Table 1 Health sector profile in Tete Province, Mozambique

Institutions

• Provincial Health Directorate, 15 subordinate district health services;

• 1 district hospital with surgical capacity per district (total 15);

• 1 provincial hospital, 3 rural hospitals, 1 district hospital, 120 primary care facilities;

• > 250 health facilities (1 per 10,000 inhabitants), in a catchment area with a radius of < 10 km;

• 6 health facilities with surgical capacity (1 since end 2015);

• on average, 1 health facility per around 20,000 inhabitants in a catchment area with a radius of approximately 16 km;

Health personnel

• 75.9 per 100,000 population, of which 35.2 medical doctors, general nurses and Mother and Child Health (MCH) nurses (of which 14.7 MCH nurses);

• > 113 per 100,000 population, of which > 77 medical doctors, general nurses and MCH nurses;

• 5 specialist obstetricians concentrated in the provincial hospital;

• specialist obstetricians in provincial and all rural hospitals.

• 1 general medical doctor for supervision and support of health care in most districts.

Maternity care

• nearly all health facilities provide MCH-nurse-led maternity services

• all health facilities provide MCH-nurse-led maternity services;

• all health facilities attending at least 100 institutional childbirths per 3 months, are included in the quarterly emergency obstetric care accreditation process;

• all health facilities attending at least 100 institutional childbirths per 3 months, gain accreditation in emergency obstetric care in each quarterly evaluation;

• caesarean sections and other obstetric surgeries are usually performed by surgically trained health technicians, some with a background as MCH nurse.

• WHO recommends at least 5 facilities accredited in basic emergency obstetric care and 1 facility accredited in comprehensive emergency obstetric care per 500,000 population, or more if distances are great, which translates to a minimum of 25 and 5 accredited facilities, respectively, in Tete Province.

• Tete provincial hospital: 320-bed tertiary facility with large maternity ward accredited as ‘model maternity’ in 2014; usually overloaded with uncomplicated births, leaving little capacity for more complicated cases and referrals; insufficient theatre capacity, regularly causing delays to surgery;

• a private health care sector is practically absent, with just one private clinic licensed to attend childbirth, without capacity for emergency obstetric care.