Mozambique

HAI was founded in 1987, under the name Mozambique Health Committee, to support Mozambique’s Ministry of Health (MISAU) to rebuild their damaged health infrastructure following years of armed conflict.

Located on the southeastern coast of Africa, Mozambique’s population is both one of the fastest growing in the world [#16] and one of the poorest [#7]. However, 40 years ago, the country looked to be on a very different trajectory.

Following a decade-long resistance movement, Mozambique won independence from Portugal in 1975 and set to work forming a new government committed to social justice. In fact, Mozambique’s early embrace of a free public education and primary health care systems gained global attention. Unfortunately, so did their support for anti-apartheid movements in neighboring Zimbabwe (then Rhodesia) and South Africa.

HAI’s Mozambique offices are located in Maputo, Beira, & Chimoio.

“We didn’t talk about data before the IDEAs programme the way that we’re talking about it in the data review meetings. We didn’t talk about it, and we didn’t make an action plan”

– MCH Nurse, Búzi District

~$4 MILLION

In the wake of 2019’s Cyclone Idai, HAI helped identify and coordinate nearly $4 million dollars worth of resources in support of Mozambique’s National Health Service response.

17 YEARS

In 2003, 17 years after the first HIV diagnosis in Mozambique, HAI helped elaborate and implement the first national HIV/AIDS treatment business plan, offering HIV treatment through the nationl health system for the first time.

100+

In close partnership with the Beira Operations Research Center (CIOB), HAI provides technical assistance and training to Mozambican health researchers. This has resulted in more than 100 health system studies, publications, and presentations by Mozambican health professionals

In response, the apartheid governments of Rhodesia and South Africa waged a 15-year-long proxy war against the progressive government of Mozambique. This, coupled with harsh austerity measures imposed by international lenders resulted in a severely under-resourced national health system left to face the global AIDS and MDR-TB crises, widespread poverty and malnutrition, and a growing mental health burden.

This is the context in which HAI supports the Mozambican Ministry of Health in building a strong, resilient public sector health system.

Today, our work in Mozambique continues with a diverse portfolio of health system strengthening engagements. From leadership & management training focused on data-driven decision making under our multi-year IDEAs Project, to rebuilding and re-equipping Sofala Province’s health infrastructure in the wake of Cyclone Idai, to taking on some of the most complicated and underresourced health threats in Mozambique: tuberculosis, hypertension, and mental health.

Explore HAI’s Portfolio of current and recent Mozambique-based programs below.

HAI is not in a district or health facility with their own program. They are part of the public system itself. They are integrated. […] HAI was crucial when some organizations did not believe that they could do things in an integrated manner. HAI provided the example: to follow one program, which is the country’s program.

Dr. Francisco songane, former minister of health, Republic of mozambique

Mozambique Portfolio

COVID-19 Risk Prevention

Evidence-to-Action: Improving MNCH Service Delivery using the IDEAs Strategy

The Systems Analysis & Improvement Approach: Applying Systems Engineering to Optimize Complex Care Cascades

Cyclone Idai Response

Diagnosing & Treating Drug-Resistant Tuberculosis

Mental Health Screening & Treatment to Improve HIV Outcomes

Complex TB Case Detection & Management

SAIA-Hypertension: Integrating Care Cascades

Evidence-to-Action: Building Institutional Research Capacity

Southern African Research Consortium for Mental Health Integration

Public Sector Mentorship Program Evaluation

Identifying Gaps in HIV Treatment Retention for Pregnant Mozambicans under B+

SAIA-Mental Health: Systematizing Detection

SAIA-PMTCT: Optimizing the prevention of mother-to-child HIV transmission

Strategic Information Improvement in Mozambique Fellowship Program

TB Activistas: Improving Tuberculosis Screening, Diagnosis, and Linkages to Care

Assessors: Expertise embedded in the public system

Operations Research & Implementation Science Training

Want to dig a little deeper?

Publications

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique.	PLoS One, 2020
Validity and item response theory properties of the Patient Health Questionnaire-9 for primary care depression screening in Mozambique (PHQ-9-MZ)	BMC Psychiatry, 2020
HIV-exposed infant follow-up in Mozambique: formative research findings for the design of a cluster randomized controlled trial to improve testing and ART initiation.	BMC Health Serv Res, 2020
Global health systems partnerships: a mixed methods analysis of Mozambique’s HPV vaccine delivery network actors	BMC Public Health, 2020
Challenges and facilitators to evidence-based decision-making for maternal and child health in Mozambique: district, municipal and national case studies	BMC Health Serv Res, 2020
Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis and Care Cascade for HIV-infected Individuals (SAIA-HTN): A Hybrid Type III Cluster Randomized Trial	Implement Sci, 2020
Usability and Feasibility of an Innovative mLearning Approach for Nurses Providing Option B+ Services in Manica and Sofala Provinces, Mozambique	J Assoc Nurses AIDS Care, 2020
Evaluating and optimizing the Consolidated Framework for Implementation Research (CFIR) for use in low- and middle-income countries: A systematic review	Implement Sci, 2020
Making smarter decisions faster: systems engineering to improve the global public health response to HIV	Curr HIV/AIDS Rep, 2019
NGOs, austerity, and universal health coverage in Mozambique	Global Health, 2019
Developing a representative community health survey sampling frame using open-source remote satellite imagery in Mozambique	Int J Health Geogr, 2019
Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project	BMC Public Health, 2019
Depressive symptoms, suicidal ideation, and mental health care-seeking in central Mozambique.	Soc Psychiatry Psychiatr Epidemiol, 2019
Barriers to access and adherence to tuberculosis services, as perceived by patients: A qualitative study in Mozambique.	PLoS One, 2019
Development and Implementation of a Mobile Phone-Based Prevention of Mother-To-Child Transmission of HIV Cascade Analysis Tool: Usability and Feasibility Testing in Kenya and Mozambique.	JMIR Mhealth Uhealth, 2019
Geographic distribution and determinants of mental health stigma in central Mozambique.	Soc Psychiatry Psychiatr Epidemiol, 2019
Scaling-up the Systems Analysis and Improvement Approach for prevention of mother-to-child HIV transmission in Mozambique (SAIA-SCALE): a stepped-wedge cluster randomized trial.	Implement Sci, 2019
Human papillomavirus vaccine delivery in Mozambique: identification of implementation performance drivers using the Consolidated Framework for Implementation Research (CFIR).	Implement Sci, 2018
Effects of Xpert MTB/RIF testing and GxAlert on MDR-TB diagnosis and linkage to care in Mozambique	Int J Tuberc Lung Dis, 2018
Tuberculosis in Mozambique: Where do we Stand?	Curr Trop Med Rep, 2018
Intervention heroes of Mozambique from 1997 to 2015: estimates of maternal and child lives saved using the Lives Saved Tool.	J Glob Health, 2018
Small area estimation of under-5 mortality in Bangladesh, Cameroon, Chad, Mozambique, Uganda, and Zambia using spatially misaligned data.	Popul Health Metr, 2018
The everyday practice of supporting health system development: learning from how an externally-led intervention was implemented in Mozambique.	Health Policy Plan, 2018
Donor data vacuuming: Audit culture and the use of data in global health partnerships	Med Anthropol Theory, 2018
Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia.	BMC Health Serv Res, 2017
Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative	BMC Health Serv Res, 2017
Measuring health systems strength and its impact: experiences from the African Health Initiative	BMC Health Serv Res, 2017
Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa.	BMC Health Serv Res, 2017
Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity.	BMC Health Serv Res, 2017
Tackling the hard problems: implementation experience and lessons learned in newborn health from the African Health Initiative	BMC Health Serv Res, 2017
Stepped-Wedge Cluster Randomized Controlled Trial to Promote Option B+ Retention in Central Mozambique.	J Acquir Immune Defic Syndr, 2017
Austerity and the “sector-wide approach” to health: The Mozambique Experience	Soc Sci Med, 2017
Assessing linkages between HIV testing and HIV care enrollment and retention in central Mozambique.	Final Report, 2016
Health facility factors and quality of services to prevent mother-to-child HIV transmission in Côte d’Ivoire, Kenya, and Mozambique	Int J STD AIDS, 2016
Wait and consult times for primary healthcare services in central Mozambique: a time-motion study	Glob Health Action, 2016
Evaluation of a Systems Analysis and Improvement Approach to Optimize Prevention of Mother-To-Child Transmission of HIV Using the Consolidated Framework for Implementation Research	J Acquir Immune Defic Syndr, 2016
Option B+ in Mozambique: Formative Research Findings for the Design of a Facility-Level Clustered Randomized Controlled Trial to Improve ART Retention in Antenatal Care	J Acquir Immune Defic Syndr, 2016
Assessment of linkages from HIV testing to enrollment and retention in HIV care in Central Mozambique	J Int AIDS Soc, 2016
Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information	J Int AIDS Soc, 2016
Impact of a systems engineering intervention on PMTCT service delivery in Côte d’Ivoire, Kenya, Mozambique: a cluster randomized trial	J Acquir Immune Defic Syndr, 2016
Suicide Attempts and Deaths in Sofala, Mozambique, from 2011 to 2014	Crisis, 2016
Mozambique’s Debt and the International Monetary Fund’s Influence on Poverty, Education, and Health.	Int J Health Serv, 2016
Remote monitoring of Xpert® MTB/RIF testing in Mozambique: results of programmatic implementation of GxAlert.	Int J Tuberc Lung Dis, 2016
Outpatient Mental Health Services in Mozambique: Use and Treatments	Psychiatr Serv, 2016
Health facility determinants and trends of ICD-10 outpatient psychiatric consultations across Sofala, Mozambique: time-series analyses from 2012 to 2014	BMC Psychiatry, 2015
Implementation of tuberculosis infection prevention and control in Mozambican health care facilities.	Int J Tuberc Lung Dis, 2015
Loss to Follow-Up Among HIV-Exposed Children in an HIV Clinic in Beira, Mozambique	Sage, 2015
The availability of essential medicines for mental healthcare in Sofala, Mozambique	Glob Health Action, 2015
An Anthropology of Aid in Africa	Lancet, 2015
Early ART initiation among HIV-positive pregnant women in central Mozambique: a stepped wedge randomized controlled trial of an optimized Option B+ approach	Implement Sci, 2015
Using routine health information systems for well-designed health evaluations in low- and middle-income countries.	Health Policy Plan, 2015
Perspectives of key stakeholders regarding task shifting of care for HIV patients in Mozambique: a qualitative interview-based study with Ministry of Health leaders, clinicians, and donors	Hum Resour Health, 2015
Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009–2012	Popul Health Metr, 2015
Healthcare workers’ challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.	PLoS One, 2014
Implementing rapid testing for tuberculosis in Mozambique.	Bull World Health Org, 2014
Effects of health-system strengthening on under-5, infant, and neonatal mortality: 11-year provincial-level time-series analyses in Mozambique	Lancet Glob Health, 2014
Linkage to HIV Care and Antiretroviral Therapy by HIV Testing Service Type in Central Mozambique: A Retrospective Cohort Study	J Acquir Immune Defic Syndr, 2014
Systems Analysis and Improvement (SAIA) Study Tools (Standard Operating Procedures)	Implement Sci, 2014
Systems analysis and improvement to optimize pMTCT (SAIA): a cluster randomized trial	Implement Sci, 2014
Stock-outs of essential health products in Mozambique- longitudinal analyses from 2011 to 2013	Trop Med Int Health, 2014
What does high and low have to do with it? Performance classification to identify health system factors associated with effective prevention of mother-to-child transmission of HIV delivery in Mozambique	J Int AIDS Soc, 2014
Transmission of nevirapine-resistant HIV type 1 via breast milk to infants after single-dose nevirapine in Beira, Mozambique.	J Infect Dis, 2014
Cooperantes, Solidarity, and the Fight for Health in Mozambique.	Book Chapter, 2013
The Struggle for a Public Sector: PEPFAR in Mozambique.	Book Chapter, 2013
Vertical Funding, Non-Governmental Organizations, and Health System Strengthening: Public Sector Health Workers in Mozambique	Hum Resour Health, 2013
A common evaluation framework for the African Health Initiative	BMC Health Serv Res, 2013
Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative	BMC Health Serv Res, 2013
Strengthening integrated primary health care in Sofala, Mozambique	BMC Health Serv Res, 2013
Integration of HIV Care and Treatment in Primary Health Care Centers and Patient Retention in Central Mozambique: A Retrospective Cohort Study	J Acquir Immune Defic Syndr, 2013
The effect of tuberculosis and antiretroviral treatment on CD4+ cell count response in HIV-positive tuberculosis patients in Mozambique.	BMC Public Health, 2012
Brain Drain and Health Workforce Distortions in Mozambique	PLoS One, 2012
An assessment of the accuracy and availability of data in electronic patient tracking systems for patients receiving HIV treatment in central Mozambique	BMC Health Serv Res, 2012
Patient Volume, Human Resource Levels, and Attrition From HIV Treatment Programs in Central Mozambique.	J Acquir Immune Defic Syndr, 2011
An Assessment of Routine Primary Care Health Information System Data Quality in Sofala Province, Mozambique	Popul Health Metr, 2011
Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans.	AIDS Behav, 2011
Nevirapine Resistance by Timing of HIV type 1 Infection in Infants Treated with Single-dose Nevirapine	Clin Infect Dis, 2010
Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique—a case study	J Int AIDS Soc, 2010
Quality of HIV care provided by non-physician clinicians and physicians in Mozambique: a retrospective cohort study	AIDS, 2010
Loss to follow-up of adults in public HIV care systems in central Mozambique: identifying obstacles to treatment.	J Acquir Immune Defic Syndr, 2009
The role of nonphysician clinicians in the rapid expansion of HIV care in Mozambique.	J Acquir Immune Defic Syndr, 2009
Treatment partners and adherence to HAART in Central Mozambique.	AIDS Care, 2009
One year after ART initiation: psychosocial factors associated with stigma among HIV-positive Mozambicans.	AIDS Behav, 2009
What if we decided to take care of everyone who needed treatment? Workforce planning in Mozambique using simulation of demand for HIV/AIDS care.	Hum Resour Health, 2008
Intermittent preventive treatment of malaria during pregnancy in central Mozambique.	Bull World Health Org, 2007
Randomized control trial of peer-delivered, modified directly observed therapy for HAART in Mozambique.	J Acquir Immune Defic Syndr, 2007
Scaling up Antenatal Syphilis Screening in Mozambique: Transforming Policy into Action.	Sex Transm Dis, 2007
Using nurses to identify HAART eligible patients in the Republic of Mozambique.	Hum Resour Health, 2007
Management of expatriate medical assistance in Mozambique.	Hum Resour Health, 2006
Comparison of the diagnostic accuracy of a rapid immunochromatographic test and the rapid plasma reagin test for antenatal syphilis screening in Mozambique.	Bull World Health Org, 2006
Condom use after voluntary counselling and testing in Central Mozambique.	Trop Med Int Health, 2006
Integrating Tuberculosis and HIV Care in Mozambique: Lessons from an HIV Clinic in Beira	COREGroup Case Study, 2005
Commodity Fetichismo, The Holy Spirit, and the turn to Pentecostal and African Independent Churches in Central Mozambique.	Cult Med Psychiatry, 2005
International NGOs in the Mozambique health sector: the “velvet glove” of privatization.	Book Chapter, 2004
Condom social marketing, Pentecostalism, and structural adjustment in Mozambique: a clash of AIDS prevention messages.	Med Anthropol Q, 2004
Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk.	Soc Sci Med, 2003
Cash income, intrahousehold cooperative conflict, and child health in central Mozambique.	Med Anthropol, 2003
International NGOs and primary health care in Mozambique: the need for a new model of collaboration.	Soc Sci Med, 2003
African independent churches in Mozambique: healing the afflictions of inequality.	Med Anthropol Q, 2002
Characteristics of drug resistance and HIV among tuberculosis patients in Mozambique.	Int J Tuberc Lung Dis, 2001
Impact of traditional birth attendant training in Mozambique: a controlled study.	J Midwifery Womens Health, 2001
Intrahousehold resource allocation and child growth in Mozambique: an ethnographic case-control study.	Soc Sci Med, 2001
HIV seroprevalence among military blood donors in Manica Province, Mozambique.	Int J STD AIDS, 2001
Community Leadership and Health Mobilization: A Rapid Ethnographic Study of Three Zones in Manica Province	Final Report, 1999
Satisfaction with outpatient health care services in Manica Province, Mozambique.	Health Policy Plan, 1998
Comparison of intramuscular sulfadoxine-pyrimethamine and intramuscular quinine for the treatment of falciparum malaria in children.	Trans R Soc Trop Med Hyg, 1991

News/Media

Trump Is Donating Ventilators to Countries That Don’t Need or Can’t Use Them	ProPublica, 2020
HAI’s Cyclone Idai Response: Keeping things moving	HAI Media, 2019
HAI’s Cyclone Idai Response: Health system infrastructure rebuild	HAI Media, 2019
Cyclone Kenneth – what back-to-back cyclones tell us about where response resources should be focused	HAI Media, 2019
HAI’s Cyclone Idai Response: High-priority medicines where they’re needed most	HAI Media, 2019
Cyclone Idai: Take Action Now to Support Relief Efforts	HAI Media, 2019
World AIDS Day 2018 – 15 Years of ART in Mozambique	HAI Media, 2018
Event Announcement (11/8): Alma-Ata Panel and Lecture	Event, 2018
Enabling Learning Systems: the African Health Initiative in Mozambique	Video, 2018
Get ready for your close up: HAI’s IDEAs project on film	HAI Media, 2018
World AIDS Day 2016: A world without AIDS is within our reach	HAI Media, 2016
Balancing breastfeeding and work	HAI Media, 2016
Why don’t more women breastfeed?	HAI Media, 2016
HIV and Breastfeeding: Challenges and the way forward	HAI Media, 2016
Publication alert: Evaluation of an innovative new approach in Mozambique and Côte d’Ivoire	HAI Media, 2016
Micro Mapping in Sofala and Manica	HAI Media, 2016
HAI Publication Alert: Outpatient Mental Health in Mozambique	HAI Media, 2016
HAI Publication Alert: Mental Health in Mozambique	HAI Media, 2015
First Training of Strategic Information Fellows in Mozambique	HAI Media, 2015
World Health Worker Week 2015: Health workers: “The best resource Mozambique has ever had”	HAI Media, 2015
World Health Day 2015!	HAI Media, 2015
Welcome to World Health Worker Week 2015!	HAI Media, 2015
World TB Day 2015	HAI Media, 2015
Health for All. Everywhere. Now!	HAI Media, 2014
Stocking health facilities needs people and supplies	HAI Media, 2014