Geographic Differentials in Mortality of Children in Mozambique: Their Implications for Achievement of Millennium Development Goal 4

Abstract

In the light of Mozambique's progress towards the achievement of Millennium Development Goal 4 of reducing mortality of children aged less than five years (under-five mortality) by two-thirds within 2015, this study investigated the relationship between the province of mother's residence and under-five mortality in Mozambique, using data from the 2003 Mozambican Demographic and Health Survey. The analyses included 10,326 children born within 10 years before the survey. Results of univariate and multivariate analyses showed a significant association between under-five mortality and province (region) of mother's residence. Children of mothers living in the North provinces (Niassa, Cabo Delgado, and Nampula) and the Central provinces (Zambezia, Sofala, Manica, and Tete) had higher risks of mortality than children whose mothers lived in the South provinces, especially Maputo province and Maputo city. However, controlling for the demographic, socioeconomic and environmental variables, the significance found between the place of mother's residence and under-five mortality reduced slightly. This suggests that other variables (income distribution and trade, density of population, distribution of the basic infrastructure, including healthcare services, climatic and ecologic factors), which were not included in the study, may have confounding effects. This study supports the thought that interventions aimed at reducing under-five mortality should be tailored to take into account the subnational/regional variation in economic development. However, research is warranted to further investigate the potential determinants behind the observed differences in under-five mortality.

Predictors of Health-Care Utilization Among Children 6–59 Months of Age in Zambézia Province, Mozambique

“… 13 We thought it pertinent to assess differences in urban and rural residence, as determinants of health, such as education and socioeconomic status, differ between the two. 7 , 9 , 10 , 18 , 24 , 29 , 42 , 52 , 53 …”

“…1 , 6 This rate has been falling over time with a 2005 national under-five mortality estimated at 138 per 1,000 live births compared with 219 per 1,000 live births in 1997. 6 – 9 Although Mozambique appears to have surpassed its 2015 national under-five mortality target for MDG 4, substantial regional differences persist. 10 Economic activity, infrastructure, and basic services are highly concentrated around the capital Maputo, which is located in the southernmost part of the country.…”

“…These have been studied in various locations worldwide, 10 , 11 , 13 , 14 , 18 , 20 – 23 but few studies include Mozambique. 9 , 24 As we move past the MDGs and begin preparing to meet the new Sustainable Development Goals of ending under-five mortality by 2030, 25 a more in-depth understanding of the social, biologic, and epidemiologic factors contributing to continued under-five mortality, will be required. Although the MDGs brought incredible advances globally, there is growing recognition that inequities persist and that the existing focus on national averages may actually have exacerbated regional and within-country inequalities, particularly for child health.…”

Revisiting public health challenges in the new millennium

“…[14] Almost half of all deaths among children under five occur in this region, where progress has slowed down due to lack of preventive care and treatment, fragile health systems, and socioeconomic stagnation due to conflicts, political instability and HIV/AIDS. [1516171819] The condition in India is also not very satisfactory in this context. [2021] The Table 2 shows that the achievements measured by infant mortality rate (IMR), in past 45 years are much less than other countries with comparable economies.…”

An Analysis of the Quality of New-Born Health Services in Nampula, Mozambique.

“…3 In 2008, the Mozambican Ministry of Health (MISAU) developed a strategy to accelerate maternal and new-born mortality rates reduction, 4 but in 2013, the country registered 27,8 deaths of children less than 28 days of age per 1000 live births, and 88.5 under ve years, 5 with higher mortality risk for those born in Nampula and other northern provinces. 6 Though child mortality rate decreased in Mozambique in the last three decades, 7 it is still high (67.3 deaths of children less than one year of age per 1000 live births, 2017). 8 Among the main causes are the reduced number of quali ed health professionals (HPs), lack of equipment and supplies.…”