Mozambican Prime Minister Carlos Agostinho do Rosário on 5 March 2021 launched the country’s National Vaccination Plan (PNV) against Covid-19.

PNV works on the assumption that having joined COVAX (the global initiative launched by the World Health Organisation to ensure vaccine access to developing countries), Mozambique will benefit from initial free access to about 12.332.897 doses of vaccine, which is enough to cover 6.166.449 people, corresponding to 20% of the population.

The 50-page document places all health professionals in Mozambique in the frontline. Vaccination began on Monday (08) and is taking place in all of the countries health units. It is possible to see queues of health professionals waiting to get a jab in health units.

The Observatório do Cidadão para Saúde (OCS) praises the initiative insofar as it will help protect health professionals, and in a way, contribute to minimise the collapse of the national health system.

However, the OCS believes that the plan fails to include activits and community health workers (agentes polivalentes), who have played a significant role in the national health system. First, it is very important to vaccinate the activists due to the role they play on caring for chronic patients – such as HIV and AIDS, and tuberculosis, as well as patients with special needs, for example.

The patients’ desire to begin treatment, the permanence and continuity of HIV patients to treatments depends, to a great extent, on these actors, that is, on the work they do. These activists, like other health professionals, have been exposed to Covid-19. In fact, cases of various activists getting contaminated have been reported. On the one hand, the network of health community actors such as Community Health Agents, first responders, midwives, community workers, have run immense risks of being contaminated by Covid-19.

Since the first case in Mozambique was identified, community health agents have not received protective equipment against Covid-19. In the most remote areas, where they operate, where patients travel long distances to find a health centre, they (community health agents) have been a solution, travelling to the homes of the patients and, in other cases, the patients travelling to the homes of community health agents.

In the case of community health agents, with the onset of Covid-19 they were forced to decrease visits to homes and lectures, due to the lack of equipment. Including these actors in the first phase of vaccination, associated to prevention methods, will benefit a large segment of Mozambicans, particularly chronic patients with little mobility, who live in remote areas.

The OCS believes that all identified community workers such as ACS, by the health units and local authorities, should be included in the group of professional beneficiaries of the first stage of vaccination, launched by government. 

The OCS understands that MISAU should draw up a cohesive plan and list, similar to what it is doing with other health professionals, and include activists. Leaving these actors out of the vaccination process is an act of lack of recognition of their work in the health system. Vaccinating this group will help to prevent all those who daily deal with activists and community health agents.

It is our understanding that the vaccination plan presented by government aims at meeting the challenges faced by the testing plan, which showed the lack of a clear plan for the promotion of equity in the access to health.

It is the opinion of the OCS that this recognition by the health authorities would allow these community actors to be included in the list of services and personnel who must also benefit from the vaccine and personal protective equipment to be able to assist people, respecting the safety standards recommended by the health authorities.

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