Cabo Delgado has a high poverty rate of 44.8% (46.1% national), an intra-hospital maternal mortality ratio of 105 per 100’000 live birth and a child mortality ratio (with 85 per 1’000 live births) that are amongst the highest in the world. Main diseases in the province are malaria and water-borne diseases such as diarrhea and cholera. Poor sanitation is among the key determinants. Rural sanitation coverage in the Province is only 7%. Access to safe drinking water is also very low with 54%. The frequent occurrence of extreme weather events, such as floods and tropical cyclones in Cabo Delgado result in loss of life and property, damage to health, water and sanitation infrastructure, and trigger outbreaks of diseases such as cholera and malaria with climate-sensitive transmission cycles. The results of the World Bank’s 2014 national Service Delivery Indicator Survey reveal that only 34.0 percent of the health facilities surveyed were found to meet minimum infrastructure requirements (simultaneous availability of clean water, improved sanitation and electricity).

Improved access to and quality of health and WASH services in the Province of Cabo Delgado, especially in the Districts of Ancuabe, Montepuez and Chiúre.

The intervention targets the 23 rural health facilities with its 23 rural health promotion frontline staff of 3 districts in the Cabo Delgado Province. They serve the population in the districts of Montepuez, Chiúre and Ancuabe with a total population of 570’000 people (300’000 women and 270’000 men).

At the Provincial and District levels a set of institutions will benefit directly: the rural Health Posts, the Provincial Directorate of Economy and Finance (DPEF), the Provincial Health Directorate (DPS), the Public Works Directorate (DPOPHRH), the District Health Directorate (SDSMAS) and the District Infra-Structures Directorate (SDPIF) as well as the implementing NGOs/CBOs.

• Improved efficiency and effectiveness in the provision of integrated health services, water and sanitation and increased accountability towards the communities
• Rural communities in the Districts of Ancuabe, Chiure and Montepuez have a voice, can express their needs and rights, and demand accountability from local governments and service providers (health and WASH)
• Improved Public Financial Management PFM through strengthened multi-sectoral coordination and inter-sectoral governance and improved management and planning at district level

Risultati principali attesi:  

The main expected outputs in the phase are as follows:

• Health facilities well equipped with WASH infrastructures and staff acting according to their roles and responsibilities
• Communities with joint health and WASH committees and members acting according to their roles and responsibilities
• Health and  WASH actions included and budgeted in the District Plans

Risultati fasi precedenti:  

The Mid-Term-Review confirms that Switzerland occupies a relevant niche with its focus on health promotion. SDC use of the country system has strengthened the overall public financial management in Cabo Delgado. SDC contributed to the motivation and retention of health promotion workers. The Provincial Health Directorate DPS claims that health promotion, including the improvements in community mobilization, the provision of family planning methods at the community level and staff training on modern family planning methods positively contributed to the overall improvement of health indicators in the Province. For instance, the rate of institutional births has improved in the last 4 years, from 69% in 2011 to 76% in 2015. No cholera case was registered in 2014, after two consecutive epidemics in 2012 and 2013 respectively. However, challenges faced by the Province and Districts remain: 1. Limited availability of human resources, inadequate funding for infrastructure and equipment. 2. The high prevalence of water-borne diseases in Northern Mozambique, vulnerability to disasters and low water and sanitation coverage need to be addressed through health promotion in order to be more effective 3. Weak inter-sectoral and multi-sectoral collaboration, coordination and use of potential partnerships with the community, private for profit and non-profit sectors, limiting the system's responsiveness to health problems.

PROSAUDE, Wiwanana, Social Accountability, GOTAS, PRONASAR, PROGOAS, SDC Global Programs Health and Water

Fase 2 01.04.2017 - 30.06.2022   (Completed)