Mozambique's step towards a strengthened health sector
In Mozambique, the Health Sector Strategic Plan (Plano Estratégico do Sector da Saúde, or PESS) covers and prioritizes all areas of the health sector. The PESS plays an important role in Mozambique’s efforts towards aid effectiveness because it is the platform through which health partners convene and it constitutes the foundation of the memorandum of understanding between the Ministry of Health and its partners. It is guided by the Government’s Five Year Plan and the Poverty Reduction Plan, and guides the health sector towards universal health coverage. At the end of 2013, Mozambique finalised its third PESS covering the period 2014-2019.
Joint Assessment of National Health Strategies (JANS)
For the first time in Mozambique, a team of international and national experts conducted a JANS review for the PESS. The JANS is a standardised, internationally recognised tool used to assess and strengthen the quality of national health strategies according to five overall attributes. The assessment encourages greater partner confidence and the likelihood of aligned health interventions.
Prior to its third PESS, national stakeholders, the technical team, and partners participated in an orientation workshop in order to clarify the purpose and value of the JANS. This was critical to ensure that the different aspects of the JANS were captured in the plan from the outset.
When the JANS team first visited Mozambique in March 2013, the draft PESS was missing some critical pieces including the final costing analysis and an M&E framework. After consultation with the JANS team, efforts were stepped up to consult provincial and district stakeholders, finalize a detailed costing analysis using the One Health tool and refine the M&E framework. This resulted in a robust draft PESS.
In the JANS assessment, the team made 40 recommendations, ranging from M&E to implementation, all of which were incorporated in the PESS. A key recommendation was to extend the timeframe of the entire PESS, thus aligning it with concurrent policy documents.
Improved country ownership and partner confidence in the PESS
There is consensus in-country that the JANS fostered a better understanding of the value of independent reviewing for quality assurance. In its early phases, there was some skepticism about the JANS. However, by the time the JANS was completed, stakeholders agreed that the JANS contributed to strong country ownership. Furthermore, the independent nature and technical expertise of the team contributed to building confidence in the PESS among partners. The hope now is that this will result in more predictable and better aligned funding, an especially important element in Mozambique considering the multitude of donors and health partners. Finally, the regular and transparent communication between Ministry of Health, partners and the JANS team enabled the successful conclusion of the assessment.
PESS ready for implementation
The resulting PESS covers the next six years and has been formally approved by the Ministry of Health and its partners. It outlines a series of reforms in-line with Mozambique’s on-going decentralization process. The PESS includes costed health interventions with an emphasis on primary health care; specifically, on increasing access, improving quality, and reducing inequalities. PESS sets out feasible interventions to reduce maternal mortality by 50 percent, increase assisted deliveries by skilled birth attendants by 36 percent, and reduce chronic malnutrition by 26 percent by the year 2019.
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