Mozambique (a country on the south-eastern coast of Africa) is a nested beauty surrounded by great coastlines and abundant wildlife and images. It has a diverse range of culture embraced by its warm hearted and welcoming people. Despite such lovely descriptions, Mozambique is heavily faced with public health challenges. Malaria is commonly one of such public health issues in Mozambique that is imperative to be addressed, especially due to its cause which is a mosquitos’ infestation in tropical climates. It is an endemic disease, which means that Mozambique remains vulnerable to wide spread malaria outbreaks. There have been successes, failures and challenges in such fight against malaria in the country for decades. This article explores Mozambique’s response to malaria breakouts; a situation aimed at outlining the challenges Mozambique faces, the initiativesating this persistent threat, and the outputs achieved in sustaining a resilience against this deadly killer disease.
Understanding Malaria in Mozambique
What is Malaria?
Malaria is a serious and often fatal disease caused by a parasite that is transmitted to people through the bites of mosquitoes. The most common symptoms of malaria are fever, chills and flu-like illness. If not promptly treated, malaria can result in severe illness and death. Malaria is preventable and curable, and simple and effective methods exist for skin testing, diagnosis, and treatment.
In endemic regions, malaria is transmitted by the female Anopheles mosquito, mainly between dusk and dawn. The mosquito picks up the parasite when feeding on a person who carries the parasite in his or her blood. It is contacted by the bite of a mosquito. Malaria caused by Plasmodium falciparium is the most deadly. Malaria can be prevented by using insect repellents and covering your clothing. There is currently no vaccine available to prevent malaria.
The proportion of the population in Mozambique living in areas at risk of malaria is 98%. Since Mozambique has a tropical climate and its elevation rises slowly, the disease is prevalent in the country.
The Impact of Malaria in Mozambique
In Mozambique, malaria is still one of the primary causes of illness and death. Transmission rates are very high; it’s estimated that more than 7 million cases occur each year and, correspondingly – because of its impact on health, lost work, and increased poverty – it has become a central challenge for national economic development. Children under five and pregnant women are most affected.
Challenges in Combating Malaria
Geographical and Environmental Factors
Its long coastline and many wetlands and forests provide perfect conditions for the mosquitoes that carry malaria, and its climate encourages large choking clouds of hungry insects in the hot moist summer rains.
Health Infrastructure Limitations
Despite efforts to improve access to healthcare services, Mozambique’s health infrastructure remains stretched thin. The country faces low access to medical facilities, a shortage of trained health workers, and a lack of supplies challenges that hinder timely treatment and prevention of malaria.
Socioeconomic Factors
Poverty and poor sanitation remain key hurdles in the fight against malaria. Many communities in Mozambique lack access to drinking water and sanitation services, allowing water to serve as a breeding ground for mosquitoes. Economic constraints create shortages in health services, including essential antimalarial drugs, and reduce the availability of mosquito control measures.
Strategies for Malaria Prevention and Control
Vector Control Measures
- Insecticide-Treated Nets (ITNs) are coated with insecticides that kill mosquitoes and keep them away from sleepers. The main strategy for malaria prevention has focused on the widespread distribution of ITNs. Mozambique has conducted widespread ITN distribution campaigns, making sure that at-risk populations such as children and pregnant women have easy access to these protective tools.
- Indoor Residual Spraying (IRS): Spraying the walls of homes with insecticide kills mosquitoes when they rest there. It’s a highly effective anti-malaria intervention and has greatly reduced transmission in many areas of Mozambique. IRS has focused on multiple campaigns in numerous districts across Mozambique, targeting high-risk areas to ensure optimal impact.
- Larval Source Management (LSM): Focuses on reducing sites where mosquitoes breed, or where they lay their eggs. This includes operations such as draining puddles of water and treating water bodies with larvicide to prevent mosquito larvae from maturing into flying adults. Mozambique: LSM involves draining stagnant water and using larvicide.
Early Diagnosis and Treatment
- Rapid Diagnostic Tests (RDTs): Malaria cases can only be treated effectively if diagnosis is quick and accurate. Diagnosis using RDTs are portable tests that can quickly show whether someone has malaria or not. This improves treatment. Through the Seven for Life program, Mozambique has expanded access to RDTs in health facilities and community health programs.
- Artemisinin-Based Combination Therapies (ACTs): The standard treatment for uncomplicated malaria is ACT. Mozambique has made concerted efforts to ensure a steady stream of ACTs for those in need. These drugs combine different drugs that together work better and offer a reduced risk of resistance.
Public Awareness and Education
Simply spreading the word about malaria prophylaxis and treatment will help control the disease. Several campaigns have focused on education in Mozambique. People learn the value of ITNs and how to use them, the importance of seeking medical care as soon as they show symptoms, and the need to practice good sanitation. An important part of this campaign has been to employ community health workers to bring education into the communities. These community health workers operate at the grassroots level and can provide immediate support and information.
Strengthening Healthcare Systems
- Health Infrastructure Improvement: Mitigate the shortcomings of the health system through investments in infrastructure upgrades, greater numbers of health workers, and strengthened supply chains for essential medicines and diagnostics.
- Training and Capacity Building: A program for training health workers, nurses, and physicians improves the capacity for malaria diagnosis and treatment. Mozambique has been involved in building the capacity of healthcare workers with skills for malaria detection and treatment.
- Partnerships and Collaboration: Mozambique has collaborated with world organizations, non-governmental organizations (NGOs), and donor agencies such as WHO, Global Fund, and others, to better control malaria. Such collaborative partnerships have been highly instrumental in providing technical support and financial and resource funding for malaria control and prevention programs throughout the country.
Success Stories and Progress
Reductions in Malaria Incidence
Since the 1990s, malaria incidence has been reduced by half in Mozambique due to intense actions to control the mosquito vectors, increased access to diagnostics and treatments, as well as improvement in public awareness. A few illustrative examples are the impact of ITNs and IRS scaling up on malaria transmission in different parts of Mozambique.
Community Empowerment
Community-based approaches can directly enhance malaria control. When communities engage in malaria prevention efforts, ITN usage increases, sanitation improves, and awareness of malaria risks grows. Community health workers and other local leaders can mobilize resources and change behavior.
Research and Innovation
Malaria research and innovation are also taking place in Mozambique. Studies into new drugs for malaria and clinical trials of vaccines and new mosquito control technologies mark the start of a mission to shore up malaria control for the coming decades. Mozambique is committed to the long-term development of science and innovation that will be essential to eventual malaria elimination.
The Path Forward: Building Resilience Against Malaria
Continued Investment in Prevention and Treatment
If Mozambique is to keep the momentum of its gains in malaria control, it can’t reduce investment in prevention and treatment. Coverage of ITNs will need to remain high, along with indoor residual spraying, and the availability and affordability of diagnostics and treatments will have to keep pace with need, particularly in the poorest sectors of the population. Vulnerability to malaria is not going to disappear from Mozambique any time soon. However, the country does seem to have put in place the necessary health infrastructure and geospatial tools to make headway at the local level.
Enhancing Surveillance and Response Systems
In order to get rid of malaria outbreaks quickly, there is a need to strengthen the surveillance systems in order to monitor outbreaks. Mozambique must lift its capacity to monitor regionally malaria situation, identifying all outbreaks hotspots, but especially the ones emerging over a limited period of time.Contributing writer: Retsepile Lekotokoane
Addressing Socioeconomic Determinants
Without addressing many of the socioeconomic determinants of malaria, such as clean water and sanitation, and without getting children into schools, we are undermining our prospects of long-term success. Integrating malaria control strategies into broader development efforts is essential.
Fostering International Collaboration
Global collaboration remains essential for malaria control. Mozambique should continue to collaborate with the international community by sharing best practices and involving itself in collaborative research initiatives. Mozambique would benefit from international support and expertise to strengthen the country’s fight against malaria.
Mozambique’s response to malaria outbreaks thus encapsulates a coordinated, multifaceted approach to tackle an enduring public health scourge. In particular, a combination of vector control, early diagnosis and treatment, public education, and healthcare system strengthening have helped to reduce the impact. While there is no reason to think that ongoing challenges and periodic setbacks shouldn’t be prodded into remission, it is important to acknowledge that this is, indeed, what Mozambicans and their international partners have accomplished thus far. Furthermore, moving closer to elimination and eradication is within reach through targeted investment in prevention and treatment, addressing underlying socioeconomic determinants, and building global solidarity.
