African Health Initiative

The African Health Initiative (AHI) seeks to catalyze significant advances in strengthening health systems by supporting partnerships that will design, implement and evaluate large-scale models of care that link implementation research and workforce training directly to the delivery of integrated primary healthcare in sub-Saharan Africa. This page summarizes one of five Population Health Implementation and Training (PHIT) Partnership projects that were supported through the AHI.

Strengthening Integrated Primary Health Care in Sofala Province, Mozambique

Grantee Institution:

Health Alliance International

Team Leaders:

• Kenneth Sherr, Ph.D., M.P.H
  Health Alliance International

• Maria de Fatima Cuembelo, M.D., M.P.H.
  Eduardo Mondlane University, Mozambique

Project Summary:

The Mozambique PHIT Partnership, a consortium comprised of the Mozambique Ministry of Health, Health Alliance International at the University of Washington and the Eduardo Mondlane University School of Medicine, aimed to improve and integrate Primary Health Care (PHC) service delivery at over 140 health facilities in Sofala Province, Mozambique (population 1.8 million). This seven-year project was built upon 25 years of collaboration for PHC service delivery through the public sector in central Mozambique.

The Mozambique PHIT Partnership project objective was to strengthen integrated health systems management at district and provincial levels through in-service training and continuous mentoring by project staff—with the recognition that training alone is inadequate to lead to sustainable capacity improvements. Building capacity to plan and manage the health system at the district level is important for ensuring that essential system resources are appropriately and efficiently distributed to health facilities. The other project objectives were to improve the quality of routine data and develop appropriate tools to facilitate decision-making for provincial and district managers, and to build capacity to design and conduct innovative operations research in order to guide integration and system-strengthening efforts.

In order to determine its impact on health system performance and the health of the population of Sofala province, a robust evaluation approach was built into the project. Using routine, provincially representative surveys, the evaluation approach compared population-level health service coverage, utilization and health status indicators between Sofala (where the PHIT project activities were conducted) and a neighboring control province (Manica) at multiple time points before and throughout the project timeframe. Supplemental data collection through ongoing health facility surveys, patient satisfaction surveys, time-in-motion studies, as well as through the routine health and financial information systems and ongoing project outputs, allowed for determining the effect of the Mozambique PHIT project on health system functioning across the World Health Organization (WHO) 6 building blocks.

To view publications about this project, please visit the Phase 1: Mozambique PHIT Partnership Publications page.

Read about the other four Phase 1 PHIT Partnership projects by visiting the links below: