The financing of the health system in Mozambique is marked by the fragmentation that also characterizes the architecture of development assistance in the country and is expressed, for example, in the high degree of external resources that do not go through government management instruments (outside the budget). Among the challenges are the centralized and verticalized structure, the high degree of dependence on external donors and their priority agendas, and a persistent underfinancing of the sector.
Authors: Elis Borde, Eliana Martínez-Herrera, Mariana Gutiérrez-Zamora Navarro, Janet Dulá, Policarpo Ribeiro, Ivan Zahinos, Joan Benach
Technical support: Medicus Mundi and National Institute of Health (Mozambique)
Funding: Spanish Agency for International Development Cooperation (AECID) and Open Society Foundations (OSF)
Social inequalities in access to health services and social inequalities in health have persisted over time and the underlying barriers have not been sufficiently addressed. There is no single answer to explain this situation, but the results of this study revealed some elements that make it possible to relate the depth and extent of social inequalities in health in Mozambique with the seriousness of health problems in the country, the fragmentation of the health system, incomplete decentralization, and the lack of financing of the health sector in the country.
Authors: Elis Borde, Elias Sete Manjate, Nicholas Soyombo, Gabrielle Lima Silva, Eliana Martínez-Herrera, Mariana Gutiérrez-Zamora Navarro, Janet Dulá, Policarpo Ribeiro, Ivan Zahinos, Joan Benach
Technical support: Medicus Mundi and National Institute of Health (Mozambique)
Funding: Spanish Agency for International Development Cooperation (AECID)
Escola Saudável (ES) is an initiative within the scope of the project “The social determinants of health: the best strategy against COVID-19 in Maputo (2021-2023)”, implemented by medicusmundi, in partnership with the Department of Health and Action Social Network of the Maputo Municipal Council and the Media Institute of Southern Africa (MISA-Mozambique), with funding from the Municipality of Barcelona.
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.
This document presents a report that was prepared from a bibliographic and documentary review, considering government publications, global funds, local and international NGOs as well as foundations on the financing of the health system, especially in Mozambique.
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.