Background:
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Mozambique: situated in southern Africa
Borders countries: South Africa, Swaziland,
Tanzania, Malawi, Zambia and Zimbabwe.
Total area: 801,590 sq Km
11 provinces and 133 districts
Population: 16,099,246 (July 2002 est.)
72% of the population live in rural areas
illiteracy: 60.5% of population
Mozambique
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Capital: Maputo
Pop:+- 2 millions
Health Status
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Population growth rate: 1.13%
Birth rate 36.41 births/1,000 population
Death rate 25.13 deaths/1,000 population
Infant mortality: 138.55 deaths/1,000 live
births
Life exp at birth:tot population: 35.46 years
female: 34.65 years; male: 36.25 years
Socio, historic & political context
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1458 – 1975: Colonial period
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1975 – 1992: civil war  destroyed most of
the infrastructures (mostly health, education
& tele and communications)
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June 25th, 1975 - Independence
Trained people left the country; 5 doctors!!!
Peace aggreement signed
1992  .... National reconstruction (after war,
floods, ....)
ICTs: Maputo
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50% of the ICTs and related technologies are
located in Maputo;
Survey: 3:1000 and 2: 10000 inhabitants
share a computer and use internet
respectively;
Challenges
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How implementation is related with
communication practices?
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What can we do about it?
MISAU
National
Plans and
resources
Province (DPS)
District (DDS)
Community (US)
Health data
Health Information System
Health system hierarchy
Health district: Xai-Xai
Health Information System (HIS)
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information flows between levels: paperbased (forms  reports)
data are collected at health facilities from
communities, aggregated and collated at
district levels
communication did not always follow a fixed
pattern
communications depended on many external
conditions, often out of control of the health
officers responsible for communication
HIS
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The information collected at facility levels and
handle at district level consists basically of
aggregating the forms from the health
facilities into district forms, which are then
submitted to the province.
Lack of skill and training of the personnel of
the district health  data are not kept in a
systematic way on a health facility basis.
HIS
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Because of these problems of
communications, the weekly and monthly
health reports were sent to the upper levels
very late
Local people showed little motivation and
commitment to communicate with the upper
levels
HISP
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Mozambique in 1999
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Eduardo Mondlane University & MISAU
Pilot districts: located in remote rural areas
with relatively good infrastructure
Actions:
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Research
Training seminars
Communication at different levels
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Health unit  health district
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Health district  province
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Province  MoH (MISAU)
Counter networks  Castells
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Globalization and Marginalization
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Exclusion vs Inclusion
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Health Information
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Information & Communication Technology
System Develeopment context &
implementation
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The culture of communication
Nature of work practices
Methods/processes of communication
Constraints to communication
Experience with new ICTs
How can new ICTs be integrated effectively
into work practices at various levels
Resistance to technology ….. question of
identity?
Expectations ...
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Assessment of current constraints to communication
between district and provincial levels in HIS, and how
these can be made more effective.
Theoretical model to help understand the interaction
between ICT and communication practices in the
health districts.
Help to produce social change on the ground in terms
of improved information management in the district
health system in Mozambique (???)