Maternal and Child Health Integrated Program Mozambique: Final Report of Social Marketing Award to PSI: March 2010 through June 2011

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1. Goals and strategies of MCHIP Program Approach – Condom Social Marketing Program

MCHIP’s vision and focus is to accelerate the reduction of maternal, newborn, and child mortality in 20 priority countries by increasing the use of a focused set of high impact maternal, newborn, and child health (MNCH) interventions that address the major causes of death among mothers, newborns, and children under five. Delivery strategies will address barriers to access and use of these interventions along an MNCH continuum of care that links communities, first-level facilities, and hospitals. One of the main goals of the MCHIP Program is to contribute to the reduction of the under 5 mortality rate and maternal mortality ratio (MMR) by 25 percent in high mortality-burden countries.

As part of its comprehensive approach to HIV prevention and family planning programming, USAID has been supporting the social marketing and free distribution of condoms in Mozambique to improve condom availability and use among most at risk behavior groups and adult Mozambicans. Since 1994, Population Services International (PSI) has been an implementing partner of condom social marketing (CSM) activities including sales, distribution, marketing, and promotion. With support of USAID and the Government of Mozambique’s National AIDS Council (CNCS), PSI promotes and distributes subsidized male and female condoms through the private sector nationwide. PSI’s socially marketed Jeito brand has become synonymous with the word condom throughout Mozambique. CSM activities have increased self-reported condom use with non-regular partners as well as increased knowledge of where condoms are available. While consistent exposure to CSM has influenced positive behavior change, condom demand and use in Mozambique continues to be lower than in some other countries in the Southern Africa region. This reality highlights the need to maintain CSM activities that build on USAID’s previous investments in social marketing and continue to increase correct and consistent condom use to reduce HIV prevalence.

2. Background

Mozambique faces a generalized HIV epidemic with nationwide HIV prevalence estimated at 11.5% of the adult population.1 Adults over the age of 25 comprise the majority (68%) of heterosexual HIV transmission.2 Multiple concurrent partnerships (MCP), relatively low condom use, and low male circumcision (MC) prevalence in some areas are key drivers of the epidemic in Mozambique. HIV prevalence varies widely between the southern, central and northern regions (South 21%, Central 15%, and North 6%). In some areas HIV prevalence exceeds 25%.3 Higher prevalence in these areas is associated with the presence of transportation corridors, higher incidence of MCP and a relatively low rate of MC. In contrast, the Northern provinces (Nampula, Niassa, and Cabo Delgado) have lower HIV prevalence than the national average which may be due to higher rates of MC and fewer transportation corridors.