Mozambique: Mozambique Mobile Clinic Project
Mozambique Mobile Clinic Q1 2014 Report
April 30, 2014
Jose Vallejo and Jonathan White
Summary of Activities
During the first quarter of 2014, the Mobile Clinic continued implementation of the strategy presented in January 2012. The main activities of the Mobile Clinic include provision of:
- Primary health care to the populations of Furquia and Mbawa;
- HIV diagnostic, care and treatment services including integrated TB / HIV services for co-infected patients;
- Antenatal health services and universal ART as well as PMTCT to pregnant and lactating women;
- Health care services and early diagnosis of HIV in infants born to HIV positive women;
- Diagnostic services, treatment and care of TB.
Stengthening Technical and Logistical Capacities
Furquia & Mbawa Communities Receive Primary Healthcare
Provision of primary health services to Furquia & Mbawa communities:
The MC team continues to strengthen the technical and logistical capacities of local personnel through on-the-job training. In order to respond to the new challenges of universal ART, the teams have been reinforced by the addition of a Health Counselor in Furquia (funded by PEPFAR).
Health Facility Reinforced by Additional Staff
Arrival of New Team Allows Proper Treatment
During the quarter, the Furquia Health Facility was reinforced by the allocation of additional staff, resulting in a current team comprised of:
- 1 General Medical Technician
- 1 Maternal Child Health Nurse (mid level)
- 1 General Nurse (mid level)
- 1 Preventive Medicine Technician
- 1 Lab Technician
- 1 Elementary Nurse
- 2 Health Counselors
With the arrival of this team, conditions are finally created to provide proper care and treatment of HIV positive patients in Furquia in the absence of the mobile clinic.
Mother-to-mother Support Groups Improve Adherence
Mothers Share Experiences During Monthly Meetings
Health Facilities supported by the mobile clinic now count on mother to mother support groups to improve adherence. Currently 83 women (Mbawa – 56 and Furquia – 27) meet once per month to share experiences and receive orientation from the MCH nurse and trained TBAs. After the meeting, HIV positive women join the larger group to participate in the demonstration of nutritional food preparation for children.
Healthcare Provision During Emergency Situation
Team Looks to Contingency Plan
After severe rains in February, some areas within Namacurra district became isolated and displaced people moved to temporary resettlement areas. A contingency plan for this type of situation was developed late in 2013 with a view to providing continuous health care and treatment to HIV+ displaced people. Prevention of gender-based violence (GBV) and provision of related health care was also made a priority.
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.
- 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.
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Q1 Report, 2014
1,212 direct beneficiaries
up to 5,736 people indirectly benefited from clinical activities
- 509 pregnant women were treated
- 287 pregnant women received HIV counseling and testing
- 83 women meet once/month to share experiences
- 41 children received HIV counseling and testing
- 13 patients enrolled in TB care
The Impact of Mother to Mother Support Groups and Male Partner Involvement in Pre-Natal Care
HIV+ Mães para Mães or mother to mother support groups (MpM) aim to help meet the special needs of HIV positive pregnant and lactating women and their babies by offering a venue for psychosocial support, mutual assistance and education.
In Mbawa health center, 56 women are currently members of MpM groups and meet monthly to share their experiences in living positively with HIV and offer each other psychosocial support and practical advice to face the challenges they encounter. The Mobile Clinic MCH nurse and traditional birth attendants (TBAs) help organize the meetings and lead the educational sessions, as well as assisting mothers and babies to access specific services.
This quarter, led by the Mobile Clinic MCH nurse, the groups discussed HIV prevention, testing and treatment; prevention of mother to child transmission of HIV; the importance of antenatal care and the participation of their partners in antenatal consultations as well as post-partum follow-up of mother and baby. The TBAs stressed the importance of adherence to pre-natal care, together with partners, and the need to continue with consultations post-partum to protect the mother and babies´ health. One of the mothers explained that among the support group, they also talked about how to raise awareness on the importance of adhering to antiretroviral treatment and spreading the message about attending consultations with their husbands to other HIV+ women in their community.
The Mobile Clinic MCH nurse explained that initially some mothers who attended a pre-natal session at the health center and tested positive didn´t return for the next consultation. However, after the nurse talked about the issues further in the maternity ward and the MpM groups were started, more mothers see value in returning. Now the health facility is supported by MpM members who discuss how to overcome the obstacles that are preventing positive mothers from adhering to consultations and treatment. The member mothers themselves live positively and offer information and support to other HIV-positive pregnant and lactating women, so they too can adhere to treatment to protect their own and their babies´ health. The MpM members have also contributed to increasing partner involvement in ante-natal care, and worked with the nutrition groups to promote and demonstrate the use of local products in a nutritional diet, including how to make first complementary feeding foods (enriched porridge).