Reduction of Child Mortality is one of the Millennium Development Goals, Reduction of Infant and Child Mortality is one of the International Conference on Population and Development Goals and one of the Poverty Reduction Strategy Goals. Adherence to the Apostle Church of John Marange (ACJM) has affected the preventive and curative health services utilization for children under the age of five. The objective of this study was to explore the ideas, beliefs and reasons influencing the under utilization of western health facilities for children under the age of five among the ACJM believers and to suggest directions for future actions in the Tete Provincial Directorate of Health (TPDH), as well as in the Ministry of Health. A qualitative study was conducted in Tete province, Mozambique because there was no information available regarding reasons for under utilization of western health facilities among the ACJM believers for their children under the age of five. This was an exploratory and descriptive study, consisting of 70 in-depth open-ended interviews (with 42 lay people, 18 health workers and 10 religious informants); 5 self- administered written questionnaires (with state and religious institutions and organizations), 3 semi-structured interviews (with religious coordinators), 2 group interviews, reviewing documents and unstructured observation.

Major findings:

1) The ACJM was originated in 1932, in the area of Marange, Zimbabwe by Muchabayiwa, who is called John Marange today. Afterwards it penetrated under the name Bapostolo (Apostles) into Congo Kasai, Kinshasa, Southern Angola, Malawi, Zambia and Mozambique; 2) the ACJM is not only against the utilization of modern western facilities but also against traditional and herbal medicines as preventive or curative measures, for all the age groups; 3) the ACJM believers are very much concerned with the child”s health; they perform religious rituals at the household and church levels as preventive and curative measures; 4) at the church, there is the Mulapi (a specialized religious healer), who also heals by performing religious rituals; 5) the main reasons for under or non utilization of health facilities by the ACJM believers seems to be the compliance with the commandments of the church associated with extremism. Are they other reasons? Socio-cultural factors need to be | taken into consideration when assessing statistics on health services coverage. It is concluded that this issue is not a constraint for the fulfillment of the goals of the health sector alone but also for the ones of the state, religious community and civil society.

Recommendations:

1) Health planners should develop an assessment tool for evaluation of the external factors influencing on the fulfillment of the health sector”s goals; 2) forums from the community to international levels involving politico- administrative, health and religious representatives should be created to address this issue; 3) the secretaries of the communities should do a systematic registration of births, deaths, religion, migration and other important data in their areas; 4) Research is needed to find out the proportion of the ACJM believers in the population and its impact on health interventions; S)more research on impact of health interventions, health seeking behavior and demand for health services is also needed.