Mozambique : final country report

Report covers the period 2/97-4/00. SEATS/Mozambique developed subprojects with four PVOs: with Save the Children Federation (SCF) and World Relief Corporation (WRC) in Gaza Province; with Terre des Hommes (TdH) in Sofala Province; and with Health Alliance International (HAI) in Manica and Sofala Provinces. In close partnership with the Ministry of Health (MOH) and the PVOs, the programs included the following major components: information, education and communication (IEC) materials development; FP/RH counseling and technical skills training; and continuous quality improvement (CQI) training and activities. SEATS also collaborated with Pathfinder International on national-level policy issues and activities, including PVO forums, community- based delivery (CBD) study tours, CBD curriculum development, CBD pilot service delivery programs, contraceptive logistics, and RH IEC materials assessments. As a result of a 1/98 contract modification, SEATS" core funds were used to intensify support to WRC"s program in Gaza Province and a small literacy activity, as well as the monitoring, evaluation, quality and sustainability components for all subprojects. Finally, the USAID/Africa Bureau funded the development of an Urban Initiative program in Beira. SEATS" program in Mozambique has made significant contributions toward achieving the Mission"s strategic objective. (1) Access to services has improved. Youth corners are operating in two pilot clinics, and 22 service providers have been trained in youth-friendly services. Forty- six community-based RH agents are working in Gaza Province (WRC and SCF districts) and 68 in Muanza and Cheringoma Districts in Sofala (through TdH). (2) To improve human resources development and technical competence, more than 60 maternal/child health (MCH) nurses in three provinces have been trained in FP technical and counseling skills. Trainee follow-up reveals over 70% learning retention one year after training. In addition, sexually transmitted infection (STI) training has been provided to 62 nurses in Manica and Sofala, and activistas, community health workers, traditional birth attendants (TBAs), and other volunteers received training in FP/RH or were trained as CBD agents. (3) Institutional capabilities have been strengthened. Health centers have formed quality teams for ongoing problem identification and resolution, and improvements have been made in infrastructure, and essential equipment has been purchased for clinics. Much work is still needed to sustain and expand these achievements. Local and external resources (material, human, and financial) are limited, and the sustainability of activities implemented under donor support is not assured. The Government of Mozambique (GOM), USAID, the subproject partners, and other interested parties should build on promising activities -- youth-friendly health services, community-based RH agents, quality teams, etc. -- to ensure continued success. Participating PVOs felt that the project"s time-frame was insufficient for adequate implementation. Lessons learned and recommendations are provided in the areas of project design, collaboration with MOH and PVO partners, supervision, training, community-based RH agents, and CQI.