Author name: CSAUDE Mozambique

The province of Zambézia is witnessing a coordinated effort to urgently reintegrate antiretroviral therapy (ART) patients who had been lost to follow-up as a result of recent public demonstrations.This initiative is being implemented in the districts of Pebane, Inhassunge, Mocubela, Maganja da Costa, Morrumbala, and Namacurra, through a partnership coordinated by C-Saúde and Serviços Distritais de Saúde. Interrupting ART poses a serious risk to patients’ health and to the stability of the gains in the HIV response. When a patient discontinues medication, there is an increase in viral load, a risk of progression to AIDS, greater susceptibility to opportunistic infections such as tuberculosis, and a significant increase in the risk of transmission of the virus. Reintegrating these patients is an urgent priority in order to protect lives and maintain control of the epidemic. The Pebane district has stood out as a model for this response. This June, the Tomeia health unit received a technical and community brigade that carried out intensive activities to mobilize, screen and reintegrate patients on ART, with encouraging results: 161 patients seen 105 patients reintegrated to ART 105 patients screened for tuberculosis 43 tested for HIV, of which 3 were positive – all immediately linked to treatment  Laboratory samples taken The strategy was based on community awareness sessions on the importance of an undetectable viral load and door-to-door visits involving community activists, religious leaders, local structures and health technicians. The success of the action in Pebane demonstrates local collaboration and integrated action between community health and health units. This model is being progressively replicated in the other affected districts, with the same commitment to rescuing all patients who have lost contact with the system. C-Saúde, as a technical partner organization of Serviços Distritais de Saúde, reaffirms its commitment to a humanized intervention guided by the right to health, placing communities at the center of the response.

As part of its commitment to supporting public health, C-Saúde is intensifying its efforts in the early identification and screening of tuberculosis (TB) in Zambézia Province.Strategic training sessions were recently held for Health Counseling and Testing (HTC) Counselors and Community Cough Officers. These are key actors in the fight against TB at both the community level and within the health facilities. Tuberculosis remains the leading opportunistic infection among people living with HIV and is one of the leading causes of preventable death in Mozambique. Recognizing this reality, C-Saúde is investing in a practical and inclusive approach that places communities at the center of the response. Training with Theoretical and Practical ComponentsTheoretical Component: This training covered various topics related to TB, including the causative agent, modes of transmission, clinical symptoms, and procedures for screening and sample collection.Practical Component: Participants received guidance on how to fill out the TB test request form (PNCT-5), the presumptive patient register, and the TB contact tracing logbook. Community-Based ScreeningWith this initiative, C-Saúde is expanding TB screening into the communities through Community Cough Officers, who now play an active role in identifying contacts of TB patients and promptly referring suspected cases to health facilities.This model aims to increase the number of people screened, improve detection quality, and ensure the timely initiation of treatment for those diagnosed with TB. Impact on Public HealthBy ensuring early case detection, this intervention helps to break the chain of TB transmission, protecting the most vulnerable families and communities. It is a vital step toward achieving the goals of the National Tuberculosis Control Program (PNCT) and saving lives.  

Recently, Quelimane Central Hospital, in collaboration with C-Saúde and with funding from PEPFAR, conducted an essential training on Advanced HIV Disease. This event not only emphasizes the importance of training healthcare professionals but also highlights C-Saúde’s commitment to supporting HIV care and treatment in Zambézia province. The main objective of the training was to equip doctors, nurses, and medical students with the knowledge needed to provide care for patients with Advanced Disease. This type of illness is characterized by significant progression of HIV infection, resulting in severe complications and compromising the patient’s quality of life. The causes of Advanced Disease may include lack of access to effective treatment, inadequate adherence to antiretroviral treatment, and the presence of other opportunistic infections. The consequences for patients are severe, including increased mortality, deterioration of general health, and the need for more complex medical interventions. The training saw strong participation from 74 professionals from various departments of the hospital, including emergency services and wards. Dr. Maria Madeira, Provincial Supervisor of the HIV Program and responsible for the presentation, began the activities with an introduction to the topic, followed by an interactive discussion that allowed the hospital’s Advanced Disease Focal Points to enrich the debate. The session ended with a Q&A segment where participants were able to clarify specific doubts, such as the interpretation of tuberculosis results (TB-LAM). The feedback received was extremely positive, reflecting the participants’ satisfaction with the level of interaction and the knowledge gained. The training not only provided a new approach to Advanced Disease but also led to an immediate change in clinical practices at the local level. It was decided that the Surgery and Gyneco-Obstetrics Wards, along with their respective emergency services, would begin implementing this new approach, while the areas of Medicine and Pediatrics would continue to improve their performance. C-Saúde, as a partner of the Ministry of Health, reaffirms its commitment to the continuous training of healthcare professionals in Zambézia province. New training sessions and follow-up actions are planned to ensure the effective implementation of the new care guidelines. Regular internal evaluations will be conducted to monitor progress and ensure that the knowledge gained is applied in the daily practice of the hospital. Furthermore, the expansion plan for the training to other health facilities is already underway, including a similar session at Hospital Geral de Quelimane. C-Saúde continues to work hard to improve the quality of care for users, demonstrating that training and capacity building are fundamental pillars for strengthening the health system in Zambezia province and, consequently, for the fight against HIV and its complications. Doctors from different specialties at the session in Quelimane

C-Saúde has launched a new version of its health service management and operation systems. This update not only enhances functionalities and corrects inconsistencies identified by users but also ensures that the platforms align with the latest technological trends and regulatory requirements, thereby guaranteeing greater efficiency, security, and innovation. Objective of the Update The new release focuses on the modernization and continuous improvement of C-Saúde’s systems. The main enhancements include: Addition of new functionalities, ensuring greater efficiency and an improved user experience. Correction of reported errors, optimizing platform performance. Technological alignment, keeping pace with industry innovations and meeting key regulatory requirements. Key Updates Among the latest improvements, the following stand out: Compliance with U.S. Government Executive Order 14168, reinforcing digital security and governance standards. Implementation of disk encryption processes on healthcare unit servers, enhancing data protection. Upgrade of the SESP Platform from version 2.3.3 to 2.6.11, ensuring greater stability and new operational features. Impact and BenefitsThese advancements positively impact C-Saúde end users and partners by providing more agile, secure, and adaptable systems that better meet their needs. As a result, user experience improves, and the monitoring of programs and operations is optimized. Challenges and ImplementationThe implementation of this update faced significant challenges, particularly due to a temporary two-week operational interruption. This situation required adjustments to the initial plan, adapting development strategies to ensure timely delivery. The methodology applied relied on collaborative meetings for requirement gathering, a process affected by the operational pause but set to be reinforced in upcoming updates. Future UpdatesC-Saúde remains committed to continuous innovation and has already scheduled the next update for June 20, 2025. The objective is to keep enhancing the systems to meet the evolving demands of users and technological advancements in the sector. With this release, C-Saúde advances in its mission to deliver efficient, and secure digital solutions. What does this mean for PrEP_NEW & PrEP_CT reporting

A look into his history Dr. Valoi’s career began with his academic training, which was consolidated in 2007, followed by extensive experience in public health, especially in HIV/AIDS. Currently serving as the Provincial Prevention Manager for the Avante Zambézia Project, he leads a collaborative effort to reduce HIV transmission and improve the quality of life for those affected by the disease. His responsibilities include implementing prevention strategies such as counseling and testing, offering PrEP, screening high-risk populations, and guiding multidisciplinary teams. His efforts extend beyond healthcare facilities: Dr. Valoi has successfully coordinated awareness campaigns in remote communities, tackling barriers such as stigma and fear associated with HIV. His journey also includes working with vulnerable populations, such as victims of violence, where he has always stood out for his empathy and welcoming approach. The role of a doctor in prevention strategy Dr. Valoi states that his work at C-Saúde is deeply aligned with the organization’s mission: to support the Mozambican government in controlling the HIV epidemic. His role is not limited to program management but also involves continuous training of healthcare teams and the implementation of new strategies to expand the reach of prevention and treatment services. As a partner of MISAU, C-Saúde has played a crucial role in implementing national guidelines, resulting in significant progress such as expanded testing, improved adherence to treatment, and reduced stigma. Dr. Valoi explains that collaboration among stakeholders has been essential in strengthening the prevention network, leading to reduced HIV transmission, higher patient retention in treatment, and better viral load coverage. humanizing care: A patient-centered approach In his practice, Dr. Valoi adopts a patient-centered approach that goes beyond mere medication. He emphasizes that each patient should be treated uniquely, considering not only their clinical needs but also their emotional and social well-being. By integrating psychosocial counseling, support groups, and individualized follow-up, Dr. Valoi has witnessed significant changes in the lives of many patients. Patients who initially feared diagnosis and stigma have now become advocates for HIV treatment and prevention in their communities. One of the most impactful cases in Dr. Valoi’s career was that of a young mother and sex worker who, after receiving a positive diagnosis, was on the verge of abandoning treatment. However, with emotional support, education about the disease, and a strengthened social support network, she not only remained in treatment but also became a peer educator, helping other women face stigma and live with HIV. Challenges and opportunities: the daily struggle Like any public health endeavor, challenges are constant. Dr. Valoi highlights that dealing with stigma, disclosure of diagnosis, and treatment adherence are among the most common obstacles patients face. Additionally, integrating youth, especially adolescents in vulnerable situations, remains a challenge, as many encounter resistance from sexual partners and family members. To overcome these obstacles, education and community engagement have been key elements. Dr. Valoi invests in awareness campaigns, training community and religious leaders, and leveraging local influencers to shift mindsets. “HIV does not define anyone. With treatment, it is possible to live a quality life,” he asserts, emphasizing that prevention is the most effective way to combat the epidemic. The impact of his work: Visible results in the community Reflecting on the outcomes of his work, Dr. Valoi highlights that Zambézia Province has made significant progress in HIV prevention and treatment. Increased testing, greater demand for prevention methods like PrEP, and adherence to ART are clear indicators of success. The reduction in AIDS cases and the improved quality of life for people living with HIV are sources of great pride for him. “Seeing these results, I realize that I am part of a story where people are helping control the epidemic, and it is an honor to be part of this story,” concludes Dr. Valoi. Towards a better future Dr. Valoi has an optimistic vision for the future of HIV treatment in Zambézia. He believes that with the expansion of PrEP, increased demand for self-testing, and ongoing community awareness, epidemic control will be even more effective. His wish is for more men, community leaders, and religious figures to actively engage in prevention efforts, fostering a profound transformation in society. Balance and purpose: Life beyond work Despite the emotional toll of his work, Dr. Valoi finds balance in his personal life. He shares his love for animals, plants, and reading activities that help him recharge and maintain his mental health. He emphasizes that the fulfillment of knowing he is fulfilling his purpose as a doctor and human being keeps him motivated to continue his mission.    

On March 24th, World Tuberculosis Day, we celebrate not only awareness of this disease but also the stories of resilience that inspire us. Today, we share the story of Thomas Bonnet, Operations Efficiency Director at C-Saúde, who faced tuberculosis and became an example of resilience and hope. Thomas Bonnet, Operations Efficiency Director at C-Saúde Contextualization of the Story Thomas Bonnet is a well-known name at C-Saúde. Having started his career in 2006, he has been a driving force within the organization, contributing to its growth. Before his diagnosis, Thomas lived a normal life, without any concern for tuberculosis, believing that the disease was something distant, reserved for individuals with compromised immunity. Discovery and Diagnosis Thomas’s life changed in 2015 when he began to exhibit symptoms that initially seemed harmless. During a dinner with friends, a persistent cough caught the attention of a physician friend, who encouraged him to seek medical help. Following screening, the diagnosis of tuberculosis was confirmed. “It was a hard blow,” recalls Thomas. “Even though I worked in the healthcare field, I wasn’t well-informed about TB, and the treatment seemed long and daunting.” Support and Challenges Support from family and friends was crucial during this time. Once treatment commenced, Thomas faced significant challenges, including workplace discrimination and the necessity to isolate himself to avoid transmitting the disease to colleagues. “I experienced a lot of discrimination, but I learned the importance of adhering strictly to the treatment,” he says. Participating in awareness events about tuberculosis helped transform his experience into an opportunity for learning and empathy. Treatment and Overcoming Obstacles The treatment was intense and demanding, but Thomas never considered giving up. “Advised by healthcare-provider friends, I realized that giving up could have serious consequences,” he asserts. With the support of a psychologist and a determination to return to his routine, he managed to overcome both physical and emotional challenges. “The treatment brought rapid improvements and allowed me to return to practicing sports.” Reflections and Lessons LearnedFor Thomas, it was an experience that allowed him to realize that “discrimination has more painful impacts than the disease,” he reflects. He learned the importance of seeking help at the healthcare facility and maintaining a healthy lifestyle. Message of HopeFor those facing tuberculosis, Thomas advises them to take their medication and not to give up. “It is important to believe in medicine and to be cautious with traditional treatments.” He emphasizes that a lack of information can lead to serious consequences, especially in our country, where tuberculosis remains a challenge. Importance of World Tuberculosis DayThomas believes that World Tuberculosis Day is a vital opportunity to raise awareness and inform the public about the disease. “It is a moment to share experiences and combat stigmatization,” he concludes. “We are all vulnerable, and together we can win this fight.”