ArticleGlobalization and health2019
NGOs, austerity, and universal health coverage in Mozambique.
Article in Globalization and health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- The successful scaling-up of antiretroviral therapy globally has many lessons for advancing universal health coverage: progress at risk.Globalization and health · 2025Article
- Social protection and the International Monetary Fund: promise versus performance.Globalization and health · 2024Article
- Improving transparency in malaria programme funds: A business case for connected diagnostics in Kenya.Journal of public health in Africa · 2024Article
- Care during ART scale-up: surviving the HIV epidemic in Ethiopia.BioSocieties · 2022Article
- Therapeutic Borderlands: Austerity, Maternal HIV Treatment, and the Elusive End of AIDS in Mozambique.Medical anthropology quarterly · 2021Article
- How prepared is Mozambique to treat COVID-19 patients? A new approach for estimating oxygen service availability, oxygen treatment capacity, and population access to oxygen-ready treatment facilities.International journal for equity in health · 2021Article
- Program sustainability post PEPFAR direct service support in the Western Cape, South Africa.PloS one · 2021Article
- Universal health coverage and primary health care: the 30 by 2030 campaign.Bulletin of the World Health Organization · 2020Article
- COVID-19 and Private Health: Market and Governance Failure.Development (Society for International Development) · 2020Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country's structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow "off-budget" to NGO "implementing partners," with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.
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