Sub-Saharan Africa: An Extraordinary Period of Change

Africa’s hopes for a better future depend in large part on improving the health of its people. Sub-Saharan Africa is experiencing a period of extraordinary change. Across the continent, policy reforms are contributing to dynamic economic growth. Greater political openness has strengthened the commitment of African governments to meeting the basic needs of their people. Despite these positive trends, sub-Saharan Africa faces a development challenge greater than any other region. Much of the continent’s population remains desperately poor.
With record numbers of adolescents entering their childbearing years, in less than three decades Africa’s population is projected to double again from the current level of 620 million. Meanwhile, many African nations are struggling to provide health and education services to populations expanding at a small percent a year. In many countries, rapid population growth is contributing to degradation of the environment and undermining prospects for prosperity. Africa’s hopes for a better future depend in large part on improving the health of its people.
Better access to good quality reproductive health services, particularly family planning, is key to improving health status – especially for women. The reality of reproductive health in Africa, however, is far from ideal. Women begin child-bearing in their teens and have an average of six children. Meanwhile, AIDS has struck hard in Sub-Saharan Africa, where roughly 1 in 10 adults – both men and women – are infected with HIV. Yet traditional attitudes favoring large families are changing rapidly, owing to the growth of cities, the rising cost of living and lower child death rates, among other factors.

Demand for family planning has increased dramatically in some countries, and the decline in birthrates ,limited as recently as a decade ago to only a few countries in the region, appears to be spreading steadily across the continent. In much of Africa, however, large families are still the norm. This situation is reinforced by low levels of education, particularly among women, and social barriers to the full economic participation of women. Yet, school enrollment rates declined or came to a standstill during the economic crisis many African countries experienced in the 1980s.
Compared to countries in other developing regions, African countries have only recently begun to adopt population policies and initiate family planning and related reproductive health programs. However, African governments increasingly recognize the individual and societal benefits of smaller families. In the last decade there has been steady growth in the number of countries establishing national family planning programs and in the scope of these efforts. Still, Sub-Saharan Africa has a long way to go.
In addition to meeting the growing need for family planning and reproductive health services, African countries must expand access to education for girls and economic opportunities for women. This will require significantly increased financial contributions from African governments and house-holds, as well as international donors. In sum, addressing poor reproductive health and rapid population growth is a daunting task requiring comprehensive action on many different fronts. A priority area is population growth. This is a function of birth or fertility, mortality, and net migration.
Sub-Saharan Africa lags behind other regions in its demographic transition. The total fertility rate, the total number of children the average woman has in a lifetime. For Sub-Saharan Africa as a whole has remained at about 6. 5 for the past 25 years, while it has declined to about 4 in all developing countries taken together. Recent surveys appear to signal, however, that several counties, are at or near a critical demographic turning point. Sub-Saharan Africa continues to maintain the highest total fertility rates in the world.
The total fertility rate is the average number of children a women will bear during her reproductive years, usually between 15 and 49 years old, although some analysts have expanded this range to include 10 and 55 year old’s. Families in the region average an estimated 6. 4 children. Although there is considerable variation by region, socioeconomic status, and place of residence (rural vs. urban). Disease vectors are not solely responsible for low fertility rates in Sub-Saharan Africa. Some countries have made significant inroads in their family planning efforts to reduce fertility.
You can separate fertility rates into two types of determinants: first being the direct that relates to the behavioral and biological aspects of fertility. And the second are indirect factors such as socioeconomic (one’s income, education, cultural, historical, environmental, and politic-institutional factors Marriage patterns in Sub-Saharan Africa have a number of features that are unique and quite distinct from North America and Europe. Most marriages, particularly in traditional societies, are universal and occur at an early age.
This may also be view as a reason to the problem of rapid population growth. The belief systems, customs, traditions, and values of Sub-Saharan Africans have significant impact on fertility levels. The African family structure is male dominated, and decisions about reproduction and family size are usually deferred to the husband. This may tend to make the women find it difficult to talk to their husbands about family planning. Since a high premium is placed on children, African women aspire to elevate their status, comparing with their husband’s request to have more children.
Mortality levels in Sub-Saharan Africa have declined substantially over the years, thus converging towards levels associated with more developed countries. Improvements in health, sanitation, and nutrition standards; massive vaccination campaigns against measles, small pox, and other diseases; and increased efforts on the part of World Health Organization and the International Red Cross have all contributed to this downward trend. Even with the lowering of death rates, there are still slight regional variations in mortality levels that reflect environmental, economic, and sociocultural factors.
Death rates may be prone to drought, areas with high incidence of AIDS and those areas that have experienced social unrest, civil war, and political upheaval also may have relatively high mortality rates. Migration involves the movement from one administrative unit to another, resulting in a change in permanent residence. Recent estimates show that Sub-Saharan Africa contains 35 million international migrants, almost half of the world’s total. Another concern like many other countries has been the “brain drain” of African intellectuals and students.
Another concern regarding international migration is the refugee crisis, which has taken on added proportions recently. The most widely used definition is one which characterizes refugees as anyone who,”owing to well-founded fear of being persecuted for reasons of race, religion, nationality and is unable or unwilling to avail himherself of the protection of that country. ” Average per capita food production has declined in many countries, per capita calorie consumption had stagnated at very low levels, and roughly 100 million people in Sub-Saharan Africa are food insecure..
The average African consumes only about 87 percent of the calories needed for a healthy and productive life. Women’s Time, and Their Role in Rural Production and Household Maintenance Systems Most women in Sub-Saharan Africa bear heavy responsibilities for food crop production, weeding and harvesting on men’s fields, post-harvest processing, fuel wood and water provision, and household maintenance. But the burdens on rural women are increasing, as population growth outpaces the evolution of agricultural technology and growing numbers of men leave the farms for urban and industrial jobs.
Many factors underlie the persistence of very high human fertility rates. The fundamental problem is low demand for fewer children. Environmental degradation, agricultural problems, food insecurity and poverty, and the heavy work burdens of woman all play a part in this respect. High infant and child mortality rates are a major factor explaining the persistent high demand for large number of children in Africa. Where girls are kept our of school to help with domestic tasks, this negatively affects their fertility preferences and their ability to make informed decisions about family planning once they reach childbearing age.
The appropriate policy response and action program to address these problems are not easily brought into compatible focus. Many of the most immediately attractive remedies have been tried and have failed. A key aspect will be to increase demand for fewer children. Educational efforts, directed at both men and women, are needed to raise awareness of the benefits of fewer children. Women’s work loads need to be eased to reduce the need for child labour. Dynamic agricultural development and improved food security will also reduce the demand for children.
Promoting Environmentally Sustainable Agriculture Farm productivity per unit area must be raised significantly to generate more output with little increase in the area farmed. To minimize negative impacts on the environment, much more emphasis is required on “environmentally benign and sustainable” technologies. Numerous such agricultural techniques have been developed and successfully applied, often through adaptation of traditional practices that have evolved in response to local agro-ecological and socioeconomic condition.
However, intensification with these technologies alone is unlikely to be sufficient in most Sub-Saharan African countries to achieve agricultural growth rates of 4 percent per year and more. Improved variety/fertilization/farm mechanization technologies will also be necessary. Increased use of fertilizers will be especially important to raise yields and maintain soil fertility. Intensive and resource-conserving agriculture must be made less risky and more profitable. This requires appropriate marketing, price, tax and exchange rate policies as well as investments in rural infrastructure, health and education facilities.
Creating parks, reserves and community-owned range land and protecting these against conversion into crop land will be important to conserve natural resources and bio diversity. So will reducing infrastructure development in forests and other fragile areas to discourage settlement in these areas. Since this will limit the scope for further expansion of cropped land and, potentially, the scope for agricultural production growth, there is a trade-off between conservation and agricultural growth.
Creating additional protection areas will only be feasible and sustainable if agricultural production can be intensified at the rate suggested here (i. e. to about a 3. 5 percent annual increase in farm out put per unit of land farmed). in this sense, conservation and agricultural intensification are complementary. As African farmers have shown, land scarcity leads to agricultural intensification — if the necessary advice and inputs are available, intensification can be made sustainable and the rate of intensification greatly accelerated.
Infrastructure Development and Settlement Policy The strong bias in urban infrastructure investments favoring the few major cities needs to be abandoned. Adequate transport lines to product markets are major factors associated with the intensification of farming — even where population densities are comparatively low. Rural roads and improved tracks navigable for animal-drawn vehicles are crucial. Major efforts are also needed to promote the use of locally suitable and appropriate intermediate transport technology, especially animal-drawn implements, and of improved off-road transport.
Infrastructure development also has a major impact on the productivity of rural labour and on key determinants of fertility. Roads provide access to health facilities and schools. Better educated and healthier farmers are more productive and more likely to be innovators. Water supply and sanitation facilities have significant impact on health and labour productivity. Rural water supply, sanitation, health and education facilities and services are particularly important in terms of their impact on infant and child mortality and on female education — both critical determinants of fertility preferences.
With the major exceptions of the humid regions of Central and coastal West Africa, almost all of Sub-Saharan Africa will be facing water shortages or water scarcity early in the next century. There is an urgent need for effective hydrological planning and for prudent demand management. Water must be recognized as the critical and limiting resource it is. it must be carefully allocated, and must be protected against pollution. Planning for water use must be based on natural hydrological units such as river basins and integrated with planning for land use and other activities that affect, and are affected by, water development.
Since water resources are frequently shared among countries, it is important to cooperate closely in planning for long-term water sharing. Twenty-one of the world’s thirty poorest countries are in sub-Saharan Africa. Nearly half the region’s people live in absolute poverty – the equivalent of a dollar a day or less. Positive per capita growth in the past four years has not been enough to prevent an increase in the absolute number living in poverty in sub-Saharan Africa.
By end of 1998, nearly 23 million adults and children were estimated to be living with HIV/AIDS in sub-Saharan Africa – accounting for 2/3 of the world’s infected persons. More than 1. 8 million Africans will die from AIDS this year. New infection rates are staggering: in South Africa, 1,750 are infected by AIDS daily. Problems extend beyond the health sector. HIV/AIDS has raised the cost of doing business, killing professionals, schoolteachers and farmers, reducing incomes now and investments in the future. HIV/AIDS is overloading social welfare systems.
Sub-Saharan Africa accounts for 95% of the 13 million children worldwide who will be orphaned by AIDS by end of 2000. At current rates of population growth, sub-Saharan Africa will grow to over one billion people by 2020, despite declining birthrates and increasing number of deaths from AIDS. Contraceptive prevalence rates have been rising for the last three decades, yet remain under 10% in most of sub-Saharan Africa. The high rate of population growth intensifies existing social, political, economic, and environmental pressures.
Aids assists African countries to reduce these pressures through family planning programs emphasizing healthier, smaller families, and through support of girls education, a major determinant of family size. As a result of the above information you can see that rapid population growth in Sub-Saharan Africa at the present time is a moment of opportunity on the African continent. Africa is making new headway: democracy and economic reform are revitalizing the continent, and a number of countries are experiencing dynamic economic growth.
With greater political open-ness, African governments are increasingly seeking to address the health and education needs of their people. Despite these positive trends, sub-Saharan Africa faces a development challenge greater than any other region. Africa’s progress has not reached enough people, and too much of the continent is still plagued by political instability. Many African nations are struggling to meet the health and education needs of populations expanding at about three percent a year. In too many countries, rapid population growth continues to threaten the natural resource base and future prospects for prosperity.
The region’s ability to slow current high rates of population growth is thus key to achieving its full potential for development. The international community has good reason to care about African development. The continent is endowed with ample mineral and agricultural resources, including the greatest potential in the world for increases in farm productivity. Africa is also one of the last untapped markets for goods and services; industrialized countries thus stand to benefit by trading with a more prosperous Africa.
Beyond economic self-interest, there are strong humanitarian reasons to support efforts to alleviate poverty in Africa, home to 11 percent of the world’s population. In many respects, Africa in the late 1990s resembles the East Asian economies as they began their economic take-off three decades ago. African governments need to emphasize three key strategies in their efforts to improve individual well-being and slow population growth. The first priority should be to expand reproductive health and family planning services to meet existing unmet needs.
The second, to expand educational and economic opportunities, especially for women, both to improve the lives of individuals and to help encourage a desire for smaller families. The third, to slow the momentum of future population growth through education and reproductive health programs that help young people choose to delay childbearing. Carrying out the comprehensive agenda described above will require enormous effort by African governments. The task is large, yet attainable if these governments increase their current low levels of commitment to reproductive health and family planning programs.
Governments and donors should be prepared to invest years of sustained effort to build successful population programs. Over the long haul, there are bound to be setbacks and difficulties. Currently, there is no reason to expect that either the fertility or development transitions will occur more quickly and with less external aid in sub-Saharan Africa than they did in other places. Yet the needs are pressing, and Africa must accelerate the development of population programs and the current trend towards smaller families.
This may be possible if African countries are willing to learn as much as possible from the experiences of other regions, while at the same time recognizing the continent’s own special challenges, such as the HIV/AIDS crisis. Africa’s relatively recent establishment of population policies and programs has given it the chance to learn from both the mistakes and achievements of other regions which have grappled with the problem of rapid population growth. African countries, with help from the world community, have the potential to build on these experiences and create their own success story.

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