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

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