Destaques

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 coordinated 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 information campaigns in remote communities, tackling barriers such as negative social perceptions and fear associated with HIV. His journey also includes working with populations at increased risk of HIV infection, 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 an organization supporting 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 negative social perceptions. Dr. Valoi explains that coordination among relevant actors 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 have now become active in promoting HIV treatment and prevention in their communities. One of the most impactful cases in Dr. Valoi’s career was that of a young mother 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 live with HIV. Challenges and opportunities: the daily struggle Like any public health endeavor, challenges are constant. Dr. Valoi highlights that dealing with negative social perceptions, disclosure of diagnosis, and treatment adherence are among the most common obstacles patients face. Additionally, integrating youth, especially adolescents in risky 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 information 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 broadening of PrEPé reach, increased demand for self-testing, and ongoing community information, epidemic control will be even more effective. His wish is for more men, community leaders, and religious figures to actively involve themselves 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 increased understanding of this disease 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 unfair treatment in the workplace 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 information 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 inform the public about the disease. “It is a moment to share experiences and combat address negative social perceptions,” he concludes. “We can all be affected, 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, HIV-free. 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 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 information 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. Negative social perceptions associated with HIV still prevent 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 support health promotion 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 understanding 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 support women in taking an active role in 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 risk factors related to health and access to services. To reach women, C-Saúde works 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. In the image, a Community Health Officer from C-Saúde is giving a lecture emphasizing the importance of early screening for cervical cancer for the women in the local headquarters, in the Nerir neighborhood, in Nicoadala district.    

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 knowledge about 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 coordination 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 patient rights and ethical care 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. 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 shared 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 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 and dignity for all patients. The training involved 45 professionals linked to the Nicoadala Health Center, located in the headquarters. Training is also being implemented for professionals from other healthcare units in the district, including Derre.

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 negative social perceptions still present in society. The psychosocial counselling promoted by MISAU and implemented by C-Saúde aims to create a safe environment where trained professionals work to improve understanding of the condition, helping patients to develop skills that enable them to face social barriers and unfair treatment 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 practices 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 spouses/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, sense of self 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 sense of self 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 2020. 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 coordinated 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 strengthening 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.  

In Nicoadala District, with support from the Provincial Health Department (DPS), C-Saúde has implemented various strategies to improve the quality of health services. In line with local socio-economic characteristics, C-Saúde has contributed to the provision of health care in a timely manner, in accordance with the needs and expectations of patients, as guided by the Ministry of Health in its policy on Quality and Humanisation of Health Service Provision. The main aim of the initiative is to guarantee wider access to healthcare for the entire community. As well as increasing the supply of health services, the initiative seeks to raise the quality of care provided, helping to overcome the low culture of care in health units and increasing the number of people tested and who know their serological status. Through the Qualy campaign, C-Saúde is reaffirming its commitment to promoting health as a fundamental right for all and is seeking to strengthen the population’s trust in the health services it offers. With this, it contributes to achieving the HIV response targets set by the MoH, which aim to eliminate the HIV/AIDS epidemic in the country as a public health problem by 2030. During the Qualy campaign, health fairs are held in the neighbourhoods and localities adjacent to the health units supported by C-Saúde in the Nicoadala district. Various health services are made available, such as tuberculosis screening Through the Retratistas group, theatre plays are disseminated to educate the community about health careIn addition, community dialogue sessions, radio programmes and spots, theatre plays and training for community and religious leaders are carried out to increase knowledge about health and their capacity to articulate health needs with health committees and services. The Qualy campaign demonstrates a significant commitment to health promotion and community well-being in the Nicoadala district.