regions, as well as between rural and urban areas. It is estimated that 80 per cent of Mozambicans still walk 5 km or further from their homes to the nearest health facility. The quality of services remains inadequate due to limited qualified medical staff and the lack of necessary medical infrastructure and equipment. The number of national health staff, including doctors and nurses, declined from 17 786 in 2003 to 17 549 in 2007. The Aids pandemic is a serious concern, as Mozambique ranks among the ten most-affected countries in the world. The incidence of other diseases, such as malaria and tuberculosis, remains high and poses a serious health challenge to the country. lxxxvi. Overall, basic social services in Mozambique, such as finance, markets and ICT, are unequally distributed not only across provinces, but also between urban and rural dwellers and the socioeconomic strata of the population. This has serious implications for improving the wellbeing of individual citizens. lxxxvii. Mozambique has, however, made considerable progress in promoting gender equality. The country has supportive policies, laws and an institutional framework in place for guiding efforts towards achieving gender equality and equal opportunities for all individuals. In this regard, the government has subscribed to several regional and international initiatives that promote equal rights for women and men. In terms of these instruments, parties commit to revising discriminatory laws, and to formulating new policies and programmes for the benefit of women. lxxxviii. Despite notable socioeconomic progress over the years, effective policy implementation remains a critical concern in Mozambique. Corruption, inadequate resources, lack of capacity (particularly at lower levels) and the politicisation of development programmes are major obstacles reinforced by the deficient management of public expenditure, growth in revenue and coordination of development assistance. This suggests that there is a need to strengthen programme monitoring and evaluation capacity. lxxxix. Although the district has been identified as the node of development, the decentralised system for service delivery suffers from a number of structural, operational and financial weaknesses. This has affected the quality of service delivery at the local level. There is also concern that significant job creation and poverty reduction have not accompanied economic growth. Moreover, the country faces high and rising unemployment, particularly among the youth. xc. Another source of concern is rising income inequality. Mozambique has not been able to address this problem fully (within and across regions, and between urban and rural areas). This inequality is not only evident with regard to income, but also in other basic social services, such as healthcare and education. 18 A P R M COU N T RY R EV IEW R EP ORT NO. 11