Experiência do Comité Nacional de Bioética para a Saúdede Moçambique após Covid-19 / Experience of the National Bioethics Committee for Health of Mozambique after Covid-19

O Comité Nacional de Bioética para a Saúde em Moçambique (CNBS) tem como missão principal fazer a revisão, para aprovação ética, de todas as propostas de pesquisa em saúde, que envolvam seres humanos, realizadas em todo o território nacional, submetidas pelos investigadores, sejam estes nacionais ou estrangeiros. É apresentado, de forma sucinta, os objectivos do Comité Nacional de Bioética para a Saúde de Moçambique e da sua redede Comités Institucionais de Bioética paraa Saúde (CIBS ́s) e o modo do seu funcionamento para garantir o cumprimento dos procedimentos éticos na investigação para protecção do agente de pesquisa e do próprio investigador, bem como desenvolver a formação em bioética para a pesquisa, melhorando e agilizando a comunicação entre os investigadores, promotores ou financiadores destas pesquisas. Com o aparecimento da pandemia deCovid-19,e havendo necessidade destes comités, mais do que nunca, manterem-se em funcionamento, introduziram-se algumas alterações à sua actividade, nomeadamente a passagem para um regime de teletrabalho, a obrigatoriedade dos protocolos de estudo conterem um capítulo (se pertinente) sobre comoenfrentaria no terreno, a situação da Covid-19 e a avaliação expedita, entre outras. Conclui-se com o relato dos resultados desta experiência vivida num período de um ano (Janeiro a Dezembro de 2020).

The main mission of the National Bioethics Committee for Health in Mozambique (CNBS) is to review for ethical approval all health research proposals involving human subjects conducted throughout the national territory submitted by national or foreign researchers. The objectives of the National Bioethics Committee for Health in Mozambique and its network of Institutional Bioethics Committees for Health (CIBS's) are briefly presented, as well as how they function to ensure compliance with ethicalprocedures in research for the protection of the research agent and the researcher himself, as well as to develop training in bioethics for research, improving and streamlining communication between researchers, promoters or funders of such research. Withthe appearance of the Covid-19 pandemic and the need for these Committees, more than ever, to remain functional, some changes were introduced to their activity, namely the change to a teleworking regime, the obligation for study protocols to contain a chapter (if relevant) on how they would deal with the Covid-19 situation in the field and the expedite evaluation, among others. We conclude with the report of the results of this experience lived in a period of one year (January to December 2020)

Cefaleia em pacientes com dor crônica entrevistados na Unidade de Dor do Hospital Central de Maputo, Moçambique / Headache in chronic pain patients interviewed by the Pain Unit, Central Hospital of Maputo, Mozambique

JUSTIFICATIVA E OBJETIVOS: Nos últimos anos, a abordagem da dor crônica em Maputo, capital de Moçambique, ganhou espaço, com a construção da Unidade de Dor do Hospital Central. No continente africano existem poucos estudos epidemiológicos sobre dor crônica. Em Moçambique, nenhum estudo prévio foi publicado. O objetivo deste estudo foi descrever e analisar as características da cefaleia em pacientes com dor crônica entrevistados no referido hospital. MÉTODO: Participantes com dor crônica de acordo com critérios da International Association for the Study of Pain (IASP), maiores de 18 anos, fluentes em português foram incluídos. Dados demográficos, características da dor crônica e presença de cefaleia foram investigados. RESULTADOS: Cento e dezoito pacientes foram avaliados. Destes, 79 (66,9%) eram mulheres e 39 (33,1%) eram homens, com média de idade de 52,4 anos. Presença de cefaleia foi frequente entre estes pacientes (53/ 44,9%) embora esta não fosse necessariamente sua dor principal. Cefaleia foi o principal segundo sítio de dor. Migrânea foi diagnóstico em 14 (11,9%) pacientes, cefaleia tensional em 28 (23,8%), cefaleia cervicogênica em 9 (7,6%). CONCLUSÃO: Os dados revelam que nos pacientes com dor crônica na Unidade de Dor do Hospital Central de Maputo há prevalência de cefaleias semelhante àquela descrita na população em geral por outros estudos.

BACKGROUND AND OBJECTIVES: Chronic pain approach in Maputo, capital of Mozambique, has gained space in recent years with the opening of the Central Hospital's Pain Unit. There are few epidemiological studies on chronic pain in Africa. In Mozambique, no previous study has been published. This study aimed at describing and analyzing headache features in chronic pain patients interviewed in the above-mentioned hospital. METHOD: Chronic pain patients according to International Association for the Study of Pain (IASP) criteria, aged over 18 and fluent in Portuguese were included. Demographics, chronic pain features and presence of headache were investigated. RESULTS: Participated in this study 118 patients. From these, 79 (66.9%) were females and 39 (33.1%) were males, with mean age of 52.4 years. Headache was frequent among such patients (53/44.9%), although this was not necessarily their primary pain. Headache was the major second pain site. Migraine was diagnosed in 14 (11.9%) patients, tension headache in 28 (23.8%) and cervicogenic headache in 9 (7.6%). CONCLUSION: Data show that the prevalence of headache among chronic pain patients of the Pain Unit of the Central Hospital of Maputo is similar to that described for general population by other studies.

The training and expectations of medical students in Mozambique.

BACKGROUND: This paper describes the socio-economic profile of medical students in the 1998/99 academic year at the Universidade Eduardo Mondlane (UEM) Medical Faculty in Maputo. It aims to identify their social and geographical origins in addition to their expectations and difficulties regarding their education and professional future. METHODS: The data were collected through a questionnaire administered to all medical students at the faculty. RESULTS: Although most medical students were from outside Maputo City and Maputo Province, expectations of getting into medical school were already associated with a migration from the periphery to the capital city, even before entering medical education. This lays the basis for the concentration of physicians in the capital city once their term of compulsory rural employment as junior doctors is completed. The decision to become a doctor was taken at an early age. Close relatives, or family friends seem to have been an especially important variable in encouraging, reinforcing and promoting the desire to be a doctor. The academic performance of medical students was dismal. This seems to be related to several difficulties such as lack of library facilities, inadequate financial support, as well as poor high school preparation. Only one fifth of the students reported receiving financial support from the Mozambican government to subsidize their medical studies. CONCLUSION: Medical students seem to know that they will be needed in the public sector, and that this represents an opportunity to contribute to the public's welfare. Nevertheless, their expectations are, already as medical students, to combine their public sector practice with private medical work in order to improve their earnings.

Between the good samaritan and everyday life: coping strategies of Mozambican health care providers

This paper summarises the research done in Mozambique in 1996-1998 as a part of the INCO.De roiect "Health Sector Reform: Coping strategies and profession identy of primary health care clinicians in Mozambique and South Africa´´. Mozambican health care providers use a vast array of coping strategies to improve ther economic situation, such as: Working in different health systems, straddling between private and public services for extra income. Using public sector resources for private gain. Selling hard to get, subsidised services and goods, especially medication, at market princes. Collectiong fees higher than the official ones, or illegally charging fees to ´help´ the users access the system. The extra money earned in health care provision is invested in other formal or informal activities, especially trade and agriculture. Other kinds of non-monetary coping strategies are used but are not considered important by the health personnel: Cultural resources, religious support, family and friend networks....