Child Survival

Young Child Survival Development

Integrated Management of Neo-natal and Childhood Illness


Photo essay


Accelerated interventions reach more children with basic health services

© UNICEF Mozambique/ Emídio Machiana
Siyabonga, 13 months old, screened for nutrition status by a mobile health unit led by Fátima Jonasse (left), in the community of Djabula. April 2008.

Maputo, April 2008 - The mornings always start early for the rural community of Djabula, in the district of Matutuine, Maputo province. Most women, usually carrying small children on their backs, start their day collecting water and firewood. Others head to farms or go to the markets to sell agricultural goods or food.

However, their daily routine was interrupted today by a very important event happening in their community. A mobile health unit was coming to Djabula, bringing basic health services for children under 5 years old.

Those who had not previously received information about this were intercepted by the health worker, Fátima Jonasse as she traveled in. With the aid of the community leader, Fátima was able to mobilize the mothers, house by house, and wherever she met them.

When the mobile unit finally arrived into the heart of Djabula, there was already a long line of women waiting anxiously with their children. Cecília, 23 years old, was one of them. She had brought her 13 month old son, Siyabonga and explains why these interventions are very important for the health of her son.

“Normally I would be at my house preparing coal to sell but today I decided to come here to take advantage of the opportunity to get vitamin A, vaccinations and de-worming tablets for Siyabonga”, says Cecília.

“My house is 2 kilometers from the local health post. But it frequently doesn’t have vaccines and medicines for the children. Many times the only option is to walk 12 kilometers to the Health Centre”, Cecília adds.

“It is very difficult to get there because the road is too sandy and there is no transport. Consequently there are many days when I have to stay at home with my sick son without any assistance or medication. But today it is possible to bring Siyabonga here because I didn’t have to walk very far or take much time off from selling coal.” concludes Cecíla.

© UNICEF Mozambique/ Emídio Machiana
Child receiving vitamin A supplement in Matutuine district, Maputo province. April 2008.

In response to the needs of children such as Siyabonga, the health authorities have developed an outreach programme aiming to reach remote communities. Health workers such as Fátima are well known in the communities because they bring basic health services once a month.

However, this time the mobile unit has brought a more comprehensive package of interventions, for children under 5 years, as part of the National Child Health Week.

The National Child Health Week is a key initiative of the Government of Mozambique, supported by UNICEF and other partners and aims to accelerate the reduction of mortality rates in mothers and children under 5 years old.  The first phase of the programme was 31 March to 4 April 2008. The second phase the programme is scheduled for August.

“During this week we offer greater assistance to the communities through our mobile units and at the health centres, providing children under 5 years old with even more integrated services”, clarifies Fátima Jonasse.

“Children have access to routine vaccinations, vitamin A supplements, de-worming tablets and nutritional screening”, she adds as she gives vitamins to one of the children in the line. Iodine supplement has also been implemented in some provinces of the country.

The most recent available data on Vitamin A deficiency in Mozambique indicates that 69 percent of children under 5 years old are affected. This has a tremendous impact on the health and mortality rate of children but the availability of routine supplementation   is still low.

It has also been proven that de-worming contributes to an increase in child survival. However, the intervention is generally still not routinely implemented in most sanitary units.

Moreover, acute malnutrition is one of the main causes of child mortality in the country, accounting for almost half of all the deaths of children under 5 years old.

“With this initiative we intend to increase health interventions by taking the mobile units wherever the children are.” says Stélio Alfredo Dimande, Head of Doctors in the Maputo province, who oversaw the work of Fátima Jonasse during her visit to Djabula.

“It means that we can take the mobile units to schools, day-care centres, and where the mothers are working, for example, in the markets. This required gathering a high volume of resources, including financial, logistical and staff.” Stélio Dimande explains.

The subsequent phases to be implemented later this year will also include vaccination against measles, polio and the distribution of mosquito nets.

Should positive results emerge from this initiative, the National Child Health Week may be routinely implemented at least twice a year from 2009, and expanding services to include mothers and women of reproductive age.



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