Why Pathfinder Works in Mozambique
Pathfinder International has been working in Mozambique since 1997. Today, fifteen years after our first office opened in Maputo and twenty years after the end of the post-independence civil war, the country has made great strides related to the health and development of its people. However, use of contraceptives, HIV prevalence, and maternal mortality due to unsafe abortion remain persistent problems for the country; prevalence of modern contraceptive use among married women has remained at only 11 percent, 13.1 percent of women and 9.2 percent of men between the ages of 15-29 test positive for HIV, and in the southern African region an estimated 18 percent of maternal deaths are attributable to complications from unsafe abortion.
Our work ranges from prevention of gender-based violence, with support from UN Women and PEPFAR, to reproductive health, family planning and maternal health at the community and facility levels, encompassing areas such as HIV and malaria with funding from USAID.
Contributing to this, Mozambique is currently implementing the USAID-funded Family Planning Initiative, integrating contraception into primary health services, and the Strengthening Communities through Integrated Programming (SCIP) project in Nampula province. The SCIP project combines innovative, community-based activities addressing sexual and reproductive health, with maternal health, HIV and AIDS, conservation farming, sanitation, and access to safe water.
And finally, a key component of Pathfinder Mozambique's work in HIV and AIDS includes support for key populations, including men who have sex with men and female sex workers—as these groups are not only at higher risk for HIV infection, but also experience the most stigma in seeking services. All Pathfinder projects are developed with the goal of scale-up and government ownership.
Evidence for Decision-Making
A key aspect of Pathfinder's approach to systems' strengthening is collecting evidence that enables public, private and community partners to make informed health-related decisions across a range of areas in which we work. To achieve this, Pathfinder has put in place monitoring systems that regularly flow into its Key Indicators Tables (or KITs).
In Mozambique, examples of the kinds of evidence we collect range from "Total number of post-secondary students who received VCT services and received their test results" and "the percentage of households practicing sustained use of water treatment technology" to the "Total number of clients who accept a family planning method at the time of an abortion or at the time of treatment for complications of an abortion." To illustrate the kind of results Pathfinder achieves, over a three year period:
- 2,759 students received voluntary HIV counseling and testing services and received their test results
- 17,902 latrines were built with project support
- In Nampula, 5,328,485 condoms were distributed
Building Capacity, Strengthening Systems
Mozambique faces critical challenges in the technical and organizational capacity of its health system and in the capacity of communities to successfully advocate for their rights, leading to lack of universal access to high-quality health services.
As with our work in other countries, a fundamental component of Pathfinder's work in Mozambique is to build this capacity in local communities, NGOs, and government agencies—helping communities to better understand their needs and engage in healthy behaviors, supporting NGOs to advance sexual rights, and helping government agencies to better respond to the sexual and reproductive health needs of their people.
Pathfinder Mozambique's approach to capacity building is systems-oriented, combining implementation of tailored programs that are responsive to the stage of development of each of our implementing partners, support for organizational systems strengthening, and training and mentorship to enhance the technical competence of local organizations. The operationalization of this approach is driven by a reliance on structures and initiatives that already exist in communities, and an emphasis on fostering an environment in which all partners have ownership of programming.
SCIP is designed to increase quality of life at the household and community levels by improving health and nutritional status and advancing household economic viability.
Pathfinder’s mHealth project in Mozambique seeks to identify and address the educational barriers that youth face in accessing and using family planning.
Iniciativa: Strengthening the Capacity of Youth Civil Society in Sexual and Reproductive Health Rights
Through this project, Pathfinder empowers youth organizations to become strong advocates for adolescent and youth sexual and reproductive health and rights.
Funded by the Centers for Disease Control, this project promotes HIV prevention among students, faculty, and staff of training institutes throughout Mozambique.
This program worked to reduce the incidence of HIV infection and the number of unplanned pregnancies among the sexually active population; empower women and sexual minorities in Mozambique through advocacy and health promotion activities.
Pathfinder works to support the Government of Mozambique to increase use of family planning and reproductive health services in 16 districts of Maputo, Gaza, Inhambane, and Cabo Delgado provinces.
Expanding and Sustaining Safe Abortion Services in Ghana, Mozambique and South Africa through the Safe Abortion Action Fund
Pathfinder built upon existing efforts to expand and create sustainable safe abortion services in Ghana, Mozambique, and South Africa. The overarching goal of this project was to reduce maternal morbidity and mortality due to unsafe abortion.
Evidence to Action for Strengthened Family Planning and Reproductive Health Services for Women and Girls (E2A)
The Evidence to Action Project (E2A) is USAID’s global flagship for strengthening family planning and reproductive health service delivery.
We believe change starts with expertly trained providers and pharmacies that never run out of supplies. It starts with open conversations among women, young people, men, religious leaders, mothers-in-law, policymakers, and others, joining to discuss their beliefs and remove barriers to their health and well-being. Our 2014 Annual Report shows a few highlights of how Pathfinder has served as a catalyst for change over the past year.
mCenas! - a comprehensive text message-based program that targeted youth aged 15-24 - has increased knowledge about contraceptive methods and dispel common myths around contraceptive methods.
This article retrospectively analyzes the scale up of adolescent-friendly contraceptive services in five countries and draws lessons learned to inform implementation and sustainable scale up of HIV and other services for adolescents.
A Holistic and Coordinated Approach to Community-based Family Planning across Projects in Mozambique
This technical highlight provides a brief overview of shared, salient project components employed by the SCIP and ESD-FPI projects for generating demand and improving supply of contraceptives.
In Kenya, health clinics are using text messages to combat empty shelves. As part of one project, nurses send inventory reports via text to a central data management centre and the contraceptives are sent out immediately. Other innovations included the mCenas! project in Mozambique, which educates young people about contraception via text, and a television and online series in India that highlights family planning through drama programmes.
What’s Youth Got to Do With It? Investing in Youth Sexual and Reproductive Health a Development Bargain
Rita Badiani, Mozambique country representative for Pathfinder International, pointed out that in Pathfinder’s Geração Biz program, government data made it difficult to target the youth they wanted to reach. “The health information system actually made adolescents and youth invisible due to the lack of disaggregation for this age group in the system,” she said.