Levels and trends of demographic indices in southern rural Mozambique: evidence from demographic surveillance in Manhica district

Background: In Mozambique most of demographic data are obtained using census or sample survey including indirect estimations. A method of collecting longitudinal demographic data was introduced in southern Mozambique since 1996 (DSS - Demographic Surveillance System in Manhica district, Maputo province), but the extent to which it yields demographic measures that are typical of southern rural Mozambique has not been evaluated yet. Methods: Data from the DSS were used to estimate the levels and trends of fertility, mortality and migration in Manhica, between 1998 and 2005. The estimates from Manhica were compared with estimates from Maputo province using the 1997 National census and 1997 Demographic and Health Survey (DHS). The DHS data were used to estimate levels and trends of adult mortality using the siblings' histories and the orphanhood methods. Results: The populations in Manhica and in Maputo province are young (44% < 15 years in Manhica and 42% in Maputo); with reduced adult males when compared to females ( all ages sex ratio of 78.7 in Manhica and 89 in Maputo). Fertility in Manhica is at a similar level as in Maputo province and has remained around 5 children per woman, during the eight years of surveillance in Manhica. Although the infant mortality rate (IMR) in Mozambique has decreased during the last two decades ( from 148 deaths per 1000 live births in 1980 to 101 in 2003), it has remained stable around 80 in Manhica during the surveillance period. Adult mortality has increased both in Manhica ( probability of dying from ages 15 to 60 increased from 0.4 in 1998 to 0.6 in 2005 in Manhica, from 0.3 in 1992 to 0.4 in 1997 in Maputo province and from 0.1 in 1980 to 0.6 in 2000 in Mozambique). Consequently, the life expectancy decreased from 53 to 46 in Manhica and from 42 years in 1997 to 38 in 2004 in Mozambique. Migration is high in Manhica but tends to stabilise after the movements of resettlement that followed the end of the civil war in 1992. Conclusion: The population under demographic surveillance in Manhica district presents characteristics that are typical of southern rural Mozambique, with predominance of young people and reduction of adult males. Labour migration and excess adult male mortality are the major factors for the reduction of adult males. Mortality is high and only infant mortality has started to stabilise while adult mortality has increased, and as consequence, life expectancy has decreased. The Manhica DSS is an adequate tool to report demographic measures for southern rural Mozambique.