Failure to comply with the actions envisaged and established by the 2001 Abuja Declaration has created severe implications on the efficiency and effectiveness in the functioning of the health sector and in the provision of basic public services.
The finding was expressed at an event that was attended by civil society organisations, representatives of parliamentary committees and the media, who met during the week.
The Abuja Declaration was signed in 2001 and Mozambique is yet to meet the health sector funding target of 15 percent.
This position was expressed involved several actors with a preponderant role in decision-making in various sectors of society, with a greater focus on the health sector. The meeting was held as part of a joint action between the Observatório do Cidadão para Saúde (OCS) and Action Aid Mozambique, within the scope of the implementation of the Project Partnership for Social Accountability (PSA).
The debate was preceded by training of journalists on issues of public finances oversight in the health sector, aimed at giving them tools for the process of monitoring and evaluating the performance of the health sector, based on the resources allocated.
“Hunger and the high cost of food contribute to dropping out of HIV treatment. By this, I mean that the rate of abandonment of HIV treatment is quite high, due to mistreatment, long lines at health units. There is a shortage of medicines because health technicians siphon them off”, said Neusa Macondzo, a member of the Community-Based Organization Kuyakana.
To solve the main problems impacting the health sector, Lúcia Mafuiane, representing Frelimo’s Parliamentary bench, defended the need to intensify monitoring work so that government can carry out planned activities to respond to the most pressing problems.
“Society must demand that the government carry out activities”, said the member of parliament, adding that climate change and the war in Cabo Delgado are factors that have also contributed to the decrease in resources allocated to the health sector.”
On his turn, Mateus Chapayatomo, representing Renamo’s Parliamentary bench, defended the need for government to stipulate a budget capable of making the equipping of health units more flexible.
“Health facilities must be equipped, investing even more in budgeting,” said Chapayatomo, arguing that “SRHR can be negatively influenced by the content on television. It’s important to disseminate information on condom use so that young people can protect themselves against HIV.”
Mozambique needs – according to Nelma de Figueiredo, representing the MDM Parliamentary bench – a law able to ensure that projects from a previous government continue, even if another government made up of different people is introduced.
“We wouldn’t be restarting every project every time. The law would be important so that the funds allocated to the sector can be properly inspected”, he said.
Global Contraceptive Usage Rate is on the Order of 42.5 Percent
During the debate, Vânia Mbezane, from the Ministry of Health (MISAU), said that – with regard to SRHR – the global rate of contraceptive use in Mozambique is 42.5 percent due to the rupture of input stock.
“The fertility rate is quite high and contraceptive supplies are extremely scarce. It is 80 to 90 percent dependent on partners for the provision of pregnancy prevention supplies. The question I ask is: how would we do to reduce the external dependence on SRHR funding. That’s why, currently, the global rate of contraceptive use is 42.5”, said Mbezane.
For Matilde Ulissene, journalist at Rádio Índico, the monitoring of resources earmarked to the health sector must be carried out taking into account human resources.
“The training of health technicians should not be restricted to academia, it is necessary to observe the levels of sensitivity of the person who will be trained to deal with sick people”, said the journalist, for whom not all people have the sensitivity to deal with sick people.
“In the absence of sensitivity, for example, we have been following cases in which health technicians arrive late and, incredibly, leave the health unit early”, added Ulissene.
“We are against the privatisation of the health sector in Mozambique, because we believe that citizens do not have the capacity to cover the basic needs for their survival”, said António Mathe of the OCS.
For Mathe, it is crucial that there is a greater engagement of the media so that the services provided to users, in health units, are more accessible and impacting.
“The citizen should not be sacrificed to have access to health and SRHR cannot be seen only in the field of health, it is a social issue that involves all vital sectors for the running of the country”, said Mathe.
The debate – under the theme “Analysis of Budget Allocations in the Health Sector, with a Focus on the Budget Allocated to Sexual Reproductive and Health Rights (SRHR) and HIV” – aimed to promote the analysis, dissemination and debate on issues related to the tools of public planning (PES and OE), as well as focusing on reflection on SRHR and HIV.