Success Stories

“The Six-Month Dispensation model came at the right time. Now, I can spend more time on my farm and don’t have to explain so often why I go to the hospital.”— Arlindo Nalili, patient at 17 de Setembro Health Facility In the heart of Zambézia Province, many families confront the daily reality of living with HIV while striving to maintain their livelihoods amid scarce resources. Until late 2024, clinically stable patients typically returned to health facilities every one to three months for antiretroviral therapy (ART) refills – a rhythm that imposed long journeys, lost wages, and the quiet toll of stigma in tight-knit communities. At that time, only seven health facilities in the province had begun implementing Six-Monthly Medication Dispensation (6MMD), which reduces routine clinical visits from as many as twelve per year to just two. This simple yet transformative change provided patients like Manuel Albano the freedom to focus on their families, farms, and futures rather than spending considerable amounts of time waiting to receive clinical services at busy health facilities. But scaling it across a province as large and varied as Zambézia demanded buy-in from national, provincial, and district managers, nurses and pharmacy technicians, data clerks, and community advocates alike. Acknowledging the potential, the Ministry of Health approved a coordinated expansion strategy in October 2024. Led by the Zambézia Province Health Directorate (DPSZ) with support from C-Saúde, district health officers and C-Saúde mentors organized intensive workshops on the 6MMD guidelines, paired with hands-on exercises in updating master cards and using the patient-tracking database to flag eligible clients. Weekly virtual check-ins and monthly in-person supervisory visits provided troubleshooting and encouragement, while data managers helped facilities generate automatic reports on uptake rates and stock levels, enabling rapid course corrections whenever bottlenecks emerged. Community engagement proved equally vital. At the 17 de Setembro Health Facility in Quelimane, a multisectoral task force comprising local activists, traditional leaders, and clinic staff hosted interactive health talks, where patients asked questions, shared concerns, and heard testimonials from early adopters. Posters and radio spots in local languages and Portuguese emphasized that six-monthly medication refills were not a reduction in care but a recognition of patients’ stability, granting them autonomy and dignity. In the rural Mocubela Sede Health Facility, community health committees invited patients to “come with a friend” during enrollment days, pairing newcomers with peers who had already experienced the convenience of longer dispensing intervals. Between October 2024 and June 2025, these efforts bore fruit. The number of supported facilities surged from seven to 37, covering most of the province’s districts. Province-wide coverage of 6MMD among eligible clients nearly doubled, from nine percent at baseline to 20 percent by the end of the reporting period, by which time more than 79,000 clients were enrolled in 6MMD. At 17 de Setembro, more than 72% of eligible patients opted in as workflows shifted to accommodate dedicated ART pick-up days and data clerks ensured accurate enrollment tracking. Even in Mocubela Sede, where infrastructure challenges once loomed large, 70% of stable patients now enjoy six-monthly medication refills. The impact extended beyond the numbers. Nurses reported a smoother outpatient flow, with fewer ART pickups per clinic day, allowing them to provide more focused counseling for newly enrolled or complex patients. Pharmacy technicians, once pressed by constant dispensing demands, found time to conduct inventory reconciliations and provide adherence support. Patients described feeling less like clinic visitors and more like empowered partners in their own care, able to sow fields, attend market days, and participate in community events without the dilemma of frequent hospital trips. Looking ahead, provincial health authorities and C-Saúde, through CDC/PEPFAR support, are committed to improving access to six-monthly drug dispensation in all supported health facilities that meet the necessary structural and staffing criteria by December 2025. Plans include scaling up mobile supervision and technical support teams to reach the most remote sites, integrating real-time performance dashboards at the district level, and deepening partnerships with community networks to sustain demand and address emerging patient concerns. For patients like Manuel Albano, who can now tend to his crops without the monthly trek to the clinic, six-monthly drug dispensation is more than a program, it is a gateway to normalcy, productivity, and hope. As Mozambique continues its journey toward epidemic control, differentiated service delivery approaches such as this offer a blueprint for balancing clinical rigor with human dignity, transforming the way HIV care is delivered across rural landscapes and urban centers alike. Health providers at 17 de Setembro Health Facility, conducting a technical review of the clinical eligibility criteria for the Six-Monthly Drug Dispensation (6MMD), reinforcing the implementation of differentiated care based on data, national protocols and collaborative decision-making.

“The new system has simplified my daily tasks. I can now swiftly obtain information that would take hours to obtain using a manual process. For example, I can extract monthly reports and use the dashboard that facilitates verification of the main performance indicators. It is easy to check patient history and monitor adherence to treatment.” Rafique Eduardo, pharmacy technician supported by Ariel in Cabo Delgado province. Rafique Eduardo is one of the hundreds of users of iDMED, which is the pharmacy information system developed by Centro pela Saúde Global (C-Saúde) in partnership with the Ministry of Health. The development and roll-out of the system has been supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Centers for Disease Control and Prevention (CDC). iDMED is currently in use at 356 health facilities throughout Mozambique. For years, the PEPFAR supported health facilities in Mozambique had been using a desktop-based electronic pharmacy system primarily used for antiretroviral (ARV) drug dispensing. The previous system while a lifeline for antiretrovirals relied on local installations, and outdated technology, hindering expansion and interoperability. Recognizing these weaknesses, the Ministry of Health, PEPFAR and C-Saúde joined forces to design iDMED, the Intelligent Medication Dispensing System. The new platform was built from the ground up as a secure, web-based solution capable of managing every essential medication, not just ARVs. By leveraging modern frameworks Vue.js on the front end, Spring Boot on the back end, RESTful APIs for seamless communication, and OpenHIM for national interoperability C-Saúde developers created a system that supports both online and offline operations, ensuring that even the most isolated health posts never lose access to critical information and functionalities. Rollout followed a deliberately phased approach, beginning in lower-volume clinics where data migration and staff training could be closely supervised. During each pilot phase, pharmacy and clinical teams provided real-time feedback on usability, allowing the technical team to refine workflows before extending the platform to busier facilities. This careful, people-centered strategy meant services never skipped a beat; health workers transitioned smoothly, armed with hands-on training and the confidence that patient care would improve rather than be interrupted. The results have been nothing short of transformative. Real-time registration and automated stock management improved, while digital records guard against transcription errors, elevating both clinical decision-making and patient safety. Whenever a network outage occurs, clinics simply switch to offline mode, maintaining full functionality until their connection returns. And because updates occur automatically through the web interface, system maintenance improved dramatically freeing IT resources for other vital tasks. Perhaps most importantly, iDMED’s integration with electronic patient tracking system (based in OpenMRS) offers a comprehensive view of each patient’s journey, smoothing referrals and underpinning data-driven policy decisions at every level of the health system.“We can track stock movements in real time and respond instantly to shortages. Even in our busiest centers, where the system sometimes slows briefly, the overall efficiency gains have revolutionized how we deliver care,” explains Dário Osmel Victor Gabriel, an ICAP-supported user in Nampula province. “Stock management has dramatically improved, facilitating the production of reports required by the Ministry of Health” adds Kátia Zacarias Chissano a pharmacy technician in Namacata health facility in Zambezia province while she is preparing her monthly inventory report. PEPFAR support in Namacata health facility has transitioned to the provincial health authorities of Zambézia and iDMED is essential in the provision of accurate reports. C-Saúde is a Mozambican association and serves as the central partner of PEPFAR for Health Information Systems (HIS) in Mozambique. Under the strategic guidance of CDC, C-Saúde supports the Government of Mozambique and PEPFAR partners in developing, strengthening, implementing, and supporting HIS, with the ultimate goal of achieving control of the HIV epidemic.      

In Mozambique, where tuberculosis remains a critical public health challenge among children, the story of Eva Evaristo, a 2-year-old girl from Namacurra in Zambézia province demonstrates the effective application of innovative diagnostic and treatment approaches under the PEPFAR-supported National Tuberculosis Control Program.Eva’s journey began when her mother, Mrs. Goi Luís, noticed that Eva was running a persistent fever and losing weight. An initial visit to the Naciaia health facility produced inconclusive results, prompting Mrs. Goi to seek further evaluation at the Namacurra sede health facility. There, considering Eva’s family history her grandmother was being treated for tuberculosis the healthcare team raised the possibility that the young girl might also have contracted the disease. Confirmation came through an unconventional test: a stool sample. Diagnosing tuberculosis in children is particularly challenging due to the difficulty they face in providing sputum samples. In response, the National Tuberculosis Control Program, in collaboration with C-Saúde and with PEPFAR funding, introduced an alternative diagnostic approach using stool samples. Despite initial reservations, Mrs. Goi understood the importance of the test and, with the help of the health team, was able to collect the sample. The result, days later, confirmed what everyone feared: Eva had tuberculosis. Mrs. Goi recalled, “It was a shock to learn that my daughter had the same disease as my mother. But at the same time, I was relieved to know that there was a cure.”Following the diagnosis, Eva commenced tuberculosis medication. Mrs. Goi observed early changes in her daughter’s condition, explaining, “At first, I received medication for a month, and I soon noticed improvements. My daughter was more energetic, her eyes began to shine again, and her appetite returned.” Alongside medication, Eva’s treatment plan included nutritional and psychological support. These integrated services were crucial given the challenges Mrs. Goi faced in managing the long-distance travel to health facilities and the ongoing risk of reinfection within the household.Reflecting on the difficulties she encountered during this period, Mrs. Goi stated, “It was hard, but as a mother, nothing stopped me from giving my best for my daughter. I knew that the cure was within our reach, and I had to fight for it.” After several months of consistent treatment and follow-up, Eva’s condition improved markedly Her recovery was evidenced by her renewed energy and a return to normal activities, attesting to the success of both the medication regimen and the novel diagnostic strategy. Mrs. Goi expressed her relief and gratitude: “Now, my daughter is cured and healthy. She is a girl full of joy. As a mother, I feel immense happiness seeing her well again. “Eva’s illustrates the tangible benefits of adopting stool-based diagnostic methods for pediatric tuberculosis. Between January and December 2024, the implementation of stool diagnosis resulted in a significant increase in the number of confirmed diagnoses: from 8 TB identified cases in 126 samples collected among children in the first quarter of fiscal year 2025 to 54 cases identified in 485 samples in the fourth quarter. This change not only saved Eva’s life but also influenced her grandmother, who found motivation in her granddaughter’s recovery to continue her own treatment. “It is essential for communities to share experiences like ours so that people know that tuberculosis is curable,” says Mrs. Goi, emphasizing the importance of awareness. Now, Eva’s next step is to ensure she is not reinfected, and Mrs. Goi is committed to following all prevention guidelines. Eva’s story is a beacon of hope, an example of the positive impact that early diagnosis and appropriate treatment can have on a child’s life. The innovation of stool-based diagnosis, supported by C-Saúde through PEPFAR funds, is a crucial tool in the fight against tuberculosis. Eva’s journey reminds us that healing and hope are within reach when we seek the right care and work together for the health and well-being of our communities. Eva Evaristo, sitting on her mother’s lap, serves as a reminder that new beginnings are always possible. “Eva’s treatment was a success. Looking back, I realize how this experience has made me stronger. The most important thing was to follow all the guidance from the health providers. My daughter is well now, and I am grateful for everything we learned in this process.” Mrs. Goi 

“Being where I am today means a lot to me. PEPFAR-funded programs were like a school and a bridge that helped me to get to where I am today.” says Santos Mucelo, currently serving as the Laboratory Mentor for Corromana health facility at Molumbo district. Corromana health facility is one of the health facilities that graduated from receiving technical support from a PEPFAR-funded International NGO to the Provincial Health Authorities and local Association Centro pela Saúde Global (C-Saúde). Based at Molumbo district capital, Santos Mucelo is the District Laboratory Chief and his own career has followed a similar trajectory as the support provided to Corromana health facility. Born in Mocuba, Zambézia province, Santos Mucelo joined to the Instituto de Ciencias de Saúde de Quelimane in 2015 and completed his Government of Mozambique (GoM)-funded mid-level academic in 2017 training graduating as Laboratory Technician. He passed the pre-employment GoM tests, but due to GoM budget limitations he couldn’t start working. His case was and continues to be similar to hundreds of health professionals across Mozambique, who although they have the necessary skills they cannot provide their services at health facilities that face shortages of qualified health professionals. It was in this context that, at the end of 2018, the PEPFAR-funded International NGO Friends in Global Health (FGH) provided a sub-agreement to Zambézia Provincial Health Authorities for hiring mid-level health professionals throughout the province. Santos was one of these professionals and started working at rural Molumbo district as a Laboratory technician, focusing on HIV-related laboratory work. “My initial experience was very good. I didn’t expect to have this opportunity.” recalls Santos. PEPFAR enabled him to step into the professional environment, apply his academic knowledge, and begin a promising career journey. But the start wasn’t without hurdles. Working in the field brought practical and emotional challenges, while also providing invaluable lessons. “It was my first contact with patients on the front lines, and life in the field wasn’t easy. However, this experience taught me a great deal about teamwork and how to cope with adversity.” Santos participated in PEPFAR-funded technical trainings and received mentoring that significantly broadened his skills. “I learned a lot, and I’m still learning. These trainings and regular mentoring were vital to my growth and continue to directly influence my work.” In 2020, Santos reached a milestone in his career when he was finally absorbed into the GoM payroll. He continued growing and today, as a District Laboratory Chief in Molumbo, he oversees teams and ensures the quality of services provided across all health facilities in the district. In October 2024, with PEPFAR funding through the Centers for Disease Control and Prevention (CDC), C-Saúde initiated the implementation of the Avante Saúde program. C-Saúde assists provincial health authorities to manage PEPFAR funds and to provide direct technical assistance at graduated health facilities across five districts of Zambezia province. Molumbo is one of the districts and Santos did not miss the opportunity: “I want to continue improving the public health system. I will keep applying everything I’ve learned.” says Santos, who is now one of the mentors of the graduated sites. Santos’s progression—from unemployment, to being hired by GoM through the support of an international NGO, to joining the government’s payroll, and ultimately becoming a mentor to other GoM providers—demonstrates the transformative power of PEPFAR programs. Santos is not an exception, but rather one of the 91 health professionals at leadership positions in Zambézia province, who were once supported by PEPFAR-funded sub-agreements. C-Saúde works with these leaders, ensuring that they seize the opportunity to retribute the technical assistance they once received and that they continue to build capacity of the public health system in Zambézia province.  

High waters and makeshift canoes often stood between Rosinha Eugénio and the vital care she needed. Yet, in a remote corner of Zambézia province, her resolve proved stronger than the current that threatened to keep her isolated—this is the story of a mother’s unwavering fight for her family’s health. Rosinha is a 35-year-old single woman from Namacurra district in Zambézia province who lives on the remote island of Marroda, in the locality of Mbaua. She is the mother of four children, two of whom, Milagre (13) and Tércia (11), are also living with HIV. From an early age, Rosinha faced the harsh reality of geographical isolation and limited health information. The nearest health facility was located on the other side of a river that had to be crossed in improvised canoes. This perilous and exhausting journey proved a constant obstacle for anyone seeking medical care. Growing up without guidance on disease prevention and treatment, Rosinha saw her vulnerability turn into a concrete challenge in 2011 when, pregnant with her first child, she was diagnosed with HIV. The impact of the diagnosis was overwhelming. Unable to accept her condition, Rosinha stopped her antiretroviral treatment while continuing her pregnancy follow-up at the maternal and child health services. Frequent rains in her district caused the river’s flow to increase, making crossing even more difficult, and the lack of alternative access routes kept her away from the health facility. Without adequate prenatal care, Milagre was born with HIV. Two years later, history repeated itself. During her second pregnancy, Rosinha avoided HIV mother-to-child transmission prevention services. Despite counseling from health professionals, she continued missing clinical appointments, resulting in long periods without medication. Consequently, her second child, Tércia, was also diagnosed with HIV. Over time, Milagre’s health deteriorated. He suffered from constant diarrhea, slow growth, and poor appetite—warning signs that Rosinha could no longer ignore. In desperation, she turned to traditional medicine, but it yielded few results; Milagre continued to fall ill. “I couldn’t sleep anymore. I felt guilty for not following the health facility’s advice,” Rosinha recalls. The weight of her guilt was enormous but change still seemed out of reach—until the day she crossed the river and met a team of community health workers. These workers were organizing a community mobilization event, where talks on HIV prevention and treatment were given. Motivated, Rosinha decided to approach one of them, informing him about her child’s illness. The community health worker offered to visit her at home and accompany her to see the child. “That gesture changed everything for me. I realized I wasn’t alone and that I could fight for my children’s lives,” says Rosinha. Seeing the child’s condition, the worker promised to support her so that she and her child could visit the health facility the next day. Without hesitation, Rosinha accepted the help and went to Mbaua health facility, where the worker was waiting for her. Rosinha and her child were received at the health facility and, because of their poor adherence to treatment, were enrolled in Enhanced Adherence Counseling (EAC) for three months. This strategy focuses on patients on ART who frequently miss appointments, interrupt treatment, or have uncontrolled viral loads. During the first EAC session, a team of health professionals including a psychologist, a clinician, and a peer educator—assessed the underlying reasons for Rosinha’s recurrent treatment interruptions. The main obstacles identified were transport barriers, distance, and psychosocial difficulties, which led to a personalized plan to reintegrate Rosinha into HIV care. Milagre and Tércia, underwent a clinical evaluation, checking for HIV-related illnesses. That same day, the children were integrated into antiretroviral therapy (ART) services. Rosinha received ART medication for the three of them, as well as a nutritional support plan for her children. To ensure her family’s continued access to ART, a mentor mother was assigned to provide community support and prevent further treatment interruptions. For the first time, Rosinha felt empowered to face her condition and ensure that her children received the care they needed. However, the road to recovery was not without obstacles. On one of their trips to the health facility, the canoe carrying Rosinha, Milagre, and Tércia capsized in the river. The three were rescued by the community, but the trauma lingers. Still, Rosinha never gave up. “The fear was immense, but my love for my children is stronger. I can’t give up,” she says firmly. Health professionals continued to monitor Rosinha and her two children regularly, ensuring they followed the treatment plan. Supported by her family and her mentor mother, Rosinha managed consistent access to medication. Over time, Milagre and Tércia’s health stabilized, allowing Rosinha to reduce her health facility visits. She began receiving medicines for herself and her children every three months, which greatly helped life in such a remote location. Thanks to the improvements in their health, Rosinha and her children began participating in mobile brigades organized in her community—an effective solution for clients living in remote areas. Determined to change her future, Rosinha remained steadfast in her treatment and had two more children, both born HIV-free. Community mobilization and mobile brigades promoted by the district health authorities in Zambézia province, in partnership with C-Saúde and funded by PEPFAR, were instrumental in transforming Rosinha’s life. “When health providers come to us, we feel our lives are valued. It’s a huge relief for many families,” she explains. Today, Rosinha Eugénio is more than just a health service user. She is a leader in her community, an inspiration to other women, and living proof that love and resilience can overcome even the greatest adversities. Her story clearly demonstrates that, with community support and determination, it is possible to create a future filled with health and hope.  

Ivanilde Lampião, a courageous 37-year-old woman, lives in the community of Magodone in Nicoadala district and her life story is a true symbol of resilience and transformation. More than a decade ago, in 2008, she received a diagnosis that would change her life forever: HIV positive. The news came after the sudden death of her husband, a devastating moment that almost made her lose hope. Initially, upon learning of the diagnosis, Ivanilde struggled against reality. Her refusal to accept the result led her to travel to Quelimane to reaffirm her fears. Unfortunately, the confirmation of the virus not only brought despair, but also the urgent need to face a new reality. In the years that followed, Ivanilde began treatment, but her lack of regular adherence to the medication almost cost her her life. In 2010, tuberculosis manifested itself in her weakened body, leading her to a hospitalisation where she finally saw the light of understanding. After receiving the appropriate treatment for TB, she realised that the only way to reverse the situation and rebuild her health was to follow her HIV treatment with the same determination. “I was very ill; I didn’t have the strength to walk. I didn’t hesitate, I decided to comply with the treatment, ‘’ says Ivanilde, now with a strong and decisive voice. “ What happened next was nothing short of a reinvention. Defying the odds, Ivanilde not only overcame tuberculosis, but also committed herself wholeheartedly to antiretroviral treatment (ART). With discipline and courage, she achieved undetectable viral load status, becoming a true inspiration. Not satisfied with just looking after her health, Ivanilde turned her pain into power. She became a patient activist and was frequently invited by health professionals to share her story. With empathy and care, she began working in the health unit, motivating others to accept the treatment she herself had embraced.In September 2020, her journey of empowerment took on a new dimension when she was invited to become a community health volunteer. With enthusiasm, Ivanilde took part in the training and embraced the task of seeking out patients who were reluctant to continue their treatments.

“I took the test, started taking the medication and, over time, my viral load became undetectable. By 2021, I was going to the hospital every six months instead of three.” Miguel recalls with a twinkle in his eye, a mixture of relief and pride at his determination. On a day that was supposed to be like any other, on 14 May 2020, the life of Miguel Bernardo, a young man of just 24 years old from Vila Sede de Nicoadala. When he was diagnosed with HIV at a health fair, he felt the weight of the world fall on his shoulders. Hopelessness enveloped Miguel like a dark cloud, and his state of health deteriorated rapidly, bringing constant headaches and a deep sense of helplessness. However, in a moment of reflection in November 2020, Miguel decided that he would not let HIV define his life. He mustered up the courage to seek help at the Nicoadala Sede Health Facility. That was the first step on a transformative journey. Referred to SAAJ, he underwent further tests and began treatment with antiretroviral therapy (ART). ‘I took the test, started taking the medication and, over time, my viral load became undetectable. By 2021, I was going to the hospital every six months instead of three,’ Miguel recalls with a twinkle in his eye, a mixture of relief and pride at his determination. Today, in 2024, Miguel lives with an undetectable viral load, the result of his strict adherence to treatment. He is not just a survivor, but a true Health Warrior, recognized by SAAJ’s Health Councilors as one of the unit’s most dedicated young people. What’s most impressive is the role Miguel has chosen to play: he’s become a health worker. Miguel turns his story into motivation, challenging the stigma and social barriers that weigh so heavily on those living with HIV. His message resonates in the communities: ‘With the right treatment, we can live a normal and full life. HIV does not define who we are; we are much more than our condition.’ By inspiring others to face HIV with courage and determination, Miguel has become a shining example that, even in the face of adversity, it is possible to turn pain into strength and stigma into solidarity. Life is a journey, and Miguel Bernardo is showing the world that, with love and support, everyone can find their way to fulfilment.

Amidst the vibrant daily life of the Namita neighborhood in the Nicoadala district, a story of overcoming and resilience emerges to inspire. Ancha Emilio Sumili, a 37-year-old woman, has faced challenges that could have interrupted her dreams, but her life journey is powerful proof that hope, and inner strength can prevail, even in the most difficult circumstances.The turning point in Ancha’s life came on 11 April 2019, when she received the news of her positive HIV diagnosis during a prenatal appointment. The discovery was devastating, but it didn’t paralyze her. With courage and determination, Ancha decided that she would not let the virus define her. She shared her condition with her husband and together they returned to the health facility where, during an appointment for couples, her husband was also tested, and it was confirmed that he too was HIV positive. She immediately started antiretroviral treatment (ART) together, as advised by the health provider, and began a new phase in their lives.Ancha’s experience as a mother is the beating heart of her story. With a baby in her arms, she was determined to ensure that her child grew up healthy. Thanks to the effectiveness of vertical HIV prevention (PMTCT) treatment, her first child was born negative. Ancha was a devoted and loving mother, nurturing her son with care and protection, always with the aim of weaning him safely and healthily.Ancha’s journey didn’t stop there. Encouraged by the success of her first child, she decided to have a second child. A new blessing came into her life: her second baby was also born HIV-negative because she complied with the PMTCT treatment. This achievement was not only a personal victory, but a testament to the positive impact that HIV awareness and effective PMTCT treatment during pregnancy can have on a woman’s life.Ancha’s story is much more than an individual narrative; it is a source of inspiration for many women in the Namita neighborhoods and beyond. By sharing her experience, Ancha has become an advocate for HIV health and education, emphasizing the importance of ongoing treatment and mental health support. As a community health activist, she organizes meetings in her community to help other mothers and people affected by HIV, breaking down stigmas and bringing light to an often-silenced issue. Ancha Emilio Sumili’s journey is a story of struggle, perseverance and victory. His journey demonstrates that, with the right support and determination, it is possible to turn challenges into opportunities. Ancha’s story is a powerful reminder that life can be full of hope and love, even in the face of adversity. Her achievements are not hers alone but reflect the strength of all women who fight every day for a better future for themselves and their children. Ancha is one of the women from Zambezia province who has successfully benefited from antiretroviral treatment through PEPFAR’s support for the Mozambican government in the fight against HIV.    

Key Achievements: Alignment with National and International Standards: Our centralized database aligns seamlessly with Mozambique’s National Health Information System (HIS) strategies and PEPFAR CDC Mozambique policies, ensuring adherence to international standards and improving overall data integrity. 2. Enhanced Data Quality and Monitoring: The centralized system reduces duplicate patient entries, identifies “silent transfers,” and flags treatment interruptions. This allows for real-time monitoring of patient and program data, addressing issues promptly and improving patient care. 3. Streamlined Reporting and Data Transfers: Reporting has become more efficient, with consolidated reports generated at the provincial level. This also includes a significant reduction in the number of Mozart data transfers from over 600 to just eleven, cutting costs and simplifying system maintenance. 4. Improved Security and Cost Efficiency: By centralizing the database, we have enhanced security and reduced the need for extensive support and maintenance. Quarterly updates are now managed at the provincial level, reducing operational costs and ensuring consistent adherence to security standards. 5. Phased Implementation for Sustainable Growth: The implementation is structured in phases: central database migration, Master Patient Index (MPI) integration, and optimization of data flow and interoperability. Each phase is designed to build on the previous, ensuring a robust and scalable solution.     Implemented Solution: Cloud-Based Centralization: The solution leverages a cloud-based server using the OpenMRS-EIP module, which integrates advanced technologies like Debezium and Apache Camel for efficient data synchronization. This central server consolidates data from all health facilities, enhancing real-time access and interoperability. Phased Approach: The process involves migrating health facility databases to a central provincial server, followed by the integration of MPI for improved patient matching and reporting. The phased approach ensures a smooth transition and scalability. Technical and Functional Requirements: The implementation requires reliable internet connectivity, harmonized OpenMRS versions, and a central cloud server with specific technical specifications. Functional requirements include real-time synchronization, a monitoring dashboard, and data quality assurance. Operational Excellence: The roll-out of the EPTS centralization is executed district by district, upgrading and merging databases into a centralized system. This methodical approach ensures that each health facility transitions seamlessly to the new system, enhancing data management across all provinces. Looking Forward: The EPTS centralization not only enhances data management but also paves the way for future interoperability with other health information systems. By ensuring a sustainable and collaborative environment, we are setting the stage for continued improvements in healthcare delivery and data management in Mozambique Members of the board of directors of C-Saúde during the visit to the health facility of Nicoadala sede