Maputo — Infant and child mortality has fallen sharply in Mozambique over the past ten years, according to the latest figures made available by the National Statistics Institute (INE).

Infant mortality (deaths before the age of one) fell from 135 per 1,000 live births in 1997 to 101 in 2003. This trend continued in the ensuing five years, but at a slower pace, and the 2008 figure was 93 infant deaths per 1,000 live births.

As for the under-five mortality rate, this fell from 201 per 1,000 live births in 1997, to 153 in 2003 and to 138 in 2008.

The 2008 figures come from a Multi-Indicator Cluster Survey (MICS) intended to assess progress in reaching the anti-poverty goals expressed in the United Nations Millennium Development Goals (MDGs) and in the Mozambican government's own Action Plan for the Reduction of Absolute Poverty (PARPA).

The survey, using internationally accepted methodologies, was undertaken by the INE in collaboration with the United Nations Children's Fund (UNICEF). It took a random sample of 13,955 households distributed across the entire country. The comparative data from 1997 and 2003 come from the INE's household surveys of those years.

Child mortality is falling more rapidly in the countryside than in the towns - which is not surprising since mortality rates in the 1990s were much higher in rural than in urban areas.

The rural under-five mortality rate fell from 237 to 162 per 1,000 live births between 1997 and 2008. Over the same period, the urban under-five mortality rate declined from 150 to 135 per 1,000 live births. Thus the rural and urban rates are drawing closer together.

There is a sharp geographical division, with the provinces north of the Zambezia showing much worse mortality rates than the rest of the country. Zambezia province has the highest under-five mortality rate with 205 deaths per 1,000 live births, followed by Cabo Delgado with 180. Maputo city and Province have the lowest rates with 103 and 108 deaths per 1,000 live births.

Turning to the main killer diseases, MICS took the number of children suffering from fever as a surrogate for malaria. The prevalence of episodes of fever among under-fives fell from 27 to 24 per cent between 2003 and 2008. But only 23 per cent of children with fever received anti-malaria drugs within 24 hours.

65 per cent of households with under-fives said they possessed at least one mosquito net, and the number of children sleeping under mosquito nets rose dramatically, from 10 per cent in 2003 to 42 per cent in 2008.

Here too the gap between town and countryside has narrowed. In 2003 only seven per cent of rural children slept under a net. The figure reached 40 per cent in 2008, catching up on the figure of 48 per cent in the urban areas.

But the prevalence of diarrhoeal diseases has actually increased. In 2003, households reported that 14 per cent of children had suffered episodes of diarrhoael disease, a figure that rose to 18 per cent in 2008. Less than half these children (47 per cent) received the life saving oral rehydration therapy.

The most disturbing statistic is that malnutrition remains at very high levels among Mozambican children. The number of children found to be in a state of chronic malnutrition (i.e whose growth is stunted because they have not received sufficient calories over a lengthy period) fell by just four percentage points, from 48 per cent in 2003 to 44 per cent in 2008.

Acute malnutrition (where the child is in danger of starving to death) stayed at much the same level - five per cent in 2003 and four per cent in 2005.

Malnutrition is much worse in the north of the country than in the south - even though the northern provinces are the most fertile parts of Mozambique and rarely suffer from prolonged drought. The worst figure is from Cabo Delgado where 56 per cent of children are chronically malnourished, followed by Nampula with 51 per cent.

Maputo city is easily the most prosperous part of the country. But even so, 25 per cent of the city's children are chronically malnourished.

Access to clean drinking water has steadily improved, but still covers less than half the population. In 2003, 36 per cent of the population had access to a safe source of water, and by 2008 the figure had reached 43 per cent. Urban clean water coverage rose from 66 to 70 per cent, while in the countryside the improvement was from 23 to 30 per cent.

The percentage of people with safe sanitation rose from 34 to 47 per cent, but this was mostly in the towns - in the countryside the rise was from four to six per cent. More encouragingly the number of people who had no sanitation at all (and so defecated in the open) fell from 51 to 42 per cent between 2003 and 2008.