SAFETY NET

Mozambique 2014 | HEALTH & EDUCATION | REVIEW: HEALTH

Major efforts are underway to improve the National Health System in Mozambique to increase the quality of services, with the possibility of more private-sector participation.

Like many countries in Africa, Mozambique is looking to improve its healthcare services. As economic growth continues, people will expect a higher level of quality when it comes to their healthcare needs. In the immediate term, the government's plan will be to increase the standard to at least that of the regional average, and then in time aim for a global average. The National Health Service (NHS) in Mozambique currently reaches 60% of the population. The NHS is split into four levels; the first level represents 40% of all healthcare services in the country. It includes both rural and urban health facilities and offers primary healthcare services; however, these facilities have insufficient laboratory capacities, no in-patient services, and a limited number of maternity wards. The second level deals with district and rural hospitals, and offers diagnostic, surgical, and obstetric services. Level three includes provincial hospitals and mainly deals with curative services and diagnostic services/equipment, as well as training centers for new staff. The fourth level is made up of the country's three referral hospitals in Maputo, Beira, and Nampula, which serve the majority of the country. These hospitals are used for specialist treatments and diagnostics, and patients are sent there often by referral from the lower levels of the NHS.

As the country moves forward, it aims to increaseits number of doctors. In 2011, there were 64.5 doctors, nurses, and maternal health nurses per 10,000 people, somewhat lower than the acceptable 230 minimum workers threshold. However, the country has made progress in this regard. In 2006, there were only 25,683 health professionals, while this number had increased by 38% to 35,503 five years later in 2011. A problem the country faces is the fact that the majority of people live in rural areas. This makes it harder to access medical healthcare in a preventative manor. In 2011, approximately 69% of the population lived in rural areas. The total expenditure per capita in 2011 equaled $65, or 6.6% of GDP, which in 2012 stood at $26 billion.


HIV/AIDS

An aim of the government is to reduce the prevalence of AIDs and HIV. According to the World Health Organization (WHO), 5,827 per 100,000 people in Mozambique are HIV+, compared to the regional average of 2,725 and the global average of 499. In 2012, a partnership between Mozambique and Brazil led to a major new anti-viral manufacturing plant, which started production in the southern city of Matola. The plant is operated by Mozambican Medicines Company (SMM) and the medicine went on sale in early 2013. The factory produces Nevirapine, which was donated by the Brazilian government, to allow for its development and eventual operation in Brazil. The medicine, which used to be produced in Brazil and shipped to Mozambique, will now be produced, packaged, and distributed in Mozambique. The factory has an installed capacity of 371 million pills per annum, of which 226 million will be anti-viral drugs. It will also produce a further 21 generic drugs accounting for the remaining 145 million capacity. The Brazilian government invested $23.5 million in the plant, while mining company Vale invested a further $4.5 million as part of its corporate social responsibility program. It is hoped that the plant will lead to an 80% decline in imports of anti-viral drugs, in addition to providing an opportunity to export the drug to other African countries.

MALARIA

Another problem the country is facing is the high contraction rate of malaria, with incidences of the disease coming in at 31,941 per 100,000 compared to the regional average of 20,913 per 100,000 and the global average of 4,082. However, malaria prevention is one of the Global Health Initiative's main objectives and it has been offering significant assistance in reducing the burden of the disease, while educating the public on proper precautions. Statistically speaking, malaria is a bigger killer, at 29% of all deaths, while AIDs accounts for 27%. The transmission of malaria is more prevalent in rural areas as in urban areas there is less standing water. Malaria is controlled in the country using three levels of administration: central, provincial, and district. The district level is a relatively new creation of the Ministry of Health, and is largely used to improve data management on the ground. The provincial level coordinates and creates plans that combat and control malaria according to each province's needs. The central level is where national plans are devised and implemented. The National Malaria Control Program (PNCM), which runs these initiatives develops policy, establishing norms, and organizing and coordinating national strategies to combat the disease. In 2012, the PNCM finalized the National Malaria Policy and the 2012-2016 National Malaria Prevention and Control Strategic Plan, which has five main objectives: the decentralization of malaria control activities, at least one preventative method available to 100% of the population, confirmatory laboratory testing for 100% of suspected cases, prevention education accessible to 100% of the population, and a strengthened monitoring and evaluation system to allow districts to effectively collect and record data on the disease. Since the establishment of the GHI, its goal has been to reduce the extent of malaria by 70% compared to pre-initiative levels.