Centro de Referência Alto Maé, Chamanculo health area, Maputo, Mozambique: evaluation of an HIV model of care in an urban setting
In 2009/2010 following the decentralisation of HIV care to primary health care in Maputo City, the former MSF-OCG Alto Maé day hospital was transformed into the chronic care HIV referral centre Centro de Referência Alto Maé (CRAM) with a double purpose: 1) to provide a safety net for the health centres of Chamanculo health area for the clinical management of complex HIV patients that do not require hospitalisation and 2) to reduce the workload of Maputo’s referral hospitals. The selection of this site as a referral centre was based on convenience by making use of the existing infrastructure of the former day hospital. Attaching it to Chamanculo hospital was not felt imperative, since this hospital, contrary to Mavalane and José Macamo hospitals, only functions like a big health centre with maternity. After three years of CRAM working as a referral centre, this evaluation was commissioned with the purpose to assess the performance and the added value of this model of care in Maputo health services network in order to define its current and potential future position in the sanitary map of the Ministry of Health.