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

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Table 3.2: Percentage of children with severe water and sanitation deprivations Percentage of children with Percentage of children with severe water deprivation severe sanitation deprivation Province Niassa 46 21 Cabo Delgado 52 39 Nampula 48 58 Zambezia 62 79 Tete 63 46 Manica 50 49 Sofala 46 71 Inhambane 55 35 Gaza 63 31 Maputo 24 8 Maputo City 3 0 Areas of Residence Urban 25 18 Rural 61 61 Sex Male 49 47 Female 49 47 Level of education of the household head No education 59 63 Primary education 48 45 Secondary and higher 21 10 Wealth index quintile Poorest 69 100 Second poorest 61 84 Middle 58 28 Second best-off 44 17 Best-off 11 4 Total 49 47 Source: INE/MPD/UNICEF 2005, additional analysis of the DHS 2003 3. Maternal survival, health and nutrition Given the absence of complete and accurate demographic data it is difficult to determine the maternal mortality ratio (MMR), i.e. the annual number of deaths among women from pregnancy-related causes per 100,000 live births. However, MMR appears to have decreased substantially in recent years, from an estimated 1,000 maternal deaths per 100,000 live births in the early 1990s to 408 per 100,000 live births in 2003. 29 The institutional maternal mortality ratio (IMMR) has also declined in recent years. 30 This reduction has been largely attributed to improved access to health services, particularly family planning and antenatal care, and improvements in the acquisition and distribution of equipment, communications material, and transport. 29 Using the sisterhood method, the 2003 DHS estimates that the MMR during the 10-year period prior to the survey was 408 maternal deaths per 100,000 live births. This method has wide margins of error, meaning that the MMR may fluctuate between 200 and 600 maternal deaths per 100,000 live births. 30 The IMMR declined from 230 per 100,000 live births in 1993 to 177 per 100,000 live births in 2003, although significant disparities between provinces exist, with the IMMR estimated at 291 per 100,000 live births in Cabo Delgado province compared to 26.5 per 100,000 live births Maputo province in 2003. CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 77
If this downward trend continues, Mozambique has the potential to reach the MDG goal of reducing the MMR to 250 per 1,000 live births in 2015 (MDG national Progress Report, 2005). As a first step towards meeting the MDG target, the Government indicated in PARPA II that it aims to achieve a reduction in MMR to 340 maternal deaths per 100,000 live births by the year 2009. The main immediate causes of maternal deaths include anaemia, haemorrhage, and rupture of the uterus, eclampsia and sepsis. Maternal deaths may also be due to complications from HIV/AIDS, malaria, and tuberculosis. Nutritional deficiencies, when concurrent with other medical conditions and anaemia, also contribute to maternal death. One of the most important factors affecting women’s health is good nutrition. The most critical factor affecting women’s nutrition is their workload. Women, especially rural women, consistently work long, hard hours. Their energy intake is not commensurate with their work output. In Mozambique, about 9 per cent of women suffer from malnutrition. 31 The prevalence of malnutrition is greater among women in rural areas than in urban areas and is twice as high among the poorest women (10 per cent) than amongst the most well off women (5 per cent) (2003 DHS). Anaemia and vitamin A deficiency are among the major nutritional problems affecting women, particularly those who are pregnant and lactating. Anaemia in association with iron deficiency in pregnant women is linked with increased maternal morbidity and mortality. Anaemia in pregnancy is also associated with low birth-weight babies (Kramer, 1987). The causes of anaemia in Mozambique are multiple and include diets low in iron, frequent bouts of malaria, intestinal worm infestation, in particular hookworm, genetic disorders, deficiencies of folic acid and Vitamin B 12, chronic infections such as TB, as well as HIV/AIDS. The 2002 National Survey on Vitamin A deficiency and Anaemia indicated that 70 per cent of pregnant women suffered from anaemia, against 48 per cent among non-pregnant women. It also indicated that iron deficiency was strongly associated with anaemia, with 81 per cent of iron deficient mothers being anaemic, against 44 per cent for those without iron deficiency. A positive correlation between vitamin A deficiency and anaemia was also established, with 67 per cent of vitamin A deficient mothers being anaemic, compared with 46 per cent for those without vitamin A deficiency. Despite the high level of anaemia among pregnant women, 39 per cent of pregnant women are not receiving iron and folic acid supplementation during pregnancy, with significant variation by area of residence (49 per cent in rural areas versus 19 per cent in urban areas) and provinces (up to 68 per cent in Zambezia province compared to 4 per cent in Maputo City) (DHS 2003). These findings illustrate low levels of compliance with existing national policy on supplementation of iron and folic acid among pregnant women. Antenatal care and childbirth care provide good indicators of maternal health care in Mozambique. Antenatal care indicates the proportion of women attended at least once during pregnancy by skilled health personnel (doctors, nurses, and midwives). Regular contact with skilled health personnel during pregnancy is critical as it allows women to identify and possibly correct potential health problems, in addition to receiving general health advice on tetanus immunisation, good nutrition, HIV/AIDS, malaria and hygiene. The Ministry of Health recommends that pregnant women should be checked five times during every pregnancy, with the first consultation during the third month of pregnancy. 31 When the ratio of the height and weight of a woman, used to derive the body mass index (BMI), is less than 18.5, then a woman is regarded as being malnourished. 78 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
Page 27 and 28: Box 1.1: Human rights conventions r
Page 29 and 30: of poverty, defined as: “Impossib
Page 31 and 32: Table 1.1: Deprivation-based indica
Page 33 and 34: The Ministries of Planning and Deve
Page 35 and 36: 34 CHILDHOOD POVERTY IN MOZAMBIQUE:
Page 37 and 38: 1. Introduction This chapter focuse
Page 39 and 40: Table 2.1: Progress towards the MDG
Page 41 and 42: 3. Economic growth and macroeconomi
Page 43 and 44: Evidence as to what extent these
Page 45 and 46: The percentage of the population li
Page 47 and 48: Arndt et al. (2005) show that, on a
Page 49 and 50: B. Assessing childhood poverty In a
Page 51 and 52: Figure 2.9: Households living below
Page 53 and 54: severe deprivation. In the poorest
Page 55 and 56: The second PARPA for the period 200
Page 57 and 58: Box 2.3: Civil society engagement i
Page 59 and 60: A key cause of these weaknesses is
Page 61 and 62: One possible way forward in tacklin
Page 63 and 64: Box 2.4: Corruption and its impact
Page 65 and 66: (vi) Analysis of monitoring and rev
Page 67 and 68: 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: Zambezia and Tete provinces. Severe
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
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The agenda for expanding water supp
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and was revised in 2005. The on-bud
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supported by key sector stakeholder
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1. Introduction Education is a fund
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B. Severe information deprivation a
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Secondary education consists of fiv
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Table 4.3: Gross and net enrolment
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Table 4.4: Gross enrolment ratio, a
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57 per cent, compared with a NER of
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DHS data show that the wealth level
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Figure 4.11: Distribution of 11-yea
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Lack of literacy is directly correl
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In addition, there is a serious gap
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The IAF showed that in 2002/3 expen
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Absenteeism is also common among te
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to the need for two or even three s
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The system is faced with a number o
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• The school represents or is a l
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(iv) Impact of natural disasters In
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The associated large off-budget res
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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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