Mozambique: Mozambique Mobile Clinic Project
Mobile Clinic Year End Report 2013
March 26, 2014
Tito Jequicene, MD
Results &
ACCOMPLISHMENTS
On-the-job Training
Technical and Logistical Strengthening
In order respond to the new challenges of universal ART, the teams have been reinforced by placement of a Health Counselor in Mbawa and a dedicated Field Data Manager (funded by PEPFAR) to facilitate input of the Clinic and laboratory registers into the electronic patient tracking system for HIV-positive patients while the Mobile Clinic is located at the health facility.
Improved Monitoring
New TB and HIV Services
To improve the monitoring of patients seeking HIV counseling and testing services, a “Revive” card was introduced in all places that offer these services, which contains information about the individual’s last date of testing. This allows better control of HIV negative cases, thereby facilitating retesting after three months.
Supporting Prenatal Care
New Services for Pregnant and Lactating Women
Technical support provided this quarter resulted in the design of a flowchart for following pregnant and lactating women in the absence of the Mobile Clinic. Creation of mobile file storage for clinical processes and files of pregnant women, mothers and children on ART has strengthened monitoring of these patients and facilitated identification of non-adherent patients that have fallen out of care.
Background
& Objectives
Background
RMF’s Mobile Clinic in Mozambique is a new model of healthcare provision for our organization, conceptualized to reach remote and rural communities with no prior access to health care. Since its inception in 2008, our Mobile Clinic has been hugely successful and remains the only mobile clinic in all of Mozambique. The clinic, a collaboration between RMF, Vanderbilt University’s Friends in Global Health, and Medical Mission International, is currently deployed in one of the most populous provinces of Mozambique, Zambézia Province, located in the central coastal region with a population of almost 4 million.
Objectives
- To improve the quality of life and provide access to health services, particularly access to maternal-child healthcare and anti-retroviral therapy (ART) for people living with HIV and AIDS, Tuberculosis and other diseases.
- To provide access to healthcare in remote areas of Zambézia Province, Mozambique.
- To reinforce the expansion of HIV care and treatment services initiated by the Zambézia Provincial Health Directorate (DPS), by providing temporary reinforcement in terms of staff, training, and space for peripheral health units initiating implementation of ART until such time as the DPS can organize the infrastructure and resources necessary for these sites to function independently.
Numbers
Served
Year End Report, 2013
1,126 beneficiaries
- 442 pregnant women treated
- 431 pregnant women received HIV counseling and testing (14% HIV+)
- 62 HIV-positive pregnant women as well as 33 lactating women were enrolled in ART
- 39 children were enrolled in the Child-At-Risk Clinic (CCR)
- 7 pediatric patients had virological testing
- 56 children counseled and tested (27% HIV+)
- 13 patients initiated ART
- 8 patients were enrolled into TB care and treatment
Success
Stories
Cidália Graciele
Cidália Graciele, 33, is separated from her spouse and lives in Mbawa with her 13-year-old daughter and an elderly aunt that she supports. Cidália recounts that when she separated from her husband she went through many difficulties dealing with the extra responsibility of her daughter and aunt. Over time, Cidália began to suffer from constant back pain and decided to go to the Mbawa Health Center for answers. However, when she arrived at the health facility, the nurse completed a transfer referral to the Macuse Hospital to receive treatments there. When Cidália sought care at the hospital, she was diagnosed with Rheumatism and prescribed Diclofenac.
Shortly after returning home, Cidália’s back pain returned, and it was very difficult to seek treatment in Macuse. With the arrival of the Mobile Clinic, Cidália heard that with it came access to many medications, so she decided to make an appointment. She shares:
"Now I always come here to help control my pain, as they can prescribe my medicine. I do not need to travel to Macuse. The Mobile Clinic has also treated other diseases, such as when I came with my daughter who had a fever and was diagnosed with malaria. She was prescribed the necessary medication and got better. I have even been controlling my blood pressure and am able to seek treatment without paying anything."
Photographer: Etelvina de Sousa
Consent: Verbal consent received and consent form completed at the time the photo was taken, January 2014
Moises Pedro Monteiro
Moises Pedro Monteiro, 50, is married and the father of a 16-year-old son. He lives in the town of Mbawa and has been a volunteer with the Mbawa Health Center for over five years. Moises has given lectures and sensitized the community on disease prevention and the importance of going to a health center as soon as you have any signs of illness. Moises recounts that:
"Before the arrival of the Mobile Clinic, I had many problems with the community. After lectures I conducted, people came to the hospital, and often received transfer slips or referrals to go to the district headquarters in Namacurra, which is 30 km from Mbawa, or at best, the rural hospital in Macuse that is about 13 km away. I myself had to take samples for suspected TB cases to Macuse, by bike, and sometimes even accompanied by patients who were very sick and unable to walk. With the arrival of the Mobile Clinic last September, everything changed. Most diseases are now being treated right here in Mbawa with medicines readily available."
Photographer: Etelvina de Sousa
Consent: Verbal consent received and consent form completed at the time the photo was taken, January 2014
Strong Staff, Improved Drug Stock Management and Increased Consultations
The Mobile Clinic’s General Medical Technician, Elévio, says that in addition to strengthening the health center staff and improving drug stock management with the arrival of the Pharmacy Technician, the Mobile Clinic has also increased consultations. There has been a more dynamic attendance among community members for a range of services. For example, cases of epilepsy have been identified, harvesting and processing of samples for suspected syphilis and other sexually transmitted infections has increased and the control of diabetes and blood pressure has been made possible.
These services did not exist at the health center before the Mobile Clinic arrived. Elévio explained that:
"There was a very large decrease in referral of patients to other hospitals, because the Mobile Clinic is equipped with a team of health professionals ranging from medical technicians, pharmacists and maternal and child health nurses.”
The head of the Mbawa Health Center feels that the Mobile Clinic has enhanced the service capabilities of the facility, providing faster results for sample harvesting and processing and providing an overall benefit to patient care.
More Reports on: Mozambique Mobile Clinic Project Archive
Country Page: Mozambique
Initiative Page: Mozambique Mobile Clinic Project