Child Poverty in Mozambique. A Situation and Trend ... - Unicef

B. Micronutrient deficiencies
The other major manifestation of malnutrition in Mozambique is micronutrient
deficiency. The lack of two minerals (iodine and iron) and one vitamin (vitamin A) plays
a particularly important role in these deficiencies.
(i) Iodine deficiency
Iodine deficiency remains the single greatest cause of preventable brain damage
and mental retardation worldwide. Iodine Deficiency Disorders (IDDs) can lead to
increased rates of stillbirths, congenital abnormalities, cretinism, psychomotor defects
and neonatal mortality. In children and adolescents the effects are manifested as
goitre, hypothyroidism, impaired mental function, and retarded mental and physical
development. In addition, iodine deficiency can lead to a diminished capacity to learn.
Milder IDD in a community means that many children without outward signs of
disabilities will suffer learning problems and do poorly in school.
All studies conducted in Mozambique indicate that IDD is a serious public health
problem. The October 2004 national survey of iodine deficiency among primary
school children indicated that the overall prevalence of goitre among children was 15
per cent. Niassa showed the highest rates (36 per cent), followed by Zambézia and
Nampula (both 24 per cent), and then Tete (11 per cent). Even the city of Maputo
indicated a prevalence of 10 per cent of goitre. While there were no significant
differences among boys or girls and areas of residence, the difference between
populations living at an altitude of 2000 feet (610 m) or above, in relation to those
living at a lower altitude, was highly significant (23 per cent versus 13 per cent,
respectively). Soil at high altitude is known to be poor in iodine, which in turn leads to
a child’s diet being poor in this micronutrient, unless he or she is eating salt enriched
with iodine (MISAU 2006).
Measuring urinary iodine provides more reliable information than measuring the
prevalence of goitre when estimating the extent of iodine deficiency. The estimated
national median of urinary iodine is 60μg/L, which classifies Mozambique overall
as mildly deficient in iodine (2004 national study). Among primary school children,
the survey indicated that 42 per cent had levels of urinary iodine below 50μg/L
(moderately deficiency), while 12 per cent has less than 20μg/L (severe deficiency).
Three provinces had average results below 50μg/L: Niassa (37μg/L), Zambézia (47μg/
L) and Nampula (47μg/L). Here again, the differences between boys and girls and
between age groups are small. However, rural areas show much lower levels of
urinary iodine (54μg/L) than the urban areas (90μg/L).
Given that the vast majority of Mozambican households have and use salt (over 90 per
cent according to the 2003 DHS), the most cost-effective and efficient way to prevent
IDDs among the child population is to ensure that the salt children eat contains iodine.
In January 2000, the Government passed a ministerial diploma (Diploma Ministerial
n.o. 7/2000) making it obligatory for all salt produced, commercialised and imported in
Mozambique for human consumption to be iodised with an iodine level of 25 and 55
parts per million (ppm). Furthermore, in order to encourage the production of iodised
salt in the country, a decree was adopted by the Government in December 2001
(decree 41/2001) to exempt all iodised salt producers from purchase tax. 37
Due to its geographical location with long coastal areas, Mozambique has a salt
production capacity estimated at 195,250 tons per year, which is sufficient to meet
the internal need and produce salt for exportation.
37 It should be noted that, beside the promotion of iodisation of salt, the Ministry of Health is planning the distribution of iodised oil capsules to
children and pregnant women in high IDD prevalence provinces in order to reduce the high level of iodine deficiency.
CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS
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