Country Statement
Mozambique is a country in Southeast Africa with an extensive coastline that stretches 2,515 km along the south east and east coast of Africa. Its population according to the 2017 census is 27.9 million, of which 48.7% are males and 51.3% are females. About 45% of the total Mozambique’s population is under 15 years old. According to the Mozambique Poverty Reduction Strategic Program (PARPAII), only 36% of people have access to a health facility within 30 minutes of their homes. About 30% of the population are not able to access health services and only 50% have access to an acceptable level of health care. [1]
Program Statement
Mozambique Eyecare Project (MEP) began in 2009 in partnership with Dublin Institute of Technology (DIT), Ulster University, Lurio University and the Mozambique Ministry of Health (MISAU). It encompassed the establishment of the school of optometry at Unilurio, research and service delivery improvement through infrastructure strengthening. The overall goal of the project was to contribute to the reduction of poverty, inequality and exclusion in Lusophone Africa through a cohesive programme of strategic cooperation that capacitates higher education and research institutions in the South through collaboration with those in the North to contribute to addressing eye health challenges in Africa.
Project Objectives;
- Establishment of a regional school of optometry for Portuguese speaking Africa to improve access to training opportunities for eye health professionals in Lusophone Africa
- Development of eye health services and infrastructure in the form of Vision Centres
- Improve existing infrastructure within government hospitals by refurbishing existing clinics and providing the necessary equipment.
- Strengthen the existing systems such as referral and data collection to improve access to eye health services.
- Improve access (both distance and affordability) to refractive errors services especially for the poor
- Provide support for the recognition and regulation of optometry as a profession by the government of Mozambique
- Advocacy for the Ministry of Health to create optometry posts and employment of optometrists in the public sector
Program Highlights
Research
A Rapid Assessment of Refractive Errors (RARE)[2] was conducted in Nampula province in 2013. The purpose of the study was to determine the prevalence of uncorrected refractive error (URE) including presbyopia, assess spectacle coverage, and to evaluate visual health-related quality of life among persons aged 15–50 years old in the province. The research findings indicated that URE prevalence was 2.6% while presbyopia prevalence was 25.8%. The spectacle coverage for uncorrected refractive error was 0% while for presbyopia was 2.2%. Although the research was conducted after the MEP project had begun, the findings reaffirmed the need for the project to support the development and delivery of a comprehensive refractive errors service in Nampula province and the entire country.
School of Optometry
The School of Optometry at Lurio University (Universadade de Lurio) in Nampula province was set up to address the critical shortage of eye health workforce needed to address uncorrected refractive errors in Portuguese speaking African countries of Mozambique, Angola, Guinea Bissau and Cape Verde. It was strategically set up to be a regional school that would provide training opportunities for optometrists in all these countries. To date it remains the only institution training optometrists in Portuguese speaking African countries.
The initial phase of the project focused on setting up the infrastructure and systems needed to run the degree course at the university such as adequate and appropriate availability of teaching and learning resources to ensure the quality of the teaching. To date over 300 Mozambican optometrists have graduated and are providing services across the country.
Vision Centres
The Institute has supported the Ministry of Health to transform the existing districts hospitals into fully functioning eye units that also offer comprehensive refractive errors services. Six Vision Centres were set up in Nampula, Beira, Quelimane, Tete and Matola Provincial Hospitals as well as at the Central Hospital of Maputo.
Each hospital was provided with equipment for clinical assessment, cutting and fitting spectacles and for dispensing. Start-up stock of frames and lenses were also provided to each hospital.
Advocacy
Together with the Mozambique NGOs Eyecare Coalition, the Foundation advocated for the recognition of optometry as a profession in the country and creation of posts by the Ministry of Public Works. This step would enable the Ministry of Health (MISAU) employ the graduating optometrists. Recognizing, registering and regulating the optometry cadre and employing them in the government hospitals will ensure permanent continuity of services as they will be included in the essential services at the hospitals. As a result MISAU is gradually employing the optometrists graduation from Unilurio and distributing them to various hospitals across the country.
References
- [1] https://www.who.int/cuntries/moz/areas/health_system/en/index1.html
- [2] James Loughman, Lindelwa L. Nxele, Cesar Faria, Stephen Thompson, Prasidh Ramson, Farai Chinanayi, and Kovin S. Naidoo