Monday, 7 September 2015

Mozambique and access to health care ...


Mozambique is a beautiful country endowed with natural resources and agricultural produce.

With a teeming population of over 24 million people (2014 estimate), millions of the people live in abject poverty.

About a decade and a half of war (1977 to 1992) post independence (1972) (Wikipedia) has made the country relatively backward and one of the poorest nations in the world at 184th out of 187 according to the United Nations human development ranking. (Action for global health network)


Between years 1994 and 2006 rapid economic growth was recorded in the country, however this growth was accompanied by chronic child malnutrition which was described by UNICEF and The World bank as paradoxical.

Corruption is a major problem in Mozambique. It is the canker worm that has eaten deep into the fabric of societal and economic growth in the said country.

Like in many African countries, poor access to health care and sub optimal health care delivery are major problems in Mozambique.

According to a report by the Action for Global Health network :

There are several obstacles to the attainment of health care services in Mozambique.

A focus on Tsangano in the province of Tete, a big region located in the center of Mozambique revealed that Tete is a severely medically under-served region with only 63 medical doctors and 300 nurses serving the two million people in the area.

The import of this finding is that there is a single medical doctor for 30,000 people, and a single nurse for 8,000 people.

Other challenges revealed in a documentary done by the said organization include difficulties with gaining access to health care services and poor quality of services rendered, which are due to:

Delay in accessing medical care: due to little or no female empowerment. A woman's decision to access health care is not her own but that of her relatives (husband and mother in law).
Usually when and if at all the decision is taken, it is often too late.

Long distances to health facilities and poor road networks:
An average person lives about 8 km from a health facility. And the roads that lead from the villages to the health facilities are also very bad and a times not motor able. Hence when the decision is finally taken to seek medical attention, there are no good roads or functional means of transportation to get to the health facility.

Thirdly, the health facilities are poorly equipped and under-served:
After the long and hazardous trip to a facility, a patient arrives to find that the nurse or doctor is not available. When available, they often lack the tools: in terms of medications, medical equipment and ambulances for effective treatment and prompt transportation to tertiary institutions when complications arise.
Furthermore, these facilities are far from comfortable, especially for pregnant women.

High out of pocket costs is also one of the highlighted issues;

A statement by the Action for global health network further showed that; in order that every one in Mozambique has access to basic health care, about $35.2 US Dollars is still needed for each person every year this is after excluding international and national cost obligations for health.

Hence the citizens end up bearing this cost both directly and otherwise as out of pocket payments for services rendered for health care received.

A statement by the said organization states that:
"When we advocate for an end to out-of-pocket payments we must ensure that the ‘key ingredients’ which make user fee removal a success are also addressed – the financing for the system as a whole and ensuring increased investment in transport and infrastructure, particularly in rural areas, the health workforce, access to medicines and better information for the population to demand their right to health."

As the world journeys towards a Universal Health care coverage, we advocate the strengthening of the primary health care systems, not only in Mozambique, but across sub Saharan Africa as a whole as this will form a strong foundation for the erection of enduring health systems.

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