Medicus Mundi and Alliance for Health hold II International Conference on Social Determinants of Health

The II International Conference on Social Determinants of Health included several panels that allowed for the promotion of a higher level of participation and sharing of information and experiences with the different actors. Civil society organizations and state institutions linked mainly to the health sector were invited to the conference, with a view to generating reflections on the main challenges they face. The II International Conference on Social Determinants of Health in Maputo began with a master class given by Professor João Schwalback, who addressed “The challenges of the health sector in Mozambique in a context of climate change, pandemics, conflicts… an approach on Social Determinants of Health, with a focus on nutrition”.

This master class marked, therefore, the start of the works of the II International Conference on Social Determinants of Health, which had the following seven panels:

Panel 1: The social determinants that influence access to health services in emergency situations.

It was clear to this panel that the difficulties are enormous in guaranteeing the provision of Primary Health Care in difficult and extremely complex times. Therefore, it recommends that:

• We must consider building robust and resilient health units to withstand the new global challenges, which requires greater effort from the Ministry of Health, in particular the Directorate of Planning and Cooperation.
• We must strengthen community work to bring access to primary health care closer to communities.

Panel 2: Why is child malnutrition not ending in Mozambique... Despite efforts?

For this panel, there are indeed several programs and policies to combat malnutrition in Mozambique, but there are also major challenges related to implementation, which greatly contributes to the high numbers/indices of malnutrition.

The deficient implementation of nutrition-related policies is even worse in contexts of wars and humanitarian crises, due to the lack of access to health and nutrition services in conflict areas, as in Cabo Delgado's province.

Panel 3: The struggle of women to guarantee the Right to Health

There is still a procedural delay of justice entities to deal with cases of women who suffer violence. Access to Justice in Mozambique is still a major challenge despite having access to the courts. It is the duty of all of us (state entities, civil society) to fight to invert this pyramid and ensure that everyone has access to justice in Mozambique.

Panel 4: The Right to Health and the Media

Regarding the media, it was clear that they are a very important tool for promoting political advocacy and citizen awareness, to influence changes in favour of the universal right to health. It is also necessary to take advantage of digital spaces to exercise digital activism, considering social and cultural dynamics, in an era when we are faced with cybercrime.

Panel 5: Right to Health and Social Inclusion

One cannot talk about health without talking about inclusion and in this Conference, it was clear that not only health services, but other public services are not inclusive.

The National Health System has several challenges around social inclusion (from access to facilities prepared to receive these groups, to the lack of specific medicines and equipment for certain diseases and specific types of disability).

The challenges also extend to health professionals who, for example, do not understand sign language, or are not aware of some rare diseases with a high financial cost for the citizen's pocket. This, in a way, limits access to health, increasing social inequalities.

Panel 6: Participation and Social Responsibility

There was also room for an exchange of experiences between some civil society movements, to ensure social accountability in health, and the various behavioural (functional/structural) barriers to accessing health services were evident.

It is important that civil society works side by side with government entities, so that actions and activities are directed in a single direction.

Panel 7: Activism for the Right to Health

This panel presented the networking of international movements and the Municipal Commission for Social Determinants of Health in Maputo, focusing on what has been done to defend the right to health. This panel also presented the experience of the “ACTIVA-TE For the Right to Health” Campaign led by the Alliance for Health, which involved several organizations that came together to advocate on various topics in favour of the right to health, with a positive and multiplier impact on the country. It became clear that the Alliance's agenda is a collective agenda of member organizations that, with few available resources, managed to achieve impressive results in just 2 years of existence as a network.

In general, during the three days of the Conference, several barriers and many challenges were pointed out, which drew attention to the need for active citizenship in Mozambique, platforms, networks, and movements to be able to work together with the Government in the different steps: build, adapt, train, train, support the SNS to be able to provide better services that are comprehensive and inclusive for all.

From our point of view, as a network of organizations, the II International Conference on Social Determinants of Health in Maputo contributed to:

• Generating and enriching debates in favour of the Social Determinants of Health and the exercise of the Right to Health in Mozambique and on a global scale, through interdisciplinary, integral and multisectoral approaches to gender and human rights.
• Addressing the problem of malnutrition in Mozambique, with contributions from different disciplines and sectors, to analyse its causes, consequences and possible measures and policies to be adopted.
• Raising awareness and commitment of all actors and people involved to adopt concrete measures to act on inequities, the Social Determinants of Health and guarantee the full exercise of the right to health for the entire population, particularly in Mozambique.
• Sharing experiences of building alternatives, strategies, and resistance, at national and international level, with the potential to guide and inspire new proposals to eliminate inequalities and inequities in the population's access to health, especially those who live in conditions of vulnerability, conflict, exclusion, and marginalization.
• Generating debates on the Social Determinants of Health and the exercise of the Right to Health, highlighting the dynamics resulting from the different power relations between men and women and promoting the inclusion and perspectives of the most disadvantaged and marginalized groups.

The II International Conference on Social Determinants of Health was held with the financial support of the Spanish Agency for International Cooperation Development (AECID), under the terms of Agreement 18-CO1-1096 «Improving the health of the population, with a focus on its Social Determinants and a special focus on nutrition, through the strengthening of Primary Health Care as the best strategy to guarantee the Right to Health and the collaboration of civil society, research institutions and the SNS”. The content of this news is the sole responsibility of medicusmundi and the Alliance for Health and does not necessarily reflect the opinion of AECID.