Mozambique is a third world country located in Southern Africa. The country is a former Portuguese colony and has been independent since 1975. The health indicators for the country are very worrying as is common with many countries in South Saharan Africa. This paper analyses the current state of the country’s healthcare system with the view of identifying its healthcare priorities. The basis for the choice of this country was the interest in finding out why the country has the worst health indicators in the world in many categories.
Geography
Mozambique is in the South Eastern coast of Africa. Its neighbors include South Africa, Tanzania, Malawi, Zambia, and Swaziland. It also has a long coast along the Indian Ocean. The country has strong links with Madagascar, which lies offshore from Mozambique. The official language in the country is Portuguese. Portugal colonized the country for close to four centuries. Mozambique experiences the tropical climate and has a wet season, and a dry season. Its coast is wetter than the rest of the country.
Population
The population of Mozambique is about twenty four million people (WHO, 2013). The Bantu form the predominant ethnic group in the country, constituting over ninety-seven percent of the country’s population (WHO, 2013). The country is also home to some Europeans, African Europeans, and Indians. The Europeans in the country are mainly from Portuguese speaking countries and Portugal. A large number of African Europeans left alongside the colonial administrators when the country attained its independence in 1975.
Government
Mozambique is a multi-party democracy that emerged after a protracted civil war that broke out two years after independence (Reuters, 2013). The civil war came to a halt in the early nineties. Since then, the country has experienced relative calm and stability. The country elects a president via a popular vote. The presidential term limit for Mozambique presidents is three terms of five years. The president is the head of state. The president then appoints a prime minister to run the government. The country also has a parliament made up of elected representatives from electoral areas throughout the country.
Economy
Mozambique’s economy went through a difficult patch during the protracted civil war soon after attaining its independence. The economic situation became worse after socialist experiments failed in the country (Reuters, 2013). The stability of the government and economic reforms in the post-civil war years has made it possible for the country to develop its economy. The country still has one of the highest poverty indices in the whole world. It relies on donor support to manage its recurrent expenditure. The production of minerals such as aluminum, natural gas, coal, and titanium will make it possible for the country to meet its recurrent expenses within the next five years.
State of Healthcare
The healthcare system in Mozambique is in a poor state. The country developed a primary care system immediately after its independence that received recognition by the WHO. However, the system suffered serious setbacks during the prolonged civil war in the country. The rebels targeted health and education institutions in their war against the government. Recent reports indicate that RENAMO, the rebel group that signed a peace deal with the government in 1992, is staging attacks against government installations (Reuters, 2013). The group claims that the government is not addressing key political and social issues in the country. Violence will lead to further degradation of the healthcare system in the country. The high number of road accidents in the country is an issue of concern for many stakeholders. Road accidents cause two percent of all deaths in Mozambique (WHO, 2013). This gives the country the tenth rank in the world among countries with the highest traffic fatalities.
Traditional Medicine
Mozambique has less than one thousand five hundred medical doctors (WHO, 2013). On the other hand, the country has more than seven thousand traditional healers (August-Brady, 2013). The traditional healers include herbalists, prophets, and spiritual healers. The herbalists make traditional concoctions from various plants and dispense them as remedies for common ailments. The prophets, on the other hand, mix Christian or Muslim practices with African traditions as the basis for their healing activities. The prophets mainly conduct exorcism ceremonies. The spiritual healers claim spiritual powers as the basis of their healing capabilities. These practitioners allow spirits to possess them to enable them to heal diseases, and to expel demons from patients. Many Mozambicans respect traditional medicine men more than medical doctors owing to the longstanding practice of traditional medicine.
Healthcare System
The healthcare system in Mozambique includes the following components. First, Mozambique has government related health agencies that seek to provide healthcare for the citizens. The healthcare system operated by the government in Mozambique has the following elements. At the primary level, the country has numerous Health Posts throughout the country. Health Centers are the next level of healthcare institutions, with each of them supporting at least two Health Posts. Thirdly, there are Rural Hospitals, followed by District Hospitals. The secondary level of healthcare provision takes place in General Hospitals and Provincial Hospitals. Central Hospitals are at the apex of the system at a tertiary level.
Mozambique has a very small number of trained professionals offering healthcare services. The formal healthcare system only handles forty percent of the country’s healthcare needs (WHO, 2013). The rest of the population relies on traditional healers. The current ratio of doctors in the country is one doctor for every thirty thousand inhabitants, while there is one nurse for every eight thousand people.
Mozambique has four levels of training for nurses. The first level is the Elementary Nurse (August-Brady, 2013). Elementary Nurses have seventh grade education and an additional seven months of training in nursing. These nurses practice in Health Posts throughout the country. The second level is the Basic Nurse (August-Brady, 2013). A Basic Nurse must attain tenth grade education with additional nursing training for eighteen months. This cadre of nurses forms the majority of nursing professionals in the country. The third level is the Medium Nurse (August-Brady, 2013). A Medium Nurse must have tenth grade education and thirty months of training in nursing. These nurses can rise to the rank of Principal Nurse after practicing for ten years. The highest level in the nursing profession in Mozambique is the Superior Nurse (August-Brady, 2013). A Bachelor’s degree is necessary for someone to become a Superior Nurse. Their number is still very low in the country. Nursing Licenses are necessary only for Superior Nurses. These nurses take an exam upon the completion of their course before getting a license (August-Brady, 2013). Nurses in Mozambique belong to the Mozambican National Nurses Association.
Health Priorities
The health priorities in Mozambique evident from the analysis above are as follows. First, the country has a very small number of doctors and nurses. The country must make the increment of the number of doctors within its borders a health priority. In addition, the number of highly skilled nurses is also very small. The government needs to find ways of covering the shortfall. The second healthcare priority is the development of infrastructure to improve access to formal healthcare. Only forty percent of Mozambicans can access a healthcare facility today (August-Brady, 2013). Part of the healthcare infrastructure was lost during the civil war. The third healthcare priority is educating Mozambicans in the importance of formal healthcare. Traditional healthcare systems currently carry a big load in the provision of healthcare services. They should only supplement the formal healthcare system. The government needs to initiate programs that will increase the confidence of the Mozambican people in the formal healthcare system.
Nursing Implications
Nurses can play a vital role in addressing the three priority areas identified above. First, nurses should encourage more people to join the healthcare profession. Nurses command respect society and can influence young people to join the nursing profession (McEwen & Wills, 2011). Secondly, nurses can push for the development of healthcare facilities to meet all the healthcare needs of the population. The nurses can use their association to identify needy areas and to lobby the government to allocate resources to improve healthcare facilities. The third way in which nurses can help to handle these challenges is by educating the public on the importance of seeking formal healthcare services. The main advantage of formal healthcare systems is that they promote evidence-based healthcare practices. Traditional healers often fail to base treatments offered to patients on clinical evidence. Traditional healers can easily misdiagnose patients because they do not have testing kits and the skills to clarify their diagnosis.
References
August-Brady, M. (2013). Nursing and Nursing Education in Mozambique from Michele August-Brady. Web.
McEwen, M., & Wills, E. (2011). Theoretical Basis for Nursing. Philadelphia, PA: MPS Limited.
Reuters. (2013). Mozambique Donors Raise Red Flag over Violence. Web.
WHO. (2013). Mozambique. Web.