Maternity care system in Maputo, Mozambique: Plans and practice?

Mixed methods were used with various data sources to describe organisation and delivery of maternity care in Maputo city, Mozambique in early 2010s and to compare the plans with the service provision in practice. In the public health sector, maternity care was organised to be area based and hierarchical with a planned referral system. The provision of basic and emergency maternity care was publicly funded, largely dependent of donor funds, and free of charge for users. Even though Maputo City was better resourced than the rest of the country, there was a large lack of health professionals. Women’s choices and self-referrals, even to higher levels of care, were common, which broke the plans of areas responsibility, gate keeping and care by medical needs. Private services for maternity care had emerged for those who were able to pay, leading to dual practices of health professionals and shortage of care providers in the public system at odd hours. Information of maternity care was aggregate and poorly stored. The gap between “planned” services delivery and “practice” in a real-life requires overall health system strengthening to improve efficiency and effectiveness of health services delivery.