Mozambique’s Healthcare System: Care, Evacuation, Vaccinations and Health Risks

France Diplomatie (“Health” page) describes very poor medical structures, above all in the provinces, with few doctors; it lists, as a reference point, facilities in Maputo, but these facilities are not named here. For serious medical procedures, it recommends having them carried out abroad if possible, South Africa being the nearest destination.

For a French resident, everyday use combines a first-contact doctor in Maputo, planned care abroad and insurance that organises evacuation. The French embassy in Maputo (+258 21 48 46 00) and its consular section (+33 1 70 71 02 54) are the contact points indicated. See also living in Mozambique.

The pages consulted describe no health insurance scheme accessible to expatriates. The National Social Security Institute (INSS) appears there for pensions: a normal old-age pension at 55 for women and 60 for men with at least 240 months of contributions, a pension with no age condition with 420 months, a pension reduced to 50% with 120 months. A foreigner’s access to the public system is checked with the Ministry of Health and the employer.

• Local employee: the employer may offer private insurance; ceilings, network and evacuation are read in the contract.
• Seconded employee: the French scheme remains applicable for 3 years renewable once (CLEISS, the French liaison centre for international social security); see healthcare reimbursement in Mozambique.
• Other profiles: the CFE (Caisse des Français de l’étranger, the French social security fund for French nationals abroad) or international insurance with medical repatriation.

France Diplomatie indicates that, without cover, access to care may be refused, even in a life-threatening emergency. The first-contact doctor is chosen in Maputo; the embassy can point you towards practitioners. The pages consulted give no emergency number for the police, ambulance or fire brigade: it is useful to save the assistance number of your contract, those of facilities identified in advance and those of the embassy.

As the road is a major risk (driving on the left, night driving to be absolutely avoided outside towns, “chapa” minibuses advised against), rescue times may lengthen outside the capital. In the provinces, the distance to a reliable care facility enters into the choice of place of residence.

France Diplomatie recommends bringing only the medicines that are strictly necessary, in their original packaging with the labels, together with a prescription giving the names as international non-proprietary names. You must check that the medicines are authorised in Mozambique and never buy medicines in the street, because of counterfeits. For a chronic treatment, a sufficient reserve and the prescription ease checks; the conditions for reimbursement are confirmed with the insurer before departure.

• Cholera: risk in the suburbs and in disadvantaged or isolated areas, with cyclical outbreaks in Beira (Sofala), Maputo and Nampula; prevention through vaccination and water and food hygiene.
• Malaria: prevention through protection against bites and preventive treatment decided with a doctor or a travel medicine centre; the page gives no details specific to Mozambique.
• Water and food: typhoid and hepatitis A, transmitted by contaminated water or food; vaccination and hygiene.
• Mosquitoes: dengue, chikungunya, yellow fever and Zika; pregnant women or those planning a pregnancy consult a doctor before travelling to an affected area.
• Others: poliomyelitis, rabies (almost always fatal after the first symptoms), tuberculosis and mpox.

France Diplomatie recommends being up to date with the French vaccination schedule (diphtheria, tetanus, poliomyelitis, whooping cough, measles); the vaccination record may be checked at the border. Depending on the situation: hepatitis A and typhoid, hepatitis B (frequent or long stays), tuberculosis (children under fifteen on a long stay), rabies (young children, rural or isolated areas), chikungunya, dengue and mpox. The WHO recommends a poliomyelitis vaccination certificate dating from less than twelve months.

Yellow fever: Mozambique does not appear in the list of 42 countries for which the page requires vaccination. The consultation with a doctor or an international vaccination centre is booked well before departure.

With no social security agreement between France and Mozambique (CLEISS list), no coordination exists between the schemes: the choice is between the employer’s insurance, the CFE and international insurance that provides for evacuation to South Africa. Reference points can be found in the pages on expat health insurance and repatriation and assistance; Expavy helps you weigh these options against your situation.

Abroad, the CFE reimburses according to a rate or flat amount specific to the country of care, applied to actual expenses: a GP consultation under the national agreement at €25 in France is reimbursed at 70%, i.e. €21. The plans have contributions that depend on age and the plan chosen, for the main plan, the youth plan (under 30) and the retirees’ plan. Care is covered immediately if enrolment takes place before departure or within three months of settling; beyond that, a waiting period of three months before age 45 and six months from age 45 applies. A seconded employee keeps the French scheme for 3 years, renewable once, with reimbursement on paid invoices and form S 3125c (CLEISS).

Before signing a contract, several points are compared: the annual ceiling, direct billing in suitable facilities, evacuation and repatriation, maternity, paediatrics, the handling of medical history and the exclusions. It is useful to keep, with your identity papers, the contract number, the number of the assistance platform and a list of current treatments, which you share with a relative and with the employer.