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Implementation phase – Strengthening community to health facility care continuum in Marrere, Mozambique

Mozambique has made it a priority to address its high maternal death rate and its high adolescent pregnancy rate. Access to quality sexual and reproductive health information, services, prenatal services, and delivery services is limited, particularly in rural areas across the country.

This project will help find sustainable solutions to these challenges in Nampula province’s rural Natikiri district. Researchers collaborated closely with the surrounding community, the local hospital, and provincial and national ministries of health to prioritize health problems and develop a set of innovative interventions.

The project will cost and assess the impact of a community-owned motorcycle ambulance service and of scaled-up access to reproductive health outreach services and community hospital emergency delivery services. Strengthening the capacity of maternity staff, enhancing emergency obstetrical and outreach services, and advancing efforts to eliminate illicit charges to clients should contribute to strengthening and improving the quality of provincial maternal health services.

An action research methodology based on intervention implementation and ongoing monitoring will be applied to cost interventions, identify lessons to improve ongoing implementation, and assess impact. Results will be shared with clinics and officials in the province and at the national level to promote wider application and adoption. Scientific publications will be produced and findings will be shared at national and international conferences.

This project will be implemented with the collaboration of the University of Saskatchewan and the Universidade Lúrio in Mozambique. It is part of, and will contribute to, the goals of the Innovating for Maternal and Child Health in Africa program by improving the scale of access to services for pregnant women in Mozambique through innovation and community engagement.

The Innovating for Maternal and Child Health in Africa (IMCHA) program is a seven-year, $36 million initiative funded by Global Affairs Canada, IDRC, and the Canadian Institutes of Health Research.

Project ID
108508
Project Status
Completed
End Date
Duration
40 months
IDRC Officer
Nafissatou Diop
Total Funding
CA$ 843,040.00
Location
Mozambique
Programs
Global Health
Innovating for Maternal and Child Health in Africa
Institution Country
Mozambique
Project Leader
Paulo Pires
Institution
Universidade Lúrio
Institution Country
Canada
Project Leader
Ronald Siemens
Institution
University of Saskatchewan

Outputs

Quality assessment in primary care : adolescent and youth friendly service, a Mozambican case study

Quality assessment in primary care : adolescent and youth friendly service, a Mozambican case study

Article

The adolescent and youth friendly service (AYFS) is an important strategy towards adolescent reproductive health. Almost half of girls aged 15-19 years have one child or have been pregnant. The highest mortality ratio is in the 12-14 age group. At 14 years old 33% of Mozambican girls are sexually active and vulnerable to HIV. Usually, they have no power to refuse unprotected sex. Survey data related to health providers in AYFS is analyzed. There are significant deficiencies in the type of information and manner of communication with adolescent users, especially regarding Family Planning. Information reinforcement about sexual and reproductive health and male participation in Family Planning needs to be strengthened.

Author(s): Bomfim, Emiliana, Mupueleque, Martins Abudo, Dos Santos, Delmar Mario Mutereda, Abdirazak, Ahmed, Bernardo, Regina de Arminda

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Language: English

Maternal and newborn mortality : community opinions on why pregnant women and newborns are dying In Natikiri, Mozambique

Maternal and newborn mortality : community opinions on why pregnant women and newborns are dying In Natikiri, Mozambique

Article

This study assesses the barriers to health care access, attendance at antenatal consultations, institutional delivery and postnatal and neonatal follow-up. It is part of the baseline study for an implementation research project to reduce maternal and neonatal mortality in Natikiri, Nampula, Mozambique. The article covers aims and activities, including survey results and analysis of the data, and includes recommendations.

Author(s): Belo, C., Pires, P., Josaphat, J., Siemens, R., Rooke, E., Spence-Gress, C.

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Language: English

Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions

Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions

Article

Radio spots, community theatre and volunteer champions together increased knowledge about sexual and reproductive health, and led to a more positive attitude toward family planning. The media campaign and local volunteers were useful in promoting maternal and child health, especially to those with no access to social media. There is an unmet need for family planning information and contraception which needs further research that includes investigating cultural barriers. There is a scarcity of professionals skilled in education for contraception, especially in rural areas.

Author(s): Pires, Paulo Henrique, Mupueleque, Martins

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Language: English

Community engagement helps eliminate illicit charges in health care

Community engagement helps eliminate illicit charges in health care

Brief

To address shortcomings of the health system in maternal and neonatal care in Mozambique, the Ministry of Health (MISAU) has targeted issues of illicit health care fees and difficulties in access to services. This project developed a series of objectives that align with the MISAU-defined strategies, programs, and tools. The research and project results show that when leadership and monitoring are supported through information sharing and Co-Management Committees, there is a decrease in illicit charges along with improved delivery of health care services.

Author(s): Pires, P, Belo, C., Siemens, R., Puaheque, C.

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Language: English

Enhancing access to safe and timely caesarian sections by prioritizing quality care and building strong partnerships in Nakitiri, Mozambique

Enhancing access to safe and timely caesarian sections by prioritizing quality care and building strong partnerships in Nakitiri, Mozambique

Brief

The Alert Community Prepared Hospital (ACPH) project team designed a strategy for the provision of safe and timely C-sections at Marrere General Hospital (MGH) in Nakitiri, Mozambique. The MGH surgery department introduced a second operating room through a joint undertaking: the ACPH project paid for equipment, the MGH facilitated the implementation measures and private Canadian donors covered construction costs. This briefing paper provides a synopsis of the project aims, background and activities.

Author(s): Pires, P., Belo, C., Siemens, R., Puaheque, C.

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Language: English

Engaging the community in transforming maternal care

Engaging the community in transforming maternal care

Brief

With 48% of girls married before the age of 18 and 46% of girls aged 15-19 already having at least one child, sexual and reproductive health education and support for adolescents is paramount. The research goal was to develop and implement community engagement interventions that promote better maternal and infant outcomes. Recommendations include developing a manual for teachers who conduct traditional initiation rites for training adolescents on sexual reproductive health, and regular radio broadcasts of key sexual and reproductive health messages in rural areas. The policy brief outlines successful actions taken to increase sexual and reproductive health by engaging communities, and through information campaigns.

Author(s): Pires, P., Belo, C., Siemens, R., Puaheque, C.

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Language: English

Maternal and child health implementation research in Mozambique : effective community interventions to promote sexual and reproductive health

Maternal and child health implementation research in Mozambique : effective community interventions to promote sexual and reproductive health

Article

The article/study assesses the impact of community participation on improving sexual and reproductive health. Comparing changes between 2016 and 2019, the number of health committees operating in Natikiri (Nampula, Mozambique) rose from 7 to 20. Population access to contraceptives was facilitated, rising from 42% to 91% in women and 65% to 90% in men. At Marrere General Hospital (Nampula) maternity deliveries rose by 60%. The article reviews a baseline study, strategies designed to improve health services, and empowerment in sexual and reproductive health and rights, as well as enhancing maternal and child health.

Author(s): Pires, PHNM, Mupueleque M,, Zakus D,, Mucufo J,, Abdirazak A

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Language: English

Implementation research methods : an extension tool in health education and information

Implementation research methods : an extension tool in health education and information

Article

Implementation research methods were found to be an efficient extension tool in population health and education, and educational professionals vocational training. The two-page article provides a review of the project, methodology, intervention and results. Reproductive health, family planning, and contraceptive knowledge and other “culturally sensitive” information was transferred from researchers, interviewers and project surveyors to target groups for further discussion and dissemination, including community leaders, religious leaders, midwives, traditional healers, school teachers, and health professionals.

Author(s): Pires, Paulo Henrique das Neves Martins

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Language: English