Access to quality health services is crucial for good and balanced health. This report aims to provide solid scientific evidence about access to the health system in Mozambique and the social inequalities that affect that access. For this purpose, a descriptive and multivariate analysis of the Family Budget Survey (IOF is the Portuguese acronym) of Mozambique 2014/15 was carried out, with regard to health needs, severity of diseases, use of health services and reasons for non-use, problems with the quality of received care and direct payments.
From 10 to 13 September 2019, a survey of the health services' functioning processes, needs and response took place, in the Montepuez district, in order to reduce and prevent malnutrition. This evaluation involved the participation of several district services (SDSMAS, SDPI, SDAE, SDEJT), Health Committees and caregiving mothers from four randomly chosen villages. The results of this diagnosis are now made known by medicusmundi and reveal, as the main aspects contributing to the high rates of malnutrition in Montepuez, the following: low access to food, shortage of funds to acquire them, poor knowledge about nutrition and consumption of inappropriate water.
In August last year (between 27th and 30th) medicusmundi carried out a diagnostic study of the health services' functioning, needs and response processes in order to reduce and prevent malnutrition in the Namuno district. This work was done in conjunction with different district services (SDSMAS, SDPI, SDAE, SDEJT), Health Committees, caring mothers in the villages of Potomola and Mahari, the Wiwanana Foundation, SolidarMed and the World Food Program (WFP) . The evaluation showed that the high levels of illiteracy and, consequently, the lack of knowledge on how to prepare food and eat a balanced diet are the main causes that are behind the high levels of malnutrition registered in Namuno. To this is added the practice of agriculture that favors commercial purposes more than own consumption.
Between 17 and 20 September last year, in the district of Ancuabe, an evaluation of the functioning processes, needs and response of health services was carried out with a view to reducing and preventing malnutrition. This diagnosis, results of which are now being released, involved the participation of several district services (SDSMAS, SDPI, SDAE, SDEJT), Health Committees, caregiving mothers from four villages and some NGOs operating in that district (Wiwanana Foundation, SolidarMed and Aga Khan). The survey concluded that the lack of knowledge about how to prepare and preserve food, the restriction of consumption of some foods due to myths, taboos, habits and customs, illiteracy and insufficient water sources and dams for irrigation, are the aspects that most contribute to the prevalence of malnutrition in Ancuabe.
Based on the diagnosis made in September 2019, in November of the same year the Multisectorial Group, composed of the District Services (SDSMAS, SDPI, SDAE and SDEJT), the Wiwanana Foundation, Solidarmed and Aga Khan prepared, together with medicusmundi, an Action Plan to improve the fight against malnutrition. The objective was to establish easy ways of intervening, with concrete and coordinated actions between all sectors, giving particular importance to training, awareness, education and supervision activities. Of this plan stands out the holding of regular lectures in the communities, with the inclusion not only of women, but also of the heads of families (men), as one of the key actions to prevent and reduce malnutrition in this district. Also noteworthy is the decision to set up a Technical Group to resolve the lack of coordination previously identified between the different actors, which will now hold meetings for planning and assessing activities at district level.
In December of last year, Montepuez hosted an important meeting of the Multisectorial Group in order to define the joint Action Plan to improve the response of its Programs to Combat Malnutrition. The Group, made up of the District Health Services (SDSMAS), Planning and Infrastructure (SDPI), Economic Activities (SDAE) and Education, Youth and Technology (SDEJT), had previously participated, in September of the same year, in a diagnostic study led by medicusmundi to assess the problems and needs associated with malnutrition. The Plan that is now made known prioritizes the training and qualification of teams and the implementation of actions such as the development of community education materials, the promotion of debates, campaigns and culinary demonstrations, the opening of fish tanks, among others. It is also worth mentioning the creation of a Technical Group to ensure better supervision and coordination of all activities.
In August 2019, the Namuno district underwent a study to identify the needs and problems that contribute to the high rate of malnutrition in the population. Based on the results obtained, medicusmundi, together with the Multisectorial Group, defined an Action Plan to improve the capacity to respond to this problem. The working group involved different District Services (SDSMAS, SDPI, SDAE and SDEJT) and NGOs such as the Wiwanana Foundation, SolidarMed and the World Food Program (WFP). The improvement of collaboration and information sharing on the different actors was one of the aspects that deserved greater attention, resulting in the creation of a Technical Group to ensure joint planning, data crossing and more effective action in communities. Among the activities defined, training and awareness-raising activities are highlighted, namely lectures and campaigns on nutrition, culinary demonstrations, radio debates and the creation of nutrition groups in schools. It should also be noted the need to assess the levels of production and nutritional security in the community and to form water committees.