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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 operation of the health sector in Mozambique are largely the result of the fact that the institutions with influence on the health sector are controlled by a minority of privileged people who do not give the appropriate priority to the basic health needs of the majority of the population. Finally, it is argued that the most important institutional measures for improving the state of health of Mozambicans are the revision of the Constitution of the Republic, the strengthening of the National Health System (particularly the National Health Service), and the reduction of poverty and economic and social inequality.