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                                                                          Mozambique's Health System

                                                                          Picture
                                                                          An estimated 25 donors finance about 70% of Mozambique’s health budget through basket funding. Some of these donors provide direct financial assistance to MISAU others to specific areas of the country or disease areas.The WHO estimated that in 2006 Mozambique spent US$ 56 per person at PPP on health, which represents 4.7% of GDP.

                                                                          Health services in Mozambique are provided at the primary level by health posts (652) and health centres (435); rural hospitals (27) and district hospitals (8) at the secondary level; general (5) and provincial hospitals (7) at the tertiary level and at the quaternary level by central hospitals (3). This is equivalent to one health unit per 15,000 inhabitants with only 40% of the population having access to these health facilities.

                                                                          The remainder of the population is covered by: traditional medicine, community health agents, elementary agents and traditional birth attendants. A small part of the population is covered by private healthcare, mainly concentrated in the big cities.

                                                                          Despite these constraints Mozambique has been able to improve some of its core health indicators.

                                                                          In addition some government measures have been implemented that benefit people with chronic illnesses. Decree 16/88 (discount on the total value of the prescription) and the more recent Ministerial Dispatch Nr. 42/2007, (unitary price of 5.00 Mts (five meticais, US$ 0.20) per prescription), clearly are measures aimed at benefiting people with chronic diseases. However, this positive measures place a heavy burden on the health system and on the country as the burden of health care costs shift from the individual to the country.

                                                                          The main health challenges in Mozambique remain Communicable Diseases. HIV/AIDS is now responsible for 1 in 3 deaths and the  death rate due to malaria in children under 5 equivalent to 1,159/100,000 population. However, Non Communicable Diseases (NCD) are also increasing in burden. In a recent study by Damasceno et al. a prevalence of 33.1% for hypertension in Mozambique was found, with only 18.4% aware of their condition. About half of those individuals aware of their condition were under treatment and control was found to be extremely low.

                                                                          NCDs are not only affecting adults, but are also starting to impact children. In a 10 year study of the causes of death of children under the age of 15 years in Manhica, Communicable Diseases are still the most prominent cause of mortality with 73.6%, but NCDs represent 13.4% of the total with 9.5% because of chronic conditions and 3.9% due to injuries.

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