The adult literacy rate is of 60.7%, ranks 181 st out of 189 countries, according to the UN Human Development Index. About 66% of the population lives in rural areas and rely on subsistence farming under rain-fed conditions which are severely affected by the cyclical occurrence of droughts and floods, causing unbalanced food and nutritional income. A large part of the population, (62.9%) lives below income poverty line. Further, the country has one of the lowest worldwide densities of health workers (0.4 physicians, 4.12 nurses and midwives per 10,000 people). 10,11 The distribution of health professionals across the country is not uniform, with more deficits in the north and central provinces, such as Nampula, Niassa, Cabo Delgado, and Zambeze.