Addressing Gaps in Men's Health Literacy and Health Seeking in Mozambique: A Case for Differentiated Care for HIV and CVD

May 2019 – April 2021

Men are more likely to disengage with health services than women in Southern Africa, a gap worsened with the rise of noncommunicable diseases (NCD) and complex patterns of co-morbidity. There is little regional data on men's health literacy, health-seeking behaviour, and experiences of receiving care in health systems. Mozambique has a high burden of infectious diseases (ID) with steady increase in NCD since the early 2000s. Retention of men in HIV care remains challenging; emerging evidence indicates that men have lower levels of awareness, control, and uptake of treatment for NCDs.

Applying a syndemics approach to the case of HIV and CVD co-morbidity among men in Mozambique, the project aims to strengthen the evidence base for developing differentiated health systems strategies to promote men's health literacy and sustained engagement with health care services in Southern Africa.

Karina Kielmann, Reader in IGHD, is Principal Investigator of the project. Karin Diaconu, IGHD Research Fellow, is using systems dynamics modelling techniques to understand social and structural determinants of men’s health literacy and health-care seeking in Mozambique.

MHIM on ukri.org

"Bilvagterne" (the car guides) by René Clausen Nielsen is licensed under CC BY-SA 2.0

  • About this project
  • Partners
  • Funding
  • Project objectives
  • Papers

Our mixed-method observational and cross-sectional study will be based in a large urban district of Maputo and has four phases:

  1. Scoping review and mapping exercise to examine current approaches tomen's health;
  2. Facility-based observations and interviews with health providers and male patients will situate illness trajectories within social, structural, and systems context;
  3. Community-based survey and a nested qualitative study will triangulate data on health literacy, self-perceived health and household influences on men's health seeking behaviour and
  4. Participatory systems modelling techniques and stakeholder consultation will inform potential strategies to strengthen men's engagement with HIV and CVD services.
  • Institute for Global Health & Development (IGHD), Queen Margaret University (lead)
  • Institute for Hygiene & Tropical Medicine (IHMT) Lisbon
  • Mozambique Institute for Health Research (MIHER), Maputo, Mozambique

Joint Health Systems Research Initiative (DfiD; ESRC; MRC; Wellcome Trust)

Our objectives are:

  • To examine the policy, programme and theoretical assumptions underlying current approaches to strengthening men's health literacy and engagement with health systems in Southern Africa broadly, and for initiatives in Mozambique specifically
  • To elucidate the social, structural, and systems influences on men's care pathways and experiences of health care for HIV and CVD in Maputo, Mozambique
  • To assess the levels, patterns and determinants of health literacy and health care seeking across the life-course for men in an urban neighbourhood of Maputo, Mozambique
  • To synthesise and apply evidence for the development of health systems strategies for strengthening men's engagement with HIV and CVD services in urban settings in Southern Africa

Dr Karina Kielmann

Reader - IGHD