Maternity care system in Maputo, Mozambique: Plans and practice?

Figures & data

Table 1. Features of maternity services in Maputo City, as planned and in practice, early 2010s

Topic	Planned	Practice	Possible causes for discrepancy
Primary health care approach	Equal access to maternity care Functional referral system	Primary health care in prenatal care Referral system crumbling	Shortage of resources Deficient budget allocation mechanisms
Area responsibility and continuity of care	Care site by residence Continuity of care from pre- to post-natal care Functional referral system Gate keeping	Self-choice for place for childbirth Referral system crumbling Continuity of care deficient	No enforcement mechanisms Poor information system Women moving to their relatives Problems of transportation Uneven availability of emergency services Long waiting times, fear of social stigma
Care availability	Increasing access Equal access to all Free of charge to women	Crowding of services Shortage of health professionals and goods, especially in lower level facilities Some user fees	Shortage of health professionals Private services draining health professionals Self-choice for place for childbirth
Private services	Not planned	Non-profit services integrated into public system Emerging private services within public hospitals Emerging for-profit health facilities	Low salaries and other incentives to care providers in public sector Perceived higher care quality in private sector
Information system	Plans for specific programmes	Much anonymous log-keeping Insufficient information for planning or distributing resources Careless storage and archiving of records	Care providers overloaded with clinical work Separate resources not available Documents not valued