Destaques

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.”  

The vertical transmission of HIV, which occurs from mother to child during pregnancy, childbirth, or breastfeeding, remains a significant challenge in the fight against the HIV epidemic. In countries such as Mozambique, where the prevalence of the disease is high, prevention during this critical phase is a public health priority. In the Zambézia Province, various initiatives are underway to ensure that mothers and children have a healthy start to life, free from the virus. It is estimated that a significant percentage of pregnant women are HIV positive. Vertical prevention is an essential strategy that encompasses various actions, from early diagnosis to antiretroviral treatment, providing expectant mothers with the opportunity to have healthy children. Understanding the magnitude of the problem and the efforts directed towards its mitigation is fundamental to the effectiveness of health policies. With the support of C-Saúde, healthcare professionals in Zambézia have mobilized around assistance programs that aim not only to treat but also to educate. In interviews with Maternal and Child Health Nurses (MCHN) working at the Nicoadala health unit, the impact of prenatal sessions that include HIV testing and guidance on the use of antiretroviral treatment was highlighted. “It is vital for women to understand that, with proper treatment, they can have healthy, HIV-free babies,” stated Lizete Manuel, an ESMI nurse. Additionally, community awareness campaigns have been organized to bring information to remote areas. Community health agents have conducted lectures and distributed informational materials about HIV prevention, addressing myths and realities that still surround the topic. Madalena Jamal, a young mother of three, shares her experience: “When I learned that I was HIV positive, I thought there was no hope. But with the support of the hospital and treatment, I was able to have my last child without the virus. He is healthy and happy.” This narrative not only highlights the importance of vertical prevention but also the transformative impact it can have on the health of mothers and newborns. Despite progress, significant challenges remain. The social stigma associated with HIV still prevents many women from seeking healthcare services. Additionally, the lack of resources in some areas and limited access to maternity care and other quality health services hinder the effective implementation of prevention programs. To address these barriers, C-Saúde is finding solutions by training community and religious leaders, midwives, and traditional birth attendants, who act as health advocates and mobilize pregnant and lactating women to access healthcare services. Lizete Manuel, health provider, conducts counseling on PTV (Prevention of Vertical Transmission) using a guideline to encourage adherence among pregnant women.

In Zambézia, one of the provinces in Mozambique with high incidence rates of cervical cancer, C-Saúde promotes screening campaigns targeted at women aged 25 to 64. With the mission of reducing mortality rates and promoting early detection of the disease, this initiative not only emphasizes the importance of preventive care but also aims to raise public awareness about the severity of this condition. The campaign extends across various locations in the districts of Nicoadala and Derre and includes the provision of free examinations, educational lectures, and training for local health agents. Our objective is to empower women to take charge of their health and understand the risks associated with cervical cancer. Early screening is essential for effective diagnosis, significantly increasing the chances of treatment and cure. The significance of this campaign becomes even more evident when considering that, according to estimates, approximately 80% of Mozambican women do not have access to regular examinations. Furthermore, the lack of information about the disease contributes to high mortality rates. Particularly among HIV-positive women, cervical cancer screening is crucial, as this population is at an increased risk of developing early lesions. Early diagnosis can reduce mortality rates and improve the quality of life for these women, who often face multiple vulnerabilities. To reach women, C-Saúde collaborates with communities and local leaders, schools, and community and religious organizations to disseminate information regarding the importance of screening. Prevention is key; we aim to change the narrative surrounding cervical cancer in our communities. The initiative involves the participation of clinical and community health providers who directly implement the campaign. Informational sessions regarding the importance of HPV vaccination, a primary contributor to the development of cervical cancer, are also organized. This cervical cancer screening campaign represents renewed hope for many women who face the fear of this silent disease. By focusing on regular screening, especially for HIV-positive women, C-Saúde not only promotes health but also commits to strengthening prevention and early detection as fundamental aspects of the fight for life.

The promotion of health and well-being in rural communities faces constant challenges, particularly in regions where access to basic services is limited. In Nicoadala Sede, C-Saúde, with funding from PEPFAR, undertook a significant gesture by donating bicycles to community health workers, facilitating not only the mobility of these volunteers but also fostering a more proactive approach in the fight for the health of the population. Nicoadala is a district distinguished by its cultural diversity, yet it simultaneously grapples with challenges in its infrastructure. Access to health units, education, and other essential services is often compromised by a lack of adequate transportation. In this context, community health workers play a crucial role, acting as intermediaries between the population and health institutions. The donation of bicycles by C-Saúde represents a practical solution to address these challenges. On this occasion, the workers also received kits containing backpacks, notebooks, and other work materials. The delivery ceremony was attended by community leaders, representatives from local authorities, community members, and the direct beneficiaries. Access to these means of transportation promises to enhance awareness of diseases such as HIV and tuberculosis while facilitating the distribution of essential health services. For local authorities, community health workers are a vital link between the community and health services. Thus, the bicycle donation will not only benefit the workers but will also indirectly benefit the entire community served. C-Saúde’s initiative in Nicoadala Sede underscores the importance of collaboration in promoting health within communities. It is anticipated that this action will not only improve the mobility of the workers but also strengthen community ties and contribute to a more effective and accessible public health system for all.  

On the last Monday, September 16th, the professionals of Nicoadala health facility in Zambézia province, participated in an important training session focused on human rights with the aim of fostering humanized care. The event aimed to equip staff with the skills necessary to provide healthcare services that prioritize the dignity, empathy, and respect for the needs of patients and users. The training was conducted by certified health professionals and included the participation of receptionists, nurses, nursing technicians, and other staff from the unit. During the training, topics such as the importance of clear communication, active listening, and family involvement in the care process were addressed. The goal of C-Saúde is to contribute to the improvement of patient care by promoting a more welcoming and respectful environment. We believe that humanized care is essential for the recovery and well-being of patients. Participants also had the opportunity to discuss practical cases and share experiences, creating a space for collective learning and knowledge exchange. Additionally, interactive activities were proposed to develop the emotional and behavioral skills necessary for more humane care. This initiative is part of a strategy by the Ministry of Health (MISAU) aimed at enhancing the quality of care in health services and reflects the commitment of the Nicoadala health facility to ensure excellence in service to the community. We expect that, with the implementation of the lessons learned during the training, professionals will be able to forge stronger bonds with patients, ensuring a more positive and effective experience during their interactions with users. The training on human rights was funded by PEPFAR and implemented by C-Saúde as a crucial step in transforming the local healthcare system, emphasizing the importance of placing the human being at the center of care. Through actions like this, the Nicoadala health facility reaffirms its commitment to promoting health, welcome, and dignity for all users.

In Nicoadala and Derre, C-Saúde has intensified its actions in collaboration with the Direcção Provincial de Saúde (DPS), with the aim of offering comprehensive support to people living with HIV. Realizing that the experience of being a person living with HIV goes beyond physical and clinical issues, the Ministry of Health’s psychosocial approach seeks to address the various dimensions that permeate the lives of people living with HIV, providing essential emotional support. Feelings of fear, anxiety and depression are common among people living with HIV, often intensified by the social stigma still present in society. The psychosocial counselling promoted by MISAU and implemented by CSaúde aims to create a safe environment where trained professionals work to demystify the condition, helping patients to develop skills that enable them to face the stigma and discrimination often associated with the diagnosis. As of August, this year, in Nicoadala and Derre, there were 30,693 patients on antiretroviral treatment, of which 864 are adolescents and young people aged 15 to 24, and 1.369 children aged 0 to 14. One of the pillars of the programme is the promotion of adherence to antiretroviral treatment, and emotional support is fundamental for these patients to face the barriers that can make adherence difficult. Psychosocial support therefore acts as a driving force, encouraging healthy behaviors and promoting a care routine that respects patients’ emotional needs. Interpersonal relationships are also profoundly affected by an HIV diagnosis. In this context, C-Saúde plays a vital role in facilitating communication and promoting diagnostic disclosure among family members, carers and partners. This support is essential for building an environment of better understanding of the disease and the treatment process as well as welcoming, allowing patients, through support groups, to feel comfortable sharing their experiences.In addition, identity and self-esteem are often impacted by an HIV diagnosis. By promoting support groups, C-Saúde offers a safe space for patients to reconnect with their identity and strengthen their self-image. The aim is to help each patient see beyond the diagnosis, rediscovering their individual value. The mental health professionals supported by C-Saúde are dedicated to ensuring that patients have access to appropriate care and support groups, ensuring that their health needs are met. Education is another fundamental component of this process; psychosocial support involves promoting information and clarifying doubts about HIV, helping to demystify the disease and encouraging safe health practices. Mental health, intrinsically linked to physical health, cannot be neglected. Psychosocial support includes constant care for patients’ mental health, addressing issues such as anxiety, depression, and stress-related disorders. In summary, C-Saúde’s work in Zambézia demonstrates that psychosocial support is not only a necessity but a crucial strategy for improving the quality of life and retaining individuals living with HIV.

As of 1 October 2024, Friends in Global Health (FGH) will complete its transition to Associação Centro Pela Saúde Global (C-Saúde), a Mozambican non-profit organisation created in 2021. This transition process represents a significant change in the way public health programmes are developed and implemented in Mozambique. C-Saúde’s mission is to support the Government of the Republic of Mozambique, its partners and civil society in designing and implementing evidence-based public health programmes. C-Saúde will play a crucial role in strengthening the National Health System, acting in various areas such as medical care, laboratories, pharmacies, health information systems, human resources management, community health, health communication, strategic information and carrying out evaluations and research. These actions aim to create effective programmes and enrich knowledge in the area of public health. The transition process from FGH to C-Saúde began in May 2023, with the signing of a sub-agreement that transferred all the central support that FGH provided to health information systems under the support of the President’s Emergency Plan for AIDS Relief (PEPFAR) in Mozambique. In October 2023, this transition expanded to technical and clinical support activities in the districts of Nicoadala and Derre in Zambezia province. Currently, at central, provincial and district level, the FGH management is holding meetings with all the organization’s employees to provide detailed information about this transition process. The purpose of the meetings is to clarify doubts and explain the implications and opportunities that will arise in this new phase. The participation of all employees is crucial for the continuation of a collaborative and transparent working environment during this period of change. With the finalization of the transition, the entire human resources team that was previously under the responsibility of the FGH will be integrated into C-Saúde. The technical supervision of the district team will continue to be carried out by C-Saúde’s provincial and central team, which remains accountable to the donors for the implementation of the project. It is important to note that this transition is part of a wider effort to transfer the implementation of HIV epidemic control programmes in Mozambique from international non-governmental organizations to local entities. This change represents an important step towards the autonomy and empowerment of local organizations to lead health initiatives in their own territory. As Mozambique moves towards building a stronger and more resilient health system, C-Saúde is emerging as a local force determined to lead the fight against epidemic diseases and strengthen public health in general.