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

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6. Malnutrition Malnutrition is the main underlying cause contributing to the high level of child mortality in Mozambique. It is also closely linked to future educational outcomes, as malnutrition seriously impacts on the immediate and future cognitive development of the child. 1997 to 2003 represents a period during which Mozambique experienced rapid poverty reduction by both income and non-income measures. Average economic growth was 8 per cent per year, the poverty headcount ratio fell from 69 per cent to 54 per cent and the under-five mortality rate was reduced by 19 per cent. However, over the same period, there was no significant change in the nutritional status of children. The causes of malnutrition amongst children are interrelated and complex. The immediate causes are related to inadequate dietary intake and diseases. The interaction between the two leads to increased morbidity and mortality. Inadequate dietary intake and diseases in turn are caused by insufficient access to food, inadequate maternal and child caring practices (particularly poor breastfeeding practices), insufficient access to safe water and sanitation and poor health care. HIV infection is also a major cause of failure to grow and of malnutrition among children. On an individual level, malnutrition places the child at risk of entering a downward spiral of malnutrition and infection. Insufficient dietary intake leads to an immunodeficiency similar to that of HIV and an increased susceptibility to infections. Infections lead to a further reduction in nutrient intake. As a consequence, the child suffers from frequent infections that become progressively more severe and longer lasting. The child fails to regain weight lost during one infection before the onset of the next. This downward spiral increases the child’s chances of dying. The major manifestations of malnutrition are macronutrient deficiencies and micronutrient deficiencies. In order to measure macronutrient deficiencies among children, three standard anthropometric indicators from the 2003 DHS are used: stunting (height-for-age), wasting (weight-for-height) and underweight (weight-forage). In order to measure selected micronutrient deficiencies (vitamin A, iodine and iron), the results of various studies conducted by the Ministry of Health are used. Poor breastfeeding practices in Mozambique contribute to both macronutrient and micronutrient deficiencies in the young child. A. Macronutrient deficiencies (i) Severity level of malnutrition among mozambican children In order to determine the severity of malnutrition within a population, WHO has established international standards on malnutrition, expressed as the percentage of malnutrition prevalence. The severity of malnutrition has been classified in four levels, from low to very high. When using this classification as a reference, it appears that stunting prevalence among Mozambican children is very high (41 per cent), underweight prevalence is high (24 per cent), and wasting prevalence is low (4 per cent). In rural areas, where about 70 per cent of children live, malnutrition levels are substantially higher than in urban areas, reaching 46 per cent for stunting and 27 per cent for underweight. The high prevalence of stunting and underweight malnutrition have enormous social and economic implications and constitute one of the main challenges for public health interventions in Mozambique. CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 93
(ii) Stunting prevalence (chronic malnutrition) Stunting, or chronic malnutrition, defined on the basis of the height to age ratio, shows malnutrition resulting from ‘cumulative inadequacies’ in the child’s nutritional status. Stunting is a good indicator for the general well being of a population, as it reflects the structural context surrounding malnutrition. It is difficult for a child who is stunted at some stage in his or her growth cycle to make up their lost growth and almost impossible for them to catch up completely, as this would need substantial improvement in the child’s quality of life. Stunting is also closely linked to impaired mental development. The national stunting prevalence for Mozambique in 2003 (DHS) was 41 per cent among children aged 0-59 months. This is slightly higher than the average estimated for that year in sub-Saharan Africa (38 per cent, UNICEF 2005). The prevalence of severe stunting was 18 per cent. Stunting prevalence among children under 3 years of age (0-36 months) has to be used to measure trends over time, as the 1997 DHS only measured malnutrition levels among children in that age group. Comparison between 1997 and 2003 data indicates that the stunting prevalence among children under 3 years of age did not improve and actually slightly worsened in rural areas. 50 Figure 3.13: Stunting prevalence among children under 3 years of age: comparison between 1997 and 2003 % 40 39 41 36 37 30 27 27 20 10 0 Urban Rural Total Source: 1997 and DHS 2003 1997 2003 Stunting, both for moderate and severe chronic malnutrition rates, increases with age up to 12-23 months. From the 24th month onwards it remains at stable levels, between 44 per cent and 49 per cent. This is because during the first months of life the nutritional demands of the child can still be met with breast milk. With increasing age, poor quality complementary feeding practices and frequent exposure to illness lead directly to impaired growth. In the absence of adequate feeding and care practices, the accumulation of deficits over an extended period of time will result in children with lower height than expected for their age. 94 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
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
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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: Box 3.3: Combating measles and poli
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
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
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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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