Improving HIV Prevention and Outcomes and Building Capacity for Malaria Control

Mozambique is challenged by a severe HIV epidemic with an estimated 1.6 million people living with the virus. In December 2015, HC3 began supporting efforts to increase voluntary medical male circumcision, an important HIV prevention treatment. In addition, because discrimination remains a key barrier to improving HIV outcomes in Mozambique, HC3 conducted a study to reduce stigma at the community-level in order to increase male engagement in HIV testing and treatment.

Malaria is another endemic health concern in the country responsible for nearly one third of all deaths. To support the U.S. President’s Malaria Initiative’s (PMI) goal of significantly reducing malaria cases and resulting deaths in Mozambique, HC3 strengthened country capacity and provided technical support to the National Malaria Control Program and the PIRCOM interfaith program against malaria.


Supporting In-service Communication and Counseling and Demand Creation for VMMC

Individual counseling manicaIn the Manica and Tete provinces, USAID-supported voluntary medical male circumcision (VMMC) services have been offered since 2014, yet site capacity analysis done in September 2015 revealed that these VMMC sites were underutilized. HC3 was contracted in December 2015 to increase demand for VMMC services, particularly among males ages 15 to 29, and improve the quality of counseling communication in these provinces. The approaches used to generate demand for services included:

  • Partnerships with community radio and national radio to broadcast radio spots, panel discussions, call-in programs and testimonials from satisfied clients
  • Promotion of the service at workplaces, formal and informal markets and soccer games, where 15- to 29 year-olds tend to congregate (through personalized invitation, mobilization and billboards at those places)
  • Targeting school dormitories of those ages 15 and up, and secondary and tertiary schools
  • Involving the local community leadership in the mobilization
  • Improving data collection at the site level to better inform demand creation efforts

Results: 13,015 Men Sought Service from late December 2015 to late March 2016
In just the first three months of HC3 support, the combined activities above has already attracted 13,015 men to VMMC service providers in Manica and Tete, of which 11,170 benefited from the service.

“Costa (a community mobilizer) said that circumcision makes the penis clean and reduces the risk of contracting HIV, in addition to what I also saw on TV, so I went to do it.”

Tauanda, a satisfied client

Community-Level Stigma Reduction

HC3 reduced community-level stigma towards people living with HIV (PLHIV) in Sofala Province. Building on work done by PACTO, the program aimed at influencing HIV outcomes among men throughout the treatment continuum:

  • Community Dialogues: Carried out by NGO facilitators, these group sessions reduced stigma among community members while educating them on HIV and gender issues. In addition, referrals for HIV testing and counseling, treatment initiation and other HIV-related services were disseminated and tracked with a tablet-based SMS referral system.
  • Men’s Positive Prevention: This participatory education program allowed men who have tested positive for HIV to challenge gender norms. Content was focused on addressing internalized stigma, self-stigma, disclosure empowerment, treatment literacy and treatment adherence.
  • Champion Testimonials: Using community radio to broaden and reinforce stigma reduction messages, HC3 and RENSIDA, a Mozambique network of PLHIV, highlighted champion testimonials that encouraged HIV service-seeking behaviors among men.
  • Linkage to Care: By collaborating with the Co-Management Health Committees, stigma reduction was integrated into health care provider and community meetings. This reduced stigmatizing behavior within health facilities and strengthens the community-facility linkage.

Strengthening Malaria SBCC Capacity

The HC3 Mozambique Malaria Project strengthened the capacity of the National Malaria Control Program (NMCP) and Ministry of Health’s Health Promotion Department (DEPROS) and other PMI partners to coordinate strategic communication campaigns. Within the focal provinces, HC3 worked with community-based organizations to improve the quality of community-level social and behavior change communication (SBCC) materials. Results from this collaboration included:

  • Assisted in the NMCP SBCC Strategy Update: HC3 supported NMCP efforts to map national malaria partners and communication interventions to ensure all programs and messages are harmonized. A national and provincial communication plan was also updated.
  • Insecticide-Treated Net (ITN) Universal Coverage Campaign: ITNs were identified as the priority national malaria control method. HC3, NMCP and PIRCOM designed and pretested materials to support the upcoming ITN universal coverage campaign. HC3 also worked to link community and media partners such as Network of Journalists against Malaria for an effective mass media campaign.
  • Community Dialogues: In Mozambique, community dialogue is a common and practical channel for change. Community activists were trained in participatory methods and stimulating individual and collective responsibility for malaria control. HC3 created a Facilitator’s Manual structured around three topics: couples communication, use of mosquito nets and prevention among pregnant women and children under 5 years.

Religious leaders were also familiarized with malaria, trained in communication and facilitation skills, and taught how to monitor and supervise SBCC activities in the field. These training sessions included a focus on gender inequalities and related health consequences. Participants were taught how to model behavior and illustrate real-life scenarios as a means of demonstrating the importance of malaria prevention and control in their communities.

Capacity strengthening: Training religious leaders in Zambezia June 27 - July 1, 2016.

Capacity strengthening: Training religious leaders in Zambezia June 27 – July 1, 2016.

  • Partners
  • AIDSFree
    National Network of Associations of People Living with HIV/AIDS (RENSIDA)
    Ministry of Health Health Promotion Department (DEPROS)
    National Malaria Control Program (NMCP)
    Inter-Religious Program against Malaria (PIRCOM)
  • Geographic Coverage
  • National
    Cabo Delgado