Prime Age Adult Mortality and Household Livelihood in Rural Mozambique: Preliminary Results and Implications for HIV/AIDS Mitigation Efforts

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Prime Age Adult Mortality and Household Livelihood in Rural Mozambique: Preliminary Results and Implications for HIV/AIDS Mitigation Efforts Annex Tables: Results from TIA 2002 Ministry of Agriculture and Rural Development Michigan State University November 20, 2003

Annex Table 1. Number of TIA 2002 Households with Member Deaths, New Arrivals, Departures, and Illness, January 1999-2002; Overall and by Age Groups Households with Changes in Composition, as Indicated Households in Sample % of Households Nationally 1 A. Deaths (all age groups) since January 1999 578 10.6 Newborn/Infant (under 5 years old) 150 2.8 Children (5 to 14 years old) 61 1.3 Prime Age (15 to 49 years) 230 2 4.2 Elderly (50 + years) 197 3.5 B. New arrivals (all age groups) since January 1999 (excluding births in family) 561 9.5 Young Children (4-under 5 years old) 35 0.6 Children (5 to 14 years old) 138 2.4 Prime Age (15 to 49 years) 407 6.5 Elderly (50 + years) 34 0.8 C. Departure for reasons other than death (all age groups) since January 1999 1047 19.3 Newborn/Infant (under 5 years old) 19 0.3 Children (5 to 14 years old) 120 2.6 Prime Age (15 to 49 years) 910 16.4 Elderly (50 + years) 57 1.0 D. Illness (all age groups) for at least three out of past twelve months 283 5.7 Newborn/Infant (under 5 years old) 20 0.4 Children (5 to 14 years old) 19 0.4 Prime Age (15 to 49 years) 141 2.7 Elderly (50 + years) 107 2.2 E. Combination of prime age death and prime age illness in the same household 7 0.1 F. Combination of prime age death and prime age new arrival in the same household 32 0.5 G. Households with 2 prime age adults currently with prolonged illness 2 0.0 1 There were 4908 households in the nationally representative sample; population estimates of percentages of households are based on the weighted sample. 2 Deaths from illness account for 217 of the 230 prime-age deaths. 2

Annex Table 2. Provincial Urban and Rural HIV Prevalence Rates and TIA 2002 Rural Mortality Rates for Adults 15-49 years Province Adult Death Due to Illness in Rural Areas, 1999-2002 (1) 1 Rural and Urban Adult HIV Prevalence, 2002 (2) ---- % of adults within province ---- Niassa 2.0 11.1 Cabo Delgado 2.1 7.5 Nampula 1.2 8.1 Zambezia 1.8 12.5 Tete 1.9 14.2 Manica 2.7 19.0 Sofala 1.8 26.5 Inhambane 1.3 8.6 Gaza 2.7 16.4 Maputo 2.0 17.4 National 1.8 13.6 Source: (1) TIA 2002 Rural Survey: TIA percentages are based on weighted estimates. They reflect the percentage of rural adults (15-49) who died during the January 1999-August 2002 period, compared to the total number of rural adults; (2) Ministry of Health, National Institute of Statistics, Ministry of Planning and Finance, and Center for Population studies (2003). Impacto Demografica do HIV/SIDA em Mocambique (based on observations from 36 urban and rural health posts across the country; figures are for age group 15-49 inclusive). 1 Percentages are based on within category weighted estimates. "% of total" refers to percentage of those within the given category distributed across the provinces. 3

Annex Table 3. Income and Land Holding Characteristics of Non-Affected Rural Households and Those With Deceased Male and Female Members: Mozambique, 2002 Characteristics of Households (average values) Non-Affected Households HH with Male Who Died From illness 1 HH with Female Who Died From illness 1 Total Land Area hectares (ha) 1.7 1.4 1.4 Cultivated Land Area hectares (ha) 1.3 1.1 1.2 % of Total Land Area cultivated 81% 78% 82% Adult Equivalents (AE) 3.5 3.2 3.8 Total Land Area/AE ha/ae 0.6 0.6 0.5 Cultivated Land Area/AE ha/ae 0.4 0.4 0.4 Total Income 1000 met 6,811 5,383 6,013 Total Income/AE 1000 met/ae 2,084 1,762 1,812 % of HHs in lowest two quartiles of income/pc 50% 61% 53% % of HHs in lowest two quartiles of total land/pc 50% 54% 60% quartile means (1000 met/capita) ---- % of HH in each quartile ---- Quartiles of 2002 Lowest 133 24.9 31.1 24.3 HH per Capita Mid-low 558 24.9 29.7 29.0 Income (%) Mid-high 1,151 24.9 23.8 24.6 Highest 4,350 25.3 15.5 22.0 100.0 100.0 100.0 (ha/capita) Quartiles of 2002 Lowest 0.09 24.2 24.3 33.4 HH per Capita Mid-low 0.22 25.4 30.1 26.3 Total Land Area (%) Mid-high 0.37 25.2 23.4 22.0 Highest 0.95 25.2 22.2 18.4 100.0 100.0 100.0 Number of Households in analysis 4572 104 106 Rural survey 1 over period from 1999-2002 4

Annex Table 4. Mobility of Members of Households With and Without Prime- Age Death From Illness, 1999-2002 Household Member Movement Non-Affected Households HH with PA Male Death From Illness (% HH) (% HH) Arrival of PA male(s) 2.3 2.0 3.4 HH with PA Female Death From Illness (% HH) Arrival of PA female(s) 4.2 4.6 11.5 Arrival of one or more children age 0-14 0.6 0.0 1.5 Departure of PA male(s) 9.0 3.6 10.3 Departure of PA female(s) 9.0 10.6 5.7 Departure of one or more children age 0-14 2.8 3.9 10.1 Cases 4572 104 106 Annex Table 5. Characteristics of Households With and Without Prime-Age Death From Illness, 1999-2002 Household Characteristic Non-Affected Households HH with PA Male Death From Illness (% HH) (% HH) HH size 1999 4.62 5.40 6.30 HH with PA Female Death From Illness (% HH) HH size 2002 4.96 4.57 5.11 Change in HH size 0.34-0.84-1.19 HH size 1999 in AE 1 3.23 3.97 4.39 HH size 2002 in AE 3.42 3.07 3.59 Change in HH size in AE (1999-2002) 0.19-0.90-0.80 Dependency Ratio 1999 1.23 0.99 1.41 Dependency Ratio 2002 1.41 1.60 1.74 Change in Dependency Ratio (1999-2002) 0.17 0.70 0.41 Cases 4572 104 106 1 AE = Adult Consumption Equivalents by age groups (0-4; 5-14; 15-24; 25-49; 50+) and by gender 5

Annex Table 6. Household Adjustment Strategies Identified in Response to Prime-Age Death From Illness By Gender Of Member Deceased Strategy Cases of Prime-Age Death Due to Illness 1 All Males Females 1. Labor replacement strategies ---- % of cases ---- Contracted labor to cultivate land 7.4 8.4 6.6 Increased labor use of other family members 3.7 4.9 2.7 Increased use of self-help (mutual help) with neighbors 6.8 9.1 4.9 Obtained more labor by bringing back a family member who had left the HH 0.4 0.0 0.7 Adopted or brought in children from other households 0.6 1.1 0.1 Increased use of children for income activities 4.0 6.0 2.3 Removed one or more children from school 2.7 2.0 3.3 2. Reduce Area Culivated or Reduce Labor Inputs Cultivate less land 44.3 52.2 37.8 Reduced the labor time for weeding 22.3 25.0 20.1 Adopted or increased crops that demand less labor 3.1 3.1 3.2 3. Asset-based strategies Lent land to others 4.3 4.3 4.4 Rented or sold land to others 0.7 0.4 1.0 Sought loan or donation 1.7 1.1 2.1 Force to spend most of household savings 11.9 8.1 15.0 Sold large animals, such as oxen, sheep, goats, pigs, to meet urgent needs 5.3 8.3 2.9 Sold some other household asset to meet urgent needs 12.1 14.7 10.0 4. Consumption-based strategies Significantly reduced the quality of the diet (eat less meat, fish, vegetables) 14.1 18.4 10.5 Sent children away to live with relatives 7.8 3.9 11.0 5. Child-related strategies Increased use of children for income activities 4.0 6.0 2.3 Removed one or more children from school 2.7 2.0 3.3 Sent children away to live with relatives 7.8 3.9 11.0 Adopted or brought in children from other households 0.6 1.1 0.1 No strategy stated 33.8 27.0 39.4 Cases 217 105 112 1 Columns do not sum to 100% because households were asked for up to 3 strategies. 6

Annex Table 7. Adjustment Strategies Indicated by Households Experiencing a Prime-age Death from Illness over 1999-2002 by Selected Characteristics Characteristics of Households That Did and Did Not Use A Given Adjustment Strategy Adjustment Strategy in Response to Prime-Age Death Shock Strategy Use (Number of Cases) HH Income per Capita (1000 mt / Capita) HH Total Land per AE (Hectares / Capita) HH Adult Equivalents (Number of AE s) Change in AE per HH 1999-2002 (# AE) Strategy Use Diff. Strategy Use Diff. Strategy Use Diff. Strategy Use Yes No Yes No Yes No Yes No Yes No 1. Hire Labor or Increase n=24 Use of Mutual Help n=193 1,635 1,221 0.66 0.48 4.1 3.4-1.10-0.83 2. Increase Use of Child Labor n=12 n=205 935 1,300 0.56 0.50 3.3 3.5-1.12-0.84 3. Reduce Area Cultivated n=82 n=135 1,190 1,346 0.51 0.51 3.0 4.0 *** - 0.87-0.86 Diff. 4. Reduce Labor Spent on Weeding n=33 n=184 998 1,358 0.57 0.49 2.5 3.8 *** - 0.92-0.85 5. Reduction of Cash, Livestock/Other Assets n=36 n=181 1,470 1,227 0.51 0.51 3.6 3.5-0.78-0.89 6. Send Children Away n=12 n=205 1,401 1,267 0.36 0.52 3.2 3.6 * -0.78-0.88 Total Cases of PA death (n=217); Mean Values of HH Characteristics: HH Income = 1,285 /capita; HH Total Land per AE = 0.53 ha/capita; HH/AE = 3.53 AE; Change in AE per HH = -0.86 AE s * indicates significant difference between mean values at the *** 0.01 level; ** at the 0.05 level; * at the 0.10 level 7

Annex Table 8. Adjustment Strategies Indicated by Households Who Experienced a Prime-age Death From Illness over 1999-2002 By Gender and Household Headship Status of the Deceased Within Each Household Category, Percentage of Households Using A Given Adjustment Strategy Adjustment Strategy in Response to Prime-Age Death Shock Number of Cases 1 HH With Male Death HH With Female Death Diff. HH With Death of Head/ Spouse HH With Death of Other Member Diff. HH With Death of Male Head/ Spouse HH With Death of Female Head/ Spouse Diff. 1. Hire Labor or Increase use of n=24 20 % 7 % ** 17 % 13 % 17 % 17 % Mutual Help 2. Increase use of Child Labor n=12 7 % 5 % 12 % 4 % * 13 % 10 % 3. Reduce Area Cultivated n=82 50 % 38 % 52 % 48 % 60 % 32 % ** 4. Reduce Labor Spent on n=33 25 % 20 % 21 % 26 % 30 % 0 % Weeding * 5. Reduction of Cash, Livestock n=36 4 % 12 % * 32 % 17 % * 33 % 30 % or Other Assets 6. Send Children Away n=12 4 % 12 % * 15 % 6 % ** 11 % 26 % 7. No Strategy n=89 27 % 41 % * 20 % 38 % ** 11 % 41 % *** % of Total Cases 2 n=217 48 % 52 % 27 % 73 % 19 % 7 % * Indicates significant difference between mean values *** at the 0.01 level; ** at the 0.05 level; * at the 0.10 level. 1 Case numbers only apply to the first two columns (male vs. female death). Household headship status could not be identified for 10% of the cases, thus these cases are not included in the columns with household headship status categories. 2 Columns do not sum to 100% because households were asked for up to 3 strategies. 8