Surviving armed conflict and natural disasters, the infrastructure of the country has suffered tremendously. Even with reconstruction and international aid, the health sector is still anguishing the consequences. Besides having to emerge from the cloak of colonialism, the other crises Mozambique has endured leaves the country particularly vulnerable to unique public health issues.
Structurally, the national health system is divided into three administrative levels: the MoH for policy formation, the 11 provincial offices for policy implementation and regional coordination, and the 144 health district divisions for health services provision. The health centers provide care at the most basic and rural level and refer to the rural and district hospitals for medical emergencies, basic surgical and obstetrical intervention, leaving the provincial and central hospitals to provide more specialized care. A total of 1,141 health posts and centers, and 43 hospitals were tallied in 2001. The private sector includes privately-owned clinics in the larger main towns, as well as health centers set up by international NGOs, bilateral agencies and religious organizations. Traditional healers cover about 60% of the population, and although not officially recognized by the MoH, they are acknowledged and regulated.xviii
The health sector capacity in Mozambique is extremely small, compared to many other countries of similar size and population. Remarkably, it only has 712 physicians, which is equivalent to 2.4 doctors per 100,000 people, which is one of the lowest medical doctor to person ratios in all of Africa.xix In addition, most of its physicians are concentrated in the capital of Maputo, leaving the more remote rural regions completely marginalized.xx This is especially significant in Mozambique’s context, as 72% of its people live in the rural areas, re-calculating the doctor to patient ratio to be 1:60,000 in the parts of the country inaccessible to the capital. Low yearly output of medical graduates, an insufficient education system, and inadequate salaries all contribute to these abysmal statistics. xxi The country spends about 5.8% of its annual GDP on health expenditures.xxii