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

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ideal solution involves the international cooperating partners dropping their exemption requirement – as the World Bank now does in all new agreements. This however remains a distant prospect for many donors as it would involve changes to their domestic legislation, and there would in any case be a lag during which the terms of existing agreements continued to affect the sector. This issue also highlights the importance of institutional capacity in the sector, which is arguably the key constraint to faster expansion. There is a need for a comprehensive institutional strengthening programme, focusing in particular on planning, budgeting and financial management capacity within Government in the sector. As with health and education, the water sector is increasingly in need of improvements in the quality of services delivered and these improvements require a concerted and coherent capacity building effort, particularly at decentralised levels. Developing improved monitoring and evaluation capacity is also a high priority for the sector in order to help feed implementation experience back into programme design and budget preparation, thereby ensuring that the potentially large new inflows of financing achieve their desired objectives. 11. The national policy framework Mozambique has been described as “policy rich but implementation poor”. In the case of child survival and development, a multitude of plans exist, often with different time-frames and targets. While effort has been made during the development of PARPA II to ensure consistency with existing national and sectoral planning documents, such the Government Five-Year Plan (2005-2009), the National Plan to Fight HIV/AIDS (PEN II 2005 to 2009), the Ministry of Health Plan to Fight STI/HIV/ AIDS (2004 to 2008) and the Ministry of Health Sector Strategic Plan (2001-2005- 2010), many discrepancies remain. Links between the plans and the subordination of one to another are unclear. There is no integrated plan that deals comprehensively with the issue of child survival or development, looking at linkages, for example, between health, nutrition, water and education. However PARPA II does recognise the importance of these linkages and includes strategies for closer collaboration between these various sectors. The 2005 report of the Special Rapporteur on the Right to Health, Mr. Paul Hunt, highlighted the discrepancy between the many commendable policy initiatives in Mozambique and capacity to implement these policies, noting that ‘without more health resources - and more health professionals enjoying improved terms and conditions of work - it will be impossible for Mozambique either to achieve all the health-related Millennium Development Goals or to make satisfactory progress towards the realisation of the right to health’(Paul Hunt 2005). A. Health In 2001, the Ministry of Health developed a national strategic plan for the health sector (PESS) for 2001-2005-2010. The PESS, which is the overall strategic framework for co-ordination of national and international inputs in the national health system, emphasises the Ministry of Health’s commitment to a nationally led, sector wide approach (SWAp). A Code of Conduct, defining the vision and rationale for the SWAp and the commitments of all stakeholders, was signed in 2000 and revised in 2003. A Memorandum of Understanding for the on-treasury sector wide pool for Support to the Health Sector between the Ministry of Health, the Ministry of Planning and Finance and the common fund contributors (“Prosaude”), was signed in 2003 49 49 The Ministry of Planning and Finance has since been divided into the new Ministry of Planning and Development and the Ministry of Finance. CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 129
and was revised in 2005. The on-budget and on-treasury Common Fund complements the existing off-treasury Provincial Common Fund and the Pharmaceutical Common Fund. The PESS sets out the common direction for the sector and aims at the consolidation of the existing network of health services, with a focus on poverty alleviation and prioritising disadvantaged population groups. The PESS was subject to a thorough mid-term review process in 2005, which found that while the document retained its validity in providing a common direction for the health sector, it was rather ambitious and lacked clear prioritisation for linking to the resources available to the sector. As a result, it was proposed that certain areas outlined in the plan were reviewed in light of the changed context, as they were no longer considered relevant or cost effective (Martinez et al. 2006). The PESS has been complemented by a sector-wide Medium Term Expenditure and Financing Framework (MTEF), which has been produced twice, first for 2001-2005 and then for 2004-2008, as well as by a Health Sector Investment Plan for 2004 to 2008. Since 2000, monthly joint “operational” meetings (Health-SWAps), are held and chaired by the Ministry of Health. Biannual high level policy meetings (CCSs), have been taking place since 2001, and the first Annual Joint Evaluation was held in 2002. Also, since 2002, the Ministry of Health has prepared Annual Operational Plans (POA), in an attempt to plan activities and resources in a more integrated manner, thereby overcoming the compartmentalisation of the vertical programmes managed by the Ministry’s national directorates, and facilitating a more transparent and accountable means of implementation. The POA also serves as a trigger for the disbursement of common funds. In 2005 and 2006, the Ministry engaged in the development of a National Health Policy, aiming to provide a strategic framework and vision in the health sector. An important feature of this health policy is the setting of time-bound targets for child survival and development in line with the MDGs. The draft of this policy was instrumental in ensuring that PARPA II also includes specific targets, such as reducing the under-five mortality rate to 140 per 1,000 and the underweight prevalence to 17 per cent by the year 2009 (see Chapter II). The linkages between the PESS and the health policy, however, remain unclear. In addition to the broader health sector policies, there are a number of sub-sectoral strategic plans, such as the National Strategic Plan for STIs and HIV/AIDS (PEN- ITS/HIV/SIDA, 2004-2008), which set specific targets for accelerating the health response to the AIDS pandemic, including treatment, PMTCT, and voluntary testing and counselling, and the Human Resource Development Plan (2006-2010), which has also recently included an accelerated training plan, primarily prompted by the needs imposed on the sector by the increasing HIV/AIDS health care demands. A nutritional plan has also been developed and the Ministry of Health is currently in the process of trying to operationalise this. The national strategy for HIV/AIDS is outlined in the second national Strategic Plan to Combat HIV/AIDS (PEN II) covering the period 2005 to 2009. The PEN II is a multisectoral plan articulated around seven areas 50 , and provides the guiding framework for all sectoral strategies on HIV/AIDS, including the Ministry of Health’s PEN-ITS/ HIV/AIDS, in keeping with the concept of the ‘Three Ones’ as espoused by UNAIDS. In the areas of treatment, PMTCT and VCT, it builds on the targets established in the PEN-ITS/HIV/SIDA. The review of these targets by the Ministry of Health at the time 50 The seven areas of the PEN II are: Prevention, Advocacy, Stigma and Discrimination, Treatment, Mitigation, Research and Co-ordination. The National Aids Council (CNCS) has the overall mandate of coordinating the implementation of the PEN II. 130 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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70 CHILDHOOD POVERTY IN MOZAMBIQUE:
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1. Introduction Every child has the
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B. Severe nutrition deprivation amo
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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 and 122: provincial level reported that only
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: The agenda for expanding water supp
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
Page 173 and 174: 172 CHILDHOOD POVERTY IN MOZAMBIQUE
Page 175 and 176: I. Introduction All children have t
Page 177 and 178: involving children. 45 per cent of
Page 179 and 180: 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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