
Despite the improvements that have been registered in the health sector in Mozambique, in recent years, challenges still prevail in terms of hospital infrastructures, provision of health services and aspects linked to health legislation.
A study carried out by the Citizen Observatory for Health (OCS) on “Provision of Public Health Services in Mozambique” concluded that, in terms of infrastructure, there are few health units, and the few existing ones offer few services in a deficient manner.
According to the research, developed within the scope of the Sou Cidadão Project, which is financed by the European Union, through the PAANE,he situation is made worse by the fact that there are localities that do not even have a health unit, forcing the population residing in these localities to travel long distances to access health services.
Other concerns regarding the provision of public health services in Mozambique include the lack of medicines, fully functioning hospital equipment, as well as the lack of medical surgical material and the lack of infrastructure conditions to accommodate people with disabilities.
Briefly, according to the OCS research findings, users living in remote areas with difficult access are forced to travel long distances to access medicines and other essential health services, which are not available in the nearest health units (US’s) in their area.
In these situations, the users resort to district and provincial hospitals, which undermines the country’s objectives to achieve universal health coverage, which is based on the main premise of guaranteeing the level of primary health care in the communities.

In addition to the arguments above, the study found that the doctor/inhabitant ratio is far from that recommended by the World Health Organization (WHO) (2.3 per 1,000 inhabitants), which is reflected in the pressure on the National Health System, as well as on health professionals themselves, who are obliged to attend to a significantly high number of users. This situation will result in long queues and many hours of waiting by the users.
With regard to legislation, the research concluded that the health laws in force are still not known, respected and applied, since the user’s right is often violated by the practice of illicit charges for priority, improved and efficient care, as well as disrespect for the application of the Mozambican Charter of the Rights of the Patient.
With regard to obstetric services or maternity wards, it was found that there have been weaknesses in the offer of humanized health services to pregnant women, a situation that challenges the health sector in responding to these constraints. This scenario is aggravated by the lack of adequate inspection of health facilities, resulting in the late start of activities and diversion of medicines by health professionals.

The research brings as recommendations: ensure financial autonomy in health facilities in order to generate efficiency in the provision and supply of health services; improve the supply and management of the stock of medicines to avoid routing; and implement the national strategy to combat illegal collections, with a view to holding offenders accountable.
It also recommends the implementation of the guidelines of the Charter of Rights and Duties of the Patient, to restoring dignity to users of public health services; application and harmonization of formal inspection or monitoring mechanisms, to assess the degree of compliance with hospital operating standards; investing in the allocation of human resources to Health Units to meet user demand, since the doctor/patient ratio is increasing negatively; and improving hospital infrastructures, including maintenance, rehabilitation and construction of more infrastructures.
The survey, which aimed to analyze the provision of health services in southern, central and northern Mozambique, specifically in the provinces of Sofala, Tete, Maputo and Inhambane, covered around 480 users per province, making a total of 1,920 users.
In Tete province, users were surveyed in the 25 de Setembro Health Centre, Changara District Health Centre, Cateme Health Centre and Dzunga Health Centre; in Inhambane, Maxixe and Bembe Health Centres; in Maputo, Machava, Habel Jafar and Ndlavela Health Centres; and in Sofala, Mascarenhas Health Centre, Chingussura Health Centre and Manga Loforte Health Centre.
Read the full survey at: https://www.observatoriodesaude.org/download/provisao-dos-servicos-publicos-de-saude-em-mocambique/