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

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Figure 3.28: Mortality level among children by type of mortality and level of education of the mothers 250 deaths per 1,000 live births 200 150 100 50 0 200 163 142 110 87 65 53 44 30 Neonatal mortality Infant mortality Under-five mortality No education Primary education Secondary education Source: DHS 2003 C. Family care practices Care practices, including child feeding practices, hygiene and sanitation, and management of childhood illnesses, play an important part in the survival and healthy development of children. Care practices not only have a direct impact on the health of children, but also shape the behaviour and treatment of their own children later in life. Due to low levels of education, limited access to information about the prevention and treatment of illnesses and the unhealthy environment of many households, the practices of care-givers are often inappropriate or even detrimental to children’s health. For example, only 30 per cent of Mozambican infants aged under 6 months are exclusively breastfed for 6 months. D. Weak human resource capacity in the health and water sectors, particularly at sub-national levels The health sector is faced with an acute shortage of human resources, particularly at the sub-national levels, a situation that is further exacerbated by the AIDS pandemic. In 2005, there were on average 1,638 inhabitants to every qualified health professional in the country. There is currently one doctor per 44,000 inhabitants, compared to the average for sub-Saharan Africa of one doctor per 22,000 inhabitants. Geographic inequalities exist in the distribution of healthcare professionals, with disparities between provinces in the north and south of the country and urban and rural areas. For example, the ratio of qualified health professionals per inhabitant in 2005 was three times lower in Zambezia province (1 per 2,685 inhabitants) than in Maputo City (1 per 737 inhabitants) (MISAU 2006). Maputo City is well served in terms of qualified health workers (1 doctor per 3,500 inhabitants), while Zambezia province is severely disadvantaged (1 doctor per 74,400 inhabitants) (MISAU 2005b). The scarcity of skilled health workers has been attributed to insufficient funding for training, low production of health workers, the ongoing brain drain to the private sector and loss through HIV/AIDS. As a result, the rate of production of new staff does not keep pace with the rapid expansion of the network of facilities. A recent study to evaluate the approaches to supporting health sector development at the CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 119
provincial level reported that only 20-35 medical doctors graduate each year, and only 5-6 specialists are trained annually, with the gaps being filled by expatriate doctors, who account for more than a third of the physician positions in the country (Costa et al 2006). In addition, the study found that the distribution of health workers is uneven due to a lack of sufficient incentives for them to locate to rural areas, particularly at district level. The deployment of staff to rural areas is particularly problematic in the field of maternal and child care. The provinces most adversely affected were Sofala, Zambézia, Nampula, Manica and Inhambane (Costa et al 2006). There are significantly more unqualified than qualified health workers in the health sector. In 2004, for example, of 20,105 public servants employed in the sector, less than 3 per cent were medical doctors, 15 per cent were mid-level health professionals (tecnicos medios de saude), 29 per cent were health assistants (“assistentes tecnicos de saude”), 11 per cent were health auxiliaries (“auxiliaries tecnicos de saude”) and 42 per cent were general service staff (carreiras de regime geral) (MISAU 2005b). Estimates on the number of workers in the water and sanitation sector infected by HIV/AIDS indicate that in 2002, 983 out of 6,618 workers in the sector were living with HIV/AIDS - with 472 workers in the Southern region, 388 in the Central region and 124 in the North (CBE 2005). The rate was higher among women than among men. Such a high prevalence rate has a huge impact on the human resource capacity of the sector and highlights the need to strengthen human resource capacity and skills within the sector, particularly at the sub-national levels, and to establish programmes that strengthen staff knowledge of HIV prevention and promote behaviour change. E. Poor quality infrastructure The poor quality of infrastructure is a challenge impeding child survival and development in both the health and water sectors. Many existing health facilities are without electricity, adequate water supplies or basic equipment. In the water sector, although poor coverage remains the main problem, another major barrier to access and use of safe water is the frequency with which existing water points break down. The National Water Directorate estimates that approximately 30 per cent of the water supply facilities that have been constructed in recent years are non-operational. This breakdown of water points can be attributed to various factors, including the lack of means to undertake adequate preventive maintenance (such as accessible spare parts); the poor quality of services delivered; inadequate community empowerment to take action; and insufficient time spent in creating demand for services (through strengthening community/family knowledge and skills in regard to safe hygiene practices and their impact on health). F. Natural disasters Mozambique is a country prone to natural disasters, including cyclones, floods and repeated drought, which can have dramatic consequences on the lives of the affected population. In rapid onset emergencies, such as flooding or cyclones, health infrastructure is damaged and roads or paths made inaccessible, reducing people’s already limited access to health services. In extreme cases (such as the severe flooding of 2000 and 2001), displaced populations move to temporary accommodation centres, where health facilities vary in quality and coverage, depending on accommodation centre management, the scale of displacement and accessibility to supplies and equipment. The public health risks of epidemic outbreaks are significant for people living in accommodation centres. However, it should be noted that, in some instances, temporary accommodation centres allow wider coverage of some 120 CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS
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CHILDHOOD POVERTY IN MOZAMBIQUE A S
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ACKNOWLEDGEMENTS This report on the
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CONTENTS ACKNOWLEDGEMENTS………
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4. Access to schooling and attendan
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TABLES AND FIGURES List of tables T
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Figure 4.20: Estimated spending on
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GBS GDP GER GNI GoM HAART HDI HIPC
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MAP OF MOZAMBIQUE Zumbu Magoe M
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een strongly positive in recent yea
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Child protection concerns Chapter F
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vaccination or malaria campaigns, w
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1. Objective of the Situation Analy
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Box 1.1: Human rights conventions r
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of poverty, defined as: “Impossib
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Table 1.1: Deprivation-based indica
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The Ministries of Planning and Deve
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34 CHILDHOOD POVERTY IN MOZAMBIQUE:
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1. Introduction This chapter focuse
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Table 2.1: Progress towards the MDG
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3. Economic growth and macroeconomi
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Evidence as to what extent these
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The percentage of the population li
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Arndt et al. (2005) show that, on a
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B. Assessing childhood poverty In a
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Figure 2.9: Households living below
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severe deprivation. In the poorest
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The second PARPA for the period 200
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Box 2.3: Civil society engagement i
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A key cause of these weaknesses is
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One possible way forward in tacklin
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Box 2.4: Corruption and its impact
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(vi) Analysis of monitoring and rev
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There are two principal drivers beh
Page 69 and 70: This has troubling implications for
Page 71 and 72: 70 CHILDHOOD POVERTY IN MOZAMBIQUE:
Page 73 and 74: 1. Introduction Every child has the
Page 75 and 76: B. Severe nutrition deprivation amo
Page 77 and 78: Zambezia and Tete provinces. Severe
Page 79 and 80: If this downward trend continues, M
Page 81 and 82: Figure 3.5: Percentage of women rec
Page 83 and 84: Mozambique has achieved a continual
Page 85 and 86: The second reason is that deaths oc
Page 87 and 88: 5. Childhood illnesses A major publ
Page 89 and 90: Figure 3.9: Malaria prevention: use
Page 91 and 92: The 2005 Nutrition Survey conducted
Page 93 and 94: Box 3.3: Combating measles and poli
Page 95 and 96: (ii) Stunting prevalence (chronic m
Page 97 and 98: Alarmingly high levels of stunting
Page 99 and 100: Figure 3.16: Underweight prevalence
Page 101 and 102: There are 86 known salt producers r
Page 103 and 104: Among children, there were no varia
Page 105 and 106: Box 3.5: Infant feeding in the cont
Page 107 and 108: highly in PARPA II, which sets a ta
Page 109 and 110: Table 3.3: Overview of PMTCT progra
Page 111 and 112: The reduction of mother-to-child tr
Page 113 and 114: It is only recently that paediatric
Page 115 and 116: 100 Figure 3.22: Use of safe water
Page 117 and 118: A. Inequitable access to and fundin
Page 119: The 2004/2005 IFTRAB survey also su
Page 123 and 124: Table 3.4: Ministry of Health budge
Page 125 and 126: Figure 3.29: Total sector resources
Page 127 and 128: Figure 3.31: Indicative per capita
Page 129 and 130: The agenda for expanding water supp
Page 131 and 132: and was revised in 2005. The on-bud
Page 133 and 134: supported by key sector stakeholder
Page 135 and 136: 1. Introduction Education is a fund
Page 137 and 138: B. Severe information deprivation a
Page 139 and 140: Secondary education consists of fiv
Page 141 and 142: Table 4.3: Gross and net enrolment
Page 143 and 144: Table 4.4: Gross enrolment ratio, a
Page 145 and 146: 57 per cent, compared with a NER of
Page 147 and 148: DHS data show that the wealth level
Page 149 and 150: Figure 4.11: Distribution of 11-yea
Page 151 and 152: Lack of literacy is directly correl
Page 153 and 154: In addition, there is a serious gap
Page 155 and 156: The IAF showed that in 2002/3 expen
Page 157 and 158: Absenteeism is also common among te
Page 159 and 160: to the need for two or even three s
Page 161 and 162: The system is faced with a number o
Page 163 and 164: • The school represents or is a l
Page 165 and 166: (iv) Impact of natural disasters In
Page 167 and 168: The associated large off-budget res
Page 169 and 170: The Ministry of Education and Cultu
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sense of providing education for ev
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172 CHILDHOOD POVERTY IN MOZAMBIQUE
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I. Introduction All children have t
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involving children. 45 per cent of
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Box 5.1: Street children in Maputo:
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Girls at greatest risk of abuse wer
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The aspirations expressed by the yo
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Against this background, Caia and C
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“Trafficking in women and childre
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Mozambique, girls aged 15-19 in the
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The survey indicates that 32 per ce
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Figure 5.5: School attendance among
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• Labour law does not define the
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- To use child labour (children age
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from their parents. Thus, the law d
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C. Birth registration - guaranteein
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such as hospitals and schools for b
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Sofala province also accounts for t
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Evidence points to worrying increas
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Figure 5.9: Primary school attendan
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activities to strengthen the capaci
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The responsibility for implementing
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214 CHILDHOOD POVERTY IN MOZAMBIQUE
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Conclusions Mozambique is one of Af
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planning in Mozambique, and has the
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7- Implementing social communicatio
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Form of Severe Deprivation Food Wat
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ANNEX II Calendar of the planning,
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ANNEX IV State Budget recurrent and
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REFERENCES AND MATERIALS CONSULTED
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Deaton, A., Ruiz-Castilo, J., and T
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Klasen, S. and Woltermann, S., ‘T
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Government of Mozambique, ‘Progra
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World Bank (WB), ‘World Developme
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World Bank (WB), ‘Mozambique Publ
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Ministry of Women and Co-ordination
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United Nations Children’s Fund (U
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Child Poverty in Mozambique. A Situation and Trend ... - Unicef

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