The Mozambican Ministry of Health has presented the draft of the Community Health strategy to development partners. Mozambique counts now with 6.790 Community Health workers, called APE (Agentes Polivalentes Elementares), who perform essential preventive health work and promote institutional deliveries and visits to health facilities. APE receive an stipend, which is currently funded by external funds.
The novelty of the strategy is the aim of integrating all community health initiatives that converge at community level together, for example NGO, traditional healers, traditional midwives, Red Cross, local committee of the District services of Social Action, churches, and others. The strategy proposes a joint strategy with monitoring and reporting to the central information system on health (SISMA).
MoH is considering financing forms different to State Budget, like some sort of micro-insurance. P4H is supporting this reflection process and promoting the “Desirable attributes of health financing systems”, published by WHO jointly with the Health Financing Progress Matrix (HFPM) in 2020. Micro-insurance at community level tends to be fragmented, with limited pooling and financial sustainability, and generally has to be merged into a national fund to achieve maximum risk-sharing, as has been the case in Rwanda.
Including this community health component in the overall MoH budget and overcoming the administrative barriers to finance these stipends or salaries would pave the way for a full integration of this component in the overall health financing structure of the National Health Service.
