Speeches Shim
Mozambique– ranked in the bottom third of countries for health indicators – faces significant challenges in the health sector that impact TB diagnosis, treatment and outcomes. At the community level there is low awareness of TB symptoms, transmission, prevention and treatment. There is also stigma associated with the disease and its common co-infection HIV. Despite some recent progress at the facility level, significant gaps remain in terms of access to quality diagnosis, treatment and care.
Mozambique’s civil war led to an erosion of funding and support for the nation’s health system. Since its end in 1992, the health system has been improving, but the gains are not enough to effectively manage the significant health challenges facing the country. People are still dying due to lack of access to health services and low-quality care. In 2015, 40,000 deaths were reported from HIV/AIDS; and according to the Ministry of Health (MISAU), with a population of 26 million, Mozambique recorded over six million cases of malaria in 2015.
The prevalence of HIV in Mozambique is 12% among adults 15 to 49 years old with substantial variation in regional prevalence rates ranging from 25% to 3.7%. Mozambique’s HIV epidemic is driven by a complex combination of structural and social and behavioral factors that vary among sub-populations, including: low literacy rates (59%); poverty; low levels of male circumcision; insufficient access to HIV prevention, care, and treatment services; sexually transmitted infections; sexual violence; transactional sex; multiple concurrent partners; cultural practices, such as rites of passage; and gender imbalances.
Mozambique has made important progress in strengthening its pharmaceutical systems and improving access to life-saving medicines including antiretroviral therapy in recent years. A new medicines law, enacted by Parliament in 2017, created the National Directorate of Pharmacy (DNF), which is the National Medicines Regulatory Authority (NMRA).
Forca a Crianca e Comunidade (FCC) is a five-year cooperative agreement implemented by World Education and designed to provide education, social and economic strengthening to orphans and vulnerable children (OVC) in Manica, Sofala and Zambezia. Food Security Innovations Lab, part of the BASIS-AMA consortium implemented by UC Davis in conjunction with other US-based universities, is completing a prospective independent impact evaluation of the FCC activity.
The Mozambique Integrated Malaria Program (IMaP) is a five-year USAID-funded project implemented by Chemonics International that will contribute to reducing malaria mortality, morbidity, and parasitemia in four high malaria burden provinces (Cabo Delgado, Nampula, Tete, and Zambézia).
High fertility rates presents a serious health threat in Mozambique, with the total fertility rate varying from 4 to 8 with an average of 6 children per woman (DHS 2011). According to the National Malaria and HIV Indicator Survey 2015 (IMASIDA), the modern contraceptive prevalence rate (mCPR) is 25% (34% urban and 22% rural) with a high demand for modern methods of 50% and unmet need of 23%. A total of 46% of adolescent girls are pregnant for the first time or already have one child, and in this group only 14% are using any contraception method.
The Demographic and Health Surveys (DHS) Program has collected, analyzed, and disseminated accurate and representative data on population, health, HIV, and nutrition through more than 400 surveys in over 90 countries. Data generated by these surveys enables countries to identify and prioritize development targets, monitor progress towards Sustainable Development Goals (SDGs), and measure the impact of programming at the population level.
The health sector in Mozambique is faced with multiple financing challenges, limited domestic resources, plateauing donor support and increasing absolute level of out-of-pocket expenditures. This contributes to limiting access to care for people in need. Palladium and its partners support Mozambican partners and stakeholders to improve the enabling environment for HIV, Family Planning and Reproductive Health (FP/RH), and maternal, newborn, and child health (MNCH) and the Palladium/Health Policy Project (HPP), 2010 –2015 collaborated with USAID and the Mozambican Ministry of Health (MISAU) on a program that supported costing of Reproductive, Maternal, Neonatal, Child, and Adolescent Health (RMNCAH) programs.
In Mozambique, all Ministry of Health interventions carried out at the provincial level are overseen by the provincial Directorates of Health (DPS). Therefore, in the area of HIV/AIDS response, the DPS implements and supervises all activities related to the care and treatment of the national strategy of HIV/AIDS fight under the guidance of the Ministry of Health.
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