Africa Asia Latin America & Caribbean Africa » Mozambique Mozambique: Integrated Management of Childhood Illness Summary of technical assistance provided to the Ministry of Health The Management and Leadership Program (M&L) of Management Sciences for Health assisted the National Integrated Management of Childhood Illness (IMCI) Program in Mozambique from September 2003 through August 2004 by providing logistics support to the development of management systems and educational materials for training medical and paramedical staff in IMCI. The IMCI Program of the Ministry of Health of Mozambique (MOH) is focused on assisting the Child Health Section of the Department of Community Health to improve the quality of childcare in the health system, leading to the reduction of morbidity and mortality of neonates, infants, and children, within the context of the overall goal of the National Integrated Health Plan. The relatively recent introduction of the IMCI Program in Mozambique by the World Health Organization (WHO), required extensive training and refresher training for all senior health care staff and institutionalization of IMCI in educational institutions that train health care providers. It also required that educational materials, namely a standard set of IMCI manuals in Portuguese, be made available in the health sector. M&L provided logistical support for IMCI training and IMCI management information systems. Development of IMCI Training Manuals Six Integrated Management of Childhood Illnesses training manuals were produced and are now in print and electronic format: Preservice Caring for a Child with a Severe Infection or Malnutrition IMCI Emergency, Triage, and Assessment Malaria Drug Policy and Macro Nutrients Initiative HIV and Prevention of Mother-to-Child Transmission Counseling and Caring for Children Suffering from HIV/AIDS It is estimated that 80 percent of clinical staff in each of the six provinces (Gaza, Sofala, Nampula, Zambezia, Niassa, and Manica) receiving the manuals will reference the learner section of the manuals. This includes doctors, nurses, medical technicians, and other health personnel. Additionally, 12—18 teachers from the six provinces will use the tutor section of the manuals to provide instruction in provincial health institutes. IMCI Trainers and Facilitators Are Trained IMCI trainers were trained in the Faculty of Medicine and Paramedical Schools and facilitators were trained in IMCI Emergency Triage and Assessment in the provinces of Gaza, Sofala, Nampula, Zambezia, Niassa, and Manica. A training plan and three regional workshops were completed, bringing together participants from six provinces. Sixty-five health personnel from the central and provincial levels were trained as facilitators and trainers who could provide district wide training to peripheral health staff in these workshops. IMCI Curriculum Development Logistics support was provided for IMCI curriculum development workshops that established a process for the incorporation of revised IMCI curriculum into schools of public health and medical faculties in six provinces. Initial contact was established with curriculum boards of schools of public health and medical faculties. Discussions focused on introducing the revised IMCI curriculum and holding trainings for facilitators of IMCI training. Three regional workshops were held to facilitate curriculum changes at the institutions. All attending institutions committed to updating their existing curriculums by including the new IMCI training manuals. Database Initial database assessments, technology upgrades, and training plans for database use were conducted in the provinces of Gaza, Sofala, Nampula, Zambezia, Niassa, Manica, and Inhambane by the M&L local professional database manager. The IMCI database software has been upgraded from FoxBASE to Access, a more advanced system. IMCI database training sessions were conducted in seven provinces, with two to three participants per province. Training included database navigation, data entry, and generation of reports. Participants were given a database user manual, produced by the M&L local professional database manager for future reference. One round of follow up visits was conducted after the training by the local professional database manager. Some provinces experienced additional technology constraints with damaged and infected computers. In these instances the database was reinstalled to enable proper use. An evaluation plan for provincial-level training has been written and finalized. Looking Forward With the assistance of M&L, the Mozambique MOH is using WHO guidelines for IMCI training and has updated IMCI training manuals in Portuguese available for use within the MOH and within schools of public health and medical faculties (as of August 2004). There is also a commitment on the part of schools of public health and medical faculties to integrate IMCI training in school curriculums. Also, seven provinces have access to the IMCI management information system and have been trained to both collect and enter information and to access and use information for decision making. M&L recommendations to the MOH include: continue to strengthen IMCI training in schools of public health and medical faculties; continue making relevant IMCI training materials available in Portuguese; continue encouraging regular use of the IMCI database not only for collecting data but for planning and evaluation purposes; build the MOH’s central- and provincial-level capacity in monitoring and evaluation of IMCI activities; and expand IMCI strategies to other provinces. Summary of M&L's technical assistance with Mozambique's       Integrated Management of Childhood Illness Program [PDF - 195KB]