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Jun 28, 2024   |   Blog Post

Strengthening Provincial Response Across Mozambique Amidst Multiple Emergencies

Public Health Emergency Management Program, hosted in May by the Tete PHEOC.

By Arsenio Manhice

Manager, Advocacy & Communications

As Mozambique battles public health emergencies including cholera, cyclones and polio outbreaks, there is an opportunity for experience exchange between the country’s provinces. That is why the Tete Public Health Emergency Operations Center (PHEOC) hosted the Public Health Emergency Management (PHEM) Program in May, outlining the key concepts involved in establishing and maintaining a PHEOC to decision-makers.

With 33 participants, including Provincial Chief Medical Officers and Heads of Provincial Public Health Departments, the training was facilitated by the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and the Ministry of Health of Mozambique (MISAU), with funding from VillageReach. Following the launch of the PHEM in February 2024, it has made a crucial contribution to improving preparedness and response to health emergencies.

A call for PHEOC expansion

Dr. Xarifo Gentivo, the Chief Medical Officer of Tete Province

Dr. Xarifo Gentivo, the Chief Medical Officer of Tete Province, noted in his opening remarks the need for PHEOCs across the country, some provinces more urgently than others.

For these provinces, he said that MISAU and partners can move forward by identifying existing or underutilized infrastructure rather than starting from scratch. MISAU’s biggest challenge is the sustainability of PHEOCs, with the aspiration that these be sustained by government in the short-to-medium term.

There is also a need for more multisectoral collaboration and coordination, although significant improvements were made. “We should move from PHEM concepts to practical implementation, to set up the functional structure. PHEOC is not just a physical location, but a dedicated group of people and resources dedicated in responding to emergencies,” he said.

Dr. Filipe Murimirgua, the Central PHEOC Coordinator

Dr. Filipe Murimirgua, the Central PHEOC Coordinator, a trainer for this course, emphasized the general principles of emergency management in public health, including understanding how to develop a PHEOC, as well as the key concepts of the emergency management cycle.

“Given that this was a training for leaders of the health sector, it was great to see their interest in implementing PHEOC in their provinces, recognizing existing challenges such as lack of infrastructure, funding for emergency response, and the need to improve multisectoral coordination and collaboration,” he said.

CDC and WHO Ready to Support

CDC and WHO trainers mentioned that their organizations are ready to support Mozambique’s PHEOC implementation efforts.

Dr. Anita Odallah, CDC Global Health Security Surveillance & Emergency Management Specialist

Dr. Anita Odallah, CDC Global Health Security Surveillance & Emergency Management Specialist, noted momentum in the preparedness and response to public emergencies. “The CDC aims y, including via scientific and technical support to MISAU and partner organizations,” she said.

For the CDC, this course is important because it is aligned with the MISAU strategic priorities which are to strengthen global health security, increase health impact and build resilient public health systems.

Dr. Odallah hoped that participants learned to increase the speed of detection of diseases that threaten health security, prioritize prevention activities to reduce the impacts of health emergencies and effectively organize responses to public health issues.

Dr. Faquir Calú, a trainer from the WHO Mozambique

Dr. Faquir Calú, a trainer from the WHO Mozambique, emphasized key elements trainees should prioritize: understanding the dynamics of public health emergencies, developing leadership and decision-making skills, knowing the protocols and strategies for emergency response, and having the ability to effectively coordinate and communicate with multidisciplinary teams during public health emergencies.

Dr. Calú recommended that trainees continue to keep up to date on best practices in public health emergency management after the training. They should participate in workshops, conferences and simulation exercises to refine the skills acquired and establish networks with professionals in the field for future exchange of experiences and collaborations.

Participants Excited for Provincial Change

After the training, all participants were excited about the new concepts learned and in their own provinces.

Dr. Selma Xavier, Chief Medical Officer in Nampula province

Dr. Selma Xavier, Chief Medical Officer in Nampula province, emphasized that the training introduced the international health regulations (2005), which she was previously unfamiliar with: “I was not familiar with them. I noticed that, as a country, we still need to coordinate with other sectors, especially human health, chemistry and the atomic energy agency. I will start by creating the PHEOC organizational chart for Nampula with all stakeholders and people to activate in case of an emergency.”

Dr. Isaias Marcos, Chief Medical Officer of Zambezia, left with a detailed understanding of the criteria, conditions and staffing of a PHEOC:. In his province, he plans to focus on important aspects such as organization, planning, response, monitoring and evaluation after outbreaks.

Dr. Vânia Nhamagone, Head of the Public Health Department, mentioned that she learned something new about the incident management schedule, which was approached holistically and openly at the provincial level. It will help in implementing activities, coordinating groups and managing each area in terms of response. With the knowledge gained, her team will be able to manage emergencies effectively.

“Upon returning, I hope to implement an incident management structure and try to look more precisely at the emergency cycles. Our biggest challenge is financial and human resources because we realize that specific people are needed in each area,” said Dr. Vânia. She recommended having an incident management manual, clearly stating when incidents are activated and deactivated, for the most frequent incident types in Mozambique.

Dr. Eugênia Assuse, Head of the Public Health Department, SPS Cabo Delgado

For Dr. Eugênia Assuse, Head of the Public Health Department, SPS Cabo Delgado, the training was an interesting opportunity following the cross-country learning visit to Sierra Leone, where she learned a lot about health emergencies. The training provided additional clarity: “We clearly understand the structure and cycle of emergencies. We managed to implement an emergency response structure in Cabo Delgado, but need a guiding document,” she stated.

In Cabo Delgado, even without physical space, it is possible to have a virtual PHEOC. The training improved their ability to respond more systematically while building the right team and devising guiding documentation.

Dr. Crimildo Alberto, Head of the Public Health Department in Inhambane

Dr. Crimildo Alberto, Head of the Public Health Department in Inhambane, “understood the concepts, so we will set up a virtual PHEOC in Inhambane. However, in the future, we will seek support to establish a physical PHEOC.”

He noted that the Inhambane province had been managing public health emergencies for a long time: “Our biggest challenge is the lack of funding for the needs of a functional PHEOC. We never know how much we have in terms of financial resources. After this training, we hope that MISAU will send us guidelines on how a PHEOC is best structured.”

Looking to the Future

The PHEM training in Tete province was a successful event that emphasized the importance of sharing lessons learned in public health emergency management at a provincial level.  Participants left equipped with the tools and enthusiasm to improve the coordination, preparation and response to public health crises.

This foundation in public health emergency management paves the way not just to meet ongoing crises, but to prepare for a future where everyone has the health care needed to thrive in Mozambique.

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