Mozambique

Situation Report

Cluster Status

Health

1,530
cholera cases in Cabo Delgado
4,557
COVID-19 cases (as of 9 Sep)

Needs

  • Reconstruction of COVID-19 treatment centres throughout the country for better flow and patients’ triage. Partners are requested to support the Ministry of Health (MISAU).

  • Inter-cluster assessment in Metuge district identified shortage of mosquito nets. Only 6,000 available nets in stock for now which is not enough; more than 15,000 nets required for IDPs and communities not only in Metuge but also in other districts. Some people in the overcrowded households within the host community are forced to sleep outside the house facing risk of malaria.

  • There is lot of loss to follow-up on patients on HIV, TB and non-communicable diseases programs as well as vaccination candidates who are among the IDPs due to disruption of the health system and lack of documentation making it difficult for continuity of care where they are being accommodated. Mapping of these patients is needed across Cabo Delgado province.

  • Health indicators in Cabo Delgado are on a downward trend including immunization which started even before COVID-19 pandemic. Provincial health directorate (DPS) and the health cluster partners are holding discussions on strategies to improve the indicators.

  • More teams of Mobile health Brigades (MHBs) and more health workers are required since most of the DPS staff are engaged in COVID19 response. MHBs which have been non-functional have been revived to offer integrated health package to the IDPs and host communities. However, they are only functioning in districts without security problems

  • In Cabo Delgado, over 1,530 cumulative cases of cholera and 23 cumulative deaths were reported since outbreak in January 2020 up to August . As cholera cases are increasing, in Pemba, Ibo, Mocimboa da Praia, Quissanga, provincial authorities (DPS) and partners are discussing possibility of conducting oral cholera vaccine which was to be conducted in February - March but postponed due to insecurity.

  • Quissanga, Palma and Macomia districts are still reporting acute watery diarrhoea (AWD) cases. All health facilities in Quissanga are closed due the insecurity and 596 health workers fled for safety

  • In Mocimboa de Praia, Quissanga, Muidumbe and Ibo, over 109,000 IDPs and 190,000 host communities are without provision and access to primary health services after 25 health facilities were closed in these districts due to insecurity.

  • Measles cases have been reported in six districts: Namuno, Montepuez, Ancuabe, Metuge, Mecufi and Pemba.

  • According to an assessment conducted by Plan International in June, IDPs responded that essential medical supplies in the health facilities were inadequate which is a norm during emergencies. Medical supplies which includes vaccines and essential drugs for routine health services at the health facilities serving host communities have been depleted

  • In Nampula, health cluster/group is not yet operational to serve 6,500 IDPs in the province. A GBV and SRH risk assessment and definition of the immediate interventions to meet the IDPs will be carried out by the Protection and SRH working group partners.

  • Safe spaces are required for approximately 3,500 IDPs children in the host communities according to clusters partners in Nampula.

  • Approximately 18 pregnant women, including five teenagers, are in urgent need pre-natal health services, according to the officer in charge of the Namialo health centre. The 5 pregnant teenagers are being followed-up on, in the local youth and adolescent health service (SAAJ).

  • In Sofala, 120 health centres need IEC materials on COVID-19 prevention and triage protocols to be distributed among health personnel working in the isolation centres and triage units. Support is being given to SDSMAS in Beira, Dondo, Nhamatanda and Buzi districts

  • Need to increase frequency of Mobile Health Brigades in Dondo and Nhamatanda Resettlement Sites to 12 per week in each District, and to 24 per week for Buzi Resettlement Sites.

Response

  • In Cabo Delgado, a boat-ambulance will be handed over to Serviços Provinciais de Acção Social to support in the provision of health services including obstetric emergency and other specialized surgeries, in the districts affected by the cyclone Kenneth in Ibo, Quissanga and Macomia districts.

  • An Epidemiological Sero survey on COVID-19 mission was held by the Instituto National de Saúde in Pemba city.

  • Mobile Brigades for provision of integrated health services (including SRH, PAV-immunization, Nutrition, Blood donation, Familly Planning, Ante-Natal Care, Nutrition) to IDPs and host communities, was held by DPS with UNFPA support, in 4 districts of Balama, Chiúre, Montepuez and Namuno. In total 72 communities were covered.

  • Serviços Provinciais de Acção Social (SPAS) distributed COVID-19 protection equipment and hygiene materials to Health units in 17 districts of the province

  • In Balama, Montepuez, Ancuabe and Chiure, 199 change agents for Sexual and Reproductive Health & COVID-19 have been trained.

  • Health cluster partners and DPS Sofala are coordinating support to the Mobile Health Brigades providing integrated services in the Resettlement Sites in Dondo, Nhamatanda and Buzi districts.

  • DPS Sofala received six tents to serve as isolation units for COVID-19, especially for Maternal & Child Health. Two tents were installed at the Provincial Isolation centre located at Centro de Saúde 24 de Julho in Bairro Macuti, in Beira.

  • An additional five Maternal & Child Health Nurses (Enfermeiras de SMI) will be deployed to Sofala for six months.

Gaps

  • In Sofala shortage of Maternal & Child Health Nurses in several rural Health units, and for complete staffing of Mobile Health Brigades as most of the health workers are engage in COVID-19 response.

  • SDSMAs (District Health & Social Welfare Authorities) lacks transport to ensure adequate supervision and follow up on the functioning of Health Centres and mobile brigades across Sofala province.

  • Establishment of permanent health infra-structures in resettlement areas (three in Nhamatanda, three in Dondo, six in Buzi) for ensure continuity of quality and adequate services provision in Cabo Delgado Shortage of essential drugs and emergency medical kits to replenish the depleted supply in the overwhelmed health facilities serving the IDPS and host communities.

  • More than 15,000 mosquito nets required to be distributed to the 300,000 IDPs and host communities in Cabo Delgado districts.

  • Proper response strategy to AWD and cholera outbreak going on particularly in Quissanga, Muidumbe, Ibo and Mocimboa da Praia where there are no functional health facilities.

  • More mobile health brigades required in Mueda, Najale, Macomia & Meluco where 13 health facilities are not functional.

  • In Cabo Delgado, disease surveillance system is weak given that no weekly reporting is done from the 42 closed-down facilities in eight districts.

  • Most of the districts in Sofala districts lack health partners as activities which were attached to the Humanitarian Response Plan which ended on 31 May 2020 have declined.

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