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

It is only recently that paediatric treatment for children living with HIV/AIDS has
received increased attention in Mozambique. Paediatric treatment was described as
“not urgent” in the Ministry of Health’s original national strategic plan for HIV/AIDS
for 2004-2008. This perception of the lack of urgency for paediatric treatment is
not unique to Mozambique – globally, paediatric AIDS treatment has not received
high priority, perhaps due to the assumption that all infected children will die in
early childhood. Policy makers, programme managers and health care providers
therefore remain to be convinced that ARV treatment is important and effective in the
management of paediatric HIV/AIDS.
It is possible that the lack of a sense of urgency articulated in the strategic plan also
filtered down to some of the treatment sites, where health workers may feel that
paediatric treatment is very complicated and difficult to implement in the context of
ever increasing patient numbers and staff shortages, especially paediatricians. Low
numbers of children receiving paediatric ARV treatment may also be due to a lack of
follow up of exposed children, routine child health consultation failing to identify or
refer children living with HIV/AIDS, mothers failing to attend the Day Hospital, as well
as fear of stigma and lack of understanding that children can be infected with HIV.
In 2005, the situation changed dramatically, with the Government making the scale-up
of paediatric treatment one of its key priority actions in the fight against HIV/AIDS and
poverty. In PARPA II, a target of 30,000 children under treatment by the year 2009 per
was established. The number of paediatric treatment sites is planned to increase from
34 sites in 2005 to 150 in 2009, with a particular focus on the centre and northern
provinces of the country. This commitment, together with international progress in
the area of more affordable and appropriate formulations of paediatric ARVs, is critical
in highlighting the need for increased attention to the care and treatment of HIV
positive children, and in moving from rhetoric to action.
8. Water and sanitation
Access to clean, safe water and adequate sanitation are vital for the survival and
healthy development of children, reducing sickness and death due to diarrhoeal
diseases and other major causes of child mortality. Use of safe water and sanitation
lowers the risk of water-borne diseases among children weakened by malnutrition
and reduces the risk of opportunistic infections among the growing number of
children living with HIV/AIDS. These children are not only more susceptible to
diseases related to poor water, sanitation and hygiene, but once infected, are more
likely to die as a result. In addition, improved management of water resources
reduces the transmission of malaria. In Mozambique, the poor situation in the sector
is directly responsible for regular outbreaks of cholera. Lack of access to safe water
and sanitation also infringes upon other rights. Children, particularly girls, may drop
out of school to collect water and may have to travel long distances, which places
them at greater risk of abuse.
It is estimated that over 300,000 Mozambican children would need to gain access to
an improved water supply and improved sanitation every year if the MDG target of
reducing by half the number of people without sustainable access to safe drinking
water and adequate sanitation is to be met by 2015 41 (WHO/UNICEF 2005).
41 A WHO/UNICEF survey in 2005 found that 600,000 Mozambicans would need to gain access to improved water and sanitation if Mozambique
is to meet the MDG. The estimate of 300,000 children is based on an estimate that at least half the population are children.
112 CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS