With the technical support of UNICEF there was an expansion in the number of Community Health Workers(APEs) from 2,225 in 2013 to 2,747 at the end of 2014, and their abilities to deal with neo-natal and infant health and other nutrition questions in the community were strengthened. The data from 2014 show that APEs made home visits to about 2.4 million people, of whom about a million were children under five years of age, and about 817,000 people benefited from treatment for malaria, diarrhoea and pneumonia.
In 2014, UNICEF provided technical and financial support for the organisation of two National Health Weeks (SNS), which benefitted more than 4 million children under the age of five in each of the rounds. This guaranteed an increase in the national coverage of provision of Vitamin A, deworming and vaccinations, as well as the number of children registered. These two SNS were also an opportunity to strengthen the coverage of new users of Family Planning.
The UNICEF contribution to interventions concerned with universal access to malaria control in 2014 was through the distribution of mosquito nets treated with long lasting insecticide in Zambézia and Gaza provinces. This contribution benefitted almost 1,600,000 people, of whom 268,000 were children. UNICEF also supported Tete and Zambézia provinces in the purchase and distribution of medicines for at least two doses of Intermittent Preventive Treatment (IPT) of malaria for pregnant women. This represents a coverage of 51 % (Tete) and 57% (Zambézia) of pregnant women with at least two doses of IPT, compared with 44% nationally.
In 2014 UNICEF supported the vaccination programmes technically, financially and with cold chain equipment, contributing so that 97% of children under one year old were vaccinated with three doses of the pentavalent vaccine. Ninety-one (91) percent of children under one year old were also vaccinated against measles.
UNICEF supported the Ministry of Health (MISAU) in updating the Cold Chain Plan to attend to the needs and capacities for introducing three new vaccines in 2015 (Rotavirus, IPV, and the second dose of the measles vaccine). This support included the acquisition of 75% of the equipment necessary for the cold chain.
UNICEF supported finalisation of the new Community Counselling Package for Infant Feeding, including the Multiple Micronutrient Powders (MNPs) component. The National Strategy for home food fortification with MNP was finalised, and is awaiting internal approval by MISAU. UNICEF will also support the introduction of MNPs, in the public sector in four or more districts in Zambézia province.
With UNICEF support, the management and data reporting of the nutrition rehabilitation programme (PRN) was improved. The proportion of health units reporting dataon acute undernutrition in outpatient and inpatient treatment has improved from 27% in 2013 to 67% (511 health units) at the end of 2014, reflecting an expansion of the PRN services to more health units. This improvement included the inclusion of relevant indicators in the Health Information System (SIS –Basic Module). In 2014, the recovery rate of cases of serious acute malnutrition (SAM) in the nutrition rehabilitation programme was 61% in both treatment services (which is still below the target of 80%).
The first National Sanitation Conference, of a multi-sector nature, was held in May 2014, under the leadership of the Government of Mozambique (five Ministries involved in the organisation), where it was agreed to eliminate open defecation by 2025, and guarantee universal access to water and to safe sanitation by 2030.
Under the leadership of the National Directorate of Water, UNICEF supported a national evaluation of open defecation free (ODF) communities. In 2014, a total of 872 communities were certified as open defecation free, of which 396 are communities with 100% improved family latrines. With this result, the country now has about 2,500 ODF communities – that is, about 10% of all existing communities are open defecation free.
Building the capacity of the Government’s partners for the provision of good quality water, hygiene and sanitation services, through support in training, recruitment of new staff, and district planning in 12 districts in Zambézia, 5 districts in Sofala, 4 districts in Tete, 4 districts in Manica, and 1 district and1 municipality in Nampula. In 2014, 131 government staff and implementing partners were trained, at the decentralised level, in the promotion of sanitation, hygiene and sustainability; 10 artisans were trained in producing components of improved latrines and 11 government staff in managing financial resources.
From 2012 to 2014, with the support of UNICEF, were developed Sanitation Master Plans in five villages (Ribáuè, Rapale, Mecuburi, Monapo and Namialo) which provided the local government guidelines and recommendations on the organization of water services and sanitation in the villages, in the promotion and regulation of family and institutional sanitation, waste management and identified key activities to be implemented in the short, medium and long term as well as the human resources and the budget needed to improve the sanitation situation in each district by 2025.
Since 2012, UNICEF has provided support so that 80,000 primary school children enjoy access to improved water supply and sanitation infrastructure in 20 districts in the provinces of Cabo Delgado, Nampula, Tete, Manica, Sofala and Gaza. The 2014 achievements include water supply infrastructure in 50 primary schools in the districts of Tete, Manica, Sofala and Gaza, reaching 19,000 students. Sanitation facilities in 82 primary schools in 13 districts (Angoche, Monapo, Namialo, Rapale, Angónia, Macanga, Changara, Guro, Manica, Gondola, Sussendenga, Buzi and Chibuto), reaching 59,063 pupils; 109 schools free ofopen defecation in 15 districts, benefitting 67,156 pupils (in Angónia, Macanga, Chiuta, Changara, Guro, Macossa, Manica, Gondola, Sussendenga, Machaze, Buzi, Nhamatanda, Gorongosa and Caia).
In 2014, a further 74,100 people living in rural areas in Tete, Manica and Sofala had improved access to water through the construction of 109 water supply sources.
A total of 246,200 people, 96% of whom live in rural areas, had access to improved sanitation in 2014 with the direct support of UNICEF. Cumulatively (2012-2014), 826 communities in 15 districts of Sofala (Cheringoma, Nhamatanda, Caia, Buzi, Gorongosa), Tete (Changara, Chiuta, Macanga, Angónia), Manica (Guro, Macossa, Gondola, Manica) and Zambézia (Gilé, Gurué), representing an estimated 22% of all communities in these districts were certified as having reached the stage of being open defecation free status.
In the Nampula province, in Ribáuè district, as part of thepartnership with the Government to accelerate the implementation of the management model delegated to the villages, with the support and technical assistance from UNICEF,the water supply system was inaugurated,capable of supplying up to 27,000 people, and access to improved sanitation was provided to 15,730 residents of Ribáuè Rapale and villages. An agreement worth 10 million Euros was signed between the European Union (9 million) and UNICEF (1 million) for a similar intervention in water supply in Inhambane province.
A proposal for the Global Partnership for Education for 57.9 million USD was developed.The prioritisation of quality and learning was leveraged (Primary Education Plan 2015-18).
Built capacities of 6,000 teachers in 7 districtsin “Child Friendly Schools” districts as well as of the teacher training institutions at national level.
Six hundred (600)primary schools implemented quality standards and guidelines on the quality of education and shared lessons learnt for nationwide roll-out of standards, their monitoring and supervision.
Twenty-two (22)teacher training institutions in 11 provinces integrate cross-cutting issues on school health, HIV/AIDS prevention, life skills, gender, prevention of abuses and practice of sport.
UNICEF supported the inclusion of school-based emergency preparedness plans in curriculum.
In 2014, 319,871 children were registered during the National Health Weeks. It is estimated that 60% of all children under 5 years old have been registered.
The National Operational Plan for Civil Registration and Vital Statistics was designed by the Government with the support of UNICEF and partners.
Technical and financial support from UNICEF contributed to an increase in the commitment of the Government and of other partners to child sensitive social protection and to revising the Social Security Strategy.
The Case Management manual was endorsed by the Government, and 1,400 Community Committees were trained in Zambézia, Inhambane and Gaza provinces, which could thenidentify protection cases involving 141,000 vulnerable children that require intervention. Evidence of the role and function of these committees which counted on support from UNICEF is being documented.
By court decision, 2,000 children were reunited with a foster family, with the technical and financial support of UNICEF.
National Campaign against Child Marriage launched by the Prime Minister, with the contribution of development partners, including UNICEF, through advocacy, and technical and financial assistance.
In 2014, UNICEF supported the Government in expanding the services of prevention of mother-to-child transmission (PMTCT), including Option B+ (simplified treatment protocols which improve retention and reduce the mother-to-child transmission rate), in Tete, Maputo, Niassa, Sofala and Zambézia provinces, through training sessions, supervision and monitoring of anti-retroviral (ARV) treatment for the nurses of the Mother and Child Health services (SMI). This contributed to significant progress in the country with a view to eliminating mother-to-child transmission of HIV. Services for the prevention of mother-to-child transmission of HIV are available in 82% (1,213) of the 1,485health units, offering ante-natal consultations throughout the country. Ninety-seven (97) percentof HIV-positive pregnant women are receiving prophylaxis for the prevention of mother-to-child transmission. Eighty-seven (87) percent of them have received ARV for PMTCT (Option B).
UNICEF, in partnership with the Clinton Foundation (CHAI), is continuing to contribute to the expansion and improvement of early diagnosis through technological innovation, by means of a national network of SMS printers which allows the immediate delivery of the results of early infant diagnosis in the peripheral units. The rapid return of the results guarantee that children infected with HIV begin treatment as quickly as possible, thus helping to save more lives. This contributed to ensuring that, by the end of 2014, 60,768 children under the age of 15 had access to anti-retroviral treatment, which corresponds to a 50% coverage of all eligible children. Ninety-five (95) of all the PCR results were sent by SMS printers. However, the rate of coverage of children remains below the anti-retroviral coverage for adults (79%).
UNICEF also contributed to the inclusion of adolescents (10-14 years of age), as a priority population for HIV prevention in the new HIV National Strategic Plan for the Response 2015-2019.
In Beira, UNICEF supported community involvement and the involvement of groups of adolescent peer educators in HIV prevention, counselling and testing, access to anti-retroviral treatment, as well as adolescent and youth friendly health services (SAAJ).
A desk review on child marriage and sexual initiation rites completed and research begun on children’s perceptions around their participation in sexual initiation rites, analysing their expectations and the correlation between “rites and child marriage”. Research begun into social norms in rural sanitation and social norms and social marketing in the sanitation area in small towns, with the data collection completed in Tete and Inhambane provinces.
One thousand and twenty (1,020) health workers and APEs were trained in inter-personal communication skills with the support of UNICEF.
UNICEF finalised the Information, Education and Communication package about birth registrationto help the registration officials of the Ministry of Justice improve inter-personal communication with the beneficiaries. Two thousand (2,000) copies were printed and distributed in all the country’s provinces.
UNICEF has developed and implemented the strategy of social influencers’ engagement at community level in Tete and Zambézia provinces. Forty thousand (40,000) copies of the booklet for Religious Leaders for the Promotion of Children’s Rights were printed and distributed. In June 2014, the alliance with religious denominations was launched in coordination with the Council of Religions of Mozambique.
With UNICEF support, more than 1.2 million people were reached in the rural areas of Zambézia, Tete, Cabo Delgado and Nampula with participatory sessions of communication for development using cinema and community theatre organised by the Institute of Social Communication (ICS)and the CTK and GTR theatre groups. More than 2.5 million people were made aware of the rights of children with disability through the multi-media campaign.
Approximately 1,500 child journalists and producers were trained and were given space on the radios and on TVM to express their opinions about their rights.
Through public and private advocacy, Civil Society Organisations, with the support of UNICEF and partners, ensured that during the revision of the Penal Code the interests of children were safeguarded. The celebration of the Day of the African Child was marked by the launch of the CD "Música é Vida" (“Music is Life”), produced by UNICEF and the Ministry of Health, with the support of 14 Mozambican singers, under the leadership of the musician Stewart Sukuma. More than 600 children, youths and adults took part in the concert, which was transmitted to millions of people throughout the country. In the framework of the celebrations of the 25th anniversary of the Convention on the Rights of the Child, a photographic exhibition was organised portraying the 25 years of the Convention in Mozambique. Opinion editorials signed by the UNICEF Representative and by the renowned Mozambican writers Mia Couto and Paulina Chiziane were published in the main newspapers. Also during the celebrations, the singer Neyma was appointed the new UNICEF Ambassador for Mozambique.
In 2014, the activities on the UNICEF Mozambique digital platforms for public advocacy reached 17.4 million people on the Facebook social network, 19.7 million on Twitter, 165,000 on Google Plus, 103,000 on Pinterest, 113,200 on the website, and 16,700 on the various UNICEF microsites.
In close collaboration with government partners, an updated and comprehensive Situation Analysis on Children in Mozambique (SITAN) was developed. The report contains up-to-date information about the life of children in the country, and is being used as an important tool in advocacy for prioritising children. Exhaustive work of calculating the costs of interventions in the social sector and the fiscal space for investments in the areas of health, education and social protection was developed as a basis for advocacy with the partners to channel larger and better investments focused on children.
UNICEF contributed to the debate on investment in children through the production of Social Sectors Budget Briefs, which are concise and simplified. These summaries analyse the evolution of the budget for health, education and social protection (the latter done in collaboration with the ILO).
Support has been provided at central and decentralised levels to the Ministry of Economy and Finance (National Budget Directorate and National Planning Directorate), to strengthen capacities to elaborate the budget and in Results-Based Management (RBM) principles. Government staff at central, provincial and district levels were trained, with a special focus on the provinces ofTete andZambézia.
In the area of promoting Evidence-Based Public Policy, support was provided to the National Institute of Statistics and the National School of Statistics for the update and national dissemination of Territorial Statistics, which is a decentralised data analysis system intended to serve as the main data base at national level,which includes disaggregated statistics at district level, updated every six months. Targeted support has been given in Zambézia and Tete provinces, with the provision of on-the-job training for statisticstechnicians at the district level, to improve the quality of data collection and consequent analysis.
As part of its emergency preparedness actions, UNICEF provided support for the strengthening of the rapid multi-sectoral assessment system in Zambézia, in developing, drafting and making operational the National Contingency Plan for 2014-2015 through the pre-positioning of emergency supplements for 25,000 people, and technical and institutional support for the relevant line ministries. Support was also given to the preparation of the National Plan for Ebola Preparedness and Response, and in training and building the capacity of the Local Disaster Management Committees.
In the flood and cholera emergency response, UNICEF intervened actively in water and sanitation, education and child protection, health and nutrition, as well as in the area of communication for development, through activities of social awareness and mobilisation. As a result, more than 126,000 people affected by the floods in Zambézia, and about 8,400 people affected by cholera throughout the country benefitted from basic humanitarian assistance, with the support of UNICEF and other partners.