Mozambique

For a summary of MCHIP work that has ended in Mozambique, click here. The project’s final report can be found here.

MCHIP Mozambique Associate Award

Start and end dates: April 2011 to June 2015

MCHIP Partners Involved

Jhpiego and Save the Children

Key Partners in Country

Ministry of Health, World Health Organization, UNFPA, UNICEF, DFATD, the Association of Midwives, the Association of Mozambican Obstetricians and Gynecologists, the Mozambican Pediatrics Society, ISCISA, Pathfinder, Ariel Foundation, SCIP, CHASS-SMT, CHASS Niassa, CCS, FGH, ICAP, CHAI, FHI360, EGPAF, I-TECH, and Doctors Without Borders.

Collaboration

  • FHI360, Abt CHASS-SMT and CHASS-Niassa projects / clinical improvements
  • Pathfinder / community activities in Zambezia and Nampula provinces
  • Elizabeth Glaser / Model Maternities and performance-based incentives
  • ICAP, CCS, EGPAF, Ariel Foundation, Doctors Without Borders and Friends of Global Health / CECAP

All of these partners supported the development and application of quality standards.

Description of work

MCHIP in Mozambique focused on building a favorable national policy environment while supporting the MOH in two of their national priorities: to scale up the Model Maternities Initiative (MMI) and the Cervical and Breast Cancer Prevention/Control Program (CECAP) in order to rapidly expand the implementation of high-impact MNCH/RH interventions. MCHIP also supported the provision of FP services through the MMI and CECAP initiatives.

At the national, provincial, facility and community levels, the Program provided technical assistance in strengthening the health system more generally. MCHIP supported policy and strategy development; health information system strengthening; human resource development; and strengthening the quality improvement regime.

Technical Scope

  • Model Maternities Initiative
  • Integrated Family Planning
  • Cervical and Breast Cancer Prevention
  • Humanization of Care and Quality Improvement
  • Community Mobilization
  • Health Management Information Systems

Scale/Coverage

National Scale: The program worked in all 11 provinces (100%), 104 districts and in 125 MMI facilities, 134 CECAP facilities, 143 FP facilities.

Integrated Approaches

    • Model Maternities Initiative‚ÄĒintegrated maternal, newborn, and child health package
    • Integrated MNCH platform includes: Basic EmONC, EMNC, Family Planning/Reproductive Health, HIV, Malaria in Pregnancy, Cervical Cancer Prevention (CECAP)

Major Program Results

  • Decreased direct institutional maternal mortality ratio by 57%, with an estimated 1,130 maternal lives saved.
  • Scaled-up high-quality, high-impact and respectful maternal and newborn health interventions to 125 Maternities.
  • Strengthened the quality and coverage of integrated family planning services in 143 health facilities.
  • Supported an enabling environment for RMNCH through policy development and implementation, information systems strengthening, and expansion of the knowledge base of related interventions.
  • Scaled-up integration of cervical and breast cancer prevention services into 134 reproductive health/family planning outpatient services.
  • Transformed the culture and delivery of in-service training and quality improvement standards for RMNCH.
  • Mobilized 389 community groups to lead or engage in efforts to improve the health of their communities.

Select Health and Demographic Data for Mozambique
GDP per capita (USD) 605.2
Total Population 27.22 million
Maternal Health
Maternal Mortality Ratio (deaths/100,000 live births) 443
Percent of maternal deaths due to HIV 25.5
Skilled birth attendant coverage 54.8
Antenatal care, 4+ visits 53.1
Newborn Health
Neonatal mortality rate (deaths/1,000 live births) 30.2
Infant mortality rate (deaths/1,000 live births) 64
Child Health
Under-five mortality (deaths/1,000 live births) 89.7
Treatment for acute respiratory infection 55.4
Oral rehydration therapy for treatment of diarrhea 61.5
Immunizations
Diphtheria-pertussis-tetanus vaccine coverage (3 doses) 76
Percent of districts with >80% DPT3 coverage 30
DPT3 coverage equity ratio (wealthiest:poorest quintile) 1.82
Family Planning
Modern contraceptive prevalence rate 11.3
Total fertility rate 5.9
HIV
HIV Prevalence, adult 11.5
ART coverage, adult 30
Health Systems
Density of physicians (per 1,000 population) 0.3
Density of nurses & midwives (per 1,000 population) 3.4
Total Health Expenditure per capita (USD) 15
Sources: Demographic information and health systems, World Bank; Newborn health, child health, DPT3 equity ratio, family planning, SBA, and ANC4, Mozambique 2011 Demographic and Health Survey; DPT3 coverage and percent districts >80%, MMR, ART coverage and maternal deaths due to HIV, WHO; HIV prevalence, UNAIDS 2010 Global Report