The drivers of child marriage are resources and benefits. In order to understand the opportunities for change a pilot project was implemented by N’weti with supported from UNICEF between March 2018 and December 2019: Community Dialogues - an approach to prevent child marriage in rural communities” (henceforth “the Project”). The Project was carried out in four districts of Nampula Province (Rapale, Monapo, Angoche and Nacala Velha). The purpose was to pilot the Community Dialogues approach for prevention of child marriage, increase awareness of the risks and disadvantages of child marriage and encourage rethinking of the tradition of marrying off girls soon after they start menstruating.
A case study was conducted on beneficiary opinion on their participation in the Community Dialogues and it was possible to ascertain that parents, who are keen to marry off their daughters, seek to lessen their own burden of providing for their family. They may also hope that the future son-in-law contributes to their household. What was often mentioned during the study, was the fear that an unmarried daughter would get pregnant and increase her parents’ already heavy burden of maintenance. Hence, there are strong motives to marry off daughters right after the initiation ritual, i.e. after she starts menstruating. On this background, the objective of preventing child marriage seems like an unsurmountable endeavor. Yet, as we heard from many, things are changing, slowly but nevertheless changing.
The objective of this study is to document and disseminate the good practices of NGO N'weti - Communication for Health, partner organization of the Actions for Inclusive and Responsible Governance (AGIR) program, implemented by Oxfam in Mozambique. The study covers capacity building and institutional development in the area of communication for health, sexual and reproductive health and rights, HIV / AIDS and gender, as well as aspects of community participation in the different phases of project implementation, as well as expected and / or others promoted by the projects implemented by N weti.
The methodology used for this Case Study was basically qualitative, especially through a direct and dialogical interaction with the different managers, technicians and funding partners and implementers of the N'weti programs. The collection of information was done through three techniques, namely reading relevant documentation and reference material, individual interviews and group interviews.
The purpose of N'weti's funding from the "AGIR" Program, through Oxfam, in Mozambique, is to strengthen the institutional capacity of the organization so that it can implement its Strategic Plan and meet the defined objective to contribute to the improvement of the health status of Mozambicans in critical health areas through a communication that promotes social and behavioral change, based on the implementation of integrated multi-media communication interventions (TV, Radio & social mobilization, advocacy and governance monitoring, with particular attention to gender and human rights.
This report presents the results of Rapid Qualitative Screening of Local Perceptions of Neglected Tropical Diseases in three districts of Nampula province, namely: Mogovolas (Nametil), Murrupula (Chinga), and Eráti (Namapa and Alua). Data collection in the field took place between 23 and 28 March 2014 and sought to look at the etiology of the disease (signs and forms of manifestation), the social representation of the disease (experience, possible stigma associated with forms advanced) and lifestyles of the target population of project implementation districts in Nampula province.
Qualitative approach is the methodological option adopted. The auscultation privileged the collection of data that allowed to understand the perceptions, the meanings and the local interpretations on DTNs.
In terms of findings, the study found:
- Existence of different knowledge and perceptions about symptoms and signs among the communities covered. The diversity of knowledge gathered among different members of the community is informed by life experiences with the disease, poor access to biomedical information on the disease, magical-religious beliefs and some stereotypes that lead to a permissive context of certain practices and attitudes that perpetuate practices. As an example, common in all districts covered by the research is to associate the illustrations of a child with a watery stomach, urine with blood to diseases related to sexuality.
- Participants were unanimous in considering that illustrated risk practices, namely: open fecalism; standing water bath; urinating on the banks of lakes, ponds, and washing their legs in ponds and lakes are common in their communities and are aware of the risks associated with the health of the individual and the community.
- Low knowledge on the transmission of bilharzia between the communities covered by the study. For, no, it was possible to perceive a direct association between the risk behaviors illustrated through billboards of the research with bilharziosis. However, the interpretations surrounding the Posters show a general awareness of the implications for the health of individuals and communities resulting from non-compliance with basic hygiene recommendations.
N'weti intends to implement an intervention for social and behavioral change with a focus on Sexual and Reproductive Health (SRH) for adolescents and young people. The materialization of the initiative involves the production of materials and information that will feed the three pillars of the organization, namely: multimedia, social mobilization and advocacy.
In order to operationalize this initiative, N'weti has conducted a documentary analysis on Sexual and Reproductive Rights (DSR) and DSR among high mobility populations, focusing on the current context and legal framework. Based on this analysis, some areas of intervention and main topics to consider in the audience research were defined. However, before beginning her intervention, N'weti decided to conduct an audience survey to characterize the needs and specificities of the target groups, including high mobility groups, in matters related to DSR for young people of both sexes. The survey was conducted in Nampula city and Nacala-Oporto, in Nampula; Chimoio, Manica and Machipanda in Manica, and Magude and Namaacha in the province of Maputo.
As a result, the present research identified four segments of audience that although they frequent the same space and sometimes relate to each other and inhabit these same spaces, present different characteristics. The first group consists of young people; the second by parents, caregivers and other adults responsible for directing the sexual and reproductive lives of young people; the third segment consists of high mobility groups, and the fourth segment consists of SRH service providers.
In terms of service provision, at the formal level there are health units (US's), Youth Friendly Services (SAAJ's), Generation Biz Program (PGB) and Non-Governmental Organizations (NGOs) in which nurses work or collaborate ( counselors, and peer educators who provide services in the area of SRH. Information, counseling, testing for Sexually Transmitted Infections (STIs) and Human Immunodeficiency Virus (HIV) and follow-up, post-abortion care, postpartum care and Pre-natal Consultation (NPC) are available in the US and some NGOs. Other NGOs, SAAJs, and PGB's school and community components offer PF services (especially NGOs) as well as STI prevention services and refer their target groups to the US for STI and HIV testing and follow-up. Peer educators and peer educators, in turn, disseminate information about SRH.
The World Health Organization estimates that about 3.3 billion people are at risk of malaria, and people living in poor countries, particularly in Africa, are more likely to get the disease. The parasitic species that causes the most common malaria in Africa is the plasmodium falciparum.
Malaria is a common disease in Mozambique as a result of the hot, humid climate that provides the ideal conditions for mosquito growth and survival. High temperatures contribute to the development of malaria parasites in mosquitoes. It is estimated that around 96% of the Mozambican population lives in areas of high malaria transmission intensity and the parasite plasmodium falciparum accounts for 90% of malaria cases.
In Mozambique malaria is the primary cause of high morbidity and mortality rates in the country; children die more from malaria than from any other disease. This disease is responsible for 60% of all pediatric admissions, 40% of all consultations and 30% of all registered deaths in hospitals.
It is in this context that N'weti, an organization focused on Communication for Health, conducted this audience research with the aim of informing its actions of production of communication materials that aim to educate and inform communities about the prevention and treatment of malaria.
This report presents the results of formative research on malaria in Mozambique. The report is structured in seven parts: the first part deals with knowledge, including causes, symptoms and vulnerability to malaria. The following are described the prevention methods, which include the use of the mosquito net and the intradomiciliary spraying. Subsequently the experiences of the interviewees regarding malaria are presented. In the fourth part are listed several aspects associated with treatment, which include knowledge about the type of treatment, determinants of treatment demand, effectiveness, withdrawal of treatment and its consequences and what can be done to follow the medical recommendations . The following is the interviewees' knowledge about the relationship between malaria and HIV and AIDS. In the final part of the report an analysis of the presented data is made and, finally, the conclusions.
This report presents the results of the Formative Survey entitled "Exploring Individual and Sociocultural Obstructions Influencing the Demand for TB Services in Three Provinces of Mozambique". The aim of the study was to explore and identify the factors underlying the sociocultural and individual aspects that influence the search for diagnostic services and treatment of TB among health professionals, elementary polyvalent agents, community health agents, TB patients, community members and their community leaders with the purpose of generating information that will serve as a basis for guiding the design of a communication strategy and interventions for social and behavioral change.
The data for the present study were collected in urban and rural contexts of the provinces of Maputo (Namaacha and Magude), Tete (City of Tete and Moatize) and Nampula (City of Nampula and Angoche) thus covering the regional diversity of the South, Center and North of the country also characterized by its socio-cultural variety. The study followed an approach that combined qualitative techniques, namely semi-structured interviews conducted among community leaders, TB patients, APEs, ACSs and health professionals, and the holding of Focal Discussion Groups with community members and miners and direct observation. Additionally, secondary data such as reports from the three Provincial Health Offices as well as from the National Tuberculosis Control Program of the Ministry of Health and other relevant material were analyzed.
In Mozambique, the number of TB cases diagnosed and treated continues to grow. From 2007 to 2011, there was a growth of 20% (from 38,044 cases in 2007 to 47, 301 in 2011) in the number of TB cases (MISAU, 2010). Several efforts have been made to ensure early diagnosis of TB. These efforts include a consistent increase in the availability of free services for the diagnosis and treatment of TB in the country. This strategy involves expanding the laboratory network and decentralizing care to more peripheral levels.
As a result of these efforts, there are successful interventions in the communities. These interventions are implemented with the involvement of various actors, namely Community Health Agents (ACS), NGOs, Community Based Organizations (CBOs) and PMT.
This report presents results of a formative survey conducted in Mozambique on the phenomenon of Multiple Concurrent Partnerships in the context of HIV and AIDS. The report informs N'weti, an organization dedicated to health communication, about audience perceptions and attitudes towards the phenomenon. It also seeks to inform about social norms and practices around the subject and to identify the barriers that prevent behavior change. The phenomenon of multi-partner relationships between men and women emerged on the program agenda of the SADC Experts Meeting in Maseru, Lesotho in May 2006 (SADC Think Tank). This meeting identified this phenomenon as one of the main vectors of HIV transmission in Southern Africa.
It was in this context that the Soul City Regional Program, in partnership with the SADC Secretariat, decided and agreed to carry out national and regional partnerships with the sole aim of influencing the reduction of multiplicity of partners in the field of HIV. As a means of informing the production of communication materials at both regional and SADC country level, a multi-partner and co-occurring training survey was suggested and carried out simultaneously in the nine SADC countries which are partners of the Regional Program of Soul City. In Mozambique the research was carried out by N'weti, an integral part of the Regional Program of Soul City.
The present report is structured in six parts: the first presents the methodology adopted for conducting research. Following is the presentation of the types of MCPs (Multiples Concurrent Partnerships) indicated by the audience: polygamy, amanism and intimate friendship. In the third are socio-economic and cultural factors that imply men and women to get involved in these networks of sexual relations. The fourth section describes the ways in which men and women manage these relationships in their daily lives. Due to the direct correlation between the phenomenon and the HIV and AIDS pandemic, perceptions of the vulnerability and risk of the HIV-infected audience and the dynamics and meanings of condom use emerge. Finally, the report presents the main strategic conclusions and recommendations to be considered in programmatic interventions aimed at reducing partners.
"Understanding the Barriers and Social Determinants that Influence the Demand for Family Planning Services and Acceptance of Modern Methods of Contraception" is the name of a survey conducted in 13 selected districts in the provinces of Sofala and Nampula between February 20 and March 4, 2017 The research commissioned by N'weti - Communication for Health had as main objective to identify the barriers and social determinants that influence the demand for family planning services and the acceptance of modern methods of contraception in the provinces of Sofala and Nampula. of modern methods of contraception among women and adolescents can catalyze significant gains in terms of the health of women and children in general and in particular in Mozambique. Conscious of this benefit, the Government of Mozambique, in the framework of the implementation of the National Strategy for Family Planning and Contraception 2010-2015, set a goal of increasing the rate of modern contraceptives by 25% by 2015. Because the country has made some progress, of the strategy was spaced out by 2020 where it is expected to reach a target of 34% adherents / users of modern methods of contraception. Aware of the problem described above and following the goals set in the National Strategy for Family Planning and Contraception, N'weti and its partners in a consortium have designed and intend to implement the Integrated Family Planning Program (IFPP) funded by the US Government through the United States Agency for International Development (USAID) over a five-year period. The Pathfinder-led consortium includes in addition to N'weti the non-governmental organizations Population Service International (PSI) and Abt Associates.
Malaria is still a major public health problem in Mozambique. In Mozambique, malaria is endemic and the entire population is at risk of contracting the disease. Malaria is considered the most important public health problem in the country, accounting for 29% of all deaths and 42% of deaths in children less than five years old5. Most of the country has year-round malaria transmission with a seasonal peak during the rainy season from December to April. Although there is a decrease in malaria mortality in recent years, malaria remains one of the main causes of morbidity and mortality. In fact, the 2015 annual report from the Malaria Prevention and Control Program at the Ministry of Health stated that there had been a 6% increase in malaria prevalence since the year prior. The 2015 IMASIDA summary of preliminary data also reported an increase in malaria prevalence. In 2015, the prevalence of malaria in children 6-59 months was 40%, which increased from 35% in 20116. In addition, there is a stark contrast in prevalence among children 6-59 months in rural (47%) and urban areas (19%) and the provinces in the north of the country have higher malaria prevalence and morbidity than the south and central regions.
Nampula Province is one of the most populated provinces in Mozambique and characteristically has a high burden of disease and poverty. It has a high prevalence of malaria with 291 cases per 100,000 people7, and in 2015 it was the province with the highest increase in malaria incidence.
“Netting Malaria” is a project managed by N’weti funded by Comic Relief to combat the high prevalence and high mortality of malaria in Nampula province, specifically in the districts of Nampula and Ribáué. The goal of the project is to increase the demand for and quality of primary health care in communities affected by malaria, increase knowledge of malaria causes, symptoms and prevention measures and to increase positive health seeking behavior. The specific expected outcomes of the project are:
• Increased communities’knowledge and awareness on malaria prevention, diagnosis, treatment, febrile illnesses and health rights;
• Increased uptake of and access to health services for diagnosis, treatment of malaria and febrile illnesses and;
• Increased citizens’ demand for quality health services and accountability by health providers.