Malaria is considered the most important public health problem in Mozambique where it accounts for nearly one-third of all deaths and 42 percent of deaths in children less than five years old. Although malaria prevalence has decreased in all provinces, the country continues to face challenges that have slowed the progress of key malaria prevention and treatment interventions. PMI-supported activities include support for the national IRS program; free routine ITN distributions to pregnant women and to children; procurement and distribution of rapid diagnostic tests to all levels of the health system; provision of intermittent preventive treatment of pregnant women; and revitalization of the community health worker program.
IRS continues to be a critical component of Mozambique’s National Malaria Control Strategy launched in December 2017 for 2017–through 2022. Through the support of PMI, Mozambique has implemented 13 rounds of IRS since 2007; these include six rounds under the AIRS Project (2011–2017) and two rounds under the PMI VectorLink project (2018–2019).
In 2019, Mozambique did IRS in five provinces: in Maputo, Gaza, and Inhambane provinces, implemented by Tchau Tchau Malaria and funded through a public-private partnership, MOSASWA; in Nampula province, implemented by the NMCP and funded by the Government of Mozambique; and in Zambezia province, implemented by VectorLink Mozambique and funded by PMI/ USAID. The Global Fund provided support to the Ministry of Health (MOH) to procure insecticide for all five provinces.
In 2019, PMI VectorLink Mozambique conducted IRS in five districts in Zambezia province, using both SumiShield® 50WG and Fludora® Fusion, from October 28 to December 14, 2019. The original target was 331,360 structures; in the end, 338,330 structures were sprayed out of 350,172 structures found by spray operators (SOPs), accounting for an IRS coverage rate of 96.6%.
In its third year, the project will conduct IRS in five districts (Maganja da Costa, Milange, Molumbo, Mopeia, and Morrumbala) from October 19 to November 27, 2020, and will provide capacity-building support to the national, provincial and district governments to plan and implement quality IRS. Figure 1 highlights the target districts for 2020 in Mozambique.
VectorLink Mozambique will work with the NMCP, Zambezia Provincial Directorate of Health (PDH), District Services for Health, Women and Social Welfare (SDSMAS), Ministry of Agriculture and Food Security (MASA), and Ministry of Land, Environment and Rural Development (MITADER) to spray 350,172 targeted structures in five districts using SumiShield® 50WG (clothianidin) and Fludora® Fusion (clothianidin/deltamethrin combination). The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations.
In 2020, PMI has revised the scope of the Mozambique project in the following manner:
- PMI shall enter into a government-to-government (G2G) agreement with the province of Zambezia to fund the following items through the province rather than through the PMI VectorLink project:
- Procurement and payment of rental of vehicles for IRS training and implementation (except for VectorLink rental and fuel costs for supervision by VectorLink staff)
- Contracting of and payment of seasonal personnel
- Payment of per diems to government staff before, during, and after spraying
- Procurement and payment of seasonal personnel breakfasts
- Financial support for community mobilization meetings and mobilizer training (except for; Mobilizers daily rate during mobilization activities)
- Payment of per diems to government staff involved in entomological activities in Zambezia (except for the first six (6)months while G2G is being concluded to avoid interruptions in entomological activities)
- The entry of spray data into the VectorLink Collect database at the summary level, instead of at the structure level.
- In accordance with country policy, human landing catches will no longer be performed.
In addition to spraying, in Year 3, the project will carry out the following activities:
- Support national and provincial government in entomological monitoring and IRS capacity building.
- Carry out a logistics assessment in all districts, and manage all international and local procurement, shipping, customs clearance, timely delivery, and storage of spray pumps, spare parts, insecticide, and personal protective equipment (PPE).
- Ensure safe and correct insecticide application, thus minimizing human and environmental exposure to IRS insecticides, and development of new Supplemental Environmental Assessment (SEA) ahead of the expiry of the current 2015 SEA.
- Continue to lead community mobilization, education, and communication (IEC) and social behavior change communication (SBCC) sensitization and mobilization activities to increase community awareness and acceptance of IRS.
- Conduct routine entomological monitoring in all spray sites.
- Complete the set-up of a replacement insectary in Zambezia and provide technical support for the Nampula insectary.
- Support attendance of three representatives from Nampula and Zambezia to an NMCP led national boot camp to be held in Maputo
- Support a one-day cascade training for Nampula province
- Continue support for environmental compliance and stock management for Nampula.
- Participate in a national IEC technical meeting in Maputo.