Project profile — Strengthening National Sexual and Reproductive Health Services in Mozambique

• Mozambique (100.00%)

• Population policy and administrative management:
Population policy and administrative management (13010) (20.00%)
Reproductive health care (13020) (30.00%)
Family planning (13030) (30.00%)
STD control including HIV/AIDS (13040) (5.00%)
Personnel development for population and reproductive health (13081) (15.00%)

• Gender equality (significant objective)
• Environmental sustainability (cross-cutting) (significant objective)
• Children's issues (principal objective)
• Youth Issues (principal objective)
• Nutrition (significant objective)

This project aims to improve the sexual and reproductive health of women and adolescents, and the health of newborns and children in underserved areas in Mozambique. It supports specific sexual and reproductive health and rights (SRHR) objectives within the World Bank’s broader “Mozambique Primary Health Care Strengthening Program”. The project focuses on 42 districts, which are among the most underserved. Key activities include: (1) increasing birth deliveries in health facilities; (2) supporting secondary schools to offer sexual and reproductive health services, such as information and support for contraceptive methods; (3) increasing family planning services; (4) increasing the number of health centers carrying out semi-annual public social audits; and (5) improving certification and coding of information on causes of death through strengthened civil registration and vital statistics (CRVS) systems. The project is implemented in collaboration with the Global Financing Facility in Support of Every Woman, Every Child. It is aligned with the priorities of the Government of Mozambique’s Health Sector Plan to improve reproductive, maternal, newborn, child and adolescent health and nutrition, as well as to strengthen its CRVS systems. The project is implemented in collaboration with the Global Financing Facility in Support of Every Woman, Every Child and is aligned with the priorities of the Government of Mozambique’s Health Sector Plan that attain to reproductive, maternal, newborn, child and adolescent health and nutrition, as well as to CRVS systems.

The expected outcomes for this project include: (1) increased empowerment of women and girls in selected districts to exercise agency in sexual and reproductive health and rights (SRHR) decision-making; and (2) improved efficiency and effectiveness of the Mozambique Ministry of Health to provide gender responsive and adolescent-friendly SRHR services that meet the standards for quality care and equity in access, and respect rights.

Results achieved as of December 2023 include: (1) 33 out of 42 priority districts reached the goal of having at least 85% of births taking place in health facilities. This is made possible through community engagement, maternity waiting homes, and district-level funding, although some areas faced challenges like conflict and medicine shortages; (2) 61% of secondary and technical schools offered sexual and reproductive health services in 2022, and 58% continued in 2023; (3) provided over 4.3 million of contraceptive protection in 2022. This is above the target, and thanks to community outreach and increased use of long-acting methods; (4) provided performance-based funding to 425 health centers in key districts by 2022. The funding is based on at least one scorecard assessment with community consultations. This exceeded targets and helped improve community involvement, especially among women; and (5) certified 65% of deaths occurred in health facilities and reported them in the national system by 2023, but only about 10% are officially registered in civil records. Investments in hospital data systems and staff training helped, but poor IT infrastructure and weak coordination limited further progress.

• Proactive disclosure