MCSP Mozambique Program Brief: Malaria

Malaria remains the major cause of morbidity and mortality in Mozambique, responsible for 29% of all deaths and 42% of deaths in children under 5 years old. Malaria also contributes to maternal anemia, stillbirth, premature birth, and neonatal mortality. To address these issues, MCSP and the Ministry of Health (MOH) worked in Nampula, Zambezia, and Sofala provinces to improve malaria prevention and treatment efforts. MCSP supported the development of sustainable training and supervision systems, and the revision of the national supervision tools for malaria. At the provincial level, MCSP worked with the Provincial Health Directorates to revitalize malaria coordination groups and held regular malaria partner meetings to improve coordination, share updated policies and work plans, and reduce duplication of efforts. MCSP provided technical assistance and supported activities to improve prevention of malaria in pregnancy (MiP). MCSP trained 2,160 providers in MiP, including initiating intermittent preventive treatment of malaria (IPTp) with sulfadoxine-pyrimethamine (SP) at 13 weeks per WHO recommendations, and distributing Long-Lasting Insecticidal Nets (LLINs) during antenatal care (ANC) visits. MCSP also provided mentoring to health workers, including maternal and child health nurses, to both reinforce their ability to estimate gestational age for early initiation of IPTp and provide high-quality counseling on the use of LLINs. MCSP worked with the MOH to strengthen the malaria diagnostic skills and case management capacity of MCSP-supported providers. MCSP trained 2,372 providers in appropriate diagnosis and treatment using rapid diagnostic tests (RDTs) and Artemisinin-based Combination Therapy (ACT). MCSP also provided mentoring and supportive supervision, per the revised national guidelines. Although MCSP did not procure malaria commodities, the Program helped ensure that RDTs and medications were available at health facilities by helping to monitor stock levels and providing forecasting support. MCSP supported the National Malaria Control Program (NMCP) and the President's Malaria Initiative (PMI) in improving malaria prevention. MCSP trained 266 Community Health Workers (Elementary Polyvalent Agents/Agentes Polivalentes Elementares [APEs]) in Nampula, Sofala, and Zambezia provinces to diagnose and treat malaria at the community level. Supply chain partners facilitated providing RDTs and ACT kits required for community case management. In Zambezia Province, MCSP also worked with 83 APEs to improve the linkages between the community and facility-based health teams. MCSP supported Social Behavior Change Communication (SBCC) activities to promote correct and consistent use of LLINs, acceptance of Indoor Residual Spraying, and awareness of the importance of prompt diagnosis, treatment, and prevention of malaria among pregnant women. SBCC messages, provided in partnership with PMI and USAID's SBCC project Health Communication Capacity Collaborative, gave community members information on the danger signs of malaria and the need to seek prompt treatment for children with fever. MCSP also supported Community Health Workers (CHWs) in completing simplified data collection forms and supported CHW supervisors with routine data quality checks and assistance interpreting and using monitoring and evaluation (M&E) data for planning and prioritization. Key results of the MCSP Mozambique Program include the revision of national policies and guidelines, improvement of quality of malaria care, increased use of data for decision-making, and supervisor and provider skills updates. The National Malaria Strategic Plan 2017-2022 was developed with MCSP's support, aiming to reduce the burden of malaria in high transmission areas and sustain gains in low transmission areas. The MOH adopted the MCSP-developed job aid on treating uncomplicated malaria among women of reproductive age based on WHO guidance, as well as parts of the toolkit to improve early and sustained uptake of IPTp.