Impact of COVID-19
Immediate health impacts on people and systems
The first case of COVID-19 was reported in Mozambique on 22 March 2020. As of 26 May, Mozambique had 194 confirmed cases of COVID-19, of which 168 were locally transmitted. The country’s capital, Maputo, and the province of Cabo Delgado are currently the epicentres of the outbreak in Mozambique, with Pemba and Afungi registering more than 50 percent of the overall cases. Other provinces affected are Manica, Inhambane,
Gaza, Tete and Sofala.
COVID-19 is expected to heighten the risks of people living with co-morbidities and in challenging living conditions. There are 1.3 million older people in Mozambique, 5 per cent of the population. About 16 percent of women over 60 years of age live alone, increasing their risk of exposure.1 2.3 million people living with HIV (12.4 per cent of the population) and an estimated 162,000 people are living with TB, of whom 58,000 also have HIV. People living with immunocompromised conditions have poor access to health services, with 50 per cent of the population living more than 20 kilometres from the nearest health facility.2 Following Cyclones Idai and Kenneth in 2019, over 100,000 people are still displaced in 76 sites across six provinces. In Cabo Delgado, over 162,000 people have been affected by insecurity, most of whom are living in overcrowded conditions in host communities. Displaced people living in camps, camp like settings, resettlement sites or host communities, are all at heightened risk as their right to information, access to healthcare, hygiene, protection services and livelihoods are constrained.
Prior to COVID-19, multiple disease outbreaks -including cholera and malaria- were already stretching Mozambique’s weak health systems and 94 health centers were damaged during the cyclones. IDPs in Cabo Delgado face significant challenges to accessing primary health care. Critical services -such as sexual and reproductive healthcare, immunization activities and continuity of care for HIV, tuberculosis, malaria and cholera- are expected to be disrupted as resources shift to the COVID-19 response, potentially increasing maternal and infant deaths.
Indirect impacts on people and systems
COVID-19 arrived in Mozambique at a time when humanitarian needs were already rising due to consecutive climatic shocks in multiple parts of the country and growing insecurity in Cabo Delgado. Drought, cyclones, floods and violence over the past year have left at least 2.5 million people in urgent need of humanitarian assistance across the country.
The destruction caused by back-to-back disasters and now COVID-19 is escalating an already alarming food security situation and exhausting families’ coping capacities. Prior to COVID-19, an estimated 2 million people were projected to be severely food insecure across Mozambique.
Households have not yet recovered from the devastation caused by Cyclones Idai and Kenneth that affected over 770,000 hectares of staple crops. At the same time, global disruptions in trade will affect food supply, resulting in lower production, higher import costs and increased prices of food in the markets. Households are likely to exhaust what little savings they had and resort to negative coping mechanisms, including increasing child marriage and transactional sex. Studies have shown that, following pandemics, there is a decrease in children that return to education and an increased risk of childhood labour and early child marriage. Those with limited mobility, particularly older persons and people with disabilities, are at increased risk from COVID-19 and may face further barriers to accessung life-saving services due to movement restrictions.
Following the country-wide closure of schools on 23 March, 235,000 children are no longer accessing critical school feeding programmes and malnutrition is expected to worsen in the period ahead. An estimated 67,500 children will require treatment for malnutrition in the next nine months. Currently, more than 3,000 children under five are being treated for severe acute malnutrition (SAM) and there have been over 4,000 cases of pellagra (vitamin B3 deficiency) recorded since May 2019.
Response priorities and challenges
Priorities and early achievements
The Humanitarian Country Team in Mozambique has developed an Emergency Appeal for the COVID-19 response, which incorporates both the public health response and action to tackle the most urgent secondary consequences. The appeal complements the Government of Mozambique’s (GoM) National Plan for Preparedness and Response to COVID-19, which calls for US$28 million for the public health response, and the Government’s Multi-Sectoral Preparedness and Response Plan.
Humanitarian partners are ramping-up their support to the Government-led response. All provincial capitals have established isolation centers and training of rapid response teams have been given at provincial level. Partners also supported prioritization of risky Points of Entry. In the Solidarity Flight that landed in Maputo on 18 April, the Jack Ma Donation provided vital equipment for the COVID-19 response, including: 18,900 swabs and viral transport medium, 18,912 extraction kits, 3800 PPE, 3800 face shields and 10 ventilators.
Partners are advocating with Organizations of People with Disabilities to ensure participation and inclusion of disability issues into COVID-19 preparedness and response. Partners are also working with the Ministry of Education and Human Development to mitigate the impact of the epidemic on children’s education.
Challenges and impact to operations
There are gaps in reagents for testing for COVID-19 and availability of personal protective equipment (PPE). There is a need to strengthen contact tracing and to increase risk communication to create awareness about COVID-19 at all levels and counteract stigma. At the same time, essential service systems -including for health, nutrition and WASH- were already strained pre-COVID-19 and will struggle to cope with additional pressures. Life-saving care and support to GBV survivors, and sexual and reproductive healthcare, in particular may be disrupted. The cost of maintaining humanitarian assistance -especially food and livelihoods- will likely increase due to COVID-related containment measures.