Mozambique was devastated by a post independence civil from 1977 to 1992 which destroyed infrastructures, ruined livelihoods and severely hampered agricultural production and economic development. Nevertheless Mozambique is a successful example of post-conflict economic recovery, even if it still lags behind in terms of human development and poverty. The country is severely affected by the HIV/AIDS pandemic, which compromises the social and economic progress the country is striving to attain.
Mozambique is a country with high agricultural potential that is still underutilized. The major part of agricultural production takes place in the northern and central provinces, where the climate is more favourable. Agricultural production has shown great improvement since the end of the war thanks to pro-active policies, the return of migrants and large aid inflows. Consequently, food aid shipments, previously very high, have decreased; currently, a third of the cereal supply still depends on imports.
In rural areas, where the majority of the population lives, the main constraint to food security is physical access to food: the country’s infrastructures, both markets and roads, were destroyed during civil war. In urban areas, economic access to food is a major issue, especially in times of soaring food prices. Natural shocks such as floods (in the Zambezi valley in particular) and drought (in south and central provinces) regularly affect agricultural production.
The Mozambican diet is mainly composed of cassava - a staple with a low protein content - in the northern part of the country, and maize in the centre and southern part. Urban households consume mostly maize and imported wheat. With the exception of green leafy vegetables which often accompany the staples, the supply of micronutrient-rich foods (other vegetables, fruit, and foods of animal origin) is dramatically low. In urban areas, where street foods, snacks and sugar-rich foods are becoming more common, the nutrition transition is currently underway. Cereals and starchy roots provide almost 80% of the dietary energy supply; this very poor level of dietary diversification has not improved for the last 40 years and is currently the lowest in the region. Besides being poorly diversified and thus extremely poor in protein and micronutrients, the diet does not supply enough energy to meet population energy requirements; the prevalence of undernourishment reached 38% in 2005-2007.
While the prevalence of wasting (i.e. acute malnutrition) is low, that of stunting (i.e. chronic malnutrition) is declining but remains at a very high level (44% of children under five in 2008). Chronic malnutrition is more widespread in the northern provinces, where chronic food insecurity is common, and access to health services, water and sanitation and education is more limited than in the south. The prevalence of stunting, already high in infants under 6 months, increases sharply during the first two years of life, mainly because of inadequate feeding practices, especially regarding exclusive breastfeeding. Generally, complementary feeding is given in a timely manner but lacks diversity and is particularly poor in foods of animal origin. Among mothers, the prevalence of chronic energy deficiency decreased between 1997 and 2003 while the prevalence of overweight and obesity increased. In 2003, the prevalence of overweight and obesity was three times higher in urban than in rural areas, a sign of the nutrition transition currently underway in cities.
Iodine deficiency was still a mild public health problem in 2004, especially in the northern parts of the country which correspond to the zones where cassava (a goitrogenic food) is the main staple. Universal salt iodization was decided in 2000 but implementation needs to be reinforced strongly: only a fourth of households consumed adequately iodized salt in 2008, with important regional disparities. In 2001-2002, vitamin A deficiency was a severe public health problem among children; in response, vitamin A supplementation coverage was increased between 2003 and 2008 to reach 72% of the children. Among women, vitamin A deficiency was a public health issue as well but the coverage of supplementation was very low. Iron deficiency anemia represents a severe public health problem among both children and mothers and coverage of iron supplementation in pregnant women remains insufficient, especially in rural areas.
The importance of micronutrient deficiencies in the population can be directly linked to a diet that is extremely poor in micronutrients. Although short-term interventions such as supplementation still need to be reinforced, investment in sustainable food-based strategies is urgently needed to combat chronic malnutrition and micronutrient deficiencies. Improving the nutritional status of young children also requires greater efforts to promote adequate infant and young child feeding practices.