World Bank officials declared that of the 20 African countries which have provided detailed surveys of living conditions since 2005, 16 have reported falls in the number of deaths among children under five (for every 1,000 live births). And 12 of these countries saw annual reductions in their child mortality rates which exceeded 4.4% each year, the improvement needed to meet the Millennium Development Goal (MDG) of cutting child mortality by two-thirds between 1990 and 2015.
A recent Economist article on this encouraging development compared the falls being recorded in African child mortality to other parts of the world. In recent history, Vietnam is the only other country to record comparable declines in child mortality (1985-90 and 1990-1995) to the best-performing countries of Senegal, Rwanda and Kenya, which have all seen reductions in child mortality of over 8% each year since 2005.
Across the best-performing countries, circumstances varied. So for example, some countries were seeing a reduction in birth rates as a whole, which might explain the cut in child mortality. However, in countries such as Kenya and Uganda, any decline in fertility rates had stalled and therefore could not account for the lower number of child deaths.
The team at the World Bank studied Kenya to analyse what other factors lay behind the remarkable progress in child mortality reductions. Kenya has reduced its rate of infant mortality (deaths of children less than one year) more than any other country, which had a significant impact on its under-five mortality rate. In addition, World Bank officials noticed that the use of insecticide-treated nets (ITNs) to protect against malaria had risen dramatically. In 2003, just 8% of households used the nets, but by 2008 this had risen to 60%. Looking at the geographical spread of malaria, the World Bank team calculated that half the decline in Kenya’s infant mortality could be attributed to the use of ITNs.
This analysis will give heart to international organisations such as the Bill and Melinda Gates Foundation, which promotes the use of tools such as long-lasting ITNs until other advances against malaria (such as the new RTS.S vaccine) can be released and made more effective. The reductions in child mortality also justify the kind of “impatient optimism” advocated by the Gates Foundation. By achieving such astounding success in one area of development, African countries are proving that even seemingly huge challenges can be tackled more speedily and effectively than anyone might have imagined.