NET RESULT: A nurse, seen through a mosquito net, tends to a baby stricken with malaria at the district clinic in Boane, south-west of Maputo. Malaria has been on the rebound in recent years in Africa after the failure of eradication programmes. Picture: Denis Farrell / AP Photo

With statistics indicating an estimated 9 800 women die from pregnancy or childbirth complications, which equates to one in seven women suffering such tragedies, Mozambique has one of the world’s highest ratios of maternal deaths.
Also, with an estimated 29 000 newborn deaths per year, its infant mortality is also among the highest.

Malaria, which killed 696 Mozambicans last year, an 8% increase from the previous year, is among the causes of the crises. Recurrent floods exacerbate the problems.

It is with great anticipation that a multimillion dollar investment has been launched to end the prevalence of the disease caused by the anopheles mosquito.

Among those affected by the prevalence of malaria is Maria Cristina, who counts her mother and husband among casualties.

“It was a complicated period for the family,” she said about the setbacks.

While she speaks, a group of insecticide sprayers are busy fumigating her house.

Cristina lives in Marracuene district, 30km from the capital, Maputo city.

Marracuene is bathed by the Inkomati River, which makes the region prone to floods and thus to water-borne diseases such as malaria.

At least 10 000 locals, from a population of 150 000 people living in Marracuene, have benefited from the malaria indoor residual spraying project, funded by Unitaid, the global health initiative that is working with partners to end the world’s tuberculosis, HIV/Aids and malaria epidemics.

The organisation is investing about $65million to eradicate malaria in the southern African country.

In Mozambique, the campaign has been implemented in strategic places of Maputo. It will be rolled out to several other malaria-prone areas in the coming months.

While the capital does not have the highest rate of malaria in the country, Maputo is the centre of the country’s migratory movement and those working in the field say it is a strategic place to counter the disease.

Francois Marteens, who leads the field work, said a large-scale awareness campaign was initiated before the beginning of the spraying exercise.

“It is a process. We are asking people to open their houses and take things out. Sometimes there is a sick child in the house,” Marteens said.

A new type of insecticide is used in Marracuene, as, according to experts, as time goes, mosquitoes become resistant to insecticides.

Lélio Marmora, executive director of Unitaid, said the community had been receptive to the exercise.

“We are very proud for the leadership and the hard work of the community workers and the government in this project,” Marmora said.

Pregnant women are receiving particular attention in Maputo because of the high maternal mortality.

Through a partnership with the Mozambican ministry of health, Unitaid aims to provide free anti-malarial drugs to at least 100000 pregnant women in the next five years.

Some $10m will be channelled towards the scheme.

The project, which was renamed Tiptop, aims to contribute to the reduction of maternal and neonatal mortality in Mozambique.

Statistics indicate that more than 28% of pregnant women have malaria infection due to late foetal delivery of prenatal services.

Those numbers are attributed to high rates of poverty, illiteracy and fears related to cultural and traditional practices.

Alexandra Cameron, a Unitaid executive, said community health workers who already have long built relationships with locals would be key in the implementation of the project.

Minister of Health Nazira Abdula said: “Through the Tiptop project, there will be community mobilisation, selection and involvement of community leaders, training, implementation, monitoring and research for demonstration of results for further implementation on a large scale.”

Lelio Marmorra, executive director of Unitaid, said this campaign against malaria was unique in that it was community-based.

“When you want to root innovation and be effective using it, you need to go to the civil society, and the community and the people adopting the change will understand it is for their benefit,” Marmorra said. - CAJ News