Outline of the Project

Project Name

The Project for Strengthening Maternal and Child Nutrition Services (ProNUT)

Country

Mozambique

Date R/D Signed

January 29, 2020

Project Site

Gaza province and Niassa province in Mozambique

Term of Cooperation

From May 13, 2021 to May 12, 2025

Implementing Organization

Ministry of Health

Background

In Mozambique, the maternal mortality rate is 289 per 100,000 live births, the neonatal mortality rate is 28.5 per 1,000 live births, and the under-five mortality rate is 74.2 per 1,000 live births (UNICEF, 2019). One of the underlying causes for the above situation is the high prevalence of chronic malnutrition in Mozambique. According to WHO, around 45% of deaths of children under five years of age are linked to undernutrition (WHO, 2021). However, over the past 20 years, the chronic malnutrition rate in Mozambique has been approximately 40%, without any signs of improvement.

Improving MCH and nutritional status is one of Mozambique's priority agendas outlined in the Five-year Program (2015-2019) and the Health Sector Strategic Plan (2014-2019). The goal is to reduce morbidity and mortality in women through expanding and improving maternal health services and to reduce the same in children through improving their nutritional status.

In response to the request from the Ministry of Health of Mozambique, Japan International Cooperation Agency (JICA) dispatched a project formulation mission to Mozambique in 2019 and made a mutual agreement for the initiation of a three-year technical cooperation project to assist the government in achieving the goal.

The Project is expected to integrate the maternal handbook and the child health card into the MCH handbook and develop a model for strengthening maternal and child nutrition services by utilizing the MCH handbook in line with the national policy and strategy. In addition, the Project will groom health workers and community health workers (APEs) for operationalizing the model at health facilities and communities.

The Project targets two provinces: Gaza and Niassa. In Gaza, a single sector (health) approach will be applied. On the other hand, in Niassa, a multi-sectoral collaboration among health, agriculture, water and sanitation will be promoted among the JICA projects.

The Project intends to make the model suitable for areas with different geographic and socioeconomic characteristics by piloting the model in the two provinces.

(The description of the project outline below is based on the initial bilateral agreement and could be modified in the course of implementation.)

The Overall Goal

1) Prevalence of maternal and child undernutrition is reduced in the target provinces.
2) MCH Handbook (MCHHB)-based nutrition service model is scaled up nationwide.

Project Purpose

MCHHB-based nutrition service model (The Model[*]) is developed.

[*] MCHHB-based nutrition service model is defined as a set of activities for facility-based and community-based nutrition services to be composed of: (i) MCHHB; (ii) minimum nutrition service package; (iii) monitoring and supportive supervision.

Output

1. The Model is operationalized in the target provinces, for its subsequent nationwide scaling-up.
2. Health workers are capable enough to provide facility-based nutrition services, by using the MCHHB.
3. APEs are capable enough to provide community-based nutrition services, by using the MCHHB.

Project Activities

(Activities for Output 1)

1-1.	Conduct technical working group meetings for the MCHHB designing and the Model
1-2.	Develop the Model
1-3.	Develop an operation guide for the Model
1-4.	Print and distribute the MCHHB and its operation guide to health facilities
1-5.	Monitor and supervise the MCHHB logistics up to health facilities for its sustainable supply
1-6.	Develop the nationwide scaling-up strategies of the Model (including plan for integration of the Model into BCC Guidelines)

(Activities for Output 2)

2-1.	Develop the training materials of the Model for health workers
2-2.	Train health workers on the Model
2-3.	Ensure availability of equipment/tools necessary for implementing the Model at health facilities
2-4.	Conduct monitoring and supportive supervision for health workers' practices

(Activities for Output 3)

3-1.	Develop the training materials of the Model for APEs
3-2.	Train APEs on the Model
3-3.	Ensure availability of MCHHB/tools necessary for implementing the Model by APEs
3-4.	Assist APEs in undertaking community-based multi-sectoral nutrition activities
3-5.	Conduct monitoring and supportive supervision for APEs' practices

Inputs

[Japanese side]

1. Long-term experts: Chief Advisor, Community Nutrition/Maternal and Child Health, Project Coordinator
2. Short-term expert(s)
3. Counterpart training in Japan or third country(-ies)
4. Equipment necessary for implementing the Project's activities
5. Operational expenses necessary for implementing the Project's activities (e.g. printing materials, conducting training and workshops

Inputs

[Mozambique side]

1. Counterpart personnel
2. Suitable office spaces for the Project in Maputo, Lichinga and Xai-Xai
3. Utility expenses for the Project offices
4. Personnel and travel costs for counterparts