upSCALE facilitates delivery of community health services in Boane district
"We are the first line of attack for disease prevention here in the community" - Júlia Luís, Community Health Worker.
Boane, MAPUTO - To achieve universal coverage of health care, it is common in low- and middle-income countries to use community health workers (CHWs) locally known as Agentes Polivalentes Elementares (APEs) who provide clinical and outreach services to remote communities. APEs carry out, in a timely manner, the assessment, diagnosis, and treatment of malaria, pneumonia, malnutrition, and diarrhea in the communities.
In Mozambique, APEs are part of the National Community Health Program (PNAPE). They receive training to carry out clinical assessments and health prevention activities in the remote areas where they live. Most of their cases focus on children under five years old. However, they also support women with antenatal and postnatal care, help with family planning, and advise tuberculosis (TB) and HIV patients on adherence to treatment.
The UpSCALE project is being successfully implemented in seven of Mozambique's eleven provinces. Between 2017 and 2022, more than 200,000 households received healthcare supported by the upSCALE app and nearly 650,000 patients were registered on the platform. For the current phase of the project, the Malaria Consortium is collaborating with the Ministry of Health (MISAU) and the United Nations Children's Fund (UNICEF), with financial support from the U.S. Agency for International Development (USAID) and the Global Fund, to integrate upSCALE into the MISAU surveillance system. This will support the collection of disease-specific data to inform decision-making around community health interventions.
The expansion of upSCALE to Maputo province was carried out in 2021, one of the APEs that benefited from this training is Júlia Luís from the Umpala community, Boane district, she is 42 years old, married, has three children, and has been working as an APE for 12 years.
The APEs are important in the control of diseases or pandemics, for example, in the prevention of Malaria or COVID-19, we are the first line of attack for disease prevention here in the community.
Júlia Luís had her first training as an APE in 2011, where she learned about health promotion and disease prevention. She also learned that 80% of her activities are focused on the preventive area and 20% on the curative area. In her own words, she declared:
“The APE is an important professional in the control of diseases or pandemics, for example in the prevention of Malaria or COVID-19, we are the first line of attack for
disease prevention here in the community”.
About the introduction of upSCALE in 2021, APE Júlia Luís revealed that at first, she was apprehensive because it was something digital and new, but still, in training, she started to like the application, and she realized that it could facilitate her work:
“For example, when I have a patient, the application guides me through the steps to follow, from registration, diagnosis, and the type of medication to be given and, if necessary, informs me that I should refer the patient to the nearest health facility. The application also helps with lectures, guides me on the steps to follow, and has illustrative pictures and messages that I should use when promoting health. The upSCALE application helps me to improve the quality of my work, now I have less chance of making mistakes because the application guides me through all the steps. The application also helps me to improve planning, now I can schedule activities in the application, and everything is well organized with the respective dates," concluded Júlia Luís.
Júlia, using the upSCALE application, has played an important role in the community of Umpala, providing necessary primary health care, and promoting health care in the areas of nutrition, family planning, diarrhea, and malaria.
According to Emedita Seifana, Boane APEs district coordinator, “Júlia, using the upSCALE application, has played an important role in the community of Umpala, providing necessary primary health care, promoting health care in the areas of nutrition, family planning, diarrhea, and malaria.”
The coordinator also revealed that the data from the reports sent by the APEs via upSCALE allow the Boane District Services for Women's Health and Social Action (SDSMAS) to have real information on the health status of communities. The application also improved the APE stock management, the upSCALE updates the stock in real-time, so the drugs are replenished before there is a stock out.
