Mozambique

Project Background:

RMF’s Mobile Clinic in Mozambique is a new model of health care 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. 

Summary of RMF/MMI-sponsored activities carried out during the reporting period under each project objective:

In the first quarter of 2012, activities focused on setting up the necessary conditions for a successful roll-out of expansion activities:

1. Finalized negotiations with DPS-Zambézia and DDS-Namacurra to agree on the new plan of expanded activities for Mobile Clinic operation. As outlined in the 2012 strategy, the Mobile Clinic will support the expansion of HIV care and treatment services to peripheral health units, while collaborating with DDS health staff in the provision of routine health services at the health facilities supported.

It was also agreed that the Mobile Clinic would attend some health fairs and other health-related events in the province, as long as its weekly calendar of support to peripheral health facilities allows for its presence.

Authorization from Zambézia Provincial Directorate of Health was finally received on April 5^th (see attachment).

2. Contracting dedicated staff to allow the Mobile Clinic to carry out the full extent of planned activities. The following positions were hired to specifically serve Mobile Clinic operations:

– Medical Officer (Técnico de Medicina)

– Maternal and Children Health Nurse (Enfermeira SMI)

– Pharmacy Officer (Agente de Farmácia)

– Lay Counselor (Conselheiro de Saúde)

– Driver/Logistician (Motorista/Logista)

3. Visits to Malei and Mexixine localities were conducted to disseminate information about the Mobile Clinic program, organized together with the Namacurra District Chief Physician. Meetings were held with different local authorities in order to secure their support to mobilize communities in those areas. Community leaders received information about visit days and services offered by the Mobile Clinic, which they subsequently transmitted to their respective communities.

4. Completed pending maintenance (winch replacement and engine cleaning).

 At the time of writing this report, the Mobile Clinic has resumed its operations again in the Namacurra District, supporting the localities of Malei and Mexixine.

Results and/or accomplishments achieved during this reporting period:

The main results obtained within the present reporting period were:

– Completion of Mobile Clinic team recruitment, which will allow us to maximize the efficacy of activities defined in the 2012 strategy.

– Securing the authorization of Zambézia Provincial Directorate of Health to start operations. Several meetings and presentations to DPS-Zambézia key staff were necessary in order to obtain all required authorizations to proceed with implementation.

– Completion of Mobile Clinic maintenance.

Plans for next reporting period:

As of April 9^th, the Mobile Clinic has been providing the following services again:

• General clinic consultations (adults and children).
• Rapid testing for malaria, HIV and syphilis.
• Basic first aid for medical emergencies.
• Referral of patients to Health Units as per clinical needs.
• Nutritional monitoring and supplementation for children and adults.
• Counseling for prevention of cervical and breast cancer and referral of suspected cases for follow-up.
• Provision of basic medicines.
• Support DPS-Z in health-related events.
• HIV services, including follow-up and point-of-care lab control, Co-trimoxazole (CTZ) prophylaxis and initiation of ART.
• Health counseling and testing (HCT), including distribution of male and female condoms.
• HIV counseling and testing for pregnant women, and PMTCT for HIV-positive women.
• Delivery of positive prevention package for HIV-positive patients.
• TB services, including TB screening, TB treatment and follow-up.
• Collection of blood and other biological samples for lab tests and transport to laboratory.
• Transport of sputum samples for TB smears, collected by DOTS-C volunteers and Mobile Clinic staff.