Integrated health care for mothers and children helps to save lives
Mozambique, Tete, September 2010 – Aida Olimpio, 22, is six months pregnant and has arrived for her antenatal consultation at the Mavuzi Ponte health centre, a rural outpost in Chiuta district.
It’s early in the morning, but a dozen mothers with their babies tightly strapped to their backs are already waiting for their consultation in the shade of the outdoor patio.
Aida takes seat on the long bench alongside the other women, and while they wait for their turn, a health worker explains to the captive audience the value of sleeping under an insecticidal mosquito net. Aida, having lost her first child to malaria, pays close attention.
The Mavuzi Ponte health centre – like all health centres in the country – offers an integrated approach to maternal and child health. The services include antenatal and post-natal care for women and a basic package of preventive and curative services for children – immunisation, vitamin A supplementation, growth monitoring and de-worming.
After the health check up, nurse Fernanda Thobve gives Aida Fansidar™, a prophylactic treatment that helps to fend off malaria, iron tablets to help prevent anaemia and a long-lasting insecticidal mosquito net to take home.
“This will help ensure that Aida enjoy a safe pregnancy,” says nurse Thobve, as she opens the door of the small consultation room to let Aida go.
Mozambican children today are more likely to have a healthy start to life than they did twenty years ago. Over the past two decades, the under-five mortality rate has decreased from 219 to 138 per 1,000 live births in 2008, and the maternal mortality ratio dropped to 520 per 100,000 live births, according to the latest available data.
The reduction in child mortality is due in part to the integrated package of preventive and curative services in health centres across the country – an approach known as Integrated Management of Childhood Illness – whereby the whole child is taken into consideration, not just the illness that he or she presents.
“A child often comes to the health centre with many diseases, not just one,” explains nurse Thobve.
The approach promotes an integrated holistic approach to the case management of sick children, looking at the top causes of child mortality – malaria, pneumonia, diarrhoea, and malnutrition.
Yet Mozambique still has one of the highest child mortality rates in the world. Gains in child and maternal well-being have not been even across the country, and large numbers of children and women, especially those living in remote rural areas, remain at risk.
This is why UNICEF supports the Ministry of Health to strengthen and expand the Integrated Management of Childhood Illness programme to reduce child deaths, aiming to have at least 85 per cent of health facilities in the country implementing the approach by 2011.
Aida starts the long way back home, reassured that she and her baby are healthy. It will take her a whole day to reach the remote village where she lives, but she knows that the long walk is worth the effort.