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Mozambique

In Mozambique, protecting children and mothers from malaria

By Ruth Ayisi

This year, Africa Malaria Day, 25 April, is focused on global action for both prevention and treatment of the deadly disease. Here is an update on anti-malaria efforts in Mozambique.

XAI XAI, Mozambique, 24 April 2007 - Zaida Alvero tenderly strokes the forehead of her frail five-month-old baby, Julieta, who lies almost lifeless on a hospital bed in intensive care with a tube inserted in her nose to help her breathe.

Ms. Alvero has camped at the hospital for 10 days now. Her daughter is severely ill with malaria.

Julieta's doctor is pessimistic, explaining that her condition is serious. "We moved her to intensive care because she is not getting any better," the doctor says.

Effects on child survival

More children die of malaria than any other disease in Mozambique. It accounts for 60 per cent of paediatric hospital admissions and 30 per cent of hospital deaths. And it is a major reason why Mozambique still has one of the world's highest child mortality rates.

Malaria is also deadly for pregnant women, who run the risk of severe anaemia, which can be fatal. In addition, malaria contracted during pregnancy can lead to low birth weight - one of the most important factors in determining a child's future survival.

There is no easy way to fight malaria, which is endemic throughout the country. The climate favours year-round transmission, with peak incidence during the rainy season.

Bednets cut transmission

To prevent the spread of malaria, the government carries out free distribution of insecticide-treated nets (ITN) to all pregnant women and to children under the age of five in many of the provinces. The bednets are an effective and cheap method of fighting malaria by preventing mosquito bites (which transmit the disease) and killing the mosquitoes.

"Not only will a pregnant woman benefit from using the net, but so will her child, because most new mothers sleep with their babies for the first few years of life," points out UNICEF Officer for Malaria Timothy Freeman.

According to the World Health Organization, ITNs can cut malaria transmission by at least 60 per cent and child deaths by a fifth if the nets are used properly. However, for maximum protection they must be used in conjunction with improved sanitation and hygiene practices. Even then, if malarial symptoms develop, prompt treatment can reduce the mortality rate.

Since 2000, some 1.7 million ITNs have been distributed through the public health system in Mozambique. Two-thirds of those nets have been delivered via UNICEF-supported programmes in about 60 per cent of the country's districts.

More ITNs for new mothers

The good news is that children slowly gain immunity against malaria, making it unlikely that they will die of the disease after the age of five, unless there is another condition - such as HIV/AIDS - that compromises their immune system.

But information about malaria does not reach a significant number of pregnant women and mothers of young children, especially if they do not attend prenatal clinics. "I have never used a mosquito net because I didn't have money to buy one," says Ms. Alvero, looking anxiously at motionless young Julieta.

At a health centre in the poor suburbs of Xai Xai, nurse Francisco Victoria says she makes sure that all pregnant women receive a bednet. She takes her time with each of them to explain how to treat and use it. "I tell them first and then I get them to explain to me to make sure they have understood well," she notes.

Nelia, 17, received her net from Ms. Victoria at the health centre. "I am relieved to have a net," says the teenager, who became pregnant while still in school. "I cannot afford to get sick with malaria."