CHILDREN IN AFRICAKey statistics on child survival and population

Key Fact: Close to half of current population in Africa is under 18, and steady growth in births and declining mortality rates will bring Africa’s child population to 1 billion by 2055

• Africa’s child population will reach 1 billion by 2055, making it the largest child population among all continents.

• From 2017 onwards, sub-Saharan Africa is the region with the highest number of births, and this trend will persist for the rest of the century.

• Based on continuation of current coverage, more than 300 million of Africa’s 730 million projected births through 2030 will not be attended by skilled health personal.

• In Africa, mortality rates among children under age 5 decreased by 58 per cent between 1990 and 2017, still, over half of the world’s 5.4 million under-five deaths in 2017 occurred in Africa.

• While mortality rates have declined among all age groups in Africa, child deaths tend to be concentrated at the youngest age groups with 85 per cent of all deaths to children under age 15 occurring among children younger than 5.

• In 2016, pneumonia, malaria and diarrhoea accounted for 36 per cent of all under-five deaths in Africa.

• On current trends, 31 million under-five deaths will occur in Africa between 2018 and 2030—if all countries at risk of missing the SDG target on under-five mortality achieved the target, 8 million lives could be saved on the continent.

• Changing demographics and a growing population in Africa will require an additional 4.2 million health workers above current growth to meet WHO minimum standards and an increase of 1.3 million primary school teachers to meet the best sub-regional performers’ pupil-teacher ratio by 2030.

Africa’s child population will be the largest among all continents in the latter half of this century, topping 1 billion by 2055

Fig 1. Total population and children under age 18 in Africa, 1950-2100 (in millions) Fig 2. Total number of births by region, 1950-2100 (in millions)

Since 1950, births in Africa have increased almost fourfold, and Africa is projected to have the largest number of births among all continents after 2050

Key Statistics

100

80

60

40

20

01950 1975 2000 2025 2050 2075 2100

Asia

Rest of the world

Africa

Source: United Nations, Department of Economic and Social Affairs, Population Division, World Population Prospects: The 2017 Revision, United Nations, New York, 2017.

1

250

110

Total populationChildren

4470

3390

2530

17001290

480820

230110 250 400 600 750 960 1100 1160

1950 1980 2000 2018 2030 2050 2070 2100

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EF/

UN

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CHILDREN IN AFRICA

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Key Fact: The under-five mortality rate for Africa declined by 58 per cent from 1990 to 2017, while mortality among older children and young adolescents (aged 5-14) in Africa declined by 54 per cent over the same period

Northern Africa109,000

Western Africa1,226,000

Eastern Africa718,000

Central Africa508,000

Southern Africa333,000

0 25

Deaths per 1,000 live births

50 75 100 128

Countries with the highest child mortality rates are concentrated in sub-Saharan Africa Child mortality declined in all African Union sub-regions between 1990 and 2017 with the largest percentage declines occurring in Northern Africa for under-five mortality and in Eastern Africa for mortality among children aged 5-14Map 1. Under-five mortality rate (deaths per 1,000 live births) by country and number of

under-five deaths by African Union sub-region, 2017

Fig 3a. Under-five mortality rate by African Union sub-region, 1990 and 2017

Fig 3b. Probability of dying at age 5–14 by African Union sub-region, 1990 and 2017

75

168

154

175

207

165

93

24

58

61

90

91

70

39

0 50 100 150

Deaths per 1,000 live births

200 250

Northern Africa

Eastern Africa

Southern Africa

Central Africa

Western Africa

Africa

World19902017

Northern Africa

Eastern Africa

Southern Africa

Western Africa

Central Africa

Africa

World

10

46

28

41

42

35

15

4

13

13

21

26

16

7

0 20 40 60 Deaths per 1,000 children aged 5

19902017

Source for all figures on this page: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) 2018.

Key statistics on child survival and population

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Key Fact: The youngest age groups face the highest burden of child deaths: roughly 85 per cent of all deaths under age 15 occurred to children under age 5 and about 38 per cent of all deaths to children under age 5 occurred in the first month of life

An increasing share of under-five deaths are concentrated among newborns The risk of dying is highest in the first month of life

As mortality levels decline with age, injuries become a more prominent cause of death among older children and adolescents

Infectious diseases and neonatal complications are among the leading causes of death among children under age 5

Fig 4. Distribution of all under-15 deaths, Africa, 1990-2017

Fig 6. Distribution of causes of all under-five deaths, Africa, 2016 Fig 7. Distribution of deaths among children and adolescents, by age group and cause, 2016

Fig 5. Age-specific mortality rates (deaths per 1,000), Africa, 2017

Source for figures 4 and 5: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) 2018.

Source: World Health Organization and Maternal and Child Epidemiology Estimation Group (MCEE), Child causes of death, by Country and by Region, 2000-2016, WHO, Geneva, 2018.

Source: World Health Organization, Global Health Estimates 2016: Deaths by cause, age, sex, by country and by region, 2000-2016, WHO, Geneva, 2018.

0%

20%

40%

60%

80%

100%

1990 1995 2000 2005 2010 2015 2017

Neonatal (first 28 days)

Post-neonatal (1–11 months)

Child (ages 1–4)

Older children (ages 5–9)

Young adolescents (ages 10–14)

24%

32%Post-neonatal (1–11 months)

Neonatal (first 28 days)

Child (ages 1–4)

Older children (ages 5–9)

Young adolescents (ages 10–14)

26

23

23

10

6

Pneumonia, 3%

Intrapartum-related events, 11%

Sepsis or meningitis, 6%

Other, 2%Injury, 0.4%

Congenital, 3%Tetanus, 0.5%Diarrhoea, 0.2%

Diarrhoea, 9%

Measles, 1%

Injury, 6%

Malaria, 10%

AIDS, 2%

Meningitis, 2%

Preterm birth complications, 2%

Intrapartum-related events, 1%

Congenital, 3%

Other, 13%

Pneumonia, 14%

Preterm birth complications, 11%

Deaths among children aged 1-59 months

Neonatal deaths

0-4

5-9

10 -14

15 -19

Communicable, maternal, perinatal and nutritional conditions

Noncommunicable diseases

Unintentional injuries

Intentional injuries

84%

67%

56%

49%

10%

13%

21%

24%

6%

20%

19%

19% 9%

4%

1%

0.3%

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CHILDREN IN AFRICA

Key Fact: Africa will need to add millions more health workers and primary school teachers by 2030 to meet the demands of shifting demographics

Africa will need an additional 4.2 million health workers above its current rate of growth to meet the WHO minimum standards for frontline skilled health personnel by 2030

More than 11 million primary school teachers will be needed in 2030 to meet the best sub-regional performers’ pupil-teacher ratio

Based on the continuation of current coverage, more than 300 million of Africa’s 730 million projected births through 2030 will not be attended by skilled health personnel

Fig 8. Number of health service providers (doctors, nurses, midwives) for each scenario for Africa total (in millions) and by African Union sub-region (in thousands)

Fig 9. Primary school teachers for each scenario for Africa total (in millions) and by African Union sub-region (in thousands)

Fig 10. Cumulative births from 2015-2030 by skilled birth attendants for Africa total (in millions) and by African Union sub-region (in thousands)

Note: For countries who already have a density of 4.45 the current value is maintained. Data from 2000 to 2015 was used for estimation. No health workforce data were available for South Sudan, hence the sub-region’s average density was assumed.

Source: UNICEF analysis based on the World Health Organization, The 2017 update, The Global Health Workforce Statistics, WHO, Geneva, 2017 and United Nations, Department of Economic and Social Affairs, Population Division, Word Population Prospects: The 2017 Revision, United Nations, New York, 2017.

Note: For missing values of pupil/teacher ratios in Libya, Sudan and Somalia the sub-regional average was used. Best sub-regional performers’ pupil/teacher ratio: Central Africa: 23; Eastern Africa: 19; Northern Africa: 17; Southern Africa: 23; Western Africa: 22.

Source: UNICEF analysis based UNESCO Institute for Statistics global databases, 2016, based on administrative data for the most recent year available during 2009-2016, and United Nations, Department of Economic and Social Affairs, Population Division, Word Population Prospects: The 2017 Revision, United Nations, New York, 2017.

Note: Most recent skilled birth attendance country values available for the period 2010-2016.

Source: UNICEF analysis based on UNICEF global databases, 2016, based on DHS, MICS, and other nationally representative surveys and United Nations, Department of Economic and Social Affairs, Population Division, Word Population Prospects: The 2017 Revision, United Nations, New York, 2017.

Key statistics on child survival and population

2

3.4

7.6

0 1 2 3 4 5 6 7 8

Africa

Number of health workers (in millions)

170

390

480

440

550

370

840

610

620

1000

930

2270

1070

1070

2280

0 500 1000 1500 2000 2500Number of health workers (in thousands)

Health worker need in 2030

Projected number of health workers in 2030

Number of health workers in 2015

Central Africa

Eastern Africa

Northern Africa

Southern Africa

Western Africa

5.4

6.7

11.2

0 2 4 6 8 10 12Number of primary school teachers (in millions)

700

1400

900

800

1600

900

1700

1100

900

2100

1500

3700

1600

1600

2900

0 500 1000 1500 2000 2500 3000 3500 4000Number of primary school teachers (in thousands)

Teacher need in 2030

Projected number of teachers in 2030

Number of teachers in 2015

Africa

Central Africa

Eastern Africa

Northern Africa

Southern Africa

Western Africa

420 310

0 100 200 300 400 500 600 700 800

Africa

Births (in millions)

72

110

72

68

110

30

110

8

29

130

0 50 100 150 200 250

Central Africa

Eastern Africa

Northern Africa

Southern Africa

Western Africa

Births (in thousands)

Births with skilled birth attendant

Births without skilled birth attendant