Mozambique

Overview

Mozambique has one of the fastest growing economies in sub-Saharan Africa. Since the end of a 17-year civil war in 1992, leaders have worked hard to leverage country resources to build infrastructure and improve the quality of life for Mozambican citizens. However, despite this promising growth, many public-sector programs remain weak. Outside major city centers, much of the population still has limited access to quality health care.

With a population of 22 million, Mozambique has less than one doctor for every 100,000 people. According to USAID, more than 1.5 million people in the country are infected with HIV. Mozambique also suffers high rates of tuberculosis and other respiratory diseases, malaria, and diarrheal diseases including endemic cholera, all of which exacerbate the impact of HIV and AIDS.

Since beginning work in Mozambique in December 2005, I-TECH’s main objective has been to provide technical support to the Ministry of Health (MISAU) to address the shortage of health care providers in the country. Central to this effort has been the training and mentoring of mid-level health care workers, such as técnicos de medicina geral (TMGs, similar to Western physician assistants), nurses, and agentes de medicina (lower-level TMGs). In addition to providing training expertise and creating training resources and curricula, I-TECH strengthens innovative programs for peer support and clinical mentoring. Ongoing monitoring and evaluation measure the effectiveness of such programs so that I-TECH and MISAU can continue to improve programs and strengthen the health system in Mozambique.

Program Highlights

• Support MISAU in the expansion of integrated health services to provide antiretroviral treatment and quality health care to people living with HIV at primary care facilities.

• Ensure that pre-service and in-service training for health care workers is high quality and is leading to better care for Mozambique’s citizens.
• Strengthen pre-service training for incoming técnicos de medicina geral (TMGs) by providing technical assistance to the Ministry’s training department and Health Training Institutes.
• Improve the skills of Training Institute faculty in lesson planning and participatory learning methods, through faculty development courses and ongoing professional development.
  
• Support prevention of mother-to-child transmission of HIV through innovative programming, such as the development of Mães para Mães (Mothers for Mothers, or MpM), a community support program for HIV-positive mothers.
  
• Respond to the training and support needs of Mozambican nurses and Agentes de Medicinia; prepare them for new task-shifted roles in HIV care, including the identification of opportunistic infections, and signs and symptoms of treatment failure.
  
• Integrate positive prevention messaging into patient encounters and referral systems within health facilities and health provider training.
• Improve the technical and clinical competencies of health care workers through strong clinical mentoring programs.
• Develop a cadre of clinical trainers who can implement effective positive prevention training to ensure that people living with HIV or AIDS are linked with both facility and community-based services and resources.
  
• Implement Biological and Behavioral Surveys among high risk populations, including men having sex with men, mine workers, long distance truck drivers, female sex workers and IV drug users to measure HIV prevalence, syphilis prevalence, related risk behaviors, and access to prevention and care services.
  
• Offer ongoing monitoring and evaluation of current programs to ensure effectiveness and opportunities for improvement.
  
• Assess the need for new programs; I-TECH Mozambique collaborates with MISAU in an ongoing effort to evaluate the need for new programs to continue to strengthen the health system.
  

Partnerships

In addition to the US Centers for Disease Control and Prevention (CDC GAP) and the Mozambican Ministry of Health (MISAU), I-TECH works closely with a number of partner organizations in Mozambique, including Columbia University (ICAP), Family Health International (FHI), CARE, HIVQUAL/HEALTHQUAL, Health Alliance International (HAI), the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), FANTA, UNICEF, Population Services International (PSI); the Clinton Foundation, and Jhpiego.