Different Civil Society organizations state that despite important advances in the health sector, there are still challenges that need to be overcome, improving especially assistance in maternal and child services and Sexual and Reproductive Health.

In order to overcome these challenges and guarantee the well-being of the population, the Government must elaborate strategies and action plans in the health sector, including the Civil Society as a partner.

This position was expressed last week (25th and 26th of October), in Maputo, by the Executive Director of the Citizen Observatory for Health (OCS), Jorge Matine, in the scope of the Workshop regarding the Reflection on the Added Value of the Involvement of the Civil Society in the Implementation of the National Health Strategy.

According to Matine, the report published this year about the HIV/AIDS seroprevalence indicator showed that, despite so many investments made, the desired advances have not yet been achieved, which means that something is failing.

In this context, said the director, the workshop aimed to collect different positions of the civil society about what can be done to improve these indicators.

Matine also argued that the country has quite frightening indicators when it comes to early pregnancies. Although the legislation on the matter is strong, the numbers on early marriages and teenage pregnancies remain high.

Thus, there is a need for a deep debate about the inclusion of health-related issues in the school curriculum, with an emphasis on Sexual and Reproductive Health, so that adolescents and young people are prepared for their own well-being.

“It is important that we realize that getting information in advance transforms lives. It allows us to stay in school longer, to learn, to prevent, and to have time to study and plan our families for later, after we finish school. This is also one of the ways to end poverty in the country”, he said.

In this way, “the dialogue between Government and Civil Society is imperative, so that we can understand the dynamics of the country and discuss the appropriate mechanisms to benefit the populations.”

The space for debate between the Government and Civil Society, according to the director, has been reduced, jeopardizing the health sector, as there are enormous challenges aggravated by the Covid-19 pandemic that plagued the world and Mozambique in particular.

“The Covid-19 pandemic weakened the National Health System in several ways, because it was a new phenomenon and no one knew how to deal with it”, he says, adding that nevertheless “it was a learning moment, but in countries with fragile systems, such as Mozambique, the challenges were greater.”

He adds that although there was an adequate response in terms of vaccines, it was more complicated to manage the situation in Mozambique because it is a low-income country.

“Covid-19 worsened the challenges of the health sector in Mozambique. Above all, it showed the level of robustness of certain countries in dealing with this kind of challenge. From this, we learned that we should invest heavily in our own capacity to find the means and strengths to deal with these challenges in the future”, he said.

The OCS director also expressed concern over the lack of interaction between Government and Civil Society regarding the GFF funding mechanism. He explained that when Mozambique signed this mechanism, Civil Society organizations met with the Ministry of Health and the Ministry of Economy and Finance to explain the importance of having a mutual dialogue on how they can improve this mechanism.

“It is a practice that should always take place, establishing a debate between the two parties. In Mozambique, this dialogue has failed a lot”, Matine said.

MISAU DEFENDS MULTI-SECTORIAL DIALOGUE

In his turn, the head of the Department of Planning and Health Economics of the Ministry of Health (MISAU), Daniel Simone, acknowledged that the health sector in Mozambique is deficient, especially in the components of hospital care, provision of services, medicines and health network.

Thus, Simone defends the need for the subject to be continuously debated by the civil society and associations linked to the sector, in order to influence other entities on decision making at each level so that investments in the health sector are improved in the short, medium and long term.

Simone pointed out the investment in hospital equipment as one of the great challenges of the sector, explaining that many times patients stay for a long time in the waiting line because a certain piece of equipment does not match the patients’ demand.
“How many of you have stood on the waiting list for so long because a certain piece of equipment did not respond to the patients? In order to correct these aspects, the sector relies on the collaboration of civil society organizations”, Simone said, and then added that “we recognize there are flaws in all the indicators referenced by the director of the OCS, but they can only be resolved in a multisectoral way.”

He admitted that civil society plays a key role in energizing, operationalizing the strategic objectives of the global and operational indicators laid out in the Government’s Five-Year Program 2020-2024.

“The plan has three main priorities, namely, the extension of the health network to guarantee access to health care; implementation of the pharmaceutical policy and management, including the distribution and logistics of medicine, and the implementation of the community subsystem”, he said, adding that “the success of the National Health Service depends on the contribution of each member of civil society at each level.”

For Simone, one of the great challenges of the sector at this time is to include everyone, in the context of universal health coverage, and to do this, “we need to consolidate the role of primary health care at the level of localities, communities and health units that correspond to the secondary level of health care.”

The sector, says Simone, must involve all social actors, mobilizing investments and mobilizing more resources for health, looking at accountability and transparency in the allocation and use of these resources at each level.

“You are called to have that integral and multisectoral role”, he stressed.

The expanded Workshop among Civil Society Organizations in Mozambique aimed to reflect on the Added Value of Civil Society Engagement in the National Health Strategy (sharing good practices, good examples of engaging with the Government and working with the World Bank, challenges and possible solutions to these challenges, as well as opportunities for greater collaboration in the future). The two-day event was organized by the Citizens Observatory for Health (OCS), in partnership with M’weti, PLASOC, Alliance for Health, and was supported by PAI and GFF.

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