PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
Since the formal establishment of the MOH PMTCT program coordination office in 2003, the USG has
supported the development of national PMTCT program guidelines and training materials, as well as the
geographical expansion of PMTCT services, including training of of PMTCT trainers and service providers.
In 2005-2006 MOH was reorganized to include PMTCT within the reproductive health section of the
community health department. USG continues to support central-level PMTCT efforts within this
framework.
FY09 funding will contribute to and support the following activities:
1) PMTCT training: Support for PMTCT training at sites that do not currently have USG partner support.
Funding for FY09 will support the revision, finalization, and dissemination of training materials. 160
personnel will be newly trained, including program trainers, using existing materials until revisions of
materials are completed. Whenever possible, training activities will incorporate evaluation and validation
activities. Specific focus will include new and refresher training for counseling and testing in PMTCT
settings. Counseling and testing will be incorporated in ante/postnatal and maternity settings, with focus on
male involvement and couples counseling and testing.
2) PMTCT supportive supervision: FY09 funding will support supervision team visits from central level to
PMTCT sites, as well as support for provincial supervisory teams. Central-to-provincial support for PMTCT
will be coordinated through the MOH reproductive health department.
3) PMTCT service provision: Funding in FY09 will support service delivery at selected sites that are not
currently supported by a USG implementing partner, including supplies, travel, specimen transport, and
other needs such as renovation projects and durable goods such as refrigerators.
4) Production and distribution of PMTCT kits for trainers and providers: These kits contain key PMTCT
program materials such as the PMTCT operational guidelines, the PMTCT training manual, PMTCT
providers' pocket guide, and other job aids and educational materials. In FY09 central level activities will
focus on finalizing norms and guidance for PMTCT, with subsequent dissemination of materials supported
through this activity.
5) Community PMTCT activities: In FY09 support will continue for MOH leadership on community
mobilization and development of facility-community linkages around PMTCT services, and the incorporation
of materials developed by other USG partners, especially on mother support groups in PMTCT settings.
Community activities will be designed to help community health agents (traditional birth attendants, peer
educators, other laypersons involved in PMTCT activities) to focus on PMTCT service promotion, PMTCT
related behavior change promotion of adherence to ante/postnatal care consultations and institutional births
in general as well as adherence to ARV prophylaxis or treatment, where applicable, and support to HIV
infected pregnant women, mothers and families.
As a follow-on to FY08 activities, MOH will continue to support training for community health agents.
Whenever possible, training activities will incorporate evaluation and validation activities. In keeping with
MOH guidance from a national meeting on community involvement, these training activities are still being
pursued as a short term solution while a holistic long-term approach is developed. This approach will
incorporate multiple health service areas.
MOH activities will include coordination with USG partners who are currently working on PMTCT PHE's that
will inform central level policy and practice.
USG funding for these activities will complement funding for PMTCT program expansion and training
support provided by other agencies such as WHO, UNICEF, and the Global Fund.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13189
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13189 8588.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $388,314
Disease Control & Mozambique Agreement
Prevention
8588 8588.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $524,200
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $200,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The proposed activities for FY09 will be used to improve access to care and treatment by mental health
related vulnerable popupations and, to continue improving and disseminatin the MOH M&E tools and data
base for monitoring admissions related alcohol and drug use.
FY08 Narrative: The goal of this activity is to support the Mental Department of the MoH to improve alcohol
and other substances abuse interventions. USG is currently supporting the MoH to formally assess alcohol
and substance abuse of vulnerable populations in Mozambique, through implementation an I-RARE
(International Rapid Assessment, Response and Evaluation) study among drug users and sex workers. It is
expected that as a result of I-RARE, awareness will be raised among alcohol and substance abusing
populations, increasing the demand for health services for treatment and support. As a starting point for a
comprehensive support to MoH in this area, the proposed activities for FY08 are to support the MoH to: (a)
develop and disseminate a Mental Health Strategy that includes alcohol and substance abuse; and (b)
revise, improve and disseminate the MOH M&E tools and data base for monitoring admissions related
alcohol and drug use.
Continuing Activity: 13191
13191 8578.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $50,000
8578 8578.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $50,000
Table 3.3.03:
The National Medical Assistance Directorate of the MOH closely linked to the National Nursing Department
has been implementing a nationwide Infection Prevention and Control (IPC) program that coordinates,
implements and supervises the prevention of medical transmission activities in the country.
PEPFAR funds have been utilized to implement the IPC program and will continue to support the MOH staff
to roll out training to health workers of health units where there is no partner. This enhances the MOH staff's
capacity to utilize training materials developed with assistance from PEPFAR supported partners, and to
implement activities on their own, strengthening their confidence and implementation experience in the
absence of outside support, which in turn will contribute to long-term sustainability and continuation of the
program activities.
In 2009, the goal is to continue to the strengthening the role of the MOH IPC program, in particular the
Nursing Department, in the expansion and institutionalization of the IPC efforts in health facilities throughout
the country.
Main activities proposed are to:
1. Conduct six provincial IPC training for health workers ($132,000)
2. Conduct twelve training for ancillary workers in IPC and basic nursing care in ten hospitals ($180,000)
3. Support supervision visits and monitor IPC activities in general and rural hospitals in ten provinces ($
50,000)
4. Printing and distribute training materials and job aids to support the implementation of IPC program
($81,700)
5. Purchase and distribute of selected personal protective equipment (PPE-face shield, surgical mask, eye
wear, caps, aprons, gloves for examinations, utility and laundry purpose) for six provinces ($905,690)
Product/Deliverables
• 150 health workers trained in IPC issues
• 240 ancillary workers trained in basic nursing care and IPC issues
• 1000 training material printed and distributed
• 2000 job aids printed
• 10 supervision visits from the central level of the MOH (to hospitals
• Personal protective equipment (PPE) ( face shield, surgical mask, eye wear, caps, aprons, gloves for
examinations, utility and laundry purpose) for six provinces
Continuing Activity: 13190
13190 8582.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $250,000
8582 8582.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $89,821
Estimated amount of funding that is planned for Human Capacity Development $422,000
Table 3.3.05:
This activity sheet describes funding and support to the Mozambique Ministry of Health (MOH) for three
components divided into Home-Based Care (HBC), Sexually Transmitted Infections (STI)/HIV, and
Opportunistic Infections (OIs) prevention and control.
Continue USG support for MOH Home Based Care activities ($50,000) as described below:
Because of considerable pipeline, only basic program costs are covered in this period:
1. Monitoring and Evaluation: Creation of materials and supervision to improve quality and assure
integration with the MOH Health Information System Database.
2. Update and revision of guidelines continues.
3. Routine supervision of the provinces by the 3 technical staff in the MOH to improve the quality of HBC
and M&E activities and assure integration of community HBC with Treatment sites. There are continued
efforts toward creation of integrated supervision tools.
Continue USG support for MOH STI/HIV program activities ($165,000) as described below:
1. ($40,000) Support STI/HIV program M&E efforts: refreshment trainings on the use of updated M&E tools;
2. ($117,000) Integration of STI screening and treatment in clinical and ART settings as well as
PMTCT/ANC services. This activity builds on the results of the STI study conducted in FY07/08 to assess
the prevalence of STIs in PLWHA and the needs for integration of STI prevention, diagnosis and treatment
in PLWHA. This task will be conducted with the assistance of the Atlanta team of STD division, currently
assisting the MoH implementing the STI integration project. The proposed activities for FY09 include the
following:
(a) revision and adaptation of current guidelines on syndromic management of STIs to address specific
needs of PLWHA attending ART settings including their partners;
(b) reproduction and dissemination of integrated STI/HIV tools for ART services, including outpatients and
MCH settings, which will involve refresher trainings of health workers from both ART and MCH settings;
(c) continue roll out training on STI syndromic management and syphilis rapid testing
(c) integrated supervision visits for technical assistance on program implementation.
3. ($8,000) As in previous years, USG proposes to continue general STI/HIV office and program support for
routine program functions (office supplies, communication expenses, etc).
Continue USG support for MOH OI program activities ($100,000) as described below:
Improvement of diagnosis and management of OIs. The main activities are: policy development and
revision, training of various cadres of health workers, acquisition of equipment and supplies, strengthening
M& E, and joint supervisions. Additional support to the MoH will strengthen meningitis surveillance including
cryptoccocal meningitis in laboratories and clinical settings.
FY08: This activity sheet describes funding and support to the Mozambique Ministry of Health (MOH) for
three components divided into Home-Based Care (HBC), Sexually Transmitted Infections (STI)/HIV, and
Continue USG support for MOH Home Based Care and Traditional Medicine Program program activities
($250,000) as described below:
HBC Program
1. Refresher training for the Provincial HBC Focal Points in conjunction with ANEMO (Mozambican Nurses
Association).
2. Monitoring and Evaluation: Creation of materials and supervision to improve quality and assure
integration with the MOH Health Information System Database. This includes a workshop with implementing
NGO partners to orient them to the MOH electronic database for direct integration to improve quality and
timely collection of information.
3. Update and revision of guidelines, training materials and job aids to include integration with treatment
sites and other changes as needed.
4. Routine supervision of the provinces by the 3 technical staff in the MOH to improve the quality of HBC
and M&E activities and assure integration of community HBC with Treatment sites. At the Central level,
HBC supervision will be integrated with Treatment supervision during this period.
Traditional Medicine Program
This will support activities already in progress based in the National Institute of Health and as start-up
monies for the Institute of Traditional Medicine planned to start in 2008. It will encompass such as activities
as:
1. Training of Trainers at the Provincial level addressing: referrals to the National Health System through
raising awareness in both Traditional Medical Practitioners and Health Personnel about the importance of
their positive interaction, the modification of harmful beliefs and practices in the areas of health, legal issues
such as inheritance rights, gender based violence and others which Traditional Medical Practitioners have
substantial influence over in the community.
2. Integration of effective approaches to traditional practices in other areas, such as: pre-service training
and continuing education for doctors, nurses and the planned Community Health Worker program, various
existing MOH programs such as STI, TB/leprosy, nutrition for adults and children, malaria and chronic
diseases, OMM (Organization of Mozambican Women) activities, Integrated Care and Support Systems
activities with MMAS (Ministry of Social Action) providing social support for those with chronic diseases and
affected family members such as orphans and vulnerable children (OVC).
3. Supervision of provincial activities
Continue USG support for MOH STI/HIV program activities ($368,000) as described below:
1. Integration of STI screening and treatment in clinical and Anti-Retroviral Treatment (ART) settings as well
as Prevention of Mother-To-Child (PMTCT)/Antenatal Care (ANC) services ($310,000). This activity will
build on the results of the assessment of STI diagnosis and treatment in ART settings supported by USG
FY06/07 funds. The assessment provides information on the prevalence of STIs in HIV-infected patients
Activity Narrative: followed at ART service sites and integration of STI prevention, diagnosis, and treatment in routine
outpatient HIV care and treatment settings. The proposed activities for FY08 include:
(a) Revision and adaptation of current guidelines, training materials and development of job aids on
management of STIs for HIV-infected patients and their partners, attending ART services;
(b) Development of guidelines, revision of training materials and job aids, to address the specific context of
pregnancy, to ensure that pregnant women and their partners, attending ANC/PMTCT services are routinely
screened and correctly treated for STIs in accordance with their status;
(c) Reproduction and dissemination of integrated STI/HIV tools for ART and ANC/PMTCT service sites,
including outpatient and Mother and Child Health Care (MCH) settings;
(d) Performance of refresher trainings for health workers from both ART and PMTCT service sites (one
course per province, therefore a total of 11 refresher trainings for approximately 275 health workers to be re
-trained);
(e) Supervision visits for monitoring of implementation of the above described activities (at least one central
level visit per province per year).
2. Finalization of the development of an algorithm on sexual abuse in children, and performance of a
dissemination and advocacy workshop ($50,000). Sexual abuse of children is an important problem among
families, where family members, friends, teachers, and others are often identified as the abuse perpetuators
therefore creating an environment facilitating repeated abuse and psychosocial problems for the victims. To
-date the MOH STI/HIV program has developed an algorithm addressing sexual abuse in adults. Funding
under this activity will support the finalization and dissemination of an algorithm for sexual abuse in children.
Existing algorithms for sexual abuse tend to mainly address clinical management of victims and lack other
aspects such as reference to and management of psychosocial and other aspects arising from the abuse.
The advocacy workshop will facilitate dissemination of the algorithms and at the same time assist the MOH
to work with other line ministries and stakeholders in developing a plan for improved referral mechanisms
and linkages.
3. As in previous years, USG proposes to continue general STI/HIV office and program support ($8,000) for
Continue USG support for MOH OI program activities ($200,000) as described below:
M& E, and joint supervisions. This year's activities will also include the implementation of OI surveillance.
Continuing Activity: 13192
13192 8587.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $818,000
8587 8587.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $767,000
Table 3.3.08:
Continuing activity: The Mozambican National Health System is leading the scale-up of comprehensive HIV
Care and ART throughout the country. By June 2007 there were 193 treatment sites providing ART in all
districts for 65,296 people in need of treatment-(this number has already increasd to 202 in July 2007). The
National Directorate of Medical Assistance (DNAM) is responsible for overseeing HIV care and ART
expansion. This funding will assist the MOH in providing quality ART services via the development of strong
systems to ensure the availability of necessary supplies, materials, and human resources for the adult and
pediatric ART program. Currently the team at the MOH conducts 2-week supervision visits in each province
annually. The visits involve in-depth analyses of the health system infrastructure, human resource
allocation, coordination between related programs, review of patient charts and data bases as available,
logistics, specific review of pediatric ART provision, etc. On average 80% of health facilities with ART in the
province are assessed during the 2 week visits. In addition DNAM coordinates weekly ART management
committee meetings designed to coordinate expansion of the program, as well as ensure quality of care
provision. Funding will support the completion of these activities and specifically assist in the following
activities:
1. ART-related training in the following areas—ART service provision, nurse training in PCR / infant
diagnosis, and monitoring and evaluation
2. Provincial supervision for ART service delivery for MOH staff including non-NGO supported ART facilities
implementing the HIVQUAL program;
3. Reproduction and dissemination of materials and guidelines for doctors, nurses and physician assistants
(técnicos de medicina) related to adult and pediatric HIV care and ART service provision
4. Revision, reproduction and dissemination of ART reports, M&E forms and site supervision tools
5. Training of health workers, provincial and district program managers in the use of the revised M&E forms
and supervision tools
Continuing Activity: 13195
13195 8580.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $335,000
8580 8580.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $470,000
Estimated amount of funding that is planned for Human Capacity Development $300,000
Table 3.3.09:
This is a continuing activity.
In Mozambique, there are an estimated 1.6 million people living with HIV/AIDS. Of these, about 141,800
are children under 15 years and 44,700 were estimated to meet the criteria for ART eligibility in 2008. ARV
treatment given to HIV-infected children improves the quality of life and reduces morbidity and mortality.
Although ART for children has expanded from 22 sites in 2005 to 148 sites in September 2007, what
represents 71% of all ART sites in the country, the national coverage of Pediatric ARV treatment remains
very low. Currently from the total of 115,665 individuals on ART, 8,112 are children under 15 years,
meaning a national coverage of only 7% of children on ART.
The Ministry of Health will use these funds to coordinate activities aimed to support the scale up of quality
pediatric HIV care and treatment services. The following activities will be undertaken:
• Reproduction and dissemination of updated Pediatric HIV guidelines and job aids
• Training of health staff in the following areas: pediatric HIV care and ART service provision, nurse training
in PCR, infant diagnosis, and monitoring and evaluation
• Coordinate with provincial health directorates in supervision of implementation of the HIVQUAL peds
program to ensure the quality of all services for HIV exposed and infected children
• Revision, reproduction and dissemination of pediatrics HIV care and treatment M&E forms and site
supervision tools
• Training of provincial program managers in the use of the revised M&E forms and supervision tools
• Provide on-job and refresher training to update providers on new ARV treatment guidelines for children
• Develop a mentoring plan to support pediatric HIV training and provide central level supervision of clinical
mentoring activities for pediatric clinical services
• Develop a supervision plan to support pediatric HIV program
• Ensure that the appropriate amounts of commodities to prevent infections in HIV exposed and infected
children are available: safe water vessels, water treatment tablets, ITN, cotrimoxazole, INH prophylaxis,
HIV test kits, EID supplies and lab reagents, CD4% equipment and reagents, etc).
Table 3.3.11:
ACTIVITY UNCHANGED FROM FY2008 BUT THE NARRATIVE HAS BEEN MODIFIED IN THE
FOLLOWING WAYS:
FY 09 funds will be provided to the Mozambique National TB program of the Ministry of health (MOH) to
support the following specific activities 1) Strengthen infection control at health facilities to prevent
nosocomial transmission of TB and drug-resistant (MDR, XDR) TB through training and implementation of
administrative measures, 2) Strengthen monitoring and evaluation of TB/HIV activities through the rolled out
implementation of the Electronic Tuberculosis Register (ETR) including supervision and training activities.
and 3) Support training of clinicians on management of TB/HIV and MDR-TB. 4) fund the salary and
benefits package for a full-time MOH CT trainer/supervisor position in the MOH TB/HIV program that will
provide significant support to the Counseling and Testing program. The trainer will assist with planning and
supervising of CT training roll-out for TB providers as well as accompany activities that look at improved
screening for TB at CT service sites and successful referral mechanisms. This person will participate in
monitoring and evaluation activities to assess and monitor linkages between CT and TB program activities.
COP 08 Narrative:
The first component of this activity ($200,000) complements and continues TB/HIV activities that were
funded during FY07. Funds or this activity will be used to scale up collaborative TB/HIV activities with the
main objective to 1) decrease the burden of HIV/AIDS in tuberculosis patients and 2) decrease the burden
of TB in people living with HIV/AIDS through key interventions that include: scaling up TB screening for all
HIV patients at the different sites offering HIV services, and HIV testing in all TB patients and suspects.
In addition the national TB program will be funded to coordinate and take the lead in the following activities:
1) Strengthening the provision of cotrimoxazole prophylaxis for TB/HIV co-infected patients
2) Intensified case finding and provision of INH for adults HIV+ patients and under 5 children with household
contact after ruling out Tb active disease.
3) Expansion and strengthening of the implementation of infection control measures in health facilities by
education of patients and health workers, training of personnel and provision of equipment and
establishment of appropriate infrastructure guided by international standards.
4) Support the improvement of the diagnosis of Pulmonary TB (smear positive and smear negative) and
Extra Pulmonary TB by training and setting up a referral path for further evaluation and treatment
.5) Provide Initial and refresher training to TB supervisors and provincial coordinator on MDR-TB
management as well as adapt training modules for "técnicos de medicina" (physicians assistants) and
nurses who follow TB patients MDR-TB.
6) Expansion and strengthening of M & E including activities related to MDR-TB, including expansion of the
electronic TB register (ETR) to additional provinces and districts, and support supervisory visits.
A complementary activity is the secondment of an M& E Specialist using resources from the Global Fund to
support efforts for program monitoring.
The second component of this activity ($150,000) is a new addition and will fund the salary and benefits
package for a full-time MOH CT trainer/supervisor position in the MOH TB/HIV program that will provide
significant support to the Counseling and Testing program. The trainer will assist with planning and
Funding will be provided to the Mozambique National TB program of the Ministry of health (MOH) to
nosocomial transmission of TB and drug-resistant (MDR, XDR) TB through the procurement of equipment
(respirators, fans, etc.) 2) Strengthen monitoring and evaluation of TB/HIV activities through the rolled out
and 3) Support renovation of the National TB reference laboratory, establishment of supervised quality
assurance programs and specialised TB training for 4 biologist in the area of TB laboratory management
Continuing Activity: 13193
13193 12267.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $350,000
12267 12267.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $300,000
Estimated amount of funding that is planned for Human Capacity Development $84,125
Table 3.3.12:
Continuing Activity:
This is a continued activity to expand and improve Client Initiated CT provision
Early in 2006, the Ministry of Health (MOH) started a process of redefining and revising national policies
and program directions for counseling and testing (CT) services. Since then the national CT expansion
strategy has undergone some major changes which aside from greater emphasis on expansion of Provider
Initiated CT (PICT) in clinical settings, the "Counseling and Testing in Health" (CTH) approach is being
extensively promoted by the Health Minister as a way to implement health promotion and prevention
activities aiming at enhancing the number of people that access health services. This health promotion
package proposes continuation and expansion of HIV counseling and testing as well as the inclusion of TB,
Sexually Transmitted Diseases (STD) and hypertension screening and referrals where necessary,
counseling on malaria prevention, environmental health education, and sexual reproductive health
orientation - especially in relation to early pregnancy diagnosis and institutional delivery. Community-based
CT is being piloted and will be expanded in FY08.
The requested funds will contribute to and support the following activities in FY09:
(a) Reproduction of CT program materials: Support the revision of the National CT Training Manual; Print
and disseminate revised guidelines and training materials for CT in clinical settings, CT in Health and
community-based CT.
(b) CTH training : CT training course to provide CT in Health knowledge and skills - including contents on
TB, Sexually Transmitted Diseases (STD) and hypertension screening, counseling on malaria prevention,
environmental health education, and sexual reproductive health orientation.
(c) Improvement of CT program management through Monitoring and Evaluation (M&E): Funds will be
utilized training of key MOH personel involved in managing CT program data.
(d) Support for CT program supervision: Funding proposed for FY08 will continue to support travel of the
central level CT staff and provincial CT trainers and supervisors for supervision of training activities. These
supervisors will monitor the quality of service provider training and accreditation of newly trained CT
trainers, and give feedback to staff at existing and newly opened CT service sites to help to improve
services.
Continuing Activity: 13194
13194 8579.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $550,000
8579 8579.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $391,700
Gender
* Addressing male norms and behaviors
Table 3.3.14:
THIS IS A CONTINUING ACTIVITY:
This activity is related to lab capacity building activites implemented by APHL, ASM, ASCP, SCMS, and
Brazilian partner (TBD).
To expand and improve laboratory services in Mozambique the Ministry of Health is in the process of
establishing central level structures to manage the lab network and therefore improve the quality of
laboratory services. One of the new positions will include a Quality Assurance Officer with oversight over
the implementation of a National Quality Management System.
Funds requested for FY09 will be used to implement and manage the National Laboratory Quality
Management System. The funds will support site supervision and training visits to all provinces for a period
of one week. The Quality Assurance officer accompanied by his provincial counterpart will visit the
provincial hospitals and selected district hospitals; conduct assessments of the quality systems and make
recommendations for corrective action where required. These visits are aimed at ensuring compliance to
the quality standards developed for the Network. In addition, funds will be allocated for the production of
materials required in the implementation of the Quality Assurance Program.
These efforts are expected to result in maintenance of good laboratory practice within the labs in the
network in line with set standards which will ensure that laboratories will produce accurate, reliable and
reproducible results which will in turn contribute to improved management of patients on or that are to
initiate ART.
Continuing Activity: 13196
13196 8581.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $480,000
8581 8581.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $604,000
Table 3.3.16:
This existing activity reflects a general strategy designed to build and strengthen MOH capacity in strategic
information. Due to recent reorganizations at MOH and chronic staffing shortages as well as vacancies in
key positions, specifics of these activities will be developed later in the year. The Minister of Health has
specifically requested USG assistance with surveillance, M&E, information systems, and human capacity
development. Areas of emphasis include:
I. Information systems and standards development
1) Create & maintain a national registry of health facilities. This activity provides support to the ongoing
development and expansion of an electronic database, in collaboration with the Provincial Directorates of
Health, which will provide information of health facilities. Information on health facilities is being collected
through GPS mapping. This is a follow up activity to the national inventory of health facilities carried out by
the MOH during 2008-2009.
2) Continue to support improved mortality surveillance through consolidating the national integrated system
and training and implementing ICD-10 coding.
The consolidated national system for mortality surveillance in the country would be comprised of all data
generated at health facilities and elsewhere, creating a unique consolidated database that can be generated
and managed by DIS. This consolidation would be facilitated by implementation of the revised death
certificate and by making the national database on mortality publicly available through various mechanisms
(e.g. published reports or web access). Additionally, mortality surveillance will be improved through training
at central and provincial levels on standard ad ICD-10 and through the use of ICD-10 coding to revise the
ICD-10 adapted list.
3) Support standards development by supporting the National Standard Commission and its related
activities. These activities include the following: continued standardization of definitions for medical
procedures and related systems; implementation of these standards at the national level; establishment of
communication standards to facilitate interoperability among systems; and production of the implementation
guide describing different national health communication standards (e.g. disease reporting, immunization,
referral and counter-referral, discharge summary, death and birth registration).
4) Help formalize, disseminate, and implement MOH "infrastructure architecture" by providing hardware,
equipment, and TA support. Specifically, this would mean some of the following activities: supporting
DIS/MOH in project management activities with regards to the Hospital Information System; providing
technical expertise in the assessment, development, adoption, and upgrading of existing health information
systems; deployment of the others national health information systems, such as mandatory disease
notification, National Immunization Database, and other epidemiologic surveillance systems (specific
programs such as Malaria, TB, AIDS and others); and construction of the national health data warehouse
strategy, including national registries of birth and deaths.
II. Develop and maintain integrated surveillance systems for HIV/AIDS, OIs, TB, STIs
III. Strengthen the laboratory network as it relates to epidemiological surveillance, referral systems,
laboratory confirmation of clinical cases, monitoring of pathogens, resistance and reporting of cases to the
central level. To achieve this goal, MOH will develop or revise appropriate guidelines, procure necessary
equipment, and strengthen the quality control of procedures at all levels.
Continuing Activity: 13197
13197 8589.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $865,000
8589 8589.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $300,000
Table 3.3.17:
Funds for the FY09 will continue to support the pre-service training and continuing education of health
workers and will spend in the following activities, ($400,000)
One activity will contribute to the strengthening of teaching resources through the purchase and distribution
of books and basic kits for practicums for health training institutions. The much needed books will facilitate
teachers' preparedness for classes in different disciplines and increase the resources for students'personal
reading. The basic kits will be used by students during their practical sessions. Currently there are not
enough basic kits available for student use.
A second activity will support the implementation of a training plan for faculty development for training
institutions to increase knowledge and skills in new interventions of the health programs including HIV, STI,
Malaria, TB and teaching methodology. It is envisioned that this will be done via training courses or using
new initiatives, such as, distance learning approaches.
A third activity is to support the monitoring and supervision activities of the MOH central training department
who has the responsibility to supervise health training institutions throughout the country.
Funds for FY09 ($60,000) also will be used to continue the activities started in FY08 for capacity building of
MoH staff from various departments, including (HR), Training, Health Education Department (RESP),
HIV/AIDS, Sexually Transmitted Infections (STI) and National Institute of Health (INS). Key activities
include: (a) Review and adapt existing Behaviour Change Communication (BCC) materials to the
Mozambican context; (b) Sponsor and participate in trainings (including data analysis); (c) Participate in
capacity-building trainings in areas of qualitative and quantitative analysis, behavioral intervention design,
and intervention evaluation; and (d) Guide implementing partners in piloting and implementing new
behavioral and informational interventions; and (e) Conduct cascade training activities involving personnel
from various Departments and Programs. The trainings will involve health workers and MOH training
institutions students, with the main objective to reduce risk associated with health workers sexual behavior
and reduce stigma at the workplace and in their personal lives.
Product and Deliverables
- 500 books for nurses and clinical officers of the 13 health training institutions
- 90 kits for clinical officer classes of three training institutions
- One refresher training course for 24 teachers
- 4 supervision visits from the central level to provincial level
- 15 health workers trained in data analysis, behavioral intervention design, and intervention evaluation
- A behavioral intervention designed for health workers and training institutions designed based on findings
of qualitative and quantitative studies
- One package of adapted BCC materials for the country
Continuing Activity: 13198
13198 5273.08 HHS/Centers for Ministry of Health, 6408 3570.08 Cooperative $814,200
8577 5273.07 HHS/Centers for Ministry of Health, 4876 3570.07 Cooperative $630,000
5273 5273.06 HHS/Centers for Ministry of Health, 3570 3570.06 Cooperative $0
Estimated amount of funding that is planned for Human Capacity Development $100,000
Estimated amount of funding that is planned for Education $300,000
Table 3.3.18:
Funds are being redirected to support the first short course that is the kick-off of the Field Epidemiology and
Laboratory Training Program (FELTP) to be held at the end of June 2009. The Minister of Health has
deemed this course and the FELTP to be a priority activity. MOH, comprised of organizations with both
experience in epidemiology and in launching a FELTP, is a centrally held cooperative agreement at CDC.
New/Continuing Activity: New Activity
