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Social accountability in the health sector has been promoted as a strategy to improve the quality and performance of health providers in low- and middle-income countries. Whether improvements occur, however, depends on the willingness and ability of health providers to respond to societal pressure for better care. This article uses a realist approach to review cases of collective citizen action and advocacy with the aim to identify key mechanisms of provider responsiveness. Purposeful...

A propitiously timed household survey carried out in Mozambique over the period 2008/ 2009 permits us to study the relationship between shifts in food prices and child nutrition status in a low income setting. We focus on weight-for-height and weight-for-age in different survey quarters characterized by very different food price inflation rates. Using propensity score matching techniques, we find that these nutrition measures, which are sensitive in the short run, improve significantly in...

This case study was commissioned by N’weti Comunicação para a Saúde to explore the changes emerging from the implementation of an adapted version of the Community Scorecard (CSC) tool in 11 health facilities catchment areas in Nampula. This case study discusses how N’weti has adapted the Community Scorecard (CSC) tool to better improve the quality of the participation and prospects of accountability for citizens. The case study presents evidence that the adapted CSC tool has resulted in an...

This chapter outlines the socio-economic and health baseline of areas (both onshore and offshore) potentially affected by the Project. The chapter is structured into a number of sections, as follows: • Sections 9.2 and 9.3 provide a summary of the baseline and sources of information used to compile the baseline, respectively. • Section 9.4 defines the Project Area of Influence, providing both an overview of the geographic characteristics as well as the respective administrative divisions and...

Since independence in 1975, development in Mozambique has been guided by a sequence of Five Year Plans, (Planos Quinquenais de Desenvolvimento). In 2002 the Government of Mozambique (GOM) initiated a series of reforms in all development sectors, aiming to start a process of decentralisation and bringing management closer to the lower levels of state organisation (Provinces and Districts). For the Municipalities, a devolution model was chosen that is currently in the process of being rolled...

A propitiously timed household survey carried out in Mozambique over the period 2008-09 permits us to evaluate the short-to-medium run relationship between sudden shocks to food prices and child nutrition status. We link local price inflation with child malnutrition status. We find that the prevalence of underweight amongst children rises in response to a higher inflation rate for basic food products. Stunting and wasting malnutrition measures are mostly insensitive to the inflation rate....

The major cross-cutting issues which featured prominently in all the thematic areas are highlighted below. A comprehensive approach is needed to address these issues as they have wider ramification for the various dimensions of governance in Mozambique. The following are the major thirteen crosscutting issues emerging from this report: Poverty and Inequality; Party/government/business dichotomy; HIV/AIDs; Land Ownership; High levels of illiteracy; High aid dependency; Information flow and...

Sociologists and anthropologists have had a long interest in studying the ways in which cultures shaped different patterns of health, disease, and mortality. Social scientists have documented low rates of chronic disease and disability in non-Western societies and have suggested that social stability, cultural homogeneity and social cohesion may play a part in explaining these low rates. On the other hand, in studies of Western societies, social scientists have found that disease and...

The main objective of this report is to capture the local configurations of gender relations in Nampula, by focussing on one rural and one urban area in the province. The former is the coastal and rural district of Mossuril, which is considered one of the most deprived districts in the province, both in terms of material poverty and human development (MAE 2005). The urban areas are Muatala and Namutequeliua, which are two of the most populous bairros in the city of Nampula and largely...

This is an update of the previous Gender Profi le for Mozambique which was produced in 2000. Sida produces gender profi les for several countries with the purpose of providing a short and concise summary of the gender equality situation in partner countries. The profi e is a desk study reviewing and compiling available statistical material that may be of interest to anyone interested in women’s social, economic and legal position and understanding gender relations in Mozambique. The human...

This report presents findings from the Social Sector Performance Qualitative Study (SSPQS). The SSPQS was designed as a follow-up to the Social Sector Performance Surveys (SSPS), which were public expenditure tracking surveys undertaken in the primary and secondary education and government health and family planning systems between 2004 and 2006. In many respects, the SSPS findings were positive, documenting that systems of health and education service provision were functioning. While there...

Despite high infant and maternal mortality rates, many Mozambican women with access to prenatal services delay prenatal clinic consultations, limiting opportunity for prevention and treatment of preventable pregnancy complications. Ethnographic research, interviews with health providers and longitudinal pregnancy case studies with 83 women were conducted in Central Mozambique to examine pregnant women's underutilization of clinic-based prenatal services. The study found that pregnancy...

This case study has attempted to show that the implementation of a policy mechanism like PSP in water and sanitation in a context like Niassa is highly unlikely to achieve the development impacts intended. It appears that the concept “PSP” itself is erroneous; it assumes that there is a private sector wishing to participate, and that public sector delivery is the key obstacle to private involvement. Equally erroneous is the idea that the private sector can just emerge from market mechanisms...

The papers and discussions included in this collection are the product of a workshop, “Discovering Normality in Health and the Reproductive Body,” held in March, 2001 at Northwestern University's Program of African Studies. The idea for the workshop stemmed from a history of collaborations among Caroline Bledsoe, Jane Guyer, and Kuate Defo Barthélemy on topics of fertility, health, and research methodology. The workshop itself grew out of a commitment to continue that conversation and to...

This article presents results from a study on the use and appropriation of information and communication technologies (ICT) in Mozambique with a focus on the health sector. The three provinces of Gaza, Inhambane and Niassa were surveyed and two questionnaires addressing 1) computer users and their ability to manage ICT, and 2) health workers and their handling of health information, were used. Based on this study appropriate strategies for developing an ICT-infrastructure with the needs of...

The IDS Participation and Health and Social Change Groups convened a workshop in October 1999 to share experience with the use of participatory approaches in enhancing accountability in the health sector, and to explore some of these challenges. The articles in this bulletin reflect some of the richness of experience on the ground in building effective participation, as well as some of the many issues that arise in moving towards more active citizen engagement with service provision. They...

In Mozambique, health services are mostly provided by the public sector, and it is the responsibility of the Ministry of Health (MISAU) to enable the creation, planning and control of national health policies. The health sector is the third sector that absorbs most resources from the State Budget (OE), followed by the Education and Infrastructure sectors, according to the methodology presented in the budget documents related to the economic and social sectors. This sector is divided into...