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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...

Primeira sessão do dia aberto ao cidadão, uma iniciativa do conselho municipal da ilha de Moçambique para escutar as questões que atinjem os cerca de 50mil habitantes da primeira capital de Moçambique. As reuniões são realizadas nas comunidades para que de forma franca e aberta os munícipes possam apresentar os seus problemas

CONTEXT: Although institutional coverage of childbirth is increasing in the developing world, a substantial minority of births in rural Mozambique still occur outside of health facilities. Identifying the remaining barriers to safe professional delivery services can aid in achieving universal coverage. METHODS: Survey data collected in 2009 from 1,373 women in Gaza, Mozambique, were used in combination with spatial, meteorological and health facility data to examine patterns in place of...

Background: In countries, such as Mozambique, where maternal mortality remains high, the greatest contribution of mortality comes from the poor and vulnerable communities, who frequently reside in remote and rural areas with limited access to health care services. This study aimed to understand women’s health care seeking practices during pregnancy, taking into account the underlying social, cultural and structural barriers to accessing timely appropriate care in Maputo and Gaza Provinces,...

Globally 2.9 million babies die each year before reaching 28 days of life. Over the past quarter century, neonatal mortality has declined at a slower pace than post-neonatal under-five mortality: in consequence newborns now comprise 44% of all deaths to children under five years. Despite high numbers of newborn deaths, global organizations and national governments paid little attention to the issue until 2000, and resources, while growing since then, remain inadequate. This study examines...

Since 1990 mortality and morbidity decline has been more extensive for some conditions prevalent in low- and middle-income countries than for others. One reason may be differences in the effectiveness of global health networks, which have proliferated in recent years. Some may be more capable than others in attracting attention to a condition, in generating funding, in developing interventions and in convincing national governments to adopt policies. This article introduces a supplement on...

Nearly 300 000 women—almost all poor women in low-income countries—died from pregnancy-related complications in 2010. This represents a decline since the 1980s, when an estimated half million women died each year, but is still far higher than the aims set in the United Nations Millennium Development Goals (MDGs) at the turn of the century. The 1970s, 1980s and 1990s witnessed a shift from near complete neglect of the issue to emergence of a network of individuals and organizations with a...

Background: Striving to foster collaboration among countries suffering from maternal and child health (MCH) inequities, the MASCOT project mapped and analyzed the use of research in strategies tackling them in 11 low- and middle-income countries. This article aims to present the way in which research influenced MCH policies and programs in six of these countries – three in Africa and three in Latin America. Methods: Qualitative research using a thematic synthesis narrative process was used...

Poor quality of care at health facilities is a barrier to pregnant women and their families accessing skilled care. Increasing evidence from low resource countries suggests care women receive during labor and childbirth is sometimes rude, disrespectful, abusive, and not responsive to their needs. However, little is known about how frequently women experience these behaviors. This study is one of the first to report prevalence of respectful maternity care and disrespectful and abusive...

Parteiras exigem entre 500 e 2.000 meticais para realizar partos. Cobranças ilícitas nas maternidades das unidades sanitárias em Nampula, Moçambique, estão a comprometer a qualidade do atendimento materno-infantil e a “forçar” as grávidas a optarem por ter filhos na comunidade. Algumas mulheres ouvidas pela VOA no Hospital Central de Nampula denunciaram o mau atendimento nas unidades sanitárias. Acusam ainda profissionais de cobrarem entre 500 e 2.000 meticais para realizar um parto.

Background: Maternal mortality remains a daunting problem in Mozambique and many other low-resource countries. High quality antenatal care (ANC) services can improve maternal and newborn health outcomes and increase the likelihood that women will seek skilled delivery care. This study explores the factors influencing provider uptake of the recommended package of ANC interventions in Mozambique. Methods: This study used qualitative research methods including key informant interviews with...

Child marriage is one of Mozambique’s most serious but largely ignored development challenges – requiring far greater attention from policy makers Child marriage rates are still very high despite a long-term decline, especially in marriage before the age of 15. Economic pressures and the incentive of bride price appear to be powerful factors driving parents to marry off their daughters at a young age. The high rates of child marriage cannot be allowed to continue without a vigorous...

Abstract Recent evidence indicates that disrespectful/abusive/coercive service delivery by skilled providers in facilities, which results in actual or perceived poor quality of care, is directly and indirectly associated with adverse maternal and newborn outcomes. The present article reviews the evidence for disrespectful/abusive care during childbirth in facilities (DACF), describes examples of DACF, discusses organizations active in a rights-based respectful maternity care movement, and...

Introduction: HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women...

Background: As low-income countries strive to meet targets for Millennium Development Goals 4 and 5, there is growing need to track coverage and quality of high-impact peripartum interventions. At present, nationally representative household surveys conducted in low-income settings primarily measure contact with the health system, shedding little light on content or quality of care. The objective of this study is to validate the ability of women in Mozambique to report on facility-based care...

The objective of this document is to share the results of work undertaken in Mozambique to promote respectful health care, particularly in maternal and neonatal care. With its origins in “humanization of care” efforts in Latin America, this approach centers on the woman and her family and is grounded by principles of ethics and respect for human rights. The approach recognizes a client’s cultural background, and views the client as a person with values and expectations that should be...

The number of people on antiretroviral treatment in Mozambique has increased by over 1,500 percent since it first became free and publicly available in 2004. The rising count of “lives saved” seems to portray a success story of high-tech treatment being provided in one of the poorest contexts in the world, as people with AIDS experience dramatic recoveries and live longer. The “scale-up” has had significant social effects, however, as it unfolds in a region with a complicated history...

See english abstract below. Pesquisa centrada nas políticas públicas do governo moçambicano para o setor da saúde, com foco voltado para programas de assistência à saúde materno-infantil. Tem o propósito de apresentar contextos básicos para a reflexão sobre a filosofia da implantação e implementação dos programas e a inserção da Enfermagem, mostrando seus marcos evolutivos. Constatou-se que, na década 70, o Sistema Nacional de Saúde adotou o Programa de Proteção Materno-Infantil, que na...

Activating communities to achieve public health change and initiate policy reform usually requires collective action from many entities. This case study analyzes inter-organizational networks among members of a coalition created to expand health insurance coverage to uninsured children in a large metropolitan area. Six networks were measured: collaboration, competition, formal agreements, receive funding from, send funding to, and greater communication. The response rate was 65.8% (50 of the...

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...