Mozambique
Country Context
According to the World Malaria Report 2022, Mozambique was one of the four countries in the African Region with more malaria cases reported globally. The entire country is considered to be at risk for malaria, but transmission dynamics are strongly influenced by geography and climate, with the highest risk occurring in the northern and coastal areas of the country. A significant proportion of the Mozambican population (about 77%) remains at increased risk of becoming ill by living in districts with malaria incidence above 100 cases per 1000 population. In 2022, 27% of outpatient visits and 38% of hospital admissions were due to malaria. However, important progress in in-hospital mortality from malaria has been achieved in recent years, with a 48% reduction from 2017-2022.
In November 2022, the Minister of Health approved chemoprevention as an intervention for malaria control in Mozambique and it is being considered for the inclusion in the next National Malaria Strategic Plan 2023 – 2030.
PMC Model
Following the updated WHO guidelines published in June 2022, the National Malaria Control Program (NMCP) organized a workshop from June 21 to 24 with the participation of other stakeholders, including the Family Health Department, EPI, Nutrition, Community Health Workers National Program and Sofala Province Health Directorate Representatives.
As a result of this co-design workshop, the 4-dose model for Mozambique was defined, as illustrated in the figure below. The choice of the model was based on the country’s evidence regarding the epidemiological profile of malaria in children under 5 years of age, and the coverage of the opportunities for children to contact the health facility. SP is being administered at Health Child Consultation (HCC) visits. Of note, NMCP decided to start with 4 doses but, opening the possibility to review and increase the number of doses in the coming years based on evidence.
In February 2023, the NMCP obtained approval from the Minister of Health to introduce the Perennial Malaria Chemoprevention (PMC) Strategy in the country, in accordance with WHO guidelines published in June 2022 and the 4-contact model which had been developed for Mozambique. This approval was preceded by a favorable opinion from the Malaria Technical and Consultative Committee (CTCM) who also gave their recommendations during the process.