The impact of South African destabilization on maternal and child health in Mozambique.

Abstract

Mozambique has felt the effects of South African destabilization since its independence from Portugal in 1975. Women and children tend to suffer from destabilization the most especially in regards to their health care. Mozambique has targeted the above groups as it strives to improve its health services. Between 1979-81 health service attendance increased dramatically (40-49% increase in antenatal clinic attendance and 27-39% increase in health facility delivery). The Expanded Program on Immunization beginning in 1980 achieved a 95% vaccination rate. 246 midwives were trained between 1976-82 and 374 maternal-child health (MCH) nurses were trained between 1903-06. Between 1902-87 rebel attacks caused 729 primary health care units to close. Maternal care facilities are constantly under attack which causes decreased attendance by fearful mothers. However overall percentages of health care utilization has dropped only slightly. Immunizations have been disrupted and mobile team operations limited in areas of attack. In quieter areas immunizations have been increasingly successful due to community cooperation. In 1987 55% of children ages 12-23 months were immunized 63% of mothers had delivered in maternity units and 66% of children had visited units 4 or more times in their 1st year of life. Rural life has been disrupted by war: from 1901-05 war has caused 320000 deaths; in 1905 infant mortality estimates were 200/1000 and child mortality was 325-375/1000. Disease epidemics caused most of the childhood deaths. 8.4% of children in war zones were malnourished vs. 6.2% in drought areas. Psychological trauma is also a problem among children. Mozambique has reassessed its MCH policies since 1985 to attempt to function under the existing conditions. Even though there is much suffering and death MCH services continue to function.