REAL Award winner Linda Paquili Amana. Photo credit: Pathfinder.

Linda Paquili Amana has than 12 years of experience as a community health worker and traditional birth attendant in Nantaca, Memba District in Northern Mozambique, Linda is a true leader in her community.

She became interested in maternity care after realizing the problems faced by many women in her community. After analyzing the high rate of maternal and infant mortality, the preventative measures that the community needed to take became obvious. She now hosts monthly meetings with her community mobilization team to educate people within the community about how to prevent maternal and newborn deaths and the team goes out and shares this information with the community at mosques, markets, and water points.

Linda now maintains a registry of the pregnant women in her area and writes a referral for them to go to their local health centre for pregnancy related care and delivery. She is a constant reminder to all of these women of the measures they can take to have a healthy pregnancy. Now when a woman thinks she is going in to labour, they immediately knock on Linda’s door, where she accompanies them to the local health centre either on foot or by motor-taxi. Without Linda’s help in her community the maternity mortality rate would have continued on a dire path.

Neonatal mortality rate  (per 1,000 live births) (2011) 34
Under-five mortality rate (per 1,000 live births) (2011) 103
Maternal mortality ratio (per 100,000 live births) (2010) 490
Number of doctors, nurses and midwives per 10,000 people (2010) 3.7
Births attended by skilled personnel (2011) 54.3%
Total expenditure on health as a percentage of gross domestic product (2011) 6.6%
General government expenditure on health as a percentage of total expenditure on health (2011) 41.7%

Almost a third of the population (30%) in Mozambique is deemed to lack access to health services, and 50% have access to quality care. Despite progress, maternal and child mortality remain high, and there is a high burden of communicable diseases.

There are a number of important health workforce challenges: the availability of skilled health professionals is low and there are both geographical and financial inequities in access. Although the percentage of female doctors is quite high and the ratio of nurses to physicians is above the OECD average, this may be a consequence of insufficient numbers of physicians, rather than an indicator of adequate skill of the workforce. Accreditation, regulation and licensing mechanisms need to be strengthened in order to improve the quality of the workforce. At the policy level, there is willingness to make HRH a priority and a Human Resource Development Plan (2008-2015) has been created, which will, however, need to be adequately costed.

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