PSI, a non-profi t organization based in Washington, D.C., harnesses the vitality of the private sector to address the health problems of low-income and vulnerable populations in 65 develop-ing countries. With programmes in safe water/oral rehydration, malaria, nutrition, family plan-ing countries. With programmes in safe water/oral rehydration, malaria, nutrition, family plan-ing countries. Witning and HIV/AIDS, PSI deploys commercial marketing strategies to promote health products, services and behavior that enable low-income and vulnerable people to lead healthier lives. Products and services are sold at subsidized prices rather than given away in order to motivate commercial sector involvement.
PSI in MozambiquePSI/Mozambique is an affi liate of Pop-
ulation Services International, a non-
profi t social marketing organization
with programs in over 65 developing
countries. PSI/Mozambique supports
the Government of Mozambique
in seeking to reduce the country’s
disease burden by promoting healthy
behaviors, harnessing the vitality of
the private sector to deliver health
products, and supporting capacity
building in civil society and the public
sector. With programs in HIV/AIDS,
malaria, child survival and reproduc-
tive health, PSI/Mozambique promotes products, services and behaviors that enable
low-income and vulnerable people to make informed choices and lead healthier
lives. In so doing, PSI/Mozambique also aims to reduce the burden on the public
sector in meeting health needs. Though PSI/Mozambique often assists the Ministry
of Health (MOH) and NGOs in distributing free products to those most vulnerable
to disease, some products are also sold at subsidized prices in the private sector to
ensure the widest possible availability. All sales revenue is
used to purchase more products or to support communica-
tions campaigns.
HistoryPSI/Mozambique was established in 1994 to assist the MOH
in scaling up its HIV prevention activities in four provinces
(this expanded to national scale by 1999). PSI added malaria
prevention to its portfolio in 2000 in Zambézia province,
and now supports the MOH in fi ve provinces. Technical and
managerial support to the MOH in voluntary counseling and
PSI/M
ozam
biq
ue
testing (VCT) began in 2002, and prevention of
mother to child transmission (PMTCT) services
were added in 2004. PSI also launched a safe
water program in 2004.
PeoplePSI/Mozambique employs 350 Mozambicans
and works with another 275 community-
based communications agents and actors in
theater groups trained by the program. Most
senior management positions are occupied
by Mozambicans, including all positions at
the provincial level. In-country technical as-
sistance is provided by four expatriates who
ensure that the program benefi ts from the
learning and best practices of PSI’s affi liates
worldwide. PSI invests heavily in building the
capacity of its local staff both through formal
courses and on-the-job learning in a disci-
plined, challenging environment. PSI/Mozam-
bique also invests in other capacity-building
activities such as training of peer educators
in the military, the police and national NGOs,
and supporting the training of public sector
health workers.
DonorsPSI receives funding in Mozambique from the
US Agency for International Development
(USAID) through the President’s Emergency
Plan for AIDS Relief (PEPFAR) and the Presi-
dential Malaria Initiative (PMI), the Govern-
ment of the Netherlands, the British Depart-
ment for International Development (DFID),
and UNICEF.
Coordination andPartnershipPSI/Mozambique coordinates closely with the
MOH through the National Directorate for Dis-
ease Control and Health Promotion as well as
the Provincial and District Health Directorates.
PSI/Mozambique works with the National AIDS
Council (NAC) in technical groups on com-
munications and condoms, co-implements a
workplace HIV program with the Ministry of
National Defense (MND), and has a memo-
randum of understanding with the Ministry
of Interior. PSI/Mozambique’s memoranda of
understanding with many other NGOs help to
expand the reach of communications cam-
paigns and product distribution to those most
vulnerable, particularly in rural areas with
weak commercial infrastructure.
HIVIn support of the NAC’s plan to reduce the
number of HIV infections in Mozambique,
PSI promotes healthy behaviors and seeks
to discourage harmful cultural norms such
as cross-generational sex. PSI/Mozam-
bique uses mass media and a network of
ten theater groups and 120 community-
based communications agents trained
to deliver messages targeted to specifi c
groups using local languages. Theater
and community agents reach roughly
500,000 people per year. PSI/Mozam-
bique has also worked with partners to
develop a network of several hundred
peer educators who implement targeted com-
munications programs with the military, police
and commercial sex workers. PSI/Mozambique
supports the MOH and the MND in delivering
VCT in 27 fi xed sites located in government
health facilities and in numerous satellite sites
in workplaces, communities, and schools. To-
gether these sites counsel and test over 13,000
clients per month, making PSI/Mozambique
the MOH’s largest partner in VCT service provi-
sion. PSI/Mozambique also supports PMTCT in
many of the fi xed sites, counseling and test-
ing over 35,000 pregnant women in a twelve
month period. PSI/Mozambique markets three
brands of condoms (JeitO, JeitO Aromatizado,
and Trust Studs) which are available at sub-
sidized rates in over 6,000 outlets nationally.
Sales increased by 15% in 2006 to 22 million.
The program recently teamed with the MOH
and the NAC to re-introduce female condoms
through a network of women’s groups work-
ing in the Maputo area.
MalariaPSI/Mozambique’s malaria interventions focus
on supporting the MOH to increase the use of
ITNs (including long-lasting insecticide-treated
nets or LLINs). Starting in Zambézia province
and expanding to Gaza and Sofala provinces,
the program delivers ITNs through multiple
channels: free distribution targeted to preg-
nant women at health facilities; free distribu-
tion targeted to children under fi ve delivered
through campaigns in remote areas; free dis-
tribution to orphans and vulnerable children
(OVCs) and persons living with HIV and AIDS
(PLWHA) through
NGO partners; and
sales of subsidized
LLINs in areas with
high coverage of
the most vulnerable
groups. In late 2006,
PSI/Mozambique
provided substantial
assistance to the
MOH in implement-
ing a campaign that
treated over 450,000
nets. PSI/Mozam-
bique also assists
the MOH to train
community health
workers in case
management and
treatment protocols.
Child SurvivalTo support the MOH in reducing the incidence
of diarrheal diseases, particularly amongst
children under fi ve, PSI/Mozambique launched
a safe water program with its own funding in
2004. To date, the program has sold or distrib-
uted over one million bottles of Certeza, each
of which treats enough water for a family of
fi ve for one month. PSI worked with a local
bleach manufacturer to improve its quality
control suffi ciently to produce Certeza locally.
Certeza is promoted through mass media and
community-based the-
ater, sold at a subsidized
price in markets, and
distributed for free
to the MOH in emer-
gency situations
(such as cholera out-
breaks and fl oods).
As with ITNs, PSI/
Mozambique part-
ners with local and
international NGOs
to distribute Certeza
for free to OVCs and
PLWHA, and trains
home-based care
workers in diarrheal
disease prevention.
Over 8,000 workers
have been trained
to date.
FamilyPlanning
PSI/Mozambique received funding from PSI
headquarters in 2006 to study the potential of
the commercial market to reduce the burden
on the MOH in the provision of oral contracep-
tives. A concept paper describing the introduc-
tion of a low cost oral contraceptive on the
commercial market has been produced and
formative research is under way.
PSI has an uncommon focus on measurable health impact and attempts to measure its effect on disease and death much like a business measures its return on investment. PSI/Mozambique estimates that its support to the MOH helped gain more than 400,000 disability-adjusted life years (DALYs) in 2006 – a 30% increase over 2005. The 150 million male condoms sold to date have provided more than 1.3 million couple years of protection; distribution of more than 1.4 million insecticide-treated mosquito nets has provided over two million person years of protection from malaria and averted millions of malaria episodes; and one million bottles of water treatment distributed in less than three years have resulted in more than 700,000 person years of safe water. In addition to these distribution-based indicators, PSI/Mozambique also fields market-based surveys to measure the availability of condoms, ITNs, and safe water, and population-based surveys to measure changes in reported use.
Health Impact
PSI/Mozambique Avenida Lucas Elias Kumato, #33Maputo, Mozambique tel: (+258) 21 485 025(-8)fax: (+258) 21 485 [email protected]/mozambique