Patients and users of various public health facilities in Mozambique are still barred and denied to access the health services because of their clothing or appearance.

This information is expressed in the III Survey on Monitoring Implementation of the Ministerial Order on Removal of the Clothing Barrier in Access to Health Facilities, conducted by the Citizen Observatory for Health (OCS).

The study – carried out under the scope of the Sou Cidadão (I am a Citizen) Project – covered 77 Health Units, and 462 users from almost the entire country were surveyed. It mentions strapless blouses, with necklines and bare backs; skirts and dresses above the knees; shorts; flip-flops and dreadlocks as the main barriers to accessing health care. In other words, the mentioned clothing is considered inappropriate to attend the National Health Service.

The survey also points out that significant number of respondents (47.2%) is unaware of the existence of the Ministerial Order because they have never seen it.

“These data show that the measure still lacks mechanisms of dissemination so that it is in the public domain, including health professionals”, it is read the survey.

Of the 462 users interviewed throughout the country, 63 people said that they have been barred, against 399 who have not. However, Inhambane Province, with 42 people interviewed, presents the highest number of cases with a total of 21 cases. It also presents 21 cases of people who are have not been barred.

“In second place, we have Tete province with 9 cases of barred users; Sofala and Niassa provinces, each with 8 cases; Nampula with 3 cases; Gaza with 2 and, finally, Maputo City and Cabo Delgado with no cases, in the present monitoring.”

“Similar to the data of the previous report (II Monitoring Survey), Nampula province did not register any case of barring”, the study adds.

These indicators, according to the study, are probably related to the fact that this research covered more US’s, not only urban ones, but also those located in peri-urban and rural areas. 

According to the same survey data, in all provinces there is still a need to implement robust strategies to disseminate and massify the implementation of the Order, creating mechanisms to sanction those who do not comply with the norms set out in the document.

These data also indicate that most of the users surveyed, a total of 312, had access to information through the media. However, 150 users are still unaware of the existence of the order.

Regarding the level of knowledge of health sector employees about the existence of the Order’s measure, the data indicate that 76.6% of providers admit being unaware of the measure.  In turn, 23.4% represents the number of providers who are aware of the existence of the Order. The discrepancies show that it is not only a question of lack of knowledge about the Order’s existence. That is, the situation also has to do with the absence of clear and effective strategies for implementing the measure.

“In this context, it is necessary to create local mechanisms for the dissemination of the measure, so that it is known to the users who go the health units”, suggests the study, calling on the National Health System to establish communication mechanisms with various social actors and civil society organizations for the production of evidence in the scope of inspection and monitoring of the implementation and dissemination of the measure.

The same measure should also be disseminated in public places, such as: schools, markets, as well as in media (community radios, televisions).

“Educational and awareness campaigns can also be carried out with users and communities through Community Based Organizations, Management and Health committees, with the help of community leaders and other social entities”, stresses the research.

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