Ensuring the mental health and well-being of public servants in Mozambique within the scope of the Sustainable Development Goals: advances, limitations, and perspectives

Abstract

Introduction  Guaranteeing the mental health and well-being of public servants is a necessary action for the materialization of national public policies and the achievement of the goals of the Sustainable Development Goals.

Objective  To understand the advances, limits and perspectives of guaranteeing the mental health and well-being of public servants in Mozambique.

Methods  Qualitative research, developed through documentary and bibliographic analysis.

Results  From 2016 onwards, elements of decent work were incorporated into current labor legislation, namely: entry into the State through provisional appointment, adequate hygiene and safety conditions at work, salary equity and labor justice. However, in reality, the realization of these rights is a utopia, since public institutions operate in a scenario of austerity and little public investment, which limits the provision of adequate working conditions, human resources and career development opportunities. Furthermore, a situation of suffering and mental distress among public servants was observed, which manifests itself in symptoms of stress, burnout, depression and alcoholism.

Conclusion  It is necessary to transform legislated rights into practice in the Mozambican context, in line with advances made in other parts of the world.

Occupational Health; Mental Health; Sustainable Development Goals

Resumo

Introdução  A garantia da saúde mental e bem-estar de servidores públicos constitui uma ação necessária para a materialização das políticas públicas nacionais e o alcance das metas dos Objetivos de Desenvolvimento Sustentável.

Objetivo  Conhecer os avanços, limites e perspectivas da garantia da saúde mental e bem-estar de servidores públicos em Moçambique.

Métodos  Pesquisa qualitativa, desenvolvida por meio de análise documental e bibliográfica.

Resultados  A partir de 2016, houve a incorporação de elementos de trabalho decente na legislação laboral vigente, a saber: ingresso no Estado por via de nomeação provisória, condições adequadas de higiene e segurança no trabalho, equidade salarial e justiça laboral. Porém, na realidade, a concretização desses direitos é uma utopia, uma vez que as instituições públicas funcionam em um cenário de austeridade e de pouco investimento público, o que limita a provisão de condições de trabalho adequadas, recursos humanos e oportunidades de desenvolvimento na carreira. Ademais, constatou-se um quadro de sofrimento e adoecimento mental de servidores públicos que se manifesta em sintomas de estresse, burnout, depressão e alcoolismo.

Conclusão  É mister transformar os direitos legislados em prática no contexto moçambicano, no esteio dos avanços ocorridos em outras partes do mundo.

Saúde do Trabalhador; Saúde Mental; Objetivos de Desenvolvimento Sustentável

Introduction

In Mozambique, the Public Administration (PA) has been the target of reforms aimed, from the government’s point of view, at bringing public services closer to citizens and improving their quality. In 2001, the Global Public Sector Reform Strategy (2001-2011) was implemented, which sought to guide public institutions towards improving the quality of their services and the state’s responses to society, with the aim of achieving a public culture geared towards integrity, transparency, efficiency, and effectiveness¹. The 2012-2025 Public Administration Reform and Development Strategy (ERDAP in Portuguese) is currently underway. This strategy sets out a development vision for the Mozambican Public Administration over a 15-year period, identifying the main objectives to be achieved from an integrated perspective of the different sectors. These guidelines are being implemented in a shared manner by the various PA bodies². The ERDAP seeks to provide public services guided by principles such as efficiency, integration, and transparency.

At the same time, the 2020-2024 Government’s Five-Year Program (PQG in Portuguese), approved by Resolution 15/2020³of April 14, focuses its government action on improving the well-being and quality of life of Mozambican families, reducing social inequalities and poverty, creating an environment of peace, harmony, and tranquility, with a strong stimulus for job creation. The preparation of this PQG was based on a set of national and international instruments. The national instruments include: 2025 Agenda; National Development Strategy; Sectoral and Territorial Policies and Strategies; Assessment of the four years of the 2015-2019 PQG; 2019-2021 Medium-Term Fiscal Scenario; Open and Inclusive Presidency Reports; Poverty Assessment Report; Integrated Investment Program and Strategic Plan for Promoting Private Investment in Mozambique. And at regional, continental, and international level, they include: the South African Development Community, Regional Strategic and Integrated Development Plan, the New Partnership for Africa’s Development, the African Peer Review Mechanism, the African Union’s 2063 Agenda, the Sustainable Development Goals (SDGs), and the Post-2015 Global Development Agenda Vision.

Mental health and well-being are one dimension of the SDG⁴. Under the slogan “leave no one behind”, the SDG aim to protect the planet and guarantee dignity for all people. Mozambique is guided by this instrument (SDGs) when drawing up its action plans, which suggests aligning its policies in a coordinated way with the objectives and targets of the SDGs. Achieving the SDGs targets and providing quality services requires a series of concrete actions, such as ensuring greater public investment, providing working conditions and human resources in quantity and quality. It is also understood that it is necessary to give importance to the quality of life of public servants, since they are responsible for the concrete operationalization of sectoral public policies, through the provision of their services.

The quality of life of public servants is a multifactorial construct. It can be promoted and ensured through a set of actions, such as guaranteeing decent work that ensures health and safety conditions at work, career development opportunities, social benefits, decent, equitable and fair pay, among other measures. Decent work is conceived as work that ensures respect for fundamental labor rights, social dialogue and social protection, resulting in quality employment in which there is freedom, security, equity and human dignity⁵.

In other words, it is necessary to ensure work with decent and healthy conditions, which promotes fair pay, health and safety in the workplace, personal and professional development, social integration and inclusion, participation in decisions that affect workers’ lives, equal opportunities and treatment for men and women, the right to social security and assistance, among other actions⁶-⁷. However, research shows that most public servants in Mozambique (for example, health, education, police, and army professionals) carry out their work activities in environments with insufficient or precarious working conditions, with a shortage of human resources and limited public investment due to the public spending containment policy in force since 2017⁸-¹⁰.

In addition, some public servants work in remote areas with difficult access, housing, and living conditions⁸,¹¹as well as limited career development opportunities⁸,¹⁰,¹². These factors, together or in isolation, negatively affect professional motivation¹³and have a detrimental effect on the mental health and well-being of these workers, causing, for example, symptoms of stress¹⁴-¹⁷ , burnout syndrome¹⁸-²⁰, and depression and alcoholism⁸.

However, ensuring mental health and well-being is target 3.4 of Goal 3 (Ensure access to quality health and promote well-being for all) of all 17 SDGs⁴. As a result, one of the Mozambican government’s priorities should be to ensure mental health and well-being, as well as decent work for public servants. It is considered that sharing theoretical and practical contributions can generate reflections for making changes to public policies to give importance to the mental health and well-being of public servants, as well as opening up avenues for future research in the area of occupational health in the Mozambican PA. In view of this panorama, the aim of this essay was to find out about the progress, limits and prospects for guaranteeing the mental health and well-being of public servants in Mozambique, who are considered to be the most important living resources of public institutions and responsible for implementing the objectives of the state and public policies.

Methods

This qualitative essay was developed through documentary and bibliographic analysis. The documentary research consisted of analyzing documents from Mozambique’s local reality, such as labor laws (e.g. the General Statute for State Employees and Agents – EGFAE in Portuguese and its regulation - REGFAE in Portuguese) and activity reports from the various public sectors, especially education, health, the police, and the army. The bibliographical research was carried out through a theoretical and empirical review of working conditions in the Mozambican PA, remuneration, career development, quality of life at work, well-being, and mental health of public servants. This search was carried out in different databases that compile materials with different levels of evidence, allowing for a broader analysis of the subject, with emphasis on data available on Google Scholar, the Biblioteca Digital Brasileira de Teses e Dissertações and Repositório Científico de Acesso Aberto de Portugal.

The descriptors used to search for the academic output analyzed were working conditions, professional development, mental health, well-being at work, motivation at work, and public policies on mental health at work. These words were accompanied by the term “public servants in Mozambique”. The choice of descriptors was based on the elements that make up the concept of decent work. Papers produced and/or published between 2016 and 2024 were considered eligible, in line with current legislation aimed at promoting progress in this field, as previously discussed²,³.

The materials retrieved in these searches were analyzed by a team of researchers made up mostly of Mozambicans with experience in research on mental health and well-being at work. The analytical corpus, made up of the studies identified in the screening and selection phases, was submitted to content analysis²¹. In the material exploration stage, an analytical reading of the documents and academic output was carried out. At this stage, thematic categories were defined, inspired by the concept of decent work, and the following emerged: decent and healthy working conditions, employment conditions - fair pay and career development, and health and safety in the workplace. Finally, the results processing phase consisted of the analysis of presence or frequency nuclei in each category analyzed, which made it possible to infer the main results of the study, discussing them based on the consolidated literature on the subject. The categories produced are discussed below.

Results

Working conditions in the Mozambican PA from 2016 to 2024

Working conditions are understood as the set of resources that make it possible to carry out the work, involving the physical facilities, the materials and inputs available, the equipment and means of carrying out the activities and other types of support needed, depending on the nature of the production²²-²⁴. Regarding adequate and healthy working conditions, there has been some progress in terms of current Mozambican labor legislation and research that makes it possible to understand and analyze them. From a legal point of view, Article 100 of Decree No. 28/2022, of June 9 - Regulation of the General Statute of State Employees and Agents (REGFAE)²⁵, indicates adequate working conditions as the existence of means and working instruments essential for the normal functioning of services, ergonomic working conditions, a good organizational climate and working environment, being one of the factors for attracting and retaining public servants²⁵.

However, the reality shows that, in general, the work activities carried out in the Mozambican public sector are mostly carried out in work environments with precarious physical and material structures, as well as insufficient working conditions(-²⁷). In the education sector, for example, the literature has shown that working conditions are potential factors of occupational stress¹⁴,²⁶,²⁸, mental illness of teachers⁸, and absenteeism²⁹.

Notably, a study found that in Mozambique around 56.6% of pupils studied in schools without water, 72.8% in schools without power, and only 16% received lessons in schools with libraries²⁷. Except for Maputo province, more than 60% of pupils sat on the floor. Likewise, the provision of schoolbooks in the last three years for public elementary school pupils in the country has been insufficient and late⁸.

Furthermore, the education sector lacks teachers in quantity and quality and, as a result, most of them teach for large groups, without the support of other collaborating teachers and some in two groups¹⁰. This same survey found that most classes in public general education schools were made up of an average of 60 students or more, in some cases reaching 100 students/class, especially in the provinces of Nampula, Zambézia, Tete, and Niassa¹⁰. This scenario, coupled with the large number of subjects taught and the time needed to correct tests and student exercises, leads to an intensification of teaching work⁸.

In the area of health, research carried out among these professionals concluded that working conditions and overload, for example, were unfavorable factors and caused damage to mental health¹⁷,³⁰-³¹. It should be noted that Mozambique has a National Health System (SNS in Portuguese) with a limited health network, fewer resources - human, material, equipment, infrastructure, and greater demand. The 2021 Health Statistics Yearbook showed that the health network consisted of 1,739 hospital units for a population of 27,909,798³². The proportion of inhabitants per health unit at national level was 17,419, still below the international recommendation (10,000 inhabitants/health unit)³².

The same yearbook states that the SNS had a total of 23,576 hospital beds and 59,176 health professionals. The ratio of doctors, nurses, maternal and child health nurses, and health technicians (i.e. the total number of human resources in the special health system, namely: general medicine, laboratory, anesthesia, preventive medicine and environmental sanitation, psychiatry, and mental health technicians) was 1/100,000 inhabitants³². This data allows us to infer those insufficient human resources, a higher professional/patient ratio, and a limited health network generate greater demand and pressure on the SNS, as well as an overload of work for professionals in the sector.

Studies with public security agents - both military and protection police - found that insufficient or precarious working conditions were factors that led to occupational stress¹⁶,³³. Another study, which analyzed the work motivation of employees at a military academy, found that insufficient working conditions and role ambiguity were some of the demotivating factors most mentioned by those surveyed¹³.

In the public security sector, there are complaints about a lack of operational resources, such as patrol cars and personal equipment - protective capes and bulletproof vests. However, although labor legislation makes it compulsory for public institutions to provide decent and healthy conditions to preserve the physical, emotional, and mental integrity of workers, its concrete materialization is nothing more than a utopia, since many of them operate in environments of material means, equipment, precarious infrastructure and insufficient human resources¹³,³³.

Conditions of employment: entry, pay, stability, and career development

The employment conditions analyzed in this essay include the forms of contract, remuneration, career, and stability. Regarding the constitution of the employment relationship in the state, this is currently done by means of career appointments, as stipulated in Article 14(1) of the EGFAE³⁴and Article 3(a) of the REGFAE²⁵. In accordance with article 14 of the EGFAE and article 8 of the REGFAE, the general requirements for appointment to careers in the PA staff are as follows: a) Mozambican nationality; b) Unique Tax Identification Number; c) age of 18 or over, provided they are able to complete at least 180 contributions for retirement purposes; d) mental health and physical capacity compatible with the activity they will be carrying out in the PA; e) not having been retired; and f) minimum basic education qualifications from the National Education System or equivalent, or qualifications specifically required in the respective professional qualifier²⁵,³⁴.

However, until the date of approval of the 2022 EGFAE³⁴ and REGFAE²⁵, the Mozambican government allowed entry on contract without provisional appointment, especially for teachers, health professionals, police officers, judges, and prosecutors. This form of entry created problems for many public servants in terms of the stability of their employment, as they remained in a contracted position for many years. It should be noted that public servants on contract did not benefit from career development opportunities - promotions, progression, and career changes, as well as appointments to management, management and trust positions. Thus, the current measure of entry via provisional appointment is in line with one of the premises of decent work, established in target 8.5 of Goal 8 of the SDGs - promoting inclusive and sustainable economic growth, full and productive employment and decent work for all⁴.

Provisional appointments last for two years. However, an official on provisional appointment who has obtained a performance evaluation of less than “good” or has committed infractions corresponding to a sanction equal to or greater than demotion is dismissed from the State apparatus. Likewise, officials on provisional appointment may, at any time, request to be dismissed by the State, without the right to compensation (article 19 of Law no. 4/2022, of February 11 - EGFAE)³⁴. The final appointment takes place after the two-year period of provisional appointment has elapsed. This is subject to annotation by the competent administrative court and implies taking office (article 22 of the EGFAE and 16 of the REGFAE)²⁵,³⁴.

Regarding remuneration, Article 66(b) of the EGFAE(³⁴) and Article 65(1) of the REGFAE²⁵state that public servants have the right to “receive their salary and other legally established supplements”. Salary is the remuneration paid to the public servant, according to their career, category or function, in return for the work they have done for the state and consists of a certain amount paid at a certain time and place.

Article 100(d) and (f) of the REGFAE²⁵also include fair pay for work, fair pay conditions, and career development - guarantees of promotion, progression, and career change, as factors in attracting and retaining public servants, respectively. In order to ensure pay equity, the Mozambican government approved Law No. 5/2022³⁵, of February 14, which defines the rules and criteria for setting the remuneration of public servants, holders or members of public bodies and holders and members of the bodies of the Administration of Justice, known as the Single Salary Table (TSU in Portuguese), amended and republished by Law No. 14/2022³⁶, of October 10, whose effective implementation began in October 2022.

The implementation of the TSU was supposed to solve two problems: career stagnation and wage inequality among public servants, since under the previous model of the Career and Remuneration System, two or more public servants with the same academic level and length of service received different salaries, depending on the sector of activity to which each was linked³⁷. Although the TSU has increased the salary base of public servants with a low level of education, there are burning problems, because the procedures used to classify public servants have not been consensual. What’s more, the workforce believes that the TSU has only benefited high-ranking state employees, as they were included without observing the criteria legally established for this purpose, namely: level of education, length of service in the Public Administration and length of career.

The dissatisfaction of most public servants can be seen in the constant complaints about the unfairness of the procedures for classifying public servants in the TSU, as well as strikes and letters to the government from different union representatives. Furthermore, in the period under review, public servants would benefit from little salary adjustment in 2016, 2017, 2018, 2019, and 2021, ranging from 223 meticais to 5% of the basic salary. On the contrary, in 2020, 2022, 2023, and 2024 there was no salary increase in PA⁸.

As far as career development is concerned, Article 53(1) of the EGFAE³⁴and Article 73 of the REGFAE²⁵state that it is based on professional merit and takes place through promotion, progression and career change. In conceptual terms, promotion is a move to the next class or category in the respective career and takes place at the step and index to which the immediately higher salary corresponds²⁵,³⁴. Promotion depends on a competitive examination, taking into account the experience and performance of the official and other legal requirements²⁵,³⁴. Progression is made by changing echelon within the respective salary range, depending on the official’s experience in the echelon, merit, and other legal requirements (article 55 of the EGFAE)²⁵,³⁴.

Finally, the change of professional career corresponds to the transition from one career to another, in compliance with the professional qualification requirements. This is done by competitive examination, subject to the existence of a vacancy, budgetary viability and the fulfillment of the requirements set out in the professional qualifications (article 55 of the EGFAE)³⁴. Article 66(k) of the EGFAE³⁴states that public servants have the right to “compete for higher categories or classes within their professional career, as well as for other professional careers based on the fulfillment of the requirements, experience and results obtained in the execution of their work”.

Although career development is a right enshrined in the labor legislation of the Mozambican PA, its realization is a huge challenge for many sectors and constitutes an obstacle for several public servants. This limitation is due to the application of public expenditure containment measures approved by Decree No. 75/2017, of 27 December³⁸, and made operational by Ministerial Diploma No. 49/2018, of 23 May³⁹. One of the measures taken by this Ministerial Diploma was to freeze all administrative career development acts.

Although it gradually returned in 2019 to 2021, few public servants have benefited from these administrative acts of career development, due to the budget deficit, strong dependence on the Ministry of Economy and Finance, bureaucracy in the processing of files, and lack of mastery of administrative procedures by the human resources area in the various sectors of activity⁸,¹². Of course, the empirical literature has highlighted the delays in processing career change processes and the lack of promotions for length of service, delays in processing overtime, low salaries disproportionate to the high cost of living, non-payment of salaries on time, as some of the problems related to the employment conditions faced by teachers⁸,¹⁰.

Health and safety in the workplace

From a legal point of view, benefiting from adequate hygiene and safety conditions at work is a right of public servants in Mozambique (Article 66(c) of Law No. 4/2022 of February 11 - EGFAE)³⁴. Likewise, hygiene and safety at work - guaranteeing factors that promote the physical and mental integrity of state employees - are part of the factors for attracting and retaining public servants listed in article 100 of the REGFAE²⁵. And article 68 of the EGFAE³⁴states that public servants “shall enjoy medical and medication assistance for themselves and their dependents, under the terms of specific legislation”.

One of the novelties of the current Decree No. 28/2022²⁵, of June 9 - REGFAE is the incorporation of hygiene and safety at work between articles 101 and 106. However, the analysis undertaken indicated that this section addresses workers’ health in the biomedical context and does not include attention to the mental health and well-being of public servants.

Although progress has been made in Mozambican legislation since 2016 in terms of incorporating matters relating to the right to career development and pay equity, as well as adequate hygiene and safety conditions at work, there has been little materialization⁸,¹³. Thus, although the literature¹⁰discusses the situation of teachers and provides important information on the working and employment conditions of public servants, current Mozambican legislation does not address the mental health situation of these and other professional categories, which leads us to conclude that it is a marginal issue or one that is given little priority in the country’s public policies.

In addition, studies on the mental health of Mozambican public servants show that they are vulnerable to mental suffering and illness, which compromises their well-being and quality of life. For example, Mucavele et al.¹⁶ examined stress in 100 police officers from the city of Xai-Xai, in the southern region of Mozambique, and found that most of those investigated reported physical symptoms (e.g. change in appetite, passing diarrhea, insomnia, muscle tension, generalized malaise with no apparent cause, feeling of constant physical exhaustion, constant tiredness, and sexual difficulties) and psychological symptoms (sudden increase in motivation, self-doubt, constantly thinking about one subject, excessive irritability, and frequent nightmares), with greater emphasis on the resistance phase. In the same vein, another study investigated stress in a sample of 20 police officers from the city of Maputo and the results reported the presence of emotional, physical and psychological discomfort manifested by insecurity, fear, headaches, backaches, footaches, joint and back pain and tiredness³³.

In health, Vicente et al.¹⁷found that 33% of 100 workers said that their work caused them a lot of stress. And Abacar et al.³⁰identified the following symptoms of stress: physical symptoms (insomnia, muscle tension, cold hands and feet, teeth grinding, memory problems, constant tiredness, feeling of constant physical wear and tear, generalized malaise with no specific cause, tingling in the extremities, and high blood pressure) and psychological symptoms (sudden enthusiasm, sudden increase in motivation, excessive irritation, excessive emotional sensitivity, and constantly thinking about one subject).

In research in the field of education, also in the Mozambican context, there was a recent publication which found that the mental illness of teachers occurred in the form of alcoholism, stress, and depression⁸. In addition, Aliante et al.²⁰assessed Burnout Syndrome (BS) in a sample of 263 public school teachers in the city of Nampula, northern Mozambique. As a result, 13.3% of the participants had low levels of work delusion, 16.3% high levels of psychological exhaustion, 13.3% indolence and 25.9% high levels of guilt. In the profile analysis, 24.0% fell into profile 1 (high levels of SB) and 11.0% into profile 2 (severe levels of BS). These results indicate that the mental health and well-being of Mozambican public servants is compromised, suggesting the implementation of intervention and care actions in mental health at work.

Final considerations

The mental health and well-being of workers are topics that are gaining greater interest and attention from researchers in various fields of knowledge (e.g. Psychology, Education, Health, Social Work, and Organizational Behavior), as well as international organizations (e.g. the International Labour Organization and the World Health Organization) and some entrepreneurs. However, there are still few government initiatives in these areas. This interest may be motivated by the increase in the prevalence of work-related mental disorders, which have severe consequences and impacts on the health of workers and the productivity of organizations. The situation described, possibly, contributed to the United Nations (UN) including mental health, well-being and decent work for all as some of the priorities to be ensured by 2030⁴.

The aim of this essay was to find out about the progress, limits, and prospects for guaranteeing the mental health and well-being of public servants in Mozambique. The analysis concludes that, from 2016 to the present, some progress has been made in terms of the mental health and well-being of public servants, with the SDGs as part of the government’s action plans. These actions include: fair pay through the application of the TSU, the right of employees to benefit from decent hygiene and safety conditions at work, professional development, participation in the work collective, and social security. However, the realization of these rights is a long way off, given the current scenario of public austerity policies, little public investment, and the budget deficit that public institutions face, limiting career development, as well as the provision of human resources, materials and equipment in quantity and quality.

Inadequate working and employment conditions, combined with the precarious living conditions of the communities where some Mozambican public servants work, are factors that compromise their mental health and well-being. The emergence of mental disorders and psychological distress in these workers will not only mean that the target related to ensuring mental health and well-being for all will not be achieved, but also other SDGs targets and national public plans and policies. It is also an indicator of failure to guarantee decent work for all. In this context, there must be greater public investment and funding, as well as prioritizing the mental health and well-being of public servants in national public policies.

Equally important are the design and implementation of actions to intervene and promote mental health at work, since the survey carried out in this study did not reveal any actions related to this area. Furthermore, it is crucial to continue developing research into mental health and well-being at work to understand the current state of health of these professionals and to monitor these indicators longitudinally. The results of these studies can help in making decisions about the intervention plans to be applied according to the particularities and realities of each sector of activity and location.

Finally, it should be noted that understanding the Mozambican scenario, which is the subject of this essay, is an important contribution to the global discussion about the world of work and the context of workers in the context of the SDGs. It is essential that different realities can be known and recognized scientifically, which can mobilize not only cross-cultural studies, but a counter-colonial narrative, that is, one that allows different realities to be described through their own beacons, such as the legislation and studies developed in the scenario discussed here, producing knowledge that will be shared and possibly trigger new reflections.

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• Data availability:
  The entire data set supporting the results of this study has been published in the article itself.
• Presentation at a scientific event:
  The authors declare that the study has not been presented at a scientific event.

• Funding:
  The authors declare that the study was not subsidized.

Edited by

• Editor-in-Chief:
  Eduardo Algranti

Data availability

The entire data set supporting the results of this study has been published in the article itself.

Publication Dates

• Publication in this collection
  10 Feb 2025
• Date of issue
  2025

History

• Received
  30 Apr 2024
• Accepted
  11 Sept 2024