Supporting Women and Children Access to HIV Services to Prevent Vertical Transmission of the Virus and to Improve Adherence to Antiretroviral Therapy in Mozambique
Project location: MOZAMBIQUE, Beira
Project start date: July 2013 - Project end date: July 2014
Project number: 2013-073
Beneficiary: Fondazione di Religione Opera San Francesco Saverio C.U.A.M.M.
Final Report period: From January 2014 to June 2014
In Beira Mozambique, CUAMM works with a group of women to improve a food rehabilitation programme aimed for mothers and children.
Chronic malnutrition reaches 44% in Mozambique, so the need of a task force in order to improve the programme was found. CUAMM is working with the Mozambican Ministry of Health, Unicef, Italian Ministry of Foreign Office and other donors to revisit the operative plan with concrete actions both in the hospital and health centres. The need to work in the communities, in order to prevent chronic malnutrition, showed the importance of local associations and activists in identifying the cases and functioning as referral to the health centres or hospitals.
The mothers of Kuplumussana are collaborating with CUAMM from 2009 and are today recognized as an association by the Mozambican Government which primary objective is "to save the others", contributing to improve mothers and children health in HIV prevention, vertical transmission aiming to improve the future of children and population as a whole.
Its range of action is spread over 7 municipalities in the city area of Beira (Nhaconjo, Macurungo, Munhava, Ponta Gae, Manga Loforte and Chamba) getting closer communities and families to the health centers of the Sofala province.
The main activity funded by the NPF has been supporting the active search of patients through Kuplumussana's mothers distributing them transport, providing nutritional and material support to the HIV+ mothers.
To tackle poor attendance, Kuplumussana's members operate in 10 Health centres in Sofala Province where they give counselling to pregnant women (or who have recently given birth), provide food education and support children at risk of being abandoned through the "madrinha" (godmother) mechanism, which ensures that this particularly fragile cases are followed, accompanied to examinations, testing and welcomed into Kuplumussana family. As of today there are more than a dozen children followed by godmothers.
This approach help them face the socio-cultural barriers and discrimination, and support them in starting and maintaining adherence in antiretroviral treatment (TARV), that requires extreme precision and accuracy in taking the drug to be effective. For this, it is essential a patient default tracing and follow up of pregnant women and children infected by HIV and children exposed to HIV and one to one support for vulnerable patients (children and pregnant women).
The mechanism through witch the Association works - in order to find missing patients -follows few steps:
every week the person in charge at the Health Centre gives a list of the missing patients including the number of visits missed, level of significance and priority;
the Association's members start the research process in the area:
instruct the families over the importance of treatment adherence;
explore the reason of the treatment abandonment and look for possible solutions with the families (i.e. godmothers, economic support)
Monitoring of the research process is been occurred through the filling of various sheets and followed by imputing of the data on a PC, ready for evaluation.
Another important activity is the accompaniment of patients to examinations in order to give them support and facilitate the communication with the health personnel.
Kuplumussana engagement also includes various sensitizations activities aimed to improve the implication of men, discriminating reduction, fighting home abuse and economic support for families with identified children during the research process.
The Association usually gives a small amount of money that will allow the family, with some administration advice from Kuplumussana, to start over. In emergency occasions, the Association, delivers to very indigent families directly food andor clothes and other small goods awaiting a lasting solution.
From the 2015 report Unicef is highlighted through interviews with all stakeholders how it was clear that the community approach was very relevant and the support to Kuplumussana Association was highlighted as a key project strength. This approach filled and continues to fill a gap which state services are unable to deliver by creating essential links between the community and health centers, providing information and advice to patients in the HC and supporting Maternal and Child Health nurses with key duties such as managing clinical processes.
The project has improved the linkages between the health facility and community, so CUAMM is recognized for its community approach in Beira, by all stakeholders.
Large numbers of beneficiaries are reached through the activities and the health facility gain from the support of Kuplumussana. The project improved patient tracing in the Health Centers through financing Kuplumussana community activists and a high number of defaulting patients returns to the Health Centre for follow up.
Increasingly the project has broadened the approach to include, strengthening the capacity of Community Health Committees to better understand the themes related to reproductive health and HIV/AIDS.
In 2014 the activities of CUAMM and Kuplumussana continued: 930 children were traced and returned to HC. There were also successful results achieved for tracing of pregnant women, in 2014, 2.300 were traced and returned to Health Centre. During 2014, the number of youths attended also increased.