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In spite of improvements registered in the last decade, the Mozambican health system is still affected by well identified shortcomings. (a) Low levels of utilisation of health services due to: low coverage, low quality of health services and lack or inadequate distribution of resources. (b) Limited access to general infrastructure such as roads, communications, electricity, safe water, etc. (c) Limited managerial, organisational and planning skills among health staff. (d) Low capacity to invest and rapidly expand the formal health network especially to rural remote areas.
Furthermore, in spite of observed improvements, referral services are still very limited, with only 50 referral hospitals in the country, of which only 37 are rural or district hospitals, for a population of 24 million. As a consequence, the access to care for most patients is often limited to primary care only, especially in rural areas. Besides, shortcomings regarding availability of care and services, quality of care and organizational issues often encourage direct use of higher levels of care mainly by urban dwellers.
Through the upgrading project of the Manhiça and Gilé health units, EU is providing support to the sector strategy for the referral health network expansion. Both districts are among the health sector priorities. Gilé District Hospital is the only referral facility in a very remote area of Zambézia, the province with worst health indicators. The Manhiça hospital, given its location along the Mozambique's backbone national road with high accident rates, has, in addition to its functional mandate, the potential of providing an essential response to the vehicle accident related traumatology needs. The Manhiça component of the project is also complementary to the internationally known multi-donor Manhiça Health Research Centre on malaria, which includes a strong component on HIV-AIDS and tuberculosis monitoring in partnership with the hospital.
Sector planning and management capacity of the whole process related to health network construction needs support. Thus, technical assistance is planned to assist the Department of Infrastructures of the Ministry of Health with the whole project implementation process and contribute in the on-going initiatives aimed at strengthening the ministry investments planning and management capacity.
Both Manhiça and Gilé District Hospitals have received EU support and funding in a first phase, through two distinct upgrading projects (EUR 4 200 000) altogether, from the 8th and the 9th EDF) but due to the high increase of costs during this period, the scope of works had to be reduced and upgrading works were not fully completed within the available funds. Consequently, the two hospitals lack essential and complementary services as well as staff housing in order to fulfil their mandate as second level health facilities. This project aims at completing these two critical upgrading processes which are deemed fundamental for the country and for sustainability of the EU 8th and 9th EDF interventions.
Contribute to the improvement of the population health status by increased access to health care by the population, with special attention to the poorest and to gender specific needs, in line with the Poverty Reduction Strategy (Plano de Acçao para Redução da Pobreza – PARP) priorities.
Complete the upgrading of two referral health facilities in two districts
Contribute to the increase and improve the stabilization of qualified health staff deployed in two districts
Contribute to the strengthening of sector planning and management capacity.
R1. Fully upgraded Manhiça District Hospital and Gilé Rural Hospital infrastructure
R2. Staff housing constructed in the two referred facilities
R3. Reinforced capacity of the Infrastructure Department of the Ministry of Health in sector planning and management of investments.
The construction operations will take place in two distinct geographical areas:
1. Manhiça District Hospital, located on the main National One Road, capital of the Manhiça district, Maputo Province, southern Mozambique. The hospital will benefit around 118 150 people representing 57% of the total population living in the district, who were 205 791 in 2012, according to projections based on 2011 population data (catchment area is divided between two health facilities).
2. Gilé District Hospital is a very remote facility located in the Gilé district, Zambézia Province, in the centre of Mozambique. The facility will serve the 185 000 total population of the district.
The project implementation team, both technical assistant and Infrastructure Department of the Ministry of Health, will be based at Ministry of Health, Department of Infrastructures.
Total Cost (EUR): 4 000 000
EU contracted amount (EUR): 4 000 000
Duration: June 2013 - December 2018
Implementing organisation: Several contractors : LENA , JFS, CONSULTEC, ALANET, TIEG
Funding Instrument: European Development Fund (EDF)
Benefitting zone: Mozambique