Integrated Malaria Program (IMaP)
Malaria accounts for nearly 30 percent of all deaths in Mozambique and is especially lethal for children under five. Malaria has a seasonal fluctuation in all parts of the country, with a seasonal peak ranging from December to April. It has a significant negative impact in the country's high-transmission north and center provinces.
The United States Agency for International Development (USAID) sponsored the IMAP project to reduce malaria-associated mortality, morbidity, and parasitemia in four high malaria burden provinces. The project strengthened the implementation of the Mozambique National Malaria Strategic Plan (NMSP) and was aligned with the US President’s Malaria Initiative (PMI) strategies. The project concluded in 2022.
Project provinces included Zambézia, Nampula, Cabo Delgado, and Tete. IMaP had three main objectives:
- Support the implementation of proven malaria interventions at community and facility levels, in alignment with NMSP
- Strengthen management capacity of the provincial, and district, and Ministry of Health personnel to provide oversight and supervision of malaria interventions
- Improve Health Management Information System data reporting, analysis, and use at the provincial and district levels
Friends in Global Health (FGH) was the clinical implementation partner of the Integrated Malaria Program (IMaP) in Mozambique, under the direction of Chemonics International. FGH activities included:
- FGH Provincial Clinical Advisors based at the provincial capitals of Zambézia, Nampula, Cabo Delgado, and Tete provinces provide technical assistance to the provincial health authorities in implementing the National Malaria Strategic Plan. FGH Provincial Clinical Advisors participate as trainers in training sessions, accompany provincial health authorities’ staff at supportive supervision visits, and on-the-job training of health facility staff in delivering malaria services.
- FGH Laboratory team provides technical support in implementing the province-led malaria External Quality Assessment process for malaria testing. FGH assisted provincial health authorities in implementing baseline assessments of laboratory capacity (infrastructure and technical) and providing technical support to low-performing laboratories, focusing on smear preparation and quantification of parasites with routine quality assessments to measure laboratory progress.
Traditional Healers as Adherence Partners for PLHIV in Rural Mozambique
Newly diagnosed persons are often overwhelmed by information about HIV treatment, diagnostics, and clinical services and may be hesitant to ask for help from friends or family given the stigma around the disease. Traditional healers, trusted health agents in rural Mozambique, were trained to provide community-based counseling, education, and disclosure support for their patients. Patients select their preferred healer, who was tasked with providing twice monthly home visits to identify any barriers to adherence, medication pick-up or clinical attendance.
With support from the U.S. National Institute of Mental Health, Friends in Global Health implemented a program on adapting effective strategies to engage traditional healers as HIV treatment adherence partners for newly diagnosed patients.
From 2009 – 2013, Friends in Global Health supported the Federal Ministry of Health of Nigeria in the implementation of HIV-related services in Federal Capital Territory, Niger and Kwara States. Through its 5-year funding award from the CDC/PEPFAR, the following services were provided in FGH supported sites: Adult and Pediatric HIV care and treatment, Prevention of Mother to Child Transmission (PMTCT), HIV Testing and Counseling (HTC), Tuberculosis and HIV (TB-HIV), Orphans and Vulnerable Children (OVC), procurement and provision of antiretroviral drugs (ARVs), strengthening of laboratory infrastructure and improvement of strategic information (SI) services. During the project period, FGH provided support for these services in eight comprehensive sites located in Gawu Babangida Rural Hospital; Lafiagi General Hospital; Sobi Specialist Hospital; Umaru Musa Yar’adua Memorial Hospital Sabon Wuse; Comprehensive Health Centre, Agwara; Shehu Shagari General Hospital, Nasko; Auna Rural Hospital; and State House Medical Centre, Abuja FCT. FGH also supported an additional 98 satellite sites, which provided counseling and testing services as well as PMTCT services.
FGH conducted minor alterations and renovations in most clinical sites, including repairing water supply systems, installing power generating sets, equipping clinic laboratories and furnishing HIV clinics. Project activities also included local human capacity-building whereby over 1,500 Nigerian physicians, nurses, counselors and allied health staff were trained in HIV counseling and testing, basic care and support, adult/ pediatric care and treatment, adherence, prevention of mother to child transmission, home-based care and laboratory management. Provision of quality HIV/AIDS prevention, care and treatment services were at the forefront of FGH’s work in Nigeria. Throughout the project period FGH staff counseled and tested a total of 171,316 clients, 8,577 adults and children received at least one service of HIV care and 5,034 adults and children were enrolled onto HIV antiretroviral treatment.
FGH also established family-centered, facility- and community-based services targeting orphans and vulnerable children in Kwara state through partnership with a local community-based organization, the Society for Youth Development and Orphaned Children (SYDOC). This alliance highlights the priority FGH attaches to cultivating strong collaborative relationships with local groups involved with development work, as such partnerships enhance the capacity of local organizations to build sustainable, high-impact public health initiatives.
At the end of the project’s fifth and final year, VU/FGH was able to transition a substantial portion of its resources to a newly registered local indigenous implementing partner, Friends for Global Health Initiative in Nigeria (FGHiN). This process enabled successful capacitation of the local entity partner, which is now implementing its own 5-year CDC/PEPFAR funded care and treatment program in Nigeria.
Strengthening Communities through Integrated Programming (SCIP)
In Mozambique, Friends in Global Health worked in collaboration with a World Vision-led consortium to implement a USAID-funded five-year multi-sector grant, Strengthening Communities through Integrated Programming (SCIP). The consortium was locally known as Ogumaniha, which in Chuabo, one of the local languages, means “united for a common purpose”.
This program improved the health and livelihood of children, women and families in Zambézia Province and focused on:
- Strengthening and increasing access to the health, nutrition and HIV & AIDS care system for target groups;
- Promoting and financing demand-driven community investments for agricultural production through value chain additions;
- Water and sanitation; and
- Building and reinforcing existing institutional capacity of governmental departments and community stakeholders.
Friends in Global Health led the monitoring and evaluation component of the program, as well as provided technical assistance in the area of health and HIV/AIDS for the seven-member consortium.
UNICEF Zambézia Equity Priority District Survey
UNICEF and the FGH collaborated to conduct a baseline survey in Gurùé and Milange districts (in Zambézia province) to measure the impact of the Mozambican adapted REC strategy. Data collected in these districts through the UNICEF-FGH collaboration complemented results gathered from the FGH implemented population-based household survey in Zambézia Province as part of the USAID funded Strengthening Communities through Integrated Programming (SCIP), known locally as the Ogumaniha program.
Accelerating Strategies for Practical Innovation and Research in Economic Strengthening (ASPIRES)
Under the direction of FHI 360, the Accelerating Strategies for Practical Innovation and Research in Economic Strengthening (ASPIRES) project supported evidence-based, gender-sensitive programming to improve the economic security and improve health outcomes of families and children infected or affected by HIV/AIDS, as well as others at high risk of acquiring HIV.
FGH collected data for a mixed-methods evaluation that utilized qualitative and quantitative data collection methodologies in the Zambézia province of Mozambique. This project included all coordination and logistical tasks related to the planning, scheduling, relationship-building, data collection implements (and programming). FGH provided a study coordinator, programmer, field supervisors, and data collectors to complete the data collection and data transfer to FHI 360. FGH arranged for the training of all study personnel, including training in ethics, data collection via an electronic device (i.e., tablet or mobile phone), data storage and transmission. FGH also provided logistical support to FHI 360 personnel for regular visits to the study communities.
UNICEF Nutrition Programme Baseline Assessment
Evaluation and Capacity Building: Zambézia & Nampula Provinces, Mozambique
This project provided baseline information and determined key indicators for the evaluation of interventions aimed at improving under five nutritional status, informed policy and advocacy programming, and contributed to the government’s five-year plan to reduce stunting among children under five.
In collaboration with a multidisciplinary team of investigators from Vanderbilt University Medical Center and Vanderbilt University, Friends in Global Health coordinated and facilitated technical and logistical tasks related to data collection for this population-based survey of nearly four thousand households within Zambézia and Nampula Provinces of Mozambique. In addition, FGH provided ethics training and built the capacity of study personnel in the collection, storage and transmission of data.