Campaign update: December 2006 - February 2007
The Children and AIDS campaign aims to mobilise partners to join efforts and increase interventions in four key areas referred to as the Four Ps – prevention among adolescents and young people, prevention of mother to child transmission, paediatric treatment and protection, care and support for children affected by HIV and AIDS.
Establishing corporate partnerships
UNICEF Mozambique has launched a new initiative to explore opportunities for partnership with the private sector. The Partnership Menu for Child Friendly Initiatives has been developed as a tool for the private sector to collaborate with innovative partnership opportunities. The Menu aims to increase awareness among companies on the current situation of children and young people in Mozambique, and how their social and economic conditions can be improved through the mobilisation of resources.
The Menu includes information on challenges faced by many children such as the threat posed by HIV and AIDS and preventable diseases, lack of adequate schools and quality education and poor access to safe water and adequate sanitation. The Menu provides detailed information on Child Friendly Initiatives that companies can sponsor in the areas of education, child protection, HIV and AIDS and communication for social mobilisation.
Prevention among adolescents and young people
The expansion of youth friendly health services (YFHS) continues to be a priority for the Ministry of Health in order to address gaps in sexual and reproductive health services for adolescents. Provincial health directorates are widely expanding YFHS in health facilities by having alternative schedules to attend young people and ensuring more confidential areas whenever available in the health facility. The demand for clinical services has increased and services are implemented in more than 87 districts throughout the country, in 179 established sites. At present, there are 14 VCT sites also offering services for young people.
A Programme Cooperation Agreement for the 2007-2009 Country Programme has been signed with ten associations of People Living with HIV/AIDS (PLWHA). During the three years, the School Awareness Programme, which is implemented by the associations in collaboration with the Ministry of Education (MEC), will be expanded to all eleven provinces and approximately 2,000 primary schools in the country out of a total of 10,000 primary schools. The key activities will include training of activists, conducting life skills sessions for children, producing information and education materials on HIV and AIDS, establishing HIV and AIDS school clubs and harmonised coordination mechanisms with MEC.
In the first year the overall goals include development of a national HIV prevention policy and package for young people, with comprehensive communication and social mobilisation components. On the School Awareness Programme, the aim is to ensure that approximately 260,000 children in over 600 primary schools nationwide have improved knowledge on HIV prevention and demonstrate positive life skills and non-discriminatory attitudes towards HIV positive people.
Prevention of mother-to-child transmission
The Ministry of Health (MoH) recently published the data for the first three quarters of the year. Data for all four quarters are expected in March. By December 2006, 222 PMTCT sites had been established, which is double the 110 sites stipulated in the MoH’s Annual Operational Plan.
Preliminary data for December 2006 indicate that out of 28,516 women eligible for PMTCT, 12,150 (43 per cent) received prophylaxis. These numbers are slightly behind the MoH plan for PMTCT scale up which aimed to have 16,000 women receiving prophylaxis by the end of 2006. During this period 950 pregnant women began taking anti-retroviral treatment (ART) for their own health. In the case of the 1026 children who tested positive at eighteen months, 211 (21 per cent) tested HIV positive. These figures demonstrate that while the expansion of PMTCT services is crucial, there are still barriers for women to access services and complete the prophylaxis process, including stigma and discrimination, and lack of understanding that children can be infected with HIV. More work in the community, especially in the area of social mobilisation and community participation, is required to increase the uptake of services and to reduce drop out.
In 2007 the goal is to increase the acceptance of HIV testing for pregnant women attending antenatal counselling in a health facility with PMTCT services to at least 85 per cent and increase the uptake of anti-retroviral prophylaxis for pregnant HIV positive women and children to at least 70 per cent.
The number of people with access to treatment is continues to increase; in 2006 Mozambique surpassed the target for the total number of PLWHA on ART. In December 2006, 44,100 people were receiving ART, compared to the target of 40,000. By February 2007, this had increased to 50,360 and of the total, 3,781are children under 15 years of age, which is eight per cent of the total number of people on ART.
Community participation and social mobilisation are key to increase the utilisation of ART services. A communication strategy for paediatric treatment and PMTCT has been drafted and is being discussed among partners. At the end of 2006, the total number of ART sites was 150, which is 30 more than the target for the year. At present, 105 of the 146 districts in the country have at least one ART facility.
The expansion plan for paediatric treatment which covers the period 2007-2009, was submitted to the Minister of Health in January. In 2007, care, treatment and nutrition services for children living with HIV and AIDS will be strengthened in the existing 60 sites in eleven provinces.
Protection and support for children affected by HIV/AIDS
At the end of 2006 the support provided to the National Birth Registration Action Plan, ensured that 1.2 million children received birth certificates. All supplies for the continuation of birth registration activities in 2007 and 2008 have been ordered, including two million birth certificates, motorcycles for the birth registration teams to reach all households and computers to facilitate data entry of registrations. Preparations for training the teams on data collection and financial management have been finalised and training will commence in March, ahead of campaign activities starting in June. In 2007, 800,000 children in 14 districts will be registered at birth.
As part of the campaign, Government is being supported to set up a more effective system for routine registration, which will help reduce the backlog of unregistered children. In 2006, the districts of Nipepe (Niassa), Maganja da Costa (Zambezia) and Xai-Xai (Gaza), in the north, central and southern regions were identified as pilot districts for the establishment of a community based routine system. A total of 210,000 children were provided with birth certificates in these districts. The production of materials for registration and communication aspects of routine work continues, and in 2007, with support from the Netherlands Government, the routine system will be expanded to 14 districts with an evaluation of the system scheduled for October 2007. The Ministry of Justice will meet with partners in March to discuss the scope of role out for routine registration.
In 2007 the aim is to ensure that 120,000 orphaned and vulnerable children have access three of six basic services in legal protection, financial support, education, psycho-social support, health, food and nutrition through partnerships with NGOs and community based organisations (CBOs). The common goal of the Ministry of Women and Social Action, civil society partners and the National Institute of Social Action is to reach at least 18,000 children in the most vulnerable households (primarily child-headed households, households headed by elderly or ill adults, as well as households headed by women or by youths) with a basic package of materials items to complement other social protection support.