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

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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$344 million – a rise from 4.3 to 5.2 per cent of GDP (see Table 3.4). There have thus been consistent annual increases in the total Ministry of Health budget, which has grown by, on average, 21 per cent per year over the period in nominal terms (compared to an average annual rate of inflation of 12.3 per cent). This has been comprised of strong average increases in both the recurrent and investment components of the State Budget (averaging 22 per cent and 37 per cent per annum respectively), although the investment budget has fluctuated a great deal more than the recurrent budget, as one would expect. CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 121
Table 3.4: Ministry of Health budget allocations, 2001 – 2005 2001 2002 2003 2004 2005 Total Ministry of Health Budget (US$ million) 165 178 209 253 344 Growth Rate (% change on previous year) n/a 7.6 17.8 20.9 36.0 Inflation (%, annual average) 9.1 16.8 13.5 12.6 6.4 Expressed as a % of GDP Total Ministry of Health Budget 4.5 4.3 4.4 4.3 5.2 Ministry of Health funding in the State Budget* 1.9 1.9 1.8 1.6 2.6 Expressed as a % of total State Budget Total Ministry of Health Budget 23.6 14.7 17.8 19.2 21.3 Ministry of Health funding in the State Budget 10.0 6.3 7.5 7.3 10.6 Expressed as a % of total Health budget State Budget 42.4 43.2 42.3 37.9 49.5 Recurrent Expenditure 37.7 39.1 38.1 34.5 32.0 Common Funds 10.0 11.5 17.7 25.0 44.2 Note: *State Budget funding comprises recurrent and investment expenditures captured in the OE. Sources: Adapted from Ministry of Health (2005, p. 53), Ministry of Health (2006) & MPD/MF data (inflation & GDP). As discussed in Chapter II, not all donor financing and internal revenues in the sector are captured in the State Budget – there are many “off-budget” funds. Cabral et al. (2005) have estimated that in 2003, 29 per cent of total sector funding was not recorded in the State Budget, 60 per cent was not registered in the Treasury and 44 per cent was not accounted for in the public accounts. This hampers sectoral planning and has prompted efforts by the sector and the Ministry of Planning and Development / the Ministry of Finance to improve the coverage of external assistance in Government Public Finance Management systems. This initiative may explain part – though by no means all – of the recent recorded rise in external assistance to the sector. Another contributing factor has been the channelling of increasing proportions of vertical funds through Common Funds rather than projects, making these funds easier to capture too. As a result of the measurement issues surrounding off-budget and vertical funds, measuring the balance between external assistance and government revenue in financing the sector’s budget is not straightforward (see Box 3.9). However, it is undoubtedly the case that the share of external financing in the health sector budget is increasing: growth in internal financing over the period 2002 – 2005 averaged 15 per cent per annum, while external financing increased by 25 per cent on average, with particularly marked increases in levels of budgeted external assistance channelled through the three sector Common Funds (total Common Fund budgets rose from US$17 million to US$152 million). 43 As a result the proportion of external financing in the total sector budget has increased from around 55 per cent to 63 per cent (see Figure 3.29). 122 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
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This has troubling implications for
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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 and 120: The 2004/2005 IFTRAB survey also su
Page 121: provincial level reported that only
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
Page 171 and 172: 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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