Mozambique

To evaluate the effort, data was collected at graduation and 10 months later from pre-revision (initial) and revised curriculum TMGs to determine the following: (1) Did cohorts trained in the revised curriculum score higher on measurements of clinical knowledge, physical exam procedures, and solving clinical case scenarios than those trained in the initial curriculum; (2) Did TMGs in both curricula retain their knowledge over time (from baseline to follow-up); and (3) Did skills and knowledge retention differ over time by curricula? Post-graduation and over time results are presented.

Successfully motivating and retaining health workers is critical for the effective performance of health systems. In Mozambique, a shortage of health care professionals and low levels of staff motivation in rural and remote areas pose challenges to the provision of equitable health care delivery.

The complex constellation of factors that underlie and reinforce gender-based violence (GBV) warrants a strong multi-level and multisectoral response. This technical brief explores Pathfinder’s experience pioneering a multisectoral approach to GBV prevention and response across two projects in Mozambique, and outlines key lessons learned and next steps. [from abstract]

Despite numerous persistent challenges – including low quality of care, continuing inequalities and the substantial impact of the HIV/AIDS pandemic – Mozambique provides important lessons to other countries aiming to scale up health provision rapidly in a post-conflict setting. These particularly include the importance of focusing on distance and education as barriers to access, using innovative and low-cost human-resource policies to scale up health personnel quickly, and of moving towards more coordinated systems of aid disbursement. [from abstract]

This report synthesises findings from five country case studies from the health dimension of this project, which focus
on maternal and child health (MCH) (Mozambique,Nepal, Rwanda) and neglected tropical diseases (NTDs)(Cambodia, Sierra Leone). MCH was selected given its centrality in two of the Millennium Development Goals (MDGs) and its ability to act as a proxy for strengthened health systems.

The objective of the prevention of Mother-to-Child Transmission (pMTCT) cascade analysis tool is to
provide frontline health managers at the facility level with the means to rapidly, independently and quantitatively
track patient flows through the pMTCT cascade, and readily identify priority areas for clinic-level improvement
interventions. [from abstract]

Despite the growing interest in the private health sector in low- and middle-income countries, little is known about physicians working outside the public sector. The paper’s objective is to contribute to the understanding of such physicians, ultimately informing the policies regulating the medical profession in low- and middle-income countries. [adapted from abstract]

The predominant model of public health commodity supply chains in developing countries is one dominated by a central medical store (CMS). In this model, the CMS plays the pivotal role of procurement, storage and warehousing of all health commodities before they are distributed to the next level in the supply chain. Challenges with technical and organization capacity at the CMS level has led to longstanding difficulties in creating sustainable performance improvements in several countries.

In 2012, Pathfinder conducted a study to explore whether CHWs who are intended to promote family planning as part of an integrated package of services do communicate with beneficiaries about family planning, and what actions women take based on these messages. The study also explored whether CHWs are reaching the poor, marginalized and vulnerable, and examined the costs of implementing the CHW component of the SCIP project. [from executive summary]

Knowledge of the relation between health-system factors and child mortality could help to inform health policy in low-income and middle-income countries. We aimed to quantify modifiable health-system factors and their relation with provincial-level heterogeneity in under-5, infant, and neonatal mortality over time in Mozambique. [from abstract]

This report combines findings from a desk review,a mapping of [Close-to-Community] CTC providers and data collected during qualitative explorations carried out in two selected districts of Maputo Province as part of the context analysis. [from introduction]

This report is an interim summary of ongoing supply chain strengthening interventions focused on community health workers in Mozambique. The piloting of these interventions aims to improve the performance of the supply chain that provides these community health workers with antimalarial drugs, rapid diagnostic tests, male condoms, and essential medicines for a variety of treatments. [from summary]

This presentation outlines the methodology, aims and results of a highly successful and innovative program of pre-service health education at Lurio University that links future health professionals with the community by assigning each student to a family. The student monitors the family’s health status and analyzes the social, economic and cultural aspects impacting on the individuals’s and family health such as education and nutrition.

In Mozambique, clinical staging may be the primary determinant of HIV/AIDS treatment decisions, and the task of staging commonly falls to non-physician clinicians. This study evaluated the quality of performance in clinical staging two years after the first Mozambican clinicians were trained in HIV/AIDS care. [adapted from abstract]

The primary objective of this study was to solicit and identify perspectives on vertical aid among key Mozambican public sector health managers who must coordinate, implement, and manage the myriad projects, agencies, and resource flows that the increase in vertical funding has produced amid continued severe workforce staffing shortages. [from author]

This study identifies the implications of different types of supervision for healthcare worker job satisfaction and intention to leave the workplace in Malawi, Tanzania, and Mozambique. [adapted from author]

This paper describes task-shifting taking place in health centers and district hospitals in Mozambique and Zambia to identify the perceived causes and factors facilitating or impeding task-shifting, and to determine both the positive and negative consequences of task-shifting for the service users, for the services and for health workers. [adapted from abstract]

This observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980–2006. [from abstract]

This policy brief explores actual performance of emergency obstetric care (EmOC) and other related maternal and newborn health services by Nurses, nurse-midwives, and non-physician clinicians who provided at least one of the EmOC signal functions in the previous three months preceding data collection in hospitals and health centres throughout Malawi, Mozambique, and Tanzania. [adapted from author]

This paper discusses the background of HRH shortages in the listed countries, as well as plans for steps to resolve the issue. [from publisher]

Human resource shortages are viewed as one of the primary obstacles to provide effective services to growing patient populations receiving antiretroviral therapy and explanding access further. This article examined the relationship of patient volume, human resource levels, and patient characteristics with attrition from HIV treatment programs in central Mozambique. [adapted from abstract]

This report presents the findings and key messages of rapid situation analysis in Mozambique of the human resources for health implications for scaling up to universal access to HIV prevention, treatment, care, and support. [from summary]

The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future. [from abstract]

This paper reflects an initial review of aid effectiveness in relation to human resources for health. It asks whether the recent aid effectiveness agenda, as expressed in commitments made to the Paris Declaration, is responding appropriately to the specific needs of HRH and countries’ efforts to strengthen and scale up human resources. [from author]

This article reports on a nationwide evaluation by the Mozambican Ministry of Health of the quality of care delivered by non-physician clinicians after a two-week in-service training course emphasizing antiretroviral therapy. [adapted from abstract]

This paper compares the socioeconomic profile of medical students registered at the Faculty of Medicine of Universidade Eduardo Mondlane, Maputo, for the years 1998/99 and 2007/08 to describe the medical students’ social and geographical origins, expectations and perceived difficulties regarding their education and professional future. [adapted from abstract]

This paper reports on two separate experiences of human resources development plans costing in Mozambique and Guinea Bissau to provide insight into the practice of costing exercises in information-poor settings and contribute to the existing debate on HRH costing methodologies. [adapted from abstract]

This report presents the results and conclusions of a case study conducted within the broader context of assessing resource flows into the development of human resources for health (HRH). Using the example of Mozambique, it examines whether the emerging policy focus on aid effectiveness responds to the evident needs in scaling up HRH. [from publisher]

While constrained health budgets and health worker shortages have been blamed for the low rates of surgery, there has been little empirical data on the providers of surgery and cost of surgical services in Africa. This study described the range of providers of surgical care and anesthesia and estimated the resources dedicated to surgery at district hospitals in three African countries. [from abstract]

In Mozambique, a country with a high HIV burden and a staggering workforce deficit, the Ministry of Health looked to past experience in workforce expansion to rapidly build ART delivery capacity, including reliance on existing nonphysician clinicians (NPC) to prescribe ART and dramatically increasing the output of NPC training. [from abstract]