Impact of malnutrition
Poor nutrition contributes to a large proportion of child deaths in Mozambique. Malnutrition – the state of being poorly nourished – is not merely a result of too little food, but of a combination of factors: insufficient protein, energy and micronutrients, frequent infections or disease, poor care and feeding practices, inadequate health services and unsafe water and sanitation.
Malnutrition compromises a child’s immune system, making him or her more susceptible to diseases such as pneumonia, malaria and HIV.
In Mozambique, 44 per cent of children under the age of five are stunted due to chronic illness and poor diet. And around 18 per cent of children are underweight, with children living in rural areas almost twice as underweight as those living in towns and cities.
Acute malnutrition, also known as wasting, does not reach the proportion of stunting and underweight but is a public health concern in Mozambique.Wasting affects four per cent of the children in Mozambique.
Children in drought-affected areas are more at risk of being malnourished. As with other forms of severe malnutrition, wasting is also strongly associated with HIV and AIDS. It is a common clinical symptom of HIV infection in children.
Micronutrient deficiencies, especially the lack of two minerals (iodine and iron) and one vitamin (vitamin A) are another major manifestation of malnutrition.
Iodine deficiency can lead to severe mental or physical impairment. According to the latest available data 15 per cent of the children between the ages of 6 and 12 have goiter. The used of iodised salt increased from 54 per cent in 2003 to 58 per cent in 2008.
Iron deficiency, or anaemia, affects 75 per cent of children and 48 per cent of mothers. Anaemic children grow more slowly and are apathetic, anorexic and without energy.
Vitamin A deficiency, which affecting 69 per cent of Mozambican children under five and 11 per cent of mothers, weakens immunity against infections.
Vitamin A supplementation coverage increased from 50 per cent in 2003 to 72 per cent in 2008.
Although a high percentage of children are breastfed in Mozambique, only 38 per cent of them are exclusively breastfed among children below 6 months. Immediate and exclusive breastfeeding for at least the first six months is the best source of nutrition for a child, providing vital micronutrients.
What is being done
UNICEF is working with the Ministry of Health to scale up integrated nutrition interventions across the country. Over the past three years, significant progress has been made in these areas:
The way forward
Between 2010 and 2011, UNICEF will continue to support the Ministry of Health in three main areas: scaling up a Basic Nutrition Package in health facilities; promoting infant and young child feeding in communities; and expanding selective feeding interventions for malnourished children.
Basic Nutrition Package in health facilities
A Basic Nutrition Package to prevent children from becoming malnourished at different stages of their life cycle is implemented in health facilities across the country.
The nutrition package includes activities on infant and young child feeding, maternal nutrition, micronutrient supplementation, de-worming and growth monitoring. The goal is to bring the Basic Nutrition Package to more than 1,200 health units in all provinces.
Community-based nutrition interventions
A range of community-based nutrition activities, including the promotion of good nutrition practices among households and caretakers are implemented to promote correct infant and young child feeding practices.
The activities include vitamin A supplementation, screening and treatment of malnourished children, nutrition education, breastfeeding promotion and training of community health workers. The goal is to scale up the promotion of correct feeding practices to 90 districts.
Communication and social mobilisation activities on nutrition are important aspects of this community approach, focusing on the empowerment of mothers, families, communities and service providers to reinforce positive behaviours.
Feeding malnourished children
To address acute malnutrition found in children living in areas of drought, food insecurity and high HIV prevalence rates, therapeutic and supplementary feeding interventions are scaled up to help save the lives of chronically vulnerable children and women.
Malnourished children living with HIV and AIDS are being treated with ready-to-use therapeutic food, also called plumpy-nut. The goal is to scale up to 150 sites for therapeutic feeding and to 150 sites for supplementary feeding.