Mozambique is one of the countries with the highest average annual demographic growth rate, at around 3% per year. This rate, coupled with the large youth population, which also includes adolescents, makes it relevant and propitious to discuss the relevance

of the intervention of various players in order to maximize synergies with the aim of obtaining better results to ensure that population growth takes place in a solid environment, full of healthy and sustainable knowledge.

In this context, the Citizen Observatory for Health (OCS) held a workshop in Maputo last week on Reflecting on the Added Value of Civil Society in Implementing Relevant Actions in the Health Sector for the Well-being of Adolescents.

The event aimed to discuss lessons learned between various organizations that have been working in the health sector, with a view to improving the country’s performance in adolescent health.

On the occasion, the OCS’s program manager, Sidónio Tembe, said that challenges remain with regard to Adolescent and Youth Support Services (SAAJ), which are considered important for providing information on young people’s sexual and reproductive health, including education and the provision of basic health services.

“We still have the challenge of covering these services. They are not representative”, he said.

In addition to the low coverage, according to Tembe, there are technical limitations in the people who provide health assistance at local level.

“We have an emerging and important service, which brings strategic indicators for adolescents and young people, which are SAAJ, which are important for young people, particularly in terms of education and the provision of basic services.

However, one of the challenges associated with these services is the technical limitations of the people who provide medical assistance at local level”, he said.

According to Tembe, at a time when the services are at an embryonic stage, it is important to standardize the forms of intervention in the different units providing these services.

“We have been observing in the health sector in Mozambique that there are significant indicators in the southern region. But in other regions of the country, they are not good,” he said.

Non-institutional births remain a challenge

Other worrying indicators, as Tembe pointed out, have to do with maternal and child health, as well as chronic malnutrition, which affects child growth associated with the postpartum period. This situation interferes with the dynamics of families’ livelihoods.

“Institutional births in Mozambique are still a challenge, as is infrastructure. There is also a challenge in raising awareness among the population about the use of these services,” said Tembe. 

Tembe also explained that civil society organizations have their own activities, as well as collective ones.

“Actions can complement each other, taking into account the national health strategy,” he said.

“It is important that the various actions or interventions converge to improve the indicators, as well as to improve the implementation strategies, improve the National Health System, as well as the implementation of the national health strategy,” he stressed.

The added value he refers to is the extent to which the actions developed by the various civil society organizations converge in the implementation of the national health strategy.

He recalled that Mozambique, like other countries in the region, has a health system that is still weak and significantly dependent on external support for its operation, including strategic activities.

External dependence hinders country’s heath programs

According to the researcher, external dependence is also a barrier that characterizes the National Health System. In other words, dependence puts the country in a situation of vulnerability, where it is obliged to follow external agendas that result in the delay in the disbursement of funds for the functioning of the sector.

For Tembe, the dependency, which began to be felt soon after independence, has created challenges that are particularly noticeable in the primary health sub-system.

“Much of the community health system is largely supported by external partners and the internal budget still makes little contribution. However, we know that the majority of the Mozambican population still lives in rural areas and the level of primary care in Mozambique is still insignificant”, he pointed out.

For this reason, Tembe explained, the workshop in question is part of the proposals aimed at helping to reduce the dispersion of resources associated with interventions by various civil society organizations, as part of the achievement of specific indicators set out in the national health strategy.

“This is one of the ways of bringing together different resources, different actions towards a common objective that is already provided for in the national strategic plan,” he concluded.

There is a need to include people with disabilities

In another development, Farida Gulamo, a representative of the Forum of Mozambican Associations of People with Disabilities (FAMOD), lamented the fact that many projects, including those of civil society, lack the involvement of teenagers and young people with disabilities.

For Farida, organizations always talk about inclusion, but don’t provide evidence of such involvement, at a time when statistics show an inclusion rate of just 0.1%.

“What is civil society doing to involve young people with disabilities in each of its projects? We talk about inclusion, but the practice leaves a lot to be desired. If we, as civil society organizations, don’t look at this aspect, what can be said of the government?”, she asked.

For her part, Violeta Bila, representing MedicusMundi, said that there is a need for civil society organizations to start producing evidence on the situation of adolescents and young people, although there are few organizations investing in this area.

“The national health system does not capture data on people or patients with disabilities. The data that does exist does not report on these situations. MedicusMundi has produced two manuals on sexual health. Teachers will be trained on the subject” he said.

“The Ministry of Health (MISAU) and the Ministry of Education and Human Development (MINEDH) refused to talk about these issues, but the Maputo City Council was open. Partnerships with the municipality allow us to continue our actions”, she said.

Like Violeta Bila, Margarida Como, from Coalizão, also acknowledged that there is a lack of evidence on the impact of initiatives aimed at youth health.

Como also stressed that the involvement of young people should be explored in all projects, from their conception to their implementation and evaluation.

“Young people should raise their questions and concerns. It has to be the young person, in the first person, who says what they feel and what they want”, she said.

“We have to advocate for the programs that support young people to be taken over by the Mozambican government and for them to be able to be followed up. This means that we must fight for these programs to be included in the Government’s Five-Year Programs (PQG’s) and in the plans of the provinces and districts”, Margarida stressed.

The researcher also stressed the importance of producing material in sign languages, calling for support from the Global Financing Facility (GFF) and the World Bank for more inclusive programs.

Another important issue, according to Sérgio Murgo of the Pfuka U Hanya Association, is the involvement of caregivers or parents in the actions carried out by CSOs, to prevent the violation of children’s rights by their caregivers.

“Parents don’t have the courage to inform, they consider it illegal to introduce children to these aspects. The higher prevalence of HIV in adolescents and young people is due to a lack of information”, he said.

The event, which was attended by civil society organizations working on behalf of young people, academics and partner organizations, was supported by the Global Financing Facility (GFF).

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