An important part of the Mozambique Canada Maternal Health Project has been to build infrastructure to support maternal health. Our project is building and renovating rural maternity clinics, maternal waiting homes, a hospital nursery, and installing boreholes for clean water supply. Project team members Horácio Mandevo and António Tanda have co-ordinated the construction phases and linkages with local communities. Here are some comments and reflections from Horácio about how the implementation has been accomplished and its impact on the community.

How do you feel the implementation of construction has gone?

I feel that the implementation of construction has been a complex, challenging and rewarding process. Its success has depended upon the active participation and commitment of all stakeholders. At the provincial level, that includes the provincial government, the provincial health directorate (DPSI), and the departments of public works, environmental management, and water; at the district level, the district government and district departments of health and public works; and at the local level, the local administrators and, importantly, the communities themselves.

This has been a key point of learning for us as a project and for all our stakeholders: that everyone’s active involvement is imperative for the success of the projects.

A key first step was to actively engage and listen to the communities at each prospective site about the space and the exact locations for buildings. This involved lots of discussion and, at times, renegotiation with district governments based on valuable community input. The same was true for identifying and agreeing on the location of boreholes in order to learn about important local specificities including the location of burial sites that would impede water access. After community-engaged site confirmation, legalization processes could begin.

Importantly, we have been careful to implement and follow transparent processes. Each supervisory site visit has been coordinated to include DPSI, the department of public works and the district or district hospital (whomever is available). We have remained open to hear and respond to all concerns arising from stakeholders including community representatives who are welcome to provide input at any time.

At the build sites themselves, we have ensured that contractors consider the concerns of community members, women generally and health committee members, and involve community members in those selected to work at the sites, including women.

Overall, the process has been one of learning – not only for us as a project, but also for our government partners. The contractors we hired have surpassed local governments’ expectations and carried out better quality work than in the past, thanks to the strong and reliable building supervisors we have working with us. Partners have commented that this is the first time they have seen this level and rigour of supervision and follow up.

What impact do you foresee the new health infrastructure having on communities?

This initiative has already had a positive impact on communities, visible in their joy at getting to this stage. Many hadn’t believed that they’d actually have a health centre built in their area, and certainly not in such a short timeframe. This, they feel, is the result of strong collaboration and the project’s seriousness and honesty.

In the medium and longer term, we believe that the new health infrastructure will reduce distances between rural communities and health services and increase the use of services, in particular for maternal health, vaccinations, and general medical assistance.

We have had numerous high-level political visits to building sites, including from the Governor of Inhambane, Daniel Francisco Chapo, who has taken a keen interest in our construction projects since the beginning. At a recent visit to the Tevele, Massinga maternity clinic, then under construction (Sept. 9, 2020), the Governor spoke highly of the quality of the work and praised the Mozambique – Canada partnership, and he commended us on the strategy to build rural-based health centres rather than larger urban hospitals. He emphasized how important this was to the health and well-being of Mozambicans broadly, most of whom live in rural areas, in supporting people’s ability to access care at quality sites without needing to travel long distances to larger centres. We feel proud of the work that’s taken place and look forward to moving into an operations phase, supporting our community and government partners in making the best use of the new infrastructure.

Maternal waiting home, Vilankulos District