Mozambique is among the six countries that accounted for more than half of all malaria cases and deaths worldwide (4% of global cases and deaths).1 The country also has the 2nd highest prevalence of malaria in Eastern and Southern Africa (17.2%).2 Between 2015 and 2018, cases fell by 14% from 356 to 305 per 1000 of the population at risk while deaths fell by 15% from 0.89 to 0.62 per 1000 of the population at risk.3 It also has one of the five countries with the highest levels of severe anaemia among children under five years of age. 

In 2015, malaria was responsible for 45% of outpatient visits and 56% of paediatric admissions. This subsequently results in 29 % of all hospital deaths among the general population   and 42 % of deaths in children under five years of age.2

IPTp3 coverage rose by seventeen percentage points and 40.6% of pregnant women in the country received IPTp 3 in 2018 versus 23.3% in 2017.2

Many donors have reduced their direct (both financial and product-based) contributions to the health sector.  This has decreased the country’s capacity to access essential anti-malarial products such as sulfadoxine pyrimethamine (S)P and vector control products.2

Key policies impacting malaria treatment

Injectable artesunate is currently recommended for the treatment of pregnant women with severe malaria at all stages of their pregnancy. Quinine was previously the recommended choice for all stages of pregnancy.

Artesunate rectal capsules is presently endorsed for children under the age of six. Only the 100 mg formulation is advised. Earlier guidelines recommended the use of all the available formulations (50 mg, 100 mg and 200 mg).3

Inpatient and mortality rates

Severe malaria distribution

Severe malaria policy and practice

National Treatment Guidelines (2011)
Recommendation Treatment
Strong IV artesunate
Strong IM artesunate
Alternative IV quinine
Recommendation Pre-referral
Strong IV or IM artesunate
Alternative Rectal artesunate
Malaria in pregnancy
Recommendation Treatment
Strong IV artesunate
Alternative IV quinine*

*Due to the risk of hypoglycaemia, IV quinine should be given as a an infusion with 30ml dextrose at 30% over 8 hours