Note: This document may not always reflect the actual appropriations determined by Congress. Final budget allocations for USAID's programs are not determined until after passage of an appropriations bill and preparation of the Operating Year Budget (OYB).
MOZAMBIQUE
FY 1998 Development Fund for Africa . . . . . . . . . . . . . . . . . $38,200,000 FY 1998 P.L. 480 Title II . . . . . . . . . . . . . . . . . $14,511,000 FY 1998 P.L. 480 Title III . . . . . . . . . . . . . . . . . $5,000,000 Introduction
Given Mozambique's importance in providing ocean access for its landlocked neighbors and its proximity to the Republic of South Africa, political stability and economic growth in Mozambique contribute to U.S. national interests throughout the entire southern Africa region. U.S. interest in Mozambique also lies in the role it plays in the development of the southern African region as a growing market for U.S. exports. An American firm, ENRON, is developing a natural gas project worth roughly $700 million, potentially the largest recent American investment in sub-Saharan Africa. Another American firm, Seaboard Corporation, has invested in a strategic maize and wheat milling operation.Mozambique is considered a major success story in war-to-peace transition programs in sub-Saharan Africa and is showing much promise in moving forward on its post-transition development efforts. USAID's support has been vital to Mozambique's peace and development efforts. The transition from brutal civil war to peace that began with the signing of the Peace Accords in October 1992 has encompassed the demobilization of opposing armies, resettlement of almost five million displaced persons and refugees, successful democratic elections, and the installation of a new government that gives high priority to economic reform. Mozambique's transition from war to peace, and relief to development continued to gain momentum throughout 1996, and is now nearly complete. War is becoming a distant memory and peace is becoming the normal state of society. The country was moving toward food self-sufficiency in 1996 and greatly reduced its reliance on external resources for relief and humanitarian assistance. Mozambique is making ever more effective use of available resources to achieve sustainable development. USAID is playing a key role in helping to create the conditions for a stable multi-party democracy with regular elections and effective citizen participation in decentralized government structures. USAID is also helping Mozambique to abandon central planning and to rely instead upon policies which lead to a rapidly growing, private-sector driven, free-market economy. As the transition process comes to a close, USAID's role in strengthening new democratic institutions and consolidating democratic processes grows even more critical. USAID's program will continue to contribute significantly as a catalyst for policy reform and in shaping the democratic and market institutions. USAID-funded programs have made, and need to continue to make, major contributions to the war-to-peace transition and the economic reform program.
The Development Challenge.
In spite of the successful transition process, Mozambique still has a long road to travel to eradicate poverty, eliminate malnutrition, reduce mortality and increase literacy and incomes. With an official average per capita income of $90 annually, Mozambique is among the poorest countries in the world. The overwhelming majority of Mozambicans live in poverty. Eighty percent of the total population lives in rural areas, two-thirds of them in absolute poverty. Rain-fed subsistence agriculture leaves the rural poor particularly vulnerable to recurrent droughts and natural disasters. The average daily caloric intake in Mozambique is just 77% of the daily estimated requirement (the average for sub-Saharan Africa is 93%). Chronic malnutrition is estimated to affect 30% to 40% of Mozambique's children, with 6% believed to be acutely malnourished.Meanwhile, the population's growth rate of 2.7% per annum erodes improvements in the standard of living. Mozambique's social services were decimated by war. One-third of all rural health units were either destroyed or closed during the long civil war there, with the result that roughly 60% of the population still lacks access to health services. Fifty percent of child deaths in Mozambique's hospitalsare attributable to common, treatable diseases. HIV infection in the parts of the country where USAID focuses its program is estimated at 10%. Illiteracy rates are 25% higher than the average for sub-Saharan Africa, although significant progress is being made in reopening the nearly 70% of primary schools which had been closed during the civil war.
A sine qua non for both rapid economic growth and democratization is good policies. USAID has been a leader among donors in supporting Mozambique's economic and political reform agenda. USAID has urged rapid privatization of state-owned firms, actively promoted private American investment in Mozambique (ENRON and Seaboard), and encouraged the Government of Mozambique (GRM) to move swiftly on financial sector reform and to clamp down on corruption. The rate of inflation had dropped from 45% in 1995 to under 20% in 1996. An unusually high level of donor collaboration exists with respect to both economic policy reform and good governance. USAID's policy dialogue with the GRM's economic team is collaborative, productive and open. This sets a positive framework for development assistance programs. Donor coordination on such programs is dynamic and effective.
The GRM recently instituted an ambitious program of financial sector reform, customs and tax reform, investment promotion, privatization, decentralization, and combatting corruption. The major commercial banks have been privatized, the customs services put under private management, an increasing number of state-owned enterprises privatized (over 700 so far), and the U.S. Treasury, at the request of the Ministry of Finance, has examined and made recommendations to improve Mozambique's tax structure. Mozambique, however, has a particular vulnerability with an external debt burden of approximately $5.2 billion, or nearly four times the Gross Domestic Product ($1.5 billion), as well as an exceptionally high dependence on external assistance (approximately $1 billion annually).
Mozambique's transition to democracy is still fragile. The willingness of the Executive Branch to share power with an increasingly capable National Assembly is tentative, and will require years of nurturing and strong political commitment. Internalizing the electoral process so that it becomes a permanent feature of Mozambique's new democracy will also require time and effort. In Mozambique, as in other African countries, there is no lack of human rights laws, but rather of an independent and effective judicial system able to ensure that such laws are consistently applied. The same can be said of laws pertaining to commercial transactions and national "economic management." As the GRM seeks to increase the pace of Mozambique's economic reform process, the weaknesses of the judicial sector will hamper progress. Unless the judiciary has the capacity to be independent and effective, the "rule of law" is an empty slogan. Increases in the prevalence of corruption and crime are of growing concern. However, the recent dismissal of the Minister of the Interior for failing to effectively combat corruption and crime is a positive sign. Greater community participation in local decision-making depends upon effective implementation of GRM decentralization goals. Delivery of social services, such as health care and basic education, requires innovative approaches involving local community participation to ensure sustainability. The task of consolidating Mozambique's economic and political reforms is complicated by its extreme poverty. Mozambique is heading in the right direction and making difficult but correct choices concerning economic, political and social policies. However, Mozambique's good intentions are often compromised by a weak institutional base, a dearth of human capital, and the fragility of the economic reform program. Continued U.S. assistance at this juncture will consolidate the gains noted above and contribute directly to preserving regional security, economic growth and poverty alleviation.
Other Donors
Recent figures indicate that the United States is the second largest bilateral donor in Mozambique and in FY 1995 committed $ 96 million. The donor community at large pledged roughly one billion dollars last year for development assistance. Other major contributors include the World Bank, the International Monetary Fund, the United Nations agencies, the European Union, Germany, Portugal, Sweden, Denmark, Switzerland, Italy and the Netherlands.FY 1998 Program
USAID's strategy focuses on the enhancement of human productivity through 1) increasing rural household income; 2) strengthening the partnership of government and civil society in democratic governance; and 3) increasing the use of essential maternal/child health and family planning services. Increasing rural income will not only provide resources to improve the quality of life, but will also lead to on-farm investments and expansion of nascent rural enterprises. Democracy and good governance, which both require and promote informed participation, accountability, and respect for human rights, are inextricably linked to sustainable development. Primary health care is critical to enhancing human productivity. Healthy people contribute to increased economic productivity and participation in governance and are better able to devote time and resources to improving their families' well-being.Agency Goal: Encouraging Broad-based Economic Growth
As one of the world's poorest countries, Mozambique requires broad-based, sustainable economic growth to reduce the number of its citizens living in poverty. The engine for this country's growth will be the agricultural sector, which employs the majority of Mozambique's heavily rural population. USAID will continue its leadership role in promoting policy reform through the Title III program, and technology transfer, market development, micro-enterprise expansion, and infrastructure rehabilitation through its regular portfolio of activities as the foundation of its strategy to accelerate economic growth. Mozambique is well-endowed with agricultural resources and possesses one of the best arable land-to-population ratios in sub-Saharan Africa. USAID's strategy will focus on the central provinces which provide homes for over half of the population and the highest agricultural potential. USAID, in collaboration with its private voluntary organization (PVO) partners, undertook a food security assessment and prepared a new strategy in March 1996. These activities will serve as the basis for the design of a new multi-year Title III program, Title II development activity proposals, and new food security related activities under the Africa Food Security Initiative.The strategy supports improved access and market development, expanded rural enterprise, and increased agricultural production. The Title III program will bring about agreement to change policies which are constraining the development of agricultural markets and production. Prominent among these will be revised procedures and regulations of the land law. These will recognize and reinforce the right of smallholders and encourage sustainable land use by small farmers and other investors, simplify licensing and registration of traders, transporters, agro-processors, and foreign investors, reduce government interference in influencing prices in ways which discourage market activity, and a policy framework within which rural financial institutions and lending programs develop and extend credit to micro-enterprises. In the post-war period, USAID-funded PVO activities provided nearly one million returning refugees and internally dislocated persons with food and/or seeds and basic tools to enable them to re-establish their farms. They will not, however, be able to increase their incomes unless they have access to improved transport. Recent USAID projects have demined and opened over 1,200 miles of rural access roads and reopened the bridge that links the north to the south, thereby significantly increasing local capacity to move surplus food crops to food-deficit areas. USAID has also identified an additional 900 miles of high-priority access roads for rehabilitation in its target areas that will further encourage agricultural production, lower the cost of marketing food crops and thus contribute to improved national food security. Support for the formation and expansion of rural enterprises will provide additional opportunities for value-added transformation, expanded services delivery and employment generation.
Africa Food Security Initiative
Under the Africa Food Security Initiative (AFSI), the Mission proposes to undertake a number of activities to increase the availability of, access to, and utilization of food for a significant number of Mozambicans. With AFSI funding, the Mission will include: (1) rehabilitating additional farm-to-market roads using proven labor-intensive methods; (2) creating the financing mechanisms involving apartnership between public and private for- and not-for-profit entities for the provision of services to promote the production, processing, and marketing of cashews and eventually other commodities; and (3) strengthening the capacity of the Ministry of Agriculture to analyze, promulgate and implement policies that stimulate agricultural production and marketing, and promote the sustainable provision of services to the sector. The latter will also help implement the sector investment program (PROGRI) by identifying the factors constraining the growth of agricultural production and marketing and at the same time provide the Mission with the information it needs to assess progress in achieving the Mission's SO1: Increased Rural Household Income in Targeted Areas.
Funding for AFSI activities will permit the Mission to increase the rehabilitation of farm-to-market roads to develop markets essential to providing farmers with incentives and price signals to increase their production, in moving produce from production centers to consumers and in increasing the marketed food supply and lowering the cost of food to consumers. The increased marketing of agricultural produce, along with efforts to identify and spread technologies that, when adopted by smallholder farmers in response to market demand, will permit farmers to sustainably increase agricultural output, and efforts to stimulate small and micro rural enterprise development assisted through PVOs, will increase rural household income in a significantly large area of rural Mozambique. All of these efforts, complemented by the work of PVOs through the Title II development activity proposals and in collaboration with the GRM, will lead to increased national and household food security.
Strategic Objective 1: Rural Household Income Increased in Targeted Areas Agency Goal: Protecting the Environment
The role of the environment in sustainable agricultural development and economic growth is critical. Productivity will be increased by preserving the resource base through sustainable management practices and by strengthening environmentally sensitive, market-driven incentives. USAID-funded activities will support rehabilitation of Mozambique's agriculture on an environmentally sustainable basis by creating opportunities for alternative resource uses through promotion of environmental enterprises, non-timber forest products, community-based natural resource management and integrated conservation and development projects. USAID will encourage community participation with the GRM in natural resource management. In conjunction with the Mission's road rehabilitation project, activities will be initiated to support biodiversity protection in buffer zones by working with communities to develop sustainable alternatives to poaching and illegal logging. Support will also be provided to strengthen the GRM's capacity to establish and implement environmental policies.
Strategic Objective 1: Rural Household Income Increased in Targeted Areas Agency Goal: Building Democracy
Emerging from 16 years of civil war and a single-party socialist government, Mozambique held successful multi-party presidential and legislative elections in 1994. While democratic institutions and processes exist at this time, they are still very fragile. USAID works on both the supply side (changes in the role, structure and effectiveness of government) and the demand side (strengthened civil society institutions and processes). A greater balance in the government-civil society partnership will correct the historically predominant role of the Executive Branch over the political, social and economic life of citizens, which was identified in the Mission's country strategic plan as the primary constraint to more democratic governance in Mozambique. The results of USAID's democracy building program will be: (i) the formulation and implementation of key macro-political reforms, such as the strengthening of an independent judiciary; (ii) increased citizen participation in governance at national and local levels, through broadened public debate; and (iii) effective and accountable government and civil society institutions at both national and local levels.There have been notable actions on the part of the GRM and the National Assembly related to improved governance and increased transparency. The issue of corruption is openly discussed in the press and National Assembly; anti-corruption legislation is also being debated. High priority is being given to decentralization of authority and the modernization of state administration. Following successful democratic elections in 1994, efforts are underway to institutionalize the electoral process and prepare for local elections, which are currently scheduled for 1997. There is recognition in all sectors of government that judicial reform is essential if Mozambique is to achieve its desired political and economic reforms. The commercial code is a legacy of past centuries and is out of sync with Mozambique's desire to promote international trade and foreign investment. Further changes in land tenure laws are required to encourage investment, to facilitate property transfer, and to ensure sustainable use of natural resources. The administration of justice needs to be revamped and alternative mechanisms established for conflict resolution, such as those provided by traditional authorities.
Strategic Objective 2: Government and Civil Society Are Effective Partners in Democratic Governance at National and Local Levels Agency Goal: Stabilizing World Population Growth and Protecting Human Health
Of the total funding requested for Population and Health, $6,000,000 is planned for population activities and $10,400,000 is planned for health activities. In Mozambique, where the health status is so poor for the majority of the population and existing systems and resources so inadequate, it is not surprising that maternal, infant and under-five child mortality are among the worst in the world. Shortened life expectancy, high fertility and frequent morbidity from mostly preventable disease have taken their toll on Mozambique's predominantly rural population. During the emergency and post-civil war periods, USAID's comparative advantage in primary health care delivery played a key role in helping Mozambique to avert health crises in many rural areas. Through the Primary Health Care Support Project, critical gaps in the supply of essential drugs were filled with USAID-financed commodities. Under this Project, USAID began the process of strengthening management in the public sector for decentralization of health services. While financial, human and institutional resources are still woefully inadequate to meet the needs of rural Mozambicans, progress is being made in using limited public sector resources more efficiently and effectively. Outside the public sector, USAID continues to support international PVOs working on high-priority child survival interventions under the PVO Support II Project. PVOs and their indigenous partners are expanding basic health activities to include reproductive health, HIV/STD/AIDS and family planning. Close collaboration with PVOs/NGOs has been and will continue to be critical, as the Mission's health strategy focuses on innovative, low-cost health interventions at the community level. These interventions are designed to provide effective, sustainable health care to the nearly two-thirds of the population living outside the reach of a fixed facility.The health care infrastructure in Mozambique lacks the institutional, human and financial resources to deliver quality health services at all levels, especially in the rural areas. USAID has been a world leader in developing innovative, low-cost mechanisms to deliver basic lifesaving health services to mothers and children. USAID's comparative advantage in the health sector lies in health services delivery as evidenced by past achievements in its Primary Health Care Support Project, USAID supplied essential drugs to rural health facilities, and provided technical assistance and in-service training for improved management and increased use of data for planning purposes in several provinces. USAID/Mozambique and its PVO partners have achieved significant service delivery results in emergency health and nutrition. These low-cost/community-based health service delivery mechanisms will be improved and expanded to newly-resettled areas. While the percentage of government resources allocated to the social sectors increased dramatically last year, they are nonetheless inadequate to provide basic services. The PVO community has collaborated closely with USAID in the formulation of USAID's strategy. Both USAID and the GRM are relying on community-led initiatives, with PVO assistance, to expand the availability of and access to adequate health care.
Strategic Objective 3: Use of Essential Maternal/Child Health and Family Planning Services Increased in Focus Areas Agency Goal: Providing Humanitarian Assistance
With drought an endemic problem in Mozambique, food security for a significant percentage of the population is threatened on a regular basis. Improvements in food crop marketing and transportation will help to diminish this problem but, for the near term, periodic emergency assistance will likely be required. USAID retains its capacity to provide humanitarian assistance using a combination of P.L. 480 Title II Emergency and Office of Foreign Disaster Assistance resources. The USAID food security assessment recommended phasing down the historical support provided by Title II emergency feeding programs and instead increasing the role of development-oriented Title II and Title III efforts.
Strategic Objective 1: Rural Household Income Increased in Targeted Areas
MOZAMBIQUE
FY 1998 PROGRAM SUMMARY
Encouraging
Broad-based Economic Growth
Stabilizing World Population Growth & Protecting Human Health
Protecting the Environment
Building
Democracy
Providing Humanitarian Assistance
TOTALS
USAID Strategic Objectives 1. Rural household income increased in targeted areas - Dev. Fund for Africa
- P.L. 480 Title II
- P.L. 480 Title III
14,700,000
---
5,000,000
---
---
---
6,100,000
---
---
---
---
---
---
14,511,000
---
20,800,000
14,511,000
5,000,000
2. Government more accountable to citizens - Dev. Fund for Africa
---
---
---
2,000,000
---
2,000,000
3. Use of essential maternal/child health/ family planning services increased in focus areas - Dev. Fund for Africa
---
16,400,000
---
---
---
16,400,000
Totals - Dev. Fund for Africa
- P.L. 480 Title II
- P.L. 480 Title III
14,700,000
---
5,000,000
16,400,000
---
---
6,100,000
---
---
2,000,000
---
---
---
14,511,000
---
39,200,000
14,511,000
5,000,000
USAID Mission Director: George Wachtenheim
ACTIVITY DATA SHEET
PROGRAM: MOZAMBIQUE
TITLE AND NUMBER: Rural Household Income Increased in Targeted Areas, 656-S001
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998: $20,800,000 DFA; $14,511,000 P.L.480 Title II; $5,000,000 Title III
INITIAL OBLIGATION: FY 1996; ESTIMATED COMPLETION DATE: FY 2001
Purpose: To increase household income of the rural poor in the central provinces of Mozambique by increasing access to markets, expanding rural enterprises and increasing sustainable agricultural output.
Background: Mozambique's economy was shattered by years of civil war and economic mismanagement. With peace and stability, a concerted effort to develop the country economically is now possible. This rural, largely agrarian, society will depend upon smallholder agriculture to propel export and overall economic growth for the foreseeable future. Therefore, USAID will direct its resources to help create the conditions to improve rural incomes through labor-intensive activities such as farming and expanding small and microenterprises to stimulate rapid growth of the direct incomes of the rural poor. This approach will produce growth with equity and contribute significantly to enhanced national food security.
USAID Role and Achievements to Date: This strategic objective builds upon the highly successful Transition Program that removed economic policies constraining the private sector, supplied a broad safety net by providing food aid and the seeds and tools needed to re-establish agricultural production, and improved market infrastructure. While the focus of the Transition Program was on averting deaths due to hunger and disease, bringing peace to the land, and reintegrating dislocated populations into the social and economic life of the country, the current strategy focuses on the development of the productive capacity of the rural population. The resurgence of agricultural production and economic activity is readily apparent. In the past year, the country moved from producing 72% to 85% of its own cereal food requirements, and improved its capacity to commercially purchase the remainder. The production of the important food crops, as well as cotton and cashews, increased significantly for the second year in a row.
Description: To increase sustainable agricultural output and expand rural small and microenterprises, the PVO Support II Project finances the work of PVOs to deliver improved seed and farming know-how to smallholders and increase the value-added processing and marketing of their production, while transferring business and entrepreneurial skills. Activities that include preservation of the natural resource base will be encouraged. Developmental food aid programs contribute significantly to these objectives by using food-for-work and monetized local currencies for the same purposes. To increase market access, the Private Sector Support Program and Technical Assistance Project are promoting an improved economic policy environment and disseminating market information that provide incentives to agricultural production. Perhaps most importantly, the new Rural Access Project is continuing to rehabilitate rural access roads, thus linking surplus food-producing areas with food deficit areas.
P.L. 480 Title II and anticipated Title III activities fall under strategic objective one and also contribute to the third strategic objective, Increased Use of Essential Maternal Child Health and Family Planning Services. These two strategic objectives jointly address food security issues and the programming of Title II and III resources: the food security objectives of access and availability are both addressed through strategic objective one; food utilization is addressed under strategic objective three.
USAID activities under Titles II and III have moved from a relief focus to a developmental focus. Under Title II, USAID will work with its PVO partners (World Vision, Food for the Hungry, CARE, Africare, ADRA and Save the Children) to design and implement programs to promote greater food access, availability and utilization. The earlier Title III commercial food aid program successfully engaged the private sector, and especially microenterprises, in the cereals market trade. The new multi-year Title III program will work to expand local oilseed production and processing, as well as continue to leverage policy reforms in liberalizing prices and marketing, de-regulating private formal and informal trade of agricultural commodities and sustainable land use management. Future year programs and funding levels will be contingent upon improvements in the policy framework and maintenance of adequate security measures at the ports. The commodities being considered for both Title II monetization and Title III programs are wheat and crude vegetable oil.
Under the Africa Food Security Initiative (AFSI), USAID Mozambique will strengthen the GRM's analytical capabilities and policy making capacity to undertake needed policy reforms in support of improved food security. Also included will be activities to strengthen financial mechanism for marketing and processing together with the requisite emphasis of business skill transfer for farmer associations and rural enterprises. AFSI-supported activities will contribute directly to achievement of the Mission's sub-goal of enhanced national food security.
Host Country and Other Donors: Key donors providing technical assistance in rural development of the central provinces include the World Bank, United States, Sweden, Denmark, Germany and Great Britain; these donors meet regularly to coordinate efforts. The Ministry of Public Works and Housing effectively coordinates donor assistance for rural road rehabilitation under the World Bank-led Roads and Coastal Shipping Project. Under the Ministry of Agriculture and Fisheries, a donor working group is chaired by the Vice-Minister, and a sub-working group coordinates the assistance of donors to the reform and implementation of land use policies. Donors are active in discussion and coordination with the GRM of macroeconomic issues (with USAID playing a key role) and sectoral policy formulation.
Beneficiaries: An estimated nine million people, 52% of Mozambique's population, live in the target areas for the USAID strategy. Virtually all of these will benefit from the improved policy environment and market information system. In conjunction with other donors, the overall multi-donor roads program and market information system will improve market access for 65% of the population. Food aid assistance, either through food for work programs or monetized food commodities (programs that permit the use of local currency from the sale of U.S.-provided food aid), will provide a food safety net for 2.5 million people.
Principal Contractors, Grantees, or Agencies: PVOs include World Vision, Care, Africare, Food for the Hungry, National Cooperative Business Association, Heifer Project, Save the Children, World Relief, and the Adventist Relief and Development Agency. U.S. universities include Michigan State University and the University of Wisconsin.
Major Results Indicators: Baseline Target Increase in real average household income $ 55 per annum (1995) $98 per annum(2001) Change in volume and value (corn) 83,000 tons (1995) 134,000 tons(2001) of marketed goods (beans) 12,500 tons (1995) 20,100 tons(2001) (cashews) 22,000 tons (1995) 35,400 tons(2001) Change in the size and number of small and micro-enterprises Increase crop production (corn) 346,500 tons (1995) 449,000 tons (2001) (in four target provinces) Increase livestock production 90,500 (1995) 145,500 (2001) -small ruminants (in four target provinces)
ACTIVITY DATA SHEET
PROGRAM: MOZAMBIQUE
TITLE AND NUMBER: Government and Civil Society Are Effective Partners in Democratic Governance at National and Local Levels, 656-S002
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998: $2,000,000 DFA
INITIAL OBLIGATION: FY 1996; ESTIMATED COMPLETION DATE: FY 2001
Purpose: To promote citizen participation and increase the effectiveness of both government and civil society in democratic governance.
Background: The government in Mozambique has historically been unresponsive, due to lack of will, capacity and resources, to the needs and interests of the vast majority of the population. Following the end of nearly two decades of civil war, the central government's power and authority in much of the rural countryside is marginal. Over the last three or four years, however, slow improvements in democracy and governance are discernable. The scores for Freedom House's Political Rights and Civil Liberties indices have both improved since 1994. However, serious problems still exist: for example, there is a sense held by much of the public that there is little justice in the country. This feeling contributes to a profound sense of insecurity and distrust within the population which undermines the emergence of a robust civil society as well as investment in economic activities. This program includes the final four years of DG activities under the Democratic Initiatives Project.
USAID Role and Achievements to Date: Mozambique represents one of the all-too-few "transition-to-democracy" success stories in Africa. USAID can take a large part of the credit for this result, starting with crucial support for the 1994 national elections which are considered a model by international observers. As a result of USAID activities, in the past few months the national legislature has undertaken steps to broaden the exchange and dissemination of information on key public policy issues by for the first time conducting public hearings and question-and-answer sessions with constituents. Support to civil society institutions has resulted in national and local initiatives to bring together political actors that in the past have at best not communicated well, and at worst have been deeply distrustful towards one another, resulting in more sustainable democratic and participatory governance.
Description: Activities focus on three complementary results areas. The first, the formulation and implementation of key macro-political reforms, is predicated on the belief that sustainable improvements in democracy and governance require a solid foundation in terms of the policy, legal and regulatory environment. USAID will continue to play a lead role among donors in engaging in a policy dialogue with the government that will contribute to implementable macro-political reforms. The second set of results pertains to increased citizen participation in governance at national and local levels. This area relates to the broadening of citizen participation in democratic processes such as public debate and elections at both national and local levels. A new DG sub-sector which USAID is supporting is the administration of justice. Although laws may seem to affect all citizens, in reality participation in modern judicial processes is low. Due to high transaction costs and uncertainty that laws will be applied in an equitable and just manner, the result for all but a few privileged citizens is that the legal system does not exist. A leadership development program also is planned which will help to provide new local governmental entities with more qualified elected leaders.
The third results area is focused on institutional strengthening of the effectiveness and accountability of both government and civil society organizations. Support will continue to be given to civil society groups, the national assembly, and, after local elections are held in late 1997, will be directed at new municipal assemblies as well. Other assistance will continue to be targeted at key institutions in the Executive Branch involved with public sector reform and anti-corruption efforts. Support to judicial system institutions begun in FY 1997 will also continue.
Host Country and Other Donors: Since the end of 1996, USAID has worked more closely with the Mozambican government in DG programming, while at the same time continuing to support civil society institutions. The World Bank, the United Nations Development Program, and the European Union will likely continue their significant DG programs. In terms of resource levels, the USAID program ranks perhaps fifth or sixth in overall size, and third or fourth among bilateral programs. In terms of influence and impact, however, the U.S. effort ranks near the top. While several other major DG donors are primarily supporting technical aspects of improved governance, e.g., providing material support to local governmental units, USAID tends to focus on the improvement of processes, such as strengthening legislative debate. USAID is also at the forefront of efforts to improve government accountability. It should be noted that in the DG sector USAID works extremely closely with other donors through the Aid for Democracy Group chaired by the United Nations Development Program.
Beneficiaries: USAID's customer service plan identifies beneficiaries of the DG program as all Mozambicans; the entire population will benefit from enhanced democracy and improved governance. Given the programmatic emphasis on greater participation, however, historically disenfranchised groups, including rural residents and women throughout the country, will be particularly benefited. Although democracy and governance are clearly national issues, due to resource constraints USAID will necessarily focus some activities in the four central provinces selected as the target of the overall USAID program. Given the potential impact of improved governance on USAID's economic and social sector efforts, such a strategy will promote useful synergy between many of USAID's activities.
Principal Contractors, Grantees, or Agencies: Activities will be implemented primarily through U.S. and local NGOs. U.S. organizations involved with the current program include the National Democratic Institute, the African American Institute, the International Foundation for Electoral Systems, and the State University of New York. USAID's principal governmental partners include the Ministry of State Administration, the National Assembly, and the Supreme Court.
Major Results Indicators: Baseline Target Within focus areas, perceptions Nat. Level - 1% (1996) Nat. Level-25%(2001) of influence on public decisions by Political actors (citizens, political Local level - 0% Local Level leaders, national and local level (1996) In Target Area-50% (2001) assembly deputies, civil society actors) (1996) In Focus Area-25% (2001) (1996) Nationally-15% (2001) Key macro-political reforms implemented 7 to 13 reforms (1996) implemented (2001) Increased citizen participation in National Level - 1% (1996) National - 25% (2001) governance at the national/local levels Local Level - 0% (1996) Local - 50% (2001) National assembly deputies 35% (1996) 100% (2001) who have consulted constituents last six months Local assembly deputies who have 0% (1996) 50% (2001) consulted constituents last six months Government and civil society National Level - 5% (1996) National Level - 50% (2001) institutions are effective and Local Level - 5% (1996) Local Level - 75% (2001) accountable at national/local levels.
ACTIVITY DATA SHEET
PROGRAM: MOZAMBIQUE
TITLE AND NUMBER: Use of Essential Maternal/Child Health (MCH) and Family
Planning Services in Focus Areas, 656-S003
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998: $16,400,000 DFA
INITIAL OBLIGATION: FY 1996; ESTIMATED COMPLETION DATE: FY 2001
Purpose: To increase use of essential maternal child health and family planning services by increasing access to and demand for community-based services and improving management in focus areas.
Background: Current estimates of infant, child and maternal mortality suggest that health conditions in Mozambique are among the worst in the world. The infant mortality rate is estimated to be 140 to 173 per 1,000 live births, while child mortality is estimated between 260 to 280 per 1,000. The official maternal mortality ratio is 300 maternal deaths per 100,000 live births, but the actual ratio is thought to be much higher since approximately 60% of births occur without assistance from a trained provider (thus, data are not captured). In addition, due in part to massive population movements during and after the civil war, it is estimated that 10% of the population in USAID focus areas is infected with HIV/AIDS. Access to health information and services remains the major constraint to increased use of health services. Only an estimated 30% of the population has access to health care, and as many as 40% of the facilities have no trained staff. The health sector lacks the institutional, human and financial resources to deliver quality health services, as well as an adequate information base on which to make decisions and set priorities.
USAID Role and Achievements to Date: Through its Primary Health Care Support Project, USAID has supplied essential drugs to most rural health facilities throughout the country. The project also provides technical assistance and in-service training for improved management and increased use of data for planning purposes in three provinces. The project and the institutional contract were extended for two years to consolidate achievements at the provincial level and to introduce decentralized planning and strengthened management in selected districts.
Through the PVO Support II Project, USAID provides grants to U.S. and international PVOs to improve rural health by delivering basic health and family planning information and services. This support has evolved from an emergency-oriented approach to one stressing long-term development and sustainability. As the Mission implements its new strategy, increased emphasis will be placed on child survival and reproductive health issues and on strengthening the capacity of indigenous partner NGOs to deliver community-based health services.
USAID's comparative advantage in this SO can make a significant difference, given 1) that USAID is a leader in MCH and family planning and has decades of experience supporting innovative low-cost approaches to health service delivery; 2) the Mission's credibility and experience in the sector; and 3) the GRM's receptivity and commitment to providing basic, decentralized health services.
Description: SO3 includes three results packages (RPs): 1) increased access to health services; 2) increased demand for these services; and 3) strengthened management of decentralized services. RPs 1 and 2 focus on delivery of essential community based maternal child health and family planning services and practices, including diarrheal disease prevention and treatment, vaccination, child spacing, prenatal care, nutrition, health education, breast-feeding promotion, and HIV/AIDS and sexually-transmitted diseases prevention and treatment. Activities entail working with communities, the Mozambican government, NGOs and the private sector to assure and expand cost-effective service delivery, while increasing community responsibility for and family knowledge of essential health behaviors and interventions. Under RP3, USAID is funding health activities for decentralization, improved pharmaceutical management, health care financing and improved systems for data collection and analysis. SO3 activities are designed to strengthen the capacity of the government and non-governmental organizations to develop and sustain effective health (including reproductive health) policies and to expand effective and efficient quality service delivery.
Host Country and Other Donors: Mozambique relies heavily on donor support for its health services, particularly in rehabilitating or refurbishing rural health facilities which were destroyed by war. However, few donors are dealing directly with community-based support for maternal child health services. Swiss Cooperation, at the request of the Ministry of Health, has taken the lead in coordinating donor activity in the area of health. At the same time, donors are "buying in" to central and provincial-level plans for health activities as the government moves from centralized to provincially-based, decentralized administrative and financial systems.
Beneficiaries: Children under five years of age and women of child-bearing age in Mozambique represent almost 40% of Mozambique's population. The USAID-supported program will focus on the most densely populated provinces and will reach approximately nine million people.
Principal Contractors, Grantees, or Agencies: USAID will continue to make grants to eligible PVOs and indigenous NGOs to carry out activities in support of this strategic objective. USAID will use U.S.-based cooperating agencies to provide technical assistance for information, education and communication programs, logistics management, data collection and analysis and training. An institutional contractor will assist the Ministry of Health's decentralized management.
Major Results Indicators: Baseline Target Percent of children between ages 12 35% (1994) 65% (2001) and 23 months who have received diphtheria, pertussis, and tetanus vaccine Percent of infants less than 24 months 10% (1990) 25% (2001) of age who receive no foods or liquid other than breast milk Proportion of all cases of diarrhea in children 15% (1994) 25% (2001) under five treated with oral rehydration salts and/or a recommended home fluid. Percent of women of reproductive age who 3% (1994) 10% (2001) are using a modern contraceptive method at a particular point in time
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