Overview
Welcome to the THRP website.
This webpage is about the long-standing cooperation project between the Health Ministry of Mozambique and the University of Saskatchewan. The 15 year-old partnership has just ended its most recent phase with the closure of the 2009-2014 project. The purpose was to increase the capacity of the Massinga Centre for Health Training (MC) to support the training mandate of the health ministry in community involvement, and to increase its adoption throughout Mozambique.
The following is taken from the final report on the project.
Background and rationale
This project built on a long-standing partnership and program between Mozambique and Canada, not only in the last 15 years, but dating back to earlier Canada-Mozambique oral health training initiatives from 1985 to 1997. The University of Saskatchewan (UofS) became the executing agency of the oral health project in 1989 and has continued in that role ever since, expanding the focus from dentistry to encompass the broader health field. Since 1998, there have been three consecutive CIDA-funded projects, all focusing on Massinga Centre (MC) in Inhambane province. This document is the final report for the most recent one, which spanned the period from January 2009 to July 2014.
The rationale for THRP arose out of the desire of the Mozambique Ministry of Health (MOH) to strengthen the capacity of health training institutions to respond to community needs. A critical step in confronting HIV/AIDS and other communicable diseases is to train health workers skilled in working with communities. Parallel to this is the need to strengthen the ability of communities to engage in a participative way in building a healthy community and addressing social and economic determinants of health. At MC, health workers would learn to practice their professional skills while fully engaging with communities. Over the years, THRP has maintained the same goal: to strengthen the capacities of Mozambican training institutions to prepare health workers committed to and skilled in creating more egalitarian and effective relationships with each other and the communities they serve.
The current 5-year project (2009-2014) was intended to build on the success of MC, and to formally establish a model centre, not only with expanded training capacity but also functioning to disseminate its knowledge, and to collaborate with the MOH in the revision of national curriculum and programs to strengthen community participation in health. The project responded to Mozambican priorities and was aligned closely with MOH annual and long-term plans.
Goals and objectives
The project had two general goals. One was to expand MC’s capacity, including the number of teachers, facilities and trainees, the number of community partnerships, and the incorporation of two new model community health centres as practicum sites. The other was to evolve MC into a national model so that knowledge about how to support community health was shared at a national level, including the two dimensions of MC’s methodology and related enabling policies.
More specifically, the project’s immediate outcomes, in its logical framework analysis, were:
Increased capacity of the Massinga Centre to serve as a national model in gender-sensitive community-based health training and practice.
Use of new knowledge for linking health training, service and community.
Increased capacity of the Massinga Centre to contribute to national dialogue on issues related to community-health.
Increased use of community-based approaches to training and health care.
Intermediate outcomes were (1) increased participation by women and men in target communities in activities for their own health improvement and (2) improved enabling environment for promotion and use of community-based approaches to health care services and training.
Results
The project succeeded remarkably well in expanding the capacity of MC, which substantially increased its enrolment from 60 to 300 students per year, more than was expected. Now more fully integrated into the national system, MC has responded to MOH requirements to increase the number and type of courses. The number of teachers has doubled. Its expanded infrastructure now includes an additional 100-bed dormitory, two classrooms, two teacher houses, 3 vehicles, and informatics capacity. There is an additional community partner and all three community partnerships have developed with both women and men participating in activities to improve their own health and that of their communities, as well as supporting the MC training program. There are two new practicum sites, one a rural maternal-child health (MCH) centre at Kangela, the other an oral health training centre attached to the Massinga District Hospital.
Throughout this expansion, MC has developed and maintained excellent quality as a training centre. Over the last 4 years, MC ranked first in the country 3 times and 2nd once in the MOH annual national evaluation. The most recent achievement was announced in late July 2014, at the meeting of the Conselho coordenador desaúde where the Minister of Health recognized MC as the best training centre (IDF) in the country.
MC was also successful in its dissemination goals. Perhaps having the most potential impact over the long term, MC was able to influence national-level evaluations and curricula for health training centres in Mozambique. Due to MC input, the national evaluation for health training centres now includes criteria for community engagement. MC also revised the national curriculum for training health teachers. And most significantly, MC revised the national curriculum for preventive medicine, and assisted with the dissemination of the revised curriculum to other centres in the country.
Another significant achievement was the production by MC of a series of manuals for teaching community participation in health. The manuals were distributed in person to the other training centres in Mozambique, and an orientation provided about their use. MC also produced audio-visual material for educational use, including videos and radio programs. In addition, MC provided advice in formal and informal settings in the country about how to foster community participation in health. Internationally, MC made presentations at conferences in Ottawa and Saskatoon.
Due to its long history and resulting wide network, the project also contributed in ways supplementary to its official objectives. Helped by the presence of Mozambicans in their visits, the project was able to increase the knowledge of Canadians about Mozambique, health and development. Audiences included students and faculty at the UofS, but extended to Saskatoon’s urban core neighbourhoods, northern Saskatchewan and rural southern Saskatchewan. This increased awareness helped other organizations in raising funds to support related aspects of MC and partner community needs. For example, depending on the initiative, funds were contributed by the Canadian Auto Workers (CAW, now UNIFOR), the Public Service Alliance of Canada, Saskatchewan schools, Canadian dentists, and the families and friends of medical students, among others, for improving the conditions and lives of Mozambicans in and around Massinga.
The project has been complementary to CIDA/DFATD’s recent emphasis on MCH. The increase in courses and enrolment for MCH workers is part of this, as is the Kangela MCH centre. Additional are MC capacities and experience in discussing gender roles with community members and in engaging community members in their own health improvement.