The lack of human resource capacity is by far the greatest barrier to overall health sector delivery and has been recognized as a major constraint in attaining the health-related Millennium Development Goals. With doctors and nurses per 1000 inhabitants, 8 Mozambique has one of the lowest health worker densities in Africa. This is as a result of low pre-service training and recruitment, increased attrition, and rapidly-changing health needs. Health staff distribution around the country still shows considerable regional asymmetries. The output of training institutions is insufficient to respond to the growing demand for a larger and better-trained workforce. Performance of health workers is affected by low motivation.
