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Commonwealth Health Partnerships 2015

There is no specific mental health legislation in Mozambique, but there is a national mental health programme. There is little data to suggest the most commonly diagnosed mental illness in Mozambique. Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. For Mozambique to achieve its targets for the reduction of child mortality, which form MDG 4, it would need to have reduced under-five deaths per 1,000 live births to 79 and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 87 deaths per 1,000 live births and measles immunisation at 85 per cent. Although significant progress has been made, Mozambique will have to work hard to meet its target for under-five deaths and it is unlikely to meet the measles immunisation target. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. For Mozambique, the maternal mortality should fall to 228 cases per 100,000 live births. In 2013 Mozambique had an adjuested maternal mortality ratio of 480 deaths per 100,000 live births (this figure was estimated at 490 deaths per 100,000 by UN agencies/World Bank in 2010). This is more than twice the target figure. Significant progress has been made, with deaths falling considerably from almost 1,000 per 100,000 live births in 1990. However, Mozambique is very unlikely to meet the 2015 target. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2011 this figure stood at 54 per cent, so achievement of this target is also looking unrealistic. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other communicable diseases. Mozambique’s prevalence of HIV was 10.8 per cent in 2013 (in the 15–49 age group). Although the HIV prevalence rate has shown a slight decline since 2009, this figure is still very high and has dramatically increased overall since 1990. While the number of reported cases of malaria in Mozambique consistently increased each year in the period 2009–12, the number of deaths from malaria has seen a gradual decline in the period 2007–12. Equally, the country is estimated to have a high and rising incidence rate for tuberculosis, while overall mortality (when mortality data excludes cases comorbid with HIV) from the disease has increased slightly in recent years. Unfortunately, Mozambique is unlikely to achieve MDG 6 by 2015. Many measures in the Post-2015 Development Agenda National Consultation Country Report (see ‘Universal health coverage’ below) are steps that will contribute further towards the aims laid out in MDGs 4, 5 and 6. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Less than half of health care in Mozambique (44 per cent) was government funded in 2012. The remaining 56 per cent was paid for by patients or funded by other non-governmental entities, such as private insurers, charities or employers. Total health expenditure Mo z amb i q u e constituted 6.4 per cent of GDP in 2012. Expenditure by government amounts to US$17 per capita. Patients are often faced with out-of-pocket payments for medical treatment, which puts it beyond the reach of many poor Mozambicans. In addition to this, many people live a significant distance from the nearest health care centres, and lack of good roads and transport make it difficult for them to access treatment. There is also a shortage of medical staff and hospital beds. A 2013 joint report by United Nations in Mozambique and the Foundation for Community Development, entitled Post-2015 Development Agenda National Consultation Country Report – Voices and Perceptions from Groups and Organizations in Mozambique, identified several key issues requiring attention in the country’s post-2015 development agenda. These included improving access to high-quality health services nationwide; improving health services for women in rural areas; increasing standards of reproductive health for girls and women; and promoting the preservation of the sexual and reproductive rights of women. Mozambique’s Health Sector Strategic Plan 2014–19 comprises seven strategic objectives, based on the principles of primary health care, equity and improving the quality of services. The plan looks to increase access and utilisation of health services; improve the quality of service provision; reduce geographic inequities between different population groups in accessing and utilising health services; improve efficiency of service provision and resource utilisation; strengthen partnerships for health; increase transparency and accountability on management of public goods; and strengthen the health system. Mozambique is not a signatory to the International Covenant on Economic, Social and Cultural Rights, the covenant that commits signees to ensuring ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. Care of the elderly: Around 847,000 people in Mozambique are over the age of 65 – three per cent of the total population (2013). At the age of 60 a person living in Mozambique can be expected to live for an additional 17 years, on average (2013). Mozambique’s Programa de Subsido Social Basico (basic social subsidy programme) dates back to 1992. Today, monthly pension credits are paid by the state at a rate of US$8 per person (2007–12) on a means-tested basis. Overall, public pension spending is equivalent to 1.8 per cent of the country’s total economic output (2012). Traditionally, the elderly were cared for by extended family members but – as with neighbouring countries – many elderly people have now been left caring for grandchildren orphaned by AIDS. HelpAge International and Unicef have been working with families that are headed by elderly people, with regular visits to the household and Population over 65 3% Commonwealth Health Partnerships 2015 217


Commonwealth Health Partnerships 2015
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