Public vs. Private Healthcare in Mozambique

Public vs. Private Healthcare in Mozambique: A Critical Guide for Expats

If you're planning to relocate to Mozambique, understanding the healthcare landscape isn't just important—it's potentially life-saving. The country operates a mixed health system with public, private, and community sub-sectors, but the reality for expatriates is unambiguous: you must prepare to rely almost entirely on private healthcare, backed by comprehensive international insurance.

This guide breaks down everything you need to know about both systems and how to protect your health during your time in Mozambique.

The Public Healthcare System: Not an Option for Expats

Mozambique's public healthcare system, known as the Sistema Nacional de Saúde (SNS), is managed by the Ministry of Health (MISAU) and primarily funded through the state budget and external donor funds. While it aims to provide free or highly subsidized services to citizens, the system faces significant challenges that make it unsuitable—and actually unavailable—to most expatriates.

The Hard Truth

Expats are explicitly not entitled to utilize public healthcare services. This isn't a quality preference issue; it's a matter of eligibility. Even if you wanted to access public healthcare, you cannot.

Why the Public System Struggles

Even for those who can access it, the public system faces considerable obstacles:

1. Resource Limitations The public system is frequently described as basic, limited, underdeveloped, and poorly equipped. Public hospitals suffer from:

• Frequent staff and supply shortages
• Long waiting times for even basic care
• Inadequate medical equipment and facilities

2. Geographical Disparity Access to quality public care varies dramatically across the country. Rural residents often have little to no healthcare options, facing scarcity of medical facilities compounded by long travel distances. There's a severe shortage of trained medical staff overall, particularly outside urban centers.

3. Top-Tier Public Facilities The highest level of public care is offered at Central Hospitals in three cities:

• Maputo Central Hospital (Hospital Central de Maputo): The largest and most important public hospital, serving as the tertiary referral center for the entire country
• Beira Central Hospital
• Nampula Central Hospital

4. The "User Fee" Controversy Although public services are generally free for citizens, some public hospitals—including Maputo Central Hospital and facilities in Zambezia province—have implemented "special fees" or "user fees" for consultations and surgical interventions. Critics argue these fees create barriers for lower-income populations and essentially "privatize" public services.

The Bottom Line on Public Healthcare

The public system serves over 90% of the local population, but as an expat, you won't be part of that equation. Your health security depends entirely on the private sector.

The Private Healthcare System: Your Only Viable Option

The private healthcare sector in Mozambique is relatively small but growing, and it represents your sole pathway to quality medical care as an expatriate.

Quality and Geographic Reality

Concentration in Urban Centers Private health facilities are heavily concentrated in major urban areas, with Maputo City alone housing approximately 63% of all private health facilities in the nation. If you're living outside Maputo, your access to quality private care becomes significantly more limited.

Higher Standards Private clinics and hospitals typically offer a significantly higher standard of care than public institutions, characterized by:

• More modern equipment
• Better hygiene standards
• Shorter waiting times
• Well-trained, experienced staff
• Greater likelihood of English-speaking medical professionals

Advanced Services Reputable private facilities provide:

• Specialized consultations across multiple disciplines
• Laboratory testing
• Advanced imaging technologies (CT scans, MRI)
• Modern surgical facilities
• ICU and emergency care

Key Private Facilities for Expats

Most top-tier private healthcare is concentrated in Maputo. Here are the facilities expats rely on:

Lenmed Maputo Private Hospital (Hospital Privado de Maputo) A multidisciplinary hospital known for high standards of care and advanced facilities including:

• Intensive Care Unit (ICU)
• Maternity and Neonatology departments
• Comprehensive Radiology services (MRI and CT)
• Multiple specialty departments

Clinica de Especialidades Often considered one of the top private hospitals in Maputo, offering a comprehensive range of specialties and modern diagnostic capabilities.

International SOS Clinic (Maputo & Pemba) A crucial resource specifically designed for expatriates, providing:

• Primary care services
• Emergency stabilization
• General practitioner consultations
• Essential medical evacuation services
• Remote site medical support (Pemba clinic)

Sunshine Hospitals (Matola & Maputo) The second-biggest private hospital in Matola, offering:

• Multi-specialty care
• International standards at relatively affordable costs
• 24/7 service availability

Clinica da Sommerschield Popular among the expat community for general care and routine medical needs.

The Cost Reality

Private healthcare in Mozambique is expensive, and payment practices can be challenging:

• Upfront Cash Payment: International patients often need to pay for services upfront in cash
• Credit Cards: Major credit cards may be accepted at the largest private hospitals in Maputo, but don't count on it
• Insurance Is Essential: You absolutely must secure international health insurance to cover these high costs

The Non-Negotiables: Insurance, Evacuation, and Emergency Planning

Here's the most critical information in this entire guide: even the best private facilities in Mozambique cannot handle serious or complex medical conditions. This reality makes comprehensive planning absolutely essential.

Medical Evacuation: Your Lifeline

The Standard Protocol For any severe illness, complex surgery, or serious injury, the standard procedure is medical evacuation—usually by air ambulance—to the nearest center of medical excellence, typically in South Africa. Mozambique is among the countries from which insurance clients are most frequently evacuated due to limited specialist care.

The Financial Stakes Without adequate insurance, medical evacuation costs can be catastrophic:

• $25,000 to over $100,000 for a single evacuation
• These costs can bankrupt families and end careers

Insurance Coverage Checklist When selecting an international health insurance plan, ensure it explicitly covers:

• ✓ Medical evacuation by air ambulance
• ✓ Repatriation to your home country if needed
• ✓ Specialized treatment in neighboring countries (especially South Africa)
• ✓ Emergency stabilization and transport
• ✓ Ongoing treatment after evacuation

Reputable International Providers:

• Allianz Care
• Cigna Global
• AXA
• Bupa Global
• GeoBlue

Critical Insight: Your insurance plan should view South Africa as part of your necessary medical network, not as an "out of network" destination. This is non-negotiable.

Emergency Response: Know Your Options

Mozambique's public emergency services are often unreliable, particularly outside major cities.

National Emergency Numbers:

• 117 – National ambulance service
• 112 or 119 – Police/general emergency

Reality Check: These numbers are often unreliable, and response times can be very slow, especially outside urban areas.

Your Real Emergency Plan: For a serious emergency in Maputo, bypass the public system entirely and contact:

• Private hospitals directly: Lenmed Maputo Private Hospital or International SOS Clinic
• Dedicated private medical evacuation services: Such as Medi Response
• Your insurance provider's emergency line: Most international policies have 24/7 emergency assistance

The Cross-Border Solution: Medical Evacuation to South Africa

While Maputo's private facilities offer relief for routine primary care and stabilization, the single most critical factor in expat healthcare planning is the frequent and necessary reliance on neighboring South Africa for specialized, serious, or complex medical treatment.

Why South Africa is the Standard Protocol

The healthcare system in Mozambique, even in its private sector, generally does not meet international standards for advanced or complex care. For expats, the need to travel to South Africa (or sometimes Brazil, India, or Portugal) is common for specialized treatment or intense surgeries.

Reasons for seeking care outside Mozambique include:

• Lack of Resources and Expertise: Even major hospitals in Mozambique may lack the expertise, specialized resources, or equipment (such as advanced diagnostic tools like CT scans and MRIs) to deal with severe illness, serious injuries, or complex cases. The Mozambican health infrastructure is described as weak, with limited medical facilities.
• Elective and Specialized Procedures: Wealthier Mozambicans and most expats often choose to travel to South Africa for elective procedures, or specialist advice, and better dental or eye work.
• High-Risk Situations: Serious illness cases and emergencies are often transferred to South Africa because the expertise and resources are unavailable in Mozambique. Those with more serious illnesses and injury will require more advanced care in South Africa, despite the presence of private medical facilities in Maputo.

The Necessity of Medical Evacuation

In the event of a medical emergency or serious injury in Mozambique, particularly outside of major cities where local facilities are extremely basic, medical evacuation (Medevac) is highly likely to be required.

• Evacuation Destination: South Africa is widely considered the nearest center of medical excellence and specialist care facilities, making it the most common evacuation destination.
• High Cost: Without insurance, the cost of medical evacuation can be prohibitively expensive, potentially starting at ** $20,000** and sometimes exceeding ** $100,000**.
• Logistics: The process involves air ambulance transport, which is determined by the patient's medical condition and adherence to global medical and aviation safety standards. Air Rescue, a leading air ambulance provider in Africa, operates from Lanseria Airport in Johannesburg, South Africa. Some specialized medical assistance providers in Mozambique, such as Medi Response, operate a 24-hour Global Coordination Centre in Johannesburg, South Africa, complementing their Maputo operations. Netcare 911 also assists with medical evacuation to the Republic of South Africa.

Insurance is Mandatory for Regional Treatment

Given that local public facilities are inadequate and even private facilities may fall short for serious conditions, securing the correct insurance coverage that explicitly accounts for cross-border care is paramount.

• Comprehensive Coverage: It is absolutely essential to secure comprehensive international health insurance that includes robust medical evacuation coverage.
• Regional Scope: Expats should choose a plan that covers the costs of private hospitalization and possible medical evacuation to South Africa. You must ensure your policy covers treatment in both countries. Some policies are explicitly tailored to include neighboring countries such as South Africa in their international insurance options for obtaining high-quality care.
• Specific Benefits: Certain evacuation insurance plans specifically cover transfer to South Africa and hospitalization if required specialized treatment is unavailable locally. Coverage for air ambulance transport is provided if it is medically necessary and the best way to reach the nearest suitable medical facility.

In short, for expatriates in Mozambique, South Africa functions as the essential quaternary level of care, necessitated by the limits of local infrastructure. Having robust insurance coverage that includes this evacuation bridge is the cornerstone of safe expat living in the country.

Your Healthcare Action Plan

The healthcare reality in Mozambique is defined by resource scarcity and geographical disparity. Your health security relies on two critical pillars:

1. Meticulous Planning Before You Arrive

Medical Supplies:

• Bring sufficient supplies of any essential prescription medications
• Supply can be unreliable even in city pharmacies (farmácias)
• Carry copies of prescriptions and medical records
• Consider bringing a basic medical kit with over-the-counter essentials

Health Assessment:

• Complete a comprehensive health check before departure
• Address any dental work or elective procedures
• Ensure vaccinations are current
• Get copies of all medical records and test results

2. Robust Financial Protection

Invest in comprehensive international health insurance that:

• Includes robust medical evacuation coverage (minimum $100,000)
• Covers treatment in South Africa without restrictions
• Provides 24/7 emergency assistance
• Has no or minimal deductibles for evacuation
• Includes repatriation coverage

Don't Gamble with "Local" Plans: Avoid relying solely on employer-provided local insurance unless it explicitly includes international evacuation coverage. Many local plans don't cover evacuation to South Africa, which could leave you financially devastated in an emergency.

3. Know Your Resources

Before you need them:

• Save emergency numbers for private hospitals in your phone
• Know the location of the nearest private clinic to your home and workplace
• Keep your insurance card and policy number readily accessible
• Establish a relationship with a general practitioner at a private clinic
• Register with your embassy or consulate

Final Thoughts: Healthcare as a Non-Negotiable Budget Item

Healthcare in Mozambique isn't an area where you can cut corners or hope for the best. The gap between public and private care is vast, and the need for potential medical evacuation is real. Many expatriates have faced serious health crises that required immediate evacuation to South Africa—those with proper insurance received life-saving care; those without faced financial ruin.

Think of comprehensive international health insurance not as an expense, but as the foundation of your safety net. It's the difference between a medical emergency being a manageable crisis and a catastrophic life event.

Your adventure in Mozambique can be rewarding and enriching, but it requires you to be realistic about healthcare limitations and prepared for the worst-case scenario. Plan meticulously, insure comprehensively, and you'll have the peace of mind to fully embrace your expat experience.