what we do
The COMSA Strategy
JHU works with the National Institute of Statistics (INE) and the National Institute of Health (INS) in Mozambique to set up a representative nationwide sample of clusters for routine surveillance of pregnancies, birth outcomes and deaths. The sample is stratified by province to allow production of mortality and cause of death estimates at the provincial level and their comparison across provinces. All deaths, including stillbirths, are followed up for a verbal and social autopsy in order to determine the cause of death and its determinants.
Since 2017, COMSA has trained over 700 Community Surveillance Assistants (CSAs) who report pregnancies, pregnancy outcomes, and deaths, and over 50 Verbal and Social Autopsy (VASA) data collectors. COMSA covers approximately 170,000 households and 800,000 people across all 11 provinces in Mozambique.
Active Community Surveillance Assistants (CSAs) trained
Thousand people reached
Active VASA data collectors trained
COMSA Project Design
The COMSA project covers 700 clusters scattered throughout the country, each covering approximately 300 households. Community Surveillance Assistants (CSAs) are recruited, trained, and deployed in each cluster to report all events on a continuous basis. VASA data collectors then follow-up each death for verbal and social autopsy data collection.
A Phase-Wise Approach
COMSA uses a phase-wise approach to implement activities in Mozambique. We started with five provinces in March 2018 and scaled up to the remaining six provinces in October 2018.
Click on the phases below:
Cabo Delgado, Nampula, Sofala, Tete, Zambezia
Gaza, Manica, Niassa, Inhambane, Maputo Province, Maputo City
“Tha data tracked and analysed by COMSA is essential to the improvement of the lives and health of the Mozambican people.”
Local Sources with Global Reach
Data is collected by the CSAs and VASA data collectors. The CSAs are members of the community who report vital events that occur within the community, such as pregnancies, birth outcomes, and deaths. Each COMSA cluster has an assigned CSA who conducts data collection using a smartphone. The CSAs also help their community members in registering births and deaths at the local registrar office. As deaths occur, VASA data collectors reach out to the families of the deceased to conduct a verbal and social autopsy interview, which allows us to determine the cause of death and its determinants.
COMSA also collaborates with CHAMPS (Child Health and Mortality Prevention Surveillance) responsible for carrying out Minimally-Invasive Tissue Sampling (MITS) on selected deaths of children under age five occurring in health facilities in Quelimane district of Zambezia. As a follow-up, verbal and social autopsies will also be collected.
The data and evidence generated by COMSA will inform similar mortality surveillance systems in the African region and globally.
What Data Means for the Future of Mozambique
COMSA data will be used to track and compare birth and mortality rates at national and provincial levels on an annual basis. Recent annual neonatal, post-neonatal, infant and under-five mortality rates will be recorded to allow a progress assessment toward SDG 3.2. Data from verbal autopsy and MITS will be used to generate cause of death fraction and rates at national and subnational level. A statistical tool will allow the country to independently analyse, obtain and interpret the results.
Overall, COMSA data will be used to inform the Mozambican Government, policy-makers, and other stakeholders on the magnitude and causes of deaths in Mozambique. The data tracked and analyzed by COMSA is essential to improve the lives and health of the Mozambican people.
Johns Hopkins Bloomberg School
of Public Health (JHSPH)
615 N. Wolfe Street, Baltimore, MD 21205
Instituto Nacional de Saúde (INS)
Vila De Marracuene, Estrada Nacional N°1,
Maputo Província – Moçambique
Instituto Nacional de Estatística (INE)
Av. 24 De Julho 1989 Caixa Postal 493,
Maputo Cidade – Moçambique