Supporting the Policy Enabling Environment for Development


Mozambique faces a complex set of public health challenges, including a widespread HIV epidemic, a high incidence of malaria and high maternal mortality rates. To respond to these challenges, the Government receives significant support from several international donors (48 percent of total health expenditures), including the Global Finance Facility, Global Fund to Fight Tuberculosis and Malaria, the Global Vaccine Initiative, the President’s Emergency Plan for AIDS Relief (PEPFAR), and the President’s Malaria Initiative (PMI). 

Heavy reliance on development partners to finance the Mozambican health system has prompted the GRM to examine domestic resources, including those in the private health sector. In recent years, the private health sector has grown rapidly, especially in urban areas. To date, the GRM has not fully tapped into this domestic resource to complement its existing efforts to deliver healthcare to the Mozambican population.

Historically, the government has appeared to take a cautious approach to market development, perhaps because healthcare in Mozambique has traditionally been considered a “right to be provided for free”. The hope is that information and dialogue will help both private and public stakeholders identify opportunities to engage the private sector to address health system challenges to improve health outcomes in Mozambique. 

In 2019, the mission commissioned a Private Sector Rapid Assessment that concluded: 

❏ The private health sector is diverse, fragmented, and not organized into functioning membership organizations that can represent the private sector’s perspective on health policy and planning; and 

❏ Private actors are active in all areas of the health system, from service provision to human resource training, to production and distribution of drugs. They also provide key support functions, such as finance or Information Technology services. 

Despite the call to develop a public-private engagement framework in the current GRM health sector strategy, the Ministry of Health has not yet defined its strategy to engage with the private sector. There is still no clear definition of the private sector in Mozambique, nor platform for dialogue. Current regulations of private facilities were issued in 1992 and the supervision function by the Ministry of Health is weak, leaving room for uncontrolled development of the sector. 

The Contractor shall facilitate improvements in the enabling environment that promote private sector participation in the health system. The Contractor shall support the government and private sector to establish a public-private dialogue platform for policy reform, sectoral planning, data collection and information sharing. 

The Contractor shall support the analytical effort of GRM to develop and pursue policy reforms with the Ministry of Health, Ministry of Industry and Commerce, and Ministry of Economy and Finance, as well as other relevant ministries and government agencies, to promote a policy environment conducive to private sector participation in the national health system.