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Mozambique LINK-INFORM Epi Profile Report (2015) Eng Mozambique: A profile of Malaria Control and Epidemiology ACKNOWLEDGEMENTS 1 Mozambique: A profile of Malaria Control and Epidemiology 2 Mozambique: A profile of Malaria Control and Epidemiology We acknowledge all those who have generously assisted with collecting and collating information, providing access to unpublished data, and reviewing the products, especially: Albert Kilian, Alexandre Macedo De Oliveira, Allan Schapira, Astrid Knoblauch, Celine Gustavson, Chandana Mendis, Emilia Virginia Noormahomed, Eusébio Macete, Eva de Carvalho, Francisco Saute, Immo Kleinschmidt, James Colborn, Kate Brownlow, Mark Divall, Michael Coleman, Milka Owuor, Natalie Roschnik, Pedro Aide, Pedro Alonso, Rajendra Maharaj, Samuel Mabunda, Susana Nery. We give special acknowledgment to colleagues at the National Malaria Control Programme who assisted in assembling data and report writing: Baltazar Candrinho, Guideon Mathe, Elsa Nhantumbo, Mariana da Silva, Sérgio Tsabete, Sérgio Gomane, João Alemão, Dulcisária Jotamo, Maria Pondja, Albertina Chiale, Carlota Nhagumbe, Eunice Alfai, Silvia Pedro, Rosália Muthemba, Natércia Macamo, Francisco Matsinhe, Luis Ismael Ribeiro e David Manjate. In addition we acknowledge the support of the following institutions: President’s Malaria Initiative/USAID/CDC, World Health Organization, Centro de Investigação em Saúde de Manhiça, World Vision International, Malaria Consortium, Clinton Health Access Initiative, John Snow International, Popuation Services International, and Global Fund for AIDS, TB & Malaria (GFATM). The report was prepared by the LINK Programme Team at the London School of Hygiene and Tropical Medicine (David Schellenberg, Sarah Saleheen, Debora Miranda, Abdisalan Noor and Caroline Lynch), the Information for Malaria (INFORM) team at the KEMRI-Wellcome Trust programme, Nairobi (Abdisalan Mohamed Noor, Robert Snow, Lukio Olweny, David Kyalo, Peter Macharia, Paul Ouma, Ezekiel Gogo, Joseph Maina, Stephen Oloo, Thomas Gachie and Fridah Karimi) who assembled the data and performed the analyses and modeling. The authors acknowledge the support and encouragement of Alastair Robb of the UK government's Department for International Development (DFID). This work was supported by funds provided by DFID‐UK to the LINK programme and by grants from The Wellcome Trust, UK to Professor Bob Snow (#079080) and Prof Abdisalan Mohamed Noor (#09512 Suggested citation: PNCM INFORM and LSHTM (2015). Mozambique: A Profile of Malaria Control and Epidemiology. 3 Mozambique: A profile of Malaria Control and Epidemiology 4 Mozambique: A profile of Malaria Control and Epidemiology CONTENTS 1. INTRODUCTION ............................................................................................................................. 9 2. COUNTRY CONTEXT ................................................................................................................... 11 Location, geographic features and population .................................................................................. 11 Administration & policies ................................................................................................................... 14 TheHealth System ............................................................................................................................. 17 Health system structure ................................................................................................................. 17 Health context and priorities .......................................................................................................... 18 Progress with Malaria Control in Mozambique .............................................................................. 19 Structure & function of the National Malaria Control Programme ..................................................... 20 Financing Malaria Control.................................................................................................................. 21 Supply chain overview ....................................................................................................................... 23 Drug & insecticide safety and efficacy monitoring ......................................................................... 25 Monitoring Malaria Control ................................................................................................................ 25 Routine Health Information System ............................................................................................... 26 Malaria mapping in Mozambique ...................................................................................................... 27 3. A TIMELINE OF MALARIA CONTROL IN MOZAMBIQUE ......................................................... 31 Detailed malaria timeline for Mozambique ........................................................................................ 33 4. OVERVIEW OF TECHNICAL METHODS .................................................................................... 43 Database of Geolocated Health Facilities ......................................................................................... 43 Mapping the population of Mozambique .......................................................................................... 45 Space-time geo-statistical modelling ................................................................................................. 46 Malaria prevalence survey data in Mozambique ............................................................................... 48 Malaria vector data in Mozambique .................................................................................................. 49 ITN/LLIN coverage mapping.............................................................................................................. 50 5. MALARIA RISK MAPPING ........................................................................................................... 51 6. ENTOMOLOGICAL PROFILE ...................................................................................................... 55 7. INTERVENTION COVERAGE ...................................................................................................... 57 Insecticide Treated Mosquito Nets (ITN) & Long Lasting ITN (LLIN) ................................................ 57 Indoor Residual Spraying .................................................................................................................. 59 8. DRAFT RECOMMENDATIONS .................................................................................................... 63 9. USB DRIVE CONTENTS .............................................................................................................. 64 5 Mozambique: A profile of Malaria Control and Epidemiology ABBREVIATIONS ACT Artemisinin-based Combination Therapy AL Artemether-Lumefantrine ANC Ante-Natal Clinic APE Agentes Polivalentes Elementares – Community Health Workers AQ Amodiaquine AQ-SP Amodiaquine – Sulphadoxine pyrimethamine AS Artesunate AS-SP Artesunate – Sulphadoxine pyrimethamine BIC Bayesian Inference Criterias CBS Chromosome Banding Sequence CDC Centers for Disease Control CHAI Clinton Health Access Initiative CHW Community Health Worker (APE) CISM Centro de Investigação em Saúde de Manhiça CMAM Central de Medicamentos e Artigos Médicos – Central Medical Stores CQ Chloroquine DCW Digital Chart of the World’s Populated Places DDT Dichloro-diphenyl-trichloroethane DFID Department for International Development (UK) DHIS District Health Information Systems DHS Demographic and Health Surveys DVS Dominant Vector Species ESIA Environmental and Social Impact Assessment ETM+ Enhanced Thematic Mapper EVI Enhanced Vegetation Index FAO Food and Agriculture Organization FEM Fine Element Method FORSSAS Fortalecimento dos Sistemas de Saúde e Acção Social GAUL Global Administrative Unit Layers GDP Gross Domestic Product GF Gaussian Field GFATM Global Fund to fight AIDS, Tuberculosis and Malaria GIS Geographic Information Systems GLWD Global Lakes and Wetlands Database GMP Global Malaria Programme, WHO Geneva GMEP Global Malaria Eradication Programme GMRF Gaussian Markov Random Field GoM Government of Mozambique GPS Global Positioning Systems GRUMP Global Rural Urban Mapping Project HDI Human Development Index HFDB Health facility database HMIS Health Management Information System 6 Mozambique: A profile of Malaria Control and Epidemiology iCCM Integrated Community Case Management INFORM Information for Malaria Project INLA Integrated Nested Laplace Approximations inSCALE Innovations at Scale for Community Access and Lasting Effects IPT Intermittent Presumptive Treatment IRS Indoor Residual Spraying ITN Insecticide Treated Nets JSI John Snow International LLINs Long Lasting Insecticidal Nets LMIS Logistics Management Information System MALTEM Mozambican Alliance Towards the Elimination of Malaria MAPE Mean Absolute Prediction Error MARA/ARMA Mapping Malaria Risk in Africa mASL Metres Above Sea Level MBG Model Based Geo-Statistics MDG Millennium Development Goals MeSH Medical Subject Headings MICS Malaria Indicator Cluster Survey MISAU Ministerio de Saude MIS Malaria Indicator Survey MODIS MODerate-resolution Imaging Spectroradiometer MOSASWA Mozambique, South Africa & Swaziland MPAC Malaria Policy Advisory Committee MPE Mean Prediction Error MPR Malaria Programme Review MTEF Medium-Term Expenditure Framework NFM New Funding Model NMCP National Malaria Control Programme NMSP National Malaria Strategic Plan
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