Maternal and Child Health Care Service Disruptions and Recovery in Mozambique After Cyclone Idai: An Uncontrolled Interrupted Time Series Analysis

Fernandes, Quinhas; Augusto, Orvalho; Chicumbe, Sérgio; Anselmi, Laura; Wagenaar, Bradley H.; Marlene, Rosa; Agostinho, Sãozinha; Gimbel, Sarah; Pfeiffer, James; Inguane, Celso; Uetela, Dorlim Moiana; Crocker, Jonny; Ramiro, Isaías; Matsinhe, Benigna; Tembe, Stélio; Carimo, Naziat; Gloyd, Stephen; Manhiça, Ivan; Tavede, Esperança; Felimone, Priscilla; Sherr, Kenneth

doi:10.9745/ghsp-d-21-00796

Cited by 5 publications

(6 citation statements)

References 36 publications

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“… 8 Fernandes et al performed an analysis of routine health data from 4 districts in Central Mozambique, reflecting the periods before and after Cyclone Idai in 2019. 37 The analysis demonstrates a rapid rebound of service utilization levels in the cyclone’s aftermath, which suggests that the AHI’s investment in strengthening district management systems had a positive effect on health systems resiliency after a devastating shock. From the AHPSR, Cambe et al illustrate the challenging context of supporting research utilization in policy contexts.…”

Section: Helping Primary Health Care Systems Bridge the Know-do Gapmentioning

confidence: 97%

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

Baynes¹,

Adedokun

Awoonor-Williams

et al. 2022

Glob Health Sci Pract

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Section: Helping Primary Health Care Systems Bridge the Know-do Gapmentioning

confidence: 97%

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

Baynes¹,

Adedokun

Awoonor-Williams

et al. 2022

Glob Health Sci Pract

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“…For instance, there was an 11.0% immediate relative loss in first antenatal care visits in March, with Sofala province experiencing a higher loss of 17%. Overall, the administration of BCG vaccines dropped by 10.0% (32). Although service delivery levels appeared to return to normal by May 2019, it is important to note that this recovery may not indicate a complete restoration, as there was a need to recover the losses incurred during the affected months.…”

Section: Direct and Indirect Health Impactmentioning

confidence: 99%

Addressing health care disruption in rural Mozambique due to extreme climate events: mobile units tackling cyclones, vaccine-preventable diseases, and beyond

Rossi,

Formenti,

Cerini

et al. 2024

Front. Trop. Dis

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Floods, and cyclones are occurring with increasing frequency and intensity worldwide due to global warming. Mozambique is very susceptible to these extreme events due to its geographical location. In the last ten years, four of the most severe extreme climatic events have been observed in this country, leading to widespread destruction of infrastructure and the displacement of inhabitants. Cyclones Dineo in 2017, Idai and Kenneth in 2019 and recently Freddy in 2023 affected in total over two million people impacting food and water security, causing cholera outbreaks and damage to health facilities. The mobile health units, known as Brigadas Móveis (BM), are crucial to the Mozambican health system as they provide people in the most remote areas with vaccinations, and antimalarials, and other interventions. The BM activities in five districts of Inhambane province in the south of Mozambique are run by the NGO Medicus Mundi Italia in collaboration with the local health authorities. Cyclone Freddy flooded the province of Inhambane, affecting road accessibility and the BM’s planned operations in all five districts with a loss of 37.8% of BM outreach activities. The temporary absence of the BM service resulted in rural communities having no access to health care, including routine vaccine administration. Adaptation strategies need to be implemented to address the healthcare challenges associated with extreme climate events. As described in our experience in Inhambane, BM restored outreach activities immediately after the cyclone, improving access to care after challenging situations.

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“…However, limitations in surveillance systems make such data rare. Tropical cyclones are an example of extreme weather events repeatedly shown to disrupt health systems for weeks to months following the event (21)(22)(23)(24)(25)(26). Madagascar, our focus here, is subject to regular tropical cyclones (Figure 1), resulting in widespread destruction, population displacement, and damage to healthcare-related infrastructure (Data S1).…”

Section: Main Textmentioning

confidence: 99%

Evidence from Madagascar shows that vaccination could mitigate climate-driven disruptions to malaria control

Rice,

Raobson,

Miharisoa

et al. 2024

Preprint

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Increasingly extreme weather events in high malaria burden areas threaten progress to disease control targets. Yet, data on the impact of these events on control programs remain rare. Using unique data from Madagascar, we estimate high rates of infection in the wake of two major tropical cyclones. Evidence that infection rebounds rapidly during gaps in interventions indicates maintaining continuity of coverage is crucial to limiting burden. Relative to other interventions, recently available malaria vaccines have a longer duration of protection, with the potential to address interruptions in prevention deployment. Evaluating this use case, we quantify the reduction in symptomatic infections expected for a range of vaccination scenarios. We find long-lasting interventions such as vaccination are a key mitigation measure against climatic disruptions to disease control.

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Maternal and Child Health Care Service Disruptions and Recovery in Mozambique After Cyclone Idai: An Uncontrolled Interrupted Time Series Analysis

Cited by 5 publications

References 36 publications

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

Addressing health care disruption in rural Mozambique due to extreme climate events: mobile units tackling cyclones, vaccine-preventable diseases, and beyond

Evidence from Madagascar shows that vaccination could mitigate climate-driven disruptions to malaria control

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