[{"bbox": [96, 136, 1132, 189], "category": "Text", "text": "to support their children) affects early childhood stimulation, again affecting stunting. It is therefore critical to address maternal health as well as promoting shared responsibility between men and women⁴⁰."}, {"bbox": [96, 200, 1132, 440], "category": "Text", "text": "☒ **Entrenched inequalities.** Undernutrition displays significant disparities and inequities across geographical location (urban/rural, among provinces) and socio-economic groups. Stunting and anaemia rates are higher in rural areas, northern and central regions, twice higher in the lowest wealth quintile and among children whose mothers did not attend school. Household wealth, maternal education levels, family planning practices/family size are key contributors to malnutrition. The importance of female education⁴¹ deserves special highlight as it shows the persistent disparities in stunting reduction linked to maternal education levels (remaining unchanged or above 45% among children whose mothers had no education or only accomplished primary education). Provincial disparities are also worth mentioning, with women's education and household sanitary environment as two most significant determinants underpinning these disparities⁴²."}, {"bbox": [96, 452, 1132, 850], "category": "Text", "text": "☒ **Conflict and displacement in the northern provinces.** The Province of Cabo Delgado witnessed since 2017 the rapid escalation and intensification of an armed conflict. This has resulted in the displacement of over 800 000 people in the region and caused over 3 700 fatalities, primarily among civilians⁴³. The violence of the conflict fuelled concerns that it could further spread in Niassa and expand to the Nampula province, where underlying structural challenges are similar to Cabo Delgado's. These violent attacks have resulted in significant destruction of private and public properties and breaches of human rights. There has also been significant limitations to the access to basic social services. At least 30% of internally displaced people (IDPs) in northern Mozambique had to flee multiple times⁴⁴. These repeated displacements and the consequent destruction of livelihoods and loss of land, exhausted the scarce resources of families, which contributed to the growing need for food and nutrition assistance. The insecurity and violence in the North have particular implications for the youth, with 68% of the population being 25 or younger. Particularly women and young girls, and persons with disabilities, while displaced, can been exposed to sexual and gender-based violence (GBV), including sexual exploitation and abuse; trafficking, forced labor, physical and psychological violence, early and forced marriage, and unwanted and unintended pregnancies. Early childbearing in adolescents remains a key risk factor for both the young mothers and their children which contribute to low birth weight babies and high prevalence of stunting."}, {"bbox": [96, 861, 1132, 1101], "category": "Text", "text": "☒ **Climate change and natural disasters** poses an additional threat to food and nutrition security in Mozambique, particularly for children. Weather-related disasters are becoming increasingly strong and more frequent, with devastating impact across sectors and provision of services that are key for human capital development, including nutrition. As 70% of the fast growing Mozambican population depends on climate-sensitive agriculture for food and livelihoods, increased frequency and intensity of storms, droughts and floods are likely to pose pressure on agricultural income undermining livelihoods as well as the food and nutrition security of the whole country. The impacts are expected to increase the population at risk of malnutrition through multiple channels such as more frequent crop failures, diarrheal episodes due to inundated or unsanitary environments, contaminated water sources, and premature infant weaning in households facing climate-induced livelihood shocks."}, {"bbox": [96, 1127, 1132, 1187], "category": "Section-header", "text": "**Main stakeholders and institutional and/or organisational issues (mandates, potential roles, and capacities):**\n**Government counterparts (duty bearers):**"}, {"bbox": [96, 1192, 1132, 1352], "category": "Text", "text": "**For coordination:** Since 2010, the Technical Secretariat for Food and Nutrition Security (SETSAN)⁴⁵ and its decentralised offices at provincial level have acted as coordinator for the implementation of national strategies for stunting reduction. At district level, the functioning of multi-sectoral technical working groups have been supported (mainly through development partners' programmes) in order to strengthen yearly planning, budgeting and monitoring of nutrition interventions. These technical groups are crucial stakeholders as they are composed by focal points from relevant sectors involved in the implementation of specific and nutrition sensitive activities"}, {"bbox": [86, 1410, 1142, 1450], "category": "Footnote", "text": "⁴⁰ Analyses including Mozambique show that improving nutritional outcomes requires addressing the underlying determinants of poor nutrition in addition to empowering women and improving gender equality (Quisumbing et al. 2021)."}, {"bbox": [86, 1453, 1058, 1474], "category": "Footnote", "text": "⁴¹ Female secondary education enrolment remains as low as 27 percent at national (with Northern provinces having lowest women illiteracy rates)."}, {"bbox": [86, 1477, 1142, 1575], "category": "Footnote", "text": "⁴² All nutrition surveys carried out over the past years consistently show that Northern and Central provinces exhibit higher rates of chronic under-nutrition. In attempting to explain the reasons for such disparities, the Nutrition Situation and Causal Analysis commission by EU in 2014 compared the behaviour of four significant underlying and basic causal indicators at provincial level: maternal education (women illiteracy rates), prevalence of early pregnancies, household access to safe water and improved sanitation. The values for these four indicators clearly show that the conditions for better nutrition are poorer in Northern provinces compared to the Southern ones."}, {"bbox": [86, 1577, 197, 1596], "category": "Footnote", "text": "⁴³ ACLED 2021."}, {"bbox": [86, 1600, 365, 1620], "category": "Footnote", "text": "⁴⁴ OCHA, The cost of inaction, June 2021"}, {"bbox": [86, 1624, 643, 1644], "category": "Footnote", "text": "⁴⁵ SETSAN is under the Ministry of Agriculture and Rural Development (MADER)"}, {"bbox": [1038, 1681, 1142, 1705], "category": "Page-footer", "text": "Page 9 of 31"}]