Description
Mozambique, a country of approximately 28.9 million inhabitants, ranks near the bottom of the Human Development Index (180 out of 188 countries in 2019). Close to 70% of the population lives in rural areas, almost half the population (43.9%) is illiterate, and more than half (59.6%) lives on less than $1.25 a day. With a large youth bulge (approximately half of the population is under the age of fifteen and two-thirds is under the age of 24), only a small proportion of Mozambicans (18% of males and 13% of females) complete secondary school. Gender-Based Violence (GBV) is common throughout Mozambique, leaving girls and women vulnerable to HIV infection and other health-related complications. Improvements in maternal mortality have stagnated for several years, at approximately 408 maternal deaths per 100,000 live births. Even with the important gains in child health (under-5 mortality declined by one-third in 2003-2011), nearly one in ten children do not survive until their fifth birthday and nearly half (43%) of the survivors are stunted. Pediatric HIV rates in Nampula are the highest in the country, signaling challenges around quality of MNCH service delivery for vulnerable populations. While contraceptive prevalence is rapidly rising (from 11.3% in 2011 to 27.4% in 2015), Mozambique has not yet experienced the same decline in total fertility rate as neighboring countries, leaving Mozambique with a fertility rate of 5.3--one of the highest in sub-Saharan Africa. Health is USAID’s largest and most complex portfolio in Mozambique, and focuses on preventing maternal and child deaths, controlling the HIV epidemic, and assisting the Government of Mozambique to strengthen critical components of the health system in order to sustain major improvements over the long-term. In close cooperation with the Mozambique Ministry of Health, USAID works in concert with the U.S. Centers for Disease Control (CDC) on infectious disease and promotes use of the resources and know-how of the private sector when advantageous to public health goals. Maternal and Child Health: Mozambique is one of USAID’s 25 focus countries for maternal and child health. Focused in Nampula province, USAID’s programming strengthens service delivery in facilities and communities in tandem with technical assistance to district, provincial and central-level health sector managers and planners. USAID supports the government´s Model Maternity Initiative to improve the quality of maternal and newborn services and respectful care to encourage facility deliveries. Family Planning and Reproductive Health (FP/RH): Mozambique is a Family Planning and Reproductive Health Priority Country. USAID increases access to and demand for voluntary, high quality FP/RH services including modern contraceptive methods in Nampula and Sofala provinces. Malaria: Since 2006, through the President’s Malaria Initiative (PMI), the United States has invested over $306 million in malaria prevention and control activities. Through PMI, USAID supports national distribution of insecticide-treated mosquito nets, indoor residual spraying, accurate diagnosis and prompt treatment, social and behavior change communication, surveillance, and operations research. Mozambique, with U.S. Government support, is working to revitalize and expand the nation’s community health worker (CHW) program. CHWs provide preventive and basic curative services, including malaria diagnosis and treatment. Nutrition: USAID’s activities focus on strengthening government systems and human resource capacity, providing technical assistance to improve “last-mile” delivery of nutrition products, social behavior change activities, and community-based nutrition interventions. HIV/AIDS: USAID aims to improve national antiretroviral treatment (ART) coverage and support the National HIV/AIDS Control Program’s ‘Five Pillars’ for linkage and retention, increase ART coverage for adolescent girls and young women (AGYW), increase case finding and retention among partners of women, and promote and expand access to pre-exposure prophylaxis (PrEP) for key populations. Tuberculosis: USAID activities focus on increasing coverage of high-quality TB diagnosis and treatment services to reduce TB-related illness and death.