Health Workforce

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Situational analysis

moz-hwMozambique has a publicly funded health system providing health care for the majority of the population. The system is based on the values and principles of primary health care . However, equity and universal access to health services is not yet a reality despite strong commitments from the Ministry of Health (MoH). The major impediment to delivering essential interventions is the shortage of skilled health workers .

With 64.5 medical doctors[1] nurses and maternal and child health nurses per 100,000 population in 2011[2], Mozambique is below the minimum acceptable health worker density threshold of 230/100,000. The shortage is further compounded by an imbalanced distribution of personnel across regions and between urban and rural areas.

The number of health workers is increasing; however, it is still not reaching the growing needs of the population. The total health workforce of the MoH increased from 25,683 health workers in 2006 to 35,503 in 2011 (+38%). Health professionals (regime especial da saúde) made up just over half (54%) of the workforce in 2011, compared to 52% in 2008. General staff constituted the remaining.

In 2011, the total number of doctors in National Health System of Mozambique was 1,268 of whom 23% (289) were non-Mozambican nationals[3] for a population of approximately 22.3 million people. Since 2005, the number of national doctors increased by 72% (from 569 in 2005 to 979 in 2011), and the number of maternal and child health nurses almost tripled over a period of 11 years (from 1,414 in 2000 to 3,926 in 2011).

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The challenges in human resources for health are a result of limited production capacity, difficulties in attracting and retaining skilled and higher qualified personnel to remote areas, inadequate human resources for health planning and management capacity at all levels, staff dissatisfaction about remuneration and working environment, low annual allocation of new posts for the health sector, and an increasing competition with the private sector (NGOs and private for profit sector) for experienced staff with managerial skills, medical doctors, laboratory and pharmaceutical staff.

To address these challenges, the Ministry of Health is currently implementing a 7-year Human Resources Development Plan 2008-2015 that outlines four key areas:

  1. Organization of services and normative framework;
  2. Strengthening management, planning and administration capacities;
  3. Improving human resources distribution, motivation, and retention; and
  4. Increasing capacity of pre-service training, post- graduate training, and in-service training networks.

Furthermore, to increase basic health services at community level, the MoH with support from partners is training more Community Health Workers (Agentes Polivalentes Elementares - APE). One initiative is the WHO supported Rapid Expansion 2015 Programme (RAcE) , which is currently being implemented in Mozambique. The RAcE aims at training community health workers in diagnosing, treating and referring cases of some of the main public health diseases, namely malaria, pneumonia and diarrhoea.

Achievements

In 2011, a national Human Resources for Health Observatory was established.moz-hw-obs

Development of key reference documents including:

Key Resources

[1] Includes generalists, specialists and medical technicians.

[2] Relatório Anuál 2011, Ministry of Health, Directorate for Human Resources for Health

[3] Relatório Anuál 2011, Ministry of Health, Directorate for Human Resources for Health

Mozambique