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Mozambique - Expenditure and Service Delivery Survey (Health)

This study is an expenditure tracking and service delivery survey. During the consultation phase of the ongoing PER, the Government of Mozambique and the World Bank agreed that a Public Expenditure Tracking Survey (PETS) would be carried out as a component of the Public Expenditure Review (PER). A proposal for an Expenditure Tracking and Service Delivery Survey (ETSDS) in the health sector was presented to Ministry of Planning and Finance (MPF) and the Ministério de Saúde (Ministry of Health)  (MISAU) in February 2001. Agreement concerning the broader scope and objectives of the survey was eventually reached in August 2001. The survey was implemented as a component of the ongoing Department for International Development, UK (DfID)-financed project of support to the Planning and Budgeting Directorate (DNPO) of the Ministry of Planning and Finance (MPF).
Contact: Magnus Lindelow,Email:


Public Expenditure Tracking Survey: The Health Sector in Mozambique, Magnus Lindelöw and Jan Dehn, February 2001. (50 pages)
(Note: The details of the survey approach have changed considerably since the original concept note, see update to survey and status report below.)

Expenditure Tracking and Service Delivery Survey: The Health Sector In Mozambique: Update to Survey and Status Report, August 2002. 

O ETSDS: Inquerito sobre os Sistemas de Financiamento, Suporte, e Fornecimento dos Serviços Primários de Saúde, PowerPoint presentation in Portugeses (8 slides) July 2002.

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Survey Information

Sampling Notes, April 2002 (15 pages)
Manual do Inquiridor (Enumerator manual), August 2002 (23 pages)
Questionário U1. A Unidade Sanitária(Facility directors), August 2002 (35 pages)
Questionário U2. Pessoal da unidade(Facility health workers), August 2002 (9 pages)
Questionário U3. Opinião do Utente da US(Facility user exit poll), August 2002 (13 pages)
Questionário D1. A Direcção Distrital de Saúde(District health director), August 2002 (15 pages)
Questionário D2. Anexo—Dados Administrativos sobre o Distrito(District admin. staff), August 2002 (21 pages)
Questionário P1. A Direcção Provincial de Saúde(Provincial director of health and admin. staff), August 2002 (13 pages)


Primary Health Care in Mozambique: Service Delivery in a Complex Hierarchy. (M. Lindelöw, P. Ward, and N. Zorzi). Africa Region Human Development Working Paper 69, 2004. World Bank, Washington, D.C. (112 pages)

This report presents findings from an Expenditure Tracking and Service Delivery Survey (ETSDS) in Mozambique. The ETSDS was implemented nationwide between August and October 2002. It focused on the primary health care system, which is the main or only source of health care for the majority of the Mozambican population. The survey collected data from five different levels, covering all 11 Provincial Directorates of Health, 35 District Directorates of Health, 90 primary health care facilities, 167 health workers, and 679 users. In this way, if offers a unique perspective on the interaction between different levels of the health system, in particular in relation to the financing, allocation, distribution, and use of resources. The report covers a broad set of issues, including institutional context, budget management, cost recovery, allocation and distribution of drugs, human resources, infrastructure and equipment, and service outputs.

O Nível Primário do Sector da Saude em Moçambique: Resultados de Um Inquérito sobre Financiamento, Gestão e Prestação de Serviços, November 2003. 

Esta brochura apresenta uma síntese dos resultados de dois estudos realizados conjuntamente pelo Ministério do Plano e Finanças (MPF) e pelo Ministério da Saúde (MISAU) em 2002. Um dos estudos - A Despesa Pública com a Saúde em Moçambique- providencia informação sobre a afectação de recursos inter e intra-sectoriais e identifica os principais constrangimentos organizacionais que impedem a prestação de serviços de saúde, com o intuito de melhorar o desempenho da despesa pública na saúde. O outro, - O Nível Primário do Sector da Saúde em Moçambique - apresenta os resultados de um inquérito que avalia o funcionamento deste nível de prestação de cuidados do Sistema Nacional de Saúde, com particular ênfase para a estrutura institucional, o fluxo de recursos e a sua relação com os serviços que presta. 

(This report presents a synthesis of findings from two studies implemented jointly by the Ministry of Planning and Finance and the Ministry of Health in Mozambique in 2002. One of the studies, the Health Sector Expenditure Reviews, provides information about inter- and intrasectoral resource allocation, and identifies constraints to improving health sector performance. The other study, the Health Sector Expenditure Tracking and Service Delivery Survey, presents results from a survey of health care providers, with a focus on institutional arrangements, the flow of resources, and service delivery.

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The following policy research working papers are drawn from the World Bank's institutional archives. Each link opens a page with an abstract of the document and several download options.Other related documents not stored in the institutional archives.

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