When a clinic is very far away, a child can grow up without a single vaccine. In parts of Gurué District in Mozambique’s Zambézia Province, families live far from the nearest health facility. The journey takes hours on rough roads. Many cannot make it. Children miss routine vaccinations, while some never receive a first dose at all.
José Tinta drives that same road, but in the opposite direction. As Namuli program manager at Legado, an international nonprofit supporting community-led development, he leads a team working to bring health services closer to these families. Together with the District Health Service (SDSMAS) and VillageReach, the team supports integrated mobile brigades that take vaccines and primary health care into communities in hard-to-reach areas.
Reaching children who have missed out
The partnership started when Legado wanted to vaccinate children in Gurué and had identified mobile brigades as a way to reach Namuli. What it needed was a connection to the district health system and a partner with experience delivering services in places that are difficult to reach. VillageReach opened that door, connecting Legado to SDSMAS and sharing its experience with mobile brigades. That connection gave the organizations a way to combine their efforts.
Community agents tell families when the brigades are coming. Mothers bring their children and health workers provide vaccinations and basic care close to home. VillageReach helps the partners document what works, learn together and strengthen demand for these services.
“VillageReach has been part of these integrated brigades with the goal of supporting the documentation of best practices, promoting collaborative learning and identifying opportunities to strengthen demand for vaccination services and primary health care,” Tinta explains.
During a recent visit to Nawitela and Murrui, mothers brought their children for vaccination. For Tinta, the clearest sign of progress is reaching people who had previously missed out entirely.
“The most visible and inspiring impact of this partnership,” Tinta notes, “is bringing vaccination to people who, until now, had never received a single dose in their lives.”
Children with their mothers on a line for vaccination. Photo credit: Arsenio Manhice
Making care last beyond the next visit
For the Legado team, these visits show what mobile brigades can achieve under difficult conditions. Seeing services reach isolated communities has also prompted a bigger question: How can care in Namuli become more dependable between visits?
Communities and health managers have begun discussing building a permanent health center. While mobile brigades bring care closer for a day, a permanent facility could give families somewhere nearby to turn throughout the year.
Tinta identifies more frequent brigade visits as a priority. Health professionals making the journey need subsidies and better working conditions, while the brigades need stronger operational support to reach the most vulnerable households consistently.
Community health agents also need regular refresher training and ongoing monitoring to support the quality of their work between visits. As these services develop, another change is taking shape: preparing local people to take greater responsibility for leading them.
Legado is planning to gradually reduce its direct presence. Its aim is to leave the community ready to lead, with the skills and relationships to sustain the work. The plan focuses on training members of the Montes Namuli association, preparing them to run health initiatives and connecting them directly with VillageReach and other partners.
Local associations are already active in Montes Namuli. Strengthening those existing groups gives the transition a place to start. But handing over responsibility takes preparation and community leadership still needs support.
Tinta sees continued collaboration with VillageReach as essential, particularly through a direct relationship with the community association. VillageReach helped launch the region’s first mobile health teams. Building on that relationship could help local leaders continue activities as Legado steps back.
A child’s first vaccine should be the beginning of regular care. In Namuli, the next step is to make brigade visits more frequent and equip local health workers and community leaders to sustain services, so families can count on care as their children grow.