Child Survival

Young Child Survival Development

Integrated Management of Neo-natal and Childhood Illness


Photo essay


Water, sanitation and hygiene promotion - The picture

© UNICEF/MOZA/01257/G.Pirozzi

Considerable efforts have been made over the past years to bring water supply and sanitation to Mozambicans, especially in rural areas. But still, only 36% of the population has access to safe drinking water, and only 45% of the population uses sanitary means of excreta disposal (National Statistics Institute, 2003).

Generally, coverage is lower in rural areas and in the central and northern parts of the country. One of the main problems is that 30% of wells and boreholes are not working, because communities have not been able to operate and maintain hand pumps. Spare pump parts are often in short supply especially in rural communities.

Only 36% of the population has access to safe drinking water, and only 45% of the population uses sanitary means of excreta disposal. Girls are particularly affected by the low water and sanitation coverage. They spend up to two hours a day fetching a bucket of water in some districts. This means less time for school. 

Water supply and sanitation in school is also a problem. Only one third of primary schools have water and sanitation facilities, and most of these are in poor condition. This has a detrimental impact on the enrollment, retention and performance of children, especially girls. Girls often drop out of school, when they reach puberty and do not have access to separate toilets or water to wash.

Despite poor water and sanitation coverage, water-borne diseases have been declining. The prevalence of diarrhoea among children under the age of five describing the rate of children suffering from diarrhoea with a 2 weeks reference period, for example, dropped from 20.7% in 1997 to 14.1% in 2003. This helped to lower the under-five mortality rate from 219 child deaths per 1,000 live births to 178 in the same period. Cholera, another water-borne disease, is endemic in Mozambique and outbreaks occur every year. In 2004, more than 24,000 cases were reported but thanks to an effective cholera response system in the country, the fatality rate was only one percent. 

With the spreading of the HIV/AIDS epidemic in the country, the need to provide safe water, improved sanitation and promote hygienic practices is more pertinent than ever. People living with HIV/AIDS are not as resilient in fighting off opportunistic infections related to poor sanitation and hygiene.



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