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Feminist political economy has illuminated the gendered dimensions of the globalisation of production. Whilst this literature provides essential insights on gendered exploitation in export-oriented industries, women’s work in localised labour markets in the Global South remains underexplored. This paper seeks to address this gap by putting into dialogue three bodies of literature – feminist political economy of globalisation, political economy of development in southern Africa and the social...

Integrated community case management (iCCM) has now been implemented at scale globally. Literature to-date has focused primarily on the effectiveness of iCCM and the systems conditions required to sustain iCCM. In this study, we sought to explore opportunities taken and lost for strengthening health systems through successive iCCM programmes. We employed a systematic, embedded, multiple case study design for three countries—Ethiopia, Malawi and Mozambique—where Save the Children implemented...

In this paper, we explore the use of a governance diaries methodology to investigate poor households’ interactions with authority in fragile, conflict and violence-affected settings in Mozambique. The research questioned the meanings of empowerment and accountability from the point of view of poor and marginalised people, with the aim of understanding what both mean for them, and how that changes over time, based on their experiences with governance. The study also sought to record how poor...

Mozambique, same as many other tropical countries, is at high risk of arthropod-borne virus (arbovirus) diseases and recently two dengue virus (DENV) outbreaks occurred in the northern part of the country. The occurrence of some important vector species, such as Aedes (Stegomyia) aegypti (Linnaeus) and Ae. (Stg.) albopictus (Skuse), besides several other sylvatic vectors, have been reported in the country, which may indicate that the transmission of some arboviruses of public health...

Abstract: The central aim of this text is to show the impact institutions have on the performance of the health sector in Mozambique. The text shows that of the social determinants of health, institutions play a central role in the performance of the Mozambican health sector—and, through it, economic and social development—particularly for the poorer and more vulnerable, such as children, women, the disabled, and the elderly. It is also argued that the deficiencies and inefficiencies of the...

Este texto tem por objectivo central mostrar o impacto que as instituições têm no desempenho do sector da Saúde em Moçambique. No texto demonstra-se que, de entre os Determinantes Sociais da Saúde, as instituições têm um papel central no desempenho do sector da Saúde — e, por seu intermédio, no desenvolvimento económico e social — dos moçambicanos, em especial dos mais pobres e mais vulneráveis, como as crianças, as mulheres, as pessoas com deficiência e os idosos. Argumenta-se também que as...

Background: Legal empowerment and social accountability are two strategies that are increasingly used to address gaps in healthcare in low- and middle-income countries, including failure to provide services that should be available and poor clinical and interpersonal quality of care. This paper is an explanatory case study of a legal empowerment effort that employs community paralegals and trains Village Health Committees (VHCs) in Mozambique. The research objective was to explore how...

Findings: In-depth interviews (n = 30), key informant interviews (n = 1) and focus group discussions (n = 3) captured experiences and perceptions of employment processes. Intra-household decision-making structures mean women may experience additional barriers to join the APE programme, often requiring their husband’s consent. Training programmes outside of the community were viewed positively as an opportunity to build a cohort. However, women reported difficulty leaving family...

Social and behaviour change communication (SBCC) is the use of communication to change behaviours by positively influencing knowledge, attitudes and social norms at the individual and community level. Approaches to SBCC include, but are not limited to: media campaigns, peer educators and mentors, small group sessions, community dialogues and events, and digital tools. This rapid literature review focuses on SBCC interventions in Mozambique across four sectors: family planning (FP); girls’...

Background: In the past decade, the negative impact of disrespectful maternity care on women’s utilisation and experiences of facility-based delivery has been well documented. Less is known about midwives’ perspectives on these labour ward dynamics. Yet efforts to provide care that satisfies women’s psycho-socio-cultural needs rest on midwives’ capacity and willingness to provide it. We performed a systematic review of the emerging literature documenting midwives’ perspectives to explore the...

CONTEXT: Research on institutional child delivery in Sub-Saharan Africa typically focuses on availability and accessibility of health facilities. Cultural factors, including religion, that may facilitate or hinder the use of such services have not been well examined and remain poorly understood. METHODS: The relationship between religious affiliation and delivery in a health facility was explored using data from a household survey of 1,297 women aged 18-50 and a census of 825 religious...

Background: Countries must be able to describe and monitor their populations health and well-being needs in an attempt to understand and address them. The Sustainable Development Goals (SDGs) have re-emphasized the need to invest in comprehensive health information systems to monitor progress towards health equity; however, knowledge on the capacity of health information systems to be able do this, particularly in low-income countries, remains very limited. As a case study, we aimed to...

Background: Despite substantial investment in women’s health over the past two decades, and enthusiastic government support for MDG 5 and SDG 3, health indicators for women in Mozambique remain among the lowest in the world. Maternal mortality stayed constant from 2003 to 2011, with an MMR of 408; the estimated HIV prevalence for women of 15–24 years is over twice that for men; and only 12.1% of women are estimated to be using modern contraception. This study explores the perspectives of...

Inequality is a key political issue of our times. It has political consequences, fuelling conflict and raising legitimacy chal‑ lenges for regimes around the world, in democratic and non‑demo‑ cratic settings alike. At the centre of these challenges is the question of accountability: who can be held accountable, on what basis, how and by whom for tackling or failing to tackle which inequalities. In the field of global health, inequality has long been a key issue. A significant body of work —...

This article aims to understand the inversion of roles between the state and citizens, by exploring its historical roots and current implications for processes of social accountability in Mozambique, particularly in the health sector. This is a practice-based reflection grounded in the evidence collected through the implementation of Community Scorecards in the health sector in 13 districts of Mozambique. The evidence has revealed a transfer of responsibilities from local governance...

Close-to-community (CTC) providers have been identified as a key cadre to progress universal health coverage and address inequities in health service provision due to their embedded position within communities. CTC providers both work within, and are subject to, the gender norms at community level but may also have the potential to alter them. This paper synthesises current evidence on gender and CTC providers and the services they deliver.

Background and objective: maternal and neonatal mortality rates in Mozambique are high, due to insufficient numbers of qualified health workers, lack of equipment and materials, referral system deficiency, difficulties to access health services and gender issues. This study assesses the barriers to health care access, regular attendance at ante natal consultations, institutional delivery and postnatal and neonatal follow-up. This is part of the baseline study for an implementation research...

Mixed methods were used with various data sources to describe organisation and delivery of maternity care in Maputo city, Mozambique in early 2010s and to compare the plans with the service provision in practice. In the public health sector, maternity care was organised to be area based and hierarchical with a planned referral system. The provision of basic and emergency maternity care was publicly funded, largely dependent of donor funds, and free of charge for users. Even though Maputo...

Multisectoral approaches represent a prominent ideological consensus, influenced by historical roots and the current political, financial and institutional landscape, to address the multi-faceted and complex causes of most nutrition, public health and food problems. However, the implementation of multisectoral approaches presents tremendous challenges; one of the most often cited problems, in the literature and by practitioners, is coordination. This study investigates the perspectives of key...

Fiscal austerity policies imposed by the IMF have reduced investments in social services, leaving postindependence nations like Mozambique struggling to recover from civil war and high disease burden. By 2000, a sector-wide approach (SWAp) was promoted to maximize aid effectiveness. ‘Like-minded’ bilateral donors, from Europe and Canada, promoted a unified approach to health sector support focusing on joint planning, common basket funding, and streamlined monitoring and evaluation to improve...