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

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The coverage of antenatal care has improved significantly in recent years, with the proportion of women attended at least once by skilled health personnel during pregnancy increasing from 71 per cent in 1997 to 85 per cent in 2003. As a result of increased coverage of health services, most gains in antenatal care were recorded in rural areas, where antenatal care increased from 65 per cent in 1997 to 79 per cent in 2003. Antenatal care in urban areas remained almost universal, with a slight increase from 96 per cent in 1997 to 97 per cent in 2003. The vast majority of ante-natal care is provided by nurses and midwives, with doctors accounting for only 2 per cent of antenatal care provided (6.2 per cent in urban areas and 0.6 per cent in rural areas). With the exception of Zambezia province, where antenatal care was only 58 per cent, all provinces in which antenatal care was less than 80 per cent in 1997 succeeded in reaching rates over 80 per cent in 2003, with some remarkable results achieved in Sofala province, where antenatal care improved from 46 per cent to 82 per cent. Antenatal care varies according to the socio-economic status of women, from 67 per cent among the poorest women to 98 per cent among the best-off women. Figure 3.4: Women attended at least once by a skilled health personnel during pregnancy: comparison between 1997 and 2003 % 100 80 91 82 86 86 84 78 89 90 76 97 93 93 91 100 100 99 93 60 58 68 69 40 48 46 20 0 Zambezia Niassa Sofala Nampula Tete Cabo Delgado Manica Inhambane Gaza Maputo Maputo City 1997 2003 Source: DHS 2003 The number of antenatal consultations increased between 1997 and 2003, as shown by the decline in the proportion of women that were never attended during pregnancy (from 27 per cent to 15 per cent) and the increase in the proportion of women attended four times or more during pregnancy, from 37 per cent in 1997 to 53 per cent in 2003. However, only 18 per cent of women received their first consultation before the fourth month of their pregnancy. The majority of initial consultations occurred during the fourth or fifth months of pregnancy (44 per cent), while 22 per cent of first consultations occurred during the sixth or seventh month of pregnancy. CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 79
Figure 3.5: Percentage of women receiving antenatal care according to the number of consultation received during pregnancy: comparison between 1997 and 2003 60 % 53 40 37 20 27 23 28 15 0 Source: DHS 2003 4 3 None One Two/Three Four or more 1997 2003 The norms established in the national antenatal care programme recommend that all pregnant women receiving antenatal consultation should be weighed, have their height measured, have their blood pressure taken and be tested for syphilis, in addition to receiving information on the possible health problems during pregnancy, HIV/AIDS and the risk of HIV transmission to the child. However, there appears to be little compliance with these norms. While the majority of pregnant women receiving antenatal care were weighed during consultation, only 52 per cent were informed about the symptoms of pregnancy-related health complications, only 48 per cent had their height measured, only 36 per cent were asked to provide a urine sample, and only 50 per cent had their blood taken for testing. In addition, only approximately half of the women were counselled about HIV/AIDS. These findings indicate the overall poor quality of the primary health care services in Mozambique and show the urgent need for training of mid-level and basic staff, in order to maintain acceptable levels of maternal health services. Childbirth care shows little improvement. Childbirth care measures the proportion of births attended by skilled health personnel (doctors, nurses, and midwives). In 2003, the DHS indicated that only 48 per cent of births were attended by skilled health personnel compared to 44 per cent in 1997, with a substantial difference between rural and urban areas (34.2 and 80.7 percent respectively in 2003). This is an important factor impacting on the uptake of prevention of mother-to-child interventions (PMTCT) as there is therefore no system in place to ensure that those who do not have institutional deliveries comply with, and therefore benefit from this intervention. Also, the lack of supervision of labour and deliveries by skilled health personnel contributes to the high level of maternal mortality in Mozambique. 32 Disparities in childbirth care remain acute in terms of women’s socio-economic status, area of residence and geographical location. Approximately two-thirds of women in rural areas are giving birth without the assistance of skilled health personnel, compared with about one fifth of women in urban areas (34 per cent versus 81 per cent). In Cabo Delgado and Zambezia provinces, childbirth care is only 32 per cent compared to almost 90 per cent in Maputo City. 80 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
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 and 78: Zambezia and Tete provinces. Severe
Page 79: If this downward trend continues, M
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 and 130: 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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