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

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The prevalence of wasting does not reach the proportions of stunting and underweight, but, given its close association with morbidity and mortality, is elevated enough to be a public health concern. For example, acutely malnourished children are 20 to 40 times more likely to die during an episode of persistent diarrhoea, and 4 to 10 times more likely to die during an episode of acute diarrhoea. Wasting prevalence found by other nutritional surveys conducted by SETSAN as part of the Vulnerability Assessment in drought affected areas all indicated moderate or low levels of wasting (6.4 per cent in November-December 2002 in six provinces, 4.3 per cent in May-June 2003 in six provinces and 4.7 per cent in October 2005 in ten provinces). However, all the evidence shows that there are pockets of the country with a high prevalence of wasting, particularly at the time of the pre-harvest season. The October 2005 nutrition survey in drought-affected areas indicated that the highest wasting prevalence was in Zambezia province (6.9 per cent). High wasting prevalence was strongly linked to dietary intake and the prevalence of diarrhoea. The survey indicated an overall wasting prevalence of 8.8 per cent among children who had not had any food during the 24 hours prior to the survey compared to 3.8 per cent among children who had food made up from three different nutritional groups. 36 Furthermore, wasting prevalence among children who had experienced a recent episode of diarrhoea was 6.5 per cent compared to 3.7 per cent among children without a recent episode of diarrhoea (MISAU/SETSAN 2005). As with other forms of severe malnutrition, wasting is also strongly associated with AIDS and is a common clinical manifestation of HIV/AIDS in children. For example, screening of 573 malnourished children hospitalised in Beira in Sofala province between January-June 2005, which has the highest HIV prevalence in the country, found that 55 per cent of the children were HIV-positive. (iv) Underweight prevalence Being underweight, defined on the basis of weight for age, shows past nutritional or health deficits experienced by a child, in a similar way to stunting. Comparison between 1997 and 2003 indicates that the underweight prevalence among children under 3 years of age remained stagnant at 26 per cent, with an improvement in urban areas (from 20 per cent to 16 per cent) and a slight worsening in rural areas (from 28 per cent to 30 per cent). The lack of progress in reducing underweight prevalence led the Government in its 2005 Report on the Millennium Development Goals to report that it was unlikely that Mozambique will meet the MDG target of reducing underweight prevalence by half (GoM/UN 2005). Underweight levels by age group are highest at ages 10-23 months, slowly decreasing after that age. However, similarly to stunting and wasting, underweight prevalence indicates high levels of malnutrition amongst Mozambican children. Boys are slightly more underweight than girls. Children living in rural areas are almost twice as likely to be underweight as those living in urban areas (27 per cent against 15 per cent among under-five children), and children in the poorest households are more than three times as likely to be underweight as children in the best off households (31 per cent against 9 per cent among under-five children). Provincial disparities in terms of underweight prevalence are particularly acute, with children in Cabo Delgado being four times more malnourished than children in Maputo City. 36 Nutritional groups are carbohydrates, fats and sugars, proteins, vitamins and minerals. CHILDHOOD POVERTY IN MOZAMBIQUE: A SITUATION AND TRENDS ANALYSIS 97
Figure 3.16: Underweight prevalence by age-group % 40 37 35 30 29 20 20 22 18 10 5 0 Under 6 months 6 to 9 months 10 to 11 months 12 to 23 months 24 to 35 months 36 to 47 months 48 to 59 months Source: DHS 2003 Box 3.4: Comparing children’s nutritional status over time In comparing children’s nutritional status over space and time it is essential to compare like with like. In Mozambique this is complicated by subtle differences in demographics and survey implementation. Simler and Ibrahimo (2005) examine four different surveys (1996/97 IAF, 1997 DHS, 2000/01 CWIQ and 2003 DHS) and find three key differences between the samples: 1. The age distributions: The prevalence of stunting (low height-for-age) and underweight (low weight-for-age) are highly correlated with age because they are cumulative processes. This means that if age distributions differ between surveys, they are no longer directly comparable. This is the case between the 1997 DHS, which only collects data for children below 36 months, and the other three surveys, which collected data up to 60 months. 2. The correlation of incomplete data with household economic status: To produce accurate child nutrition data it is crucial to know the child’s age to at least the nearest month, usually using a health card or birth certificate. Without this information, stunting cannot be calculated and the child is left out of the analysis. Since poorer and older children are less likely to have adequate documentation of their date of birth, they are underrepresented in the analysis of stunting, thereby tending to underestimate the prevalence of stunting and underweight. If this bias changes over time it undermines inter-survey comparisons. 3. Changes in child mortality: Obviously, measurements are only available for surviving children. Reductions in child mortality therefore make more children eligible for measurement and also probably change the characteristics of those survivors (i.e. there are more “survivors” in the more recent samples, who in the past would not have survived). This effect undermines comparability between surveys. The authors, controlling for these factors, show that there has been a more positive change in the nutritional status over time than the uncorrected data. Stunting amongst children of 0 – 59 months in particular is adjusted down from 41% to 38% in the DHS 2003 (thereby bringing it into line with the average for sub-Saharan Africa). The adjusted data are presented in Annex V. Overall, the authors still find that changes in child malnutrition are very small in comparison to recent gains in economic growth and poverty reduction. 98 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
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 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: Alarmingly high levels of stunting
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
Page 145 and 146: 57 per cent, compared with a NER of
Page 147 and 148: 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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