Background: The number of undernourished children worldwide has increased by 45 million since 1990. In Mozambique, Zambézia and Nampula Provinces carry a heavy burden of infectious diseases, as well as high rates of stunting and wasting. Mozambique developed a Multisectoral Action Plan for the Reduction of Stunting (2011–2014) that aimed to reduce the national prevalence of stunting to 20% by 2020, but little is documented of its impact on childhood stunting since the 2011 DHS survey.
Methods: Cross-sectional data from a population-based household-level survey was collected between February and July 2019, among heads of households ≥ 15 years of age in Zambézia and Nampula Provinces. The survey tool was a 500-item questionnaire covering domains related to household health and economics, with a special emphasis on maternal and child health, nutrition and WASH and the collection of anthropometric measurements in children 0-59 months. Children were assessed for Stunting and Wasting according to the WHO Child Growth Standards. SurveyToGo software was used for developing the data collection form, gathering data on mobile devices and sending securely to a server. Descriptive statistics were calculated for continuous variables as median with interquartile range and for categorical variables as percentages. The significance level for all testing was two-sided, set at 0.05.
Results: A total of 3,937 households were included in our analysis, including anthropometric measurements of 5,423 children under five. Nearly half (45%, n=2,460) of all children assessed met the criteria for stunting, with a higher prevalence in Nampula Province (51%, n=1,180) than Zambézia Province (41%, n=1,280). Four percent of children met the criteria for wasting in both provinces with children aged 6-11-months having the highest wasting prevalence overall (7%).
Conclusions: Based on survey results using highly standardized anthropometric measurement methods, these two provinces are on track to meet international 2025 targets for reduction in wasting in children under 5 years. However, stunting prevalence over time in both provinces has maintained at 40-50% with no clear evidence of decline since 2003. It is doubtful the related Sustainable Development Goal targets will be reached unless a focused multi-sectoral approach is employed and closely monitored.