Language; access to public services; Mozambique

The freedom to express thoughts, to live a life with rights and duties are important aspects that
motivate the development of public and social policies. It is the responsibility of governments to
develop innovative public and linguistic policies that meet the needs of the population. Souza
(2003).
Mozambique has made remarkable progress in expanding access to primary education. From
independence in 1975 the number of primary schools increased from around 5,000 to 13,800 in
2021, while enrolment increased seven-fold to 8.8 million students (Johnston 1984; MINEDH
2022). The civil war (1977–92) destroyed half of the country’s primary schools, but they have
since been rebuilt. Thousands of new schools and classrooms have been added to provide
education for all, especially as each cohort of primary school-aged children has been bigger than
the previous one. School fees have been abolished, free textbooks are provided, and teacher
training has been expanded countrywide. The steep upward trend in enrolment will continue over
the coming decades due to fast population growth, requiring a continued expansion of the
education system.
However, what has not improved with increased access to schooling, unfortunately, is
educational quality—quite the contrary. In a national test in 2016, for example, only 4.9 per cent
of thirdgraders achieved the reading and writing skills as required in the curriculum
(INDE/MINEDH 2017), a decline from an already very low achievement rate of 6.3 per cent in
2013 (INDE/MINEDH 2014). These national tests are in Portuguese only. According to the
Service Delivery Indicators (SDIs) in 2018, similarly, less than half of grade 4 students were able
to recognize simple words, while less than 20 per cent were able to read a paragraph in
Portuguese (Bassi et al. 2019).
Another piece of evidence of declining education quality comes from the Demographic and
Health Surveys which are comparable across time and countries, and which include a simple
literacy test for repeated cross-sections of women1 born between 1950 and 2000 (Le Nestour et
al. 2022). This long-term analysis of a total of 87 countries includes Mozambique. Practically all
Mozambican women born in 1955 and who had completed five years of schooling were literate.
More recently, only 42 per cent of women born in 1998, after having completed five years of
schooling, could pass the simple literacy test—that is, were able to read one sentence in the
language of their choice. The overall literacy rate has still increased in Mozambique over the past
decades thanks to massive schooling expansion.
However, at the same time, education quality offered in primary schools— defined as literacy,
conditional on completing five years of schooling—has declined markedly over the years.
A number of reasons have been suggested to explain the poor learning outcomes. These include
very high levels of student and teacher absenteeism, low teaching quality, inadequate training
opportunities for teachers, and the choice of Portuguese as the language of instruction.
Like most sub-Saharan African countries Mozambique uses its former colonial language,
Portuguese, in education, even if it is not spoken either at home or in the community by the
majority of the population. Primary school students must learn in Portuguese even if they are not
familiar with the language before entering school, especially in rural areas. As part of its
response to this situation, the government has been expanding bilingual education based on local
languages for the past two decades. In its approach the language of instruction is the child’s
mother tongue in the early grades of primary school. Portuguese is introduced gradually and
becomes the language of instruction in the higher grades of primary school and Secondary
schooling is in Portuguese-only. (Chimbutane 2011).

In line with previous legislation the Mozambican Constitution of 2004 designates Portuguese as
the national language. In addition it states that ‘the State shall esteem national languages as
cultural and educational heritage, and shall promote their development and increasing use as
languages that convey our identity’. Of a total Mozambican population of 29 million, as of the
2017 national population census, 16.6 per cent reported Portuguese as their first language (L1)
and an additional 41.4 per cent reported it as their second language (L2) (Chimbutane 2022; INE
2019).
According to linguistic scholars the number of local languages spoken in Mozambique ranges
from 20 to 43, depending on the definition used for language and language variety (Terra 2021).
Local languages are widely used in daily interactions across the country, especially in the rural
areas. Portuguese is used in government, the education system, and urban settings.
Unlike in the neighboring countries, local Bantu languages have not been accorded an official
status in Mozambique. Nonetheless they are making inroads in some formal settings, including
education.
A study that was carried out in six rural districts (Gilé, Ile, Namacurra, Inhassunge, Alto
Molócuè, and Lugela) in Zambézia Province, Mozambique (Figure 2).
 This study was evaluated and approved by the Mozambican National Bioethics Committee and
the Vanderbilt Institutional Review Board. The study was conducted in three focus groups in
each district to achieve saturation: one with women from the community, one with men from the
community, and one with health care workers (HCW) who treat people living with HIV.
Potential participants from the community were invited by a community leader to share their
experiences and perceptions related to HIV and ART medication adherence, regardless of the
given HIV serostatus of the participant.
The focus groups were conducted by trained moderators (all had previous experience conducting
multiple focus groups in Mozambique) who spoke Portuguese, Chuabo and Lowme. All
community focus groups were conducted in the preferred local language. Participants were
asked a variety of questions regarding perceptions of HIV illness as well as perceived barriers
to ART adherence. Sessions were audio taped and translated/transcribed into Portuguese and
English. Transcriptions were reviewed by three members of the team to ensure that the spirit of
the responses was preserved in the translation.

HCW also note the challenges of creating good relationships and communicating information
about HIV to their patients. Health care workers suggest language barriers and problems with
patients being overwhelmed with information. A HCW from Lugela noted, “Some people don’t
understand what we say, but always respond affirmatively by nodding their heads.” In large part,
language is the barrier to effective communication.
This was noted by many in the community, including a man from Namacurra who said, they
explain things in Portuguese in the hospital. The only things we know how to say are head and
belly [in Portuguese]. Sometimes when we have chest pain, we say we have belly pain because
we don’t know how to say “chest.” When we have ear pain, we say “head” because we don’t
know how to say “ear” and the nurse gives us a prescription that functions for my complaint.
The language barrier creates a challenge in ensuring that patients truly understand the importance
of ART adherence or how to take their medication properly.