Direct Service Delivery

Direct Service Delivery

With funding from PEPFAR through the Centers for Disease Control and Prevention (CDC), the VUMC/FGH Avante program seeks to control the HIV epidemic by supporting the sustainable implementation of HIV and Tuberculosis (TB) services in the province of Zambézia. Avante is implemented by Friends in Global Health (FGH), which works in partnership with the Government of Mozambique at the national, provincial, district, health facility and community levels. FGH has been working in Zambézia Province since 2006.

Avante has steadily increased support for Health Care Workers, lay staff and volunteers, who provide direct service delivery.

Health Care Workers (HCWs): FGH currently supports HCWs through sub-agreements with district health authorities (DHA). FGH sub-agreements include the location, the function, and the performance evaluation process for each supported HCW. FGH supports clinical officers providing antiretroviral treatment (ART) consultations and community ART distributions, MCH (Mother and Child Health) Nurses at antenatal care (ANC) and cervical cancer services, HCWs at youth and adolescent-friendly services (SAAJs), HCWs implementing mobile brigades, psychologists, laboratory technicians and pharmacy technicians. The primary reason for hiring HCWs through sub-agreements and building their capacity through training and mentoring is to achieve HIV epidemic control. FGH sub-agreements serve as a funding bridge between the time an HRH need is identified, and Government of Mozambique (GOM) resources become available for fulfilling this need. Over time, the GOM budget absorbs the staff added through FGH sub-agreements, capacitating a stronger system with staff who have the requisite resources and skills to respond to future epidemics.

Lay staff: To sustain and strengthen HIV services at health facilities and in the community, FGH directly supports lay staff for the following interventions and initiatives: HIV testing and counseling, psychosocial support, tuberculosis, cervical cancer, gender-based violence, family planning, antenatal care, at-risk children, and adolescents and youth. In addition, lay staff support service delivery at DREAMS school health corners, health facility receptions and mobile brigades. They are recruited locally and speak the local language.

Volunteers are a vital community resource served by the local health facility. FGH supports a broad range of volunteers for the following initiatives:

  • Peer Educators strengthening ART linkages for newly identified patients and ART retention through home visits
  • Mentor Mothers supporting ART retention for pregnant and lactating women(PLW)
  • Early Infant Diagnosis and children linkage and retention to ART
  • Adolescent and youth mentors supporting ART retention for adolescents and youth respectively
  • Male Champions and Traditional Birth Attendants supporting PLW partners’ participation at ANC and institutional births
  • Cough Officers supporting the identification of TB cases at HFs.

Volunteers are monitored and supported through weekly meetings at the local health facility, and members of the community.