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

Among children, there were no variations in the coverage according to gender but
important variations according to area of residence. In urban areas, 65 per cent of
children aged 6-59 months had received vitamin A supplementation, compared with
only 43 per cent among children in rural areas. Provincial disparities were also acute,
with 77 per cent coverage in Maputo City compared to only 37 per cent in Niassa
province.
In Mozambique, the significant variations observed by the 2003 DHS between the
coverage of Vitamin A supplementation correlate with household wealth levels and
with mothers’ level of education. Only 39 per cent of children from the poorest
households received vitamin A supplementation compared to 70 per cent among
children from the best-off households. The immediate cause of this disparity is
the lower access among poorer children to health facilities. It is very likely that
the national immunisation campaign against measles conducted between August
and October 2005 in all provinces of the country, which also included vitamin A
supplementation for 6-59 month-old children, substantially reduced the disparities
recorded in the 2003 DHS. The October 2005 nutritional survey conducted by
the Ministry of Health as part of the Vulnerability Assessment in drought affected
districts indicated almost universal coverage with 96 per cent of children reporting
having received vitamin A supplementation in the six months prior to the survey. All
provinces indicated coverage above 90 per cent (the lowest being Niassa with 92
per cent coverage and the highest being Cabo Delgado with 98 per cent coverage)
(MISAU/SETSAN 2005).
The campaign-based approach such as the 2005 nationwide immunisation campaign
is therefore a powerful vehicle to addressing issues of disparity and inequity, in
addition to ensuring very high coverage. The main limitation, however, is that children
need two doses of vitamin A each year. A campaign-based approach is difficult and
costly to sustain. In addition, because the causes of vitamin A deficiency are diverse,
interventions should also be targeted through channels other than routine services
and campaign activities. For example, immediate reasons for a child to be deficient in
vitamin A are low vitamin A levels in the mother’s breast milk and low consumption of
vitamin A rich foods. Food-based approaches such as food fortification with vitamin A,
cultivation and consumption of vitamin A-rich foods such as orange sweet potatoes,
and nutrition education are the preferred long-term strategies to improve the vitamin
A status of children and women.
(iii) Anaemia and iron deficiency
Iron deficiency is the major cause of anaemia (causing 50 per cent of anaemia
worldwide), and remains one of the most severe and important nutritional deficiencies
in Mozambique today, thus constituting a serious public health problem. The World
Health Organisation lists iron deficiency as one of the top risk factors for “lost years
of healthy life” in developing countries. Severe iron deficiency causes iron deficiency
anaemia, which impairs the cognitive development of children from infancy through
to adolescence. Anaemic infants and children grow more slowly than those who are
not anaemic and are apathetic, anorexic and without energy. Anaemia has multiple
causes, including, in order of importance, iron deficiency caused by poor dietary intake
and quality, diarrhoea, malaria, helminth (worm) infections, chronic diseases such as
TB, and HIV/AIDS.
102 CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS