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Mozambique is still recovering from a 17-year civil war that ended in 1992. The country’s healthcare system has been left weak and understaffed, its facilities overwhelmed by the HIV/ AIDS epidemic. Around 16 percent of people over 15 years old are HIV-positive, and 68 percent of tuberculosis patients are co-infected with HIV. Doctors Without Borders/Médecins Sans Frontières (MSF) is helping patients with these two diseases in the rural provinces of Niassa in the north, Tete in the center of the country, and the capital Maputo in the south.
In Niassa, MSF provides care in the provincial hospital, in health centers in the town of Lichinga, and in three other rural areas. In Maputo, MSF operates in the Alto Mae and Primeiro de Maio hospitals in the city center, as well as in nine health centers outside the main towns.
In Tete, MSF provides HIV/AIDS care in three districts and encourages the local communities to support patients by helping them to adhere to treatment, for example. Equipping health facilities in remote locations also reduces the time many patients have to take and the distances they have to travel for medication and routine consultations.
During 2008, MSF carried out more than 229,000 consultations for HIV/AIDS in Mozambique, and initiated more than 6,600 new patients on antiretroviral therapy (ART).
MSF has been implementing a decentralization plan in cooperation with local health authorities. As part of this strategy, local health facilities are responsible for first-line HIV treatment, including counseling services, prevention of mother-to-child transmission, and tracing patients who allow their treatment to lapse. Such decentralization is especially valuable in rural areas where resources are limited. It helps bring treatment closer to the homes of patients and helps to reduce the pressure on the central healthcare facilities.
To support the local treatment centers, MSF has strengthened their staff’s clinical knowledge, provided management and staffing support, ensured a steady drug supply to pharmacies, and upgraded medical facilities.
Currently, MSF is also lobbying to allow local paramedical staff to prescribe ART drugs and to administer repeat prescriptions, and to use lay counselors. Such measures would allow nurses to devote more time to their medical responsibilities.
MSF has worked in Mozambique since 1984.