In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
Weak but Improving
In cooperation with the private sector, make available the benefits of new technologies, especially information and communications
Weak but Improving
Goal 1. Mozambique has made significant progress towards halving the proportion of people living in extreme poverty. The percentage of people living below the poverty line decreased from 69 per cent in 1997 to 54 per cent in 2003, making MDG target 1 one of the few targets with the potential to be reached by 20152. The reduction in poverty, however, masks significant disparities, with higher levels of poverty registered among those living in particular provinces and rural areas. Poverty also tends to vary according to household characteristics, being higher for female-headed households and households with more than four children (65 per cent live in poverty, as compared with 24 per cent in households with no children).
In spite of progress made in reducing poverty, the target on halving the proportion of people who suffer from hunger by 2015 is less likely to be met. The prevalence of underweight children under five remains high, at 24 per cent, with little improvement registered between 1997 and 20033. Disparities are again evident, with underweight prevalence ranging from less than 10 per cent in Maputo to 34 per cent in Cabo Delgado province and being almost twice as high in rural areas as in urban areas (27 per cent versus 15 per cent). Protracted drought, combined with the AIDS pandemic and limited coping capacities, has resulted in high levels of household food insecurity and persisting pockets of high malnutrition, particularly affecting the most vulnerable, such as pregnant women and orphaned children.
Goal 2. Despite major progress in improving access to primary education, and increasing the net enrolment ratio in lower primary level from 69 per cent in 2003 (66 per cent girls/72 per cent boys) to 83 per cent in 2005 (81 per cent girls/86 per cent boys)4, the quality of education has not improved and the MDG target is unlikely to be reached by 2015 unless substantial human and financial resources are invested in the system. Completion rates at lower primary level in 2004 were 48 per cent (39 per cent girls/57 per cent boys) and the net attendance rates in primary schools remained low, at 60 per cent (57 per cent girls/63 per cent boys). There are wide geographical disparities in net attendance rates, from over 90 per cent in Maputo City to less than 50 per cent in Zambezia and Nampula provinces, which account for 40 per cent of the country’s child population. The quality of education is further compromised by the high learner/teacher ratio (74:1) and the increasing proportion of unqualified teachers (44 per cent in 2005). Progress has been made in increasing the literacy rate among 15-24 year olds, which rose from 52.1 in 1997 to 58.2 per cent in 2003. Moreover, the literacy rate of the population aged 15 years and above has increased from 39.5 per cent in 1997 to 46.4 per cent in 2003. There are almost twice as many literate men (63.3 per cent) as women (31.2 per cent), however, and there remains significant disparity between literacy levels in rural and urban areas (34.3 versus 69.7 per cent).
Goal 3. Gender inequality remains a significant barrier to development in Mozambique, and the country is currently ranked 133rd out of 140 countries in the Gender-related Development Index. In spite of progress made in reducing the gender inequalities in primary level education, with the ratio of girls to boys at lower primary level increasing from 0.71 in 1997 to 0.83 in 2003, the ratio remains low - around 0.67 - at the upper primary (EP2) and secondary levels, and has remained unchanged since 1997. These trends show that the target of achieving gender parity in higher primary and secondary education will require considerable progress if it is to be met by 2015. While some progress in increasing literacy has been made since 1997, illiteracy remains much higher among women than among men (68.8 versus 36.7 per cent). In addition, the most recent data indicate that the share of economically active women in wage employment in the non-agricultural sector was only 10.1 per cent, compared to 30.7 per cent for men, a situation likely to be linked to women’s high illiteracy rates and the low proportion of girls and women in technical education at secondary and tertiary levels. Nevertheless, the representation of women in decision-making structures continues to improve, particularly within the parliament and central Government. The proportion of seats held by women in parliament is 35.6 per cent in 2005, although lower progress has been registered at the sub-national levels.
Goal 4. Mozambique has achieved a continual decrease in the rates of child mortality. Between 1997 and 2003, under-five mortality rates decreased by about 19 per cent, from 219 to 178 per 1,000 live births, while infant mortality rates decreased by about 16 per cent, from 147 to 124 per 1,000 live births5. If these trends continue, the country has the potential to reach the MDG targets by 2015. Mortality levels among children are strongly associated with the economic characteristics of their households and the education level of mothers. Among children in the poorest households, the under-five mortality rate is twice as high as that among children in better off households (196 versus 108), while children of mothers with no education are 130 per cent more likely to die before reaching five years of age than children of mothers with secondary education. Malaria remains the primary cause of under-five mortality, followed by acute respiratory infection. AIDS, however, is fast emerging as a major killer of children. Immunisation against measles (among one year-old children) increased by 19 percentage points between 1997 and 2003 (from 57.5 to 76.7 per cent, although residential disparities are significant, with 70.8 per cent measles immunisation coverage recorded in rural areas versus 90.8 per cent in urban areas in 2003.
Goal 5. Maternal mortality ratio trends show a substantial reduction over the past decade, from an estimated 1,000 per 100,000 live births in the early 1990s to 408 per 100,000 live births in 2003, putting the country on track to meet the MDG target by 2015. Despite improvements in the quality of obstetric care, the main causes of maternal deaths are due to direct factors (75 per cent), such as haemorrhage, rupture of the uterus, eclampsia and sepsis, while a quarter of deaths (25 per cent) are due to indirect causes, such as malaria and HIV/AIDS. The proportion of births attended by skilled health personnel (also known as institutional deliveries) has increased from 44.2 per cent in 1997 to 47.7 per cent in 2003, although disparities are considerable between rural and urban areas (34.2 and 80.7 per cent respectively in 2003).
Goal 6. The 2005 MDG Progress report found that without a significant acceleration in the national response to HIV/AIDS, the MDG target relating to the halt and reversal of the HIV/AIDS pandemic is unlikely to be met by 2015. The rate of HIV/AIDS prevalence among adults aged 15-49 has been steadily increasing over the past few years, from 12.2 per cent in 2000 to 16.2 per cent in 20046, with the highest rates in the central and southern regions of the country, reaching 26.5 per cent in the province of Sofala. In 2006, an estimated 1.7 million people are living with HIV or AIDS and the disease is claiming over 120,000 lives each year7. HIV/AIDS in Mozambique has a women’s face; the prevalence among women in the 15-24 age group is three times higher than that among men. The increasing HIV/AIDS prevalence is also leading to a greater number of children infected or affected by HIV/AIDS. In 2006, there are an estimated 99,000 children under the age of 15 living with HIV/AIDS, with approximately 80 per cent below the age of five. The AIDS pandemic also continues to compound the crisis of increasing numbers of orphaned and vulnerable children (OVC). It is estimated that there are over 1.6 million orphans in Mozambique and that more than 20 per cent of these are due to AIDS.
Malaria remains a major public health problem in Mozambique, particularly in rural areas where the majority of the population resides, largely due to the poor utilisation of preventive measures and limited access to health services. It is estimated that over 40 per cent of all outpatient cases and 60 per cent of paediatric cases in hospitals are a result of malaria. It is also estimated that malaria accounts for almost 30 per cent of all hospital deaths. The disease remains the primary cause of deaths among children under five, accounting for approximately 20 per cent of all deaths, although the disease is both preventable and treatable. There is also increasing evidence on the adverse interaction between HIV and malaria, with HIV/AIDS increasing the severity of malaria symptoms and malaria increasing the viral load among those living with HIV or AIDS. The situation in relation to tuberculosis, however, is more positive. The national target for the proportion of tuberculosis cases cured has almost been achieved, although detection remains a problem, and…
Goal 7. The context of extreme poverty puts extreme pressures on natural resources in Mozambique, which are the main source of subsistence for the majority of households. In addition, uncontrolled urban expansion and pollution due to increasing industrialisation are harming biodiversity and the quality of soils and water. It is thus fundamental to improve the environmental management of natural resources in Mozambique if the targets relating to MDG 7 are to be met. In addition, water and sanitation coverage is low, particularly among those living in rural areas. The 2003 Demographic and Health survey indicated that only 37 per cent of the population had access to an improved water source, with 23 per cent of those in rural areas and 69 per cent in urban areas. 48 per cent of the population had access to improved sanitation, with 36 per cent in rural areas and 78 per cent in urban areas. The lowest coverage levels of both water and sanitation were found in Zambezia, the most populous province, and the highest in Maputo city province. The Government is committed to the promotion of sustainable development and has adopted a number of legal instruments with transversal impact for the sustainable development of the country, but considerable efforts will be required to ensure that the pace of economic growth does not jeopardize the quality of life of future generations.
Goal 8. Mozambique remains one of the most aid dependent countries in the world. Overseas development assistance (ODA) accounted for over 50 percent of the State Budget in each of the past five years. However, aid dependence as a share of gross national income (GNI) has declined from 87.1 percent at the end of the civil war in 1992, to 29.5 percent in 1997 and 25.1 percent in 2003. While the Government has made good progress in raising revenues and improving public financial management through the implementation of an integrated public financial management system and action to fight corruption, government generated resources for financing Mozambique medium-term development goals fall short by about $750 million a year. In April 1998, Mozambique was the sixth country to be declared eligible and to benefit from the HIPC initiative, which would reduce its debts by about $3.7 billion. In 2004, the Government and the IMF established that Mozambique’s debt was sustainable. Long-term debt sustainability, however, will depend on solid growth based on sound government policies, including prudent external borrowing and debt management.
Annex F: Interrelatedness – MDGs, PARPA II and UNDAF III
1 The National target is 144,000 HIV+ pregnant women receiving ARV prophylaxis by 2009.
2 Household Income and Expenditure Survey, 2002/2003, Ministry of Planning.
3 Demographic and Health Survey, 2003, National Institute of Statistics.
4 Annual School Surveys, Ministry of Education and Culture.
5 Demographic and Health Surveys, 1997 and 2003, National Institute of Statistics.
6 Report on the Update of the HIV Epidemiological Surveillance Data - 2004 Round, Multisectorial Technical Group for the Fight against HIV/AIDS in Mozambique, Maputo, August 2005.
7 Impacto Demografico, INE, MISAU, MPF, CNCS, CEP/UEM, UEM, May 2004.