CLIP Site Visit: Maputo and Manhica, Mozambique

Peter von Dadeleszen undertook a site visit to Maputo and Manhiça on 21-24 October 2013.  We extremely grateful for the hospitality shown by the CISM, the CLIP Mozambique team as well for the opportunity to be present during discussions with the National Public Health Directorate, Ministry of Health and the participation of Dr Teresa Mapasse, National Director of the CHW Programme.

The site visit was productive allowing for discussion on the CLIP Feasibility Study in Mozambique. The Feasibility Study had already begun collecting data in Calanga, with 5 APE IDIs completed prior to this site visit.  Dr Cassimo Bique participated in the visit to CISM on 23 October 2014.  He expressed strong support of the CLIP Trial to the attendees at the meeting at CISM; in particular he expressed support for the potential for task-shifting of i.m. MgSO4 administration to APEs within the context of the CLIP Trial.

The National Public Health Director was generally supportive of the CLIP trial, including the proposed role of APEs within the protocol, but requested an ongoing dialogue and that the Directorate be kept informed as the Feasibility Study become known and as the CLIP Trial commencement draws close. Peter described the broader long term vision for an integrated MNCH mHealth platform that could be introduced should CLIP, with its relatively narrow focus on pre-eclampsia, be successful. 

Dr Teresa Mapasse travelled to Manhiça on 23 October and presented articulately and passionately in support of CLIP to a mixed audience of APEs, APE supervisors, medical assistants, and community leaders.  Dr Mapasse appears to support the full utilisation of APEs as proposed for CLIP once we have determined their capacity to learn and adapt to the proposed role. Peter undertook discussion on data collection, drugs and devices and other trial related activities. The immediate and intermediate goals are to complete the CLIP Feasibility Study and Trial that have a particular focus on pre-eclampsia.  However, the CLIP model of mHealth- and outcome prediction model-supported community level healthcare provision is generalisable across the spectrum of contraception provision, maternity and child health.  There appears to be support amongst Mozambican decision makers for this broader long term initiative.