The Infrastructures Department of the MOH's Planning and Cooperation Directorate (DPC) is responsible for all aspects of health system infrastructure development and rehabilitation. Its administrative functions include physical and financial planning, coordinating donors' infrastructures programs, setting performance targets and monitoring expenditure and progress. It is also responsible for commissioning designs for health facilities and developing technical standards.

The MOH recognizes that poor infrastructure is a major constraint to delivery of basic health care to the rural population. In recent years the Infrastructures Department has promoted standardized designs for

rural health clinics, which have been adopted by several donor agencies, including USG, and are now being replicated throughout the country. There is also recognition that new state-of-the-art facilities, such as the National Reference Laboratory and the training center to be built at Marracuene, are essential if MOH is to achieve needed improvements to the quality of its service delivery and pre-service training.

The Infrastructures Department employs 10 architects and 8 engineers, none of whom have trained recently as health facility specialists. The objective of this activity is to strengthen the capacity of the Infrastructure Department by attaching an expert health facility architect to the department for two years. Expected results of this technical assistance include: 1) Transfer of current technology and modern best practices in health facility design; 2) Updating Infrastructure Department standards and model designs to respond to recent challenges, such as PMTCT, separation of TB consultation facilities, mitigating risks of staff infections, safe handling and disposal of biological waste; 3) Technical interaction between the department and specialist consultants designing new state-of-the-art facilities.

This activity supports Partnership Framework Objective 3.5: improve and expand the public health infrastructure. The cross-cutting attribution is construction.

This technical assistance is cost-efficient as it will transfer knowledge and skills to Mozambican staff in the Infrastructure Department, so that the MOH can take leadership of developing its own infrastructure plans and policies. This person will also help ensure better coordination among the various infrastructure initiatives of the government and donors.

The technical advisor will develop a work plan in coordination with the Infrastructure Department and USG, with indicators and benchmarks to measure capacity-building progress.

The systems barrier addressed is weak health infrastructure in Mozambique and weak capacity of the Infrastructure Department of the MOH. This activity will provide a health facility architect technical advisor to the Infrastructures Department. The technical advisor (TA) will build the capacity of and mentor the architects and engineers in the department, who have not received any recent training as health facility architects. The TA will ensure quality standards and best practices are adhered to in construction, rehabilitation, and maintenance activities.

There are linkages among the areas of service delivery, human resources and leadership, since the technical assistance will improve the quality and coordination of health facility construction and rehabilitation; build the capacity of MOH staff to plan and manage infrastructure projects, as well as take a stronger leading role in infrastructure development. The technical assistance will have benefits for the whole health system.

There are no next generation indicators that capture the progress of this type of technical assistance, but a work plan with indicators and targets will be developed after the TA begins.