M OZ AM BI Q U E G EN D ER A S SE S SM EN T Leveraging women and girls’ potential Photo credits. Cover: © Andrea Borgarello / World Bank; pX: ©Vincent Tremeau/World Bank Group; p8: ©2019 777Stvolin/Shutterstock; p12: ©Vincent Tremeau/World Bank Group. p34: © 2022 Ivan Bruno de M/Shutterstock; p46: ©2020 JonathanJonesCreate/Shutterstock; p58: ©Eric Miller/World Bank; p78: © Andrea Borgarello / World Bank; p92: ©2020 JonathanJonesCreate/Shutterstock; backcover: ©2019 nooaonphoto/ Shutterstock. MOZ A M BI Q U E G EN DER A S SE S SM EN T Leveraging women and girls’ potential MAY 2023 i Contents Acknowledgements vii Acronyms viii Executive Summary 1 References 6 Introduction 9 References 11 CHAPTER 1 Voice and Agency: Leveraging Women and Girls’ Potential 13 Women’s leadership and decision-making 14 Protecting girlhood: child marriage and adolescent pregnancy 17 Child marriage: robbing girls of childhood 18 Adolescent pregnancy: the early motherhood trap 21 Breaking the cycle of violence 24 Intimate partner violence 25 Violence in public spaces 28 Data and knowledge gaps 30 References 31 CHAPTER 2 Educate: Learning and Skills Development for Life 35 Keeping girls in school: Enrollment, retention, progression, and learning outcomes 36 Safe and inclusive schools 39 Contents ii Mozambique Gender Assessment  |  Leveraging women and girls’ potential Transitioning from education to employment 41 Data and knowledge gaps 43 References 44 CHAPTER 3 Enhancing the Health of Adolescent Girls and Women 47 Sexual and reproductive health and rights 48 Fertility and family planning: reaping the demographic dividend 49 Engaging men for improved reproductive health 51 HIV/AIDS has a female face 52 Persons living with disabilities are also at higher risk of contracting HIV/AIDS 54 Data and knowledge gaps 55 References 56 CHAPTER 4 Economic Inclusion 59 Female labor force participation 60 Gender gap in agricultural productivity 63 Access to land 65 Wage employment 67 Entrepreneurship 68 Financial inclusion 70 Data and knowledge gaps 73 References 74 CHAPTER 5 Resilience and Inclusion 79 Resilience: conflict and climate-related shocks 80 Inclusion 83 Regional disparities 83 Contents Mozambique Gender Assessment  |  Leveraging women and girls’ potential iii Sexual orientation and gender identity 84 Disability and gender 85 Data and knowledge gaps 86 References 87 CHAPTER 6 Strategic Priority Areas 93 Strategic Priority 1: Reduce adolescent pregnancy and child marriage, and keep girls in school  95 Strategic Priority 2: Increase women’s economic opportunities and productivity 98 Strategic Priority 3: Improve women and girls’ SRMH, reduce unequal burden of HIV/AIDS, and reduce fertility rates 101 Strategic Priority 4: Reduce high rates of GBV and improve access to survivor support services 104 Strategic Priority 5: Increase women and girls’ resilience to climate change, natural disasters, and conflict shocks 106 References 108 Annex 1: Women, Business and the Law Mozambique Country Brief 115 Annex 2: Gender-Based Violence Definitions 116 Figures Figure 1: Gender assessment overview 10 Figure 2: Ibrahim Index of African Governance: 2019 Gender Indicators 14 Figure 3: Husband controls wife’s earnings, by wealth quintile, 2015 15 Figure 4: Husband controls wife’s earnings, by wife’s education level, 2015 15 Figure 5: Child marriage and adolescent pregnancy rates, 1997–2015 (%) 18 Figure 6: Women age 20–24 first married by age 15, 2015 19 Figure 7: Women age 20–24 first married by age 18, 2015 19 Figure 8: Share of adolescent girls (15–19) who have begun childbearing, 2015 (%) 21 Figure 9: Use of any method of contraception by women ages 15–19, 2015 (%) 22 Figure 10: Use of any modern method of contraception, all women, 2015 (%) 22 Figure 11: Ecological model of GBV risk factors 24 Figure 12: Women experiencing physical violence in the past 12 months, 2015 (%) 25 Figure 13: Women experiencing sexual violence in the past 12 months, 2015 (%) 25 Contents iv Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 14: School enrollment is particularly low among girls, 2015 36 Figure 15: Share of married and unmarried girls attending school, 2017 (%) 37 Figure 16: Association between gender of teacher and student test scores, 2018 38 Figure 17: Unmet need for family planning, 2015 (%) 50 Figure 18: Total fertility rate 15–49, 2015 (births per woman) 50 Figure 19: Labor force participation rates, 2019 (%) 61 Figure 20: Employment sector by gender and location, 2018 (%) 61 Figure 21: Gender gap in agricultural productivity, 2018 (%) 63 Figure 22: Property ownership type 65 Figure 23: Gender gaps in entrepreneurship productivity, 2018 (%) 69 Figure 24: Ownership of identification information, 2020 (%) 70 Figure 25: Use of savings mechanisms, 2020 (%) 72 Figure 26: Secured loans by gender, 2020 (%) 73 Figure 27: Comparison of access to basic services between national and regional levels, 2017 (%) 84 Figure 28: Ecological model for women and girls’ empowerment 94 Tables Table 1: Summary of policy and programmatic interventions 2 Table 2: Mozambique’s gender inequality index 10 Table 3: Familiarity with banks by gender, 2020 (%) 71 Boxes Box 1: Legal framework for child marriage 20 Box 2: Do child marriage laws work? 20 Box 3: Mozambican youth on use of modern contraception 23 Box 4: What works to prevent violence against women and girls 27 Box 5: National Strategic Plan for Professional Technical Education (2018–2024) 41 Box 6: Economic impacts of COVID-19 62 Box 7: Evidence on women crossing over into male-dominated sectors 67 Box 8: Criminal Code (2019) sexual harassment provisions 68 Box 9: Mozambique’s Climate Change and Gender Action Plan 83 Contents Mozambique Gender Assessment  |  Leveraging women and girls’ potential v Acknowledgements This report was prepared by a team led by Hiska Noemi Reyes and composed of Stephanie Kuttner, Laurel Eliza- beth Morrison, Isabel Micaela Santagostino Recavarren, Daniel John Kirkwood, and Tamara Bah. The team would like to extend sincere thanks to Olga Guerrero Horas and Marina Bassi for their guidance on the overall content, quality of analysis, and organizational structure. We also thank Valeria Cardia and Dbora De Carvalho for their support during the elaboration of the gender assessment as well as for leading on the Portuguese translation of the same. We profess our immense gratitude to the members of the Coalition of the Willing, civil society organizations and representatives from the Government of Mozambique for their participation in consultations and supporting the team to streamline the report’s main messages. For their managerial support and continued guidance, the team extends its appreciation to David Warren, Michel Matera, and Zviripayi Idah Pswarayi Riddihough. The report was peer reviewed by Helle Buchhave, Niklas Buehren, and Eliana Carolina Rubiano Matulevich. Sin- cere thanks also to Victoria Stanley, Diana Arango, and Steffen Soulejman Janus for their review of this assessment’s concept note. Acknowledgements Mozambique Gender Assessment  |  Leveraging women and girls’ potential vii Acronyms AGYW Adolescent Girls and Young Women GNI Gender Inequality Index AIDS Acquired Immunodeficiency Syndrome HDI Human Capital Index AMODEFA Mozambican Association for HIV Human Immunodeficiency Virus Development of the Family ICT Information and Communication AYFS Adolescent and Youth-Friendly Services Technology CAI Centro de Atendimento Integrado ID Identification (Integrated Service Center) ILO International Labor Organization CCGAP Climate Change and Gender Action IMAGES International Men and Gender Equality Plan Survey CCT Conditional Cash Transfer IMASIDA Inquérito de Indicadores de Imunização COVID-19 Coronavirus Disease (Survey of Immunization, Malaria and HIV/AIDS) CSA Climate-Smart Agriculture IPAJ Instituto do Patrocinio e Assitencia CSO Civil Society Organizations Juridica (Institute for Legal Assistance CWC Children with Disabilities and Representation) DHS Demographic Health Survey IPV Intimate Partner Violence DUAT Direito do Uso e Aproveitamento de MGCAS Ministério de Género, Criança e Acção Terra (Right to Land Use and Land Social (Ministry of Gender, Child and Benefit) Social Action) ELA Empowerment and Livelihood for MINEDH Ministério da Educação e Adolescents Desenvolvimento Humano (Ministry of Education and Human Development) FCV Fragility Conflict and Violence MISAU Ministério da Saúde (Ministry of FDI Foreign Direct Investment Health) GBV Gender-Based Violence MMR Maternal Mortality Ratio GDP Gross Domestic Product MSF Médecins Sans Frontières (Doctors GIL Gender Innovation Lab Without Borders) Acronyms viii Mozambique Gender Assessment  |  Leveraging women and girls’ potential MSM Men who have Sex with Men SOGI Sexual Orientation and Gender Identity MSME Micro, Small and Medium-sized SRH Sexual and Reproductive Health Enterprises SRHR Sexual and Reproductive Health and NEET Not in Education, Employment or Rights Training SRHS Sexual and Reproductive Health Services NGO Non-Governmental Organization STAT Statistics OHCHR Office of the High Commissioner for STEM Science Technology Engineering and Human Rights (UN) Math PEPFAR US President’s Emergency Plan for AIDS STI Sexually Transmitted Infection Relief TFR Total Fertility Rate PLWD Persons Living with Disabilities TVET Technical and Vocational Education and PLWHA Persons Living with HIV/AIDS Training PNAD Plano Nacional de Acção para Área da UCT Unconditional Cash Transfer Deficiência (National Plan of Action on Disability) UK United Kingdom PNDDR Programa Nacional de Desmobilização, UN United Nations Desarmamento e Reintegração UNFPA United Nations Population Fund (National Program for Disarmament UNICEF United Nations International Children’s Demobilization and Reintegration) Emergency Fund PPP Purchasing Power Parity USAID United States Agency for International SAAJ Serviços de Saúde Amigos dos Development Adolescentes e Jovens (Adolescent and VAC Violence Against Children Youth-Friendly Services) VSLA Village Savings and Loans Association SDI Service Delivery Indicators WASH Water Sanitation and Hygiene SINTEF Survey on Living Conditions Among People with Activity Limitations WBL Women Business and the Law SME Small and Medium-sized Enterprises WLWD Women Living with Disabilities Acronyms Mozambique Gender Assessment  |  Leveraging women and girls’ potential ix Mozambique Gender Assessment  |  Leveraging women and girls’ potential Executive Summary M ozambique has made great strides in reducing poverty rates in recent years. However, a series of overlapping crises, compounded by the COVID- surveys from which these data are drawn are (i) the 2011 Demographic Health Survey (DHS 2011),2 and (ii) the 2015 Survey of Indicators of Immunization, 19 pandemic, has caused scores of vulnerable Malaria and HIV/AIDS (IMASIDA 2015),3 which col- people to slide back into poverty and has reversed lected similar data to the DHS on key gender-related recent human development gains, particularly for topics. More recent administrative data from the Min- women and girls. Putting women and girls at the cen- istries of Education and of Health, as well as the Service ter of the recovery and development agenda will be key Delivery Indicators 2018 Survey,4 was used to comple- to regaining lost ground, as well as to achieving the pro- ment the DHS 2011 and IMASIDA 2015 data. Data ductivity and human capital gains needed to drive the on labor force participation is largely drawn from the country’s economic and spatial transformation, to reap- World Bank’s 2018 Jobs Diagnostic.5 Population data ing the demographic dividend, and to building social is drawn from the 2017 Census. Stakeholder consulta- cohesion and resilience to climate and conflict shocks. tions were also held in Maputo in July 2022 to confirm the assessment’s key findings and recommendations. This gender assessment has been prepared as an Data being collected at the time of this assessment’s input for the preparation of the World Bank’s writing (2022–23) for the next DHS will be key for Country Partnership Strategy for Mozambique understanding recent trends; a similar update to the (2023–2027). However, this assessment is not limited to Jobs Diagnostic is also needed. Unfortunately, there areas of the World Bank’s current country engagement; are indications that many human development and rather, it seeks to provide a general overview of the economic indicators are expected to have worsened as key challenges and opportunities facing Mozambican a result of the COVID-19 pandemic. In order to tar- women and girls across different dimensions of their get programs to regain this lost ground, such new data lives. The assessment adopts a life-cycle approach iden- will be important. tifying key inflection points in the lives of women and girls that either limit or facilitate their empowerment. Findings point to numerous challenges facing The assessment is based on a desk review of available women and girls in Mozambique. While the coun- studies, reports, and data from Mozambique, and draws try has largely achieved gender parity in primary on global evidence, largely from the Africa region. school education, once girls reach puberty, they start to drop out at higher rates than boys. A significant Much of the data used in this assessment was drawn driver of this is high rates of adolescent pregnancy and from the World Bank’s open access World Develop- child marriage with nearly half of all adolescent girls ment Indicators Databank.1 The primary household 2 MISAU, INE, and ICF International (2013). 3 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 4 https://www.sdindicators.org/. 1 https://databank.worldbank.org/source/world-development-indicators. 5 Lachler and Walker (2018). Executive Summary Mozambique Gender Assessment  |  Leveraging women and girls’ potential 1 Table 1: Summary of policy and programmatic interventions Strategic Priority 1: Reduce child marriage and adolescent pregnancy and keep girls in school Policy & Programmatic Interventions Driver Intervention Options • Improve access to education addressing the specific constraints affecting girls High rates of • Improve quality of education adolescent school • Ensure schools are safe and inclusive dropouts • Facilitate continued enrollment and/or the return to school or technical and vocational education and training (TVET) of pregnant and parenting adolescents • Cash transfers to girls and their families to mitigate the financial burden of secondary school Economic enrollment and prevent early marriage constraints and • Behavior change interventions and public awareness campaigns to increase awareness of returns to harmful social girls’ education norms • Integrate income generation support in life skills and sexual and reproductive health interventions for adolescents • Strengthen enforcement of 2019 Child Marriage law and monitor impacts • Behavior change interventions to reduce early marriage and childbearing Early marriage and • Increase access to adolescent and youth-friendly sexual and reproductive health services providing childbearing the full range of contraceptive methods • Deliver age-appropriate sexual and reproductive health education at all levels of schooling and ensure sex education reaches out-of-school youth Strategic Priority 2: Increase women’s economic opportunities and agricultural productivity Policy & Programmatic Interventions Driver Intervention Options • Reduce sectoral segregation and improve women’s access to better jobs through increased vocational and educational attainment Gender gap in • Reduce domestic time constraints to better economic opportunities across the economy through quality of labor access to childcare services and behavior change interventions promoting equitable division of force participation domestic work • Strengthen enforcement of laws on employment discrimination and sexual harassment • Improve laws on pension, parenthood, and pay, and remove sex-based work restrictions • Increase women’s access to secure land tenure under statutory and customary legal systems • Increase women’s access to access to capital Low agricultural • Increase adoption of cash crops by women farmers through skills training, subsidies, and out-grower productivity contracts • Increase women’s access to inputs and use of mechanization and productive labor through subsidies, cash transfers, and direct, gender-targeted input provision • Increase women’s access to banking and credit through improved mobile networks in rural areas for mobile banking; incentivize financial institutions to implement innovative credit schemes that Low are inclusive of women; increase women’s financial literacy through public awareness campaigns to entrepreneurial increase women entrepreneur’s access to capital productivity • Increase women’s entrepreneurial skills and mindset by integrating socio-emotional and personal initiative skills training with business development skills training Executive Summary 2 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Table 1: Summary of policy and programmatic interventions (continued) Strategic Priority 3: Reduce high rates of fertility; improve women and girls’ sexual, reproductive, and maternal health; and reduce unequal burden of HIV/AIDS on women and girls Policy & Programmatic Interventions Driver Intervention Options • Expand coverage of community and facility-based sexual, reproductive, and maternal health care Insufficient (SRMH) services to underserved areas access to sexual, • Prioritize continuity of care in conflict and disaster affected areas reproductive, and • Increase coverage of emergency obstetrical care to underserved areas maternal health • Expand access to safe abortions through increasing numbers of trained providers and availability of care medical equipment throughout the country • Remove any formal or informal requirements for parental or spousal consent to access SRMH and Low uptake family planning services of modern • Increase access to modern contraception and increase numbers of community health workers and contraception and services offering contraceptive methods family planning • Behavior change interventions and campaigns to educate public, including men and boys, on services contraceptive use and access information Prevalence of risky • Integrate issues of gender, power relations, and consent in sex and HIV/AIDS education programs sexual behaviors • Strengthen protections against violence, discrimination and abuse of persons living with HIV/AIDS and sexual power • Improve targeting of social safety nets to support persons living with HIV/AIDS (PLWHA), their relations caregivers, and caregivers of HIV/AIDS orphans Strategic Priority 4: Reduce high rates of GBV and improve quality and access to support services Policy & Programmatic Interventions Driver Intervention Options • Decrease women’s dependence on intimate partners through cash transfers and other economic Harmful social empowerment programs norms • Behavior change campaigns and interventions targeting, men and boys, couples, and women to reduce acceptance and rates of GBV • Strengthen data collection and case management systems Low rates of • Behavior change campaigns to reduce stigma and backlash associated with reporting GBV reporting • Increase access to survivor-focused police and legal services, such as specialized police stations and pro bono legal representation • Provide resources and establish responsibility for the implementation of the National Plan to Prevent Inadequate support and Combat GBV, and strengthen and enforce legal framework for GBV prevention to survivors of GBV • Strengthen referral systems and the capacity of service providers including medical, psychosocial, and child marriage police, and legal • Expand access to Integrated Survivor Support Service Centers (CAIs) Executive Summary Mozambique Gender Assessment  |  Leveraging women and girls’ potential 3 Table 1: Summary of policy and programmatic interventions (continued) Strategic Priority 5: Strengthen women and girls’ resilience to climate change, natural disasters, and conflict Policy & Programmatic Interventions Driver Intervention Options • Increase women’s ex ante socioeconomic standing through poverty reduction and economic Socioeconomic inclusion programs inequality • Increase women’s ability to benefit from safety nets following disaster • Strengthen implementation of Gender and Climate Change Strategy and increase women’s Less access to participation in peace processes and local efforts to build social cohesion decision-making • Increase women’s access to climate smart agricultural information, technologies, insurance, and and resources capital to increase resilience to shocks • Increase income diversification to increase resilience at the household level • Include women in climate change and disaster risk reduction planning Increased • Ensure provision of SRMH and GBV survivor support services in emergency responses vulnerability/ • Provide direct economic support to women dependence • Integrate sexual exploitation and abuse prevention in emergency responses pregnant or already mothers by the time they reach Access to sexual and reproductive health services 19 years of age. Rates of child marriage are similarly (SRHS), including family planning, is limited by high and there is concern that, as a result of COVID- both supply and demand challenges. For adolescent 19’s economic impacts, lockdowns and disruption of girls in particular, accessing SRHS is often stigmatized, basic services, dropout rates, child marriage, and ado- and services are not always sufficiently youth and ado- lescent pregnancies have all likely increased. Entering lescent-friendly. Unequal power relations and gender the reproductive phase of their lives is another critical norms disadvantage girls’ and women’s ability to nego- juncture for women and girls, and early pregnancies tiate safer sex and control their reproductive lives. particularly reduce their opportunities to pursue Young men’s risky sexual behaviors in particular drive education and employment. Women who begin child- HIV/AIDS infection rates, which remain among the bearing early are likely to have more children and highest in the world. Involving men in family plan- less economic opportunities over their lifetimes as a ning, reducing risky sexual behaviors, and increasing result of the heavy burden of childcare and domestic women and girls’ sexual and reproductive agency will labor. There are also significant risks associated with be key to reducing adolescent pregnancies, HIV/AIDS, pregnancy and childbirth in Mozambique where the and high fertility rates, which are putting the country’s maternal mortality ratio, although declining, remains hoped-for demographic dividend at risk. high. While recent reductions are associated with increasing national rates of assisted births, there are Low levels of education and a high reproductive significant variations in access based on region and and domestic burden translate into less economic location, and particular challenges for those living in opportunities for women. Although labor force conflict- and disaster-affected areas. COVID-19 also led participation of both men (79 percent) and women to disruptions in the provision of maternity health (78 percent) in Mozambique is high, the quality of services, estimated to have resulted in a 15 percent female labor force participation is lower than that increase in maternal deaths.6 of men. There is a high degree of sex-segregation in terms of both sectors and types of jobs in each sector with women generally concentrated among the low- er-skilled and less-remunerative jobs. Most women work in agriculture, but have less access to land, 6 UN Women, UNFPA, and ILO (2021). credit and other inputs than men. This makes them Executive Summary 4 Mozambique Gender Assessment  |  Leveraging women and girls’ potential particularly vulnerable to the impacts of climate worse health impacts on women and girls, in part change as they have less access to climate-smart tech- linked to impacts on reproductive health. As well, in nologies and alternative sources of income than men. times of crisis, girls are more likely than boys to be taken out of school; and financial strain leads some There are significant regional and rural-urban parents to marry their daughters prematurely. Rates variations across almost all indicators of human of GBV are higher in areas affected by conflict and dis- and economic development in Mozambique. Most placement while access to support services is curtailed. are worse in the north of the country and among poor and rural households. Many gender gaps and Notwithstanding these challenges, Mozambican gender-specific challenges are worse in the north as women are strong and resilient; empowering them well, whether in access to education, rates of adoles- to gaining greater control over their lives will cent pregnancy, or economic inclusion. Furthermore, be key to achieving gender equality. Stimulating gender intersects with other forms of social exclusion, growth and development to increase their human notably based on disability and sexual orientation and capital and economic opportunities is only part of the gender identity (SOGI). solution—empowering women and girls to take those opportunities will be key. Building alliances with part- Lifetime exposure to gender-based violence (GBV) ners in government, civil society, and international is high in Mozambique with more than a quarter organizations is essential to drive change. of all women experiencing intimate partner vio- lence (IPV) during their lifetimes.7 Women and girls The six strategic priorities presented below are tied living with disabilities are at particularly high risk of to specific gender gaps and gender issues identified sexual and other violence as are people with non-con- in this assessment. Policy and institutional reform forming SOGI. The cycle of violence starts early with proposals seek to create an enabling environment to 32 percent of young women and 40 percent of young empowering women and girls; programmatic options men having experienced some form of physical, sex- point to interventions for which there is existing or ual, or emotional violence during their childhoods.8 emerging evidence showing promise and impact. Trans- Violence begets violence and men exposed to violence forming gender norms toward greater equality will be at young age or who witness it in their households key to the sustainability of programs and policies. This, more likely to become perpetrators and girls more for example, would include interventions to rebalance likely to become victimized. High rates of child mar- the gender division of labor, combat GBV and child riage, itself a form of GBV, are also associated with marriage, reduce sectoral segregation in the labor IPV. Exposure to urban violence and armed conflict market, and increase women’s bodily autonomy and drives violence behavior and both are significant chal- ability to decide about sex and relationships, among lenges in Mozambique. other gendered social norms. The following strategic priorities are organized around five key entry points Conflict, climate change, and natural disasters for removing critical constraints and leveraging the pose particular challenges to Mozambique, and potential of women and girls to drive Mozambique’s their effects are not gender neutral. Although more transformation. Table 1 presents a summary of the research is needed in Mozambique, international evi- more detailed set of policy and programmatic interven- dence suggests that climate and natural disasters have tions presented in the final section of this assessment. 7 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 8 INS et al. (2020). Executive Summary Mozambique Gender Assessment  |  Leveraging women and girls’ potential 5 References Instituto Nacional de Saúde (INS), Ministry of Health Maryland, USA: MISA/Moçambique, INE/Moçam- (MISAU), Ministry of Gender, Child and Social bique, and ICF International. Action (MGCAS), Instituto Nacional de Estatística Ministerio da Saude (MISAU)/Moçambique, Instituto (INE), and the U.S. Centers for Disease Control Nacional de Estatística (INE)/Moçambique, and ICF and Prevention. 2020. “Violence Against Children International. 2018. “Inquérito de Indicadores de and Youth Survey in Mozambique, 2019 (VACS Imunização, Malária e HIV/SIDA em Moçambique 2019). Priority Indicator Report.” Maputo, Mozam- (IMASIDA), 2015.” Maputo, Moçambique: MISAU/ bique. https://www.togetherforgirls.org/wp-content/ Moçambique, INE, and ICF. uploads/2021/12/Mozambique-VACS-Primary-Indica- UN Women, United Nations Population Fund (UNFPA), tor-Report-EN-edited-2021.pdf. and the International Labor Organization (ILO). Lachler, Ulrich, and Ian Walker. 2018. “Mozambique Jobs 2021. “COVID-19 Rapid Gender Assessment: Mozam- Diagnostic: Volume 1. Analytics.” August 16. World bique 2020.” UN Women, Mozambique Country Bank, Washington, DC. https://doi.org/10.1596/30200. Office, Maputo, Mozambique. https://data.unwomen. Ministério do Género, Criança e Acção Social, Moçambique. org /publications/covid-19-rapid-gender-assess- 2016. “Perfil de Género de Moçambique.” Maputo, ment-mozambique. Moçambique. https://www.eeas.europa.eu/sites/default/ World Bank Group. 2015. “World Bank Group Gen- files/perfil_de_genero_de_mocambique.pdf. der Strategy (FY16–23): Gender Equality, Poverty Ministerio da Saude (MISAU)/Moçambique, Instituto World Bank, Reduction and Inclusive Growth.” ©  Nacional de Estatística (INE)/Moçambique, and Washington, DC. https://openknowledge.worldbank. ICF International. 2013. “Moçambique Inquérito org/entities/publication/95293946-99d3-5ef3-92a0- Demográfico e de Saúde–DHS 2011.” Calverton, 1fd78a3f11e6 License: CC BY 3.0 IGO. Executive Summary 6 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 7 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Introduction M ozambique faces a series of overlapping chal- lenges compounded by direct and indirect impacts of COVID-19, which have caused thousands participation rates are similar, the quality of women’s participation is lower. Women have notably achieved significant political representation in parliament; to slide back into poverty and reversed recent however, this does not translate into participation human capital gains, particularly for women and at lower levels of government and many other deci- girls. A COVID-19 rapid gender assessment revealed sion-making settings. that women and men experienced employment losses, but while women had a smaller decline, their house- Social norms restrict women’s economic poten- hold and childcare burdens increased. The study also tial and contribute to high rates of GBV. Overall, revealed that one in four girls did not continue with women have a larger share of childcare and household their learning due to school closures.9 Putting women responsibilities, while men have the decision-making and girls at the center of the development agenda will power in the home. Mozambique has the sixth highest be key to regaining lost ground, achieving the produc- rate of adolescent fertility and the tenth highest rate tivity and human capital gains needed to drive the of child marriage in the world. Available data on GBV country’s economic and spatial transformation, reap shows that 37 percent of women and girls have experi- the demographic dividend, and build social cohesion enced physical or sexual violence, and 12 percent have and resilience to climate and conflict shocks. reported being forced to have sex at least once in their lives; over 40 percent of women were married before Mozambique’s Gender Inequality Index places it they were 18 years old; and, one in every four children 136th of the 191 countries ranked in the UNDP’s age 15–19 experienced physical violence, with girls 2021 Human Development Report.10 The coun- three times as likely to experience sexual violence than try’s index value of (0.537) reflects gender-based boys. Evidence shows that experiencing or witnessing disadvantages across three dimensions: reproductive violence at home as a child increases the likelihood health (based on maternal mortality and adolescent of becoming survivors or perpetrators as adults, in a birth rate), empowerment (based on male and female vicious cycle that perpetuates violent behavior and its education levels and shares of seats in parliament), acceptance from one generation to the next. and labor market participation of men and women (Table 2: ). Women in Mozambique fare poorly across Geographic disparities interlink with fragility and several of these indicators. Maternal mortality and poverty. Decades of neglect and marginalization in adolescent birth rates remain very high, and women Mozambique’s northern provinces has meant popula- are half as likely as men to have some level of second- tions in the north lack access to basic services and suffer ary education. While women and men’s labor force from higher poverty rates and lower development indicators than the rest of the country. Adolescent pregnancy rates are considerably higher in the three 9 UN Women, UNFPA and ILO (2021). 10 UNDP (2022). northern provinces than in the rest of the country. Introduction Mozambique Gender Assessment  |  Leveraging women and girls’ potential 9 Table 2: Mozambique’s gender inequality index Value Rank Maternal Adolescent Seats in Population with at least some Labor force participation Mortality Fertility (births parliament secondary education (% ages 25 rates (% ages 15 and older) (deaths per per 1,000 held by women and older) 100,000 live women ages (%) births) 15–19) Female Male Female Male 0.537 136 289 165.8 42.4 10.8 20.2 77.7 78.9 Source: UNDP 2022. Figure 1: Gender assessment overview • Voice & leadership • Gender norms • Labor force participation • Child marriage & Economic • Agricultural productivity adolescent pregnancy Inclusion • Entrepreneurship • Gender-based violence • Employment Agency • Keeping girls in safer • Sexual, reproductive & schools maternal health • Not in Education, • Fertility & the Health Education Employment or Training demographic dividend (NEET) • HIV/AIDS • Skills development Resilience & Inclusion Countrywide, adolescent girls in rural areas are almost year 2027. The primary objective is to identify key twice as likely to become pregnant as those in urban gender disparities in Mozambique and strategic prior- areas and, similarly, the poorest are more than twice ity areas where coordinated and holistic approaches as likely to become pregnant than the wealthiest.11 are both needed and would have greater impact. The The ongoing humanitarian crisis and natural disasters gender gaps assessed in this assessment are, there- have further aggravated the situation of women and fore, not comprehensive and focus primarily on girls, further limiting their access to basic services and areas where women and girls face disadvantages. The increasing their risk of facing GBV. Persons living with report is based on a desk review of available studies, disabilities (PLWD) are particularly vulnerable during reports, and data from Mozambique, and draws on displacement due to either conflict or crisis and gen- global evidence, largely from the Africa region. Much erally face difficulties accessing public services. There of the data used in this assessment was drawn from also continues to be social stigma associated with sex- the World Bank’s open-access World Development ual orientation and gender identity (SOGI) minorities Indicators Databank.12 The primary household sur- although legal protections are in place. veys from which these data are drawn are (i) the 2011 Demographic Health Survey (DHS 2011)13 and (ii) the This assessment has been prepared to accompany 2015 Survey of Indicators of Immunization, Malaria the preparation of the World Bank’s Country Part- and HIV/AIDS (IMASIDA 2015),14 which collected nership Strategy for Mozambique, which will cover similar data to the DHS on key gender-related topics. the period spanning from fiscal year 2023 to fiscal 12 https://databank.worldbank.org/source/world-development-indicators 13 MISAU, INE, and ICF International (2013). 11 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 14 IMASIDA 2015 (MISAU, INE, and ICF International 2018). Introduction 10 Mozambique Gender Assessment  |  Leveraging women and girls’ potential However, given different sample sizes, care should References be taken when comparing the two surveys. Further- more, these data are outdated; a new survey round Ministerio da Saude (MISAU)/Moçambique, Instituto would be needed to understand the evolution of key Nacional de Estatística (INE)/Moçambique, and ICF indicators—for example, to assess whether adoles- International. 2018. “Inquérito de Indicadores de cent pregnancy rates are continuing to increase. This Imunização, Malária e HIV/SIDA em Moçambique is particularly relevant in the post-COVID-19 period (IMASIDA), 2015.” Maputo, Moçambique: MISAU/ since some areas may have experienced setbacks. More Moçambique, INE, and ICF. recent administrative data from the Ministries of Edu- UN Women, United Nations Population Fund (UNFPA), cation and of Health, as well as the Service Delivery and the International Labor Organization (ILO). Indicators 2018 Survey,15 were used to complement 2021. “COVID-19 Rapid Gender Assessment: Mozam- the DHS 2011 and IMASIDA 2015 data. This report bique 2020.” UN Women, Mozambique Country presents data and research available as of May 2022. Office, Maputo, Mozambique. https://data.unwomen. org /publications/covid-19-rapid-gender-assess- This assessment is structured around a framework ment-mozambique. encompassing five key domains of women and United Nations Development Programme (UNDP). girls’ empowerment: Agency, Education, Health, 2022. Human Development Report 2021–22: Uncertain Economic Inclusion, and Resilience and Inclusion Times, Unsettled Lives: Shaping our Future in a Trans- (Figure 1). This framework draws from several World forming World. New York: UNDP. https://hdr.undp. Bank strategies including the Gender Strategy,16 the org/content/human-development-report-2021-22. Human Capital Project,17 and the Social Sustainabil- World Bank Group. 2015. “World Bank Group Gen- ity and Inclusion Strategy.18 The analysis presented in der Strategy (FY16-23): Gender Equality, Poverty this assessment identifies key moments in the lives of World Bank, Reduction and Inclusive Growth.” ©  women and girls when interventions can have signifi- Washington, DC. https://openknowledge.worldbank. cant impacts for unleashing their full potential. These org/entities/publication/95293946-99d3-5ef3-92a0- are inflection points that can determine the course of 1fd78a3f11e6 License: CC BY 3.0 IGO. women and girls’ lives. This analysis focuses on some Sivaraman, Aarthi. 2020. “Five Things You Need to of these key moments. Section 1 starts with adoles- Know About Social Sustainability and Inclusion.” cence and focuses on early marriage, pregnancy, and Feature Story, September 2. World Bank, Wash- GBV. Section 2 examines the challenges facing adoles- ington, DC. https://www.worldbank.org/en/news/ cents in completing their education and acquire skills feature/2020/09/02/five-things-about-social-sustain- needed to transition into the labor market. Section ability-and-inclusion. 3 then looks at risks to women’s health as they enter their reproductive years, while Section 4 looks at barri- ers to their full economic inclusion. Section 5 focuses on inclusion and resilience to shocks such as natural disasters and conflict. Finally, Section 6 presents key considerations and identifies strategic priority areas. 15 https://www.sdindicators.org/. 16 World Bank (2015). 17 https://www.worldbank.org/en/publication/human-capital. 18 Sivaraman (2020). Introduction Mozambique Gender Assessment  |  Leveraging women and girls’ potential 11 Mozambique Gender Assessment  |  Leveraging women and girls’ potential CHAPTER 1 Voice and Agency: Leveraging Women and Girls’ Potential I ncreasing women and girls’ agency, namely, the ability to make choices and trans- form those choices into actions and desired outcomes,19 is crucial for advancing gender equality and the empowerment of women and girls. Agency is the prod- uct of the intersection of both internal factors (such as internalized social norms and self-efficacy) and external factors (such as legal frameworks or labor market opportuni- ties). In Mozambique, social and gender norms, legal and institutional frameworks, and socioeconomic conditions all affect the degree to which women and girls can exert agency throughout their lives. Addressing the intersection of these factors will be key to leverag- ing women and girls’ potential both to enjoy meaningful and productive lives and to drive Mozambique’s transformation. This section identifies both constraints and opportunities for increasing women and girls’ agency. The section first presents evidence on gender equality and women’s agency under the law and in practice. It then zooms in on two powerful impediments to ado- lescent girls’ agency with life-long impacts—namely, extremely high rates of adolescent pregnancy and child marriages or early unions. As with most other human development indicators, adolescent pregnancy and child marriage rates are particularly high in north- ern provinces. Finally, this section considers how other forms of gender-based violence, in both public and private spheres, harm both women and men throughout their lives. Unfortunately, emerging evidence suggests that COVID-19 has likely worsened all of these problems in Mozambique, requiring a redoubling of efforts to address these challenges. 19 World Bank (2012). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 13 Figure 2: Ibrahim Index of African Governance: 2019 Gender Indicators 100 80 60 SCORE 40 20 0 hts en ty n ve es s t ty en en en en y n en i t ie ar me me cie ali u ti r ti om om om om om rig iam ici un qu wo be wo so ec jud tw fw w w rw ty t ’s e arl i ex or il l l for r or or i er o ns r fo wo ity fo civ he np pp civ n the f sf op ion i es y me a nt we co n ni t ce ni pr ag cio ty in r ti tat i al in ni Wo en r vi po rtu me mi in qu be ce en en me om se li o o ty al e wo l li en res ua om on p ali ce c lic fw op ivi iol liti eq ec rep of w qu pla ub c v o of Po ic ion of n’s & e on op on om ork & ion n’s ts on so me tat ati er ws st on W gh tat tai me n’s ow en Wo cip es La ec l ri en en me Wo es lp cc r ti cio ua es es pr la ca Pa Wo Eq So pr pr Re ua liti Re Re Po Eq Source: Ibrahim Index of African Governance. https://iiag.online/ accessed September 13, 2023. Women’s leadership and in social institutions.22 Mozambique similarly ranks decision-making low—118th—on the Global Governance Forum’s Gen- der Equality and Governance Index, which integrates a broad set of indicators of women’s participation in Mozambique has a history of strong women lead- governance such as holding important ministerial ers, yet gender inequality in formal and informal and judicial posts.23 The Ibrahim Index of African institutions limits women’s opportunities as Governance also presents a detailed and sobering pic- well as the country’s development. The Constitu- ture: while in some domains of governance, gender tion affirms the principle of gender equality “in all equality has improved, gender equality and women’s spheres of political, economic, social and cultural life” empowerment decreased between 2010 and 2019.24 and that the state shall “recognize and hold in high The Ibrahim Index measures various indicators of the esteem the participation of women in the national political power and representation of women, equal liberation struggle and in the defense of sovereignty civil liberties for women, socioeconomic opportunity and democracy.”20 Women have held leadership posi- for women, equal access to public services for women, tions in politics, state-run industries, collectives, and and laws on violence against women (Figure 2). farms since the country’s independence in 1975 and retained a significant national political representation Nonetheless, there has been some progress in legal during the country’s transition to a market economy and policy reforms that contribute to greater gen- (ranking 22nd globally in terms of representation in der equality. According to the World Bank’s Women, parliament21). However, there are large disparities in Business and the Law (WBL) database, Mozambique women’s representation in local institutions, authori- scores above the Sub-Saharan Africa index value of ties and provincial assemblies. Mozambique ranks low 71 with a score of 82.5.25 The country received per- on the Organization for Economic Cooperation and fect scores under the mobility, workplace, marriage, Development’s Social Institutions and Gender Index (SIGI), which measures gender-based discrimination 22 The SIGI is a composite index that measures gender-based discrimina- tion in social institutions taking into account formal and informal laws as well as attitudes and practices that discriminate against women in five dimensions: discriminatory family code, restricted physical integ- 20 Constitution of Mozambique (1975, amended and supplemented in rity, son bias, restricted resources and assets, and restricted civil liberties. 1990 and 2002), Articles 36 and 122. https://www.genderindex.org/. 21 Inter-Parliamentary Union, global data on national parliaments 23 Lopez-Claros, Ellis, and Halperin-Kaddari (2020). monthly rankings. https://data.ipu.org/women-ranking?month=1&- 24 Ibrahim Index of African Governance (IIAG). https://iiag.online/. year=2022. 25 World Bank (2020). Voice and Agency: Leveraging Women and Girls’ Potential 14 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 3: Husband controls wife’s earnings, by Figure 4: Husband controls wife’s earnings, by wealth quintile, 2015 wife’s education level, 2015 Percent Percent 20 15 18% 18 17% 13 13% 16 11% 11 10% 14 13% 12 9 10% 10 7 8 5% 5 6 6% 6% 3% 3 4 1 2 Total No Primary Secondary Higher 0 -1 education Total Lowest Second Middle Fourth Highest Source: IMASIDA 2015, STAT Compiler. Source: IMASIDA 2015, STAT Compiler. entrepreneurship, and assets indicators. However, marriage and inheritance, establishing that: (a) cus- further legal action is needed to guarantee equal tomary or religious marriages must be registered with remuneration for work of equal value, maternity leave civil authorities; (b) de facto unions are recognized as of at least 14 weeks, and parental leave. Current leg- legal; and (c) all children have equal inheritance and islation establishes different retirement ages for men legal rights regardless of whether they are born within and women and includes prohibitions for women to or outside of a marriage. perform jobs deemed hazardous (see Annex 1 for a full list of relevant legislation). Notwithstanding the gender-equality provisions in various legal frameworks, in practice, women The 2004 Family Law contains various provisions in Mozambique have less decision-making power establishing gender equality protections for wom- than men in their households. They are less likely en.26 The law establishes equality among spouses, and to be involved in decision-making about their health- in the contexts of marriage, divorce, raising children, care, major household purchases, and visits to their and sharing assets within marriage. Husbands and family. Women are more likely to participate in wives share equal standing—on paper—as heads of these decisions if they live in urban areas, receive households and parents. In the case of unmarried cash remuneration from employment, have higher couples and single mothers, the law requires that levels of education, or are in wealthier households. husbands pay child support upon recognition of Similarly, women’s control over their own income paternity. In instances of divorce, it allows for equal varies significantly by province, educational achieve- splitting of property and payment of alimony and ment, and household level of wealth (see Figures 3 child support depending on which one of the spouses and 4, which show the percentage of women whose is at fault and their economic possibilities. The law husbands decide how to use their earnings). Women also codifies gender equality in property ownership. in Tete have the lowest control of their income (14.6 It provides provisions equalizing rights in relation to percent), while women in Maputo City have the high- est (59 percent). Women’s control of their income is generally limited, but it is greater among those in the 26 Law No. 10/2004. highest wealth quintiles, compared to low and middle Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 15 wealth quintiles (47 percent versus 40 percent). Low the family line passes through men (and thus lobolo levels of education clearly limit a woman’s ability to or bride price in practiced as an exchange for a bride control her own earnings. Women with less than pri- becoming the ‘property’ of her husbands’ family), mary education are more than twice as likely to report while under the matrilineal systems practiced in the that their husbands have full control of their earnings north, the family line passes through women. While than women with more than secondary education women enjoy some benefits under the matrilineal sys- (12.6 percent versus 4.7 percent).27 tem—notably to relation to property, inheritance, and custody of their children—both systems nonetheless Improving women’s decision-making power has traditionally recognize men as head of the household implications at the individual, household, and com- and place women under men’s authority. The north munity levels. A study undertaken in 23 Sub-Saharan (Cabo Delgado, Nampula Niassa, and Zambezia prov- African countries found improved maternal and child inces) is generally considered to have more traditional health outcomes among women who claimed that gender norms contributing to high levels of child they were the primary or sole decision-maker of large marriage and adolescent pregnancy, lower levels of household purchases. Among couples who agreed on female education and literacy, and weaker economic the wife’s role as primary or joint decision-maker, the participation of women. As well, the north has a large positive maternal and child health outcomes were Muslim population and thus Islamic traditions influ- increased, and the prevalence of emotional, physical, ence gender norms in the region.31 and sexual intimate partner violence (IPV) was signifi- cantly lower. However, the study found a significant Communities in the central provinces of Sofala, increase in IPV among couples who contested the Tete, and Manica are mostly patrilineal with woman’s decision-making power in the household.28 influences of Muslim and Christian migrants and These findings highlight the importance of engaging traders, and direct impact of Portuguese colonizers men and facilitating communication between cou- who established private agricultural companies. ples when implementing programs aiming to increase These provinces were also the center of a long and bru- women’s agency and decision-making power. tal civil war (1977–92) between Soviet-backed Frelimo (controlling mostly urban areas), and Western-backed Social and gender norms in Mozambique are in Renamo (operating largely in rural areas). The gen- transition—some are questioned more openly dered legacy of this conflict continues to influence the while others remain ‘sticky’ and are changing region and is manifested though trauma and GBV, as slowly. For example, the study “Being a Man in Maputo well as high numbers of female-headed households (City): Masculinities, Poverty and Violence in Mozam- (FHH). At independence, the socialist Frelimo govern- bique” found that about two-thirds of all women and ment had as its explicit policy to work toward gender men believed that “levirate”—the tradition where a equality and the empowerment of women in the “new male family member ‘inherits’ the wife after her hus- Mozambique” that it wanted to create by involving band’s death—should be abolished. At the same time them in political and economic life.32 Women’s polit- two-thirds of men and over half of women felt that ical participation increased as did their employment paying a bride price or “lobolo” was good as it made in state-controlled farms, cooperatives, and industries. men behave more responsibly toward their wives and Transition from a planned to a market economy led children.29 Despite the existence of these customs, 56 to many women losing their employment at ‘unprof- percent of women and 44 percent of men in the study itable’ state-run industries and in the public sector, said that gender equality had already been achieved which increased their economic insecurity and led to for the most part, suggesting that efforts will need to many returning to subsistence agriculture.33 be made for inequality to be recognized before it can be addressed. The southern region (Maputo City and the prov- inces of Maputo, Gaza, and Inhambane) has a Gender norms also vary by region.30 Under the history of out-migration to South African mines patrilineal system of the south and center regions, and is generally more economically dynamic. More 27 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 28 Annan et al. (2020). 31 Bonate (2021). 29 Slegh et al. (2017). 32 Abrahamson and Nilsson (1995). 30 For a fuller discussion, see Tvedten (2011). 33 Tvedten (2011). Voice and Agency: Leveraging Women and Girls’ Potential 16 Mozambique Gender Assessment  |  Leveraging women and girls’ potential economic development and male out-migration has education and limited skills, job opportunities, and driven a higher degree of ‘modernization’ of gender motivation as barriers to their own success. relations,34 although women suffer high rates of HIV/ AIDS linked, in part, to high rates of male migration. Social and gender norms undermine girls’ agency Urbanization is also contributing to this moderniza- starting at a young age and constraints to women’s tion of gender norms and is reflected in higher levels agency continue throughout their life cycle. At female educational attainment and participation in puberty, as many as one in five Mozambican girls is the labor market. High levels of male unemploy- subjected to sexual initiation rites signaling their read- ment in urban areas and has also led to many women iness for marriage; these rites are often followed by effectively becoming the main family breadwinners.35 payment of a bride price (lobolo) to the head of the Women have thus been gaining more economic girl’s family.38 Initiation rites serve to broadly under- independence which in turn tends to increase their mine young girls and adolescents’ agency to decide bargaining power and autonomy within the house- about sex and relationships. Girls are taught that they hold, although this autonomy can also contribute to are responsible for sexually ‘provoking’ men who are male backlash. Notwithstanding all these changes, unable to resist their ‘natural urges’ and that women marriage continues to be seen as an avenue for both are required to respond to a partner’s advances.39 economic security and fulfilling social expectations. Although such rites vary by linguistic and religious group, sexual initiation rates are particularly high in It will be important to consider the significant vari- the northern and central regions.40 Boys are also sub- ation in gender norms throughout Mozambique ject to initiation with 29 percent of male participants when designing and implementing of programs in a study conducted in Maputo reporting having par- and policies. These variations will be a particularly ticipated in initiation rites in order to “become men.”41 important factor for the success of any gender-related behavior change interventions. For this, additional Early school leaving, child marriage, and adolescent qualitative research will be needed to better under- pregnancy put girls on a pathway of limited oppor- stand how norms affect behaviors and what drives tunities. By some estimates, Mozambique has the transformation of behaviors. sixth highest rate of adolescent fertility42 and the tenth highest rate of child marriage in the world43 (fourth highest for girls44). Worryingly, these rates appear to be increasing although comparisons between datasets Protecting girlhood: child should be made with caution and more updated data marriage and adolescent is needed (Figure 5). Such a high prevalence of child pregnancy marriage prompted the government to introduce a law combatting child marriage in 2019.45 The COVID- 19 pandemic has likely exacerbated this trend since Like adolescents elsewhere, young Mozambicans girls have been out of school and many are unlikely aspire to get good jobs, support themselves and to return—a factor associated with higher rates of their families, and be respected in their communi- child marriage and early pregnancy. Many households ties. However, a study conducted in five communities have also either become poor or slipped deeper into in Zambezia, Sofala, and Maputo City36 found that poverty during the pandemic, leading to economic girls were significantly less optimistic than boys that pressure to marry girls or for adolescents to engage in they would be able to reach their goals.37 According transactional sex.46 to caregivers, adolescents, teachers, and local leaders, the main barrier to success for girls was early mar- 38 World Bank (2020). riage and childbearing, followed by inability to pay 39 Bagnol (2022). 40 World Bank (2020). for education. Boys pointed to the inability to afford 41 Slegh et al. (2017). 42 https://databank.worldbank.org/source/world-development-indicators. 43 UN Women (2018). 44 UNICEF Data Portal: https://data.unicef.org. 34 Tvedten (2011). 45 A recently introduced law to prevent and combat child marriage (Law 35 Tvedten, Paulo, and Tuominen (2009). No. 19/2019 of 22 October 2019) establishes penalties for anyone enter- 36 Participants in interviews and focus group discussions included ing or facilitating a child marriage or who has knowledge of a child in-school girls and boys (ages 10–19); out-of-school girls and boys (ages marriage. The effectiveness of this new legal framework has not yet been 15–19); their guardians, teachers, and local leaders; and NGO local per- established, and further efforts will undoubtedly be needed to achieve sonnel. See Boisvert and Heaner (2020). its intended effects. 37 Boisvert and Heaner (2020). 46 UN Women, UNFPA, and ILO (2021). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 17 Child marriage: robbing girls of childhood Figure 5: Child marriage and adolescent pregnancy rates, 1997–2015 (%) Child or early marriage is defined as a formal or informal union before the age of 18. Early marriage Percent is a harmful practice and form of GBV that limits 60 girls’ agency to make vital decisions about their sex- ual health and general well-being. It exposes them to 50 48% 47% 46% increased risk of violence and adolescent pregnancy, 43% and often forces them out of education and into a life 40% 41% 41% 40 38% of poor prospects. In Mozambique, age gaps between couples of five or more years are associated with 30 higher rates of IPV.47 Poverty leads families to marry off their daughters, or girls themselves decide to marry early to relieve the burden on their families.48 Where 20 bride price (lobolo) is practiced (primarily in the south- ern region) early marriage can become a household 10 poverty reduction strategy.49 0 In Mozambique, one of the countries with the 1997 2003 2011 2015 highest prevalence of child marriage, 53 percent Girls (15-19) who are mothers or pregnant of women age 20–24 were married before 18 and Girls (15-19) who are married 17 percent before 15.50 Child marriage is more prev- Source: DHS 1997, 2003, 2011; IMASIDA 2015. alent in the rural areas and highest in the northern and central regions (Figures 6 and 7). According to 2015 IMASIDA data, 62 percent of women age 20–24 were married by the age of 18 in rural areas, com- before age 18 fell from 78 percent to 62 percent. Tete pared with 38 percent in the cities. Marriage before also showed a decline in marriage before age 15, from the age of 18 was found to be particularly high in 17 percent to 14 percent. Zambézia (68 percent), Niassa (65 percent), Nampula (63 percent), Tete (62 percent), and Cabo Delgado (62 Mozambique’s legal framework provides pro- percent). In Zambézia, over one quarter of women tections to combat child marriage. The National (27 percent) were married by the age of 15. These Strategy to Combat Early Marriages51 outlined the rates of early marriage are putting more than half of country’s framework to combat early marriage and all girls traps them in a cycle of lower levels of edu- paved the way for reforms to the legal framework cation, early childbirth, worse health outcomes for through the adoption of the revised Family Law (Law them and their children, higher risk of IPV, and less No. 22/2019) and the Law to Prevent and Combat productive lives—most importantly, it robs them Early Marriage (Law No. 19/2019). These new laws of their childhoods. However, the practice of child include a comprehensive legal framework including marriage has declined most sharply in the provinces prohibition, prevention, mitigation, and punishment where it is most common, suggesting that cultural of the perpetrators and accomplices of child mar- norms about marriage are evolving in these areas. In riages, as well as protection of children who are in or Nampula, for example, the proportion of women age were in a child marriage (Box 1). The revised Family 20-24 who married before they were 15 fell from an Law that came into effect in June 2020 eliminated pro- incredibly high rate of 53 percent in 1997 to 23 per- visions allowing minor girls and boys to get married cent in 2015, while the proportion married before age with parental or other form of consent.52 This new law 18 fell from 82 percent to 63 percent. In the same cur- took inspiration from the Southern African Develop- rent age group in Cabo Delgado, marriage before age ment Community (SADC) Model Law on Eradicating 15 fell from 42 percent to 24 percent and marriage 51 República de Moçambique (2015). 47 Otieno (2017). 52 Under the previous Family Law (Law No. 10/2004), other forms of 48 Kok et al. (2022). consent included judicial consent, and by other authorities such as a 49 World Bank (2020). ministry, president, government agency, public officer, or marriage reg- 50 IMASIDA 2015 (MISAU, INE, and ICF 2018). istrar. Voice and Agency: Leveraging Women and Girls’ Potential 18 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 6: Women age 20–24 first married by Figure 7: Women age 20–24 first married by age 15, 2015 age 18, 2015 TANZANIA TANZANIA ZAMBIA ZAMBIA MALAWI MALAWI ZIMBABWE ZIMBABWE 3.9 15.9 SOUTH 4.0 to 9.5 SOUTH 16.0 to 28.8 AFRICA 9.6 to 15.2 AFRICA 28.9 to 41.8 15.3 and higher 41.9 and higher ESWATINI ESWATINI Source: Mozambique DHS, IMASIDA 2015, STAT Compiler. Source: Mozambique DHS, IMASIDA 2015, STAT Compiler. Child Marriage and Protecting Children Already in in other countries (see Box 2). The adoption of child Marriage, which provides a common framework to marriage laws may have a role in shifting social atti- end child marriage and protect children already in a tudes;53 however, criminalizing child marriage may marriage. also result in unintended negative consequences for children and families.54 Girls and their families may Mozambique’s child marriage law represents a first face social stigma, retaliation, and mental distress asso- step for the implementation of policies, programs, ciated with putting family members in prison, and and services to prevent and address child mar- similarly, families and communities may be destabi- riage. However, for changes to be effective, laws must lized. Criminalization may also deprive other family also be accompanied by robust enforcement and mon- members of their primary caregivers and income pro- itoring mechanisms that monitor the broader impacts viders. The obligation to report child marriage as well of the law. This is especially needed given conflicting as the penalties for not doing so may result in less evidence regarding the impact of child marriage laws child marriages being reported. 53 LSE (2019). 54 UNICEF (2020). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 19 Box 1: Legal framework for child marriage The 2019 Family Law establishes 18 years old as the legal age of marriage. This new law eliminated an exception that allowed children age 16–18 to get married with their parents’ consent. However, the law still provides for an exception that can be granted by the Juvenile Court to allow the marriage of a minor of any age in case of pregnancy and under the condition that both spouses agree to contracting such a marriage. The law also establishes that a marriage can be annulled or is voidable if celebrated between minors or if one of the parties is a minor. The 2019 Law to Prevent and Combat Early Marriage prohibits child marriage, establishes procedures for the protection and care of the children, and introduces broad and severe criminal penalties for whoever enters into, allows, or facilitates a child marriage. Chapter 2 of the law establishes that only individuals above the age of 18 can get married; no authority can allow a marriage when one or both parties are minors; and the celebrating authority must obtain a document proving the age of the parties. Criminal penalties of up to two years imprisonment are established for any adult who enters into a child marriage, and for whoever collaborates or enables the celebration of such a marriage, including public servants and religious, traditional, or local authorities. The Law establishes legal prohibitions against paying a bride price and punishes with up to 12 years of imprisonment the exchange of a child, for the purpose of a union or marriage, for money or goods. The Law to Prevent and Combat Early Marriage also establishes government responsibility for the prevention of child marriages. This includes responsibility for the adoption of policies and programs to reduce child marriage, including the provision of services such as shelters, improving access to primary and secondary education, support for economic opportunities for low-income households, and awareness-rais- ing activities, among others. However, no specific ministry or governmental agency is assigned the task of implementing the law, and nor have budgetary allocations for the overall implementation of the law been set. Box 2: Do child marriage laws work? Research on child marriage laws suggests that such laws alone are not enough to curb this practice. The Child Marriage Restraint Act of 2017 in Bangladesh only marginally influenced people’s beliefs and attitudes toward child marriage within their community.55 Similar laws in Benin, Mauritania, Kazakhstan, and Bhutan were not effective in curbing early marriages.56 However, significant reductions in early mar- riage following the adoption of laws were observed in Tajikistan and Nepal.57 While standalone laws and provisions banning child marriage are an important element of a multifaceted strategy to reduce child marriage, additional enforcement mechanisms, policies, and interventions are needed to support their implementation.58 To be effective, child marriage laws should clearly set a strict and consistent minimum age of marriage and be accompanied by other measures such as capacity building of key actors and resources for legal enforcement.59 55 Amirapu, Asadullah, and Wahhaj (2019). 56 Batyra and Pesando (2021). 57 Batyra and Pesando (2021). 58 Collin and Talbot (2017). 59 Maswikwa et al. (2015); Kim et al. (2013). Voice and Agency: Leveraging Women and Girls’ Potential 20 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Adolescent pregnancy: the early Figure 8: Share of adolescent girls (15–19) who motherhood trap have begun childbearing, 2015 (%) TANZANIA Child marriage and high rates of adolescent preg- nancies are closely related. Adolescents in child Cabo marriages begin their reproductive lives earlier, and Delgado ZAMBIA Niassa 65% conversely, unintended pregnancies often push ado- 61% lescents into an early marriage. Child brides generally MALAWI lack agency to negotiate marital relations, which puts Nampula them at greater risk, not only of premature preg- Tete 60% 46% nancy, but also of sexually transmitted infections (STIs).60 This likely contributes to adolescents and Zambézia 46% young women age 15–24 bearing a higher Human Immunodeficiency Virus/Acquired immunodefi- ZIMBABWE Sofala ciency Syndrome (HIV/AIDS) burden of disease (9.8 38% 18% - 38% percent) compared to that of their male counterparts 39% - 44% (3.2 percent).61 In urban areas, and particularly in the Manica 45% - 50% south of the country, there has also been a rise in ado- 44% 51% - 65% lescent pregnancies outside of marriage.62 Drivers of these high rates of adolescent pregnancies include a Gaza Inhambane combination of lack of accurate information about 41% 43% Maputo sexual and reproductive health; taboos around teen Cidade sexuality; lack of access, misinformation, and reticence SOUTH 18% AFRICA to use modern contraception; as well the inability to negotiate ‘safer sex’63.64 Maputo ESWATINI Provincia 26% The likelihood of becoming pregnant before age Source: IMASIDA 2015. 19 varies significantly by wealth and location. Ado- lescent pregnancy rates are considerably higher in the three northern provinces than in the rest of the country (see Figure 8). There are stark differences that among students in Mozambique ages 11–18, between rates observed in the northern province of more than half (57.4 percent) reported at least one Cabo Delgado (65 percent) and the southern province sexual experience: 68.4 percent of boys and 45.8 per- of Maputo City (18 percent). Countrywide, adolescent cent of girls. Furthermore, sexually active boys were girls in rural areas are almost twice as likely to become more likely to have multiple sexual partners and they pregnant as those in urban areas and similarly, the were almost twice as likely as girls to have engaged in poorest are more than twice as likely to become preg- multiple sexual risk behaviors (68.4 percent and 36.5 nant than the wealthiest.65 percent, respectively).67 A review of risk and protec- tive factors linked to sexual and reproductive health Young people in Mozambique become sexually among adolescents found that greater educational active at an early age with one-quarter of females attainment was associated with delayed sexual initi- and males surveyed ages 15–24 reporting having ation and increased likelihood of contraceptive use, sex before the age of 15.66 These rates increase signifi- including condoms.68 cantly by age 18, especially for boys. A study using data from the Global School-Based Health Survey, found Mozambique’s high rate of adolescent pregnancies is closely tied to low use of modern contraception and high rates of unmet need for family planning. 60 Ministério do Género, Criança e Acção Social (2016). 61 MISAU, INE, and ICF International (2019). The unmet need for family planning (the percent of 62 UNICEF (2015). 63 The term ‘safer sex’ is used instead of ‘safe sex’ to indicate that risks of women who do not want to become pregnant but are unwanted pregnancy, HIV/AIDS or other STIs cannot be completely illuminated through the use of condoms. 64 Kok et al., “Being Dragged into Adulthood?” 65 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 67 Pengpid and Peltzer (2021). 66 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 68 Mmari and Sabherwal (2013). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 21 Figure 9: Use of any method of contraception Figure 10: Use of any modern method of by women ages 15–19, 2015 (%) contraception, all women, 2015 (%) TANZANIA TANZANIA ZAMBIA ZAMBIA MALAWI MALAWI ZIMBABWE ZIMBABWE 7.9 15.2 SOUTH 8.0 to 16.5 SOUTH 15.3 to 22.7 AFRICA 16.6 to 25.2 AFRICA 22.8 to 30.3 25.3 and higher 30.4 and higher ESWATINI ESWATINI Source: Mozambique DHS, IMASIDA 2015, STAT Compiler. Source: Mozambique DHS, IMASIDA 2015, STAT Compiler. not using modern contraception) is estimated at 57 Adolescent and youth-friendly health services percent among adolescents ages 15–19 who are unmar- within public health facilities (Serviços de Saúde ried and sexually active and at 23 percent among those Amigos dos Adolescentes e Jovens, SAAJ), were cre- who are married.69 Evidence from both developed and ated in 2009–10 in Mozambique. In 2019, the national developing countries shows that adolescents are more directives for the provision of sexual and reproductive likely to use effective modern contraceptive methods health (SRH) in schools were revised by the Minis- when they have access to: (i) high-quality services try of Health (Ministério da Saude, MISAU).71 MISAU delivered by competent providers well trained in established the kind of SRHR services to be provided family planning and sexual and reproductive health to students based on the school year in which they are and rights (SRHR) and including proper follow-up; enrolled as opposed to their age. Information, educa- (ii) improved counseling with shared decision-mak- tion, and communication on wellbeing, hygiene, and ing and without provider bias against recommending services is provided to all secondary school students long-acting reversible contraception to adolescents (from grades 7 to 12). Certain contraceptive methods and nulliparous women; (iii) discounted or free ser- (oral contraceptives and condoms) are made available vices; (iv) integrated services with postpartum and to students in grades 10 to 12. post-abortion care; and (iv) reaching adolescents at school.70 As a result, rates of modern contraceptive use among women vary significantly by region (see Fig- ures 9 and 10). 69 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 70 Track20 (2020). 71 MISAU Despacho 765/GMS/002/2019. Voice and Agency: Leveraging Women and Girls’ Potential 22 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Box 3: Mozambican youth on use of modern contraception More young people would use contraception if more easily available. In a recent qualitative study con- ducted in five communities in Zambezia, Sofala, and Maputo City, over half of in-school youth participants of both genders were more certain that young people would use modern contraception if available to them.72 The number was lower (38 percent) for out-of-school youth, suggesting that community outreach in addition to comprehensive SRH education at schools is essential. Interestingly, boys and men were much more likely to believe young people would use contraception if available than did girls and women (71 percent versus 30 percent), suggesting that SRH education services need to take gender differences in attitudes and behaviors into account. When asked about the types of SRH services that are most needed for youth, respondents prior- itized SRH education, followed by counseling and access to contraception. Youth pointed specifically to the fear that contraception could be harmful (leading to sterility, other health side effects, or contracting STIs, among others), embarrassment and taboos, as well as parents and guardians not allowing access. Other challenges mentioned by respondents included: partners and parents disallowing use of contraception; insufficient depth and breadth of SRH education services; lack of youth-specific services for women’s health; and general low quality of services. Fear that contraception will hurt a woman was more widespread among out- of-school than in-school youth, both boys and girls. Another qualitative study of unsafe sexual behavior among schoolgirls in Maputo found that poverty and class further disadvantage girls in their attempts to negotiate safer sex. Girls from lower socioeconomic classes tended to be less assertive, more accepting of gender power dif- ferentials, and more likely to be depending on partners for material needs than their better-off counterparts.73 Access and uptake of SRH services is constrained Poverty is also an important structural driver of by a combination of supply- and demand-side fac- both early marriage and pregnancy. In a qualitative tors. Demand is limited by adolescent girls’ sexual and study conducted in five communities in Zambezia, 72 73 reproductive agency, which is often constrained regard- Sofala, and Maputo City, participants explained how less of their marital status. For married adolescents some parents arrange marriages for their daughters to access SRH services or to choose a family plan- because they cannot afford to support their whole ning method, the husbands’ consent may be needed families. Study participants also pointed to the phe- (whether formally or informally).74 For unmarried nomenon of girls engaged in transactional sex (often adolescents, a guardian’s consent is often unofficially for very small amounts of money or small personal required and withheld as persistent social norms dic- items) either becoming pregnant unintentionally tate that girls should not be sexually active outside or, in some cases, trying to become pregnant in the of marriage (while for boys this is generally accepted hopes of financial support for themselves and their and even expected). Given these social taboos, girls are families.76 In such contexts, unconditional cash trans- often stigmatized for seeking SRH services—including fers have shown some promise in delaying marriage by health providers themselves. Further, they may be in beneficiary households, although effects stop once subject to common misconceptions or providers’ own grants do.77 Cash transfers conditional on girls remain- biases regarding contraception. SOGI minority youth ing unmarried may be effective in delaying fertility in may face further stigmatization and discrimination by settings where pregnancy primarily occurs inside of peers, adults, and SRH service providers. Similarly, ado- marriage but may hasten marriage (and, likely, preg- lescents and women living with disabilities (WLWD) nancies) after the cessation of transfers.78 Thus, while experience higher rates of sexual abuse while simulta- cash transfers hold promise in the short term, in the neously facing higher barriers to accessing SRH services longer term, evidence suggests that enhancement of due to physical accessibility challenges, stigma, and dis- girls’ own human capital, opportunities, and agency is crimination by service providers.75 the most sustainable pathway for delaying marriage.79 72 Boisvert and Heaner (2020). 76 Boisvert et. al. (2021) 73 Machel (2001). 77 Bergstrom and Özler (2021). 74 UNFPA, “SRHS Situation Analysis in Mozambique,” n.d. 78 Bergstrom and Ozler (2021). 75 UNFPA (2018). 79 Malhotra and Elnakib (2021). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 23 Figure 11: Ecological model of GBV risk factors Societal Relationship • Gender, social and economic Societal • Marital discord inequalities • Poor parenting • Discriminatory legal frameworks • Violent parental conflict • Cultural norms that support • Low socio-economic household violence status Community • Inequitable decision making Community Relationship Individual • Poverty • Childhood violence • High crime levels • Acceptance of VAWG • Acceptance of gender norms and VAWG • Age • Stigma for divorce • Education • Community violence • Employment or livelihoods • Lack of sanctions for violence Individual opportunities • Asset ownership Migration linked to large infrastructure and mining Health Services provided at health facilities, expansion projects also contributes to high rates of adoles- of Adolescent and Youth Friendly Services (SAAJ), cent pregnancy. Studies of the impact of the influx and distribution of a wider range of contraceptive of workers from Mali, Senegal, Tanzania, and Malawi methods at secondary and vocational schools, through during the opening of ruby mines (garimpos) between the existing network community of health workers 2012 and 2016 point to numerous negative impacts and mobile brigades in hard-to-reach areas and places on women and girls living in these areas. The influx were adolescents regularly meet.81 However, increased of “unattached” male migrants into impoverished com- provision of contraception is not enough. Ensuring munities led to an increase in transactional sex and favorable attitudes and knowledge of parents, part- unintended pregnancies, as well as child and forced ners, and other influential figures is needed, as well as marriages. One civil service organization (CSO) infor- addressing taboos, misinformation, and other factors mant familiar with the mines said that when workers preventing adolescents from seeking SRHS. Strate- returned to their home countries, local communities gies therefore need to include interventions to reduce were left with large concentrations of newly single social stigma and counter misinformation; increase mothers.80 This experience points to the need for strong adolescents’ agency to make informed choices around safeguards and safety nets in areas affected by ongoing sex, relationships, and marriage; and strengthen the infrastructure and mining projects in Mozambique. delivery of specialized adolescent and youth friendly SRH services, including access to safe abortion. Efforts to empower adolescent girls and reduce teen pregnancy need to be multi-sectoral and address both supply- and demand-side con- straints. In health, there has been large-scale donor Breaking the cycle of violence commitment and government buy-in to ensure con- traceptive procurement; however, distribution and Building on the ecological framework of factors that uptake among key segments of the population and constrain or drive the empowerment of women and different regions has not been uniform. Thus, the con- girls broadly, this section zooms in on overlapping tinued scale-up of contraceptive provision through risks factors for GBV at the level of the individual, multiple channels is necessary. This could include the relationships within households, community, and at a further integration with other Maternal and Child broader societal level (Figure 11). 80 USAID (2019). 81 World Bank (2021) Voice and Agency: Leveraging Women and Girls’ Potential 24 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 12: Women experiencing physical Figure 13: Women experiencing sexual violence in the past 12 months, 2015 (%) violence in the past 12 months, 2015 (%) Total Total Manica Zambézia Gaza Niassa Zambézia Cabo Delgado Sofala Maputo Provincia Maputo Cidade Inhambane Maputo Provincia Manica Cabo Delgado Maputo Cidade Inhambane Sofala Nampula Nampula Niassa Gaza Tete Tete 0% 5% 10% 15% 20 25 0% 2$ 4% 6% 8% 10% Source: Mozambique DHS IMASIDA, 2015. Source: Mozambique DHS IMASIDA, 2015. GBV is an extreme denial of agency and has sig- Intimate partner violence nificant costs. In addition to the direct physical and psychological harm to women, GBV is a drain on In Mozambique, 1 in 4 women ages 18–49 have expe- human capital development, poverty reduction, and rienced physical or sexual violence at some point growth. Conservative estimates suggest that up to 3.7 in their lives, and many reported in 2015 that they percent of GDP can be lost annually due to GBV— experienced violence in the past 12 months with about the amount most developing countries spend huge regional variation (Figures 12 and 13). Most on primary education.82 There are also direct costs on of this violence is perpetrated by a current or former the health care system; for example, women survivors intimate partner.84 Although men are also subject to of violence make much greater use of health services high rates of violence (1 in 5 have experienced physical than non-abused women, even years after the violence violence), IPV (physical, sexual, or emotional) is more has ended.83 GBV comes in many forms, including than twice as likely to affect women than men (24 per- child marriage, IPV, sexual exploitation and assault, cent compared to 13 percent, respectively).85 A third and sexual harassment, among others (see Annex 2 for of women and a quarter of men who had at one point GBV definitions). been married reported that their partner was jealous or enraged if they spoke to a person of the opposite sex, while 40 percent of women and 18 percent of men were frequently or sometimes afraid of their partners.86 Globally, girls and young women living with 84 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 82 World Bank (2018). 85 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 83 Bonomi et al. (2009). 86 IMASIDA 2015 (MISAU, INE, and ICF International 2018). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 25 disabilities are even more likely to have experienced the prevalence of such violence; transforming social sexual violence by family members or neighbors.87 A norms and attitudes toward GBV will be key. study in Maputo and Matola from 2010 found that as many as three-quarters of WLWD reported having suf- Exposure to violence starts at a young age for both fered at least once from sexual violence.88 men and women. A 2019 national survey on violence against children and youth found that among 18–24 Less than 50 percent of Mozambican women who year olds, 32 percent of young women and 40 percent experience physical violence seek help and only of young men had experienced at least one form of a quarter of victims of sexual violence do so.89 physical, sexual, or emotional violence in childhood Women mostly seek help from their own or their with women more likely to have experienced sexual partner’s families; only 10 percent seek help from assault than men.96 Only 38 percent of young women police or social services.90 GBV support services are and 22 percent of young men knew of a place to seek generally uneven and poorly coordinated. Access in health, suggesting the need for increased awareness conflict-affected areas, where sexual violence risks are raising among children and young people on avail- heightened, is severely limited.91 able support services. While rates of physical violence against women and men in Mozambique overall are Attitudes and norms related to GBV are complex similar, the perpetrators of this violence are different. and at times contradictory. About two-thirds of Over 90 percent of women were assaulted by a current both women and men feel that GBV is a substantial or previous intimate partner; while for men less than problem in Mozambique.92 Although relatively few half of assaults were committed by intimate partners women and men justify wife-beating (14 percent and and 36 percent were committed by a parent, sibling, or 17 percent, respectively),93 rape myths that blame the other family member.97 victim as well as the belief that forced sexual relations in marriage are not rape are widespread. A survey in Rapid assessments conducted on the impact of Maputo found that 40 percent of men and 34 percent COVID-19 suggest that violence against women of women agreed that a woman who did not dress and child abuse increased during the pandemic, decently was asking to be raped; similarly, 40 percent but access to support services has been disrupted. of men and 13 percent of women said there were Almost half of women felt that GBV had gotten worse times a woman deserved to be beaten. Qualitative data since the onset of COVID-19 and many reported collected as part of the survey revealed that men and directly knowing someone who had experienced phys- women think that women generally cause “problems ical violence.98 Pandemics exacerbate GBV for several in families” because they possess “bad powers and are reasons, including those linked to poverty-related accused of controlling men with the use of “spirits.”94 stress, the psychological stress of increased social iso- Belief that spirits play a role in provoking violence lation, and the decreased ability of women to escape provide men an excuse for using violence and women from abusive partners.99 Additionally, the sudden a reason to forgive a partner who uses violence. Nor- onset of increased economic stress and anxiety may malization of GBV persists in Mozambique despite lead to negative coping mechanisms and exacerbate the high levels of awareness of laws related to vio- violent behavior at the household level, including lence: 86 percent of men and 77 percent of women child maltreatment and corporal punishment, trans- were aware of the law against violence against women, actional sex, and exploitation of child labor to increase while 83 percent of men and 79 percent of women the family income.100 agreed that a man who forces his wife to have sex is committing a crime.95 These findings suggest that laws Engaging men and boys is a key element of break- and even knowledge of laws prohibiting GBV may be ing the cycle of violence. More than half of the men necessary but not sufficient in any efforts to reduce who participated in a survey on men and violence in Maputo had witnessed their siblings being beaten and 30 percent had witnessed violence between their 87 UNFPA (2018). 88 Handicap International (2010). 89 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 90 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 91 UNHCR (2021). 96 INS et al. (2019). 92 UN Women, UNFPA, and ILO (2021). 97 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 93 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 98 UN Women, UNFPA, and ILO (2021). 94 Slegh et al. (2017). 99 Ptermanet al. (2020). 95 Slegh et al. (2017). 100 De Paz Nieves, Gaddis, and Muller (2021). Voice and Agency: Leveraging Women and Girls’ Potential 26 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Box 4: What works to prevent violence against women and girls The What Works to Prevent Violence against Women and Girls program, a six-year initiative, funded innovative prevention programs that were implemented by over 20 organizations in 12 countries. The prevention inter- ventions researched the impact of community activism, couples’ interventions, economic empowerment, and prevention of violence against children (VAC) interventions. The lessons learned include the following: • Community activism interventions that trained community members as volunteer activists, engaged GBV survivors individually as well as in a couple, and had a longer training and implementation duration, were found to be the most successful interventions. • Couples’ interventions with greater impact were those that allowed for sufficient program exposure and tested and piloted the implementation of the curriculum before the delivery of the program. This allowed for critical program adaptations to be done in a timely manner. • Economic empowerment interventions that worked with everyone in the household, reflected the drivers of violence in the program design, provided funds that were under the woman’s control, and had lengthier and more frequent trainings and other program activities had greater impact. The inter- vention results also suggest that working with men and other family members, rather than only working with women, may have greater impact, especially in changing men’s behavior. • Prevention of VAC interventions had greater impact when these were implemented for a longer time, addressed social norms and multiple drivers or violence, and integrated experiential learning that sought to foster positive interpersonal relations. Source: Elaborated based on Jewkes et al. 2020.101 parents. 102 Witnessing violence in childhood is known to prevent and raise awareness, respond, improve 101 to contribute to the ‘normalization of violence’ and the legal framework, invest in research, and rig- of violent and other abusive behaviors later in life. orously monitoring and evaluate GBV activities. Alcohol often plays a role in men’s use of violence: While there are budgetary allocations for the imple- 16 percent of men reported using violence of some mentation of the plan,104 some of its priority actions kind after consuming alcohol. The survey also found are quite broad and no specific steps for their imple- that 12 percent of men reported having at some point mentation have been set. For example, it is not clear forced a woman or girl to have sex when she did not how and if gender and social norms will be targeted want to or said they had had sex with a woman when or how the efficiency of the judicial system will be she was too drunk to consent.103 increased when it comes to GBV cases. Further, no clear monitoring and evaluation indicators are estab- There is an increasingly rich body of research on lished to verify if the strategies adopted are effective. what works in other countries (Box 4). However, there is a need for research on what works in Mozam- Prohibitions, penalties, and the provision of ser- bique and how this varies between groups and settings: vices for survivors are codified in three laws in what works in Cabo Delgado may not work in Maputo Mozambique’s legal framework. Namely, the Law on City, and similarly what works in urban areas may not Domestic Violence Perpetrated Against Women,105 the work in rural settings. Criminal Code,106 and the Regulation on the Organi- zation and Operation of Integrated Care Centers for The National Plan to Prevent and Combat Gen- Victims of Domestic and Gender-Based Violence.107 der-based Violence (2018–2021) addresses the need Domestic violence, as defined by the domestic violence 104 República de Moçambique (2018). 101 R Jewkes et al. (2020). 105 Law No. 29/2009. 102 Slegh et al. (2017). 106 Law No. 24/2019. 103 Slegh et al. (2017). 107 Law No. 75/2020. Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 27 law, is any act perpetrated against a spouse, former these services under the coordination of the Minis- spouse, partner (de facto union), former partner, try of Gender, Children and Social Action (MGCAS). boyfriend, former boyfriend, or family member, and Each sector included in the multisectoral mechanism including physical, sexual (including marital rape), has its own specific protocols: (i) the health sector psychological, and economic abuse. However, while would provide emergency first aid and psychological article 17 of the domestic violence law criminalizes support, including through paragem única or one-stop marital rape and punishes it with imprisonment from centers for GBV survivors; (ii) the police, through its six months to two years,108 the Criminal Code provides specialized offices called gabinetes, provide protec- harsher penalties for rape outside of marriage, set- tion for survivors and follow law enforcement and ting imprisonment between two to eight years.109 The criminal investigations; (iii) the justice sector over- Domestic Violence Law provides for protection orders sees the free legal support provided by the Institute that include measures such as distancing between for Legal Assistance and Representation (Instituto the perpetrator and the survivor, protection and res- do Patrocinio e Assitencia Juridica, IPAJ); and finally titution of the property of the victim, child custody social services, including psychosocial support and rights, and financial support in favor of the plaintiff, referral to other services, are under the direction of among others. The law establishes procedures (related MGCAS. Mozambique’s 2020 Law on the Regulation to the hearing, notification of the parties, and evidence, on the Organization and Operation of Integrated Care among others) to ensure that domestic violence cases Centers for Victims of Domestic and Gender-Based have a quick response and allows for the survivor as Violence111 established the Centro de Atendimento Inte- well as third parties to file a complaint. Depending on grado (CAI) to provide protection, healthcare, legal, the gravity of the crime committed, penalties under the and social assistance to survivors of domestic and law include community work and up to eight years in GBV. There are currently 25 CAIs in Mozambique; prison. The 2019 Criminal Code imposes aggravated only four are in the north and central region while the penalties if a crime is committed against a spouse. The rest are in Maputo, Gaza, and Inhanbane provinces. crime of “mistreatment” against a cohabiting partner In addition to the geographic limitation, the services is defined as “physical or psychological abuse, includ- offered at CAIs are often limited. ing corporal punishment, deprivation of freedom and sexual offenses, or cruel treatment;” it is punishable Data collection around GBV prevalence rates are with a fine and imprisonment up to five years. No spe- also not routinely systematized. Adequate funding cific penalties are present for breaches of a protection for GBV services would focus on strengthening refer- order; nor is mediation prohibited. While it is broadly ral pathways and ensuring that good quality medical, used and promoted as an alternative to criminal justice legal, and psychosocial services are available for sur- and family law processes, mediation is not considered vivors. Integrating evidence-based social and behavior a good practice for cases of domestic violence because change communication interventions such as through it removes cases from judicial scrutiny, presumes that safe spaces for girls, couples training, intervention both parties have equal bargaining power, reflects an with adolescent boys, and community interventions, assumption that both parties are equally at fault for vio- among others, will also be key.112 lence, and reduces the accountability of the offender.110 As in many developing countries, services for sur- Violence in public spaces vivors of violence in Mozambique are limited. The Multisectoral Mechanism for Integrated Care of There are many ways in which violence in public Women Victims of Violence, approved in May 2012, and private spheres intersect in Mozambique, as defined the guiding principles and standard proto- elsewhere. Being either a victim or a perpetrator in cols for four GBV essential services—medical, social, one sphere increases the likelihood of being a victim police and justice—and provided for integration of or perpetrator in the other. There is a higher risk of violence in more insecure areas, and the more vio- lence is normalized in society, the more it is likely to 108 Law No. 29/2009. Law on Domestic Violence against Women. https:// permeate different aspects of life. www.wlsa.org.mz/wp-content/uploads/2014/11/Lei_VD_2009.pdf 109 Law No. 24/2019. Law Revising the Penal Code. https://www.wlsa.org. mz/wp-content/uploads/2021/08/Lei-24-2019-Lei-de-Revisao-do-Codigo- Penal.pdf. 111 Law No. 75/2020 110 UN Women (2012). 112 Jewkes et al. (2020). Voice and Agency: Leveraging Women and Girls’ Potential 28 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Men and women have different experiences of (IMAGES)115 found that residents were exposed to vio- public violence, with women being more exposed lence at a young age: 80 percent of men and 75 percent to risks of sexual harassment and assault while of women reported having witnessed at least one of men are more likely to be victims of other forms act of violence before the age of 18.116 Respondents of physical assault or involvement in gangs, par- had also been victims of violence at a young age with ticularly in urban areas. A quarter of women and a 45 percent of men and 30 percent of women having fifth of men and women, respectively, in Mozambique either been assaulted or beaten in the street, attacked report having experienced some form of physical or shot by someone with a gun, threatened with death, violence since age 15 (combining both violence in been subject to police violence, and/or had their home and outside of the home). Rates of physical violence or workplace hit by gunshots before the age of 18. against both men and women are higher in urban Notably, men and boys were exposed to high levels of areas by about 10 percentage points in both cases. violence at the hands of police with 21 percent of men Men are at highest risk of violence in Cabo Delgado reporting they had suffered police violence before where there is an ongoing armed conflict (40 percent age 18. By comparison, national statistics show that of men report having experienced physical violence among the 20 percent of men who ever experienced since age 15) followed by Zambezia, Manica, Sofala, physical violence, only 2.2 percent of this violence had and Maputo City (ranging between 25 percent-28 per- been perpetrated by police.117 cent). For women, the highest risks occur in Gaza and Maputo provinces as well as Maputo City where 39 A significant portion of IMAGES study partici- percent, 33 percent, and 35 percent of women report pants in Matola and Maputo cities also reported having experience physical violence, respectively. Men being themselves aggressors. Before the age of 18, were also significantly more likely to suffer physical 21 percent of men and 12 percent of women reported violence at the hands of a teacher, the police, a soldier having fought using a gun or other weapon, threat- or at work.113 ened to kill someone, or participated in beating someone publicly.118 In addition, 4 percent of men Poorer and more densely populated neighbor- reported to be involved with a gang. Consistent hoods (bairros) in larger urban centers suffer with research on the intergenerational impacts of particularly high rates of violence. A study by UN both public and private violence, the IMAGES study Women conducted in two districts in Maputo City found that that experiencing physical or psychologi- found that 43 percent of women and girls had suffered cal violence at home or at school or witnessing father some type of physical violence in public spaces and beating their mother was significantly associated with this percentage rose to 61 percent for sexual violence increased perpetration of IPV among participants. (including harassment) and 77 percent for psycholog- Similarly, the study also found an association between ical violence.114 Girls between the ages of 12 and 18 men involved in urban violence before the age of 18 suffered higher rates of sexual violence in public spaces and later perpetration of IPV. Additionally, violence than older women. Only 16 percent of all respondents was associated with other antisocial behaviors, nota- indicated that they knew of the existence of an orga- bly excessive alcohol consumption, with nearly one in nization or institutions in their neighborhood that five men reporting having used violence of some kind could provide support in the case of violence, primar- after consuming alcohol. Furthermore, nearly half of ily an association, police station, hospital, or church. all male respondents reported having at some point A separate study looking at the intersection of mas- engaged in transactional sex and the study found an culinities, poverty, and violence conducted in four association between paying for sex and committing districts in Matola and Maputo cities (including the acts of both public and private violence. Men who two districts of the UN Women study) as part of the reported having exchanged money or goods for sex global International Men and Gender Equality Survey were more likely to have perpetrated physical, psy- chological, or sexual violence and to have witnessed, 113 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 114 Mariano et al. (2020). For the purpose of this study, psychological 115 Slegh et al. (2017). violence includes assaults, robbery, insults, threats, gross and sexual com- 116 Violence acts included assault or robbery with a firearm, police violence, ments, gestures and innuendoes; physical aggression includes assaults beatings or assaults in the street, heard gunshots or saw a shooting, or and robberies of goods with use of force, pushing, battering, choking, saw someone threatened with being killed. and stabbing; and sexual violence encompasses touching of intimate 117 IMASIDA 2015 (MISAU, INE, and ICF International 2018). parts of the woman’s body and forced sexual intercourse. 118 Slegh et al. (2017). Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 29 experienced, or participated in urban violence in the is outdated and updates to the 2011 DHS and 2015 last year. Given the overlapping drivers of different IMASIDA surveys are needed. Statistical data on rates forms of violence, it will be important for violence of urban and other forms of violence is also lacking. prevention strategies to take a holistic approach tai- In order to reduce GBV, child marriage, adolescent lored to the local context. pregnancy, and urban violence, norms will need to change and poverty be reduced. Successful interven- tions will need to be adapted to local contexts and founded on in-depth, qualitative research that inves- Data and knowledge gaps tigates the drivers of these problems. Some behavior change interventions have had success, but they will Nationally representative data on rates of adoles- need to be tested in Mozambique and in the particu- cent pregnancy and child marriage, as well as GBV lar socio-economic and geographic context in which prevalence, attitudes, and health seeking behaviors, they are implemented. 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Mozambique Country Development Cooperation.” UN Women, United Nations Population Fund (UNFPA), June 2019. Washington, DC: USAID. https://pdf. and the International Labor Organization (ILO). usaid.gov/pdf_docs/PA00WGW3.pdf. Voice and Agency: Leveraging Women and Girls’ Potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 33 Mozambique Gender Assessment  |  Leveraging women and girls’ potential CHAPTER 2 Educate: Learning and Skills Development for Life I nvesting in girls’ education not only increases their opportunities but is also a key driver of the poverty reduction and economic transformation. Mozambique’s Human Capital Index (HCI) ranking is one of the lowest in the world: a child born in Mozambique today will only reach 36 percent of her human capital potential by the age of 18 relative to a benchmark of full health and complete education, signaling substantial productivity losses for the next generation (and today’s) workers.119 In Mozambique, as elsewhere, increasing human capital will be a critical driver of poverty reduction and inclusive growth. There are many challenges to increasing access and quality of education that affect both boys and girls in Mozambique; however, girls experience additional challenges requiring specific attention. Although Mozambique has made progress in increasing enrollment rates and closing gender gaps in early grades, when girls hit puberty, they start dropping out at higher rates, primarily as a result of pregnancy and early marriage. While secondary school completion rates and learning outcomes are low for both girls and boys in Mozambique, girls generally perform worse on standardized tests than boys. Gender gaps in learning outcomes are particularly pronounced in northern provinces, where rates of adolescent pregnancy and child marriage are also highest. Furthermore, emerging evidence suggests that COVID-19 has led to increased rates of early school leav- ing with girls particularly affected. Improving access and quality of education for both boys and girls is essential for growing Mozambique’s human capital. In addition, address- ing the gender dimensions of school dropouts, improving girls’ learning outcomes, and helping them build skills needed for transition into productive activities leads to greater opportunity and better outcomes for themselves and the next generation. 119 Mozambique Human Capital Index 2020 (World Bank 2020). Educate: Learning and Skills Development for Life Mozambique Gender Assessment  |  Leveraging women and girls’ potential 35 Keeping girls in school: Figure 14: School enrollment is particularly Enrollment, retention, low among girls, 2015 progression, and learning 1.05 160 outcomes 140 Mozambique has made significant progress on 1.00 increasing enrollment and reducing gender gaps 120 in lower primary education, but at the upper primary and lower secondary levels, the gender gap increases. At higher levels, boys’ enrollment 100 0.95 drops which closes the gender gap; but few girls or boys complete secondary school (Figure 14). While 80 Mozambique has achieved almost universal enroll- ment at primary level, completion rates remain 0.90 60 stubbornly low, particularly for girls: there’s gender parity at entry, but only 45.6 percent of girls com- plete primary education compared with 50.4 percent 40 of boys,120 and only 12.8 percent of girls who enroll 0.85 in secondary school complete their studies.121 Worry- 20 ingly, primary completion rates have been worsening in recent years—a trend likely to be accelerated by 0.80 0 disruptions in schooling during the pandemic with 1 2 3 4 5 6 7 8 9 10 11 12 many children unlikely to return to class. Pro- Gender parity index in enrollment gression rates of both girls and boys to secondary Gross enrolment (male + female) education are also low (and lower than the average Source: Ministry of Education and Human Development (Ministério de for Sub-Saharan Africa) with the gross enrollment Educação e Desenvolvimento Humano, MINEDH) administrative data, 2015. ratio dropping from 113 in lower primary (grades 1–3) to 67 in upper primary (grades 4–7) and 36 in secondary.122 Gender gaps in access to education are with tertiary education almost three times as much as generally wider in northern provinces where girls’ those with no education.124 gross enrollment in upper primary is 10 percentage points below that of boys.123 In Mozambique, girls are more likely than boys to be on track before the onset of puberty—when Incomplete education not only limits girls’ learn- they start to fall behind or disappear from the sys- ing and potential, but also comes at a significant tem.125 In practice, this means that girls age 15 can cost in lost productivity and income. The costs of often be found in early grades of primary education not educating girls are high for girls, their future fam- with the implication that sex education is important ilies, and Mozambique’s development. Global data even at lower primary schools and certainly through- suggests that if a child stays one more year in school, out secondary school. The national directives for she will earn 9.7 percent more as an adult. Women the provision of SRH services in schools established with primary education (partial or completed) earn that information, education, and communication only 14 to 19 percent more than those with no edu- on wellbeing, hygiene, and services is provided to all cation. By contrast, women with secondary education secondary school students (from grades 7 to 12) and may expect to make almost twice as much, and women certain contraceptive methods (oral contraceptives 124 Q. Wodon, C. Montenegro, H. Nguyen, A. Onagoruwa. 2018, Missed opportunities: The High Cost of Not Educating Girls. The Cost of Not Edu- cating Girls Notes Series. Washington, DC: The World Bank. https:// 120 MINEDH, EducSTat, 2020. openknowledge.worldbank.org/bitstream/handle/10986/29956/High- 121 MINEDH (2019). CostOfNotEducatingGirls.pdf?sequence=6&isAllowed=y 122 UNESCO UIS Education Statistics 2017. 125 UNICEF, Avaliação Longitudinal da Desistência Escolar em Moçam- 123 MINEDH (2019). bique. 2018 Baseline results presented 11 March 2020 in Maputo. Educate: Learning and Skills Development for Life 36 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 15: Share of married and unmarried meta review found that increasing girls’ education girls attending school, 2017 (%) has been shown to be one of the most effective ways to reduce adolescent pregnancy and early marriage, 70% suggesting the need to redouble efforts to keep girls in school.130 Recent shifts in policy to allow pregnant 60% girls to attend regular classes are encouraging but will need to be accompanied with efforts to address 50% root causes.131 School-related costs also drive dropouts of both 40% girls and boys. In a recent study conducted in Zam- bezia, Sofala, and Maputo provinces, lack of financial 30% resources, early marriage or pregnancy, and pressure to work or get a job were the top reasons for dropout 20% cited by both in- and out-of-school youth as well as their guardians.132 Both in- and out-of-school youth 10% also complained of lack of quality or interesting con- tent in school as a reason for not achieving the desired level of education. Although a 2018 National Educa- 0% 15 16 17 18 19 tion System Law abolished fees for grades 1 through 9, Married Unmarried there remain many costs to attending school—fees for uniforms, school materials—that limit poor families’ Source: 2017 Census. ability or willingness to send their children to school. Cost barriers vary in importance across regions and poverty levels. For example, in Nampula cost is the and condoms) would be made available to students in primary impediment to school enrollment (although grades 10 to 12.126 only slightly higher than pregnancy) while nationally it is the third reason after lack of interest/relevance Pregnancy, early marriage, and poverty are key and marriage.133 drivers of dropouts for girls. Married girls are much less likely to be enrolled in school than unmarried Financial incentives such cash transfers with accom- girls (Figure 15). In Mozambique, marriage and preg- panying measures promoting behavioral change nancy were cited as top reasons for not being enrolled that encourage families to send their children to in school.127 This affects all provinces, but there is sig- school and provide relevant information have nificant regional variation; 1 in 10 girls in Maputo been shown to be very effective at keeping girls Province and 1 in 4 girls in Manica Province cite preg- (and boys) in school.134 The most robust evidence is nancy as the reason for not being in school. of the effectiveness of conditional cash transfers and labelled cash transfers (that is, which provide informa- Conversely, having lower levels of education is tion on the importance of girls education and ‘nudge’ linked to a higher likelihood of early pregnancy parents to send daughters to school) at keeping girls and motherhood. Causality between child mar- in school as well as getting recent dropouts to return. riage, early pregnancy, and education goes both This is true for both transfers whose conditionality ways.128 Six in 10 adolescents without any level of or labelling focus specifically on girls’ education as education have children or are pregnant by age 19 well as those focused ensuring school-aged children whereas for those with secondary or higher levels of education this number drops to 3 in 10.129 A recent 130 Bergstrom and Ozler, “Improving the Well-Being of Adolescent Girls in Developing Countries.” 131 USAID, “Gender Assessment for USAID/Mozambique Country Devel- opment Cooperation.” p. 18. In December 2018, the government 126 Despacho 765/GMS/002/2019 issued by MISAU revoked an earlier law requiring schools to transfer pregnant students 127 MINEDH (2019). to evening classes. 128 Chata Malé and Quentin Wodon, Basic Profile of Child Marriage in 132 Boisvert and Heaner (2020). Mozambique, World Bank, 2016; Chata Malé and Quentin Wodon, Basic 133 MINEDH (2019). Profile of Early Childbirth in Mozambique, World Bank, 2016. 134 Bergstrom and Ozler, “Improving the Well-Being of Adolescent Girls in 129 IMASIDA 2015 (MISAU, INE, and ICF International 2018). Developing Countries.” Educate: Learning and Skills Development for Life Mozambique Gender Assessment  |  Leveraging women and girls’ potential 37 generally are going to school. Regardless of whether Figure 16: Association between gender of interventions are targeted to girls or not, attention to teacher and student test scores, 2018 the specific barriers constraining girls’ access to edu- cation are important, as is addressing the challenges 40 that specific groups of girls may face relative to the general population of girls. Such challenges include Female teacher the obstacles girls in rural areas face, including long distances and lack of safe transportation to secondary 35 schools, or the lack of safe accommodation at second- ary schools. Even when they stay in school, girls are also not 30 doing as well as boys. The 2018 Service Delivery Indi- cators (SDI) student assessment results showed that on average, students scored only 31.3 out of 100 with Male teacher similar outcomes in math and Portuguese. Worry- 25 ingly, while learning outcomes are improving overall, regional and rural-urban inequalities are widening. Educational attainment and outcomes in the center and north of the country are generally worse than in 20 southern areas, including higher rates of absenteeism Boys Girls by both teachers and students, lower numeracy and Source: Service Delivery Indicators (2018). literacy, and higher dropout rates.135 Furthermore, the SDIs reveal that gender gaps have not been narrow- ing: girls scored lower in both math and Portuguese with gender gaps of almost 4 percentage points in increase access, reduce costs, and improve quality of math and around 6 percentage points in Portuguese. education.138 This would suggest that understanding The size of gender gaps in these subjects also varied the specific barriers to access, retention, and learning significantly by region. In the south there was almost outcomes of both boys and girls in each context is no gender gap in mathematics, and girls scored over essential to determining whether general or girl-tar- 7 percentage points higher than boys in Portuguese. geted interventions are likely to have the greatest In the north and center, however, the disadvantage impact on improving educational outcomes broadly of girls compared to boys is evident.136 Learning out- and on reducing gender gaps where these persist. comes have likely worsened as a result of COVID-19 as Improving the quality of teaching, reducing teacher dropout rates have likely increased and it is expected absenteeism, improving infrastructures, and provid- that many will not return to school. ing educational resources such as textbooks are all general interventions that improve the quality of edu- While cash transfers are effective at improving cation for both boys and girls. girls’ enrollment and retention rates, research has also demonstrated that improving the general The 2018 SDIs revealed that students of female quality of teaching and teaching materials benefits teachers performed better than students of male children, especially girls.137 A recent review of 270 teachers, and the difference was larger for girls. education interventions in 54 low- and middle-in- (Figure 16). This is consistent with broad research find- come countries suggests that general interventions to ings suggesting that increasing the presence of women improve access and learning have comparable impacts in education can improve learning outcomes.139 In to girl-targeted interventions, such as investments that Mozambique, this effect was great enough to largely erase the gender gap in average students’ test scores, 135 Bassi et al. n.d. 136 Marina Bassi, Octavio Medina and Lúcia Nhampossa. n.d. Education Service Delivery in Mozambique: A Second Round of the Service Deliv- ery Indicators Survey. 138 David and Yuan (2022). 137 In Mozambique, a government reform that included a reduction in 139 Eble, A., & Hu, F. (2017). Stereotypes, role models, and the formation of direct costs for households and the provision of free textbooks was beliefs. Columbia University, Center for Development Economics and found to have particularly benefitted girls’ enrollment (Fox et al. 2012). Policy, CDEP-CGEG Working Paper, (43). Educate: Learning and Skills Development for Life 38 Mozambique Gender Assessment  |  Leveraging women and girls’ potential with both girls and boys performing better.140 How- was found to have almost entirely prevented the rise ever, while women constitute 51 percent of teachers in teenage pregnancies for villages where it was imple- in lower primary, this share decreases sharply to 30 mented.144 These results highlight the importance of percent in upper primary, then to 23 percent in lower providing girls with alternative ‘safe spaces,’ away from secondary, and falls to 19 percent in upper secondary men and boys, that can be used to build their skills education, suggesting the need to redouble efforts to and social connections, especially when they do not train, hire, and retain female teachers, particularly at have access to school. Such safe space interventions upper levels of education.141 can also be useful for reaching the large number of girls who drop out of school outside of a pandemic or Lack of gender-friendly sanitation facilities is other similar crisis, especially as this group of girls may another contributing factor to the low retention be at a higher risk of early marriage and childbearing, rates of girls upon reaching puberty. In general, which can combine with early school drop-out to fur- access to basic water, sanitation, and hygiene (WASH) ther reduce their ability to transition into productive at school in Mozambique is low. Only 20 percent of employment. Unconditional cash transfers can also schools have facilities for students to wash their hands; be effective at reaching these high-risk girls who have and while most schools have toilets, many do not already dropped out: one study found that UCTs effec- meet basic standards as they are either not clean or tively significantly delay marriage and childbearing accessible.142 During menses, girls are often unable to for out-of-school girls, while conditional cash transfer go to school when they do not have access to adequate (CCTs) may be more effective for reaching those still facilities and/or to sanitary menstrual products. A in school.145 lack of safe and private WASH facilities also increases opportunities for school-related sexual exploitation and abuse. Furthermore, WASH facilities are often not sufficiently accessible for children with disabili- Safe and inclusive schools ties, further driving their exclusion from education. Increasing access to accessible, gender-friendly WASH In Mozambique, as elsewhere, schools are not facilities that support the management of menstrual always safe spaces for children. This not only hygiene is an important component of any effort to undermines learning but is detrimental to children’s increase the retention of girls at upper primary and physical and emotional well-being. Girls and boys secondary school levels. experience bullying, abuse, and harsh discipline per- petrated by both teachers and peers. Baseline results Progress in enrollment and retention rates have for 2018 from an ongoing UNICEF longitudinal been set back by COVID-19. A recent COVID-19 study on the determinants of school dropouts in rapid gender assessment found that about 25 percent Mozambique found that 17 percent of primary school of children between 7–18 years old did not continue children complained about other children in school, their education from home after the onset of the with girls being slightly more likely than boys to do pandemic.143 While no differences were yet observed so. There were also regional variations with close to with regard to gender, there are reasons to believe 30 percent of children in Gaza and Maputo City feel- that schooling interruptions brought on by crisis ing mistreated by peers compared to under 10 percent may increase girls’ risk of early childbearing and per- in Zambezia. The same study found that complaining manent school drop-out. This impact was observed about other children in school reduces the odds of during the Ebola outbreak, with research in Sierra regular attendance by 54 percent. Harsh punishment Leone showing that villages highly disrupted by Ebola was also widely reported by more than half of all chil- saw the teenage pregnancy rate increase by 11 percent- dren, who complained about teachers and referred age points. A program that used girls-only clubs as safe to ‘hits or pinches’ and ‘physical punishment’ as their spaces to provide adolescent girls with life skills, liveli- hood skills, and credit for income-generating activities 144 Oriana Bandiera et al., “Women’s Empowerment in Action: Evidence from a Randomized Control Trial in Africa,” American Economic Jour- nal: Applied Economics 12, no. 1 (January 2020): 210–59, https://doi. 140 Bassi et al, n.d. org/10.1257/app.20170416. 141 MINEDH, “Relatório de Desempenho do Sector da Educação” 145 Sarah Baird, Craig McIntosh, and Berk Özler, “Cash or Condition? (Républica de Moçambique, 2020). Evidence from a Cash Transfer Experiment *,” The Quarterly Jour- 142 Bassi et al, n.d. nal of Economics 126, no. 4 (November 1, 2011): 1709–53, https://doi. 143 UN Women, UNFPA, and ILO (2021). org/10.1093/qje/qjr032. Educate: Learning and Skills Development for Life Mozambique Gender Assessment  |  Leveraging women and girls’ potential 39 explanations for complaints.146 The 2017 study “On Children who have a sexual orientation or gender Being a Man in Maputo” found that, of the 1,014 male identity (SOGI) outside of accepted gender norms survey respondents, a third reported that they had are particularly at risk of bullying, harassment, been subject to threats, intimidation, or harassment and violence in school. This not only causes direct by other students and 57 percent had experienced emotional and physical harm, but also puts these chil- physical violence by a teacher.147 dren at higher risk of drop-out, which would leave them with lower levels of skills and job opportunities Girls face additional risks of sexual harassment, and deepen their marginalization. In recent years, coercion, exploitation, or abuse by both teachers Comprehensive Sexuality Education has been intro- and peers. A 2019 national survey of violence against duced to increase children’s and youth’s knowledge children and youth found that 14.3 percent of young about sexual and reproductive health and rights, but women ages 18–24 had experienced sexual violence teaching in relation to sexual orientation and gender before age 18; that 20 percent of assaults were com- identity issues remains controversial.154 Moreover, mitted by a friend, classmate, or schoolmate; and that there are no legal provisions mandating equal access 13.1 percent of assaults had taken place at school.148 and non-discrimination in education and there are “Sex for grades” and abuse perpetrated by male teach- no established mechanisms for reporting cases of ers against female students is common and often SOGI-related discrimination, violence, bullying, and results in the pregnancy of young girls, further driving cyberbullying. Unsurprisingly, these behaviors go female dropout rates.149 The issue is widely known; largely unchecked. across Mozambique, 7 in 10 girls report knowing of cases of sexual harassment and abuse in their school.150 Children with disabilities (CWD) face additional However, currently, no law or regulation explic- challenges in education. Although the National itly criminalizes or prohibits sexual harassment in Policy on people with disabilities established in 1999 schools. While the government has put in place strat- protects the right to education, CWD face overlapping egies to address this issue, most parents and students constraints related to accessibility, lack of adapted are not aware of the legal and institutional protections learning materials, discrimination, and exclusion from in place.151 The Ministry of Education and Human schools. MINEDH data from 2020–2029 and the 2017 Development (Ministério da Educação e Desenvolvi- Census suggest that only half of school-aged CWD mento Humano, MINEDH) and its partners developed are enrolled in school.155,156 A 2018 UN Disability and a “Zero Tolerance for Abuse and Sexual Harassment Development Global Report found that in Mozam- in Schools” campaign to raise awareness of the issue. bique, girls with disabilities are even less likely than There are few mechanisms for reporting abuse or pro- boys with disabilities to have ever attended school.157 tection of a complainant.152 A new mechanism has Key factors influencing dropout rates of students with been developed by UNICEF and civil society organiza- disabilities in Mozambique included prohibitive costs tions. Although there have been some localized efforts (18 percent), school too far or no transport (24 per- to encourage denunciation, impunity remains a prob- cent), schools not accessible (33 percent), and refused lem as there are rarely any consequences for abusers.153 school/preschool entry because of disability (17 per- cent). On top of these challenges, some families keep school-aged CWD home due to social stigma and atti- 146 UNICEF, Avaliação Longitudinal da Desistência Escolar em Moçam- tudes that do not value education for CWD, further bique. 2018 Baseline results presented 11 March 2020 in Maputo. 147 Slegh et al. (2017). limiting their opportunities for skills development 148 INS et al. (2020). The Survey defined sexual violence as including unwanted sexual touching, attempted forced sex, pressured/coerced sex, necessary to get jobs and become self-sufficient. or physically forced sex. 149 “Gender-Based Violence in Mozambique.” 150 See USAID (U.S. Agency for International Development). 2015. Lessons from the Gender-Based Violence Initiative in Mozambique; and Osorio. 2016. Mulher e Lei na África Austral 151 While the previous 2014 Criminal Code (Law No. 35/2014) explicitly 154 “ UNESCO Moçambique: Relatório Anual 2017—UNESCO Digital prohibited sexual harassment in education, the 2019 Criminal Code Library,” accessed May 10, 2022, https://unesdoc.unesco.org/ark:/48223/ (Law No. 24/2019) does not make any specific mention of education pf0000265472_por. or schools. The Mecanismo Multissectorialpara a Prevenção, Denúncia, 155 MINEDH. (2020). Plano Estratégico da Educação 2020-2029. Maputo: Encaminhamento e Resposta a Violência contra Crianças nas Escolas, Ministério da Educação e Desenvolvimento Humano. p.51. https://www. Incluindo Assistência às Vítimas lists a set of laws considered to cover globalpartnership.org/sites/default/files/document/file/2020-22-Mozam- sexual harassment and violence in education, though none refer to it bique-ESP.pdf explicitly. 156 MINEDH (2019a). Análise do Sector de Educação (ESA) Relatório Final. 152 USAID, “Gender Assessment for USAID/Mozambique Country Devel- Julho de 2019 Maputo: MINEDH. opment Cooperation.” 157 United Nations and Department of Economic and Social Affairs, Dis- 153 “Estratégia de Género do Sector da Educação e Desenvolvimento ability and Development Report: Realizing the Sustainable Development Humano” (MGCAS 2016: 17). Goals by, for and with Persons with Disabilities: 2018, 2019. Educate: Learning and Skills Development for Life 40 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Lower levels of education have negative long-term Box 5: National Strategic Plan for effects for both men and women living with disabil- Professional Technical Education ities, but the intersection of gender and disability (2018–2024) leads to worse outcomes for women. In Mozam- bique, about half of men with disabilities can read and write (compared to 73 percent for the general adult Mozambique’s 2018–2024 Strategic Plan male population), while only 17 percent of WLWD for Professional Technical Education (Plano can read and write (compared to 50 percent for the Estratégico do Ensino Técnico Profissional) has general adult female population).158 A 2018 survey the reduction of regional and gender dis- conducted in four communities in Sofala found that parities among its strategic objectives. This adult WLWD were more likely to have had no formal includes increasing girls’ enrollment in tradi- education (51 percent) compared to men with disabil- tionally male sectors, improving standards and ities (39 percent) and women without disabilities (44 safety in schools, reducing sexual harassment percent); exposing the double disadvantage of gender and abuse—particularly by instructors, and and disability and its life-long impacts.159 strengthening networks for girls to transition into the labor market. The policy also mandates the creation of specialized units and services for monitoring and supporting implementation of Transitioning from education to the plan. The plan includes activities for aware- employment ness raising in the community and business sector to counter the view of traditional male/ female sectors and on sexual harassment and Young people go to school not only to gain knowl- abuse, and to strengthen regulatory framework edge, but also to become productive adults. In to mitigate the risk of sexual exploitation and addition to the academic school track, there are both abuse and sexual harassment. The plan does formal and non-formal technical and vocational train- not identify or address gender gaps among the ing (TVET) programs in Mozambique. At the lower teacher corps. Responsibilities for the monitor- and upper secondary school levels, formal TVET pro- ing and implementation of the plan as well as grams are offered in technical schools and institutes dedicated resources will be important to the in three main areas: commerce, industry, and agri- success of the policy. culture.160 About 9 percent of all secondary students in Mozambique are enrolled in TVET.161 While the number of female students in TVET has increased from 36 percent in 2011 to 45 percent in 2017,162 sig- and Social Security in both public and private insti- nificant sectoral segregation persists. The percentage tutions. These non-formal programs are targeted to of female students enrolled in the sector of indus- youth who have dropped out of primary and sec- trial maintenance is only 11 percent, compared to 37 ondary school and provide training in the areas of percent in agriculture and 59 percent in administra- commerce, industry, and agriculture.165 The Govern- tion of management.163 Only 22 percent of all TVET ment of Mozambique has identified the reduction of teachers are women resulting in few role models for gender and regional disparities as one of its strategic adolescent girls, particularly in traditionally male sec- priorities (Box 5). tors.164 Non-formal TVET programs are offered as part of short-term vocational training programs under the Transition to the labor market after completing responsibility of the Ministry of Labor, Employment their education is not straightforward for Mozam- bican youth, particularly for young women. 158 Ibid. Estimates suggest that 21 percent of Mozambican 159 WHO (2018) Inclusive Sofala Program: Baseline Assessment (CBR young women age 15-24 are not in education, employ- Outcome Indicators). https://europeanevaluation.org/wp-content/ uploads/2021/08/Annexe-3_Report-CBR-Indicators-WHO-LFTW-final.pdf ment, or training (NEET) compared to 14 percent 160 UNESCO. 2022. Mozambique: TVET Country Profile. file:///C:/Users/ wb253633/Downloads/exp-2022-05-11_04_14_34.pdf 161 World Development Indicators 162 UNESCO, 2019. Análise do Sector de Educaçao. 163 World Bank. 2020. Improvement of Skills Development in Mozam- bique Project Appraisal Document. (Project ID: P167054). 165 UNESCO. 2022. Mozambique TVET Country Profile. https://unevoc. 164 UNESCO, 2019. Análise do Sector de Educaçao unesco.org/home/Dynamic+TVET+Country+Profiles/country=MOZ Educate: Learning and Skills Development for Life Mozambique Gender Assessment  |  Leveraging women and girls’ potential 41 of their male counterparts.166 Though overall unem- provinces were asked if they had thought about enroll- ployment in Mozambique is low, unemployment ing in school or a training program, just over half said among urban youth is high and has been increasing they would like to enroll in vocational or skills train- steadily since 1996. Youth unemployment in urban ing, while nearly half said they would like to enroll areas decreased slightly from 21 percent in 2014 to in formal education. Girls were more likely to want 19 percent in 2019.167 Rising unemployment, particu- to get vocational or skills training (69 percent) while larly among young men, increases risk of frustration, boys were more likely to prefer to return to formal low self-esteem, and anti-social behaviors that strain a school (56 percent) suggesting gender differences in fragile social fabric, especially in urban areas. A study youth aspirations.171 Within TVET there are signifi- of men and masculinity in Maputo found direct links cant gender imbalances across the main subject areas, between poverty, unemployment, stress, and increased which is then reflected in the labor force where sec- risk of violence or negative coping strategies. Of those toral segregation leads to lower earnings for women. men surveyed, 63 percent felt stressed or preoccupied To counter this, there is some evidence that providing because of their precarious income and 52 percent students information on labor market opportuni- felt ashamed to face their families when their income ties across sectors and occupations can motivate girls was insufficient. These men explained that they lost to study in traditionally ‘male’ subjects (see “Wage “rightful respect” and “authority” at home when Employment” in Section 4).172,173 unemployed. Some said that “no work means no woman.”168 An integrated approach is needed to support adolescent and young women facing several Unemployment is also concentrated among richer intersecting challenges: transitioning to the households and more educated youth. There are sev- labor market, avoiding unplanned pregnancies eral contributing factors. Young people are provided and early marriage, and staying or returning to with insufficient labor market opportunities and school. An International Labour Organization (ILO) knowledge or means to access them, and they rely on intervention also in Uganda suggests that combining informal networks that provide inaccurate informa- vocational business and life-skills training is a promis- tion instead of employment centers and newspapers. ing approach. Participation in the program led to a 38 Youth don’t leave school job-ready, post-secondary percent increase in income and a 26 percent reduction TVET is limited and expensive, and opportunities to in early marriage and pregnancy, and it was associated gain work experience are rare.169 Female graduates with a one-time increase in profits of supported firms of secondary level TVET education are at a particu- by 54 percent.174 Furthermore, efforts are needed to lar disadvantage when entering the labor market. A reach out-of-school youth, given that 73 percent of 2019 survey of final year secondary TVET students in upper secondary age girls (and 65 percent of boys) Maputo City, Maputo Province, Nampula, Tete, and are out-of-school.175 There has been some success in in Cabo Delgado found that 19 percent of young men making girls clubs available for out-of-school girls as and 37 percent of young women graduated without well as those who are still enrolled. This includes the prior work experience. Furthermore, female graduates Empowerment and Livelihood for Adolescents (ELA) in services and industry have lower earnings expecta- program in Uganda. An impact evaluation of the tions, expecting to earn between 23–27 percent less ELA program found that participating young women than men with average expected monthly salaries were 26 percent less likely to have a child, 58 percent depending on type of work.170 less likely to be married or cohabiting, and 72 per- cent more likely to be engaged in income-generating NEET youth want more opportunities for edu- cation or training. When out-of-school youth in five communities in Zambezia, Sofala, and Maputo 171 Boisvert and Heaner (2020). 172 Joan Hamory Hicks, Michael Kremer, Isaac Mbiti, and Edward Miguel, Vocational Education Voucher Delivery and Labor Market Returns: A 166 ILOSTAT. Modelled estimates for 2020. In World Bank. n.d. Empow- Randomized Evaluation Among Kenyan Youth, LSE & Oxford Univer- ering Women and Girls to Accelerate the Demographic Transition: A sity, S-2004-KEN-1 https://www.theigc.org/wp-content/uploads/2011/04/ Country Snapshot of the Current Situation and World Bank Support. Hicks-Et-Al-2011-Working-Paper.pdf 167 World Bank, Jobs Diagnostic Mozambique, Ulrich Lachler and Ian 173 Addressing Gender-Based Segregation through Information: Evidence Walker, 2018 (for years 2008 and 2014) and International Labor Organi- from a Randomized Experiment in the Republic of Congo Gassier, zation for 2019. Pierotti, Rouanet and Traore 2022 168 Slegh et al. (2017). 174 Fiala, N. 2015. “Access to Finance and Enterprise growth: Evidence from 169 WB Jobs Diagnostics, 2018. an experiment in Uganda.” Employment Working Paper No. 190. 170 UN-WIDER Baseline 2020. 175 DataBank Gender Statistics Educate: Learning and Skills Development for Life 42 Mozambique Gender Assessment  |  Leveraging women and girls’ potential activities.176 Analysis of the results suggests that the life Nonetheless, for NEET youth who are to enroll or skills training plays a more important role than the complete vocation training, on-the-job training has vocational skills in achieving these impacts, but that also been effective through wage subsidies to firms. a large portion of the impact could also be attribut- able to the impact of the girls’ clubs in providing a safe space for girls to interact with each other.177 Data and knowledge gaps Both vocational training and on-the-job training are important strategies to get NEET into the labor The last Multi-Indicator Cluster Survey was conducted market. A recent paper compares demand-side and in 2008 and therefore data from this source is signifi- supply-side policies to tackle youth unemployment cantly outdated. A new survey would help to better by tracking 1,700 workers and 1,500 firms over four understand the gender dynamics of household behav- years to contrast the effects of offering workers voca- iors and conditions related to children’s education, as tional training to offering firms wage subsidies to train well as access to social transfers and other forms of workers on the job. Both treatments led to skill accu- protection. In order to track safety in schools (notably mulation, while earnings increased by 34 percent and rates of sexual exploitation, abuse, and harassment), 20 percent, respectively, because of the improvement incident reporting and monitoring systems need to on their employment status. Therefore, tackling youth be in place that ensure the safety and well-being of unemployment by skilling youth using vocational the survivor. Finally, for interventions to close gender training before labor market entry appears to be more gaps in various education-related outcomes, in-depth effective than incentivizing firms through wage sub- qualitative research to investigate drivers of these sidies to hire and train young labor market entrants.178 problems will be important. 176 Bandiera, O., Buehren, N., Burgess, R., Goldstein, M., Gulesci, S., Rasul, I., & Sulaiman, M. (2018). Women’s Empowerment In Action: Evidence From A Randomized Control Trial In Africa. World Bank. 177 E.G. See Feigenberg, B. Field, E. And Pande, R. (2013) “The Economic Returns To Social Interaction: Experimental Evidence From Microf- inance,” Review Of Economic Studies 80: 1459-83; Ashraf, N., Bau, N., Low, C. And Mcginn, K. (2017) Negotiating A Better Future: How Inter-Personal Skills Facilitate Inter-Generational Investment, Mimeo LSE; Cai, J. And Szeidl, A. (2018) “Interfirm Relationships And Business Performance,” Quarterly Journal Of Economics 133: 1229-82. 178 Alfonsi, Bandiera, Bassi, Burgess, Rasul, Sulaiman, and Vitali, 2017. Tack- ling Youth Unemployment: Evidence from a Labor Market Experiment in Uganda. Educate: Learning and Skills Development for Life Mozambique Gender Assessment  |  Leveraging women and girls’ potential 43 References Feigenberg, B. E. Field, and R. Pande. 2013. “The Eco- nomic Returns to Social Interaction: Experimental Alfonsi, L., O. Bandiera, V. Bassi, R. Burgess, I. Rasul, Evidence from Microfinance.” Review of Economic M. Sulaiman, and A. Vitali. 2020. “Tackling Youth Studies 80: 1459–83. Unemployment: Evidence From a Labor Market Fiala, N. 2015. “Access to Finance and Enterprise growth: Experiment in Uganda.” Econometrica 88: 2369–2414. Evidence from an Experiment in Uganda.” Employ- https://doi.org/10.3982/ECTA15959. ment Working Paper No. 190. International Labour Ashraf, N., N. Bau, C. Low, and K. Mcginn. 2017. “Nego- Organization, Geneva. tiating A Better Future: How Inter-Personal Skills Fox, Louise, Lucrecia Santibañez, Vy Nguyen, and Pierre Facilitate Inter-Generational Investment.” Mimeo. André. 2012. Education Reform in Mozambique: Lessons London School of Economics. and Challenges. Direction in Development. Washing- Baird, Sarah, Craig McIntosh, and Berk Özler. 2011. “Cash ton, DC: World Bank. or Condition? Evidence from a Cash Transfer Exper- Gassier, Marine, Lea Rouanet, and Lacina Traore. 2022. iment.” The Quarterly Journal of Economics 126(4): “Addressing Gender-Based Segregation through 1709–53. https://doi.org/10.1093/qje/qjr032. Information: Evidence from a Randomized Exper- Bandiera, Oriana, Niklas Buehren, Robin Burgess, iment in the Republic of Congo.” Policy Research Markus Goldstein, Selim Gulesci, Imran Rasul, and Working Paper No. 9934. © World Bank, Washing- Munshi Sulaiman. 2020. “Women’s Empowerment in ton, DC. https://openknowledge.worldbank.org/ Action: Evidence from a Randomized Control Trial in entities/publication/42454850-ffd1-5fdc-97ac-6ed- Africa.” American Economic Journal: Applied Economics d643cdefc. License: CC BY 3.0 IGO. 12(1): 210–59. https://doi.org/10.1257/app.20170416. Hicks, Joan Hamory, Michael Kremer, Isaac Mbiti, and Bassi, Marina, Octavio Medina, and Lúcia Nhampossa. Edward Miguel. 2011. “Vocational Education Voucher 2019. “Education Service Delivery in Mozambique: Delivery and Labor Market Returns: A Randomized A Second Round of the Service Delivery Indicators Evaluation Among Kenyan Youth.” Working Paper Survey.” Report No. 139063. World Bank, Washing- S-2004-KEN-1. LSE & Oxford University. https://www. ton, DC. https://documents1.worldbank.org/curated/ theigc.org/wp-content/uploads/2011/04/Hicks-Et-Al- en/811891562864504006/pdf/Education-Service-De- 2011-Working-Paper.pdf. livery-in-Mozambique-A-Second-Round-of-the-Ser- ILOSTAT. 2020. Modelled estimates for 2020. In World vice-Delivery-Indicators-Survey.pdf. Bank. n.d. “Empowering Women and Girls to Accel- Bergstrom, Katy, and Berk Özler. 2021. “Improving the erate the Demographic Transition: A Country Well-Being of Adolescent Girls In Developing Coun- Snapshot of the Current Situation and World Bank tries.” Washington, DC: World Bank Group. Support.” World Bank, Washington, DC. Boisvert, Kayla, and Gwendolyn Heaner. 2020. “Quali- Lachler, Ulrich, and Ian Walker. 2018. “Mozambique Jobs tative Study on Youths’ Access to Social Services in Diagnostic: Volume 1. Analytics.” August 16. World Mozambique.” World Bank, Washington, DC. Bank, Washington, DC. https://doi.org/10.1596/30200. Cai, J., and A. 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United Nations Children’s Fund (UNICEF). 2020. “Aval- United States Agency for International Development iação Longitudinal da Desistência Escolar em (USAID). 2019. “Gender Assessment for USAID/ Moçambique.” 2018 Baseline results presented 11 Mozambique Country Development Cooperation.” March 2020 in Maputo. UNICEF. June 2019. Washington, DC: USAID. https://pdf. United Nations Department of Economic and Social usaid.gov/pdf_docs/PA00WGW3.pdf. Affairs (UN DESA). 2019. Disability and Development Wodon, Q., C. Montenegro, H. Nguyen, and A. Ona- Report: Realizing the Sustainable Development Goals by, goruwa. 2018. “Missed Opportunities: The High Cost for and with Persons with Disabilities—2018. New York, of Not Educating Girls.” The Cost of Not Educating NY: United Nations. Girls Notes Series. Washington, DC: The World Bank. United Nations Educational, Scientific and Cultural Orga- https://openknowledge.worldbank.org/bitstream/ nization (UNESCO). 2018. “UNESCO Moçambique: handle/10986/29956/HighCostOfNotEducatingGirls. Relatório Anual 2017—UNESCO Digital Library.” pdf?sequence=6&isAllowed=y. Maputo: UNESCO Office Maputo, 2018. Accessed World Bank. 2020a. Improvement of Skills Development May 10, 2022. https://unesdoc.unesco.org/ark:/48223/ in Mozambique Project Appraisal Document. (Proj- pf0000265472_por. ect ID: P167054). World Bank, Washington, DC. United Nations Educational, Scientific and Cultural World Bank. 2020b. “Mozambique Human Capital Index Organization (UNESCO). 2019. Análise do Sector de 2020.” Human Capital Project. World Bank, Washing- Educaçao. UNESCO. ton, DC. https://databankfiles.worldbank.org/public/ United Nations Educational, Scientific and Cultural ddpext_download/hci/HCI_2pager_MOZ.pdf. Organization (UNESCO). 2022. Mozambique: World Health Organization (WHO). 2018. “Inclu- TVET Country Profile. UNESCO-UNEVOC, Bonn, sive Sofala Program: Baseline Assessment (CBR Germany. https://unevoc.unesco.org/home/Dynam- Outcome Indicators).” Geneva: WHO. https://euro- ic+TVET+Country+Profiles/country=MOZ. peanevaluation.org/wp-content/uploads/2021/08/ United States Agency for International Development Annexe-3_Report-CBR-Indicators-WHO-LFTW-final. (USAID). 2015. “Lessons from the Gender-Based pdf. Educate: Learning and Skills Development for Life Mozambique Gender Assessment  |  Leveraging women and girls’ potential 45 Mozambique Gender Assessment  |  Leveraging women and girls’ potential CHAPTER 3 Enhancing the Health of Adolescent Girls and Women E ntering the reproductive years comes with both risks and opportunities for women. Although diminishing, Mozambique’s maternal mortality ratio remains high. Rates of adolescent pregnancy are very high in Mozambique and appear to be increasing, putting girls on a path of limited opportunities, in addition to increasing their risks of morbidity and mortality. Fertility rates also remain high, limiting the opportunities for women to engage in productive activities and for the country to reap a demographic dividend. There are both supply and demand factors contributing to these high rates including uneven access to services and disruptions in services linked to conflict, natural disasters, and most recently COVID-19. On the demand side, desired numbers of children, although falling, remain high, and uptake of modern contraception remains low. Involving men and boys in family planning and reducing stigma and misconception regarding modern contra- ception, particularly among adolescents and their families, leads to healthier sexual and reproductive lives for both men and women. Mozambique has one of the highest rates of HIV/AIDS in the world, and women face higher rates of infection and mortality, as well as bearing more of the burden of car- ing for the sick and for orphans. Furthermore, infections are primarily driven by men, whose risky behaviors combined with women’s limited empowerment to negotiate safer sex contribute to high rates of infection. In this regard, involving men and boys in efforts to change behaviors is key. Enhancing the Health of Adolescent Girls and Women Mozambique Gender Assessment  |  Leveraging women and girls’ potential 47 Sexual and reproductive health as 47 percent in Nampula Province, while in Maputo and rights Province the rate is 8 percent.183 Not only does this have a negative effect on children’s development and health, but also leads to poor education outcomes Reproductive years are a critical point in the life and reduced lifetime productivity. Malnutrition, weak cycle of women where they face divergent tra- educational outcomes, and poor health conditions jectories that can either limit or expand their make a less productive nation and aggravate the inter- opportunities. Unintended pregnancies at a young generational cycle of poverty. age and early marriage significantly increase women’s domestic labor burden and limit their opportunities Access to reproductive and maternal health ser- to continue with their education and engage in remu- vices remains unequal across the country and is nerated economic activities. particularly low among the most vulnerable. Over- all, 71 percent of pregnant women have 1–3 antenatal Adolescent pregnancy can be dangerous, even care (ANC) visits, varying from 96 percent and 90 per- deadly, and the negative health impacts are trans- cent in Maputo City and Sofala province, respectively, ferred to the next generation. Adolescent pregnancy to 46 percent in Zambezia province. Poorer women is correlated with increased risk of maternal death and and those with lower levels of education are less likely is in fact the leading cause of death globally among to seek ANC. Similarly, 90 percent of women in urban girls ages 15–19.179 Premature pregnancy puts adoles- areas have assisted births compared to 63 percent in cent girls at risk of lasting health complications such rural areas; delays in getting emergency obstetric care as fistulae, particularly for the 14 percent of Mozam- in the case of complications contributes significantly to bican girls who become pregnant before their 15th maternal mortality.184 In order to continue the positive birthday.180 Adolescent mothers face higher risks of trend in reducing maternal mortality in Mozambique, eclampsia, puerperal endometritis, and systemic infec- increasing access to antenatal and assisted births for tions than mothers age 20–24 years, and babies born underserved groups will be important. from adolescent mothers face higher risks of low birth weight, preterm delivery, severe neonatal conditions, Estimates of Mozambique’s maternal mortal- and child stunting.181 ity ratio (MMR) (number of deaths per 100,000 live births) fell from 389 in 2011 to 289 in 2017,185 Mozambique’s high rates of stunting are closely but unfortunately these gains have likely been linked to poor maternal, neonatal, and child reversed due to interruptions in access to mater- health. Anemia and HIV/AIDS among pregnant nal and reproductive health services during women, fetal stress linked to poverty, conflict, and COVID-19. The country’s declining MMR has been displacement, and other health stressors are all con- closely tied to improvements in access to ante- and tributing factors to stunting. High rates of adolescent post-natal health services, with numbers of assisted pregnancies are also an important contributor, as births rising from 54 percent in 2011186 to 85 percent pregnant adolescents have lower body mass index in 2020.187 Most direct causes of maternal mortality themselves and higher rates of anemia, leading to sig- are linked to conditions that could have been detected nificantly lower birth weights and other indicators of through antenatal care (such as pre-eclampsia), and newborn health.182 Stunting is associated with cogni- the inability to access emergency obstetrical care in tive and physical development limitations and affects life-threatening emergencies.188 However, the most fre- boys more than girls, 41 percent versus 35 percent. quent causes of maternal death remain indirect causes Stunting is very unequally distributed and particu- including malaria, HIV/AIDS, and anemia, which is larly acute in the northern provinces: rates are as high particularly concerning in a country with some of the highest rates of each.189 179 Every Woman Every Child. The Global Strategy for Women` s s, Children` and Adolescents` Health (2016-2030). Geneva: Every Woman Every 183 Instituto Nacional de Estatística. 2021. Inquérito sobre ao Orçamento Child, 2015 Familiar—IOF 2019 (Suplemento Relátorio Final). Maputo, Moçam- 180 IMASIDA 2015 (MISAU, INE, and ICF International 2018). bique. 181 WHO, Adolescent Pregnancy, 2020. https://www.who.int/news-room/ 184 IMASIDA 2015 (MISAU, INE, and ICF International 2018). fact-sheets/detail/adolescent-pregnancy 185 World Development Indicators, Gender Statistics 182 Jaén-Sánchez N, González-Azpeitia G, Saavedra-Santana P, Saave- 186 Macicame et al. (2018). dra-Sanjuán E, Manguiza AA, et al. (2020) Adolescent motherhood in 187 MISAU-DSMC (2020). Mozambique. Consequences for pregnant women and newborns. PLOS 188 UNFPA (n.d.), “SRHS Situation Analysis in Mozambique.” ONE 15(6): e0233985. https://doi.org/10.1371/journal.pone.0233985 189 UNFPA (n.d.), “SRHS Situation Analysis in Mozambique.” Enhancing the Health of Adolescent Girls and Women 48 Mozambique Gender Assessment  |  Leveraging women and girls’ potential High rates of HIV/AIDS and malaria among preg- abortion during the first 12 weeks of pregnancy (up nant women also contribute to poor maternal and to 16 weeks in cases of rape or incest and up to 24 neonatal health. Testing and treatment of HIV/AIDS weeks for fetal abnormality), timely access remains among pregnant women is an important strategy to a significant constraint for many women who are reduce maternal mortality in Mozambique, but it is forced to have unsafe abortions. A survey conducted insufficiently done. The HIV prevalence rate among in the provinces of Maputo and Zambezia found that women in antenatal consultations has been estimated at among women who had had an abortion, 63 percent 15.8 percent, and AIDS represents the foremost indirect of these were unsafe. Furthermore, many women are cause of maternal mortality.190 Mozambique also has the not aware of the recent legalization of abortion: only 11th highest malaria incidence rate in the world,191 and 29 percent of women surveyed knew the legal status rates of anemia remain persistently high with almost of abortion.195 Adolescents and young women consti- half of all women of reproductive age (15–49) affected.192 tute a high number of those seeking abortion services. The Mozambican Association for Development of the The COVID-19 outbreak has particularly affected Family (AMODEFA) reports that between 2010 and access to reproductive, maternal, and child health 2016, 70,895 women of reproductive age sought safe and nutrition services. As a result of disruptions abortion services at AMODEFA’s clinic in Maputo. Of in all essential services due to the COVID-19 pan- the total, 43 percent were women ages 15–24.196 demic, maternal mortality in Mozambique may have increased by as much as 15 percent and child mortality by 16 percent in 2021. The volume of family planning services provided nationally between April and June Fertility and family planning: 2020 was 27.5 percent lower than during the same reaping the demographic period in 2019. Rates of institutional deliveries during dividend the earliest months of the pandemic (April–August 2020) were up to 10 percent lower in some provinces compared to the same period in 2019. As a result, the Mozambique is a pre-dividend country, with high estimated protection provided by family planning ser- levels of fertility. This is largely driven by early mar- vices, measured as Couple-Years of Protection, was 18 riages and unwanted pregnancies. Reducing high percent lower than during the same period of 2019. fertility rates is key to reaping Mozambique’s demo- Thus, efforts to address the unmet need for family graphic dividend. Although Mozambique’s total planning, reduce adolescent pregnancy, and reduce fertility rate (TFR) fell from 5.4 in 2010 to 4.7 in 2020,197 total fertility have likely lost significant ground. Mental the country still has one of the highest total fertility health has also been significantly affected according to rates in Sub-Saharan Africa and rates are falling only a rapid assessment conducted by the United Nations, slowly. Worryingly, adolescent fertility has actually which found that half of men and women reported been increasing (see Figure 8, adolescent pregnancy) that their mental or emotional health had deterio- and has likely further worsened as a result of increased rated during the onset of the COVID-19 pandemic.193 school dropouts and child marriage linked to COVID- 19 impacts on vulnerable households. The poorest Difficulty accessing safe abortion is another and most vulnerable households are also those with life-threatening challenge facing adolescents and the highest numbers of children: fertility rates vary women with unintended pregnancies. A 2013 significantly across regions, wealth quintiles, and lev- UNFPA report estimated that 6.7 percent of maternal els of education, as well as between rural and urban deaths in Mozambique are due to abortion complica- areas. On average 2.5 more children are born per rural tions and up to half of those deaths occurring in the woman (6.1) than urban woman (3.6). Fertility is par- first 28 weeks of gestation.194 While a 2014 abortion law ticularly high in northern and central regions: Niassa, and amendments to the penal code in 2019 legalized Zambézia, Tete, and Sofala provinces all have rates at or above 6.0 births per woman, while women in Maputo city have on average 2.5 births. Women without any 190 MGCAS (2016). 191 https://databank.worldbank.org/source/health-nutrition-and-popula- tion-statistics. 192 World Development Indicators, Gender Statistics. 195 Frederico et al. (2020). 193 UN Women, UNFPA, and ILO (2021). 196 AMODEFA (2017). 194 UNFPA (2013). 197 https://data.worldbank.org/indicator/SP.DYN.TFRT.IN?locations=MZ Enhancing the Health of Adolescent Girls and Women Mozambique Gender Assessment  |  Leveraging women and girls’ potential 49 Figure 17: Unmet need for family planning, Figure 18: Total fertility rate 15–49, 2015 (births 2015 (%) per woman) TANZANIA TANZANIA ZAMBIA ZAMBIA MALAWI MALAWI ZIMBABWE ZIMBABWE 12.4 2.2 SOUTH 12.5 to 15.6 SOUTH 2.3 to 3.2 AFRICA 15.7 to 18.8 AFRICA 3.3 to 4.3 18.9 and higher 4.4 and higher ESWATINI ESWATINI Source: Mozambique DHS, IMASIDA 2015, STAT Compiler. Source: Mozambique DHS, IMASIDA 2015, STAT Compiler. or only primary education have almost twice as many is decreasing but not fast enough to reap the demo- children as those with secondary or higher levels of graphic dividend. Only 50 percent of women declare education. Similarly, those in the highest wealth quin- an interest in family planning methods to delay, limit, tile have less than half as many children as those in or avoid childbearing, and only about half of these have the lowest and second quintiles.198 Without curbing their needs met. Married women ages 15–49 in urban these high fertility rates, UN population projections areas are more likely to want to limit the number of are that by 2032, Mozambique’s population will have children than those living in rural areas (32 percent ver- increased by a third, straining resources and delaying sus 25 percent); also, desire for fewer children increases the demographic dividend.199 as wealth increases (from 21 percent and 22 percent in the first and second quintiles to 36 percent in the By reducing fertility, the country would be able to highest). Overall, 23 percent of married Mozambican leverage the productive fruits of a bulge in the work- women ages 15–49 would like to have access to family ing age population, with fewer young dependents. planning but do not. These rates vary significantly by Indeed, World Bank estimates suggest that if Mozam- location: Maputo Province (45 percent), Zambezia (30 bican women today had on average one less child, by percent), and Niassa (29 percent) have the highest rates 2050 this could bring a 31 percent increase in GDP of unmet family planning needs, whereas the city of per capita and accelerate the pace of poverty reduction Maputo (17 percent), Nampula (19 percent), and Sofala by around 60 percent.200 Overall, desired family size (20 percent) have the lowest (Figures 17 and 18). Although increasing, only 25 percent of Mozambi- 198 IMASIDA 2015 (MISAU, INE, and ICF International 2018). can women ages 15–49 use a modern method of 199 https://worldpopulationreview.com/countries/mozambique-population 200 Word Bank (2018); Gragnolati (2016: Figure). contraception, with higher rates in urban areas. Enhancing the Health of Adolescent Girls and Women 50 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Furthermore, while it has been increasing, use of when combined with interventions that change long-acting reversible contraception (such as intra- behavioral, cultural, and economic factors affecting uterine devices and hormonal contraceptive implant) demand for children.205 Empowering women and girls is still low. These are more likely to be more effec- to have greater control over their reproductive lives tive than short term methods (oral contraceptives, and greater opportunities in general is key to reduc- particularly) which are more likely to result in user ing high rates of fertility and reaping the demographic failure or discontinued use. Women in the south of dividend. Mozambique are about twice as likely to use mod- ern contraction than those in central and northern Increasing men’s involvement in and understand- regions where approximately 1 in 5 women use ing of prenatal and postnatal care will also be modern contraception compared with 44 percent of important to continue to reduce maternal mortal- women in Maputo Province. Demand-side factors ity and high fertility rates in Mozambique. In a Men emerge prominently as one of the main self-reported and Gender Equality Survey conducted in Maputo in reasons for nonuse.201 2017, 69 percent of men said they had accompanied their partner to a prenatal visit, but only 41 percent of Women are often prevented or discouraged from women said this was the case. Both men and women accessing sexual and reproductive services in reported that work was the primary reason why men Mozambique. In some cases, health care providers did not attend more prenatal visits.206 insist on spousal consent for services, even if it is not required by law, making it harder for women and young people to access the information and services they need to protect their own health and well-being.202 Engaging men for improved In a mixed-methods study of masculinities, poverty, reproductive health and violence conducted by Promundo and Edward Mondlane University in Maputo city, 20 percent of women said their male partner decided if she could Gender roles and power dynamics between men go to a health center.203 Similarly, a qualitative study and women influence nearly all health decisions. on youths’ access to social services in five Mozam- According to both men and women, men play a dom- bican communities reported that male relatives or inant role in decisions regarding women’s health, spouses were frequently gatekeepers for women’s use although there is variation depending on women’s of contraception and access to sexual and reproductive level of education and economic status.207 In a study healthcare.204 WLWD are further constrained by stig- of masculinity, poverty, and violence in Maputo, 53 matization and discrimination, including due to poor percent of women participants and 29 percent of accessibility of physical infrastructures. men felt women were responsible for contraception.208 Empowering women to make informed sexual and Both supply and demand factors contribute to reproductive health choices, ensuring they can access high fertility rates and will need to be addressed sexual, reproductive, and maternal health services, for any strategy to reduce Mozambique’s TFR to and supporting more equal distribution of domestic be successful. That is, it will be important to increase labor, puts women and girls on a path toward reach- supply of family planning services to meet rates of ing their full potential. Improving women’s sexual unmet needs, including services particularly adapted and reproductive health has intergenerational bene- for adolescents and young people. At the same time, fits as well: healthier mothers have healthier children it will be important to address the social, cultural, and who can contribute their full talents to harnessing the economic drivers that underpin the desire for large demographic dividend. families, particularly among the rural poor, and resis- tance or reluctance to seeking SRH services. Global Engaging men and boys is essential for reducing evidence shows that family planning programs can adolescent pregnancy and transmission of sexually have particularly strong effects on fertility reduction transmitted infections (STIs), including through 201 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 205 Bongaarts (1978). 202 Williams (2011). 206 Slegh et al. (2017). 203 Slegh et al. (2017). 207 MGCAS (2016). 204 Boisvert and Heaner (2020). 208 Slegh et al. (2017). Enhancing the Health of Adolescent Girls and Women Mozambique Gender Assessment  |  Leveraging women and girls’ potential 51 education around issues of consent, limiting think it is fair for a woman to refuse to have sex with risky behaviors, engaging in safer sex, and sharing her husband if she knows he has had sex with other joint responsibility in family planning. Given the women. important role of slow-changing social norms under- pinning the interrelated issues of girls’ schooling, early The study also found that many respondents marriage, and fertility, a greater focus on engaging accepted sexual violence within marriage, with communities on these norms and behaviors may help higher rates of women (24 percent) than men speed up progress on these issues.209 In Mozambique, (19 percent) agreeing that sexual violence cannot one study looked at the impacts of a community exist between a husband and wife. Notwithstand- dialogue program that used videos to highlight the ing that marital rape is included in the legal benefits and challenges of developing more gender-eq- definition of rape,215 men’s and women’s attitudes uitable relations, with a focus on issues such as division toward sexual and reproductive rights often disem- of household tasks and protecting one’s family from power women. On the one hand, according to most HIV, to spark discussions among male and female female respondents, men “need” a second women community members.210 The study finds significant and a “good” woman will have patience with this. positive impacts from dialogue, including increased Women underlined the importance of having “good sharing of household tasks between women and men, behaviors” in relation to men—cleaning, cooking, more agreement with gender equitable attitudes, and and having sex when a partner wants—believing this lower levels of HIV social stigma. to be the normal order of things, and that if not per- formed well, would lead a husband to seek another Engaging both men and women is key to wife or partner. On the other hand, both men and changing attitudes and behaviors toward sex, sex- women said that good sexual relations are important uality, reproductive health, and family planning. for a couple and highlighted the need for good com- Research shows that providing men with informa- munication, respect, and dialogue—opening the tion on family planning can increase the use of door for effective couples’ interventions to address family planning methods and reproductive health sexual behavior and other gender norms that disad- services.211,212 Men’s general abdication of respon- vantage women. sibility for contraception is another contributing factor to low rates of contraception use, particularly given that women, while seen as responsible for con- traception, are at the same time often disempowered HIV/AIDS has a female face in negotiating its use. Traditional attitudes toward sexuality and reproductive health contribute to risky Mozambique has the fifth highest incidence rate behaviors and disempower women in family plan- of HIV/AIDS in the world, with women almost ning decision-making and control. The report “Being twice as likely to be infected by HIV and to die a Man in Maputo,” conducted as part of the Interna- from AIDS as men.216 Women face higher prevalence tional Men and Gender Equality Survey (IMAGES),213 and mortality rates, lesser ability to negotiate safer suggests that sexual activity is an important charac- sex and protect themselves from men’s risky behav- teristic associated with manhood with around half of iors, and a greater burden of care for those made sick men agreeing that “men need more sex than women and orphaned by HIV/AIDS. Not only does Mozam- do” and “are always ready for sex.” Unsurprisingly, bique have one of the highest rates of HIV/AIDS in men ages 15–49 are significantly more likely to have the world, but it is also increasing—from 11.5 per- multiple sexual partners than women.214 Yet social cent in 2009 to 13.2 percent in 2015.217 It is by far the norms limit women’s ability to protect themselves: leading cause of death among adults—both men and only 42 percent of women and 54 percent of men women ages 15–49. However, HIV/AIDS kills women at a significantly higher rate than men, accounting for 63 percent of causes of mortality among women 209 Hasan and Moucheraud (2014). 210 Figueroa et al. (2016). 211 Msovela et al. (2020); Doyle et al., “Gender-Transformative Bandebereho Couples’ Intervention to Promote Male Engagement in Reproductive and Maternal Health and Violence Prevention in Rwanda.” 212 Doyle et al. (2018) 215 Law No. 29/2009 on Domestic Violence Perpetrated Against Women. 213 Slegh et al. (2017). 216 World Development Indicators, Gender Statistics. 214 Instituto Nacional de Saúde and Instituto Nacional de Estatística 217 IMASIDA 2015, Supplemental Report (2019) (MISAU, INE, and ICF (2009). International 2019). Enhancing the Health of Adolescent Girls and Women 52 Mozambique Gender Assessment  |  Leveraging women and girls’ potential ages 15–49 compared to 42 percent of causes of death percent said they always used condoms, with those among their male counterparts.218 married to or living with AGYW partners much less likely to use condoms.224 HIV prevalence varies significantly by province with highest rates found in the south—24.4 per- Stigmatization of persons living with HIV/AIDS cent in Gaza and 22.9 percent in Maputo Province, is widespread in Mozambique. Curiously, Mozam- compared to 5.2 percent in Tete and 5.7 percent in bicans are significantly less tolerant of PLWHA than Nampula (combined average for both men and wom- neighboring countries notwithstanding similarly high en).219 On average, 50 percent more women have HIV/ rates of disease. According to the 2014–15 AfroBa- AIDS than men, with the prevalence rate for women rometer, only two-thirds of Mozambicans would feel at 15.4 percent versus 10.1 percent for men.220 Among comfortable living next to a PLWHA, while in Zim- young people ages 15–24, the difference is even starker babwe, Eswatini South Africa, and Malawi, acceptance with prevalence among young men only a third of rates are above 90 percent, suggesting the need for that of young women. And yet, women are more increased efforts to promote acceptance of PLWHA likely to help lower the spread of HIV/AIDS by taking in Mozambique. Although this may be evolving as a antiretroviral medication at higher rates then infected result of advocacy by CSOs, such norms tend to be men—82 percent versus 70 percent.221 Furthermore, ‘sticky’ and change only slowly over time. Stigmatiza- women are less able to access quality health services tion not only subjects PLWHA to discrimination and than men, often impeded by healthcare providers harassment, but also negatively affects health-seeking prioritizing male clients or female clients who bring behaviors. A study of male involvement in rural areas their male partners with them.222 of Zambézia province revealed the widespread belief that seeking antenatal care, particularly if accompa- In Mozambique, HIV infections are driven by nied by a male partner, means that a woman is HIV young men and the young women they infect. positive.225 Low anti-retroviral treatment (ART) coverage among young men is the primary factor driving these new Low levels of knowledge about how to protect infections. Although as of 2021, 66 of all persons liv- against HIV/AIDS infection, particularly among ing with HIV/AIDS (PLWHA) were estimated to be young men and women, contributes to low rates of on ART, only 41 percent of men ages 20–29 were on condom use. Only 47 percent of women and 56 per- treatment. The majority of these young HIV+ men cent of men know that the transmission of HIV can be are sexually active, asymptomatic, and have limited reduced by using condoms and limiting numbers of interactions with the health system. Two-thirds of sexual partners. Among married women merely 2 per- the new infections among adolescent girls and young cent report using condoms and the number increases women (AGYW) ages 15–24 come from young men to only 20 percent among unmarried women.226 Com- ages 20–29.223 Getting these young men and young prehensive knowledge of HIV among adolescents women on ART will be critical to slowing the epi- is particularly low: only 28 percent of adolescents, demic in Mozambique, but access remains uneven both boys and girls surveyed between 2011 and 2016, throughout the country. Given the high rates of early knew how HIV is transmitted and how to protect marriage and sexual initiation in Mozambique, tar- themselves.227 geting education to partners of adolescent girls and young women on delaying childbearing and pre- Men’s risky sexual behaviors put women at risk venting transmission of HIV and other STIs will be of contracting HIV/AIDS. While 21 percent of men important. Among male sexual partners of AGYW reported having multiple sexual partners within the in Beira, Quelimane, and Xai-Xai districts, only 41 previous year, and only 26 percent of these report using condoms.228 Furthermore, around one in five men report having paid for sex in the previous year, 218 Global Burden of Disease Estimates by the Institute of Health Metrics and Evaluation, 2019. https://vizhub.healthdata.org/gbd-compare/. 219 IMASIDA 2015, Supplemental Report (2019) (MISAU, INE, and ICF International 2019). 224 Chapman et al. (2018). 220 IMASIDA 2015, Supplemental Report (2019) (MISAU, INE, and ICF 225 Audet et al. (2016). International 2019). 226 IMASIDA 2015 Supplemental Report (2019) (MISAU, INE, and ICF 221 IMASIDA 2015, Supplemental Report (2019) (MISAU, INE, and ICF International 2019). International 2019). 227 UNFPA (2018). 222 USAID (2019). 228 IMASIDA 2015 Supplemental Report (2019) (MISAU, INE, and ICF 223 PEPFAR (2020). International 2019). Enhancing the Health of Adolescent Girls and Women Mozambique Gender Assessment  |  Leveraging women and girls’ potential 53 and only 31 percent of these report using condoms.229 Rates of HIV/AIDs are also higher among at-risk At the same time, women are often disempowered populations linked to vulnerability, exploitation, to negotiate safer sex or to protect themselves from and risky behaviors. Men who have sex with men men’s risky behaviors: only 60 percent of women and (MSM), women whose partners engage in risky behav- 72 percent of men consider it fair for a woman to pro- iors, women and girls as well as men and boys engaged pose using a condom if she knows that her husband in transactional sex, and persons subject to sexual has a sexually transmitted infection. The percentages exploitation and abuse are particularly at risk. These of both men and women who think it is acceptable risks are heightened among vulnerable populations in for women to negotiate safer sex is higher in urban conflict zones and situations of displacement, whether areas compared to rural areas and, for both sexes, it due to conflict or climate. There are also higher rates increases with the level of education and wealth.230 of infections among migrant workers, truck drivers, Many women, especially adolescents, poorer women, prisons populations, and members of the military, and those from rural areas and with lower levels of who in turn put their sexual partners at risk.235 Sex education, often lack agency over their own bodies workers anywhere are at increased risk: worldwide, and are unable to negotiate safer sex with their sex- they are 12 times as likely as the general population ual partners. Attitude surveys indicate that many have to be HIV positive.236 Particular high-risk zones in internalized norms around sexual submission to male Mozambique include the Beira transport corridor in partners.231 Manica province (connecting Beira to Zimbabwe). In 2012, Médecins Sans Frontières (MSF) estimated that Coerced or forced sexual relations expose women there over 7,000 sex workers in Beira alone. Thirty per- and men to risks of contracting HIV/AIDS. In addi- cent of women in Beira surveyed by MSF who were tion to forced sexual initiation, young girls are also at free of HIV contracted the disease in the following 12 risk of sexual exploitation or assault given the widely months.237 As one sex worker put it in a recent inter- held view that intercourse with a virgin is a cure for view, “sex sells and there’s a good chance that HIV will HIV. In a national survey of violence against children be part of the transaction.”238 Another study showed and youth, 4 percent of young women age 18-24 who that a third of MSM in Beira over the age of 25 are had had sexual intercourse before age 18 reported living with HIV.239 Lessons learned from MSF’s Cor- that they had been pressured or forced to have sex.232 ridor project suggests that for high-risk populations, Overall, about 6 percent of both men and women the provision of condoms is not enough; provision report having experienced sexual assault at least once of anti-retroviral drugs and prophylaxis drugs is also since age 15.233 Among 18–24 year olds who partici- necessary to control rates of HIV/AIDS. Furthermore, pated in a national survey of violence against children their experience suggests that sex workers need to be and youth, 7.6 percent of young women and 2.3 per- part of the solution as they are much more effective cent of young men were HIV positive. HIV prevalence in communication and outreach such as regarding the was higher among women who experienced sexual availability of free anti-retroviral treatment. violence (9.4 percent) and even higher among those who experienced emotional violence (27.2 percent), suggesting a strong link between GBV and HIV/AIDS. Not only does physical and sexual IPV increase the Persons living with disabilities risk of HIV infection, but women who experience IPV are also at higher risk of are less likely to be receiving ART or to achieve viral contracting HIV/AIDS 240 load suppression,234 contributing not only to their own ill-health but also undermining efforts to elimi- nate high rates of HIV/AIDS in Mozambique. Data is not systematically collected on the prevalence of HIV/AIDS among PLWD in Mozambique. However, available evidence suggests that PLWD are at higher 229 IMASIDA 2015 Supplemental Report (2019) (MISAU, INE, and ICF International 2019). 235 PEPFAR (2021). 230 IMASIDA 2015 Supplemental Report (2019) (MISAU, INE, and ICF 236 https://mosaicscience.com/story/sex-workers-hiv-Africa-Mozambique/ International 2019). 237 https://clubofmozambique.com/news/doctors-worried-about-spread-of- 231 See, for example, Slegh et al. (2017). hiv-in-mozambiques-beira-corridor/ 232 INS et al. (2020). 238 https://mosaicscience.com/story/sex-workers-hiv-Africa-Mozambique/ 233 IMASIDA 2015 (MISAU, INE, and ICF International 2018). 239 Nalá et al. (2015). 234 Kuchukhidze et al. (2022). 240 UNFPA (2018). Enhancing the Health of Adolescent Girls and Women 54 Mozambique Gender Assessment  |  Leveraging women and girls’ potential risk of contracting HIV/AIDS and less likely to be able Data and knowledge gaps to access health and other services. A large majority of PLWD have lower levels of knowledge on HIV preven- Much of the data available on SRMH in Mozambique tion, due to low levels of education and limited access is taken from IMASIDA 2015 and therefore somewhat to information (especially those with intellectual dis- outdated. A new Demographic Health Survey data is abilities), including information on prevention, care, being collected (June 2022–January 2023) and will and treatment programs.241 Law 12/2009 on the rights provide important information on trends and any and duties of persons living with HIV/AIDS to state backsliding linked to either conflict, natural disasters, that persons with disabilities have an equal right to and COVID-19. In addition, there are many areas HIV/AIDS prevention, protection, and treatment. where additional qualitative research into the drivers However, services are often not adapted for disabil- of SRMH behaviors would be helpful for the design ity, and there is prejudice among service providers as of more effective policies and programs. In particu- well as double stigmatization of PLWD who are also lar, more information is needed in relation to certain PLWHA. While many NGOs/CSOs target vulnerable marginalized subgroups, such as PLWD and SOGI groups such as sex workers, migrants, MSM, or SOGI minorities. A significant amount of data is regularly minority individuals, they often do not particularly collected with the support of PEPFAR on rates of target PLWD. As with other high-risk populations, infection and transmission of HIV/AIDS, as well as on PLWD should be included in programs to train and ART coverage and compliance. Whether in relation to support peer education. HIV/AIDS or SRMH more broadly, it will be import- ant to assess how gender norms and their variation across different contexts are driving both positive and negative behaviors. As with all new interventions, it will be important to conduct impact evaluations to assess their effectiveness in the Mozambican context. 241 UNICEF (2014). Enhancing the Health of Adolescent Girls and Women Mozambique Gender Assessment  |  Leveraging women and girls’ potential 55 References Associação Moçambicana Para Desenvolvimento da Evidence-based Policies and Programs.” World Bank, Família (AMODEFA). 2017. Estatisticas de Serviços Washington, DC. Prestados em Saúde Sexual e Reproductiva. Moçam- Instituto Nacional de Estatística. 2021. “Inquérito sobre bique: AMODEFA. ao Orçamento Familiar—IOF 2019” (Suplemento Audet, C. M., Y. M. Chire, L. M. Vaz, R. Bechtel, D. Carl- Relátorio Final). Maputo, Moçambique. son-Bremer, C. W. Wester, K. R. Amico, and L. 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Persons with Disabilities: Global Study on Ending Enhancing the Health of Adolescent Girls and Women Mozambique Gender Assessment  |  Leveraging women and girls’ potential 57 Mozambique Gender Assessment  |  Leveraging women and girls’ potential CHAPTER 4 Economic Inclusion F emale labor force participation in Mozambique is high, yet the quality of employ- ment women are accessing is low. The lower quality of women’s labor force participation is manifested through underemployment and women being less likely to enter high- er-paying non-agricultural sectors. Female entrepreneurs, farmers, and wage employees are less productive on average than their male counterparts and spend fewer hours per week engaged in economic activities. Drivers of underemployment and sectoral segregation include unequal burdens of unpaid childcare and domestic responsibilities.242 The negative impacts of unpaid domestic work are likely to have increased during the COVID-19 pandemic, with the crisis increasing the burden of unpaid domestic work and unpaid care work at a greater rate for women than men.243 Withing the agricultural sector, female-headed households are 24 percent less productive than their male counterparts. Drivers of women’s lower agricultural produc- tivity include lower technical efficiency, lower use of labor and mechanization, and women’s low participation in cash crop farming. While the private sector has driven growth within wage employment, women are benefiting less than men. As a result of gender differences in time use, sectoral segregation, and human capital, women are concentrated in sectors with lower average earnings. Slightly more women than men are engaged in entrepreneurship in urban areas. In rural areas, men are much more likely than women to work in entrepreneurship; this is because in rural areas the agriculture sector can absorb a larger number of low-skilled women compared to urban areas. Women-owned small and medium-sized enterprises (SMEs) earn 16 percent less than male-owned SMEs, due to lower technical skill levels, time constraints imposed by domes- tic responsibilities, and less access to finance. To increase women’s economic productivity, the drivers of gender gaps must be addressed. This will entail encouraging women and girls to enter male-dominated sectors, increasing women farmers’ access to inputs, and increasing women entrepreneurs’ access to capital. Policy efforts and programmatic interventions should aim to (i) increase the time women are available to work, by addressing the unequal burden of domestic care held by women through accessible childcare, and changing social norms to distribute unpaid care work more evenly between men and women; (ii) increase women farmers’ access to extension services and agricultural inputs; and (iii) address discrimination in wage employment through amending discriminatory employ- ment policies and strengthening protections against sexual harassment in the workplace. 242 Martinez, Naudeau, and Pereira (2012). 243 UN Women, UNFPA, and ILO (2021). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 59 Although Mozambique has seen impressive growth rapidly, with almost twice as many people expected since the end of the civil war in 1992, the capi- to enter the labor force each year as did in the previ- tal-intensive nature of this growth has not brought ous decade. As the working-age population rises, the broad-based benefits in terms of poverty reduction dependency ratio is expected to fall, especially if the and job creation, especially for women. This is partly country can also reduce fertility rapidly, thereby cre- due to the country’s reliance on megaprojects within ating an opportunity to increase living standards and the export-oriented energy and extractives sectors for benefit from a demographic dividend. However, the economic growth.244 While the share of GDP attribut- size of any demographic dividend will be constrained able to the industrial sector increased from 10 percent if either: the economy cannot generate enough new in 1996 to 19 percent in 2014, this was mostly due to and more productive jobs to absorb the increased growth in the foreign direct investment (FDI)-depen- labor supply; or the capacity of public services such dent mining sector, which employs few people directly as education and health are not sufficient to provide and has weak links to domestic firms.245 Consequently, the large youth population with the requisite human over the same period the share of jobs estimated to be capital to take up those jobs.248 in the industrial sector increased only slightly (from 4.4 percent to 4.9 percent) and in 2014 non-farm wage employment (considered the highest quality and pay- ing jobs) represented only 16 percent of employment. Female labor force participation Moreover, women’s specific constraints—lower levels of education; lower representation in science, tech- Female labor force participation is high, yet the nology, engineering, and math (STEM) subjects; time quality of female labor force participation is low. constraints related to domestic work, gender, and social The labor force participation of Mozambique is rel- norms, among others—make it even more difficult atively high compared with other countries in the for them to access the few formal wage job opportu- region and is driven by the higher participation rate nities that the energy sector has produced.246 Women of Mozambican women249 (Figure 19). Despite high are also likely to face more significant constraints in male and female labor force participation rates, there taking advantage of self-employment opportunities is a high degree of sector-based sex segregation, and connected to the energy sector, given some of the the quality of women’s participation appears to be specific problems highlighted in recent literature in lower than that of men. The lower quality of women’s linking SMEs to large FDI projects in Mozambique.247 labor force participation is manifested through the These problems include large size of contracts (women underemployment of women and women being less are more concentrated in smaller firms), the techni- likely to enter higher-paying non-agricultural sectors cal complexity of opportunities (women-owned firms (Figure 20).250 tend to suffer from weaker skills), and the perceived lack of transparency in procurement processes (with Women’s underemployment and concentration women having weaker business networks, especially in in less productive jobs and sectors is partly driven male-dominated sectors). by unequal burdens of care and domestic respon- sibilities. Significant gender differences exist in time Beyond factors related to the sectoral composition allocation between men and women, often guided of the economy in Mozambique, a broader set of by deep-rooted social norms, and can be a driving gender gaps (including in education, capital, and force behind gender gaps in labor force participation social norms) are hindering women’s economic rates and biasing the type of economic opportunities inclusion and may impede Mozambique’s abil- women can access. The social norms that drive time ity to fully leverage the productive potential of allocation are, to some extent, based on socio-cultural its large youth population and capture a demo- perceptions of men’s and women’s responsibilities graphic dividend. About 45 percent of the total toward the wellbeing of the household. The unequal population is currently under age 15. With such a burdens of care work and domestic responsibilities large youth population, the labor force will grow result in women engaging in fewer hours of paid 244 Lachler and Walker (2018). 248 Lachler and Walker (2018). 245 Lachler and Walker (2018). 249 “World Development Indicators | DataBank,” https://databank.world- 246 Lachler and Walker (2018). bank.org/source/world-development-indicators. 247 Robbins, Lebani, and Rogan (2009). 250 Lachler and Walker (2018). Economic Inclusion 60 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 19: Labor force participation rates, 2019 (%) Percent 90 80 78% 79% 78% 78% 80% 78% 73% 74% 70 68% 68% 69% 67% 63% 60 60% 53% 50 40 30 20 10 0 Mozambique Eastern & Southern Africa Sub-Saharan Africa Low Income World Female LFP Male LFP Total LFP Source: World Development Indicators (ILO Projections, 2019). Figure 20: Employment sector by gender and location, 2018 (%) Percent 100% 93% 90% 80% 76% 70% 60% 50% 46% 40% 38% 30% 29% 24% 25% 20% 16% 10% 11% 12% 10% 8% 3% 2% 1% 3% 0% Agriculture Non-Farm Self-Employment Private Wage Employment Public Wage Employment Rural Women Rural Men Urban Women Urban Men Source: Lachler and Walker (2018). “Mozambique Jobs Diagnostic: Volume 1—Analytics. labor and prioritizing job flexibility over job quality. indicates that childcare service provision increased Domestic responsibilities often prevent women from the caregivers’ employment rate by 26 percent.252 The taking better-quality jobs, such as wage employment negative impacts of unpaid domestic work are likely with fixed schedules or full-time work. Often a low- to have increased during the COVID-19 pandemic, er-quality job in the agricultural sector, part-time with the crisis increasing the burden of unpaid domes- work, or being self-employed provides more flexibil- tic work and unpaid care work at a greater rate for ity to women, allowing them to meet childcare and women than men.253 While data measuring the impact other domestic demands.251 Increasing access to child- of COVID-19 is still being gathered, it is likely that care is an effective mechanism for increasing women’s women’s increased burden of care will further impact employment. A study conducted in Mozambique their productivity (Box 6). 252 Martinez, Naudeau, and Pereira (2012). 251 Rubiano-Matulevich and Viollaz (2019). 253 UN Women, UNFPA, and ILO (2021). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 61 Box 6: Economic impacts of COVID-19 the provision of childcare service increased the care- givers’ employment rate by 26 percent.258 Women are more than twice as likely as men to cite domes- Emerging evidence from Mozambique tic responsibilities as preventing them from working and other countries in Sub-Saharan Africa full-time.259 While domestic responsibilities are cited suggests the COVID-19 pandemic has signifi- less frequently in urban areas, the gender gap is larger, cantly impacted livelihoods. The pandemic as women cite this as a reason for underemployment caused a sudden loss of income for businesses. more than three and a half times more often than In the northern region, the pandemic coupled men. While women in urban areas spend more time with the escalating conflict resulted in the clo- in productive labor than women in rural areas, both sure of 38 percent of businesses. Many firms in groups work significantly less than their male coun- Mozambique do not have the capacity or liquid- terparts.260 The more significant negative impact of ity to survive such an enormous shock as the domestic labor on women’s economic productivity in pandemic, and this is especially true of small rural areas is not surprising, given the greater relative firms, which were the most affected.254 This is lack of time-saving infrastructure and public services. especially relevant to women business owners. Such infrastructure and public services include access The World Bank’s 2018 Enterprise Survey for to electricity and water, which decrease the time-con- Mozambique showed that formal firms with suming nature of domestic activities such as collecting a top female manager were smaller than their water, gathering fuel, and preparing food.261 Given the male counterparts, with an average of 17 work- impact that a lack of basic infrastructure has on the ers and 47 workers respectively. Beyond size, time women spend on domestic labor, it is concern- women entrepreneurs’ concentration in hard- ing that the proportion of households with access to hit consumer-facing sectors and their greater water within 30 minutes (roundtrip) decreased from burden of unpaid care work may also have 51 percent in 2015 to 44 percent in 2018, a trend put them in a particularly vulnerable position. which increases during droughts that are made more Emerging evidence from a May 2020 survey of frequent by climate change.262 Additionally, it has Facebook business page administrators from been found that within Mozambique, electricity is the several countries in the region suggests that most unequally distributed basic service, leaving poor 43 percent of women-owned businesses closed women in an especially challenging position.263 during the pandemic, compared to 34 percent of men-owned business.255,256 Surveys show that women’s care work and domestic responsibilities also contribute to their concentra- tion in less productive sectors and jobs and impedes Underemployment is a significant constraint to their productivity within given sectors and jobs. women’s economic productivity and participation Evidence shows that men benefit more from being in the labor market and is largely driven by the married than women, as the likelihood of working unequal domestic work and childcare burden. outside the agricultural sector increases significantly Women in Mozambique, on average, spend signifi- more for married men than married women as com- cantly fewer hours being economically productive pared to unmarried people.264 This finding underlines than men. In 2007, housework was the main reason the negative impact household and care responsibil- for not being employed, given by 21 percent of the ities have on women’s productivity by making them female working-age population as compared with more likely to stay in a less productive sector (agri- 6 percent of the male working-age population.257 culture). Agriculture and self-employment are likely Among women in rural areas, domestic responsibil- appealing to women experiencing time-poverty as it ities are the most cited reason for working less than is possible to multitask their unpaid care work simul- 40 hours per week on income-generating activities. taneously. Traditional female responsibilities and care A study in Mozambique highlights the impact of care work as a deterrent to employment, finding that 258 Martinez, Naudeau, and Pereira (2012). 259 Lachler and Walker (2018). 260 Lachler and Walker (2018). 254 World Bank (2021). 261 Fox, Benfica, and Ehrenpreis (2008). 255 Goldstein et al. (2022). 262 “Gender Statistics,” World Development Indicators; Fischer (2016). 256 World Bank (2021). 263 World Bank (2018). 257 Gradín and Tarp (2019). 264 Gradín and Tarp (2019). Economic Inclusion 62 Mozambique Gender Assessment  |  Leveraging women and girls’ potential work have also been linked to women’s concentration Figure 21: Gender gap in agricultural in small, unproductive household enterprises,265 as, productivity, 2018 (%) like agriculture, these allow women to juggle income Percent generation with unpaid domestic work. As well as 100 pushing women into less productive sectors and jobs, 93% unpaid care work and domestic responsibilities may 90 also reduce women’s productivity within a given sector 80 76% or job. For example, in agriculture, a woman farmer carrying a child on her back may not be able to cul- 70 tivate as much of her plot as she would otherwise be 60 able to. Yet, a study in Mozambique found that almost 20 percent of women care for a child while working 50 46% on the farm.266 In self-employment, analysis of data for SMEs in Mozambique indicates that having children 40 widens the gender gap in firm profits.267 30 24% Evidence from Sub-Saharan Africa finds that access 20 to childcare increases the ability of caregivers, and 10 especially women, to participate in economic activities. An intervention in Mozambique provided 0 Rural Urban community-based preschool centers for children ages Women Men 3–5 to attend for a little over three hours per day. In Source: Lachler & Walker. 2018. “Mozambique Jobs Diagnostic: Volume addition to positive impacts that the program had on 1—Analytics.” child outcomes, the intervention was found to relieve caregivers of childcare responsibilities by more than 15 hours per week. The reduction in time devoted to especially true for women. Of those employed in caring for children resulted in the increased employ- agriculture, 66.8 percent are self-employed, 3.1 per- ment of caregivers by 26 percent, with the effect cent are wage employees, 1.3 percent are employers, being larger for mothers as compared with fathers.268 and 28.9 percent are unpaid family laborers. In rural Another intervention that took place in Kenya pro- and urban areas, women are more likely than men to vided vouchers for subsidized childcare. Experimental be employed in agriculture (Figure 21). Within the evidence from this intervention shows that women agricultural sector, men are more likely than women who received vouchers were 8.5 percent more likely to be involved in cash crop production, while women to be employed, and single mothers specifically bene- provide the majority of labor to produce food crops. fited by shifting to jobs with more regular hours and Female-headed households are on average poorer than less loss to their income.269 male-headed households, own smaller agricultural plots, and use less fertilizer, pesticides, machinery, and other modern inputs. Additionally, women farmers have less access to capital, land, and livestock than Gender gap in agricultural male farmers.270 productivity Mozambique has been ranked among the countries most impacted by climate change, and women, Although there has been a significant decline in as the majority of the agricultural workforce, are the share of jobs in agriculture since 1997, most particularly vulnerable to its impacts.271 As the of Mozambique’s working-age population (71 per- country has warmed at a greater rate in the southern cent) remain engaged in the sector, and this is region, rainfall has become more variable, resulting in hotter and dryer conditions and increased incidence 265 See Gradín and Tarp (2019); also see Lachler and Walker (2018). 266 Arora (2015). 267 Campos et al. (2019). 268 Martinez, Naudeau, and Pereira (2012). 270 Morgado and Salvucci (2016); Arndt, Benfica, and Thurlow (2011). 269 Clark et al. (2019). 271 Eckstein, Künzel, and Schäfer (2021). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 63 of drought.272 Farmers are also in danger of flooding pay laborers or purchase labor-saving technolo- near the country’s numerous river basins, a threat that gy.277 Gendered roles within the agricultural sector is compounded when coupled with cyclonic storm also impede women’s autonomy and their ability to surges. The changing climate within the country nega- benefit from their labor, restricting women to lower tively impacts agricultural productivity and puts food levels within crop value chains. Traditional gender security at risk.273 roles and cultural restrictions concerning women’s mobility and access to transportation prevent wom- Despite the predominance of women in the agri- en’s participation in markets while promoting men’s cultural sector, women still achieve lower yields decision-making role in crop sales, market partici- than men, with this driven by gaps between pation, and their control of agricultural revenue.278 female- and male-headed households in the north- Women’s lower engagement in cash crop value chains ern and central regions. Gender gaps in agricultural is due in part to of the greater constraints they face productivity are critical given both the high rate of with regard to access to transportation, land tenure female employment in the sector and the recent eco- insecurity, access to labor, and access to the levels of nomic development which has favored the non-poor capital required to begin cash crop production.279 in urban areas, mainly leaving the poor and those in rural areas behind.274 Evidence shows that nationally, The design of agricultural extension services is female-headed households are 24 percent less produc- likely to have important impacts on both the tive than male-headed households. However, this gap endowment and structural component of gender is driven by the northern and central regions of the gaps in agricultural productivity, influencing both country, where there are productivity gaps between the level of various productive inputs women have female and male-headed households of 17 percent and access to and (via exposure to improved techniques) 28 percent, respectively (while in the country’s south- the returns they are able to generate from those ern region there are no significant productivity gaps inputs. The design of agricultural extension services based on the gender of household headship). The larg- tends to favor men implicitly, including by targeting est proportion of the productivity gap is explained by the head of the household (usually a man, meaning female-headed households’ lower returns to factors of the women in the household only get the information production (the ‘structural effect’) rather than lower provided secondhand) and by using men as exten- use of these factors (the ‘endowment effect’). This sion agents, making it more difficult for women to reflects unobservable factors, such as women’s lower interact comfortably. When these weaknesses are technical efficiency, possibly due partly to inadequate addressed, evidence suggests extension services can be access to extension services, and gender discrimina- better leveraged to increase women’s yields. A study tion, perhaps manifested by the quality of land to in Mozambique found that in communities in which which women are granted access.275 Gender differences female extension agents were used to deliver extension in the level of factors of production used also matter services, female farmers were more likely to learn and but less so, only accounting for 21 percent of the gen- adopt new techniques. On the other hand, the study der gap in yields. Within this portion of the gap, the found that male extension agents only had a significant endowment effect related to the level of use of labor impact on male farmers’ practices.280 Digital technology and mechanization are especially important, followed can also be leveraged to improve women’s ability to by female-headed households’ lower participation in engage with agricultural extension services, by making cash crop farming (for example, cotton and tobacco).276 extension services more scalable and reducing the need for women to travel. For example, regional evidence Women’s constrained access to labor and mecha- shows that women who watched videos of extension nization is partly driven by insufficient funds to messaging were more knowledgeable about cultivation practices and the adoption of inputs, played a more prominent role in agricultural decision-making, and 272 WFP (2019). had higher production and sales.281 Meanwhile, the 273 World Bank Climate Change Knowledge Portal (https://climateknowl- edgeportal.worldbank.org). 274 Lachler and Walker (2018). 275 Morgado and Salvucci (2016). 276 It should be noted that this evidence comes from gender analysis at 277 Anderson and Donald (2022). the level of the household head. This is significant as most women are 278 Adam et al. (2020). part of male-headed households and because women in female-headed 279 Navarra (2019). households and those in male-headed households may face a different 280 Kondylis et al. (2016). range of constraints from each other. 281 Lecoutere, Spielman, and Campenhout (2019). Economic Inclusion 64 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 22: Property ownership type 13% 28% Men Land 4% 48% Women 15% 43% Men House 3% 67% Women 0% 10% 20% 30% 40% 50% 60% 70% 80% Sole Ownership Joint Ownership Source: Mozambique DHS, 2011, STAT Compiler. Kenyan farmer helpline M-Kilimo has enabled farmers rights also enable farmers to capitalize on the grow- to call directly from their mobile phones to get agricul- ing contract farming industry by permitting farmers tural advice and 43 percent of the callers are estimated to enter into contractual agreements.287 In addition to to be women.282 Other recent research suggests that the economic benefits and increased food security, secure efficiency of household agricultural investment deci- land rights can increase bargaining power within the sions is undermined by a lack of information sharing household and decrease women’s dependency on and joint decision-making between spouses283 and that their partner.288 Secure land tenure can also reduce programs that address this by delivering extension ser- the need women may feel to protect their land with vices to couples can improve the overall efficiency of physical presence and agricultural activity, enabling household production.284 Finally, the specific content women to transition into more productive sectors.289 of training delivered through extension services may The lack of land tenure security is especially problem- also have gender implications. Emerging evidence atic in conflict-affected areas. Secure land rights both from Mozambique suggests that ‘personal initiative’ ensure one’s ability to return to their homes and prop- training, focused on non-cognitive qualities such as erty after fleeing violence and reduce the likelihood of self-initiative and future-orientation, may be espe- further conflict over the disputed property upon their cially impactful, facilitating women farmer’s greater return.290 Yet, the World Bank has estimated that 90 adoption of higher-value crops and establishment of percent of rural land in Sub-Saharan Africa is undoc- off-farm businesses.285 umented and that women are more likely than men to lack land titles.291 Despite the legal framework and the presence of matrilineal societies in areas of the Access to land country, women have weaker land rights than men. The DHS for Mozambique reports sex-disaggregated Land is a valuable productive asset as a source data on land ownership for both sole and joint own- of household food and income, and secure land ership; however, data is only available from the 2011 rights are vital for women’s economic empower- survey and thus somewhat outdated.292 While women ment and security. Globally women and girls often are less likely than men to report not owning land lack the rights and or protection of their rights to own and are more likely than men to own property jointly and inherit land. Ownership of valuable assets such with their spouse, men are more likely than women to as land increases women’s access to credit as many own property on their own (Figure 22).293 The gender financial institutions require collateral in the form of immovable assets.286 Officially recognized land 287 Norfolk, Quan, and Mullins(2020). 288 Richardson and Hughes (2015). 289 Goldstein et al. (2016). 282 Manfre and Nordehn (2013). 290 Tuck and Zakout (2019). 283 Apedo-Amah, Djebbari, and Ziparo (2020). 291 Hanstad (2020). 284 Donald, Goldstein, and Rouanet (2022). 292 A 2022-23 DHS survey is expected to be released soon and will present 285 Boxho et al. (2019). a more up-to-date picture of gender gaps in land ownership. 286 O’Sullivan (2017). 293 USAID (2015). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 65 gap in sole property ownership is vital as it can con- the Land Law provides women with the right to reg- fer greater decision-making power over a plot of land ister DUATs individually and fully participate in land compared to jointly owned land. For jointly owned decisions. While the Land Law has been widely recog- land, women may be at a disadvantage if their inter- nized as impactful and progressive, the lack of formal ests differ from those of her husband.294 For example, registration, low public understanding of the law, evidence from some countries across the region has and the high opportunity cost involved in petition- shown that women are less likely than men to have ing local communities and the government for leases the right to sell jointly owned land.295 This is likely to have left those with land rights through occupancy, also apply in the case of Mozambique, where men are and especially women, vulnerable to their land being predominately the primary decision-makers in the purchased from under them.297 household and over agricultural land in both matri- lineal and patrilineal societies. Despite legal reforms, While statutory law is nominally protective of customary rules remain an essential instrument for women’s equal land rights, this is not the case for asserting men’s rights to and control over land and customary laws and practices, which are predomi- are often supported in their implementation by local nant in much of the country. A recent study in the Ile land authorities whose positions are dominated by district found that over 73 percent of land parcels were men.296 The gender gap in sole property ownership, acquired through customary practice. Both matriar- coupled with the continued importance of customary chal societies (in the north) and patriarchal societies rules and the prevalence of male leadership, imply (in the south) are present in Mozambique, and both that joint property ownership may still materially dis- approach land tenure and inheritance distinctly. In advantage women in Mozambique. matrilineal societies, land is inherited by daughters; upon marriage, men are expected to live with their Mozambique has implemented an overarching wife’s family, and most men, therefore, access land statutory framework intended to support and pro- through marriage. However, men in matrilineal societ- tect equitable land rights. Following the civil war, ies are more likely to purchase land than women, often conflict over land tenure escalated between those who driven by the man’s desire for land tenure security had fled the violence and third parties who had pur- instead of being dependent on in-laws. While the land chased land use rights from the government. To secure is inherited by women, men are the decision-makers the land rights of returnees, indigenous communities, regarding the use of the land, the primary deci- women, and smallholder farmers while encouraging sion-makers being first the parents of the women and investment, the government enacted the Land Law then their husbands.298 Conversely, in patrilineal soci- of 1997. The law reaffirms state ownership of all eties, land is inherited by the sons of the family or close land while providing individuals and communities male relatives, and women are dependent on men for with long-term or perpetual rights to land. The right access to land. Dependence on men for access to land is referred to as a DUAT, an acronym for the Portu- leaves women in more vulnerable positions. Widowed guese term “the right to land use and land benefit.” and divorced women are vulnerable to losing access to DUATs protect communities’ customary land rights to agricultural land and their homes with the loss of or their traditional territories and recognize land rights separation from their spouse. If a woman loses access obtained by individuals and groups. The DUAT is to her land, her family may provide her with land, the only recognized right to use of land and can be though it is often lower quality. Finally, due to lower obtained in three ways: (i) perpetual rights of land literacy and education levels, women are less likely use through customary occupation under customary to be aware of their ownership rights or be empow- norms and practices; (ii) perpetual rights of land use ered to advocate for them.299 Given the ambiguities in to individuals or groups after occupying the land for women’s land rights in customary practice versus statu- 10 years for residential or family use; or, (iii) tempo- tory law, programs that provide women and men with rary rights of land use through leases valid for up to information on their land rights and the processes nec- 50 years through application to the government and essary to effectively claim those rights would be highly consultation with local communities. Additionally, relevant and may help women exercise their rights. 294 Gaddis, Lahoti, and Li 2(018). 297 USAID (2021). 295 Slavchevska et al. (2017). 298 Ugaz-Simonsen (2020). 296 Kaarhus and Dondeyne (2015). 299 USAID (2021). Economic Inclusion 66 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Box 7: Evidence on women crossing over into male-dominated sectors A vocational training program in Kenya included an information session that provided participants with information about returns to vocational education, broken down by trade. The program highlighted the large discrepancy in earnings between traditionally male-dominated (for example, mechanic) and female-dominated trades (for example, seamstress). Furthermore, this intervention (which provided vouch- ers to out-of-school youth to help overcome cost barriers to TVET) found that the return on investment (that is, the increase in earnings following completion of the course) were greater for young women than men.300 In the Republic of Congo, a study found that providing information on returns per sector through a video at the time of application to the program increased the likelihood that women would pick a male-dominated trade by 28.6 percent. In addition, women were at least three times more likely to cross over when seeing the video if they had higher technical experience, higher technical knowledge, or a male role model.301 Wage employment 300 301 contributing to their low rate of wage employment.304 By decreasing the number of hours they are available Mozambique’s ability to reap a demographic div- to dedicate to income generation, unpaid domestic idend is contingent on increasing the supply of responsibilities in particular restrict women’s ability non-agricultural wage employment opportunities to engage in better-paid, full-time wage employment.305 to absorb a growing and increasingly educated working-age population.302 Yet as it stands, women While Mozambique received perfect scores from and men are not equally able to take advantage of Women, Business and the Law (WBL) for Mobil- the opportunities that do exist. The private sector has ity, Workplace, Marriage, Entrepreneurship, and driven growth in wage employment, which grew by Assets indicators, WBL’s assessment found room for 63 percent from 2008 to 2014, increasing the overall improvement in the areas of Pay, Parenthood, and employment share by almost five percentage points. Pension. Deficits include the lack of provisions on However, wage employment still makes up only 16.3 equal remuneration for work of equal value, mater- percent of jobs in Mozambique, combining (12.2 per- nity leave of at least 14 weeks, and parental leave; and cent in the private sector and 4.2 percent in the public legislation establishing different ages of retirement for sector) with most of these concentrated in Maputo men and women; and prohibitions on women per- and other urban areas. Moreover, women appear to forming jobs deemed hazardous. As well, while there be less able than men to take advantage of the jobs are legal protections for women against the dismissal that do exist, with the gender gap in employment rates of pregnant workers and from sexual harassment, in having increased over time and women moving from practice they are not always enforced, and these issues agriculture to non-farm employment at a slower rate.303 remain barriers to women’s workforce participation. Thus, addressing gaps in employment legislation Women in both rural and urban areas are less and increasing its enforcement will be important likely than men to work in wage employment. to facilitate women’s equal participation in formal Women also spend less time engaged in economi- employment. cally productive activities than male wage employees. As a result of gender differences in time use, sectoral While providing some protections to women, the segregation, and human capital, women are concen- labor code can be contradictory and may contrib- trated in sectors with lower average earnings. Evidence ute to gender gaps in the quality of labor force points to women’s unpaid domestic responsibilities participation. An example of such a contradiction and lower levels of education as factors significantly is that while on the one hand, hiring discrimination based on gender is prohibited, the law also pro- hibits the employment of women in jobs that are 300 Hicks et al. (2011). 301 Gassier, Rouanet, and Traore (2022). 302 Lachler and Walker (2018). 304 Gradín and Tarp (2019). 303 Gradín and Tarp (2019). 305 Gradín and Tarp (2019). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 67 Box 8: Criminal Code (2019) sexual harassment provisions The new Criminal Code (Law No. 24/2019) criminalizes sexual harassment, including in the workplace. The Code establishes a penalty of imprisonment up to two years and a fine for whomever was found to have committed the act, and it established compensation in the amount of 20 times the minimum wage for the offended employee. The Criminal Code does not establish specific procedures for sexual harassment cases; survivors would instead have to follow existing judicial procedures for criminal cases. In the Labor Law, sexual harassment falls under the category of “disciplinary offenses” that only apply to employees, not the employer, and which can lead to the dismissal and application of a fine of the employee who perpetrates the act. Good practices in the area of sexual harassment in employment establish that laws should provide a comprehensive description and examples of the prohibited behaviors as well as creation of special proce- dures and a body or agency that can conduct investigations and rule on such cases.306 “harmful to their health or their reproductive func- in which women were not more negatively impacted 306 tion.” Similarly, the law lacks any provision for equal than men.311 In addition to the impacts of the pan- renumeration for work of equal value, despite the demic, the conflict in the northern province of Cabo fact that Mozambique has signed the International Delgado is directly risking and restricting economic Labor Organization’s Equal Remuneration Conven- and job growth within the wage sector, including in tion of 1977.307 Finally, despite prohibiting sexual sectors that are important for women. The tourism harassment in the workplace, the criminal code could sector, which directly employs around 400,000 work- better protect women in the workplace (see Box 8). ers, more than half of whom are women, is negatively The economic costs of workplace sexual harassment impacted by the increased longevity and spread of are shared by individuals, their employers, govern- conflict, which increases the personal safety fears of ments, and society.308 Addressing sexual harassment at international tourists and the likelihood that they will the workplace is not just beneficial for female work- go elsewhere.312 On the other hand, the extractive sec- ers, it is also important for business. Recent studies tor, which is a more important source of employment on the costs of sexual harassment have found that for men, has also been put at risk by the conflict, as eliminating sexual harassment from the workplace was shown in 2020 when the insurgency threatened leads to increased productivity.309 Indirect and often the largest gas project on the continent.313 less quantifiable costs also include reduced morale or motivation of employees, tardiness or absenteeism, damage to external reputation, and loss of shareholder confidence.310 Entrepreneurship The combined shocks of COVID-19 and conflict Entrepreneurship in Mozambique, here referred pose significant threats to the wage work sector to as non-farm self-employment, primarily con- in Mozambique. Early evidence on the gendered sists of household enterprises (HEs), which are impacts of the COVID-19 pandemic shows that vul- generally small and unproductive but represent nerable urban households have been most impacted. an especially important source of income for Women primarily lost employment in the hospitality urban women. In 2018, only 12.2 percent of the labor and services sector and the entertainment and rec- force was engaged in non-farm self-employment as reation sector. The sectors in which men were most their primary occupation. There are significant gaps affected were the extractive, construction, and hos- in participation between men and women and urban pitality sectors. Wage employment is the only sector and rural areas. In urban areas, slightly more women than men are engaged in non-farm self-employment 306 https://www.eeoc.gov/harassment 307 World Bank (2020a). 308 Hejase (2021). 311 UN Women, UNFPA, and ILO (2021). 309 Cici et al. (2021). 312 Batey (2014). 310 McDonald (2012). 313 IISS (2021). Economic Inclusion 68 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Figure 23: Gender gaps in entrepreneurship programs support women entrepreneurs through productivity, 2018 (%) a combination of skills training, productive asset or cash transfers, in-person support, and savings vehicles, Percent hinting at the likelihood that these women face mul- 35 tiple constraints to their productivity that should be addressed simultaneously.316 Throughout the country, 30 29% and especially in rural areas, HEs are less likely to be 25% full-time businesses, often operating around seasonal 25 agricultural work.317 In addition, sector segregation appears to play a significant role, with women’s HEs 20 concentrated in less profitable activities such as sew- ing.318 Finally, women entrepreneurs in Mozambique 15 appear to be less able to cope with shocks, with results from a COVID-19 rapid gender assessment finding a 10% higher portion of women entrepreneurs lost or left 10 their business because of the pandemic than did male 5 entrepreneurs.319 3% Among SMEs in Mozambique, there are significant 0 Rural Urban gender gaps in performance outcomes between Women Men male and female entrepreneurs. Women-owned SMEs earn about 16 percent less in profits than do Source: Lachler & Walker. 2018. “Mozambique Jobs Diagnostic: Volume 1—Analytics.” male-owned SMEs. Similar to other economies in the region, this gender gap is due in part to underlying factors such as (i) constraints related to the contexts (29 percent versus 25 percent), while in rural areas, in which they operate (regulatory constraints, norms, men are about three times more likely than women to and risks of GBV); (ii) constraints related to endow- work in non-farm self-employment (Figure 23). ments (skills, capital, confidence, and networks), and; (iii) constraints related to household organiza- This difference is likely related to the fact that tion (allocation of resources, childcare, and domestic in rural areas the agriculture sector can absorb a responsibilities).320 In Mozambique, evidence shows larger number of low-skilled women compared to that female owners of SMEs have lower technical skill urban areas. Off-farm self-employment encompasses levels than their male counterparts and are less likely SMEs, microenterprises, and HEs, the most common to introduce an innovative process. Regional evidence being HEs. As HEs tend to be informal, there is lim- demonstrates that socioeconomic skills trainings are ited data available regarding specific characteristics especially effective for women’s business outcomes and activities. However, we do have some important and can increase self-initiative qualities that help them insights on these businesses. On average, the owners overcome barriers. The domestic responsibilities of of HEs are significantly less educated than owners of women entrepreneurs contribute significantly to the SMEs. The businesses are primarily small family oper- gender gap in productivity, such that having children ations that often do not operate from a fixed location was found to increase the gap in business perfor- and are less likely to use formal banking services.314 As mance. In addition, access to finance, described below, a result, HEs are more restricted in growth opportuni- is also a contributing factor to women-owned SMEs’ ties. For example, evidence shows that few HEs grow lower productivity.321 into microenterprises: in 2005, 85 percent of HEs own- ers had no plans to expand their business.315 Productive inclusion programs have demonstrated promising evidence regionally of increasing the productivity of such small-scale women-owned enterprises. These 316 J-PAL and IPA Policy Bulletin (2015). 317 Lachler and Walker (2018). 318 Fox and Sohnesen (2012). 319 UN Women, UNFPA, and ILO (2021). 314 Lachler and Walker (2018). 320 Campos et al. (2019). 315 Lachler and Walker (2018). 321 Campos et al. (2019). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 69 Financial inclusion Figure 24: Ownership of identification information, 2020 (%) Access to financial services continues to be a sig- Percent nificant barrier to women’s empowerment, rural 90 development, regional economic growth, and sustainable development. There is a 7 percent gap 80 77% globally and a 9 percent gap in developing countries between men and women who own an account with 70 a financial institution. Globally, women entrepreneurs 60% 60 are estimated to have up to US$320 billion in unmet 56% financing needs; 70 percent of these women entre- 50 preneurs own SMEs with insufficient or non-existent 42% access to formal financial services. While financial 40 inclusion in Mozambique has significantly increased in 31% 30 recent years, as men’s and women’s account ownership 22% are increasing at a similar rate, the gender gap persists.322 20 The gender gap in access to financial services is a sig- 10 nificant barrier; it is harmful to women and it holds 0 back Mozambique’s potential for strong economic 1st Quantile 2st Quantile 3rd Quantile growth. Lower access to financial services means that Women Men women entrepreneurs are less able to invest in their Source: FAO. 2020. “Deconstructing the Gender Gap in Rural Financial businesses, have less access to markets, are less able to Inclusion.” capitalize on economic opportunities, are less able to utilize technology that could improve productivity, and are less able to navigate financial shocks. In Mozam- men in Mozambique, it is significantly more challeng- bique, women are less likely to be able to come up with ing for women. Article 5(g) of Mozambique’s Code of emergency funds, and of those who can, women are Conduct for Credit and Financial Institutions prohibits more likely to depend on friends and family for such discrimination in access to financial services based on funds.323 Women’s access to financial products is par- gender and other grounds. Yet, the law does not prohibit ticularly critical given their lower earnings (so ability discrimination in access to credit on the basis of gender.324 to save, increasing the importance of credit) and their Additional barriers to women’s financial inclusion lower agency (so lower control over the resources they include formal financial institutions’ preference for have and greater need for financial products that give male-dominated sectors and larger enterprises that men them greater control/privacy). Gender gaps in this more often own and women’s limited access to credit domain not only have implications for women’s welfare due to a lack of collateral, such as land. In Mozambique, at the household level but also for national economic women’s lower levels of education directly impact their growth, given the impediment they present to the cre- levels of financial literacy and familiarity with financial ation and growth of women-led businesses. services. In addition, Mozambican women lack access to formal financial services as they are less likely to possess Lack of access to capital is a significant challenge to proof of legal identification required by formal finan- women entrepreneurs in Mozambique and is closely cial institutions (Figure 24). 325 tied to levels of wealth. Throughout the continent, women entrepreneurs have lower levels of business capital than their male counterparts. Access to and use Account ownership of financial services, such as secure savings accounts and lines of credit, increase one’s ability to accumulate Access to formal financial services is low through- capital and help mitigate the impact of shocks. While out the country but significantly lower among financial inclusion remains a significant challenge for women. In rural areas, the most common reasons 322 FAO (2020). 324 World Bank (2020a). 323 Demirgüç-Kunt et al. (2020). 325 FAO (2020). Economic Inclusion 70 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Table 3: Familiarity with banks by gender, 2020 (%) Familiarity with Banks 1st Quintile 2nd Quantile 3rd Quantile Women Men Women Men Women Men Have been inside a Bank 4% 12% 8% 19% 32% 47% Personally have an account 2% 1% 1% 4% 11% 23% Source: FAO. 2020. “Deconstructing the Gender Gap in Rural Financial Inclusion.” cited by those of the poorest wealth quantile (group- Mobile money may be a promising approach to ing the population by lowest, middle, and highest increasing women’s financial inclusion by reducing the levels of wealth) for not having an account with a need for women to travel to bank branches, thereby financial institution were not knowing how a bank reducing the time investment necessary to access account works or being unaware that they could open financial services and reducing the financial burden of an account. Among the wealthiest quantile, the most minimum funds required to open an account in tradi- common reasons cited were a lack of access due to the tional banks. The use of mobile money has increased scarcity of bank branches in rural areas and insufficient dramatically since 2015, at about three times the rate funds required to open an account.326 Mozambique of bank account ownership. While this increase has has the third-highest gender gap in account ownership improved women’s access to financial services, there in Sub-Saharan Africa, with 26 percent of women hav- remains a significant gap between men’s and women’s ing an account at a financial institution, compared to ownership of mobile money accounts.329 As of 2017, 40 percent of men.327 17 percent of women and 27 percent of men owned a mobile money account.330 The gender gap in mobile In rural areas, where over 60 percent of the of the money account ownership may be due in part to population were living in 2020, more women than differences in phone ownership and how men and men are excluded from formal financial services. women use their phones. Nationally, 60 percent of Analysis of financial inclusion in rural areas by wealth women and 74 percent of men are reported to own level found that women in the poorest wealth quantile mobile phones in the country, and 45 percent of men are less than half as likely as men to have ever been and women own phones with access to the internet.331 inside a bank. However, there is not a significant dif- However, rural areas of the country lack the telecom- ference in account ownership at this wealth level due munication infrastructure and coverage of Maputo to both men and women having such low account and other urban areas. As a result, 69 percent of the ownership rates (both under 2 percent). In the sec- population and 62 percent of women are excluded ond quantile, women remain less than half as likely from digital financial services in rural areas.332 Men as men to have been inside a bank, and women’s rate and women differ significantly in their use of their of account ownership is less than a third the rate of phones and the internet in making financial trans- men’s. In the third and wealthiest quantile, the gender actions. Men are more likely than women to use the gap between men and women having entered a bank internet to access accounts and make or receive digital or owning an account widens still further. The gender payments.333 Such gender differences are magnified in gap also increases as familiarity and account owner- rural areas where in the highest wealth quantile, 18 ship increase at a greater rate for men than women percent of men and just 5 percent of women report (Table 3).328 using their mobile phones to conduct financial trans- actions. This finding underlines the larger gender gap Despite the rapid increase of mobile money of digital financial services in rural areas.334 accounts, there remains a significant gender gap in access to digital financial services in rural areas. 329 World Bank (2021). 330 Demirgüç-Kunt et al. (2020). 331 Afrobarometer (https://www.afrobarometer.org/online-data-analysis/). 326 FAO (2020). 332 World Bank (2020a). 327 Demirgüç-Kunt et al. (2020). 333 Demirgüç-Kunt et al. (2020). 328 FAO (2020). 334 FAO (2020). Economic Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 71 Figure 25: Use of savings mechanisms, 2020 (%) 1% 1st Quantile 1% Women Men 2nd Quantile 2% 7% Bank 3rd Quantile 13% 19% 0.1% 1st Quantile 4.2% Microfinance Institution 2nd Quantile 4% 2% 3rd Quantile 3% 6% 1% 1st Quantile 3.4% Credit Union 1% 2nd Quantile 3% 3rd Quantile 3% 2% 1st Quantile 5% 6% Credit Group Savings & 2nd Quantile 9% 9% 3rd Quantile 16% 11% 1st Quantile 14% 24% Friends & Family 2nd Quantile 27% 30% 3rd Quantile 28% 23% 0% 10% 20% 30% 40% 50% 60% Source: FAO. 2020. “Deconstructing the Gender Gap in Rural Financial Inclusion.” Savings this reason, it is essential to increase women’s access to secure savings accounts under their name, which A gender gap in savings mechanisms further can give women greater privacy and control over their decreases women entrepreneurs’ ability to invest finances, allowing them to invest more in their busi- in their businesses. Gender gaps in savings rates con- ness activities and incentivizing them to maximize tribute to unequal levels of capital investments into their productivity in the workplace knowing they will entrepreneurial activities. Secure savings mechanisms be able to benefit fully from the fruits of their labor.336 enable women, who often have less bargaining power In Mozambique, fewer women save money than men, in the household, to insulate capital from household 38 percent and 48 percent respectively, and of those expenditures and redistributive pressures. Secure sav- women were less likely to have saved to start, oper- ings mechanisms, including mobile money savings ate, or expand a farm or business than were men.337 Of services, have been found to have a positive impact women who save money, more than twice as many on increasing capital, business investments, and use informal or semiformal savings mechanisms. In entrepreneurial performance in Sub-Saharan Africa. rural areas, the most common savings mechanism In addition to increasing investment into existing for men and women is through friends and family. businesses, saving mechanisms aid women to leave The vast majority of men and women in the lowest agriculture and start businesses and have helped wealth quantile do not save with banks. Yet, as wealth reduce extreme poverty among women-headed increases, more men than women use formal finan- households.335 In addition to more limited access to cial institutions, such as banks, for their savings needs. financial services, social norms can make it more chal- While friends and family remain the most frequently lenging for women to save and invest their earnings used savings mechanisms, women use semiformal how they see fit, with pressure to redistribute their savings and credit groups more than men within the earnings to household expenses or extended family middle and highest wealth quantiles (Figure 25).338 members rather than investing in their businesses. For 336 Carranza et al. (2018). 337 Demirgüç-Kunt et al. (2020). 335 Demirgüç-Kunt et al. (2020). 338 FAO (2020). Economic Inclusion 72 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Credit Figure 26: Secured loans by gender, 2020 (%) Percent Access to credit is crucial for growing and starting 12 businesses, yet there are significant gender gaps in accessing credit through formal financial insti- tutions. Access to credit can enable entrepreneurs 10% 10 to build their businesses, take advantage of market opportunities, and better navigate economic shocks. 8 Findings show that more women in the lowest of the 7% 7% three wealth quantiles (divided into lowest, middle, and highest wealth groups) in rural Mozambique 6 have a loan than men. However, almost twice the 5% proportion of men versus women hold loans in the 4% 4 4% second and third wealth quantile (Figure 26). While men and women report similar sources of credit, there is a gender gap favoring men in the second and 2 third quantiles in accessing credit through traditional banks. The most common source for loans is friends 0 and family among men and women at all three wealth 1st Quantile 2st Quantile 3rd Quantile quantiles in rural areas, followed by semiformal sav- Women Men ings and credit groups and informal money lenders. Source: FAO. 2020. “Deconstructing the Gender Gap in Rural Financial These findings suggest that women face more signifi- Inclusion.” cant challenges accessing credit from formal financial institutions, but informal financial services fill that gap.339 Innovative loan products targeted to women SMEs) have more extensive collateral requirements have been piloted regionally with positive results. than their male counterparts.341 These loan products are less reliant on collateral, utilizing new methods, such as psychometric tests, to gauge creditworthiness.340 There is a lack of evidence in the difference in average loan volume between Data and knowledge gaps men and women entrepreneurs of micro-enterprises, which make up the majority of the self-employed In addition to the new DHS data being collected population. Women entrepreneurs of larger SMEs in (June 2022–January 2023) that will highlight gaps in Mozambique appear to have higher aggregate loan asset ownership, a follow-up to the Mozambique 2018 amounts than their male counterparts, in stark con- WB Jobs Diagnostic, collecting data on the impact of trast to other countries in the region. However, the COVID-19, will be important in understanding the percent of women entrepreneurs (of larger SMEs) impact of the pandemic on gender gaps in employ- who have taken out loans for their business is lower ment. In addition, further research into time use, than the regional average. In addition, while there sexual harassment in the workplace, and skills gaps in are no legal constraints to women accessing credit, the private sector will improve targeting of interven- findings show that women entrepreneurs (of larger tions going forward. 339 FAO (2020). 340 Alibhai et al. (2018). 341 Campos et al. (2019). 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Retrieved from http://pubdocs.worldbank. and Climate Change, the Pressing Reality of Mozam- org /en/170131495654694482/A2-ABCASlavches- bique” WFP. https://www.wfp.org/publications/ ka-et-al-2016-Beyond-ownership-working-paper.pdf. food-security-and-climate-change-pressing-reali- Tuck, Laura, and Wael Zakout. 2019. “7 Reasons for Land ty-mozambique. and Property Rights to Be at the Top of the Global Economic Inclusion 76 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 77 Mozambique Gender Assessment  |  Leveraging women and girls’ potential CHAPTER 5 Resilience and Inclusion M ozambique is dealing with multiple overlapping crises and inclusion chal- lenges that have significant gendered impacts on women and girls’ physical security, human capital, and economic stability. Climate change and natu- ral disasters may be gender blind, but their impacts are not gender neutral. Men and women, boys and girls are affected differently by climate change and disasters, even if they live in the same household.342 Resource and structural constraints, as well as gender norms and inequalities, are the main drivers of gender-differentiated impacts of conflict, climate change, and natural disasters. Conflict itself as well as its consequences are highly gendered phenomena. Men and boys are more likely to be drawn into the conflict as combatant, whereas women and girls (as well as boys) bear the brunt of the violence, par- ticularly in conflicts targeting civilian populations as is occurring in Cabo Delgado. GBV against women and girls increases both as a direct consequence of conflict where rape is too often used as a weapon of war, and as a result of displacement—whether caused by armed conflict or natural disasters. Biological factors also play a role in disproportionate negative health outcomes particularly in situations of food scarcity, extreme heat, and displacement. Poor women in particular face barriers to accessing timely information and resources needed to adequately prepare for, respond to, and cope with disasters—includ- ing access to early warning and safe shelter, as well as to economic resources to cope in the face of emergencies. Involving women in the design and implementation of climate adaptation and mitigation measures as well as disaster preparedness, response, and recov- ery efforts has a double positive impact. It not only reduces women’s vulnerability and increases their resilience in the case of shocks, but also leads to better environmental pol- icy and impacts overall.343 Women also have an important role in building social cohesion to prevent the emergence of conflict and in the maintenance of peace through participa- tion in peace and reconciliation processes. 342 Erman et al. (2021). 343 Tandrayen-Ragoobur (2021). Resilience and Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 79 Climate change and natural disasters are gen- droughts, floods, and tropical cyclones. The 2015–16 der-blind, but their impacts are not gender El-Niño induced drought was the worst for over 35 neutral. Men and women, boys and girls are affected years.350 Despite significant investments to mitigate differently by climate change and disasters, even if the effects of climate change, the country remains vul- they live in the same household.344 Resource and nerable to an increasingly volatile environment and structural constraints, as well as gender norms and thus the frequency and severity of extreme weather inequalities are the main drivers of gender-differ- events are expected to increase. entiated impacts of disasters and climate change. Biological factors also play a role in disproportionate Compounding these challenges, there has been negative health outcomes particularly in situations of ongoing armed conflict since October 2017 in the food scarcity, extreme heat, and displacement. Poor northern province of Cabo Delgado, leading to sig- women, in particular, face barriers to access infor- nificant displacement and loss of life. Between 2018 mation and resources needed to adequately prepare, and 2021, Al-Shabaab insurgents linked to the Islamic respond, and cope with disasters—including access to State Group have carried out more than 800 attacks early warning and safe shelter, as well as to economic against civilian and military targets in Cabo Delgado’s resources to cope in the face of emergencies. Involving northern districts351 and there are signs the conflict is women in the design and implementation of climate spilling over into neighboring provinces.352 This vio- adaptation and mitigation measures as well as disas- lence has left over 3,100 dead and has displaced over ter preparedness, response, and recovery efforts has a 850,000 people.353 Conflict and climate crises feed on double positive impact. It not only reduces women’s each other. Diminishing access to resources such as vulnerability and increases their resilience in the case water and arable land resulting from climate change of shocks, but also leads to better environmental pol- intensifies competition for resources that can lead to icy and impacts overall.345 violence. According to the UN’s World Food Program, climate change threatens the livelihood of 70 percent in Mozambique.354 Regional inequality in private and public investments can further intensify resentment Resilience: conflict and in disadvantaged regions. Seeing few economic oppor- climate-related shocks tunities increases the number of disenfranchised young people with a feeling of little to lose.355 This disaffection makes some, particularly young men, During the previous decade (2000–19), Mozam- more susceptible to recruitment into armed groups.356 bique and was ranked as the fifth most extreme Furthermore, it imperils liquified natural gas (LNG) weather event–affected country in the world, and projects in the area meant to be an engine of eco- in 2019, Mozambique ranked the most climate nomic growth for the country357 and an important change–affected country in the world.346 The costs source of low-carbon energy to drive the country’s are staggering: Cyclones Idai and Kenneth alone cost green transition.358 nearly US$3 billion.347 A catastrophe risk modeling study estimated that floods alone cost the country Both climate change and conflict have dispropor- US$440 million in average annual losses, which trans- tionate and gender-specific impacts on women lates into a loss of nearly 3 percent of GDP in a and girls’ wellbeing and security. Preexisting social country struggling to provide basic services.348 The norms and inequalities are often exacerbating during extreme vulnerability of Mozambique is a product crises and displacement, further eroding women’s of both location and geography, as large areas of the human capital, economic security, and increasing country are exposed to tropical cyclones, droughts, their exposure to GBV. The gendered health and and catastrophic flooding.349 In the 35 years prior to mortality implications of climate change and conflict 2021, there were 75 declared disasters, encompassing 350 “Disaster Response” Fact Sheet for Mozambique (USAID n.d.). 351 Human Rights Watch (2021). 352 Miguel and Baptista (2022). 344 Erman et al. (2021). 353 Miguel and Baptista (2022). 345 Tandrayen-Ragoobur (2021). 354 Paul (2021). 346 Eckstein, Künzel, and Schäfer (2021). 355 Honwana (2013). 347 World Bank (2020b). 356 Swain et al. (2011). 348 World Bank. (2020b). 357 World Bank (2020b). 349 USAID (2018). 358 AfDB (2015). Resilience and Inclusion 80 Mozambique Gender Assessment  |  Leveraging women and girls’ potential are significant. Natural disasters lower women’s life Girls’ education outcomes face more significant expectancy more than men’s, both directly by killing risks than boys’ due to climate change, natural women at a higher rate than men and indirectly by disasters, and conflict. Lower levels of rainfall and killing women at an earlier age due to higher mor- resulting incomes shocks have more significant nega- bidity and worse economic impacts.359 Similarly, in tive impacts on girls’ test scores and school enrollment the years following conflicts, there is often increased than boys’.368 Girls are more likely to drop out or female mortality resulting from malnutrition, inacces- attend school infrequently when parents are either sible healthcare, and the physical impact of stress and unable to afford the tuition or need help with domes- disease.360 During conflict women are at an increased tic tasks.369 In Mozambique, girls often have less time risk of GBV and rape, which are used as weapons of for homework than boys due to greater burdens of war. In Mozambique, many women and girls dis- domestic labor, which can be exacerbated by natural placed by the conflict cite threats of abduction, rape, disasters.370 In 2019, Cyclone Kenneth further limited and forced marriage to Al-Shabaab combatants as the access to education through damages to the already reasons for their flight.361 sparse educational infrastructure of Cabo Delga- do.371 During conflict, girls experience higher rates Maternal health is heavily impacted by conflict and of school-related GBV, including “sex for grades”; climate shocks. Damage to health facilities during teacher-perpetrated rape and sexual abuse; and sexual natural disasters and conflict severely compromises harassment, abuse, or rape on the journey to and from women’s access to family planning as well as ante- school, leading many parents to pull their daughters and postnatal care leading to increases in maternal from school.372 As of mid-2021, at least 51 children had mortality.362 The negative effects of the resulting fetal been abducted in last year, most of them girls.373 Access stress on birthweight, neonatal morbidity and mor- to education is also a significant barrier as a result of tality, and longer-term child behavioral and cognitive conflict; the conflict in Cabo Delgado had destroyed outcomes are well established.363 Following Cyclone at least 221 schools by the end of 2021.374 In times of Kenneth in 2019, 19 health facilities were damaged conflict, natural disasters, or resource scarcity, girls are in Cabo Delgado alone, leaving pregnant women and at an increased risk of early or forced marriage as an new mothers without access to healthcare for them- economic coping strategy.375 The ongoing conflict in selves and their children.364 Displacement due to the Cabo Delgado has driven an increased rate of early conflict in Cabo Delgado is greatly impacting women and forced marriage among adolescent girls in the who have fled violence. As of February 2021, UNFPA province.376 Early marriage and adolescent pregnancy, estimated that 3,200 women were in need of urgent in turn, have lifelong impacts on women’s economic care due to sexual violence, 950 women were at risk of activity, empowerment, and wellbeing. maternal death, and 46,000 women were at increased risk of unwanted pregnancy, due to lacking access to The economic impacts of conflict and climate maternal health and family planning services.365 Addi- shocks also fall heavily on women. The agricultural tionally, through inflated prices and disruptions in sector, where women’s employment is concentrated, is supply chains, conflict restricts access to necessary constantly threatened by climate change. Women are goods (such as medicines, clean water, and food), less able than men to transition to off-farm work and contributing to food insecurity and mortality rates.366 are disadvantaged in adopting agricultural adaptation Declines in food consumption are commonly concen- strategies as they have less access to inputs, informa- trated among women and girls when resources are tion, and resources than men.377 Women farmers are scarce, contributing to women being twice as likely as less likely to have the necessary resources or knowledge men to suffer from malnutrition and girls being twice to adopt climate-smart agricultural (CSA) practices. as likely to die from malnutrition as boys.367 368 Zimmermann (2020); Björkman-Nyqvist (2013); Dasgupta and Karand- ikar (2021); Kwauk and Braga (2017). 369 Erman et al. (2021); Kwauk and Braga (2017). 359 Erman et al. (2021). 370 Madigan (2019). 360 Pluemper and Neumayer (2006). 371 Madigan (2019). 361 “Mozambique,” March 2, 2021. 372 INEE (2022). 362 Behrman and Weitzman (2016). 373 World Bank (2020a). 363 Glover (2019). 374 Algu (2021). 364 Marima (2019). 375 Cas et al. (2014); Kwauk and Braga (2017). 365 Madigan (2019). 376 Care International (2020). 366 Pluemper and Neumayer (2006). 377 Hisali, Birungi, and Buyinza (2011); Coulibaly et al. (2015); Simtowe 367 PMNCH (2014). (2010). Resilience and Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 81 However, they are more likely to adopt CSA practices Social protection programs can play important than men when they have access to the resources.378 role in reducing individual and household vul- Ensuring that both men and women farmers have nerabilities, including to climate shocks. Adaptive access to such resources not only increases women’s or shock-sensitive social protection programs are spe- resilience and contribution to climate change mitiga- cifically designed to be flexible and agile for quickly tion and adaptation, but more generally helps to close responding to natural disasters and other shocks.386 gender gaps in agriculture.379 Experience has shown that having a social protection system or program in place before a crisis reduces Conflict makes informal work increasingly risky its negative impacts by helping poor households to as damage to infrastructure such as access to san- smooth consumption and income. Mozambique’s itation, markets, food, and electricity, can push national social protection program has been a cen- women toward coping strategies that put them at tral instrument for providing income support to poor higher risk of violence and exploitation.380 The loss households and emergency cash transfers in responses of property during conflict is detrimental to women to a series of shocks—most recently COVID-19. Once engaged in the agricultural sector as both a source of the crisis is over, such programs can also support income and food security. As a result of conflict, dis- recovery.387 Reconstruction after natural disasters placement, low rainfall, and high food prices currently and conflict presents an opportunity to build back Mozambique is experiencing acute food insecurity in a way that breaks down the constraints faced by with 1.9 million people in crisis.381 A study of the women. Whether through the construction of more impacts of extreme-weather events on poverty and gender-sensitive physical infrastructures such as roads food insecurity in Mozambique found that experienc- and water sources, the adoption of climate-smart ing a cyclone, flood, or drought can lead to a drop of agriculture, or the development of alternative liveli- up to 25–30 percent per capital food consumption.382 hoods, reconstruction offers an opportunity to reduce Female-headed households are particularly affected women and girls’ vulnerability to climate change and and more likely to be experiencing poverty and food natural disasters going forward.388 Social protection insecurity.383 programs also provide an opportunity to reduce risks of GBV and empower women and girls in multiple Climate change has been driving increases in male domains of human and economic development.389 migration from regions hardest hit by floods and drought.384 In a qualitative study of two communi- Meaningful participation by women is necessary ties in Gaza Province men and women explain that to increase the effectiveness and sustainability their migration is due to lack of food, drought con- of climate change programming. Countries with ditions, or lack of water. The study also found that higher female representation in government are more extended periods of drought increased the amount of likely to set aside protected land and ratify environ- time women spent to collect water from roughly 2 to mental agreements.390 Given women’s traditional 6 hours per day and that young girls are leaving school household responsibilities, they play an essential role to help. Travelling long distances has been increasing in the preservation of natural resources and transition women’s risks of experiencing sexual and GBV as well to household use of renewable energies.391 However, a as confrontations with wild animals. In Inhambane gender and diversity audit of the Mozambique Com- Province where seasonal male migration has been a munity Land Initiatives managed by the country’s traditional agricultural household strategy, many men Natural Resources Institute and operating in eight did not return during the 2015–16 drought cycle and a provinces found that women experienced limited new trend of female migration emerged, leaving many access to and control over land and natural resources, children in the care of grandparents.385 and lacked knowledge of their rights to these resources. The audit revealed that women were often excluded from household and community decision-making in 378 Glazebrook (2011); Nhemachena and Hassan (2007); Twyman et al. (2022). 379 Huyer and Partey (2020). 380 Pluemper and Neumayer (2006). 386 Bowen et al. (2020); Bastagli (2014). 381 IPC (2022). 387 Bastagli (2014); Venton (2018). 382 Baez, Caruso, and Niu (2020). 388 Erman et al. (2021). 383 Ministério de Género, Criança e Acção Social (2016). 389 Botea et al. 2021. 384 Stal (2011). 390 UNDP (2017). 385 Fischer (2016). 391 AfDB (2015). Resilience and Inclusion 82 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Box 9: Mozambique’s Climate Change and Gender Action Plan The Government of Mozambique launched the Climate Change and Gender Action Plan (CCGAP) to mainstream gender issues into climate change adaptation and mitigation policies. The CCGAP aims to com- prehensively develop and integrate the gender perspective throughout the environmental sector to improve the quality of life for all Mozambicans, and, in particular, for women and local communities. The priority sectors identified are: (i) water, (ii) agriculture, (iii) health, (iv) forests and energy, (v) disaster risk reduction, and (vi) coasts and fisheries. The CCGAP is in line with Mozambique’s development priorities and with the National Climate Change Adaptation and Mitigation Strategy, which recognizes the importance of integrat- ing a gender perspective, including through policies, programs, and budgets, through all sectors affecting and affected by climate change.  resource management in both matrilineal and patri- likely to last at least two years and is 35 percent more lineal communities.392 It is also essential to adapt likely to last at least 15 years.396 Mozambican women disaster and risk planning and responses to be more are already playing an important role in peacebuild- inclusive, gender responsive, and accessible for PLWD.393 ing and working with communities to mitigate Often the specific skills, resources, knowledge, and conflicts, particularly in relation to growing tensions agency of women, and of marginalized groups more over natural resource management. Amplifying these generally, are overlooked in emergencies, but can be efforts could strengthen social cohesion and conflict strategically utilized to reduce risk and support emer- prevention in areas affected by conflict and fragility.397 gency response.394 Mozambique is making efforts to integrate women, and their expertise and knowledge, to enhance climate adaptation and mitigation as out- lined in the country’s Climate Change and Gender Inclusion Action Plan (Box 9). However, for women’s partici- pation to have meaningful impacts, investments in Regional disparities human and financial resources will be needed. There are significant regional disparities across Women are also critical stakeholders in conflict almost all human development and economic prevention and peacebuilding. Increasing gender indicators in Mozambique. Mozambicans living equality is crucial to sustainable peace, as unequal in the northern and central regions are significantly gender relations have been linked to increased risks worse off than those living in the south across multi- of conflict and violence. Cultures in which mascu- ple metrics (Figure 27), and gender gaps and measures linity ideals are built upon domination, aggression, of women’s agency are also worse. The location of and being the sole financial provider are at greater the capital in the extreme south, and its proximity risk of conflict. In such societies, governments can to South Africa, has contributed to concentrating manipulate ideas of masculinity to build support for higher-growth sectors and resources in the southern conflict and recruit men who “fail” to live up to mas- region, including those help build human capital, culinity standards while simultaneously increasing while much of the country continued to be relatively the likelihood of men using violence against women marginalized.398 Despite various efforts since the coun- and children over whom they have perceived power.395 try’s independence to support decentralization and What is more, evidence shows that women’s participa- reduce inequality, the legacy of poor inter-regional tion in peacebuilding positively impacts the durability connectivity and decades of underinvestment have of peace agreements. If women are involved in the perpetuated the regional gap in basic infrastructure peace process, the peace agreement is 20 percent more and service provision, compounded by the impacts of 392 NRI (2012). 393 Erman et al. (2021). 396 O’Reilly, Súilleabháin, and Paffenholz (2015). 394 Lindley-Jones (2018); Oxfam Canada (2018). 397 World Bank (2020b). 395 OECD (2017). 398 Vines (2021). Resilience and Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 83 Figure 27: Comparison of access to basic services between national and regional levels, 2017 (%) 100 90 80 70 60 50 40 30 20 10 0 No access: No access: No access: No access: No quality No quality No quality No durable No education No education Sanitation Water Electricity cooking fuel housing: housing: housing: goods (all) (children) floor ceiling walls National Northern Provinces Center Provinces Southern Provinces Source: 2017 Census. recurring natural disasters, rapid population growth, the private sector. It also prohibits discrimination on rural-urban migration, and conflict.399 Inequalities in the basis of sexual orientation (but not gender iden- per capita spending are reinforced by limited deci- tity) and requires equal remuneration for employees sion-making powers and voice at the subnational that belong to sexual and gender minorities. However, levels in the allocation and distribution of expen- it does not provide equal pension benefits for same- ditures. Perceptions of preferential treatment and sex partners and there is no national body with a corruption undermine a sense of inclusion and fair- mandate for addressing of employment-related SOGI ness and continue to reinforce a north-south divide discrimination. Same-sex partnerships, civil unions, and are a driver of conflict in the region.400 marriages are not recognized, and adoptions by same- sex partners are not allowed. There are also no legal provisions explicitly prohibit discrimination on the Sexual orientation and gender identity basis of SOGI in the provision of public services. Mozambique lacks specific mechanisms, laws, consti- Mozambique rates relatively well in the World tutional provisions, or regulations criminalizing hate Bank’s Equality of Opportunity for Sexual and crimes based on sexual orientation, gender identity, Gender Minorities (EQOSOGI) index and has fairly gender expression, or sex characteristics. Furthermore, progressive laws related to sexual orientation and there is no mechanism in place for monitoring acts of gender identity.401 Mozambique does not criminal- violence against sexual and gender minorities. ize same-sex relations and prohibits discrimination on the basis of sexual orientation, though not gender Social acceptance of persons with minority sexual identity. Employment law prohibits employers from orientation or gender identities in Mozambique is discussing sexual orientation, gender identity, or mari- relatively high in comparison the African context tal status during the recruitment process, and protects generally. As summarized in the 2014/15 Afro-ba- sexual and gender minorities seeking employment in rometer: “Africans express high levels of tolerance for people of different ethnicities, religions, and nation- 399 World Bank (2021a); authors’ estimations using multidimensional pov- alities. A large majority also express tolerance for erty data from Atlas de Pobreza Multidimensional em Mozambique, people living with HIV/AIDS, though HIV-related Draft June 2020 (World Bank and Ministério de Economia e Financas), based on Recenseamento Geral da População e Habitação 2017 http:// stigma remains a reality in most countries. Africans www.ine.gov.mz/operacoes-estatisticas/censos/censo-2007/censo-2017 [Ask Northern HCD project team for editable graph] are far less tolerant of homosexuals, though even on 400 World Bank (2021b). 401 Indicators used to construct the EQOSOGI index include: (i) criminal- this issue, country-level variations prevent the conti- ization and SOGI, (ii) access to inclusive education, (iii) access to the nent from being painted as uniformly intolerant.” labor market, (iv) access to public services and social protection, (v) civil and political inclusion, and (vi) protection from hate crimes. Mozambique has one of the highest levels of tolerance Resilience and Inclusion 84 Mozambique Gender Assessment  |  Leveraging women and girls’ potential for homosexuals in Africa: 56 percent would like or population.405 However, these numbers are underesti- not mind having homosexual neighbors (particularly mated according to local disability organizations whose among younger, urban, and more educated peo- own research suggest that about a quarter of Mozam- ple) compared to the African regional average of 21 bican households include at least one family member percent (excluding Algeria, Egypt, and Sudan where living with functional limitations. This would mean researchers deemed questions about tolerance for that the actual number of PLWD in Mozambique is homosexuals too sensitive, suggesting the actual aver- closer to 1.5 million.406 There is significant marginaliza- age is even lower). tion of children with disabilities (CWD): 68.1 percent of CWD ages 0–17 have not been registered at birth,407 Although there is a relatively high tolerance for whereas in the general population, the births of almost SOGI minorities in society generally, there are 60 percent of children under five are registered.408 some contradictions with attitudes in private life. This ambiguity was made evident in a study of Men Disability, gender, and poverty in Mozambique and Masculinities in Maputo where just over half of remain intrinsically linked.409 For example, the men believed there should be laws protecting homo- 2009 survey from The Foundation for Scientific and sexuals from discrimination, but at the same time, a Industrial Research at the Norwegian Institute of similar number agreed that “I would never have a gay Technology (SINTEF) suggests that WLWD face much friend.”402 Following a 2018 visit to Mozambique, the worse living conditions when compared to women UN Independent Expert on Protection against vio- without disabilities and small differences with men lence and discrimination based on sexual orientation with disabilities.410 A more recent study in Sofala and gender identity noted that homosexuals, lesbians, found that a WLWD is more likely to be single, poor, bisexuals or gender diverse persons are not subject to uneducated, and marginalized.411 WLWD are also less the high levels of violence experienced in other coun- likely work outside home,412 and have lower literacy tries; however, this comes at the price of staying in rates (17 percent) than their male counterparts (49 per- the shadows. “It appears that a tacit social agreement cent), which impacts significantly on WLWD entering exists not to attack homosexuals, lesbians, bisexuals or the job market.413 This compounds the already signifi- gender diverse persons as long as they hide their true cantly lower rate of labor force participation rates of nature.” He therefore called for greater efforts to dispel PLWD: the PNAD II estimate unemployment rates of myths and reduce discrimination and marginalization 39 percent for PLWD compared to 9 percent among of homosexuals, lesbians, bisexuals, or gender diverse persons without disabilities. Although the need for persons.403 social protection programs tends to be higher among PLWD compared to the general population, 87 per- cent of PLWD who needed welfare services were not Disability and gender able to receive them.414 Among the few PLWD who do have access to social transfers, the significant majority Despite anti-discrimination laws and civil society (80 percent) are men suggesting the need for better advocacy, PLWD continue to face social stigma, targeting of social protection programs for PLWD and exclusion, and discrimination within their commu- for WLWD in particular.415 nities and households. Furthermore, they face barriers to accessing education, employment, and healthcare, as several programs that promote access to human 405 The primary causes of disability in Mozambique are disease and congen- ital problems at birth and the most common form of disability is limb rights do not explicitly consider PLWD due to lack of amputation, followed by mobility, vision, hearing, and cognitive impair- awareness about disabilities among service providers, ments. Men are slightly more likely to have disabilities and more likely to have disabilities related to military service and landmine injuries. See including negative attitudes that often treat PLWD INE (2017). 406 UNFPA (2018). as “objects of care.”404 The 2017 Census data indicated 407 Zavale (2012: 17). 408 IMASIDA 2015 (MISAU, INE, and ICF International 2018). that over 700,000 persons are living with disabili- 409 FAMOD (2020: 4). ties in Mozambique, or about 2.6 percent of the total 410 SINTEF (2009); UNDP (2019). 411 Light for the World (2018). 412 Gradín and Tarp (2019). 413 United Nations (2019). 414 Access to Mozambique’s National Institute of Social Action (INAS) Social Protection may be restricted by issues such as lack of infor- mation/awareness, absence of documentation, lack of clarity in the 402 Slegh et al. (2017). disability evaluation process including prejudice of INAS staff toward 403 OHCHR (2018). certain types of disabilities, particularly mental. United Nations (2019). 404 SINTEF (2009); Sida (2014). 415 Instituto Nacional de Estatística (2019: 48). Resilience and Inclusion Mozambique Gender Assessment  |  Leveraging women and girls’ potential 85 Women with living with disabilities face over- or ancestors as retribution for sins committed by the lapping drivers of stigmatization, exclusion, and parents. Disabled elderly women are more likely to be abuse. A Sofala study found that while (only) 43 per- accused of witchcraft and ostracized or driven from cent of women without disabilities feel they are able their communities.419 to make significant life decisions (where to live or how to spend money), only 16 percent of WLWD do. And while 74 percent of women without disabilities felt respected in their communities, only 45 percent Data and knowledge gaps of WLWD did.416 Women and girls with disability are at higher risk of abuse both in and outside of home. While there is a lot of international evidence of A UNFPA global study found that women and girls the gendered impacts of conflict, climate change, with disabilities are up to 10 times more likely to expe- and natural disasters, their particular manifes- rience sexual abuse than those without disabilities.417 tation in Mozambique is not fully understood. With limited livelihood options, WLWD often see no Understanding these impacts will be important to option but to engage in transactional sex to survive design inclusive, evidence-based policies and pro- at significant disadvantage to negotiate condom use.418 grams for natural disaster management as well as Many children with disabilities (CWD) are isolated for climate change mitigation and adaptation strate- at home, making them especially vulnerable to sex- gies. As well, more evidence is needed on the specific ual abuse committed by family members. Such abuse challenges and opportunities for women as well as can go on for years and remain unreported to com- other marginalized groups to benefit from the tran- munity leaders, police, social workers or neighbors, sition to the green economy. Qualitative research to mostly because CWDs have a low level of education understand the drivers of marginalization as well as and high level of dependence on their families, which sources of resilience and identify opportunities for makes it more difficult for them to seek help. Mothers greater inclusion will be important. Collecting data of CWD can also face stigmatization based indirectly among displaced populations as well as in conflict- or on the disability of their children. For example, it is disaster-affected areas is a challenge in Mozambique. not uncommon for men to divorce the mothers of Nonetheless it remains extremely important to gather CWDs because of beliefs that the birth of CWDs is a information to assess the specific needs of women and punishment inflicted on the family by divine powers girls in such situations. 416 Light for the World (2018). 417 UNFPA (2018). 418 UNFPA (2018). 419 World Bank (2021c). Resilience and Inclusion 86 Mozambique Gender Assessment  |  Leveraging women and girls’ potential References African Development Bank (AfDB). 2015. “Transi- “Responding to Crop Failure: Understanding Farmers’ tion Toward Green Growth in Mozambique: Policy Coping Strategies in Southern Malawi.” Sustainability Review and Recommendations for Action.” Abidjan, 7(2): 1620–1636. https://doi.org/10.3390/su7021620. Côte d’Ivoire: AfDB. Dasgupta, Aparajita, and Anahita Karandikar. 2021. 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Resilience and Inclusion 90 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 91 Mozambique Gender Assessment  |  Leveraging women and girls’ potential CHAPTER 6 Strategic Priority Areas E mpowering women and girls in Mozambique is a development priority that will require a coordinated and holistic approach. As shown in Figure 28, greater impact will be achieved by layering interventions at individual, household, societal and institutional levels rather than by focusing on one dimension or sector. Coordination and building partnerships that include government, civil society, private sec- tor, development partners, and other key stakeholders will be critical. The design and implementation of robust monitoring and learning mecha- nisms as well as adequate targeting and strategic resource allocation are necessary for greater impact of policies and programs that empower women and girls. Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 93 Figure 28: Ecological model for women and girls’ empowerment Institutions Institutions Household Laws, policies & institutions on: • Gender division of labor • Child marriage, GBV, employment, • Gender divison of HH assets & resources financial inclusion, inheritance, • Intra-HH decision making discrimination Society • Intimate partner violence Household Society Individual • Women in leadership Gender • Child marriage norms & enaging men • Educate • Discrimination based on sex, SOGI, • Healthy secual and reproductive lives disability, HIV/AIDS status Individual • Productive inclusion • Fragility & Violence Source: Authors. Mozambique is a large and diverse country with priority but rather constitute a set of complementary regional variations in opportunities and challenges, actions. They build on or can be anchored in existing cultures and gender norms, and vulnerability to cli- policies and programs and are in areas where existing mate change and conflict. Across almost all human or emerging evidence shows promise and impact. The development, vulnerability, and poverty indicators the tables below present policy priorities needed to create northern and central regions are lagging, suggesting an enabling environment for change, as well as pro- the need for targeted multi-sectoral interventions to grammatic interventions options that could help to close address these overlapping vulnerabilities. The needs gender gaps in the short, medium, or longer term. Some of women and girls living in conflict-affected areas interventions are broader, system-wide engagements such and among internationally displaced populations are as increasing the quality of education, which has been particularly acute. In almost all domains of empow- shown to improve outcomes and enrollment of all chil- erment, interventions to mitigate direct negative dren while also closing gender gaps. To close gender gaps impacts of gender inequality on women and girls (as in other sectors may require gender-targeted interven- well as on persons with non-conforming SOGI, PLWD, tions such increasing women farmers’ access to finance, PLWA and other groups facing intersecting discrimi- land, and green technologies in order to close the gender nation) will be needed. However, for impacts to be productivity gap in agriculture. Some interventions can sustainable, these need to be accompanied by efforts to be leveraged to have positive impacts across a number transform gender norms toward greater equality. This, of domains in which the women and girls face overlap- for example, would include interventions to rebalance ping constraints (particularly if they have intersecting the gender division of labor, combat GBV and child vulnerabilities such as disability, SOGI, or HIV/AIDS). marriage, reduce sectoral segregation in the labor Cash transfers have been shown to be effective not only market, and increase women’s bodily autonomy and at reducing poverty and food insecurity (with female ability to decide about sex and relationships, among headed households being over-represented among the other gendered social norms. In all cases, these efforts poorest), but also increasing access to health and educa- need to address not only norms and relationships at tion (closing gender gaps and increasing human capital), the level of the household but also at the community increasing resilience to climate and other shocks (which level, working with both traditional norm ‘enforcers’ have disproportionate negative impacts on women and as well as with women to support their empowerment girls), reducing child marriage and adolescent pregnancy, and disrupt the internalization harmful gender norms. and enhancing women’s economic inclusion and liveli- hoods. Finally, cash transfers can be effective as platforms The strategic priorities presented below are tied to for direct engagement with communities and households specific gender gaps and gender issues identified to stimulate women’s empowerment, GBV prevention, in this assessment. They are not presented in order of and gender norm transformation. Strategic Priority Areas 94 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Strategic Priority 1: Reduce adolescent pregnancy and child marriage, and keep girls in school  For Mozambican women and girls to be able to achieve their full potential it is imperative to ensure ado- lescent girls enter adulthood educated and unburdened by early motherhood and marriage. Thus, the first strategic priority in Mozambique is to reduce adolescent pregnancy and child marriage, and to keep girls in school. This will require empowering adolescent girls and transforming social norms, as well as increasing access to edu- cation and sexual and reproductive health services. Investing in adolescents makes good economic sense with research suggesting returns on investment (mean benefit-to-cost ratio) ranging from 5.7 to nearly 12.420 Objective: Reduce adolescent pregnancy and child marriage, and keep girls in school  Policy interventions 1. Strengthen enforcement of 2019 Child Marriage law and monitor impacts. 2. Provide age-appropriate sex education based on student age rather than grade level. 3. Ensure implementation of policy permitting pregnant girls to attend regular classes. 4. Strengthen enforcement, sanctions, and redress for sexual exploitation, abuse, and harassment in school. Programmatic interventions Problem Drivers Intervention Options Supporting Evidence (country or region) Sources (Gender Gap/ (short versus medium/ Issue) longer timeline for impacts) High rates of Poverty and Cash transfers (short) • Cash transfers can lead to significant reductions Bergstrom and adolescent lack of econ in child marriage and adolescent pregnancy. Özler (2021) pregnancy and opportunities Unconditional cash transfers may be more effective in early unions Sub-Saharan Africa. (Global)x undermine human capital accumulation and economic development Life skills & SRH + • Vocational training & financial literacy + life skills Bandiera et al. income generation training for girls ages 11–19 reduced adolescent (2014) support (short) pregnancy (26 percent) and early marriage (58 percent). (Uganda) • Livelihoods and life skills training by peer educators in Kanesathasan et safe spaces for youth ages 12–24 (male and female), al. (2008) increased age at marriage, and use of modern contraceptive among marriage youth. (India) • ‘Safe spaces’ for adolescent girls focusing on life Botea et al (2017) skills and SRH training promising for reducing child marriage & adolescent fertility when combined with livelihood training or incentives for schooling. (Global) • Safe spaces providing tutoring, life skills, and SRH + Amin et al. (2016) livelihoods training led to decline in child marriage, improved educational outcomes, and increased income. (Bangladesh) Social norm Provide information to • Providing parents and young women in rural India Jensen (2012) change parents and girls on with information on job opportunities led to an returns to education for increase in schooling and postschool training. (India) girls (med/ long term) 420 Sheehan et al. (2017). Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 95 Problem Drivers Intervention Options Supporting Evidence (country or region) Sources (Gender Gap/ (short versus medium/ Issue) longer timeline for impacts) Supplement • In a multipronged intervention, girls ages 15–17 • Erulkar, enforcement of minimum residing in the community dialogue site had two- Medhin, and age of marriage law thirds less risk of being married compared to those in Weissman enforcement with the control. (Burkina Faso) (2017) behavior change interventions School dropout Cash transfers (short) • Conditional cash transfers have the largest effect on • Bergstrom and girls’ schooling, but unconditional cash transfers also Özler (2021) impactful and may be more cost-effective. Strongest impacts when combined with improvement in quality of education. (Global) • Education subsidy through two free school uniforms • Duflo, Dupas, reduced drop out from 19-16 percent and teen and Kremer pregnancy from 16 percent to 13 percent. (Kenya) (2015) Improve access and • Non-targeted interventions on average increase both • Wodon et al. quality of education for girls’ and boys’ access to school and their education (2018); Evans all (medium/long) outcomes, with larger effects for girls. (Global) and Yuan (2022); Evans and Acosta (2020a) Increase safety & • A “girl-friendly” primary school expansion program • Kazianga et al. inclusion at schools (separate latrines, more female teachers and (2013) (medium/long) gender-sensitivity training) led to large gains in girls’ educational attainment and learning. (Burkina Faso) Facilitate return to • Ensure pregnant girls can attend regular school is • Evans and school or enrollment in associated with a decrease in rates of adolescent Acosta (2020a) TVET for pregnant and pregnancy and better learning outcomes for girls. parenting adolescents (Global) (short) • Safe spaces for out-of-school girls ages 11–15 • Brady et al. providing literacy, life skills, nutrition, and financial (2007) education increased middle school enrollment from 9 percent to 68 percent. (Egypt) Low levels of Increase access to • Provide adolescent and youth friendly SRHS • Denno, adolescent sexual and reproductive increases access to and use of contraception. (Global) Hoopes, and sexual and health services Chandra-Mouli reproductive (medium/long) (2015); Brittain empowerment et al. (2015) Social and behavior • Mobile text messages about contraception and • McCarthy et al. change communication reproductive health self-efficacy increased young (2019) to counter stigmatization women’s use of modern contraception. (Palestine) and misinformation and empower adolescents • Community dialogue on social norms and adolescent • Tavadze, reproductive health using ‘Theatre for Development’ Bartel, and improved family planning knowledge, attitudes, and Rubardt (2009) behaviors. (Republic of Georgia) • Sex education programs that address gender and • Haberland power in sexuality are more effective in preventing (2015) HIV acquisition than those that do not. (Global) Provide sex-education Education focused CCT that included condom Duflo, Dupas, to both in- and out- education increased SRH knowledge. (Kenya) and Kremer of-school adolescents (2015) (short) Strategic Priority Areas 96 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Problem Drivers Intervention Options Supporting Evidence (country or region) Sources (Gender Gap/ (short versus medium/ Issue) longer timeline for impacts) Group-based microcredit + HIV/AIDS education Hargreaves et al. resulted increased use of condoms and testing. (South (2010) Africa) Peer educators delivered SRH and econ empowerment Edmeades et al. training resulting increased use of family planning / (2014) modern contraception. (Ethiopia) META-REVIEWS: Bergstrom, K., and B. Özler. 2021. “Improving the Well-Being of Adolescent Girls in Developing Countries.” World Bank Group. https:// openknowledge.worldbank.org/handle/10986/36478 [See live database of all interventions reviewed at https://rrmaximiliano.shinyapps. io/asa_ado_app/ ] Chandra-Mouli, V., C. Lane, and S. Wong. 2015. “What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices.” Global Health, Science and Practice 3(3): 333–340. https://doi.org/10.9745/ GHSP-D-15-00126. Evans, D., and J. Yuan. 2022. “What We Learn about Girls’ Education from Interventions That Do Not Focus on Girls.” The World Bank Economic Review 36(1): 244–267. Gottschalk, L. B., and N. Ortayli. 2014. “Interventions to Improve Adolescents’ Contraceptive Behaviors in Low- and Middle-Income Countries: A Review of the Evidence Base.” Contraception 90(3): 211–225. DOI: https://doi.org/10.1016/j.contraception.2014.04.017. Malhotra, A., and S. Elnakib. “20 Years of Evidence Base on What Works to Prevent Child Marriage: A Systematic Review.” Journal of Adolescent Health 68: 847–62. https://www.sciencedirect.com/science/article/pii/S1054139X20306868. Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 97 Strategic Priority 2: Increase women’s economic opportunities and productivity The economic potential of women in Mozambique is significantly constrained by gender gaps in their access to skills development, domestic and reproductive labor, quality jobs, and productive inputs, including land and finance in particular. Thus, the second strategic priority to increase women’s economic opportunities and produc- tivity will be critical for driving Mozambique’s recovery and transformation. Objective: Increase women’s economic opportunities and productivity Policy interventions 1. Improve laws on pension, parenthood, pay, and remove sex-based work restrictions. 2. Strengthen enforcement of laws on employment discrimination and sexual harassment. 3. Implement provisions ensuring equal right to marital assets and inheritance. 4. Protect women’s land rights through both statutory and customary systems and increase women’s ability to exercise their land rights through advocacy and public awareness campaigns. 5. Increase women’s access to banking and credit through improved mobile networks in rural areas for mobile banking, incentivize financial institutions to implement innovative credit schemes that are inclusive of women, and increase women’s financial literacy through public awareness campaigns. Programmatic options Problem Drivers Intervention Options Supporting Evidence (country or region) Sources (Gender Gap/ (short versus medium/ Issue) longer timeline for impacts) Gender gap Sectoral Increase vocational and • Utilize mobile technology to improve adult • Aker, Ksoll, and Lybbert in quality of segregation into educational attainment education. (Niger) (2012) labor force less productive/ participation remunerative • Increase skill levels and knowledge of • Croke et al. (2020) activities earnings in male-dominated sectors. • World Bank (2022) (Democratic Republic of Congo; Global) Low time Reduce domestic • Increase access to childcare services. • Martinez, Naudeau, and agency due to constraints to better (Kenya; Mozambique) Pereira (2012) disproportionate economic opportunities • Clark et al. (2019) burdens of across all areas of the unpaid domestic economy (agriculture, • Address gender norms, including through • Vaillant et al. (2020) labor wage employment, couples’ and men’s discussion groups, to • Doyle et al. (2018) entrepreneurship) increase men’s participation in household and childcare responsibilities (Democratic Republic of Congo; Rwanda) Gender gap Less land Increase access to secure • Offering subsidized land titles on the • Cherchi et al. (2019) in agricultural security (in land titles condition that the wife’s name is included productivity practice) and informational interventions on the benefits of titling and joint titling (Uganda) • Strengthen women’s inheritance rights • Donald et al. (2020) by increasing the attainment of birth and marriage certificates (Côte d’Ivoire) Lower cultivation Increase adoption of cash • Provide psychosocial skills training to • Montalvao et al. (2017) of cash crops crops by women farmers women farmers to increase their risk through skills training, tolerance, motivation, and inter-personal subsidies, and out-grower skills (Malawi) contracts • Incentivize male farmers to transfer out- • Ambler, Jones, and grower contracts under their wife’s name O’Sullivan (2018) (Uganda) Strategic Priority Areas 98 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Problem Drivers Intervention Options Supporting Evidence (country or region) Sources (Gender Gap/ (short versus medium/ Issue) longer timeline for impacts) • Subsidize improved seeds targeted to • Agboh-Noameshie, women farmers (Benin; Uganda) Kinkingninhoun- Medagbe, and Diagne (2008) • Buehren et al. (2022, forthcoming) Less access Support extension • Increase number of, and women’s access • Kondylis et al. (2016) to agricultural services that are more to, female extension workers (Mozambique; • Benyishay et al. (2016) information tailored to women’s Democratic Republic of Congo) • Lambrecht et al. (2016) specific needs • Leverage digital technologies (conditional • Aker and Ksoll (2016) on prior support to women’s phone • Lecoutere, Spielman, ownership) (Niger; Uganda; Ghana) and Campenhout (2019) • World Bank (2017) • Empower women’s social networks to • Vasilaky and Leonard disseminate agricultural information (2018) (Uganda) Less access to, Increase women’s • Provide inputs through grants to female • Beaman and Dillon and use of, inputs access to inputs through farmers (Mali) (2018) (seeds, fertilizer, subsidies and direct, pesticides, etc.) gender-targeted input • Provide input subsidies to female farmers • Awotide et al. (2013) provision (Nigeria; Benin; Uganda) • Agboh-Noameshie, Kinkingninhoun- Medagbe, and Diagne (2008) • Buehren et al. (2022, forthcoming) Less access to Increase women’s • Increase women farmer’s use of • Daum, Capezzone, and more-productive access to, and use of, mechanization to improve time-use Birner (2019) labor and mechanization and efficiency (Zambia; Sub-Saharan Africa) • Banerjee et al. (2014) mechanization productive labor • Increase women’s access to mechanization • Hajdu et al. (2020) through cash transfers (South Africa) Insufficient • Increase women’s access to productive • Daidone et al. (2015) access to finance labor through grants (Zambia) Increase access to capital • Secure savings mechanisms to give • Bastian et al. (2018) women greater control and privacy over • Carranza et al. (2018) their savings (Tanzania; Côte d’Ivoire) Gender gap in • Engage women with productive asset • Noble et al. (2020) number and transfer, microcredit, and productive • Bastian, Goldstein, and productivity of inclusion programs—a combination of Papineni (2017) entrepreneurs skills training, productive asset or cash • Glass et al. (2017) transfers, in-person support, and savings • FAO (2017) vehicles (Democratic Republic of Congo; • J-PAL and IPA Policy Mali; Bangladesh; Ethiopia; Ghana; India; Bulletin (2015) Pakistan) • Increase women entrepreneurs’ access • Campos et al. (2019) to credit by supporting non-collateral dependent loans (e.g., lending based on psychometric testing (Ethiopia) • Increase women entrepreneur’s J-PAL (2015) access to credit by supporting lines Alibhai et al. (2019) of credit targeting women that offer the larger volume loans necessary for transformational business growth (Global; Ethiopia) Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 99 Problem Drivers Intervention Options Supporting Evidence (country or region) Sources (Gender Gap/ (short versus medium/ Issue) longer timeline for impacts) Entrepreneurial Increase women’s socio- Support socio-emotional and personal Campos et al. (2018) skills gap emotional skill levels initiative skills training, shown to be effective Alibhai et al. (2019) for women’s business outcomes and can give women to help them overcome the gender barriers (Togo; Ethiopia) META REVIEWS: leveling the field, profiting from parity, breaking barriers Banerjee, Raka, Kajal Gulati, Michael B. O’Sullivan, Arathi Srijaya Rao, and Margaux Laurence Vinez. 2014. “Levelling the Field: Improving Opportunities for Women Farmers in Africa (English).” Washington, DC: World Bank Group. http://documents.worldbank.org/curated/ en/579161468007198488/Levelling-the-field-improving-opportunities-for-women-farmers-in-Africa. Campos, Francisco Moraes Leitao, Rachel Dawn Coleman, Adriana Conconi, Aletheia Amalia Donald, Marine Gassier, Markus P. Goldstein, Zenaida L. Chavez, Joanna Mikulski, Annamaria Milazzo, Maliheh Paryavi, Rachael Susan Pierotti, Michael B. O’Sullivan, and Julia Vaillant. 2019. Profiting from Parity: Unlocking the Potential of Women’s Businesses in Africa: Main Report (English). Washington, DC: World Bank Group. http://documents.worldbank.org/curated/en/501971553025918098/Main-Report. World Bank. 2022. “Breaking Barriers: Female Entrepreneurs Who Cross Over to Male-Dominated Sectors.” © World Bank, Washington, DC. https://openknowledge.worldbank.org/handle/10986/36940. License: CC BY 3.0 IGO. Strategic Priority Areas 100 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Strategic Priority 3: Improve women and girls’ SRMH, reduce unequal burden of HIV/AIDS, and reduce fertility rates Once women and girls enter their reproductive years, they face significant risks to their health and well-being. Thus, the third strategic priority comprises improving women and girls’ sexual, reproductive, and maternal health outcomes; reducing the disease and social burden of HIV/AIDS that falls disproportionately on them; and reducing high fertility rates. Improving this situation would not only lead to healthier and more productive lives for women and girls, but also help to reap the demographic dividend and help the fight against HIV/AIDS in Mozambique. Objective: Reduce high rates of fertility; improve women and girls’ sexual, reproductive, and maternal health; and reduce unequal burden of HIV/AIDS on women and girls Policy interventions 1. Remove any formal or informal requirements for parental or spousal consent to access SRMH and family planning (FP) services. 2. Deliver age-appropriate sexual and reproductive health education at all levels of schooling. 3. Strengthen protections against violence, discrimination, and abuse of persons living with HIV/AIDS. 4. Improve targeting of social safety nets to support persons living with HIV/AIDS (PLWHA), their caregivers, and caregivers of HIV/AIDS orphans. Program interventions Problem Drivers Intervention Options (short Supporting Evidence (country or region) Sources (Gender Gap/ versus medium/longer timeline Issue) for impacts) Maternal Uneven access Expand coverage of community- • Increasing number of homebirths • Sabin et al. (2012)  mortality and to assisted and facility-based SRMH attended by midwifes or skilled attendant • Bartlett et al. fertility rates deliveries, services to underserved areas with referral when needed significantly (2014) remain high ante- and post- (medium/longer) improves maternal and neonate outcomes natal care Prioritize continuity of care in and is cost effective. (Global) conflict- and disaster-affected areas (medium/longer) • Increasing access to ‘Waiting Mother • Levitskaya and Homes’ prioritizing conflict- and Piffer (2022) disaster-affected areas and remote rural areas increases access to ante-natal and post-natal care and assisted births. (Mozambique) • Providing incentives to both providers (e.g. • Bellows, Bellows, performance-based financing) and users and Warren (2011) (e.g. vouchers) increases facility-based • Basinga et al. births. (Global) (2011) Insufficient Increase coverage of emergency • With every doubling of distance between • Gabrysch and access to obstetrical care to underserved home and closest health facility, odds Campbell (2009) emergency areas (medium/longer) of delivery in a facility decreased by 29 obstetrical care percent. (Zambia) High rates Expand access to safe abortions • Access to safe abortion care reduces • Mulligan et al. of unsafe through increasing numbers of maternal mortality and morbidity, and (2010) abortions trained providers and availability unintended pregnancies. (Global) of medical equipment throughout the country (medium/longer). High rates of See interventions under Strategic Priority 1 (Reducing child marriage and adolescent pregnancy and adolescent keeping girls in school) pregnancy Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 101 Problem Drivers Intervention Options (short Supporting Evidence (country or region) Sources (Gender Gap/ versus medium/longer timeline Issue) for impacts) Engage men & boys in FP • Safe spaces for married girls and young • Erulkar et al. (medium/long) women (ages 10–24) providing life skills, (2014) SRH, and financial literacy training: Low uptake increased use of FP and impacts greater of modern if husbands participate in companion contraception program. (Ethiopia) & family planning • Delivery of FP information by to husbands • Shattuck et al. services by male peer educators effective in (2011) increased FP use among couples. (Malawi) Ensure access to full range of • Introduction of mobile services within • Casey et al. (2013) modern contraception methods existing clinic-based services in a post- conflict setting led to increased use of modern contraception. (northern Uganda) Social marketing (short) • Social marketing combining ‘product, • Chapman and price, place, and promotion’ is effective Astatke (2003) in increasing use of condoms and oral • Madhavan and contraceptives. (Global) Bishai (2010) • Sweat et al. (2012) Mass media • Entertainment education (Edutainment) • Rogers et al. radio program increased adoption of FP (1999) and discussion of FP between spouses and peers. (Tanzania) Community engagement • Participants (male and female) in • Institute for (medium/longer) community dialogue on FP were 2.8 times Reproductive more likely to ask a health worker about FP Health (2016) information. (Benin) Community health workers and • Community-based programs can lead • Philips, Greene, mobile services offering broad to a significant increase in contraceptive and Jackson range of contraceptive methods use and/or reduction in fertility rates, and (1999); (medium/longer) when combined with clinic-based service • Prata et al. (2005) delivery, are more cost-effective than either alone. (Sub-Saharan Africa) Unequal burden Risky sexual Increase access to sex education • School sex ed + youth-friendly SRHS • Doyle et al. (2011) of disease and behaviors and condom distribution (short) + condom distribution improved SRH impacts of HIV/ knowledge and sexual behaviors. AIDS (Tanzania) • School program providing life skills, HIV/ • Hallman and Roca AIDS information, and financial literacy (2011) training reduced number of sexual partners and increased abstinence for boys. (South Africa) • Safe spaces with health, nutrition, life skills, • Austrian et al. and financial literacy training + savings (2016) accounts and health vouchers reduced transactional sex, increased condom use, increased savings. (Zambia) • Lottery with a chance to win a cash prize • Björkman Nyqvist conditional on negative test results for STIs et al. (2018) resulting in 21 percent reduction in HIV incidence over two years. (Lesotho) Strategic Priority Areas 102 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Problem Drivers Intervention Options (short Supporting Evidence (country or region) Sources (Gender Gap/ versus medium/longer timeline Issue) for impacts) Empower girls to have • A review of 22 interventions found that Haberland (2015) agency over their sexual and sex education programs that address reproductive health gender and power were 5 times more likely to be effective with 80 percent showing significantly lower rates of STIs or unintended pregnancies versus a 17 percent reduction in those which did not. (Global) Negative Poverty reduction and protection ‘Cash plus care’ (ICT + positive parenting Culver et al. (2014) coping from shocks (short) and/or teacher support) reduced HIV risk strategies to behavior from 41 percent to 15 percent for poverty/shocks girls and from 42 percent to 17 percent for etc. boys ages 10–18. (South Africa) Sexual See interventions under Strategic Priority 5 (Reduce high rates of GBV and improve quality and access of exploitation support services) and abuse Care burden See interventions to reduce domestic care burden under Strategic Priority 2 (Improve women’s economic (sick and opportunities and productivity) orphans) META REVIEWS Black, R. E., R. Laxminarayan, M. Temmerman, and N. Walker, editors. 2016. Reproductive, Maternal, Newborn and Child Health. Disease Control Priorities, 3rd ed. Vol. 2. Washington, DC: World Bank. https://openknowledge.worldbank.org/handle/10986/23833. Holmes, King K., Stefano Bertozzi, Barry R. Bloom, and Prabhat Jha. 2017. Disease Control Priorities, 3rd ed: vol 6. Major Infectious Diseases. Washington, DC: World Bank. https://openknowledge.worldbank.org/handle/10986/28659. Bertrand, J., K. O’Reilly, J. Denison, R. Anhang, and M. Sweat. 2006. “Systematic Review of the Effectiveness of Mass Communication Programs to Change HIV/AIDS-Related Behaviors in Developing Countries.” Health Education Research 21(4): 567–97. For further evidence on what works in family planning, consult briefs available at http://www.fphighimpactpractices.org/. Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 103 Strategic Priority 4: Reduce high rates of GBV and improve access to survivor support services High rates of GBV in Mozambique not only affect the physical and mental health of women and girls, but also per- petuate a cycle of violence and significant lost productivity. Thus, reducing these high rates of GBV and mitigating their impacts on women and girls by improving access to quality survivor support services is the fourth strategic priority. This requires a multi-level response to address social norms perpetuating violence, increasing women’s agency, and ensuring their access to robust protection and support. Objective: Reduce high rates of GBV and improve access to survivor support services Policy interventions 1. Provide resources and establish responsibility for the implementation of the National Plan to Prevent and Combat GBV. 2. Strengthen and enforce legal framework for GBV prevention. 3. Strengthen data collection and case management systems. 4. Increase access to health, social, and legal services and improve coordination. Program interventions Problem Drivers Intervention Supporting Evidence (country or region) Sources (Gender Gap/ Options (short Issue) versus medium/ longer timeline for impacts) High rates of Social norms Cash transfers • Cash transfers can prevent or mitigate GBV, by • Dervisevic, Perova, GBV increasing women’s economic empowerment and and Sahay (2022) bargaining power, well-being, and social networks. • Pettifor et al. (2016) (Philippines, South Africa; LMICs) • Buller et al. (2018) Social Behavior • Edutainment television programming using storytelling • J-PAL (2023) Change to transmit messages on HIV, and violence against Campaigns women. (Nigeria) • Training for boys on sexual and reproductive health • Shah et al. (2022) behaviors and relationships with girlfriends through soccer clubs. (Tanzania) • Gender-transformative couples’ intervention for • Doyle et al. (2018) expectant/current fathers and their partners in small group discussions. (Rwanda) • Provide information or training to women engaged in • Croke et al. (2020) high-risk sectors or jobs to better navigate the risks they may face in their daily lives. (Democratic Republic of Congo) Low rates of Social norms, SBCC to • Social movements and awareness raising can increase • Levy and Mattsson reporting stigmatization, reduce stigma reporting of sexual crimes. (OECD countries) (2022) and backlash and backlash associated with reporting GBV Inadequate Increase access • Improving responses to sexual assault disclosures by • Lonsway and response to to survivor- formal and informal service providers improves rates Archambault (2020) reporting focused police or reporting and survivor outcomes. (United States and • U.S. Department of and legal services Global) Justice (2022) (e.g., specialized • Identifying and preventing gender-bias can improve police stations, law enforcement responses to GBV. (United States and pro bono legal Global) representation, etc.) Strategic Priority Areas 104 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Problem Drivers Intervention Supporting Evidence (country or region) Sources (Gender Gap/ Options (short Issue) versus medium/ longer timeline for impacts) Inadequate Insufficient Strengthen • Comprehensive and integrated care is feasible and can • Keesbury and Askew support to access to capacity of improve quality and timeliness of support. (Zambia, (2010) survivors of specialized service providers South Africa, Kenya, Malawi, Zimbabwe, Ethiopia, and • Watts and Mayhew GBV and child services; low including medical, Senegal). (2004) marriage rates of uptake psychosocial, • Improving the access and quality of reproductive health • UNFPA (n.d.) police and legal service responses to IPV can be achieved through Strengthen focusing on provider responses, clinical settings, policy referral frameworks, improved documentation and intersectoral mechanisms collaboration and referral. (Sub-Saharan Africa) Expand access • In conflict and disaster affected areas, expanding to Integrated remote services to GBV survivors can mitigate reduced Survivor Support access to services. (Global) Service Centers (CAIs) Expand access to remote services, particularly in conflict and disaster affected areas. META REVIEWS: Jewkes, R., S. Willan, L. Heise, L. Washington, N. Shai, A. Kerr-Wilson, and N. Christofides. 2020. Effective Design and Implementation Elements in Interventions to Prevent Violence against Women and Girls. What Works To Prevent VAWG? Global Programme Synthesis Product Series. South African Medical Research Council, Pretoria. Kerr-Wilson, A., A. Gibbs, Fraser E. McAslan, L. Ramsoomar, A. Parke, H. M. A. Khuwaja, and R. Jewkes. 2020. A Rigorous Global Evidence Review of Interventions to Prevent Violence against Women and Girls. What Works to Prevent Violence Against Women and Girls Global Programme, Pretoria, South Africa. Morrison, S., J. Hardison, A. Mathey, and J. O’Neil. 2004. “An Evidence-Based Review of Sexual Assault Preventative Intervention Programs.” U.S. Department of Justice. https://www.ojp.gov/pdffiles1/nij/grants/207262.pdf. Strategic Priority Areas Mozambique Gender Assessment  |  Leveraging women and girls’ potential 105 Strategic Priority 5: Increase women and girls’ resilience to climate change, natural disasters, and conflict shocks The impacts of climate change, natural disasters, and conflict risks are steadily increasing in Mozambique. These negative impacts fall disproportionately on women and girls, reinforcing pre-existing vulnerabilities and gender gaps. Increasing women and girls’ resilience to climate change, natural disasters, and conflict shocks will be key not to mitigating these gendered impacts, but also accelerating the country’s resilience and recovery in the face of a growing and intersecting risks. Objective: Increase women and girls’ resilience to climate change, natural disasters, and conflict shocks Policy interventions 1. Strengthen implementation of Gender & Climate Change Strategy. 2. Increase women’s participation in climate change policy and planning. 3. Increase women’s participation in peace processes and local efforts to build social cohesion. 4. Increase women’s participation in local conservation and climate adaptation efforts. Program interventions Problem (Gender Drivers Intervention Supporting Evidence (proven, promising, Sources Gap/Issue) Options (short emerging) versus medium/ longer timeline for impacts) Negative impacts Socioeconomic Increase See Strategic Priority 2: Increase women’s economic opportunities and of climate inequality women’s ex ante productivity change and socioeconomic natural disasters standing • Among ex ante actions, human capital accumulated • Yamachi et al. disproportionately in the household prior to disasters helps mitigate (2009) affect women and the negative effects of disasters in both the short girls and long run. (Bangladesh, Ethiopia, Malawi) Increase women’s • Food for work and cash for work programs when • Mascie-Taylor et ability to benefit well targeted increase household consumption al. (2010) from safety nets and women and children’s nutrition and health. • Echevin (2011) following disaster (Bangladesh, Haiti) Less access Increase women’s • Women are less aware of CSA practices and • Twyman et al. to adaptation access to climate- technologies, but women have been found to be (2014) resources smart agricultural more likely than men to adopt CSA when aware. • Nhemachena and (CSA) information (Mozambique, Africa) Hassan (2007) and technologies • CIAT and World Bank (2017) See agriculture interventions in Strategic Priority 2: Increase women’s economic opportunities and productivity Income • Households where an individual is able to • Eriksen et al. diversification specialize in one favored activity, in the context (2005) of overall diversification by the household, were often less vulnerable than households where each individual is engages in many activities at low intensity. (Kenya and Tanzania) Index insurance • Insurance schemes must be designed for women in • Akter et al. (2016) consideration the higher risk for women associated • Delavallade et al. with agricultural insurance products. Women’s (2015) increased risk results from their lower willingness to purchase weather index insurance due to lower trust in financial institutions; their lower financial literacy; and their lower access to and additional sources of lifecycle risk than men. (Kenya, Tanzania, Sahel) Strategic Priority Areas 106 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Problem (Gender Drivers Intervention Supporting Evidence (proven, promising, Sources Gap/Issue) Options (short emerging) versus medium/ longer timeline for impacts) • Increase access to resources, land and extension • -See Agriculture services to increase interest in index insurance. under econ section (South Africa) • Born, Spillane, and Murray (2019) Increase women’s See Insufficient access to finance under econ section access to credit Breakdown in Include SRMHS • Integrating the Minimum Initial Service Package • UN Inter-Agency SRMHS and in emergency (MISP) in humanitarian responses improves Standing GBV support responses outcomes. (Global) Committee (2015) services Include GBV Women face survivor support additional risks services in during conflict and emergency displacement responses Increased Direct support to • Involve women in development of climate change • Hemachandra, vulnerability/ women strategies and disaster risk management. (Global) Amaratunga, and dependence Prevention of Haigh (2018) sexual exploitation and abuse in • Ensure women and women’s organizations play a • United Nations emergency role in initiatives to build social cohesion within and and World Bank responses between communities. (Global) (2018) • Monitor and mitigate security risks for women • UN Inter-Agency and girls in situations of displacement and conflict Standing related to physical infrastructure (e.g., access to Committee (2015) safe sanitation, placement of water sources, etc.), • CARE (2019) sexual exploitation and abuse by humanitarian and emergency responders, human trafficking, and sexual assault by armed forces and militias, among others. (Global) META REVIEWS: Global Gender and Climate Alliance (GGCA). 2016. “Gender and Climate Change: A Closer Look at Existing Evidence.” GGCA. https://wedo. org/gender-and-climate-change-a-closer-look-at-existing-evidence-ggca/. Erman, Alvina, Sophie Anne De Vries Robbe, Stephan Fabian Thies, Kayenat Kabir, and Mirai Maruo. 2021. “Gender Dimensions of Disaster Risk and Resilience: Existing Evidence.” © World Bank, Washington, DC. https://openknowledge.worldbank.org/entities/ publication/88d46d58-c4ca-53bf-82ea-4f3cc423b67e License: CC BY 3.0 IGO. 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The overall score for Mozambique is higher than the regional average observed across Sub-Saharan Africa (71.5). When it comes to constraints on freedom of movement, laws affecting women’s deci- sions to work, constraints related to marriage, constraints on women starting and running a business, and gender differences in property and inheritance, Mozambique gets a perfect score. However, when it comes to laws affecting women’s pay, laws affecting women’s work after having children, and laws affecting the size of a woman’s pension, reforms are needed for to advance legal equality for women. Annex 1: Women, Business and the Law Mozambique Country Brief Mozambique Gender Assessment  |  Leveraging women and girls’ potential 115 Annex 2: Gender-Based Violence Definitions Gender-based violence (GBV) is an umbrella term for any harmful act that is perpetrated against a person’s will and that is based on socially ascribed (that is, gender) differences between males and females. It includes acts that inflict physical, sexual, or mental harm or suffering and threats of such acts, coercion, and other deprivations of lib- erty. These acts can occur in public or in private. Globally, women and girls are at greater risk of experiencing GBV. However, men and boys may also experience GBV, particularly those who are members of the lesbian, gay, bisexual, transgender, queer, intersex, and asexual community and perceived to transgress ascribed male gender roles. Intimate partner violence (IPV) refers to violence committed by a current or former spouse or partner in an intimate relationship against the other spouse or partner. While IPV can be experienced by men, the majority of IPV is committed against women, particularly the most extreme forms that lead to serious injury and death. IPV is the most common form of domestic violence, although the latter also includes violence against other household members, such as children, the elderly, and persons with disabilities. Sexual exploitation and abuse (SEA) includes any actual or attempted abuse of a position of vulnerability, differ- ential power, or trust for sexual purposes, including, but not limited to profiting monetarily, socially, or politically from the sexual exploitation of another. Sexual assault (SA) includes any actual or threatened physical intrusion of a sexual nature whether by force or under unequal or coercive conditions. Sexual harassment (SH) includes any unwelcome sexual advance, request for sexual favor, verbal or physical conduct, or gesture of a sexual nature that might reasonably be expected or be perceived to cause offence or humil- iation if such conduct interferes with work, is made a condition of employment, or creates an intimidating, hostile, or offensive work environment. Annex 2: Gender-Based Violence Definitions 116 Mozambique Gender Assessment  |  Leveraging women and girls’ potential Mozambique Gender Assessment  |  Leveraging women and girls’ potential 117