Publication: Working Toward Better Health: Expanding Community Health Services in Mozambique
Loading...
Date
2025-05-05
ISSN
Published
2025-05-05
Author(s)
Editor(s)
Abstract
In low-income countries, formal health systems are stretched thin, and rural and underserved areas often lack adequate primary healthcare coverage, delaying essential interventions and leaving populations vulnerable to preventable diseases. Mozambique was no exception. The country had particularly poor health outcomes among its peers, with high rates of stunting (40%) and malnutrition, as well as one of the highest rates of child marriage and adolescent fertility in the world. Its share of deaths from communicable diseases and maternal, perinatal, and nutritional conditions was 62% – three times the global average. Only half of births were attended by a skilled professional, and the neonatal mortality rate was 27.9 per 1,000 live births. But the problem went beyond reach and access: providers had weak competencies, clinical guidelines were often not adhered to, and there were high levels of dropout for child immunization. To improve health outcomes, Mozambique would have to increase both coverage and quality of service.
Link to Data Set
Citation
“World Bank Group. 2025. Working Toward Better Health: Expanding Community Health Services in Mozambique. © World Bank. http://hdl.handle.net/10986/43158 License: CC BY-NC 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication The Primary Health Care System of the Republic of the Marshall Islands(Washington, DC: World Bank, 2024-01-05)This report presents the findings of the primary health care (PHC) system in the Republic of the Marshall Islands (RMI), an assessment that the World Bank conducted in consultation with the Ministry of Health and Human Services (MHHS) of the government of RMI. The assessment provides an opportunity to understand the performance of RMI’s PHC system, highlighting important areas of strengths and opportunities to address ongoing challenges. The assessment uses the Primary Health Care Performance Initiative (PHCPI) framework, which organizes various domains and subdomains of primary care using a logic model approach that encompasses the traditional inputs and outputs of a system, emphasizing service delivery and performance.Publication Path to Transform Bangladesh's Health System for Better Results(Washington, DC: World Bank, 2024-07-09)Over the past decade, under the astute leadership of the Government of Bangladesh (GoB), the country has made impressive strides in enhancing the health and well-being of its people. The remarkable gains include a notable surge in life expectancy and a significant reduction in maternal mortality rates, a testament to Bangladesh's commitment to fostering a healthier future for all. The GoB’s maternal and child health programs showcase a comprehensive approach to public health, with immunization drives and family planning initiatives serving as models for other health challenges. Disease control efforts, such as those targeting tuberculosis and malaria, and the eradication of polio, leprosy, and Kala-azar highlight the effectiveness of targeted interventions and strategic planning. Central to this progress is the commitment of the Bangladeshi people, particularly women, to healthy and prosperous families, supported by the GoB's clear vision, incremental budget increases, and strategic policy initiatives, recognizing health as fundamental to national development. As Bangladesh works to achieve its ambition of becoming an upper-middle-class country, improving the health of its people will be key to success. To do so, it must anticipate and address numerous challenges, including those that originate from outside its borders, such as climate change and pandemics. The World Bank's review of the Bangladesh health sector for this report identifies five systems-level changes the country needs to make to strengthen health service delivery. First, the country should finance a resilient health system through measures such as increasing public funding and exploring earmarked taxes. Second, the country needs to improve governance and political commitment including by prioritizing political support for health financing and strengthening regulatory capacity. Third, the country should advance digital health including by strengthening investment in digital technology and improving regulatory oversight of digital health initiatives. Fourth, the country needs to address market failures that result in poor quality of many private-sector providers including by adopting measures to remove the lowest-quality practitioners and benchmarking the performance of licensing and accreditation bodies. Finally, the country should purchase support services at scale including by developing more coherent policy, legal, and administrative frameworks for this purchasing and grounding strategic health purchasing in performance data.Publication Taking Stock, June 2012(World Bank, Hanoi, 2012-06)The authorities' determined implementation of stabilization measures over the past year has helped to avert a macroeconomic crisis. If the deterioration of the macroeconomic environment in 2010-11 was rapid, the improvement in the situation in the past twelve months has been equally swift. Regaining macroeconomic stability has been costly, but not stabilizing the economy would have led to even bigger losses. Real gross domestic product (GDP) growth has decelerated from 6.8 percent in 2010 to 5.9 percent in 2011, and further to 4 percent in the first quarter of 2012 as higher prices has lowered domestic demand, affecting sectors such as construction, manufacturing and utilities. Industrial production has slowed, inventory for key industrial products has accumulated, and a number of small and medium enterprises have either closed, been liquidated or temporarily suspended their operations. While the stabilization efforts may have contributed to a cyclical slowdown, Vietnam's trend growth rate has been on a downward path for the last 5-6 years, largely on account of the slow pace of structural reforms. Inefficiencies in state-owned enterprises, banks and public investments have been a drag on the country's long-term growth potential. With gains from macroeconomic stabilization still recent and fragile, especially in an external environment that is fraught with uncertainty, the government needs to be careful not to shift to an expansionary stance prematurely.Publication Bosnia and Herzegovina : Poverty Assessment, Volume 1. Main Report(Washington, DC, 2003-11-21)The report consists of two volumes. The first volume contains the main Poverty Assessment report, integrating various data sources and inputs from local counterparts. The second volume provides an in-depth analysis of the Living Standards Measurement Survey (LSMS), jointly implemented by the Bank, and the Republika Srpska Statistical Institute (RSIS), the Federation of Bosnia and Herzegovina Statistical Institute (FIS), and the Bosnia and Herzegovina State Agency for Statistics (BHAS). This report presents the most comprehensive analysis of poverty in Bosnia-Herzegovina (BiH) to date, whose calculations suggest that poverty - defined as lack of adequate consumption - is quite substantial, affecting every fifth citizen. Poverty is substantial compared to some neighboring countries. Nevertheless, and despite the country's post-conflict situation and its low officially measured level of GDP, there is no extreme poverty. Inequality in material well-being also appears to be quite moderate by international standards and, the non-income dimensions of poverty are also generally not extreme in BiH. The analysis finds that a sizable proportion of the population faces the risk of falling into poverty, and it identifies risk factors that may thrust a non-poor household into poverty: a) precarious earning sources, because the predominant living arrangement features a single-earner household; b) widespread health risks, including uninsured financial risks, and lingering post-conflict risks; c) violation of human rights, discrimination and corruption; d) limited geographical mobility; e) limited access to formal safety nets; and, f) worn-out stock of household assets and limited access to credit. Physical security remains an issue, economic security is also a problem, and, powerlessness and voicelessness impede the capacity of poor people to break out of a vicious circle of impoverishment. To reduce poverty, selectivity, stability and growth are outlined, particularly focusing on prudent monetary policy, and responsible fiscal management.Publication Uruguay : Strengthening Participatory Monitoring and Evaluation of Social Policy(Washington, DC, 2007-06-22)The Uruguay Non-lending Technical Assistance (UY NLTA) for Uruguay was undertaken at the request of the Government of Uruguay's Ministry of Social Development (MIDES). Following a devastating financial and macroeconomic crisis in 2002, MIDES was established with a view to coordinating social programs and providing a safety net program for Uruguayans affected by the crisis: the National Assistance Plan of Social Emergency (PANES), which was established in 2005. The objectives of the UY NLTA are to: (i) evaluate the impact of PANES social emergency programs; (ii) inform a dialogue about the future role of social emergency programs and of MIDES as the lead authority responsible for the coordination and oversight of social policy in Uruguay, and (iii) strengthen MIDES capacity to assess, monitor and evaluate social policy in Uruguay, with considerable weight on participatory approaches to monitoring and evaluation.
Users also downloaded
Showing related downloaded files
Publication Unlocking the Power of Healthy Longevity(Washington, DC: World Bank, 2024-09-12)Noncommunicable diseases (NCDs) are among the major health and development challenges of our time. Every year, about 41 million people die due to NCDs. This makes up about 74 percent of all deaths globally, the majority of which are in low- and middle-income countries (LMICs). Countless more people live with NCDs every day. Yet, NCDs are largely treatable and preventable. The risk of developing NCDs and deaths from them can both be lowered with appropriate attention to prevention and treatment. However, weak health systems and limited access to affordable care and information, especially in LMICs, contribute to lapses in seeking and receiving appropriate and timely care. This compendium is a compilation of 18 chapters, each exploring a different but related topic in the nexus of NCDs, human capital, and productivity. It is based on a series of analytical work taken up by the World Bank to support the Healthy Longevity Initiative (HLI) - a collaborative effort between the World Bank, the University of Toronto, and key academic and development partners including the Harvard University and the University of Washington. The HLI presents one of a growing set of efforts to increase the urgency of policy response to NCDs across the world.Publication Zambia Poverty and Equity Assessment 2025(Washington, DC: World Bank, 2025-02-25)Zambia is simultaneously amongst the poorest and the most unequal countries in the world. In 2022, 64.3 percent of the population - about 12.6 million individuals - was living on less than US$2.15 a day. This level is not only the 6th highest in the world but it is also misaligned with the country’s Gross Domestic Product (GDP) per capita level. In four of the five poorer countries, GDP per capita is between one-quarter and one-half of Zambia’s GDP per capita. The remaining country is South Sudan, which is immersed in a protracted fragility and conflict situation. At the same time, consumption inequality is high, even when compared with the sub-group of highly unequal resource-rich countries. In 2022, the Gini index stood at 51.5 - significantly above the World Bank’s newly adopted high-inequality threshold of 40. This places Zambia as the country with the 4th highest inequality in the region and the 6th highest globally. Resource-rich countries with similar or higher inequality have substantially lower poverty levels.Publication Air Quality Management in Central Asia(Washington, DC: World Bank, 2025-05-02)This report aims to enhance the understanding of the priorities, needs, and solutions for improving air quality (AQ) in Central Asia (CA) through local action and regional collaboration. It focuses on key components of holistic air quality management (AQM): evidence-based analytics to identify the main sources of air pollution in CA, application of modern tools to assess the impact of cost-effective measures to improve AQ, assessment of the institutional and governance setup for AQM in CA with recommendations to strengthen it, and approaches to financing AQ improvement. Given the lack of comprehensive systematic and validated emission inventories of all PM2.5 precursor emissions, the technical assessment employs the regional emission inventory of the Greenhouse Gas - Air Pollution Interactions and Synergies (GAINS) model. Input data were updated for this study based on recent energy statistics and relevant national surveys. This report addresses emissions and the regional transboundary flows of pollution between Kazakhstan, the Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan. Subsequently, the resulting PM2.5 concentrations in ambient air throughout CA were computed with the atmospheric chemistry and transport calculations of the GAINS model. Employing the source apportionment results of the GAINS model, the analysis then examines the contributions to PM2.5 population exposure. The report also presents source apportionment analyses for important air pollution hot spots in CA: Dushanbe (Tajikistan), Bishkek (the Kyrgyz Republic), Tashkent (Uzbekistan), Samarkand (Uzbekistan), Astana, and Almaty (Kazakhstan).Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Working Without Borders(Washington, DC: World Bank, 2023-07-24)Online gig work poses both opportunities and challenges for governments and workers. On the upside, it offers prospects for income generation, especially in developing countries, where most people work in low-productivity, low-quality, often informal jobs. The virtual and often temporary nature of gig work also provides flexibility for often neglected groups such as women, youth, migrants, and people with disabilities. These jobs could be a stepping-stone to bet¬ter-quality jobs for low-skilled workers by helping them learn critical digital skills and close the digital divide. But most gig jobs offer little to no protection for workers, with uncertain income streams and no clear career pathways. Depending on local labor regulations, many gig workers are not protected against unfair practices, abuse or injuries while working. Gig work also raises challenges for managing data security and privacy. The report examines how countries can navigate the promise and perils of online gig work. It reveals that the online gig workforce is much larger than previously assumed with an estimated 154 million to 435 million Online gig workers around the globe. For the first time ever, the report mapped and tracked regional platforms and gig workers who work in languages other than English. Key messages are: • Online gig work is expanding, accounting for up to 12% of the global labor force and is a growing source of income for millions. • Demand for online gig workers is rising faster in developing countries than in industrialized countries. • Local gig platforms play a vital role in the local labor market, but they face challenges in establishing a viable business model, and opportunities for long-term growth. • Online gig work can support inclusion by providing work opportunities for youth, women, and low-skilled workers. • Gig workers, like most other informal sector workers in developing countries, are often outside the purview of labor regulations. • The gig economy can offer opportunities locally to build digital skills, increase income-earning opportunities, and facilitate social protection coverage of informal workers.