Fact Sheets

• Agriculture and Food Security
• Biodiversity, Livelihoods and Countering Wildlife Trafficking
• Democracy, Human Rights, and Governance
• Economic Growth & trade
• Education
• Gender Equality and Women's Empowerment
• Global Health
• WASH - Water, Sanitation and Hygiene
• Working in Crises and Conflict

Agriculture and Food Security

Feed the Future Mozambique Climate Smart Agriculture Activity – Beira Corridor (FTF CSA-BC)

Climate-smart agriculture (CSA) offers a promising pathway to sustainable intensification of agriculture and increased farm productivity, income and resilience for smallholder farming families. CSA is not new to Mozambique, but uptake has been slow due to various demand- and supply-side challenges. Limited awareness and trust in new technologies and a lack of access to markets and finance constrain demand. Further, even where demand exists, low-capacity and poorly functioning systems fail to deliver a supply of high-quality inputs and services to the rural farmer.

Mozambique Smallholder Farmer Production and Productivity Activity (MSFPPA)

Agriculture is the backbone of Mozambique’s economy with more than 80% of the population employed in this sector, 90% of those being women. However, the sector’s performance is characterized by low levels of production and productivity due to numerous challenges. These include the adverse impacts of climate change and climate variability (droughts, floods, emergent crop and livestock pests/diseases); lack of availability and access to quality inputs and technologies; soil degradation and low fertility; poor capacity for disease surveillance and control; inadequate veterinary services; insufficient extension services and poor linkages between extension and research. As a result, the Mozambican Ministry of Agriculture and Food security (MASA), in partnership with FAO, would like to build its capacity to improve service delivery to farmers to counter the climatic and pest/disease challenges facing them.

Partnering for Innovation (P4I)

Despite Mozambique’s recent economic growth and its strategic location in southern Africa, the country still faces challenges in developing its agriculture sector and reducing hunger. The most common is the lack of access to quality inputs and markets. The Mozambican agricultural market has an undeveloped agro-inputs distribution system, with very few agriculture supply shops in rural areas. The few inputs that are commercially available are found in distant urban centers, inaccessible to most farmers. 

Resilient Agricultural Markets Activity (RAMA) - NACALA

Rural livelihoods in Mozambique are primarily agriculturally based and climate dependent. Climate shocks will likely increase poverty and malnutrition for rural households, which are not currently resilient enough to withstand the effects of a changing climate. According to the Feed the Future Resilient Agricultural Markets Activity (RAMA) Framework, “Resilient Agricultural Markets Activity encompasses how agriculture affects and is affected by climate change and aligns this integration with food security objectives

Integrated Land and Resource Governance (ILRG) GLOBAL

An estimated 70 percent of land in developing countries is not documented, and hundreds of millions of households in rural and urban areas lack secure rights to the land and resource they live and rely on. This limits access to capital and the ability to make long-term investments. As a result, these individuals are particularly vulnerable in the event of conflict or natural disaster. Countries where property rights are perceived as insecure are less attractive for investors and more reliant on donor funding. USAID recognizes that strengthening rights to land and natural resources is central to achieving a broad range of development goals on the journey to self-reliance including: conflict prevention and mitigation; countering violent extremism; realizing inclusive economic growth, managing biodiversity and natural resources sustainably; enhancing agricultural productivity; generating own source revenue; and empowering women and vulnerable populations.

Integrated Land and Resource Governance (ILRG) Mozambique

In the 1990s, the government of Mozambique created a legal framework for land which recognized traditional community rights while encouraging investment. While the resulting legislation is progressive – land is owned by the state, and communities and good faith occupants have perpetual use rights – it has been unevenly implemented. The majority of rural residents are unaware of their communal and individual land rights, or, if aware, lack the political, financial, and technical means to effectively assert those rights in key situations.

Viable Sweet Potato Technologies in Africa (VISTA) 

While Mozambique’s economy has had consistent growth rates for several years, progress has been much slower in rural areas. Food insecurity in these rural areas remains a significant challenge. At least 25% of the rural population consistently suffers from food insecurity, 43% of children under the age of five suffer from chronic malnutrition (stunting), and more than 65% of children under five have deficiencies of essential micronutrients, such as vitamin A – which compromises the immune system and can lead to blindness.

USAID OLIPIHANA (“Support Each Other”) in Cabo Delgado

Cabo Delgado, Mozambique’s northernmost province, has enormous economic potential including natural gas reserves that could make it a leading natural gas exporter and a coastline attractive to tourism. Yet its 3.2 million residents are faced with high youth unemployment, poor access to education, especially for young women, and high rates of early marriage and gender-based violence. Since 2017, violent extremists have killed more than 1,500 people, destroyed villages and government facilities and caused ongoing insecurity for residents. In April 2019, Cyclone Kenneth compounded the situation by destroying housing, public infrastructure, and farmland. These dual crises have had a dramatic impact on the communities of Cabo Delgado, with the UN estimating that approximately 800,000 people have been forced to flee their homes over the past several years and almost 1 million people remain severely food insecure.

Biodiversity, Livelihoods and Countering Wildlife Trafficking

Support To Conservation Partners in Natural Resource and Fire Management

Mozambique’s rich biodiversity and natural resources have the potential to drive economic growth through increasing the tourism and extractive industries. Historically though the government has lacked the capacity and political will to effectively protect these resources from illegal activities and corruption. To expand both sectors responsibly, the Mozambican government is now working to curb corruption, enact conservation laws and policies and enforce meaningful legal penalties. Better coordination between relevant government agencies and improved systems and tools for stopping illegal wildlife and timber trafficking, illegal fishing, and uncontrolled forest fires are necessary for the government to succeed in its efforts.

USAID Environmental Security and Resilience in Northern Mozambique (USAID ECOSMART-2)

The Niassa Special Reserve (NSR) in northern Mozambique is one of Africa’s largest, wildest landscapes. In an area roughly the size of Switzerland, the NSR harbors the largest intact miombo woodland and some of Mozambique’s most significant population of lions, elephants, leopards, and wild dogs. The NSR is also home to 40,000 people, who depend on its natural resources for their livelihoods. The NSR is under significant threat from ivory poachers, illegal loggers, miners and fishers as well as violent extremist criminal networks. With USAID support, since 2015, the NSR has greatly expanded anti-poaching and surveillance efforts. Nonetheless, the overall stability of the region remains fragile as the conflict in coastal areas of Cabo Delgado intensifies, displacing large numbers of people and rendering the Reserve’s southern and eastern borders increasingly vulnerable. While the management capacity of reserve officials has improved, an ambitious 20-year co-management agreement between the National Administration for Conservation Areas (ANAC) and the Wildlife Conservation Society (WCS) was signed in 2020, establishing a management committee that includes communities and wildlife-management concession operators. By bolstering co-management, law enforcement, and community-based natural resources management, the recent conservation successes - such as zero elephants poached since May 2018 - can be expanded to include similar successes in fire management, stopping illegal resource extraction and other direct threats to biodiversity and natural capital in the long term.

Resilient Gorongosa

Gorongosa National Park and the surrounding landscape provides ecosystem services of food, freshwater and fuelwood to communities who have experienced conflict, food insecurity, and Cyclone Idai of 2019. The abundance and diversity of wildlife, decimated by decades of civil strife and poaching, has been restored alongside ecotourism and community infrastructure. Since 2008, USAID has invested $20 million, matching contributions of American philanthropist Greg Carr and other international partners, in the conservation and development of Gorongosa National Park. With reintroductions of key species lost during the civil war, increased protection, and improved local livelihood options, the Gorongosa Project has restored ecosystem services and provided agriculture, education, health and water/sanitation services to communities in the buffer zone.

KHETHA – Protecting Wildlife, Benefiting Communities

Wildlife crime is threatening both the black and white rhino and elephant populations in the Greater Limpopo Transfrontier Conservation area (GLTFCA), a transboundary area bordering Mozambique, South Africa and Zimbabwe. Poaching and illegal wildlife trade remains an alarming threat to the survival of rhino and elephant species, particularly in the Kruger National Park in South Africa where populations have rapidly declined as the region has become a lucrative rhino poaching hotspot.

USAID Disaster Recovery Cash Assistance in Sofala

Mozambique has long-standing, high levels of chronic malnutrition, affecting almost half of all children under the age of five. According to the latest Global Nutrition Report, approximately one third of all child deaths in Mozambique are linked to malnutrition and the prevalence of stunting in children under five is over 40%. Current levels of food and nutrition insecurity are exacerbated by multiple shocks including the effects of climate change, natural disasters, and internal displacement. Mozambicans living in the southern buffer zone of Gorongosa National Park have been particularly hard hit recently with Cyclone Idai destroying homes, schools, medical facilities and crops in 2019 and more recent flood events. Food security and nutrition in this area remains low as many families do not have the resources to maintain secure and nutritionally diverse diets.

Feed the Future Mozambique Resilient Coastal Communities (RCC) Activity

Resilient Coastal Communities (RCC) is a 4.5-year, $25M activity that focuses on a subset of the coastal region south of Pemba and North of Maganja da Costa. The RCC activity will blend USAID Agriculture, Biodiversity, and Climate Change resources to improve the resilience of coastal communities where rich, yet fragile land and marine ecosystems are at risk of climatic shocks and human-inflicted degradation. The activity will create high-quality, effective partnerships to pilot new and innovative ways to improve the resilience of coastal communities. Working with the public and private sector, civil society, and religious stakeholders, this activity will develop and pilot projects that will create a significant number of jobs and sustainable economic opportunities for youth and women, while positively impacting the long-term health and productivity of critical ecosystems, particularly the extraordinarily diverse marine ecosystems that are vital to food security.

Democracy, Human Rights, and Governance

Community Radio Assistance for Greater Empowerment of Mozambican Institutions (USAID CORAGEM)

Community radios are a major information source in Mozambique’s rural areas.  A 2015 Eduardo Mondlane University study revealed that community radios can reach approximately 2/3 of the population, with the largest numbers of listeners concentrated in the two most populous provinces of Nampula and Zambézia.  However, due to poor journalistic skills and ethical standards, lack of financial sustainability, and low levels of direct community engagement, the potential for community radio to inform and empower Mozambican citizens has not been fully realized.

USAID Local Governance Strengthening (USAID LOGOS)

In 2018, Mozambican leaders amended the Constitution and legal framework to progressively decentralize provincial and district governance. While progress has been made in giving more autonomy to subnational government offices, significant challenges remain, including: 

• lack of clarity and alignment of the legal authorities of national, provincial, district and municipal government offices, 
• low capacity in public financial management and tax revenue collection processes,
• ineffective service delivery systems, and 
• weak mechanisms of accountability to citizens and communities.

USAID sees an opportunity to partner with local governments as Mozambique works to fully implement decentralization reforms and improve local public services and governance effectiveness, transparency and accountability to local citizens.

Building Social Cohesion in Northern Mozambique

Despite having significant economic potential in terms of natural resources and tourism, Cabo Delgado is one of the poorest regions in Mozambique and is a hub for wildlife, human and drug trafficking; it also has the highest illiteracy rate in the country, a history of economic marginalization and high unemployment rates. Since October 2017, the province has seen an increase in violent attacks, creating a climate of fear and distrust in communities. The insecurity has forced over 750,000 individuals out of their homes and into host communities, overstretching resilience capacities. The devastation caused by Cyclone Kenneth in April 2019 destroyed over 45,000 homes in Cabo Delgado and Nampula as well as farmland, livestock and fisheries. This has further compounded the economic difficulties in the region and tension within communities. 

TV SURDO: Improving Inclusive Information and Advocacy

In Mozambique people with disabilities (PWD) are routinely marginalized and discriminated against, particularly in rural areas. They often lack full access to education, health care, information and employment. In addition to practical barriers, prejudice and stigmatization make it even more difficult for Mozambicans with disabilities to maximize their contribution to society.  TV Surdo, a local NGO promoting the inclusion of PWD and expansion of advocacy for their rights, focuses on using inclusive media content to accomplish this.

USAID Recovery Cabo Delgado

Cabo Delgado, Mozambique’s northernmost province, has enormous economic potential including natural gas reserves that could make it a leading natural gas exporter and a coastline attractive to tourism.  Yet its 3.2 million residents are faced with high youth unemployment, poor access to education, especially for young women, and high rates of early marriage and gender-based violence.  Since 2017, violent extremists have killed more than 1,500 people, destroyed villages and government facilities and caused ongoing insecurity for residents. In April 2019, Cyclone Kenneth compounded the situation by destroying housing, public infrastructure, and farmland. These dual crises have had a dramatic negative impact on the communities of Cabo Delgado, with the UN estimating that approximately 800,000 people have been forced to flee their homes over the past several years and almost 1 million people remain severely food insecure. 

USAID Youth-Led Action for Peace (USAID Youth-Led)

Cabo Delgado, Mozambique’s northernmost province, has enormous economic potential, including a coastline attractive to tourism and natural gas reserves that could make it a leading natural gas exporter. Yet it faces high youth unemployment, poor access to education (especially for young women), and high rates of early marriage and gender-based violence. Since 2017, violent extremists have caused thousands of deaths, destroyed villages and government facilities, displaced hundreds of thousands of people, and caused ongoing insecurity for residents. In April 2019, Cyclone Kenneth hit the region, destroying housing, public infrastructure, and farmland. Due to these crises and ongoing social exclusion, unemployment, poverty and fears about their future, many of the approximately 400,000 youth in Cabo Delgado have few economic options and can become easy targets for manipulation and recruitment by extremists, criminal networks or other negative actors.

Strengthened Investigative Journalism in Natural Resources Management and Other Economic Governance Issues (USAID REAJIR)

Mozambique stands poised to reap the benefits from an abundance of hydrocarbon, mineral, and other natural resources, yet the government faces challenges related to transparency, accountability, inclusion, and participation. Over the past two decades, civil society and the media have demanded greater government transparency and accountability. However, significant challenges persist, including harassment of journalists and self-censorship. To increase influence and accountability, civil society and the media will need to inform citizens and advocate effectively on increasingly complex economic governance issues at national and local levels. 

Economic Growth and Trade

USAID/DFC Partnership with ABSA Bank to Increase Access to Finance in the Agricultural Sector

The agriculture sector in Mozambique is a leading driver of Mozambique’s economy, contributing about one quarter of its GDP and employing 80 percent of the national workforce. Despite its significance, agriculture productivity and growth remain relatively weak, with most agricultural production concentrated in subsistence farming. Mozambique’s agriculture productivity is well below the regional average, and there has been little progress in agricultural innovation. The lack of access to financial capital for small- and medium-sized enterprises (SMEs) and to competitive financial services tailored to agricultural production and agri-businesses act as barriers to overcoming these challenges. Most SMEs operate on a low-risk, low-input system resulting in poor productivity and low volumes. Without financial access, SMEs have little incentive to invest in productivity and quality-enhancing technologies and practices or otherwise shift production to align with market demands.

Loan Portfolio Guarantee – Development Credit Authority

Mozambique’s agricultural sector comprises an overwhelming majority of smallholder farmers. About 70 percent of the population is engaged in agriculture, which serves as the main economic sector in Mozambique (24 percent of GDP). Only 16 percent of the country’s 36 million hectares of arable land is currently under cultivation. In addition, due to obstacles such as lack of access to financing, markets and quality inputs, productivity of small-holder, family-based agriculture is very low. Agricultural development is the key to reducing poverty. USAID agriculture focused programs use a value chain approach to strengthen the agribusiness sector through improved linkages between smallholder farmers and large commercial agribusinesses, processors, and traders. Productivity, processing, and marketing of staple agricultural commodities are expanded by enhancing access to finance, forging public-private partnerships, providing business development services, and improving the business-enabling environment.

Mozambique Monitoring and Evaluation Mechanism and Services (MMEMS)

Over the past several years, USAID/Mozambique has managed development assistance activities designed to achieve a wide-ranging set of results in the areas of health; agriculture, environment, and business; education; and democracy, human rights, and governance. Disaster assistance is a growing focus area. USAID provides development assistance in the form of grants, cooperative agreements, and contracts to a wide range of implementing partners (IPs), including: the Government of the Republic of Mozambique; international and local non-governmental organizations; other donors; other U.S. Government agencies; and public international organizations through more than 70 separate mechanisms. This complex portfolio, implemented over a large geographic area, requires strong management for results based on high-quality data and robust evaluations. USAID/Mozambique designed MMEMS to provide capacity building and technological solutions to USAID’s IPs and our own staff and to assist us with transforming our data into learning and adapting.

USAID Supporting the Policy Enabling Environment for Development (USAID SPEED)

A strong business enabling policy environment is critical to private sector competitiveness, attract investments, and create jobs. However, Mozambique ranks 135th (out of 190 countries) in the World Bank’s 2019 Doing Business Report and is not keeping pace with other countries in implementing reforms. Given the prospective natural gas bonanza, the next ten years represent a critical period for Mozambique to address multiple challenges through increased engagement with the private sector and civil society. An improved policy environment is required for balanced growth beyond the extractives industry, to diversify the economic base through expanding agriculture and other strategic sectors.
The USAID SPEED activity supports policy reform and implementation, which helps improve the business enabling environment and will enhance the role of the private sector in agriculture, trade facilitation, health, energy, water and biodiversity and conservation. The activity also supports policy reform and implementation that strengthens economic governance and public financial management, and enhances the role of civil society, supporting Mozambique’s ability to plan, manage, and finance its own development as part of a long-term journey to self-reliance. 

USAID Southern Africa Trade and Investment Hub

The USAID Southern Africa Trade and Investment Hub (USAID TradeHub) engages with partners across the region to increase sustainable economic growth, global export competitiveness, and trade in targeted Southern African countries. It supports these objectives by increasing exports from Southern African countries to South Africa and the United States (under the African Growth and Opportunity Act [AGOA]), boosting capital and technology flows from South Africa to other Southern African countries, and providing targeted trade facilitation support to Zambia. The USAID TradeHub works with market actors to identify and resolve enterprise constraints and implement sustainable solutions through market-based trade and investment facilitation services. The USAID TradeHub partners with the USAID Bilateral Missions through the Regional Mission to successfully deliver its objectives

Education

USAID Community Libraries Program (CLP)

The overall primary school completion rate in Mozambique is an alarmingly low 15% through grade 7 (30% in  urban areas; 7% in rural areas). The overall literacy for Mozambicans over 15 years old is 58% and only 45% for females specifically. Completion rates have stagnated within the last 3 years due to inadequate infrastructure, poor teaching methodologies, limited instruction and time in school and high absenteeism among students, teachers and school administrators. As a result, less than 5% of students demonstrate the desired grade-level reading proficiency by grade 3. Poor education in early grades not only impacts an individual student’s life, but also impedes Mozambique’s economic growth and the overall well-being of its citizens. 

Vamos Ler! / Let’s Read!

Since the end of the civil war in 1992, the Government of the Republic of Mozambique (GRM) has been rebuilding its education system with the goal of providing universal access. Under the policy of free and compulsory primary education, the primary education net enrollment ratio has expanded from 52% in 1999 to 94% in 2016. This expansion has placed pressure on school management, teaching personnel, and the overall quality of classroom instruction, resulting in overcrowded multi-shift schools, high student/teacher ratios, and plummeting reading and math test scores.  As a result, less than 5% of students demonstrate reading proficiency. To address these challenges, USAID is working closely with the Ministry of Education and Human Development (MINEDH) to implement data-driven reforms designed to improve reading outcomes in the early grades. 

USAID Apoiar a Ler! 

Primary school students in Nampula Province are not gaining the basic skills needed to progress in their school careers, which impacts their future ability to secure economic stability and fully participate in society. Only slightly more than one-third of students have obtained a basic level of reading, writing and math prior to leaving school. Two primary causes of this problem are poor quality of instruction and an insufficient quantity of classroom instruction time. Furthermore, most instruction takes place in Portuguese, a language many children and most parents/caregivers do not understand. As a result, poor learning outcomes are being reproduced from one generation to the next. Since 2016, USAID has supported the Ministry of Education and communities to address these challenges through stronger bilingual education policy implementation, improved early-grade reading instruction and increased parental and community engagement. 

USAID Community Engagement in Bilingual Education 

Mozambique has made remarkable progress expanding access to primary education. From 1975 to 2018, the number of primary schools increased from 1,000 to 12,768, and enrollment has more than tripled to over 6.5 million students currently. Unfortunately, the educational quality did not improve with increased access to schooling. In 2016 only 4.9% of children achieved the required reading and writing skills, dropping from 6.3% in 2013. Global evidence shows that most children who attend school in resource-deprived contexts learn to read better in the language they speak at home. Since only 1 in 10 Mozambican children speak Portuguese at home, providing bilingual education in early grades is critical to improving reading. The government of Mozambique has made bilingual education a priority, but implementation has been difficult due to a lack of training for teachers and understanding among parents and communities.

USAID Higher Education for Career Development Initiative

Mozambique is entering a demographic transition with a working-age population that is rapidly expanding. Youth unemployment represents a sizable economic loss due to unrealized human resources and foregone tax revenues which contribute to creating a tax burden in future years. Broadening education and training opportunities to youth will enhance their employability and the country’s overall competitiveness and economic growth. While the portion of public education funding dedicated to the higher education system increased from 15.3 percent in 2009 to 18.4 percent in 2014, a 2019 UN University study found university graduates in Mozambique most often described their entry into the job market as difficult. The jobs graduates did find, often did not match their skill set, were of low quality, and had little job security and low pay. 18 months after graduation, 23% of graduates were still unemployed. There is a clear disconnect between the soft skills the private sector requires to compete in a global economy and the skills job seekers currently possess. Women and persons with disabilities face particular difficulties, including gender biases and accessibility issues. 

Gender Equality and Women's Empowerment

Gender Equality & Female Empowerment

Mozambique ranked 181st out of 188 countries in the 2015 UNDP Human Development Index, and 139th out of 159 countries in the UNDP Gender Inequality Index. Extreme poverty and the HIV/AIDS epidemic have contributed to the precarious status of women and girls in the country. Low levels of education, high maternal health risks, pressure to marry at a young age, limited economic prospects, gender-based violence, and accepted cultural norms place women at a high disadvantage. Few girls finish primary school (46%), even fewer finish secondary school (22%), and 56% of women are illiterate (upwards of 70% in rural areas).

Global Health

USAID Alcançar

The government of Mozambique has committed to improving maternal, neonatal, and child health (MNCH) and there has been progress in expanding the network of health facilities.  This has resulted in increased coverage and provision of lifesaving MNCH services. However, the expansion in network and coverage has not consistently yielded improvements in actual health outcomes. Nampula, Mozambique’s largest and most populous province, has some of the worst statistics surrounding maternal, neonatal and child mortality. 

Adapting and Modifying Optimized Sample Transport Routes for Achieving Impact (USAID AMOSTRA)

Mozambique’s health system faces several major challenges, including limited funding, insufficient infrastructure, and a critical shortage of human resources. Additionally, over 90% of Mozambicans live over a one hour walk from a primary health care center.  Under these circumstances, consistent, efficient diagnosis, and monitoring of diseases - especially critical in HIV/AIDS and TB treatment- remains difficult. While some progress has been made, the laboratory specimen transportation system is inadequate which has very real negative health consequences for patients. Delayed testing and results often mean delayed care and treatment. With USAID support, the Mozambique Ministry of Health has advanced diagnosis capabilities in select laboratories throughout the country to help manage HIV treatment and care. Important tests to manage HIV patients such as HIV viral load (VL) tests and tests to measure if an infant has been exposed to the HIV virus (called EID) and tests to find out if a patient has multidrug resistant tuberculosis (TB) are all now available in Mozambique. However, in many cases the laboratory that can process these tests is far from where the patients live -thus requiring laboratory samples to be collected at lower-level health facilities and transported long distances to where they can be processed. An additional challenge is making sure the results of these important tests are returned to health care providers and patients so that the patient’s care is properly managed.  

Central Contraceptives Procurement (CCP)

USAID’s family planning and reproductive health (FP/RH) program aims to: 1) increase access to a wide range of modern contraceptive methods and high quality services for postpartum women, HIV positive women and adolescents, high parity women, and post-abortion care women at both community and facility levels; 2) increase demand for modern contraceptive methods and high quality FP/RH services; 3) strengthen social behavior change communication interventions; and, 4) strengthen FP/RH systems in strategic planning, human resources, financial systems, commodities, and supply chain management. Improving civil society engagement regarding family planning and sexual reproductive health/safety plays an invaluable role in USAID’s support to the health sector in Mozambique. As the largest bilateral donor of family planning assistance in the world, USAID continues to support safe, effective, and acceptable contraceptive technologies designed for provision and use in low-resource settings. Increased use of modern contraceptives by Mozambicans who specifically want to avoid pregnancy saves lives and improves health.

USAID Chenguetai Vana (Care for Children) - ANDA

Mozambique’s HIV/AIDS epidemic has resulted in an estimated 920,000 children orphaned by AIDS and an approximately 2.2 million people living with HIV. Adolescent girls and young women are especially vulnerable to HIV infection, given that 48% of women age 20-24 years are married or live with a partner before age 18, 14% before age 15,  and, of girls who ever attend school, half drop out by the fifth grade. Moreover, Mozambique has the fourth largest youth bulge in the region, with half of the national population under the age of 17.  As this growing youth population becomes sexually active, effective interventions to ensure knowledge of HIV status and adherence to treatment are crucial for HIV epidemic control.

Support to CISM for Malaria and Maternal and Child Health Research

The government of Mozambique has made progress in combating malaria and addressing issues pertaining to Maternal and Child Health (MCH). However, as in much of the developing world, the major causes of under-five deaths are pneumonia, diarrhea, and malaria. All these diseases are both preventable and treatable. Malaria is still endemic throughout Mozambique, and its entire population of 31.3 million (2020) is at risk. Malaria is considered the most important public health problem in Mozambique and accounts for 29% of all deaths. Among children under five years of age, malaria accounts for 42% of deaths. Streptococcus pneumoniae is the leading cause of bacterial pneumonia and a major cause of meningitis, sepsis, and ear infections among children in developing countries. An estimated 826,000 children less than 5 years of age die of pneumococcal disease worldwide each year and most of these children live in developing countries.

Service Delivery and Support for Orphans and Vulnerable Children (COVIDA)

Nearly 12 million children in Sub-Saharan Africa have lost one or both parents to AIDS. Many more children have been made vulnerable because of family illness and the widespread impact of HIV/AIDS on their communities. Orphans and vulnerable children (OVC) are more vulnerable to abuse and exploitation and are also more likely to engage in unsafe behaviors, increasing the risk of HIV infection. Targeted OVC interventions, linked with broader development efforts around education, food and nutrition, and livelihood assistance, contribute to reducing the risk and impact of HIV/AIDS on the most vulnerable population in Mozambique.

USAID Commodities for Health: Ensuring Guaranteed Access and Reliability (USAID CHEGAR)

In Mozambique, over 70 percent of the population lives in rural and remote areas. Mozambique’s health system faces several major challenges to reaching these communities with essential medicines and medical supplies: limited funding, insufficient infrastructure, and a critical shortage of human resources. Additionally, as the government of Mozambique continues to decentralize, local private companies are increasingly involved in the delivery of medical commodities to health facilities and pharmacies throughout the more remote parts of the country. Many of the smaller local private companies are well-positioned to do this work, but currently lack the technical and management expertise to effectively take on this critical function.

Efficiencies for Clinical HIV Outcomes (ECHO)

Mozambique has the eighth highest HIV prevalence in the world, with a prevalence estimated at 13.2% according to the latest national Indicators of Immunization, Malaria and HIV/AIDS survey (IMASIDA - 2015). As of 2020, 2.1 million people were estimated to be living with HIV in Mozambique, 13.8 percent of women and 8.8 percent among men. Among adolescent girls (ages 15-19) prevalence is estimated at 3.3 percent and among young women (ages 20-24) at 9.3 percent, compared to 1.6 percent and 3.7 percent among adolescent boys and young men, respectively. While the country has made strides in testing and treating HIV, systemic challenges such as the need to travel great distances to access care, long wait times in facilities, stigma, poor quality healthcare, and inadequate communication about the importance of staying on treatment have resulted in a high proportion of HIV-positive individuals discontinuing their treatment. Consequently, Mozambique continues to have among the highest HIV mortality rates in the world.

Apoio aos Serviços Provinciais de Saúde de Tete (G2G -TETE)

Em Moçambique, todo o trabalho do Ministério da Saúde realizado a nível provincial é supervisionado pelos Serviços Provinciais de Saúde (SPS) e pelas Direcções Provinciais de Saúde (DPS). Isto inclui a resposta do país ao HIV/SIDA e à TB e o controlo da Malária. Contudo, a capacidade dos SPS e DPS em todas as províncias em geral, não é suficientemente elevada para implementar na íntegra as intervenções sanitárias necessárias para comunicar dados adequados, ou para desenvolver planos estratégicos. Este projecto aborda o problema da capacidade na província de Tete e será utilizado para desenvolver outros acordos directos com direcções provinciais nas restantes províncias onde a USAID é líder na implementação dos programas PEPFAR. 

Health Policy Plus: Mozambique

The health sector in Mozambique is faced with multiple financing challenges, limited domestic resources, plateauing donor support and increasing absolute level of out-of-pocket expenditures. This contributes to limiting access to care for people in need.  Palladium and its partners support Mozambican partners and stakeholders to improve the enabling environment for HIV, Family Planning and Reproductive Health (FP/RH), and maternal, newborn, and child health (MNCH) and the Palladium/Health Policy Project (HPP), 2010 –2015 collaborated with USAID and the Mozambican Ministry of Health (MISAU) on a program that supported costing of Reproductive, Maternal, Neonatal, Child, and Adolescent Health (RMNCAH) programs. 

Demographic and Health Survey Support (DHS-8)

The Demographic and Health Surveys (DHS) Program is USAID’s primary implementation mechanism for demographic and health data collection.  The purpose of this contract is to improve the collection, analysis, and dissemination of population, health, and nutrition data and to facilitate use of these data for planning, policy-making, and program management. It has collected, analyzed, and disseminated accurate and representative data on population, health, HIV, and nutrition through more than 400 surveys in over 90 countries. Data generated by these surveys enables countries to identify and prioritize development targets, monitor progress towards Sustainable Development Goals (SDGs), and measure the impact of programming at the population level. 

Integrated Family Planning Program (IFPP)

High fertility rates present a serious health threat in Mozambique, with the total fertility rate varying from 4 to 8 with an average of 6 children per woman (DHS 2011). According to the National Malaria and HIV Indicator Survey 2015 (IMASIDA), the modern contraceptive prevalence rate (mCPR) is 25% (34% urban and 22% rural) with a high demand for modern methods of 50% and unmet need of 23%.  A total of 46% of adolescent girls are pregnant for the first time or already have one child, and in this group only 14% are using any contraception method. There is also a high unmet need for family planning (FP) with 46% of women that express a desire to limit or space pregnancy not using any form of contraception. There is a high unmet need for FP especially among HIV positive women. However, few programs targeting HIV-positive women provide counseling and services for FP. IFPP will focus on young people and smart integration of FP into other services. 

Support to the National Council to Combat HIV/AIDS (CNCS G2G)

Mozambique has the second largest HIV epidemic in the world. With an estimated 2.2 million Mozambicans infected with HIV (13.9% of people over age 15), and new infections continuing at a high rate (130,000 per year), particularly among adolescents and young women and men, HIV is the leading cause of mortality for Mozambicans over the age of 5. While the country has made strides in testing people for HIV and providing treatment, systemic challenges, such as the need to travel long distances to access care, long wait times in facilities, stigma, poor quality healthcare, and inadequate communication about the importance of staying on treatment have resulted in a high proportion of HIV-positive individuals discontinuing their treatment. Consequently, Mozambique continues to have among the highest HIV mortality rates in the world.

Mozambique Integrated Malaria Program

Preventing, Testing, Treating, and Tracking Malaria

The Mozambique Integrated Malaria Program (IMaP) is a five-year USAID-funded project implemented by Chemonics International that will contribute to reducing malaria mortality, morbidity, and parasitemia in four high malaria burden provinces (Cabo Delgado, Nampula, Tete, and Zambézia). IMaP will achieve this goal through three objectives: 

• Support the implementation of proven malaria interventions at community and facility levels, in alignment with the National Malaria Strategic Plan
• Strengthen management capacity of the provincial and district Ministry of Health personnel to provide oversight and supervision of malaria interventions
• Improve Health Management Information System data reporting, analysis, and use at the provincial and district level

Mozambicans, especially in the high-transmission north and center, continue to be stricken with malaria. The disease accounts for nearly 30 percent of all deaths and is especially lethal for children under five. Despite significant investments by the Government of Mozambique, USAID, and other donors, cases continue to increase, even accounting for improved reporting. The causes are complex– the country’s ability to address health challenges is hindered by such issues as health system weaknesses, low uptake of preventive and treatment services, and broader climatic and environmental factors that compromise progress.

Food Security Innovation Lab – Impact Evaluation of FCC - SFCS Project 

Força a Criança e Comunidade (FCC) is a five-year cooperative agreement implemented by World Education and designed to provide education, social and economic strengthening to orphans and vulnerable children (OVC) in Manica, Sofala and Zambezia. Food Security Innovations Lab, part of the BASIS-AMA consortium implemented by UC Davis in conjunction with other US-based universities, is completing a prospective independent impact evaluation of the FCC activity.

Community-based HIV Services for The Southern Region - N'WETI

The prevalence of HIV in Mozambique is 12% among adults 15 to 49 years old with substantial variation in regional prevalence rates ranging from 25% to 3.7%. Mozambique’s HIV epidemic is driven by a complex combination of structural and social and behavioral factors that vary among sub-populations, including: low literacy rates (59%); poverty; low levels of male circumcision; insufficient access to HIV prevention, care, and treatment services; sexually transmitted infections; sexual violence; transactional sex; multiple concurrent partners; cultural practices, such as rites of passage; and gender imbalances. Despite gains made in scaling up access to Anti-Retroviral Treatment (ART), Mozambique has not yet achieved epidemic control. Although ART is now being provided in every district, national coverage has reached only 74% for adults and 46% for children as of 2014.

N’weti Zambézia

Mozambique has a population of approximately 32.5 million people with 14.4 million (44%) under 15 years of age. The national Indicators of Immunization, Malaria and HIV/AIDS survey (IMASIDA) in 2015 estimated HIV prevalence at 13.2 percent, with substantial variation in provincial prevalence that ranged from 5.2 percent in Tete Province to 24.4 percent in Gaza Province (2015, IMASIDA)2. IMASIDA data indicate that Mozambique is still challenged by a generalized HIV epidemic. For example: HIV prevalence in Zambézia is estimated at 15.1% among adults aged 15-49.2 Due to the high population in Zambézia, this percentage represents the highest number of PLHIV in Mozambique. Prevalence is higher among women (16.8%) than men (12.5%) and this discrepancy in prevalence rate is even more strongly reflected among young men and women aged 15-24: from those who were tested for HIV, 14.3% of the young women and 4.1% of young men in Zambézia tested positive. This project started in Zambezia in March 2019 and expanded to Gaza in April 2021.

Integrated HIV Prevention and Health Services for Key and Priority Populations (PASSOS)

According to UNAIDS (2014), as many as 30 percent of newly HIV-infected people in Mozambique are female sex workers (FSW), their customers, or their regular partners. A 2010/2012 Integrated Bio-Behavioral Surveillance (IBBS) study of FSW in the urban areas of Maputo, Beira and Nampula showed HIV incidence rates around 20 percent, with regional variation. A 2011 IBBS study of men who have sex with men (MSM) in the same urban areas showed approximately eight percent HIV prevalence among this group. 

Last Mile Supply Chain (LMSC)

In 2013, the Mozambique Ministry of Health (MISAU) adopted the Pharmaceutical Logistics Strategic Plan (PELF) prompting several reforms to improve the distribution of critical health products to health facilities. It also expanded the use of electronic logistics management information systems (LMIS) to help ensure end-to-end visibility and quality of key logistic information throughout the supply chain. In its efforts to provide quality health services to its citizens, the Government of Mozambique and USAID are partnering with VillageReach to design and implement a streamlined and effective last mile supply chain system. The primary objective is to improve the availability of medical commodities and diagnostics at the last mile. The Last Mile Supply Chain (LMSC) program is aligned with long-term national strategies and efforts, while taking short-term steps to address chronic logistics and transport challenges at the sub-national level. The program initially is being implemented in Zambézia province, with plans to expand in the future. Strategic partnerships are core to the program, helping ensure effective implementation, results maximization and sustainability. The Ministry of Health, CMAM (Center for Drugs and Medical Supplies), and the Provincial Health Directorate (DPS) in Zambezia are central to the work. Other technical partners include Bolloré Transport & Logistics, ThinkWell and Nichols Group LLC. Trucks loading medicines at a provincial warehouse site.

Medicines, Technologies and Pharmaceutical Services (MTAPS)

Mozambique has made important progress in strengthening its pharmaceutical systems and improving access to life-saving medicines including antiretroviral therapy in recent years. A new medicines law, enacted by Parliament in 2017, created the National Directorate of Pharmacy (DNF), which is now elevated to Autoridade Nacional Reguladora de Medicamento, Instituto Público (ANARME, IP)). The number of people living with HIV receiving antiretroviral therapy (ART) has increased from 914,000 in 2016 to approximately 1,600,000 in 2021, and new policies to strengthen the human resource capacity in the health sector, including shifting HIV care and treatment functions to clinical officers and nurses, were introduced. Still, there are still gaps in the ANARME, IP’s immediate capabilities and long-term regulatory planning.

Mwanasana (Healthy Child) Project

Mozambique’s HIV/AIDS epidemic has resulted in an estimated 920,000 children orphaned by AIDS and approximately 2.2 million people living with HIV. Sofala Province has one of the highest HIV prevalence rates in the country at 16.3% and the highest early sexual debut (< 15 years old) rate in Africa at 28%. Sofala is also home to Beira, Mozambique’s second largest city, which is densely populated with vulnerable youth moving to it for education and employment opportunities. Buzi, Dondo, Nhamatanda and Caia districts all have high population, poverty and orphans and vulnerable children (OVC) rates, with at least one-fifth of residents classified as OVC.

PIRCOM: Integrated Social Behavior Change Communication (SBCC)

Mozambique faces major health challenges that demand combined and intensive interventions at different levels. Malaria, HIV/AIDS and tuberculosis continue to have serious impacts on the health of the country.  Chronic malnutrition rates hover around 43%, concentrated primarily in the northern and central provinces. The maternal mortality ratio is currently at 408 per 100,000 live births, with only 13% of women with obstetric complications having access to emergency obstetric care.  Addressing these challenges not only requires a strengthened health system, but also an increase in access to and demand for health services at the individual and community level. 

Preventing Child and Early Forced Marriage in Cabo Delgado

In Mozambique’s Cabo Delgado province—one of the poorest in Mozambique—18% of young women aged 20-24 marry by the age of 15 and 61% marry or live with a partner by the age of 18. Cabo Delgado has the second highest rate of child marriage and the highest rate of adolescent pregnancy in the country—65% of adolescents aged 15-19 are already mothers or pregnant. In Cabo Delgado early marriage is a leading cause of school drop-out among adolescent girls, and early pregnancy is associated with a variety of negative health outcomes for both mothers and their children. While Mozambique passed a national law criminalizing early marriage in 2019, the law is not well known nor enforced. Cabo Delgado has been subject to natural disasters and conflict, including attacks by armed insurgents, which have disrupted social services, education, livelihoods; displaced populations; and led to increased poverty. Reducing child, early, and forced marriage (CEFM) will enhance girls’ freedoms and life options, keep them connected to and supported by their families and peers, and break cycles of poverty.

Global Health Supply Chain - Procurement and Supply Management (PSM)

Mozambique’s health system has improved over the last several decades, but the gains are not enough to effectively manage the significant health challenges facing the country. The health supply chain in particular has struggled to keep up with the growing and increasingly complex demands of the health system. While the Central Medical Stores (CMAM) is tasked with managing Mozambique’s medical commodities supply chain, it has limited resources to effectively implement all the necessary functions such as warehousing, distribution, commodity quantification, stock procurement, logistics management, monitoring and evaluation, and staff training. Limited warehousing space and staff specialized in supply chain and logistics pose significant challenges to adequate supply chain management. The supply chain also lacks end-to-end visibility in the logistics management information systems (LMIS). While information systems exist to meet the basic needs of the health system, the quality of data is too inconsistent for reliable decision-making and planning. 

Reducing Aflatoxin Exposure: Nutrition Innovation Lab

Aflatoxins are pervasive in the value chains of key staple crops such as maize and groundnuts in many developing countries where agriculture is a significant contributor to Gross Domestic Product (GDP). Mozambique is one such country, where agriculture constitutes 24% of the GDP, with 80% of the population dependent on it as a source of income. Some of the most commonly cultivated crops in Mozambique, such as maize, cassava, and groundnuts, are easily contaminated by aflatoxins and widely consumed by the population. Aflatoxin exposure and its association with growth impairment in children may contribute to a significant public health burden, especially in less developed countries like Mozambique. Many studies have found strong associations between aflatoxin exposure and stunted fetal, infant, and child growth, thus providing evidence for the first criterion for causality. Mozambique is a country with high rates of chronic malnutrition (stunting), particularly in rural areas and the provinces where USAID activities linked to the Feed the Future (FTF and Preventing Child and Maternal Deaths (PMCD) initiatives are being implemented. While some data on soil and crops which show high levels of aflatoxin exist in Mozambique, there is no data on levels of aflatoxin in human serum. While the case for aflatoxin mitigation to decrease stunting is slowly being made, there is still lack of data to understand the extent of the problem at the national and sub-national level in Mozambique. Furthermore, there is very little or practically no knowledge of if and how the presence of aflatoxin in the body might interact with other risk factors of stunting, thereby exacerbating the problem.

Support Community Health Interventions to Address Neonatal and Child Health - UNICEF

Mozambique has shown significant improvements in health indicators and progress in maternal and child health over recent decades. However, despite substantial improvements in infant and child mortality rates, preventable maternal and child deaths continue to be unacceptably high in Mozambique. Neonatal complications or infection, malaria, diarrhea, pneumonia and HIV/AIDS account for more than 80 percent of all deaths of children under five in the country, with malnutrition as a contributing factor in 35 percent of children deaths.   

Strengthening Family and Community Support to Orphans and Vulnerable Children Program, “FCC – Força à Comunidade e às Crianças”

With over 60% of Mozambicans living below or just above the poverty line, regular shocks leave most of the population at risk of becoming poor or sinking deeper into poverty. Without adequate care, the consequences of growing up in this environment have life-long implications for the wellbeing and development of orphans and vulnerable children (OVC). To address these concerns, USAID, in collaboration with the Mozambican Government (GRM), civil society, local organizations, and other donors, support the technical areas of HIV/AIDS, malaria, health systems strengthening, maternal and child health, family planning, nutrition, tuberculosis, water and sanitation, and neglected tropical diseases. More specifically, USAID seeks partnerships to implement programs designed to reduce the vulnerability of OVC and the poor in Mozambique, including social protection programs and comprehensive OVC programming, which can contribute to positive wellbeing outcomes. 

Strengthening High Impact Interventions for an Aids-free Generation (AIDSFREE) Project

Latest figures indicate that HIV/AIDS prevalence in Mozambique is 13%, with 29% prevalence among orphans aged 15-17, and almost 40,000 AIDS related deaths in 2015. Three randomized clinical trials showed that male circumcision (MC) reduces female to male HIV transmission by approximately 60%. In Mozambique, MC has been practiced by many communities for centuries. In addition to having religious significance, MC often serves as a rite of passage to adulthood and is performed as part of adolescent initiation rites. Approximately 63% of men aged 15-49 are circumcised (up from 51% in 2009), although there is significant variation across the nation’s 11 provinces, with low circumcision rates and high HIV prevalence observed in the southern and central regions of the country.

TB Response

Mozambique– ranked in the bottom third of countries for health indicators – faces significant challenges in the health sector that impact TB diagnosis, treatment and outcomes. At the community level there is low awareness of TB symptoms, transmission, prevention and treatment.  There is also stigma associated with the disease and its common co-infection HIV. Despite some recent progress at the facility level, significant gaps remain in terms of access to quality diagnosis, treatment and care. The four target provinces - Nampula, Zambézia, Tete and Sofala- represent 56% of all new TB notifications in 2018 and the TB treatment coverage of those cases was at 59%.  This provides both a challenge in tackling such large numbers and gaps, but also an opportunity to allow the government to take lessons learned here and apply elsewhere in Mozambique.  

Transform Nutrition

Mozambique – ranked 170 of 188 countries on the Human Development Index – faces significant development challenges. The country is largely dependent on agriculture (mostly subsistence-based with small family farms) and is vulnerable to drought and natural disasters. 66% of the population live in rural areas, most live below the poverty line, and one-third is chronically food-insecure with high child stunting. The situation is worse in Nampula – Mozambique’s largest, most densely populated province –particularly for pregnant and lactating women, adolescent girls, and children under 2.  The most recent surveys show that Nampula has the highest stunting rate for children under 5 at 55%, a full 12% higher than the national average. 51% of adolescent girls are anemic, early marriage and pregnancy rates are among the highest in the country, and women and girls face extreme socio-economic exclusion.  The causes of and contributing factors to malnutrition are complex including inadequate food intake; diets low in micronutrients and protein; gender inequity in access to nutritious foods; misconceptions about nutritious diets; poor infant and young child feeding practices; poor sanitation; and low dietary diversity. Transform Nutrition (TN) aims to address these challenges in Nampula Province, particularly for pregnant and lactating women, adolescent girls and children under 2.

USAID Advancing Nutrition
Malnutrition is an underlying cause in almost half of child deaths and a persistent barrier to economic growth, with countries in Africa and Asia losing up to 11% of their gross domestic product each year because of malnutrition. Nampula—Mozambique’s largest and most densely populated province—has the highest prevalence of malnutrition with 55% of children with stunted growth, a full 12% higher than the national average. The Government of the Republic of Mozambique (GRM) has made the reduction of malnutrition one of its key economic and health priorities. Yet, despite recent decades of investments in food security and nutrition, the prevalence of malnutrition remains high and its social and economic effects continue to hinder Mozambique’s progress. 

USAID Local Empowerment to Advance Development (USAID LEAD)

Non-governmental organizations (NGOs) play a significant role in providing quality social services to citizens in every country. Yet NGOs in Mozambique face challenges to achieving institutional, financial and programmatic sustainability. Many Mozambican NGOs show weak institutional governance, leadership, and systems, and lack stable and diversified funding. Combined, these factors result in weak performance and eventually failure.  By building local capacity to plan, finance, and implement solutions to Mozambique’s development challenges, USAID will help ensure the sustainability of development initiatives and will broaden the partner base for future initiatives. 

U.S. Bureau of the Census Project 

The U.S. Bureau of the Census has an existing Interagency Agreement with USAID at the global level to provide technical assistance to National Statistical Organizations in the preparation, implementation, analysis and dissemination of national population and housing censuses. 

VectorLink

Malaria is considered the most important public health problem in Mozambique. It accounts for nearly one third of all deaths and 42% of deaths in children less than five years old. Although malaria prevalence has decreased in all provinces, the country continues to face challenges that have slowed the progress of key malaria prevention and treatment interventions.

Voluntary Medical Male Circumcision (USAID VMMC)

Male circumcision reduces female to male sexual transmission of HIV by 60% and is a highly cost-effective means of reducing infection rates.  Voluntary medical male circumcision (VMMC) has historically been a priority for the Mozambique Ministry of Health (MOH), however the VMMC program has consistently not met goals particularly among males 15-29. Mozambique's voluntary medical male circumcision initiative was initiated in Manica and Tete after other provinces. The rates have been the lowest in the country across all age groups, but particularly among this priority population. Recent gains in these rates have been seen since USAID VMMC began in 2019, but more work is needed to reach the goal of 80 percent of the target population.  

World Food Program

Almost one-third of Mozambicans suffer from chronic food insecurity, exacerbated by the historic drought of 2015-2016. Nationally, 43 percent of children under 5 are stunted. Micronutrient deficiencies are widespread: 69 percent of children under 5 are anemic, and 74 percent of children under 5 are vitamin A deficient, with negative impacts on growth, immunity and development. The National Nutrition Rehabilitation Program (PRN) was established by the Government of the Republic of Mozambique in 2010. The PRN sets clinical protocols for treating acute malnutrition for two distinct groups: 1) patients below 15 years of age 2) patients aged 15 years of age and older (including pregnant and lactating women). Corn-Soy Blend plus (CSB+) is the supplementary food used for treatment of moderate acute malnutrition (MAM) in the areas of Prevention of Mother-to-Child Transmission (PMTCT) of HIV, support of orphans and vulnerable children (OVC), and support to people living with HIV/AIDS.

Youth Power

Mozambique faces a large youth population with high unemployment, low levels of secondary education, and limited support to help young people transition from adolescence to adulthood. There is insufficient attention and understanding on youth development and on adolescence in particular, and addressing the needs of youth during this phase of life has not been a high priority in Mozambique. For youths without one or both parents, obtaining education is very difficult. Many young orphans are obligated to live with distant family members, work to generate income and, sometimes, abandon their studies. Without the financial or emotional support of a respected adult and living in an unstable emotional state as a result of traumatic experiences, they remain exposed to conditions of risk. Early trauma may have impacted cognitive development and the ability to develop positive “non-cognitive behaviors” such as social and relationship skills, positive self-concept and communication skills. While all youth need to develop key skills and behaviors to help them transition successfully into adulthood, youth who have experienced trauma and who lack supportive parenting to help them transition into productive, healthy and engaged adults benefit from additional supports such as having positive relationships and adult role models.

WASH - Water, Sanitation and Hygiene

Water, Sanitation and Hygiene Finance (WASH-FIN) Mozambique

Expanding finance for viable water service providers to enable investment in improved service for safe and affordable water supply. Beyond the urban core of Maputo and other larger urban centers, where water supply is the responsibility of the Water Supply Asset and Investment Fund (FIPAG), Mozambique has active local private water service providers known as Fornecedores Privados de Agua or FPAs, distinguished by the fact that they are many and operate small to medium sized piped networks. In 2018, there were over 1,800 FPAs across the country with the majority concentrated in the greater Maputo area (58%).  FPAs are concentrated in the peri-urban areas, mainly the most heavily populated and areas where there has been unprecedented growth in recent decades. Private investment from FPAs has rapidly scaled to meet demand, and FPAs are estimated to cover 23% of the total peri-urban population of Mozambique. 
In secondary towns, the Water and Sanitation Infrastructure Administration (AIAS), was created in 2009, as a national asset management unit with a mandate of promoting autonomous, efficient and financially sustainable management of water supply systems. AIAS currently oversees 130 secondary water supply systems in small and medium-sized urban areas, and rural towns, accounting for13% of the total Mozambique population.  With support from development partners, such as the World Bank, AIAS has built capacity and assumed responsibility to oversee a portfolio of lease contracts with professional operators in more than 40 systems across all 10 provinces, with approximately 70% being operated by the private sector.  However, significant investment is still required to rehabilitate, and jump start water systems in many secondary towns. Improving the lease contract model, to encourage private investment for services expansion by private operators and operation of AIAS systems, will be an efficient path to mobilize the required investment and to provide safe and reliable water supply services to unserved secondary towns. To meet this goal, the legal and institutional framework needs to be updated to allow scaling up of private investment in water supply infrastructure.

USAID Transform WASH 

With a population of around 28 million people, Mozambique ranks 180th out of 189 countries on the United Nations Development Program 2018 Human Development Index. Almost half of the country’s population still lives in poverty, with the highest concentration in Nampula and Zambezia provinces, where almost half of the 11.2 million poor live. In the last decade, the Government of Mozambique focused water, sanitation, and hygiene (WASH) investments in urban and rural areas. In small towns, around 15 percent of the total Mozambican population, little investment for water and sanitation has been provided, despite the trend of economic growth. The water services coverage rate in small towns is at around 20 percent, 14 percent with hand pumps and 6 percent piped water, often neither functioning. USAID has designated Mozambique as one of its WASH High-Priority Countries, to provide safe and resilient water, sanitation, and hygiene assistance.

Water Sanitation and Hygiene (WASH) in Health Centers 

The 29 million Mozambicans are served by approximately 1,640 primary level health facilities. Due to inadequate investment in routine maintenance and upgrades many of these facilities are in a poor condition and lacking essentials such as water, functioning sanitation systems, safe medical waste disposal and electricity.  A lack of access to safe water and adequate sanitation, and poor hygiene practices creates the environment for an alarmingly high prevalence of diarrhea throughout the country. Furthermore, 16 percent of all deaths in Mozambique can be attributed to inadequate WASH practices. 

Working in Crisis Response

Disaster Response

Mozambique is the third most vulnerable country in Africa to disaster risks (according to the UN’s Global Assessment Report on Disaster Risk Reduction). Frequent natural disasters disrupt livelihoods and food production of the most vulnerable people, undermining the fight against extreme poverty. During the last 35 years there were 75 declared disasters in Mozambique consisting of 13 drought events, 25 floods, 14 tropical cyclones and 23 epidemics (Instituto Nacional de Gestao de Calamidades, 2016). The regional El Niño-induced drought emergency of 2015-2016 was the worst in 35 years.

Southern Africa - Tropical Cyclones

Mozambique is the third most vulnerable country in Africa to disaster risks (according to the UN’s Global Assessment Report on Disaster Risk Reduction). Frequent natural disasters disrupt livelihoods and food production of the most vulnerable people, undermining the fight against extreme poverty. During the last 35 years there were 75 declared disasters in Mozambique consisting of 13 drought events, 25 floods, 14 tropical cyclones and 23 epidemics (Instituto Nacional de Gestao de Calamidades, 2016). The regional El Niño-induced drought emergency of 2015-2016 was the worst in 35 years.