“Our institute is training nurses and other health professionals and we believe that the deployment of qualified health personnel to the districts and rural areas is contributing to improving significantly the health status of our populations down to the communities,” said Arlinda Chaquisse, director of the ICS of Nampula.
Mozambique’s health system faces particular challenges in human resources, public financial management, health care financing, health coverage and quality of care. The country has the fifth lowest ratio of health workers to population in any country in Africa, with 0.03 doctors, and 0.21 nurses per 1,000 people. Although access to key health services such as vaccination for children and pre-natal care has improved between 2001 and 2011 and resulted in decreased mortality rates for children under five, glaring inequalities persist across regions and between urban and rural areas. For example, approximately 43% of children under five suffer from stunting, a rate that has remained unchanged since 2003 and accounts for at least one-third of child deaths.
To expand community-based services in remote and rural communities, $80 million has been allocated through the project for mobile units, training for health personnel and new community health agents. Community health agents act as liaisons between communities, nurses and health professionals, and provide knowledge to largely underserved communities in an effort to counter cultural beliefs and myths that often interfere with good health and nutrition practices, maternal and child health.
A total of 455 professionals are expected to graduate until the end of the project, and most of them are being trained at Nampula’s ICS. Given the high rate of malnourishment among children in rural areas in particular, the project is also training nutritionists in the City of Quelimane, center of Mozambique, to be deployed across the country.
Currently, Mozambique relies heavily on external financing for its health system. The health budget as a proportion of the total budget increased slightly from 7.2% in 2012 to 8% in 2013, but is very low by regional standards, and it offers little space for the government to increase salaries without reducing financing of basic inputs. The WBG is committed to assisting the Government of Mozambique to tackle some of these challenges, including by supporting improvements in the Public Financial Management (PFM) in the health sector through a variety of instruments such as those linking disbursements to PFM reforms in health and education, among other supports.