Availability and Access to Cardiovascular Medicines in Mozambique: A Scoping Review
Year: 2026
Type: preprint
Study design: Systematic Review
Abstract: Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide, with more than 80% of deaths occurring in low- and middle-income countries. In Mozambique, non-communicable diseases account for approximately 28% of deaths, with CVDs contributing substantially to this burden. Despite the country’s hierarchical health system and the World Health Organization target of 80% availability of essential medicines, access to cardiovascular medicines remains poorly documented. This scoping review mapped the availability, prices, affordability, physical access, and health-system barriers affecting access to essential cardiovascular medicines in Mozambique. The review followed the PRISMA-ScR guidelines and the Arksey and O’Malley framework. PubMed, Scopus, and Web of Science were systematically searched without publication-year restrictions. Eligible studies assessed the availability, stock-outs, prices, affordability, or health-system barriers related to cardiovascular medicines and diagnostics in Mozambique. Study selection and data extraction were independently performed by multiple reviewers. Consistent with the scoping review design, formal risk-of-bias assessment was not undertaken. Fifteen studies met the inclusion criteria. Essential cardiovascular medicines showed persistently low availability, with mean availability of approximately 21% across public hospital pharmacies, private retail outlets, and private hospitals, substantially below the WHO 80% target. Public facilities consistently provided only a limited range of older first-line medicines, while second- and third-line medicines, statins, digoxin, direct oral anticoagulants, and diagnostic reagents were frequently unavailable. When public stocks were depleted, patients relied on private-sector purchases, where generic medicines cost an average of 4.51 times international reference prices. Long-term secondary prevention could require 14.0–17.8 days of wages per month for low-income workers. These barriers were associated with low hypertension awareness, treatment, and control, substantial target-organ damage, high stroke case-fatality, and poor anticoagulation control. Access to cardiovascular medicines in Mozambique is severely constrained by low availability, frequent stock-outs, and unaffordable private-sector prices. Strengthening medicine selection, supply-chain management, financial protection, and decentralized protocol-based care is essential to improve equitable access to cardiovascular treatment.
Source: Preprints.org
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7223072014