With more than 2 million people estimated to be living with HIV (PLHIV), Mozambique is a key country in the global fight to control the HIV epidemic. With President’s Emergency Plan for AIDS Relief (PEPFAR) support, the Government of Mozambique (GoM) has made significant progress towards UNAIDS 95-95-95 targets. Reported global coverage rates, however, mask notable gaps in populations that drive the HIV epidemic, namely, adolescents, men, children, and Key Populations; and these groups present the most important challenges in the HIV response. Intimate partner violence, low patient literacy, stigma and discrimination against PLHIV fuel the epidemic, while weak infrastructure and scarce Human Resources for Health (HRH) impede control efforts.
Located in the central region of Mozambique, the Zambézia Province has the largest number of people living with HIV in the country. PEPFAR-Mozambique has classified Zambézia as a priority province and allocated resources to scale up and expand access and utilization of HIV prevention, care, and treatment services.
Established in 2016, the “Avante” (Portuguese for “Move Forward”) program assists the GoM to accelerate the pace towards epidemic control in Zambézia province, through the delivery of high-quality, evidence-based HIV and tuberculosis services. Avante employs sustainable models of community and facility-based services covering the full continuum of response.
The Avante program assists the GoM in Zambézia province to identify and operationalize strategies in the areas of HRH, Prevention, Care and Treatment (C&T), Laboratory (Lab) and Data Systems. The rapid transition to Tenofovir/Lamivudine/Dolutegravir antiretroviral medication, expansion of 3-monthly antiretroviral therapy dispensation, improved retention to ART, reduced vertical transmission, expansion of Cervical Cancer Program screening and Pre-Exposure Prophylaxis are some of the improvements achieved. As of September 2021, FGH supported 144 Health Facilities (HF) in Zambézia province, serving over 305,000 patients on ART.
Avante is implemented in Zambézia province in partnership with the provincial health authorities through a provincial team based in provincial capital Quelimane, 12 district-based multidisciplinary teams and HF-based managers. Provincial and district-based teams are comprised of specialists in Health Communications, HIV Counseling and Testing, HIV C&T, Psychosocial Support, Maternal and Child Health, Tuberculosis, Lab, Pharmacy, and Strategic Information (SI). At HF-level Avante supports an extensive team of clinicians, nurses, pharmacy and laboratory technicians, lay staff and volunteers, who provide direct services to patients in supported HF and surrounding communities. FGH and all other PEPFAR clinical implementing teams are supported by the FGH Health Information Systems (HIS) team, which ensures that the appropriate systems are in place to monitor and improve the quality of services.