Mozambique

HKI has been working in Mozambique since 1997 with programs that focus on providing technical support to the Ministry of Health (MISAU) in the areas of nutrition and eye care. Since 2001, HKI has also provided eye care services implemented in close collaboration with the Provincial Health Services.

Today HKI's activities include:

Nutrition activities: Policy design and advocacy; vitamin A and iron folate supplementation; improved service delivery >> more
Trachoma control >> more

The main goal of the nutrition program is to assist the Ministry of Health (MoH) in the development and implementation of nutrition policies and an integrated package of nutrition services at health facilities, and community and school levels. The areas of assistance at the national and provincial levels are policy design and advocacy, vitamin A supplementation, iron folate supplementation for communities and schools, and improved service delivery.

In 1999, HKI-Mozambique provided technical support to develop a National Micronutrient Strategy that led to the creation of Micronutrient Norms that are part of the 5-year Strategic Plan for Nutrition that has been accepted by the MoH. PROFILES are used as advocacy tools for high-level officials, such as the Minister and Vice Minister of Health, and representatives of major health donors. The PROFILES are adjusted to reflect the situation at in each of the ten provinces and were used to introduce nutrition during planning and MINPAK (minimum package of nutrition activities for health services) training meetings at the provincial level.

HKI, together with UNICEF, has taken a leadership role in Mozambique in supporting the MoH in the area of vitamin A deficiency control. The two organizations are recognized as the catalysts for the inclusion of vitamin A distribution (VAD) in the 1999 National Immunization Days (NIDs) for polio, which was the first nationwide VAD in Mozambique. Subsequent distributions took place during Mother and Child Health Care Campaigns in 2000 and 2001 following the termination of NIDs in 1999, with assistance from these agencies.

In 2002, after three successful campaigns, with coverage varying from 80-100% of target group, the MoH decided to integrate VAS into routine services for infants, in conjunction with growth monitoring and vaccination. At the same time, postpartum VAS started as a pilot project in the city of Maputo.

After 2003, it became clear that a strategy in addition to routine vitamin A supplementation had to be found to reach all children under five since the coverage rate has been only 51% and 44% respectively. HKI and UNICEF supported the MoH in supervising each health facility in the country. Over 1,000 facilities were visited to investigate the problems on the ground. At the same time, the supervisors took the opportunity during these visits to train all health staff in the facilities in vitamin A procedure.

In 2004, HKI started piloting VAS to children under five through carefully-selected community health agents (CHAs) who provide help to eligible children on a monthly basis. During the first six months of this pilot project, the health facilities and the CHA reached a coverage rate of 96% of children in their area. Over half of these children received VAS from the CHAs. This pilot will be expanded to other areas in 2005. HKI will also try to take advantage of other opportunities for integration of VAS, such as measles vaccination campaigns, and during routine services.

In 2002, HKI started a pilot project in Manica Province to deliver weekly iron folic supplements and nutrition education through schools. After initial success in 12 schools, the project, with the financial support of UNICEF, expanded to 56 schools in two districts of Manica Province. This pilot project led to a collaboration among HKI, FAO, and the Ministry of Education to develop school materials on nutrition that may be included in the curriculum of primary school children throughout Mozambique.

In addition to the school-based program, HKI supports CHAs to provide daily iron folic supplements to pregnant women at the community level in selected districts of Manica Province. By 2004, with stronger support for the CHAs, the uptake by women improved from 300 women per month in 2002 to 3,400 women per month in 2004, as did the length of supplementation. The project provides supplements in combination with nutrition education for women at their homes.

From 2002 to 2004, HKI trained about 100 public health and mother and child health nurses in Manica provinces. These nurses were trained in nutrition issues such as balanced diets, infant and child nutrition, micronutrients, and balanced diet during pregnancy. Regular supervision and small refresher sessions were also conducted during these two years. These trainings and supervision have been suspended until the finalization of the MINPAK, which will include national nutrition training packages for health workers.

The main goal of the HKI-Mozambique eye care program is to assist the MoH in the development of programs to reduce avoidable blindness, with a focus on trachoma treatment and prevention. In the Northern Manica Province, HKI trained health workers in basic eye care, and is organizing trachoma days in the community and in schools in selected districts of this province.

After community mobilization with the help of a nearby health center, community leaders are introduced to eye health problems, including trachoma. HKI asks patients who have been successfully treated to talk about their experiences. Many express the impact of the dramatic change in their lives from someone who has to rely on others to get around to becoming productive members of the family and community.

On the scheduled trachoma day, community members of all ages are screened and treated for any eye problems. Community members that need special care are referred to the nearest available clinic or hospital. HKI is currently working with the Provincial Hospital to treat patients free of charge, often restoring eyesight for many of them.

The trachoma days in schools introduce the topic of eye problems and stimulate the students to express what they have learned through songs and play. After this introduction, all the children are screened and treated if necessary. Many students refer to HKI's health officer as "Dr. Trachoma."

Key Staff

Diane Bosch - Country Director
Carina Ismael - Vitamin A Coordinator
Odete de Sousa - Financial Manager
Mateus Noé - Provincial Coordinator
Maruicio Pene - Provincial Coordinator

Photo: Nutrition

We are never really happy until we try to brighten the lives of others.

—Helen Keller

Contact Information:

Mozambique

Program Partners

Key Staff