Saude de Criança em Mafuiane: Prevention, assistance and socio-health care services in the maternal-child sector.
Mozambique, Province of Maputo, District of Namaacha, Mafuiane
Mission of San Frumenzio (Archdiocese of Maputo)
Mozambique is one of the poorest countries in the world, 36.4% of the population live with less than a dollar a day, and 74.1% with less than two dollars a day. Around half of the population does not have direct access to drinking water. The lack of health services results in many problems, especially in rural areas like that of Mafuiane.
Mafuiane is a village with around 5000 inhabitants, situated 40km west of Maputo, on the road that leads to the border with Zimbabwe and South Africa. The area is flat and is surrounded by a hill and bathes in the water of the River Umbeluzi.
The local economy is essentially based on agricultural production, still characterized as a subsistence economy. The main local agricultural crops are millet, corn, tomatoes, cabbage, cucumber, and green beans. Farming, on the other hand, is almost non-existent, the population subsidises the poor diet by buying eggs, poultry, rice, and beans from elsewhere. Furthermore, in recent years due to climate change, the increasingly frequent drought phenomena compromise agricultural activities. Consequently, the malnutrition of the inhabitants of the community has taken the same dimensions as the emergency epidemic. In the area there are also problems related to the water supply through the wells, some manual pumps are distributed in the village for domestic use, and the irrigation system created by the Italian Cooperation in the 1990s, which is active today for 20% agricultural use.
Health coverage in the area is still very low. There is only 1 “health post” which is the smallest territorial unit, where the presence of a doctor is not even guaranteed and whose figure is not covered by a nurse. The poor hygiene-health conditions favor the spread of skin and respiratory diseases and diarrhea etc. mostly among children. Furthermore, a high percentage of people are affected by the HIV virus.
Since 1991, the Mission of San Frumenzio has built a collaborative relationship with the local population by carrying out projects which aim to improve the living conditions of the inhabitants. In 2013 AUCI started a collaboration with the Mission to carry out a support program for the land and the local community.
The objective is to support 3 nursery schools, one in Mafuiane (130 children), one in Baka Baka (80 children), and one in Goba (80 children) in managing staff and maintaining schools expenses such as the purchase of books, uniforms, etc, and minibus transport. For older children, school education is supported through issuing scholarships. Furthermore, the aim is to offer the children of the nursery school mentioned above and their families the support and healthcare necessary to combat illnesses due to precarious and insufficient hygenic-health conditions. Finally, we want to increase the development and the quality of agricultural production, also improving the nutrition of around 2000 Mafiuane families.
The direct beneficiaries over 3 years will be 300 pupils from three nursery schools aged 3 to 5, 23 teenagers from the community, and 2000 Mafuiane families. The indirect beneficiaries will be 1000 residential families of the Mafuiane area with a total of 6000 people.
The project takes action the strengthen of the prevention, pediatric care, and hygenic-health services for around 250 children aged 3-5 years during the first year, in addition to around 500 children aged 6-8 years in the second and third years. The health service will be carried out, waiting for the renovation of the “health post” in the first year, and for the Pediatric Centre to become operational, which will be built in the second year directly in the existing local school structure, so that all of the children can be visited and carefully monitored and there will detailed medical record for all.
- Medical visits, diagnosis, monitoring, and drug therapies (2 times a month) for 250 children aged 3-5 years directly at the nursery of Mafuiane and at the nursery of Baka Baka with the compilation and management of the medical records.
- Nutrition support with verification and monitoring of nutritional intake for the 250 children of the nursery aged 3-5 years.
- Medical visits, diagnosis, monitoring, and drug therapies (2 times a month) for 500 children aged 6-8 years at the primary school of Mafuiane, in order to complete the coverage action in support of the children and always draw up a medical record.
- Organisation, monitoring, and management of the database on the mapping out of clinical and hygienic-environmental cases of children and their respective families, as well as basic social and health needs.
In particular, the project intervenes more in the improvement of the child-maternal health services offered by the Health District of Namaacha with the technical-functional restructuring of the public health unit “health post” of Mafuiane. The renovation involves the refurbishment of the roof, the plaster of the external and internal walls, painting, the laying of tiles, an electrical system, the plumbing of the clean and dirty water of the health post and of the external bathrooms with sanitary purification up to the septic tank:
- 1 external waiting room with a canopy, porch, and a toilet to allow the community users to find shelter from the sun and rain whilst waiting for their medical visits
- 1 first aid room
- 1 delivery room
- 1 maternal-child room with 3 beds
Once the renovation work has been completed, the health post will return to offering its basic health services thanks to the involvement of the Provincial Health Director of the Province of Maputo which will guarantee the management and operational presence of the necessary medical and paramedical staff.
The project will extend the prevention, pediatric care, and hygenic-health services directly in the schools to 500 children aged 6-8 years, in order to complete the coverage actions in support of the children and always draw up detailed medical records. During the year, there will be the construction of the Pediatric Hospital of Mafuiane. According to the Provincial Director of Health of the Province of Maputo, and in collaboration with the Archdiocese of Maputo (on whose land the building will be built), the pediatric complex will be built, according to the planned schedule of approximately 6 months, (according to the attached technical document: plan and metric calculation) by a local construction company. The technical design, metric calculation, and expense specifications will be defined by AUCI, Archdiocese of Maputo- Mission of Mafuianae, and Provincial Director of Health of the Province of Maputo. The Central Pediatrician has a surface area of 300 sqm, of which 120 sqm will be built in masonry and reinforced concrete, a plumbing installation for clear and wastewater, a water purification installation, and an electrical system, composed as follows:
- 1 administrative register room
- 1 room for medical visits
- 1 hospitalization room with 4 beds and internal toilets, dedicated to children with respiratory illness
- 1 hospitalization room with 4 beds and internal toilets, dedicated to children with dermatological illness
- 1 hospitalization room with 4 beds and internal toilets, dedicated to children with gastrointestinal illness
- 1 analytical laboratory room
- 1 warehouse/archive/pharmacy room
During the year, the protection and health care service of 750 children aged 3-8 years continues its activities directly extending to education, support, and assistance of families who live in the Mafuiane area. The objective is to make sure that the hygiene and health prevention program for the protection and promotion of children has become common practice in the local community and among the inhabitants involved, health structures, and local schools. An extensive and profound health care service on a community and rural basis, with specific protection and treatment actions in the pediatric and maternal-infant sector, with direct and integrated involvement of various local inhabitants (local community, schools, health centers, and hospitals). Thus, it will find its ultimate “public” fulfillment with a wide range of education and raising awareness in the local community on knowledge of health and transmissible diseases. This year, finally, thanks to the active involvement of the Faculty of Pedagogy at the University of Maputo, a team of 5 educators will present a community education and information service by organising and preparing 3 theatrical perfomances and informative materials. The theatrical form was chosen because the involvement of local rural communities on educational issues is now positively recognised. When the local community sees the performances in a realistic form with characters they represent, in accordance with local cultural habits and customs, together with the daily situations of contagious diseases (AIDS) or behaviours/habits which jeopardize the health, then they perceive better what is asked of them and therefore what is best to do to stay well.