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 029generalinfo@psi.org.mzwww.psi.org/mozambique