The Mozambican health system remains weak in terms of infrastructure, human resource and information systems capacity. The result is that maternal mortality rate remains very high at 408/100,000 live births although it has gradually decreased by more than 60% over the last two and a half decades^[1]. This is still far from reaching the SDG target of 70/100,000 live births.

The Health Common Fund (PROSAUDE) was created jointly by the government and other partners and managed by Switzerland in the year 2003. In 2013, a thorough analysis of PROSAUDE II achievements and weaknesses led to a major redesign of PROSAUDE. PROSAUDE III is a revised financing mechanism supporting primary health care with a focus on the local level and supported by a rigorous allocation criteria and a specific joint management unit with stronger flow of funds monitoring. PROSAUDE is an essential mechanism for the nation to achieve its national health related development targets. SDCs important historical role and constant engagement created a unique position for Switzerland: During this phase, Switzerland will chair PROSAUDE, and seize this opportunity to further support the elaboration and implementation of a national health financing strategy with the aim of gradually increasing domestic funding for the sector.

[1] UNICEF. 2013. Maternal mortality report 1990-2013.  

To support Mozambique in its efforts to provide more and better essential primary health care services, universally accessible, through a decentralized and strengthened health system

People resident in Mozambique (more than 21 mio), in particular poor people as well as women and children as main users of primary health care services.
The major share (up to 80%) of the common fund for the health sector is allocated to local governments who are responsible for providing basic health care for local communities.

1. Increased efficiency in resources allocation and utilization
2. More equity in the access and distribution of maternal and child health services
3. An increased contribution from domestic resources to PHC/RMNCH
4. More coordinated external financial support to the sector

Expected results:  

• The capacity for management of resources at all levels including procurement and logistic of medical supply is improved.
• A sustainable health financing strategy for increased domestic funding from state budget and coordinated external support is established.
• The Strategy for the Inclusion of Gender in the Health Sector from 2009 is updated and an implementation plan exists.

Results from previous phases:  

• Reforms are high on the sector agenda, and the commitment was emphasized by the establishment of the decentralization reform unit in 2016 and its action plan.
• In order to mitigate stock outs, pharmaceutical supply and logistics are now more structured and this has resulted in an increase in the percentage of provinces that are able to manage and request medicines timely, from 59% in 2014 to 72% in 2015.
• Policy dialogue and interventions by Ministry of Health (MISAU) with Partners have resulted in improved sector financial tracking and reporting with a quarterly budget execution report available, capacity building in public finance management at provincial reported, in budget execution reporting, financial statements and M&E tools.
• Community involvement and health promotion strategies improved significantly and influenced policy and planning; Structures have since been established to ensure consistent and sustainable community involvement.

• MISAU and its Provincial and District level representation, Ministry of Economics and Finance, Tribunal Administrativo
• Common Fund  partners:, Italy, Spain, CIDA-Canada, The Netherlands, Denmark, Irish Aid, Flanders, UNICEF, UNFPA
• Additionally in SWAP: World Bank,  DFID, USG, GFATM, Germany, WHO, NGOs,
• P4H

Cabo Delgado Health Plan: 7F - 07796.02

Wiwanana: 7F- 06006.02

Social Accountability: 7F-08743.01

PRODEM: 7F-06298.03

LGM: 7F-05704.03

Phase 7 01.01.2017 - 31.12.2019   (Completed)