Like many of his age, Cristiano Vaz, a retiree living in Maputo’s Mavalane A neighborhood, is hypertensive. He used to skip blood pressure checks as he did not always have the time or money to visit the hospital or the pharmacy.
I have hypertension. To measure my blood pressure, I had to either go to a distant hospital or pay 15 meticais at a pharmacy. With the community post now close to home, I check my blood pressure every other day. Cristiano Vaz retiree
Born as a World Bank-financed short-term, low cost, rapid response initiative to address the urgency of the COVID-19 pandemic and aiming to cover all the poor neighborhoods (30% of Maputo’s land area), community health posts have evolved into a powerful, locally led and municipally owned initiative to provide crucial frontline basic health and social services for urban poor communities.
The story of Maputo’s community posts
As the pandemic spread across the globe, increasing demand for health care, the City Council responded by establishing 20 temporary community health posts in Maputo’s most vulnerable neighborhoods. The World Bank in Mozambique supported the initiative, aimed at improving the capital’s urban infrastructure.
Initially, these posts aimed to raise awareness about COVID-19, conduct screenings, and refer suspected cases for further medical attention. Within the first year of operation, almost 90,000 individuals benefitted from essential healthcare services closer to the community.
Part of the initiative’s effort was decentralize and improve accessibility to basic health services, so each post was assigned to a specific neighborhood and managed by a Civil Society Organization (CSO) with extensive local knowledge, which helped foster community trust . Initially, 80 local activists, predominantly women, underwent training to address various healthcare needs and facilitate referrals. Equipped with essential materials, including handwashing stations and thermometers, these posts offered basic health screenings and education. Technicians engaged community leaders, associations, and media to disseminate prevention information, conduct home visits, and raise awareness in public spaces while adhering to distancing protocols.
From World Bank-supported to city-led initiative
As the pandemic subsided, the community continued to seek out these posts, as strong ties with the teams were already built. Initially catering to COVID-19 concerns, the posts adapted to meet broader health needs like providing information on tuberculosis, malaria, sexually transmitted diseases, HIV, hypertension, and diabetes, as well as public services like land use titles. From December 2022 to December 2023, alongside 17,812 screened for COVID-19, the posts recorded 1,940 tuberculosis screenings, 11,342 blood pressure measurements, and 446 tests malaria tests.
Responding to the community’s evolving health demands, additional training and internships were provided to enhance the post team’s qualifications, bolstering service quality. Moreover, the posts began addressing social issues, notably identifying and addressing 38 cases of gender-based violence (GBV) by January 2024. Workers were trained in GBV awareness and referral mechanisms. The City Council, through the Health Municipal Directorate, recognized the posts’ importance and included their operationalization in the budget, responding to community demand.
Rejuvenating local leadership for better service delivery
The success of the new services led to the conversion of certain community posts into permanent structures in selected neighborhoods. The selection was based on service utilization, neighborhood population, health access gaps, and commitment from neighborhood leadership. Recognizing this model’s effectiveness, the Ministry of Health decided to fund pilot community health posts elsewhere, indicating potential scalability.
Local leaders, among whom Mrs. Hortência Mazive is a shining example as the Secretary of Mavalane A neighborhood, saw an opportunity. As the Municipality informed the local leaders of the community posts sustainability plans, she expedited the process by allocating left over revenue to start the construction of a multipurpose facility for the community. Project funds will be used to adapt the structure for comfortable service delivery, ensuring privacy and equipment safety.
“The Mavalane A community post has become a regular part of people’s lives. On the days when the elderly receive their benefit payments, they seize the opportunity to visit and consult with us, getting their blood pressure measured and other services,” said Mrs. Mazive.
“Community and civil society engagement is key to ensuring interventions’ sustainability and maximizing impact. How Maputo’s community health posts have been integrated into the lives and demands of communities, as well as the government’s flexible and coordinated approach to keeping up with the change in their use, gives essential lessons on the importance of community ownership and involvement. It also contributes to designing better infrastructure and services that match the community’s needs and respond more effectively and inclusively to social and health issues,” noted Gayatri Singh, Senior Urban Development Specialist at the World Bank and Task Team Leader of the Maputo Urban Transformation Project.
What began as a rapid pandemic response has grown into a lasting model for inclusive, community-driven health and social services–showing how local leadership, trust, and smart investment can transform lives, one neighborhood at a time.
