main goal of the follow-up project FOCO III, which was also implemented in both provinces (Bié and Huíla) and aimed to develop the technical capacity of two youth female-only associations, apart from promoting female leadership. The activities directly reached more than 2 800 young women and over 100 civil society organizations.

Economic dependency and the lack of knowledge of basic rights and freedoms are among the main causes of high levels of violence towards women in Angola, where civil war often leaves more women dependent on men. As a result, we focus on raising awareness about domestic violence, violence against women in general, and on legislation and services available for victims and vulnerable women.

We support local community initiatives, mostly women’s groups, to disseminate basic information on the issue, provide them essential assistance and refer them to relevant institutions. We also work with the local police, judges, medical personnel, the local Directorate for Women and Family Matters, and other organizations or groups that deal with the issue. They receive training and we link them to a social protection network that helps to manage individual cases in a consolidated and efficient process.

Additionally, we train local initiatives on how to carry out income generation projects whose aim is to increase the economic self-sufficiency for vulnerable women. The best from these groups then receive a financial grant to implement their smaller projects, allowing vulnerable women to establish and manage their own small business (canteen, shop etc.).