10 research outputs found
Setting the scene and generating evidence for malaria elimination in Southern Mozambique
Mozambique has historically been one of the countries
with the highest malaria burden in the world. Starting in the
1960s, malaria control efforts were intensified in the southern
region of the country, especially in Maputo city and Maputo
province, to aid regional initiatives aimed to eliminate malaria
in South Africa and eSwatini. Despite significant reductions in
malaria prevalence, elimination was never achieved. Following
the World Health Organization's renewed vision of a
malaria-free-world, and considering the achievements from the
past, the Mozambican National Malaria Control Programme (NMCP)
embarked on the development and implementation of a strategic
plan to accelerate from malaria control to malaria elimination
in southern Mozambique. An initial partnership, supported by the
Bill and Melinda Gates Foundation and the La Caixa Foundation,
led to the creation of the Mozambican Alliance Towards the
Elimination of Malaria (MALTEM) and the Malaria Technical and
Advisory Committee (MTAC) to promote national ownership and
partner coordination to work towards the goal of malaria
elimination in local and cross-border initiatives. Surveillance
systems to generate epidemiological and entomological
intelligence to inform the malaria control strategies were
strengthened, and an impact and feasibility assessment of
various interventions aimed to interrupt malaria transmission
were conducted in Magude district (Maputo Province) through the
"Magude Project". The primary aim of this project was to
generate evidence to inform malaria elimination strategies for
southern Mozambique. The goal of malaria elimination in areas of
low transmission intensity is now included in the national
malaria strategic plan for 2017-22 and the NMCP and its partners
have started to work towards this goal while evidence continues
to be generated to move the national elimination agenda forward
Setting the scene and generating evidence for malaria elimination in Southern Mozambique
Mozambique has historically been one of the countries
with the highest malaria burden in the world. Starting in the
1960s, malaria control efforts were intensified in the southern
region of the country, especially in Maputo city and Maputo
province, to aid regional initiatives aimed to eliminate malaria
in South Africa and eSwatini. Despite significant reductions in
malaria prevalence, elimination was never achieved. Following
the World Health Organization's renewed vision of a
malaria-free-world, and considering the achievements from the
past, the Mozambican National Malaria Control Programme (NMCP)
embarked on the development and implementation of a strategic
plan to accelerate from malaria control to malaria elimination
in southern Mozambique. An initial partnership, supported by the
Bill and Melinda Gates Foundation and the La Caixa Foundation,
led to the creation of the Mozambican Alliance Towards the
Elimination of Malaria (MALTEM) and the Malaria Technical and
Advisory Committee (MTAC) to promote national ownership and
partner coordination to work towards the goal of malaria
elimination in local and cross-border initiatives. Surveillance
systems to generate epidemiological and entomological
intelligence to inform the malaria control strategies were
strengthened, and an impact and feasibility assessment of
various interventions aimed to interrupt malaria transmission
were conducted in Magude district (Maputo Province) through the
"Magude Project". The primary aim of this project was to
generate evidence to inform malaria elimination strategies for
southern Mozambique. The goal of malaria elimination in areas of
low transmission intensity is now included in the national
malaria strategic plan for 2017-22 and the NMCP and its partners
have started to work towards this goal while evidence continues
to be generated to move the national elimination agenda forward
Mothers' satisfaction with care during facility-based childbirth : a cross-sectional survey in southern Mozambique
Background Client satisfaction is an essential component of quality of care. Health system factors, processes of care as well as mothers' characteristics influence the extent to which care meets the expectations of mothers and families. In our study, we specifically aimed to address the mothers' experiences of, and satisfaction with, care during childbirth. Methods A population-based cross-sectional study, using structured interviews with published sequences of questions assessing satisfaction, including 4358 mothers who gave birth during the 12 months before June 2016 to estimate satisfaction with childbirth care. Regression analysis was used to determine the predictors of client satisfaction. Results Most mothers (92.5%) reported being satisfied with care during childbirth and would recommend that a family member to deliver at the same facility. Specifically, 94.7% were satisfied with the cleanliness of the facility, 92.0% reported being satisfied with the interaction with the healthcare providers, but only 49.8% felt satisfied with the assistance to feed their baby. Mothers who had negative experiences during the process of care, such as being abandoned when needing help, disrespect, humiliation, or physical abuse, reported low levels of satisfaction when compared to those who had not had such experiences (68.5% vs 93.5%). Additionally, they reported higher levels of dissatisfaction (20.1% vs 2.1%). Regression analysis revealed that mothers who gave birth in primary level facilities tended to be more satisfied than those who gave birth in hospitals, and having a companion increased, on average, the overall satisfaction score, with 0.06 in type II health centres (CI 0.03-0.10) and with 0.05 in type I health centres (CI - 0.02 - 0.13), compared to - 0.01(CI -0.08 - 0.07) in the hospitals, irrespective of age, education and socio-economic background. Conclusion Childbirth at the primary level facilities contributes to the level of satisfaction. The provision of childbirth care should consider women's preferences and needs, including having a companion of choice. We highlight the challenge in balancing safety of care versus satisfaction with care and in developing policies on the optimum configuration of childbirth care. Interventions to improve the interaction with providers and the provision of respectful care are recommended
Concordance of the categorization of the causes of death established by the complete diagnostic autopsy (CDA, gold standard) and the minimally invasive autopsy (MIA) in stillbirths.
<p>Concordance of the categorization of the causes of death established by the complete diagnostic autopsy (CDA, gold standard) and the minimally invasive autopsy (MIA) in stillbirths.</p
List of microorganisms identified as the cause of death in the complete diagnostic autopsy (CDA, gold standard) and in the minimally invasive autopsy (MIA) in neonates.
<p>List of microorganisms identified as the cause of death in the complete diagnostic autopsy (CDA, gold standard) and in the minimally invasive autopsy (MIA) in neonates.</p
Sensitivity, specificity, positive and negative predictive value (PPV and NPV), and accuracy of the minimally invasive autopsy (MIA) for the different diagnostic categories in stillbirths and neonates.
<p>Figures are percentages and 95% confidence intervals.</p
Concordance of the categorization of the cause of death established by the complete diagnostic autopsy (CDA, gold standard) and the minimally invasive (MIA) diagnosis in neonates.
<p>Concordance of the categorization of the cause of death established by the complete diagnostic autopsy (CDA, gold standard) and the minimally invasive (MIA) diagnosis in neonates.</p
Characteristics of stillbirths and neonatal deaths.
<p>Characteristics of stillbirths and neonatal deaths.</p