Maternal Health Services Disrupted in Mozambique's Niassa Province Due to Aid Cuts

Maternal health services in Mozambique's northern Niassa province have faced significant disruptions after the withdrawal of funding from the United States Agency for International Development (USAID) and other Western nations a year ago. Fatima Abacassamo, head of Mozambique programming for EngenderHealth, stated that many pregnant women now arrive at health facilities only after complications have developed, often requiring urgent surgical interventions that are not always available.

For three years, EngenderHealth provided community-based maternal services with $6.74 million in USAID funding, identifying high-risk pregnancies and monitoring access to facilities. These activities, including training for healthcare providers and community awareness programs, have stopped in Niassa.

Newborns Abacassamo reported that women are presenting with issues such as high blood pressure, excessive bleeding, and placenta covering the cervix, which can lead to death or long-term disabilities like infertility from uterine rupture. She noted a critical gap in timely access to safe cesarean sections by trained personnel.

Delays in services, limited early detection, and gaps in referrals are expected to increase maternal deaths, according to Abacassamo. Nelida Rodrigues, the representative in Mozambique for the UN Population Fund (UNFPA), stated that gains in reducing maternal deaths and infant morbidities are at risk due to changes in the donor landscape.

In Niassa, mobile clinics have ceased, community outreach has halted, and distribution of life-saving commodities may become inconsistent. Throughout Mozambique, 48.6 percent of women receive four or more antenatal care visits, while 36 percent of women and 41 percent of newborns get postnatal consultations within two days after birth.

Infant mortality has declined from 54 deaths per 1,000 live births in 1997 to 24 per 1,000 in 2022/2023, and the maternal mortality ratio has fallen from 690 to 233 per 100,000 live births over the same period.

members in Niassa reported that pregnant women and new mothers are left without support in many districts, with some still awaiting follow-up treatments. In villages along the Niassa River, home births remain common due to distances and the need to cross Lake Niassa by boat, with trained matrons providing basic care but struggling with complications.

Other organizations, such as ActionAid, are experiencing funding reductions, leading to shortages of medicines, equipment for deliveries, and anesthesia materials. Clotilde Noa, who works for ActionAid in Mozambique, stated that the country is prone to natural disasters like cyclones and floods, which impact health infrastructure.

Noa added that ActionAid has received requests for funding support from local organizations and district governments. To address aid reductions, organizations are shifting to sustainable approaches, including integrated community-based programs and strengthening primary health care.

UNFPA is collaborating with non-traditional donors like South Korea and Ireland, exploring African partnerships, and integrating maternal health with climate resilience to maximize funding impact. It is also building capacity for domestic NGOs and provincial health authorities.

EngenderHealth is seeking new funding and partnerships for technical assistance in Niassa and other areas. Abacassamo stated that without secured funding in the coming months, the organization may withdraw from Mozambique. Mobilizing domestic resources remains challenging amid precarious finances and climate change effects on the agricultural sector, which accounts for about 25 percent of GDP.