Anemia in Pregnant Women and Children Aged 6 to 59 Months Living in Mozambique and Portugal: An Overview of Systematic Reviews.

INTRODUCTION: Globally, anemia is still a public health issue faced by people in low and high-income countries. This study gives an overview of published scientific articles related to the prevalence, nutritional indicators, and social determinants of anemia in pregnant women and children aged 6 to 59 months living in Mozambique and Portugal. METHODS: We performed a review of scientific literature in April 2021, searching for published indexed articles in the last 15 years (2003-2018) in electronic databases. Subsequently, quality assessment, data extraction, and content analysis were performed. RESULTS: We have identified 20 relevant publications. Unsurprisingly, anemia plays a relevant role in disability and life imbalances for these subgroups in Mozambique compared with Portugal. For both countries, data on anemia and iron deficiency in pregnant women and children aged 6 to 59 months old are either outdated or remain unclear. Similarly, studies on social determinants and anemia are also still scarce. CONCLUSIONS: A gap of information on anemia, other nutritional indicators, and social determinants in pregnant women and children between 6 and 59 months of age living in Mozambique and Portugal is highly observed. More research is crucial to help achieve the goals established by the Sustainable Development Goals.

"We have this, with my husband, we live in harmony": exploring the gendered decision-making matrix for malaria prevention and treatment in Nampula Province, Mozambique.

BACKGROUND: Conceptualizing gender dynamics and ways of bridging entrenched gender roles will contribute to better health promotion, policy and planning. Such processes are explored in relation to malaria in Mozambique. METHODS: A multi-method, qualitative study using focus group discussions (FGDs) and in-depth interviews (IDIs) explored the perspectives of community members, leaders and stakeholders on malaria. The study was conducted in Nampula Province, in an intervention district for the Tchova Tchova Stop Malaria (TTSM) gender-sensitive community dialogues, and in a non-intervention district. RESULTS: Participants (n = 106) took part in six FGDs and five IDIs in each district. Those exposed to TTSM commonly stated that the programme influenced more equalitarian gender roles, attitudes and uptake of protective malaria-related practices. These positive changes occurred within the context of an observed, gendered decision-making matrix, which aligns inward- or outward-facing decisions with malaria prevention or treatment. Decisions more dependent on male or elder sanctioning at community level are outward-facing decisions, while decisions falling within women's domain at household level are inward-facing decisions. Related to prevention, using bed nets was largely an inward-facing prevention decision for women, who were generally tasked with hanging, washing and making nets usable. Net purchase and appropriation for malaria prevention (rather than for instance for fishing) was men's prerogative. Regular net use was associated with sleeping together more regularly, bringing couples closer. Attending antenatal care to access intermittent preventive treatment during pregnancy was often an outward-facing prevention decision, under the purview of older, influential women and ultimately needing sanctioning by men. With respect to seeking care for malaria symptoms, women typically sought help from traditional healers first. This inward-facing treatment decision was within their control, in contrast to the frequently transport-dependent, outward-facing decision to attend a health facility. Sharing decisions was described as a feature of a "harmonious household," something that was said to be encouraged by the TTSM intervention and that was both lived and aspirational. CONCLUSIONS: TTSM community dialogues helped communication on both interpersonal (couple) and community levels, ultimately encouraging malaria-related behaviours. Leveraging ways of bringing men and women together to share decision making will improve malaria intervention success.

Conhecimentos e atitudes das mulheres em relação ao exame preventivo do câncer do colo uterino / Women's knowledge and attitudes regarding cervical cancer screening

Este estudo teve por objetivo avaliar os conhecimentos e atitudes das mulheres em relação a importância do exame preventivo do câncer do colo uterino. Estudo descritivo e exploratório de abordagem qualitativa, realizado com 14 mulheres atendidas em um serviço de saúde de Moçambique. A coleta de dados foi por meio do roteiro de entrevista semiestruturada, entre os meses de fevereiro a março de 2015. Os resultados foram analisados pela técnica de análise de conteúdo. A maior parte das mulheres embora tenha ouvido falar do câncer do colo uterino (CCU) na televisão e nas palestras dos hospitais, tem pouco conhecimento em relação à prevenção, desconhece a importância do exame preventivo e realiza o exame devido a queixas ginecológicas. O conhecimento das mulheres é incipiente e aquém do esperado sobre a temática da importância do exame preventivo.

This study aimed to evaluate women's knowledge and attitudes regarding the importance of cervical cancer screening. This is a descriptive, exploratory, with a qualitative approach study, carried out with 14 women assisted at a health service in Mozambique. Data collection occurred with a semi-structured interview from February to March 2015. The results were analyzed using the content analysis technique. Although most women have heard of cervical cancer (CC) on television and in hospital lectures, they have little knowledge about prevention, are unaware of the importance of the screening and have the exam due to gynecological complaints. Women's knowledge is incipient and below the expectations about the importance of the screening.

Práticas e saberes socioculturais sobre saúde, doença e morte de crianças de 0 a 5 anos de idade, na comunidade de Mopeia (Moçambique) / Socio-cultural practices and awareness about health, disease and death of children aged between 0-5 at Mopeia Community (Mozambique)

Estudo qualitativo que tem como objetivo compreender os significados socioculturais relacionados à saúde, doença e morte de crianças de 0 a 5 anos na comunidade de Mopeia tendo por objeto as campanhas sanitárias governamentais em Moçambique, particularmente, vacinação de crianças, utilização de redes mosquiteiras e amamentação exclusiva até os 6 meses de idade. Através do método etnográfico e particularmente da observação participante, do uso de diário de campo e entrevistas semidiretivas, no sentido de captar as vinculações das práticas e saberes socioculturais com os elementos do contexto de vida da comunidade, realizou-se o trabalho de campo entre os meses de Julho e Setembro de 2010. Os resultados apontam que certas praticas socioculturais relacionadas à falta de higiene e saneamento do meio, à não-amamentação exclusiva até os 6 meses, bem como ao uso incorreto das redes mosquiteiras, associadas às limitações na efetividade das intervenções sanitárias, podem estar contribuindo para a mortalidade de crianças menores de 5 anos por doenças preveníveis. Observou-se também que há falta de consonância entre os programas de intervenção de saúde pública, particularmente as medidas mecânicas para o controle de certas doenças preveníveis, como a malária e a diarréia, através de campanhas sanitárias e a realidade de vida das populações. Neste contexto, há necessidade de se articular as campanhas sanitárias com as práticas socioculturais da região, concomitantemente com a disponibilidade e expansão de infra-estruturas básicas, para que haja mais eficácia na intervenção das políticas de saúde pública na luta contra a redução da mortalidade de menores de 5 anos por doenças preveníveis.

This qualitative study seeks to understand the socio-cultural meanings about health, disease and death of children aged between 0-5 at Mopeia community. Its object is the government run health campaigns in Mozambique, particularly children vaccination, mosquito nets use, exclusive breast feeding up to six years of age. By applying the ethnographic method, particularly through participative observation, field diary and interviews to capture the relationship between the practices, the socio-cultural knowledge and the individuals of the community, a field work was carried out between July and September 2010. The results show that some socio-cultural practices like lack of hygienic practices and community sanitation, non exclusive breast feeding up to six years of age, the improper use of mosquito nets, associated to the shortage of health care assisance can be contributing to the mortality of children under five by preventable diseases. It was also observed that there is a mismatch between public health programs, particularly those addressed to preventable diseases like malaria and diarrhea and the reality of the community. Thus, there is the need to match the campaigns to the socio-cultural practices in the region, make available and expand infrastructure for primary health care to boost the efficacy of the intervention in public health policies aimed at fighting and reducing the death rates by preventable diseases of children under five years of age.