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Various investments could help countries deliver on the universal health coverage (UHC) goals set by the global community; community health is a pillar of many national strategies towards UHC. Yet despite resource mobilization towards this end, little is known about the potential costs and value of these investments, as well as how evidence on the same would be used in related decisions. This qualitative study was conducted to understand the use of evidence in policy and financing decisions...

Os objectivos e os pilares do PES e OE de 2020 não mudaram, substancialmente, em comparação com o que foram as prioridades do quinquênio 2015-2019. Em linha com os compromissos internacionais, o Governo procurou manter os pesos relativos da despesa nos sectores prioritários, com particular realce para a educação e a saúde. Contudo, o aumento dos preços e dos encargos da dívida, que se seguiu à descoberta das dívidas não declaradas, baixou o valor real das provisões feitas nestes sectores. O...

A área de logística farmacêutica (LF) é vital pelo facto de assegurar que os medicamentos e produtos médicos estejam disponíveis no país e nos pontos de entrega e inclui seleção de medicamentos, quanti cação, procurement, controle de qualidade, armazenamento, transporte e distribuição. O Governo de Moçambique reconhece a importância deste sector e como parte da agenda de reforma do MISAU desenhou o Plano Estratégico de Logística Farmacêutica (PELF) juntamente com o respectivo Plano...

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...

The main focus of the report is the impact of the coronavirus (Covid-19) pandemic on democracy and freedom around the world. It looks at how the pandemic resulted in the withdrawal of civil liberties on a massive scale and fuelled an existing trend of intolerance and censorship of dissenting opinion (see page 14). The report also examines the state of US democracy after a tumultuous year dominated by the coronavirus pandemic, the Black Lives Matter movement and a hotly contested presidential...

In the case of Mozambique, the pandemic came on the heels of two destructive cyclones that had devastated large parts of the country in 2019 and whose consequences were still being felt. In northern Mozambique, increasing violence in Cabo Delgado province resulted in a surge of internally displaced persons into local communities in Cabo Delgado, Nampula and Niassa provinces. With host communities ill equipped to meet the needs of those displaced, this population movement created a new...

The healthcare system in Mozambique is striving to reduce the high maternal and child mortality rates and stay on par with the Sustainable Development Goals (SDG 3.1). A key strategy to curb maternal and child mortality is to promote the use of professional childbirth services proven to be highly effective in averting maternal deaths. Currently, little is known about the use of childbirth services in Mozambique. The present study investigated the prevalence of professional healthcare...

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’...

This policy brief, apart from describing the dilemmas of the democratization process of health services it, aims to analyze its implications on the dynamics of social accountability in the health sector and, finally, to inform on possible ways for a more coherent democratization, considering the normative discourses

The inclusion of persons with disabilities is an essential element of a strong democracy and a just society. Persons with disabilities (PWDs) being included means that they have a full and equal opportunity to participate in society and in political decision-making processes, to develop their capacities, and to contribute to national progress Like everywhere, persons with disabilities in Mozambique face physical, social, economic and/or environmental barriers to participation. For example,...

Research has highlighted disparities in family planning outcomes by wealth and by region separately. This analysis examines regional disparities within specific poverty groups. Twelve USAID family planning priority countries with recent DHS or AIS surveys were selected for the analysis, including 11 DHS surveys (Democratic Republic of Congo (DRC), Ethiopia, Ghana, Haiti, Malawi, Nepal, Nigeria, Pakistan, Rwanda Uganda, and Zambia) and one AIS survey (Mozambique). The measure of absolute...

O presente relatório resume os resultados do Inquérito Nacional sobre Indicadores de Malária em Moçambique, conduzido pelo Instituto Nacional de Saúde (INS), em colaboração com o Programa Nacional de Controlo da Malária (PNCM) e o Instituto Nacional de Estatística (INE). O inquérito contou com a assistência técnica da ICF, através The Demographic and Health Surveys (DHS) Program. O inquérito foi financiado pela Agência dos Estados Unidos para o Desenvolvimento Internacional (USAID) através...

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...

Evidence suggests that many women experience mistreatment during childbirth in health facilities across the world, but the magnitude of the problem is unknown. The occurrence of disrespect and abuse (D&A) in maternity care services affects the overall quality of care and may undermine women’s trust in the health system. Studies about the occurrence of disrespect and abuse in Mozambican health facilities are scarce. The aim of this study was to explore the experience of women giving birth in...

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 The Maternal Mortality Ratio in Mozambique has stagnated at 405 deaths per 100,000 live births with virtually no progress over the last 15 years. Low Institutional Birth Rates (IBRs) levelling around 50% in many rural areas constitute one of the contributing reasons. Demand-side financing has successfully increased usage of maternal health services in other countries, but little information exists on in-kind incentives in rural Africa. The objective was to test the impact on...

Key Messages: - Health is a human right and is constitutionally protected in Mozambique; - The health sector is considered a priority sector by the Government of Mozambique; - The health sector is amongst the least funded by the State Budget in the past four years, (with less than 8% on average), against the 15% assumed in Abuja; - For the year 2014, of the 762.8 million USD allocated to the health sector, 44% came from external sources (REO MOH, 2014). The combined PROSAUDE resources,...

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...