Introduction Mozambique is home to 18 million children and adolescents largely underrepresented in mental health research. We conducted a systematic review of evidence-based resources addressing this population.

Methods We included prevalence estimates, assessment instruments, and interventions on mental health-related outcomes in Mozambican samples aged 0-19. We searched PubMed, Web of Science, PsycINFO, CINAHL, Google Scholar, African Index Medicus, and local catalogues. Extraction followed COSMIN and Cochrane manuals (PROSPERO: CRD420251016208).

Results The search yielded 58 prevalence studies, 26 reports on 35 instruments, and 7 trials. Most research focused on psychosocial adversities and neurodevelopment in vulnerable populations. The prevalence of mental disorders were estimated in two surveys in Nampula (ADHD: 13.4%; N=748, 6-18 years) and Maputo (anxiety disorders: 17.5%; major depression episode: 8.5%; disruptive behavior disorder: 6.6%; ADHD: 3.3%; N=486, 12-19 years). Nationally-representative adolescent surveys report health determinants (physical/emotional violence anually: 24.86%; girls suffering intimate partner violence: 21.11%; lifetime sexual abuse: 16.55%). National suicide rates were highest among 15-19-year-olds (1.53 per 100,000). Only three instruments were culturally-adapted with reliable psychometrics, enabling screening of anxiety and general symptoms. Unadapted tools performed poorly. One randomized trial reported a cost-effective intervention for neurodevelopment among high-poverty preschoolers.

Discussion Children and adolescents in Mozambique face significant psychosocial adversity, with a high estimated burden of mental disorders. Prevalence data remains limited to two localized samples. There are few tools evaluating mental conditions, and culturally-sensitive approaches are warranted. It is essential to strengthen local academic capacity.

Luis Augusto Rohde has received grant or research support from, served as a consultant to, and served on the speakers' bureau of Abdi Ibrahim, Abbott, Aché, Adium, Apsen, Bial, Cellera, EMS, Hypera Pharma, Knight Therapeutics, Libbs, Medice, Novartis/Sandoz, Pfizer/Upjohn/Viatris, Shire/Takeda, and Torrent in the last three years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr Rohde have received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Novartis/Sandoz and Shire/Takeda. Dr Rohde has received authorship royalties from Oxford Press and ArtMed. All other authors declare no competing interest.

This work is conducted by the Stavros Niarchos Foundation (SNF) Global Center at the Child Mind Institute with funding support from the Stavros Niarchos Foundation (SNF) as part of its Global Health Initiative (GHI). The funder had no role in the methodology, execution, analyses, or interpretation of the data.

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