Improving maternal and child health and family planning

Mozambique’s maternal mortality rates have been stagnating for several years, at approximately 408 maternal deaths per 100,000 live births. Even with improvements in child health, nearly one in 10 children do not survive until their fifth birthday. Also, a leading cause of child deaths remains vaccine-preventable diseases such as pneumonia, diarrhoea and measles.

For Dr Dulce Nhassico, the United States Agency for International Development (USAID) team lead for Maternal and Child Health and Family Planning in Mozambique, the situation is not acceptable.

Dr Nhassico’s work focuses on eradicating preventable maternal and child mortality, a priority under the United Nations’ Sustainable Development Goal 3, good health and wellbeing. She is determined to combat some of her country’s major health challenges, including preventing maternal, new-born and infant mortality.

Under Dr Nhassico’s leadership, USAID Mozambique supports the Mozambican Government to combat some of the country’s health challenges. It does so by working through local and international non-government organisations.

In her work, Dr Nhassico relies on knowledge and skills developed while completing her Master of Public Health and Nutrition degree from the University of Queensland in 2010. As a public health professional, Dr Nhassico relies on the communication and analytical skills gained during her scholarship to design, develop and support the implementation of health programs. Her work in Nampula Province, for example, has already benefited three million people, including women of reproductive age, pregnant women, new-borns and children under five. Also, in Nampula, 80 per cent of children diagnosed with diarrhoea and around 97%  with pneumonia have been treated in USAID-assisted health facilities.

Dr Nhassico is also dedicated to making children safe from vaccine-preventable diseases. New vaccines for diseases like rotavirus, inactivated polio and measles-rubella are now available in Mozambique. As a vaccine champion, Dr Nhassico coordinated the nationwide upgrade of cold chain vaccine equipment in partnership with the United Nations Children and Education Fund (UNICEF). She also organised the US Government’s support for polio outbreak response in Nampula and Zambézia provinces.

Developing health policies through strategic partnerships with Mozambique’s Ministry of Health, UNICEF and the World Health Organization are key. Dr Nhassico believes investing in healthcare facilities, including by providing adequate technical assistance, equipment, commodities and patient-centred services, will further reduce maternal, neonatal, and child mortality in her country.

“It’s rewarding to see more children celebrate their fifth birthday because they’ve been vaccinated and women have received better quality services and opted to give birth at health facilities,” says Dr Nhassico.

Dr Nhassico’s work has led to great gains. Today, more women in underserved communities have access to family planning services, four antenatal consultations and institutional delivery. Indeed, the percentage of pregnant women accessing institutional delivery increased to 90 per cent in the last five years alone in USAID-supported health facilities compared to the national average of 70 per cent.

In addition to developing technical skills, Dr Nhassico’s mindset on gender equality and inclusiveness shifted while studying in Australia.

“Back then, in my country, gender awareness existed but with minimal practical impact,” says Dr Nhassico. “When in Australia I saw how gender equality supports society. Policies are important but I saw first-hand how an inclusive society operates and the benefits resulting when people can express their views, values and beliefs, especially women and other vulnerable groups.”

Dr Nhassico’s Australian studies and experiences have made her a stronger advocate for cultural and gender issues in USAID’s maternal and child health and family planning programs. “We want more women to practice birth control, more pregnant women to attend appropriate antenatal care and more skilled birth attendants to help with deliveries”, says Dr Nhassico.

The statistics surrounding Dr Nhassico’s work speak for themselves.

The percentage of women of reproductive age or whose partner is using contraception, increased from 11 per cent in 2011 to 25.3 per cent in 2015, and figures continue to improve. In 2019, the number of community health workers trained and deployed nationwide increased by 40 per cent, resulting in around 167,000 women of reproductive age using contraception at community level. Awareness campaigns on birth control options are empowering women to make better decisions for their families and communities.

Dr Nhassico continues to be a leading light in promoting maternal and child health and improving the health of some of the poorest and rural communities in Mozambique. Her notable work will a positive impact on health systems and the lives of women and children for years to come.

Photo Credit: Dr Dulce Nhassico

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