MORTALITY

Mortality is defined as the action of death on a  population and is one of the central components of the demographic dynamic. The pace at which deaths occur  in a population varies greatly between the various regions of the world, socio-economic groups, sex etc. The way in which people die is a good representation of the conditions under which they live.

Table 3.1 shows several indicators of mortality for Mozambique, according to the IIRGPH. The first measure, the gross death rate, is simply the ratio between the number of deaths in a year, and the estimated population in the middle of that year. This rate, with a figure of 21.2 per 1,000, although easy to calulate, has the disadvantage that it is greatly affected by the age structure of the population.

TABLE 3.1: Selected indicators of mortality by sex, and by area of residence, Mozambique, 1997

In Mozambique, life expectancy at birth is 42.3 years for both sexes, 40.6 years for men and 44.0 years for women. In general, life expectancy at birth in most countries is lower for men than for women. In the respective literature there is no unanimity on the weight of biological or social factors in this trend. In any case, the life expectancy at birth estimated for Mozambique shows a high level of mortality. It is important to note that this high level is mainly determined by mortality in childhood. If that were to fall substantially, then there would be a significant increase in life expectancy.

Considering the great weight that mortality in childhood has on life expectancy at birth, it is also important to consider life expectancy at other ages. Table 3.1 includes life expectancy at 10 years of age. This figure indicates the number of years that a person can be expected to live, on average, after reaching that age, It is important to stress that life expectancy at 10 is higher than life expectancy at birth (47.2 against 42.3 years, respectively); this fact shows the great influence of mortality in childhood on overall mortality. In other words, the children who survived the first years of life have, on average. More years of life ahead of them, than those recently born.

Table 3.1 also shows the indicators of mortality according  to area of residence. The difference in life expectancy at birth between rural and urban areas is important: 48.8 years in urban areas, and 40.2 years in rural ones, which is a difference of 8.6 years. Similar inequalities may be observed between life expectancies at birth for men and for women. This difference in mortality between urban and rural areas may be due to the greater availability of health services in the former. However, the higher educational level of the urban population (see section 8) may also have an influence, as may the possible better living conditions in the urban areas when compared with the countryside. As for life expectancy at the age of 10, the differences between urban and rural areas are lower than in the case of life expectancy at birth (3.2 against 8.6 years). As explained above, this lesser difference between the urban and rural sectors indicators that mortality in childhood is one of the main components of the higher mortality observed in the country’s rural areas.

Graph 3.1 shows three indicators of mortality in the first years of life. The first, infant mortality, with a figure of 145.7 deaths for every 1,000 live births, is defined as the probability of dying before completing the first year of life. This is one of the most adequate indicators of the level of socio-economic development and the state of health of a population. The second, child mortality, refers to the mortality of children aged between 1 and 5 years. The figure for this indicator for Mozambique is 116.9 per 1,000. The final indicator, mortality in childhood, is the combination of infant and child mortality: it stands at 245.6 per 1,000. Thus, mortality in the first five years of life is extremely high in Mozambique.

<Graph 3.1>

Before closing this section, it is worth mentioning that in most third World countries, child mortality (1 to 5 years of age) falls to a third of even a quarter of infant mortality (0 to 1 year of age). However, in most of the countries of sub-Saharan Africa, the child mortality rates are only somewhat lower than, or even similar to, the infant mortality rates. In the case of Mozambique, one notes that child mortality (116.9) is only 24.6% lower than infant mortality (145.7). One of the possible determinants for this pattern is interruption in breast-feeding in a context of  precarious health conditions, which increases the exposure of children to infectious and parasitic agents; also as from this moment competition for food begins, particularly in large households. Frequent episodes of diarrhoea, combined with high levels of acute and chronic malnutrition may contribute substantially to the rise in mortality during this period of life. In addition, the damaging effects of malaria and of respiratory illnesses should be recognised