Human resources for health

Situation analysis

The functioning of the Mozambican Health System is severely constrained by shortages in health personnel. By regional standards Mozambique's health staff indicators are among the worst. The shortage is characterized by a general shortage of health workers and in particular of qualified personnel. The total number of Mozambican doctors in 2007 is slightly more than 600, adding up the expatriate doctors the total approximates 900 medical doctors for a population of around 20,5 million people, in 2007. The shortage is further compounded by imbalanced distribution across regions and between urban and rural areas, compromising access to primary health care services for the poor.

The output of training institutions is insufficient to respond to the growing demand for a more and better trained work force. The output of medical schools (public and private) is on the rise but remains far from matching the country needs. Factors affecting the quality of training include insufficient numbers of qualified trainers; inadequate infrastructures (classrooms, laboratories), scarce and inadequate teaching aids, research materials and equipment as well as inadequate and poorly supervised practical training sites.

Performance of health workers is affected by low motivation and discontent over salaries, poor career prospects, increasing workload and a difficult working environment. Human resources management and planning has been decentralized to the provinces but these departments are understaffed and generally weak in organizational and administrative management.

Internal migration of the health work force has been increasing in the last five years. Health workers are attracted by a growing NGO sector active in often well funded HIV programs offering better employment conditions. External migration is far less common and not much of a concern.

WHO in Mozambique is strongly committed to the HR agenda and has provided technical assistance to the development of the new HRH development plan 2008-2015.

Health systems strengthening

Mozambique has a publicly funded health system which is providing health care for the majority of the population. The system is designed to support national health policy based on the values and principles of a primary health care approach. However, equity and universal access to health care is far from being realized despite strong commitment of the MoH.

The health system is under pressure to adapt and respond to old and new challenges but remains under resourced and is in need of strengthening institutional capacity building.