Community Leadership and Health Mobilization: A Rapid Ethnographic Study of Three Zones in Manica Province

Publication Date:

01 Mar 1999


Chapman RR, Davissone R, Machobo F, Pfeiffer J. (1999) Community Leadership and Health Mobilization: A Rapid Ethnographic Study of Three Zones in Manica Province (Final Report) Health Alliance International and Manica Province Provincial Health Directorate. Retreived from Health Alliance International website:



Ethnographic research on the dynamics of community leadership and health mobilization was conducted in three communities in Manica Province, Mozambique to support improvement of the Manica Community Leaders Councils program. The study aims to provide guidelines for more effective identification and selection of local leaders with genuine influence in two key areas: 1) personal health-related behaviors, 2) participation in community health promotion activities. This is a qualitative study. Insights gained from this research are derived from in-depth discussions with a small number of respondents in a limited number of communities chosen for specific characteristics of

The following research methods were employed to gather data:

  • Structured key informant interviews with community leaders and residents.
  • Focus group discussions with women, youth, church pastors and others.
  • Unstructured open-ended interviews with key informants and bairro residents.
  • Brief exit surveys, using consecutive sampling, at vaccination points in the target
    communities during the National Vaccination Day campaign.
  • Participant-observation through attendance by researchers at church services,
    healing ceremonies, family meals, and community meetings.

The research was conducted in three communities in Manica Province – Bairro 16 de
Junho in the City of Chimoio, Bairro Mucessua in the town of Villa Gondola, and
Munhinga Locality in Sussundenga District.

Major Findings
Leadership Categories

  • The influence of both traditional and formal government officials with titles is
    variable by community. Overall, local government officials are loosing power as
    the importance of resources they control also change in each community.
    Traditional authorities retain power only in Munhinga.
  • Religious leaders are substituting traditional healers and leaders in their
    importance in delivering health care outside the formal sector, influencing
    individual health behaviors, and motivating community participation in health
  • Neither merchants nor traditional healers were identified as “leaders” in any of the
    three communities. Both categories include individuals who deliver specific
    services in the community, and neither category is chosen by community
    members for leadership. However, healers are consulted frequently and continue
    to greatly influence individual health beliefs and behaviors. Most urban church
    leaders stated that they would not participate in councils with traditional healers.
  • During the research, new terms were developed to identify two new categories of
    leaders not referred to in previous studies of community leader councils. Informal
    organic leader refers to those individuals who are identified in their community
    as influential and well respected, but who do not hold any official title or position
    of authority. Accumulated leadership refers to individuals who have acquired
    increasing status and power in a community based on an accumulation of
    qualities, history and reputation for being active. Often these individuals are
    selected by their community to hold official roles of authority based on personal
    qualities, activity and exemplary personal behavior.
  • Women and youth constitute important sub-groups in all three communities who
    are already being mobilized outside of the formal health sector. Leaders in
    mobilizations of these sub-groups are members of the group itself – women and

Leadership and Community Influence

  • Community leaders who hold positions with traditional or official titles may not
    have actual influence on the health behaviors of residents in their community.
  • Leadership varies among different social groups in each community.
  • Community-based organizations are already mobilizing community members
    around health issues independently of the health system.

General Council Creation Principles

  • Communities should select their own leaders for CLCs through a grassroots
    process of consensus.
  • CLCs should be organized around pre-existing community organizational
  • CLCs should address community-identified priorities.
  • CLCs should include leaders who represent diverse social sub-groups within the
    communities, or separate councils should be developed to address specific group


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