Recovery with a Human Face
Rapid Assessment Questionnaire on Crisis Responses – UNICEF Mozambique
1. Priority interventions to address urgent needs
1.1. Has there been a rapid assessment of the social impact of the food/fuel and economic crisis? (by UNICEF or any other institution). If so, to what extent have child and maternal malnutrition incidences increased, or there have been indication of children dropping out of schools and losing access to basic health services? Please indicate sources and, if possible, send materials.
An analysis of the impact of the global increase in food and fuel prices in 2008 by the Ministry of Planning and Development (MPD), with support of the World Bank and IMF, predicted a negative impact on urban areas and the southern region in Mozambique. Rural areas were not expected to be directly affected because of reliance on household production for consumption, with less dependency of the volatility on imported food prices. As a low income food deficit country, Mozambique imports annually 100 and 75 per cent of its internal demand for wheat and rice, respectively (UN Concept Note 2008). The rise in food prices between March 2008 and March 2009 had a direct negative impact in the purchase power of the most vulnerable groups (SETSAN Report 2009). While food prices stabilised by February 2009, they remained much higher than what was observed before the crisis (with the exception of rice, which is low in most parts of the country) (SETSAN Report 2009). Nevertheless, in addition to pockets of social unrest, the crisis increased the country’s propensity to food insecurity that currently affects approximately 0.8 of the population (Fews Net/Mozambique, USAID, October 2009).
In May 2008, a Concept Note was developed by the UN Country Team (UNCT), at the request of the President of the Republic. A two-pronged approach was developed in support of the Government three-year Food Production Action Plan. The firs track focused on measures to enhance food production and trade, while the second aimed at strengthening social safety nets to mitigate the negative impact of the rise in food prices on the most vulnerable groups in three areas: nutrition, education and social protection (in-kind and cash transfers). UNICEF was requested to lead the development of the nutrition and social protection (cash transfers) components of the UN Concept Note.
In response to global financial crisis in 2009, a briefing note was prepared by UNDP based on an IMF study and a review conducted by the African Development Bank in Mozambique. With little exposure to the international financial systems at developed countries, Mozambique has not experienced the large-scale bank bankruptcy observed elsewhere. As a result, the Mozambican economy has continued to grow at an average rate of 7.6 per cent (2006-2008) (PRSP II Evaluation 2009) and has remained stable in the first quarter of 2009, with per capita growth rates of 5.4 per cent (United Nations Development Programme, Overcoming Barriers: Human mobility and development, Human Development Report 2009, New York, 2009). Projections for 2010 and beyond are mixed, however. The Government Medium Term Expenditure Framework (MTEF 2010-2012) forecasts growth rates of 6.1 per cent for 2010 (or 4.3 per cent, assuming partial recovery in the global economy). The African Development Bank (AfDB) and the Development Centre of the Organisation for Economic Cooperation and Development (OECD), on the other hand, paint a more conservative picture, estimating growth at 4 per cent in 2009, bouncing back to 5.2 per cent in 2010 (also contingent on a boost in the global economy) (The African Development Bank and the Development Centre of the Organisation for Economic Cooperation and Development, African Economic Outlook 2009).
The medium- and long-term impact of the international financial crisis on services for children and women remains uncertain, particularly as the State Budget is highly dependent on international assistance. With 53 per cent of the 2009 State Budget composed of external aid, any retraction in donor funding – whether from aid or private capital flows – will have a significant negative impact on child development as the related sectors are highly dependent on international assistance. While donor support via direct budget support is expected to increase slightly in 2010, reductions in assistance to sector common funds have already been observed. The education common fund (FASE) was particularly affected, with a 25 per cent reduction of pledged funds in 2010 as of September 2009 (MTEF 2010-2012). The Government was quick to react to this cutback by increasing internal commitments to compensate the drop observed in the sector. In addition, UNICEF, as sector chair in the SWAp, has steered a successful campaign to leverage at least US$ 5 million for FASE from various donors to alleviate the budget reduction. Nonetheless, there has been a 10 per cent reduction in the total envelope targeting social sectors between 2009 and 2010 (from 45 per cent to 35 per cent) (Information based on a comparison between the MTEF 2009-2011 and MTEF 2010-2012). While the State Budget proposal for 2010 has yet to become available, the orientation observed in the MTEF 2010-2012 is likely to be maintained in the State Budget in 2010. The impact of these budget cuts on children is yet to be measured.
1.2. If there has been a policy response linked to providing social protection, please briefly explain along the following lines:
(i) new social protection programmes created;
(ii) expansion of existing social protection programs; or
(iii) adjustment or reform (e.g. redesigning of key features of a program). (ii) (iii) Policy responses to global crises continue to focus on the strengthening of national social protection systems. Particular efforts have been mobilised towards the scaling up of the existing unconditional cash transfer programme (Food Subsidy Programme - PSA). Currently, the main direct beneficiaries are the elderly (93 per cent), followed by people living with disabilities (6 per cent) and the chronically ill (1 per cent) (INAS BdPES 2008). Mozambique is one of the few low-income African countries with such a longstanding cash transfer programme that is supported by State funds and national legislation. In 2007 the Food Subsidy Programme reached 128,000 households with monthly cash transfers, increasing to 143,455 households in 2008. The latter households consist of 143,455 direct beneficiaries and 143,999 indirect beneficiaries. A significant proportion of the indirect beneficiaries are children, including biological children of the direct beneficiary and orphans and vulnerable children that live within the household.
In 2008, the PSA went through two important reforms: an incremental increase of the subsidy scale, and an increased focus on inclusion of eligible dependants as indirect beneficiaries in the payment scheme. A significant part of these indirect beneficiaries are children. Inclusion of indirect beneficiaries, especially children, in the PSA program has been problematic due to the fact that they frequently do not meet the eligibility criteria. In the case of children this is often due to the lack of a birth registration document or the orphan-hood status. Non-orphans who are living with the elderly and do not receive any (financial) support from their parents are not considered eligible as beneficiaries to the PSA program. Consequently, a significant number of extremely vulnerable children are excluded from the programme.
An impact assessment of the PSA Programme is ongoing, in which a treatment (1016 households) and control group (1650 households) participate in a survey to establish the impact of the monthly cash transfer on consumption, health and education (including access to services), employment, housing, and intra-household demographic changes. The base-line survey was conducted in 2008 and follow-up surveys are scheduled for 2009, 2011 and 2013. The first evaluation report will be available by April 2010. The objective of the evaluation is to analyse the impact of the PSA on individual beneficiaries and families so as to inform the technical and political dialogue with government and partners on the future direction of the PSA programme.
In addition to the impact assessment, in 2008, UNICEF supported a costing of the various expansion scenarios and a simulation of the corresponding impact on the levels of poverty was completed with support from ESARO and was shared to support the advocacy effort. In 2009, the Council of Ministers approved regulations for the Basic Social Protection Strategy, which will secure inclusion, for the first time, of a specific provision for social transfers for vulnerable children and child headed households.
In spite of these gains, the State Budget funding for social protection remains insufficient given the extent of the need. UNICEF has chaired the Delivering as One UN Joint Programme on Social Protection since 2007, assisting in the coordination of UNCT activities in this area. In late 2009, under the framework of the this Joint Programme, the ILO provided technical support to the Ministry of Women and Social Action for development of the overall Basic Social Protection Strategy; UNICEF also contributed to the policy dialogue resulting in the targeting of vulnerable children as a specific beneficiary group within the strategy and WFP advocated to ensure incorporation of food security into the overall social protection package. A new costing exercise based on recent data, (particularly the 2008 MICS) was developed. It includes a menu of options for different scenarios for expansion of the PSA programme (including the option of child grants) to support the recently developed Basic Social Protection Strategy (2010-2014).
For 2010, advocacy efforts to ensure buy in from the Government in support of the pending Basic Social Protection Strategy and regulations will be mobilised (particularly under the umbrella of the office-wide Advocacy Strategy 2010-2011). In addition, focus will also be drawn to ensure a broader outlook at social protection programmes beyond cash transfers.
2.3. Please describe briefly the measures that the government has taken to mitigate the social impact of the crisis as part of its crisis response package. What are the coverage and the adequacy of these measures in addressing urgent social needs? In response to the unexpected rise in food prices in the first quarter of 2008, the Government adopted an ambitious three-year Food Production Action Plan with two key objectives: (i) to eliminate the deficit of the most common food products in three years; and (ii) to reduce the national dependency on food imports. The plan covers three agricultural seasons (2008-2009; 2009-2010; and 2010-2011) and has a budget of approximately US$ 600 million, of which 26 per cent is to be funded by private investment and 74 per cent by public resources. To complement the medium terms actions outlined in the plan, immediate nutrition and social protection measures were prioritised in the UNCT Concept Note to mitigate the negative impact of the rising food prices on the most vulnerable children. This approach was also prioritised in 2009 as a pre-emptive response to the global financial crises. Specifically:
The Ministry of Health implemented two rounds of National Child Health Weeks in 20091 resulting in successful interventions for Vitamin A supplementation, de-worming, routine immunisation, nutritional screening and breastfeeding promotion in all 144 districts of the country:
Vitamin A supplementation -1st round: 3.6 million children 6-59 months (or 100 per cent) and 2nd round: 3.4 million children 6-59 months (or 97 per cent).
De-worming - 1st round: 2.8 million children 12-59 months (or 96 per cent) and 2nd round: 2.9 million children 12-59 months (or 95 per cent).
Nutrition status screening/referrals -1st round: 3.5 million children 6-59 months (100 per cent).
Routine immunisation -1st round: 95,386 children immunised against measles and 59,636 children immunised against DPT3 (or 85 per cent and 75 per cent increase, respectively, compared to an average weekly coverage in 2008) and 2nd round: 101,337 children immunised against measles and 58,149 children immunised against DPT3 (or over 86 per cent and 76 per cent increase, respectively, when compared to an average weekly coverage in 2008).
Behaviour change communication -1st round: promotion of improved infant feeding practices, with emphasis on exclusive breastfeeding via the distribution of 1,650,000 leaflets with messages accompanied by education sessions to the mothers, as they waited for the NCHW interventions to take off.
Scale up of nutrition rehabilitation reaching over 14,415 children2 with severe acute malnutrition in all provinces (8,840 in-patient / 5,573 out-patient) and 5,200 moderately malnourished children.
Establishment of learning centres for the Community Based Management of Acute Malnutrition (CMAM) in three districts to ensure early detection and effective follow up of children. CMAM will be rolled out in at least four provinces in 2010.
Finalisation of the Strategy on Communication and Social Mobilisation for the Promotion, Protection and Support for Breastfeeding. The implementation of the campaign will be rolled out in 2010.
monitoring and enforcement of the national Code of Marketing of Breastmilk Substitutes (approved in 2005 and in force since 2008) through training of trainers in all 11 provinces in the country. Training of health workers has taken place in four provinces, involving around 259 health workers from the district and province levels. The remaining provinces will follow in 2010.
Scale up of social protection programmes, reaching over 160,000 direct beneficiaries and over 145,000 indirect beneficiaries, an estimated 60 per cent of whom are children.
Vulnerable children included as a target group in the National Basic Social Protection Strategy and Regulation for the Basic Social Protection Law (final approval pending in 2010).
In total, 4,500 household basic kits were distributed at the provincial level, reaching an estimated 18,000 children in vulnerable households.
US$ 5-15 million leveraged for the education common fund in response to the 25 per cent cut observed in pledges for 2010.
UNICEF is coordinating with FAO, WFP and WHO for the implementation of a Joint Programme on Children, Food Security and Nutrition (2009-2011), which is funded by the MDG-Fund. This Joint Programme covers several of the activities mentioned above (food supplementation, Child Health Weeks), as well as the support for urban and peri-urban gardening, nutrition surveillance and the strengthening of nutrition education.