Palma Mozambique

Keywords: Palma Mozambique
Description: Health project to strengthen children’s emergency services in the district of Palma Intervention areas Health project to strengthen children&rsq

Mozambique is located in the south-eastern part of Africa. In administrative terms the Republic of Mozambique is divided into eleven provinces, including the city of Maputo which has the status of a province. The provinces are subdivided into a total of 128 districts and, in turn, these are divided into administrative districts called Postos Administrativos. In addition there are 43 municipalities, created in 1998 as part of a process of decentralisation. Cabo Delgado is the northernmost province of the country and is also the source of some critical health indicators. Located in the north-east, on the border with Tanzania, it has a total estimated population of 1,700,000. The distribution in terms of age groups shows a prevalence of younger people: 46% are under the age of 15, of which 17% are under the age of five. Malaria, diarrhoea, pneumonia, malnutrition, HIV and TB are the leading causes of infant and childhood morbidity and mortality. There is also a high maternal mortality rate. The sero-prevalence of HIV is also increasing and both leprosy and schistosomiasis are among neglected diseases. The density of healthcare infrastructure and trained health personnel is still below the standards established by the local Ministry of Health (MISAU),which also explains the rates of provision of reproductive and children’s healthcare that are below the national average.

The Province of Cape Delgado is divided into 17 districts, its capital is the city of Pemba. The specific context is the district of Palma, a coastal area overlooking the Indian Ocean. The population is just under 60,000, half of which is concentrated in the city of Palma, while the remainder is scattered throughout the territory. Communications and transport networks are very poor. The main economic activity is fishing. The direct beneficiaries of the initiative are pregnant women and infants in the district of Palma (about 3,000). The initiative will also benefit healthcare workers in the department of obstetrics and gynaecology at the Health Centre (approximately 50 people) and the staff of 6 health centres (about 30 persons) responsible for providing basic emergency obstetric services. The indirect beneficiaries are the inhabitants of the district of Palma who will have access to improved health services (60,000 people).

The project aims to help the Mozambique authorities to reduce infant and maternal mortality in the Palma district by improving quality and access for children’s and maternal healthcare services.

  • improved quality of emergency obstetric and neonatal services
  • the reinforcement of diagnostic support services (X-rays, ultrasound and lab analysis).
  • improved access to MCH services for women with high-risk pregnancies
  • improved quality of MCH services and in the organisation of the Health Centre
  • organisational and technical support for Palma’s District Health Office in the provision of basic health services at the district’s peripheral health centres.

The local partners are the Ministry of Health (MISAU), the Capo Delgado Provincial Health Department (DPS), the District Health Office (DHO) and the District Health Centre of Palma. The strategy for the initiative, agreed with local health authorities in 2012, was officially ratified with the MISAU in an agreement signed on 3 March 2013.

The initiative has been carried out in close collaboration with provincial and district health authorities and with the support and patronage of the First Lady, Maria da Luz Guebuza.

The Italian non-governmental organisation of doctors in Africa (CUAMM), has a consolidated and accredited presence in the Mozambique (since 1978), as well as deep roots in the territory, was chosen as the organisation to oversee the implementation of certain of the project’s acitivities.

The project aimed in its first phase to begin the strengthening of the Palma District Health Centre as a prerequisite to the development of the entire district system.

This first step, following the immediate rehabilitation of the fresh-water supply system, involved the following activities:

  • the construction of a fully-equipped surgical unit at the Health Centre (CDS) in Palma to respond to all obstetric emergencies and the relative training of staff assigned to such services.
  • the acquisition and provision of x-ray, ultrasound and diagnostic laboratory diagnostic equipment to reinforce the diagnostic capacity of the centre and to oversee the on the job training of staff.
  • the creation of a Childbirth Wing (Casa de Espera) to provide shelter for women with high-risk pregnancies from remote areas with difficult access to the relevant training.
  • the expansion of the clinical and management capacity of the Health Centre and and the district office.
  • the local training of medical, nursing, technical and administrative staff. During 2014 at the Palma Health Centre ran the following training courses for various healthcare workers throughout the district:

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