A former Portuguese colony, Mozambique has been independent since 1975. Since then, it has experienced many setbacks to the country’s development that include a severe drought and a prolonged civil war. Mozambique’s 799 380 sq. km. territory is bordered by Malawi, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe and is located in south eastern Africa. 24.1 million people are estimated to live in the country as of July 2013, 31.2% of who live in urban areas. The public health sector is the largest provider of general health services to the country but only an estimated 50% of the population is able to easily access these services.
Malaria is a large contributor to the country’s disease burden2 and puts all regions at risk of transmission. It is considered to be the most important public health problem and accounts for 29% of all deaths and 42% of deaths of children under five. Children under five, pregnant women, socially disadvantaged groups and those living with HIV are most vulnerable to the parasite. Malarial infection is responsible for 44% of all outpatient consultations, 57% of paediatric admissions and is a leading cause for the low birth weight. Parasite prevalence in 2007 was 38.5% in children under five and 16.3% in pregnant women with the Plasmodium falciparum strain, accounting for over 90% of all malaria infections.2 Parasite resistance testing was conducted from 2007 to 2011. The study showed variant levels of susceptibility of An. Gambiae s.l. and An. Funestus s.l. to four classes of indoor residual spray (IRS) pesticides, possible resistance to DDT and confirmed resistance to deltamethrin and lambdacyhalothrin in some areas.
The National Malaria Control Program (PNCM) is responsible for developing policy, establishing norms and the planning, organizing and coordination of all malaria-related activities in Mozambique. The distribution of free long-lasting insecticidal nets (LLINs) to children under five years old and pregnant women has been a policy since 2006. In 2009, the policy of universal coverage was adopted, which is defined as one LLIN for every two people. Implementation of the universal coverage campaign started in 2010 in 11 out of 144 total districts. In 2011, it was extended to a total of 45 districts. District-level programmes have shown improvements in infection rates. 4.5% of children under five that were experiencing fever received artemisinin-based combination therapy (ACT) within 24 hours of symptom onset in 2007. In 2011, this increased to 15.3%. During the same period, the proportion of pregnant women who slept under LLINs increased from 7.3% to 19.5%. A combined LLIN and IRS strategy is implemented in the country with IRS targeting the 40% of the population located in urban and peri-urban areas. Prevention methods such as LLINs have improved but, nevertheless, malaria continues to pose a major public health problem in the country.
Several indicators have shown little progress. This can be seen in the proportion of pregnant women who received two or more doses of intermittent preventative treatment of malaria (IPTp) during their previous pregnancy (over the past two years), which only increased from 16.2% to 18.6%. Some of the weaknesses that prevent prompt diagnosis and correct treatment include inadequate storage of rapid diagnostic tests (RDTs), lack of quality control and quality assurance, lack of trained personnel, poor understanding of RDT usage criteria and over testing of non-target groups. Health facilities are usually difficult to reach and suffer from commodity stock-outs and a general lack of basic amenities. There is only an estimated three doctors and 21 nurses per 100 000 population, a proportion that is among the lowest in the world.
Malaria control in Mozambique’s public health system is dealt with on three administrative levels: central, provincial and district. The central level in centred on PNCM, which is understaffed and some staff are undertrained. Each province has a malaria focal point that coordinates malaria control implementation. The district malaria focal points are responsible for improving data management and reporting on malaria indicators at that level. PNCM’s National Malaria Policy and 2012–2016 National Malaria Prevention and Control Strategic Plan focuses on the five points of decentralization of malaria control activities, access to at least one prevention method for 100% of the population by 2014, 100% confirmatory lab testing on suspected malaria cases by 2014, prevention messaging reaching 100% of the population by 2016, and strengthening of the M&E system so that all districts are capable of reporting malaria indicators by 2014. In addition to health problems, malaria also contributes to lessened country productivity through the loss of workdays.
Seasonal flooding, periodic droughts and the burden of malaria and other communicable diseases continue to bring suffering to much of the population of MozambiqueRead more
The Health Ministry has received a grant of US$85 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria to step up the fight against malaria.Read more
Maputo ? The director of the Mozambican government's National Malaria Control Programme, Graca Matsinhe, recognised on Thursday that the government will not be able to eradicate malaria on its own, since this is a task in which all Mozambicans should pay their role.Read more
Malaria Consortium trains a group of teachers in malaria prevention and control, enabling them to conduct educational activities in the classroom. In addition to the training, the teachers will receive a kit of educational materials with visual illustrations and texts, to stimulate interactive discussion between teachers and students about malaria.Read more