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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...
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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...
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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...
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The Citizen Engagement Program (CEP) supports citizens to monitor the quality of health and education service delivery in 4 of the 11 provinces of Mozambique, as well as to advocate for the improvement of the quality of those services at the district, provincial and national levels. The CEP aims at contributing towards the increased availability of relevant information for citizens to better access and benefit from services delivered by the public sector; improving citizens' capacity to...
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OBJECTIVES: We explored and analyzed how findings from public affairs research can inform public health research and practice, specifically in the area of interorganizational collaboration, one of the most promising practice-based approaches in the public health field. METHODS: We conducted a systematic review of the public affairs literature by following a grounded theory approach. We coded 151 articles for demographics and empirical findings (n = 258). RESULTS: Three primary findings stand...
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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...
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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...
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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...
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The article discusses some of the economic effects of war in northern Mozambique. It indicates how the historical and structural features of the economy of northern Mozambique restricted post-war reconstruction and post-war poverty alleviation. These features include the dominance of only a few cash crops for export, the absence of much rural trading, poor communication infrastructure, and weak political and state institutions. The specific nature of the internal war further weakened the...
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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...
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A multi-centre study in four African countries was undertaken to test the acceptability and effectiveness of Health Workers for Change, a methodology to explore provider–client relations within a gender-sensitive context. This intervention addresses the interpersonal component of quality of care. The methodology, consisting of six workshops, was implemented by research teams in Zambia, Senegal, Mozambique and Uganda. It was found to be acceptable within in a range of cultural and primary...
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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...
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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...
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In 1985 Mozambique commemorated its tenth year of independence against a background of a continuing need to defend the country, not only against the actions of the externally-backed Mozambique National Resistance (MNR), but also against drought, acute food shortages and a world economic recession. These external factors have significant implications for the implementation of Mozambique's health policy. The MNR has chosen as deliberate targets for attack: health posts, health centres, rural...
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