"During the suspension of our activities, we modified the focus"
"During the suspension of our activities, we modified the focus"
"The protection of our workers, their families, and the communities where we work is of utmost importance for us." Mari Luntamo and Arsenio Paulo Manjate work for NGO N’weti. They report from Mozambique about the impact of COVID-19 for communities and how its prevention measures interrupt implementation of the Kusingata programme: improving quality of HIV services and creating demand for these services among pregnant women and children.
What are the main COVID-19 measures currently taken by the Mozambican Ministry of Health?
Mari starts telling: "Authorities have provided guidance. It aims to guarantee continuous services to people living with HIV while protecting them from the COVID-19 infection through, for example, provision of information on its prevention and by reducing the frequency of visits to the health facility. To this effect, more patients will receive ART for three months at a time thus reducing the number of visits to the health facility needed to collect the medication. Furthermore, most community-based activities have been suspended including community-based HIV testing and home visits to support people to keep taking medication."
What is your major concern when it comes to care and support for people living with HIV?
"We have heard reports that people living with HIV fear to come to the health facility due to COVID-19. As a result, they do not receive their ART timely, leading to deteriorating health. Among pregnant women this increases the risk of mother-to-child transmission", explains Mari. "It might also delay the HIV diagnosis with delayed treatment initiation as a consequence."
What are the consequences for the Kusingata programme?
"The COVID-19 crisis has major consequences", continues Mari. "Basically all Kusingata interventions are group activities such as community dialogues, mentor mother activities and community score card methodology. We suspended all meetings in groups until a time when they no longer pose a serious threat to our field staff and the communities we serve. We still continue with preparatory work for these activities though, such as finalizing the development of the needed tools. So that we are ready to implement them immediately when the situation allows."
What is currently allowed to do to reach people in need of HIV services?
Arsenio tells: "I keep updated on the development of the crisis and the restrictions on activities by the government and Ministry of Health. Based on these, I provide guidance to the project team.’’
"During the suspension of our activities, we modified the focus", Mari continues. "Our community facilitators are currently guided by N’weti supervisors and the health facility staff to deliver COVID-19 prevention messages in the health facilities. They also manage queues at health facilities and ensure prevention measures are followed, such as maintaining at least 1-meter distance to others."
"Our supervisory nurses support the main health facility of each district by attending the patients coming to maternal and child health services", adds Arsenio. "So what we are currently allowed to do at the moment is mainly health facility-based. The community facilitators could disseminate information regarding COVID-19 also in the communities and thus make the communities aware of the preventive measures they can take", he suggests.
Mari agrees and concludes: "All our activities follow the guidance of the Ministry of Health, provincial and local level health authorities. We are currently awaiting further guidance on whether we can provide more support to the COVID-19 response, including community sensitisation".
About Kusingata programme
In Inhambane province in Mozambique, the HIV prevalence rate increased from 8.6% in 2009 (INSIDA) to 14.1% in 2015 (IMASIDA). To avert this increase, the Kusingata programme aims to increase quality of HIV services and create demand for the services among pregnant women and children. The programme is implemented by N’weti in collaboration with Mahlahle from Mozambique and KIT Royal Tropical Institute from the Netherlands.
N’weti is a Mozambican non-governmental organisation founded in 2008. Its mission is to contribute to improving the health status of Mozambicans through communication interventions that promote social and behavioral change at individual and community levels, which lead to healthier life styles and behaviors. Mari Luntamo works as senior HIV technical adviser for N’weti and joined the organisation in 2017. Arsenio Paulo Manjate joined one year later and currently works as the senior project officer of Kusingata.
This article was published in the Children & HIV e-news of April 2020: COVID-19 and the paediatric HIV response