LocationsBringing safe motherhood within reach in Marimanau
July 22, 2026
For Isabel Inácio, a 31-year-old mother from Marimanau, a rural community in Tambara district of Manica, central Mozambique, childhood ended much too soon. With her education cut short after just the sixth grade, she found herself facing the complicated reality of motherhood long before she turned twenty.
“I once thought about leaving the community to live close to a hospital”, Isabel shares, holding her son, Francisco, close. “But today, I feel that I have care, safety, and even hope very close to me”.
Vulnerable, young, and miles away from medical assistance, her introduction to motherhood was marked not by joy, but by pure uncertainties. "One of the most defining moments of my life was when I had my first child," Isabel recalls, the trauma still vivid despite the eleven years she has since built with her second husband, Izaquiel Stiven.
"I couldn't reach the hospital in time and ended up giving birth in a stranger's house along the way. It was a very difficult experience, full of fear and uncertainty, which I will never forget".
For years, becoming a mother in Marimanau often meant embarking on a journey filled with uncertainty and hardship. The nearest health facility was located 20 to 30 kilometres away, a distance that represented far more than a physical barrier. For many families, reaching care required spending scarce household resources on motorbike transport, an expense that could compete with other essential needs.
For those who managed to make the journey, the road itself presented additional challenges. Pregnant women travelled along rough, unlit paths across remote areas, often at night and under difficult conditions, facing risks that no mother should have to endure while seeking care for herself and her unborn child. For many expectant mothers, pregnancy became a journey of difficult choices. Long distances, poor roads, and the cost of transport often meant missing essential antenatal appointments or facing childbirth far from the safety of a health facility.
Some women gave birth in the homes of strangers or by the roadside before they could reach medical care, relying on the support of community matronas – elderly women who, drawing on generations of traditional knowledge, helped deliver babies with the limited resources available. While their care offered comfort and solidarity, mothers and newborns remained at high risk of life-threatening complications without access to skilled health professionals.
For those unwilling to risk giving birth on the road or at home, the only alternative was equally difficult. In the final weeks of pregnancy, many left behind their children, farms, and families to stay near a distant hospital, exhausting what little savings they had while waiting for labour to begin. Whether they travelled early or waited too long, the experience was marked by uncertainty, sacrifice, and fear. Across the community, mothers carried remarkably similar stories, of dangerous journeys, financial hardship, and the quiet indignity of having to choose between their safety and their family's survival.
But today, the story of Marimanau is one of transformation.
Today, the health centre stands as a vibrant hub of inclusive care for the entire community. From mothers like Isabel and supportive men prioritizing their families' health, to young girls and youth claiming their right to safe, dignified medical services close to home.
On 24 March 2026, Isabel welcomed her sixth child, Francisco, into the world. Unlike her previous pregnancies, this birth was not marked by fear, uncertainty, or an exhausting journey in search of care. Francisco was safely delivered at the newly inaugurated Marimanau Health Centre, located less than two kilometers from the family's home, on the very day the facility opened its doors. His arrival marked more than the birth of a healthy baby, it became a powerful symbol of change, reflecting a future in which women in Marimanau can give birth with dignity, close to home, and with the support of skilled health professionals.
For Isabel, those memories are deeply personal. Of her six children, her first was born far from any health facility, in the middle of nowhere, with no trained health worker to care for either mother or baby. She was still a young girl, thrust into motherhood before she had the chance to grow into adulthood herself.
In Mozambique, where child marriage and adolescent pregnancy continue to affect many girls, countless young mothers face childbirth before their bodies are fully developed, increasing the risk of complications for both themselves and their babies. Isabel remembers the fear, the uncertainty, and the overwhelming sense of vulnerability that accompanied that first birth, an experience that left scars time has never erased and one that too many girls across the country still endure today.
Just four months after opening its doors, the health centre has already become a place of hope for families across Marimanau. Its corridors are now filled with the reassuring sounds of new life as mothers like Isabel return with their babies for postnatal check-ups, growth monitoring, vaccinations, and advice from skilled health professionals. Where childbirth was once marked by fear and uncertainty, families now find safety, dignity, and care close to home.
Expected to serve more than 5,900 people – including over 3,100 women and girls – the health centre is transforming access to essential healthcare for some of the district's most remote communities. Beyond treating illness, it is helping ensure safer pregnancies, healthier newborns, and stronger families, laying the foundations for more resilient and sustainable development in Marimanau.
Cidália Isaque, a pharmacy technician at the center, has witnessed the change firsthand. “As soon as the hospital opened, we were treating approximately 50 patients a week, among young people, men, women and girls”, she says. This surge in patients is not just a statistic; it is a profound revelation of the silent struggle that once defined Marimanau.
"These numbers simply show how many health issues people here had but were unable to treat because of the distances they were forced to travel”, Cidália concludes.
Cidália Isaque, a pharmacy technician in Marimanau
The change is visible across the entire community. Community leader António Wilson has witnessed how access to healthcare has restored confidence and peace of mind for families, who no longer face the same uncertainty when illness strikes, or a woman goes into labour. “We did not expect this moment would ever reach us here”, he says. “Today, I have more confidence in the future, above all because my family and so many others in this community now have access to safe healthcare services closer to home”.
The birth of baby Francisco was a powerful symbol of the change that had arrived. In Marimanau, distance no longer dictates a person's life. For mothers, children, and the entire community, the future is now filled with hope.
António Wilson, Marimanau's community leader
Today, the health centre is more than a place where lives are saved, it is a source of pride for the community. Health professionals and residents work side by side to care for the facility, organising regular clean-up and maintenance activities to keep it welcoming and functional. Their shared commitment reflects a common understanding that this is not simply a building, but a lifeline that belongs to everyone and will continue serving future generations.
“Despite the progress made, important challenges remain”
Yet the journey is far from over. Every day, the health centre receives pregnant women who still arrive exhausted after travelling long distances, some already in labour. Without a maternity waiting home, many continue to face the agonizing choice between risking childbirth on the road or leaving their families behind days before their due date to wait near the facility. Equally urgent is decent accommodation for the healthcare professionals who have relocated from distant parts of the country to serve Marimanau. Ensuring they can live safely and remain in the community is essential to sustaining the quality of care. Access to safe drinking water through a water treatment system is another pressing need, protecting patients, newborns, and health workers alike from preventable waterborne diseases.
For generations, treatable illnesses too often became life-threatening conditions because accessing care was a challenge many families could not overcome. Today, the voices of mothers and the cries of newborns filling the health centre’s corridors tell a different story: one of progress, resilience, and renewed hope. The Marimanau Health Centre represents a turning point for a community that can now access essential healthcare closer to home, where women can receive support during pregnancy and childbirth, and families can seek treatment when they need it most.
Yet this transformation is only the beginning. As the community embraces this new chapter, continued investment in local health systems will be essential to ensure that the promise of accessible, quality care becomes a lasting reality for every family in Marimanau.
The Marimanau Health Centre is one of three (two in Niassa province) built under UNDP’s Decentralization Project
About the Programme
The Marimanau Health Centre is a Type II primary healthcare facility established through an investment of approximately MZN 14 million (around USD 220,000), funded by the European Union and co-financed by the United Nations Development Programme (UNDP). Implemented in partnership with the Government of Mozambique under the Decentralization for Development (D4D) project, the facility was designed to bring essential healthcare closer to communities that previously travelled between 20 and 30 kilometers to access basic health services.
The D4D project forms part of the broader Decentralization and Localization of the Sustainable Development Goals (SDGs) Programme (2021–2026), supported by the European Union, the Swiss Agency for Development and Cooperation, and the Andalusian Agency for International Development Cooperation. Through this programme, UNDP works with national and local institutions to strengthen decentralized governance, expand equitable access to quality public services, and foster inclusive local development. The Marimanau Health Centre is one of three health facilities constructed under the programme, demonstrating how strategic investments in local infrastructure can improve health outcomes, reduce inequalities, and advance progress towards the Sustainable Development Goals.
