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

health services, such as vaccination. In drought affected districts groundwater
sources are depleted, resulting in the drying up of a significant number of shallow
wells. The increased water demand then places enormous pressure on the fewer
functioning deep wells, which often results in their failure. The climatically vulnerable
situation of the country also impacts on the implementation of planned activities
within the water sector, as it diverts resources (particularly human resources at the
sub-national level) and priorities to respond to emergency needs, thus delaying the
implementation of regular planned activities.
G. Involving service users
Relatively low levels of satisfaction among health service users have been registered
in several surveys. The 2002/2003 IAF survey indicated, for example, that 38 per
cent of the population was not satisfied with the health services provided, the first
reason being the long waiting time, the second being the lack of treatment and the
third being unsuccessful treatment. The 2004/2005 IFTRAB survey confirmed these
findings, although the level of dissatisfaction slightly decreased to 31 per cent. The
long time waiting was the first reason of dissatisfaction, followed by unsuccessful
treatment and the lack of treatment. While the level of dissatisfaction did not vary
much between urban and rural areas (28 per cent and 33 per cent respectively),
variation by provinces were significant, reaching 46 per cent in Zambezia province
and 44 per cent in Nampula province. The main reason for dissatisfaction in Zambezia
province was unsuccessful treatment (34 per cent).
The water sector has embarked upon a process of decentralisation, which aims to
transfer decision-making processes to the lower (sub-national and community) levels,
in order to ensure increased accountability and enhanced ownership of water and
sanitation facilities by the users. This process has not been complemented with
the necessary strengthening of capacity, particularly at the sub-national level (district
and provincial levels), which is negatively affecting the sector’s ability for planning,
management and absorption of allocated funds.
10. Financing health and water
Developing an accurate picture of financing for the health and water sectors is
difficult as data are often inconsistent and incomplete. This situation is the result of
incomplete – though dramatically improving – coverage of external funding flows and
internal revenues, and differences in planning, budgeting and reporting cycles and
systems within the sector and between the sector and the central agencies. The
problem is more acute in the water sector.
A. Health sector
While treating the data with caution, the global picture indicates that between 2002
and 2005 total budgeted resources for the Ministry of Health increased by a dramatic
108 per cent, from around US$165 million to an estimated US$344 million – a rise
from 4.3 to 5.2 per cent of GDP (see Table 3.4). There have thus been consistent
annual increases in the total Ministry of Health budget, which has grown by, on
average, 21 per cent per year over the period in nominal terms (compared to an
average annual rate of inflation of 12.3 per cent). This has been comprised of strong
average increases in both the recurrent and investment components of the State
Budget (averaging 22 per cent and 37 per cent per annum respectively), although the
investment budget has fluctuated a great deal more than the recurrent budget, as one
would expect.
CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS
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