The National Malaria Control

Program in Mozambique Summary of technical assistance provided to the Ministry of Health

The Management and Leadership (M&L) Program of Management Sciences for Health assisted the National Malaria Control Program (NMCP) of the Mozambique Ministry of Health (MOH) to pursue its goal of reducing morbidity and mortality caused by malaria in vulnerable groups: women of child bearing age, children aged 0-5 years, and the socially disadvantaged. M&L collaborated with the NMCP from October 2002 through August 2004. Its primary role was to provide financial and administrative support for a variety of priority activities designed to enhance overall program management capacity of the NMCP, improve the performance of management systems and managers, and increase efficiencies in future planning and implementation efforts of the NMCP. M&L also helped develop a sentinel surveillance system in three provinces.

From 2002 to 2004, the MOH developed and implemented the malaria control activities as described below, to which the M&L Program provided financial and administrative support. The priority activities included:

• contracting NMCP staff, staff development, supply of office materials, and vehicle maintenance;
• strengthening clinical and laboratory diagnosis;
• improving surveillance of malaria cases, monitoring drug efficacy, and monitoring insecticide resistance;
• increasing community participation, health promotion, and advocacy for prevention and diagnosis;
• strengthening epidemic and emergency preparedness;
• coordinating a spraying campaign.

Contracting staff, staff development, supply of office materials, and vehicle maintenance

Two national field workers were contracted by the MOH for entomology and epidemiology field surveys and lab work in Maputo , and a local advisor was contracted to work in all the provinces on the MOH Case Management and Implementation of Drug Policy Training Program. English language training for two MOH staff was also arranged. A coordination meeting was organized in May 2003 in Maputo with all malaria control partners, including WHO, UNICEF, Population Services International, USAID, DFID, National Institute of Health, Centro de Investigação da Saúde em Manica, World Vision, and Save the Children. Funding for supervision training visits for NMCP activities in three provinces and the procurement of supplies, equipment, and vehicle maintenance for NMCP operations were also provided by M&L.

Strengthening clinical and laboratory diagnosis

Funding was provided for two regional malaria training and refresher training courses held in the northern and central regions of Mozambique , involving approximately 180 participants from seven provinces. Courses in drug policy and clinical diagnosis training, supported in nine provinces, were attended by approximately 620 participants.

Improving surveillance, monitoring drug efficacy, and monitoring insecticide resistance

Thirty clinical and laboratory MOH staff were trained and supervised in malaria diagnosis and the assessment of treatment efficacy. Supervision visits to six sentinel sites to ensure bioassays and susceptibility tests were conducted for monitoring the effectiveness of vector control activities. Logistics support was also provided for three MOH supervisors to monitor and supervise surveillance systems for case management in eleven district sites, and for supervision visits by two MOH central level personnel for mapping vector distribution and bionomics in selected sites. A report on the surveillance system was edited and distributed.

Increasing community participation and awareness for prevention and diagnosis

M&L supported the National Malaria Awareness Day in November 2003 in Ponta d'Ouro, a city south of Maputo . The event included international and local participation in a day of cultural events. There were approximately 1,500 attendees in the district and the event was televised and aired on the radio throughout the nation. A community-based malaria education program in the districts of Manica, Chibuto, and Homoine was also conducted and delivered to approximately 6,000 children in three districts.

Strengthening epidemic and emergency preparedness

Logistics support was provided to identify and designate a health center in Manica province to provide epidemiological data for national analysis, and to train twelve MOH central level p ersonnel in the use of the epidemiological database. S upplies and computer equipment were purchased for a situational analysis room at the MOH to monitor the epidemic situations and emergency response in the country.

Coordinating a spraying campaign

A spraying campaign in Maputo province involving 22,000 structures was conducted during a three-month period, January through March of 2003. M&L provided support to procure necessary protective material and spray pumps.

M&L's technical role

In coordination with NMCP staff, M&L helped develop a data collection and monitoring and evaluation system for the NMCP in three sentinel sites in Sofala, Gaza , and Nampula provinces. Sentinel site visits resulted in the collection of baseline data and the preparation of action plans for evaluating intervention activities. Support for the establishment of the monitoring and evaluation system in the three sites included: contracting local data collectors and managers, procurement of three motor bikes for data collection efforts, and the purchase of computers. The final analysis and impact assessment report could not be carried out due to delays in the establishment of the system and human resource constraints within the MOH. As a result, only four months of data were collected prior to the close of this component of M&L's Mozambique Program in August 2004. The MOH, USAID/Mozambique, and M&L agreed that this work would continue with assistance from a World Health Organization data manager.