Mozambique has 19.6 million inhabitants, the majority of whom live in rural areas (66.8%). Despite strong growth in gross domestic product (GDP) in the years since the 1992 peace accord, incomes in Mozambique remain low. The GDP per capita is US$230, and 69% of the population lives below the poverty line. Infant and maternal mortality are high; in fact, the World Health Organization and UNICEF rank Mozambique’s maternal mortality rate as one of the highest in the world.

Overall, the health status of the population is lower than the average for African countries, and conditions have been exacerbated by years of flood and drought. The public health system in Mozambique is stretched thin as it attempts to provide coverage for a large, dispersed, and poor rural population. The progress made has been limited by various factors, including:

* High rates of infectious disease and malnutrition

* Inadequate access to potable water

* Growing prevalence of HIV/AIDS

* Limited numbers of trained health personnel

* Annually decreasing funds for basic health care delivery

Fertility and maternal mortality are high, and contraceptive use is low. HIV prevalence is rising, with ominous implications for economic development and social stability. USAID/Mozambique’s strategy in health and family planning is to increase the use of essential maternal and child health and family planning (MCH/FP) services in eight provinces. The major program areas in family planning are designed to increase contraceptive prevalence; strengthen training for local health care delivery; and reduce policy, attitudinal, and medical barriers to family planning.