Thinkwell Mozambique health center

Improving the patient experience in Mozambique’s health centers

28 April 2021

In Mozambique, management systems in high-volume health facilities are adapting slowly to demographic and epidemiologic changes and growth in patient demand. This often leaves management teams and clinical staff to implement ad-hoc adjustments to respond to patients’ needs. High patient volumes paired with clinical and administrative challenges and lack of clear national guidance can lead to critical consequences. For example, key primary healthcare professionals, including doctors, nurses, MCH nurses, clinical officers, and pharmacy and laboratory technicians, spend on average 34% of their time in non-clinical tasks—time that could be better spent with patients and addressing their needs.

Mozambique health center
Women queueing to weigh their babies at the Ndlavela health center.

As part of the project “A Comprehensive Approach to Improve Performance of Human Resources for Health in Mozambique,” ThinkWell’s Mozambique team collaborated with the Maputo Provincial Health Directorate to assess two health centers to understand formal and informal managerial and administrative systems currently in place and to identify quality improvement areas. We used a variety of methods, including semi-structured interviews, observation, and patient flow analysis, to assess performance areas, including human resources, pharmacy and laboratory services, data management, and service provision. Evidence from the assessments showed, among other challenges, inefficiencies in patient flow management, such as weak queue management procedures and peaks of patient arrivals early in the morning, long wait times, short consultations, overreliance on clinical staff for administrative tasks, and low utilization of strategic information for decision-making.

Following the principles of human-centered design, the team currently works with the health facility staff to identify and implement sustainable, practical interventions to improve their day-to-day operations and the patient experience. Examples of currently implemented interventions include tool design to speed-up the process of producing monthly data reports, the creation of a communication strategy between the health facility and the community of patients, and the design of a signage and wayfinding system to improve how patients navigate the health facility.

Mozambique health center
Clinical staff discussing potential interventions to implement in Ndlavela health center with ThinkWell’s team.

ThinkWell’s team has so far been successful in ensuring a high level of engagement, motivation and commitment from the health facilities’ leadership and staff in collecting data, critically analyzing strengths and weaknesses, prioritizing quality improvement areas, and designing interventions. The team effort of ThinkWell staff and the Provincial Health Directorate also resulted in a package of data collection tools that will ensure replicability of the study and comparability of results in other primary health centers.

Written by Federica Fabozzi, Program Analyst, and Toze Namalela, Senior Program Analyst

Mozambique health center
Toze Namalela (Sr. Analyst, ThinkWell) with Dr. Carmen, Dr. Neuza and Dr. Benvinda (Provincial Health Department)