Community involvement

Situation analysis

In Mozambique, there is a renewed interest in strengthening community involvement and community based services. The Ministry of Health (MoH) considers that community involvement must be strengthened as an explicit and priority objective of the national plan for health in order to:

• Strengthen health interventions at community level;
• Achieve the Millennium Development Goals (MDGs);
• Face the human resource crisis;
• Improve quality, coverage and coordination of health interventions at community level.

Challenges

• Limited number of people familiar with the community based approach for health at all levels;
• Need for the development of a programmatic approach to community interventions so that the community's role in the formal health system is identified and supported and that elements of their roles are captured in the health management information systems;
• The development of standards and training material for community-based prevention, treatment, care and support;
• The promotion of community based initiatives;
• Revitalization of a community health workers program as an intermediate solution to bring health care to remote areas;
• Sustainability of community health workers: issues of remuneration remain unsolved in Mozambique, development of better supervision mechanisms;
• Revision of the manuals for community health workers;
• Revision of the national strategy on community involvement;
• Development of tools for monitoring and evaluation.

Achievements & next steps

Achievements

• Draft of the Plan of action to promote community involvement for health;
• National meeting on community involvement for health.

Perspectives

• To build capacity of the MoH and their partners to support communities' participation;
• To face the priority challenges at community health level to accelerate, promote and coordinate community involvement strategy and activities.

Non-governmental organizations

Despite numerous NGOs interventions, Mozambique is still facing various critical problems in the health sector and is not getting the targets at community level.

The proliferation of NGOs and programs in Mozambique has, at times, occurred at the expense of accountability and quality programming, and has led to fragmentation of the NGO "voice." It is a fact that NGOs tend to compete amongst themselves rather than to work together. Since the MoH is still not completely prepared to orient and control most of NGOs activities, the principles of collaboration between the MoH and NGOs need to be strengthened.

As it was confirmed by the recent creation of the health partners group on NGOs in July 2007, the MoH and NGOs agree that their health services are complementary and absolutely in need of optimal coordination through strategic partnerships and policies.

There are key priority issues that need to be strengthened:

• To establish a common diagnosis of the situation;
• To develop a data base and mapping on NGOs information and activities;
• To share best practices of NGOs evidence-based interventions;
• To create complementarities and efficient interventions in line with the MoH strategic plan;
• The development of the NGO unit at the MoH;
• To improve coordination and partnership mechanisms between the MoH and NGOs through a better contractual approach and policies documents;