DFID has actively supported the health systems in Mozambique for a number of years. DFID Mozambique provided support to the Technical Planning Unit within the Ministry of Health to facilitate development of a national health plan for the period 2000-05. DFID also funded the HIV/AIDS and Maternal Health Programme (2001-07) which aims to increase access to and use of good quality reproductive and sexual health services. DFID funding of the Essential Medicines programme (2000-06) aimed to improve the availability and rational use of essential medicines by strengthening procurement and distribution systems.
DFID is currently supporting the development of a Sustainable Distribution System for Insecticide Treated Nets (ITNs) for Malaria Prevention. The programme, which has a total allocated budget of £8.6 million, started in 2005 and is due to run until 2010. It builds upon the lessons learnt as a result of a pilot Malaria Prevention and Treatment project. DFID recently agreed a new five-year programme of support to the Ministry of Health for £3.7 million per annum. In 2006, DFID also signed a five-year £215 million programme of direct support to the budget of the Government of Mozambique, which helps provide additional funding for health systems. The total amount of bilateral DFID expenditure in the health sector in Mozambique is shown in the following table. This includes a notional proportion of DFID’s general budget support.
Expenditure (£ million) 2002-03 10.2 2003-04 13.3 2004-05 16.3 2005-06 15.9 2006-07 111. 9 1 Provisional.
Expenditure (£ million)
DFID has been working in the health sector in China since 1999. The focus has been on helping the Chinese Government to control HIV and AIDS, increasing the detection and cure rate for people suffering from tuberculosis, and reforming the health system so that poor people receive basic health services. The total amount of bilateral DFID expenditure in the health sector in China is shown in the following table.
Expenditure (£ million) 2002-03 12.6 2003-04 11.1 2004-05 10.5 2005-06 13.0 2006-07 111. 9 1 Provisional.
Expenditure (£ million)
It is for national Governments to decide their own policies in relation to user fees in health. However, because of our own UK experience and that of developing countries, DFID is committed to helping countries that want to remove charges at the point of delivery. The recent White Paper commits DFID to help partner Governments abolish user fees for basic health services and help them tackle other barriers to access, including discrimination against women.
DFID is working with the Government of China to facilitate the provision of free (or substantially subsidised by the Government) primary health care. China is formulating a major health policy to address inequity in the health system, of which free primary health care for all is likely to be an important feature. Meanwhile various health insurance programmes for urban and rural residents will be improved to provide better financial risk protection and reduce out-of-pocket payments on in-patient services.
DFID has supported China on rural and urban health and health policy capacity building since 1999. Our large and well designed pilots have provided evidence to Chinese policy makers on rural and urban health reform, which is now being used to inform the development of the new policies.
In Mozambique, services are already formally free for malaria, TB, HIV treatment, maternal health services and immunisation for children. The Government of Mozambique have already made a public commitment to look at the case for removing fees, at least for primary health care. DFID is now working closely with the Government of Mozambique to consider the practical implications of removing the remaining user fees. This includes: studying the expected implications for demand; considering how systems will need to be reinforced to support the change; and preventing illegal charging. If the Government of Mozambique make a decision to abolish more fees, DFID will support this, including through our continued financial support to the sector.