In the spotlight: The improvement of the child mortality rate in Africa

on .

Written by Dario Ruggiero (June 2012)

Thomas Robert Malthus, an English Mathematician, in his book “An essay of the principle of the population as it affects the future improvement of society”, argued thatthe growth of food would not be able to sustain the increasing population, with the final consequences of a shortage of food and a stop in the economic development. The Malthusianism is a current that supports the control of births in order to avoid the impoverishment of the humankind. Actually, in our opinion, it is not the number of people the real problem, but the impact each person has on the ecosystem where he lives (as we well argue in the conclusions of this paper).
In the 19-25 May edition of the Economist two interesting articles were published: the first one focuses on the significant decrease in infant mortality rate in Africa (The best story in development Africa is experiencing some of the biggest falls in child mortality ever seen, anywhere, May 19th 2012 ); the second one describes the changes in the demographic science (A new science of population. The digressions of people power, May 19th 2012).

As follow, there is a synthesis of these two articles with the purpose to catch positive and negative elements with regards to the population growth debate.

The best story in development Africa is experiencing some of the biggest falls in child mortality ever seen, anywhere

The survival of every being species is strongly related to its capacity to reproduce and to the likelihood its children don’t die before reaching the maturity age. So a low infant mortality rate (the number of children, with an age lower than 5, died per thousand of births) is a fundamental element for a specific species in order to survive over the time. This article is based on the World Bank’ surveys on life conditions in 20 African countries since 2005; according to these surveys, 16 countries among the 20 analyzed reported a reduction in the infant mortality rate; moreover, Twelve had falls of over 4.4% a year, which is the rate of decline that is needed to meet the millennium development goal (MDG) of cutting by two-thirds the child-mortality rate between 1990 and 2015. Three countries—Senegal, Rwanda and Kenya—have seen falls of more than 8% a year, almost twice the MDG rate and enough to halve child mortality in about a decade. The decline in African child mortality is speeding up. In most countries it is now falling about twice as fast as during the early 2000s and 1990s. The only recent fall comparable to the largest of those in Africa occurred in Vietnam between 1985-90 and 1990-95, when child mortality fell by 37%—and even that was slower than in Senegal and Rwanda. Rwanda’s child-mortality rate more than halved between 2005-06 and 2010-11. Senegal cut its rate from 121 to 72 in five years (2005-10). The striking thing about the falls is how widespread they have been. They have happened in countries large and small localized in every corner of the continent.

Graph – Under-five mortality rate per 1,000 live births
(Annual % change)

Source: LTEconomy elaboration on World Bank data

But what has really caused this improvement in African countries to ensure children more likelihood to survive? the demographic transition from poor, high-fertility status to richer, low-fertility status is not the key factor, as countries like Kenya and Uganda did well on child deaths, though their fertility declines have stalled recently; On the other hand, countries like Namibia and Lesotho – characterized by a low fertility rate - did badly on child mortality. What makes a bigger difference, Mr Demombynes – researcher at The World Bank - argues, is some combination of broad economic growth and specific public-health policies, notably the increase in the use of insecticide-treated bednets (ITNs) which discourage mosquitoes, which cause malaria.

But growth offers no guarantees. High-mortality Liberia actually saw impressive GDP increases whereas Senegal, whose record in child mortality is second to none, had a rather anemic growth rate by recent African standards (3.8% a year, half that of Rwanda). To look for other explanations, therefore, Mr Demombynes studied Kenya in more detail Kenya is a test case.

It has cut the rate of infant mortality (deaths of children under one year old) by more than any other country. It has had healthy economic growth (4.8% a year in 2005-10) and a functioning democracy, albeit after horrendous post-election violence in 2008. But Mr Demombynes noticed something else: it increased the use of treated bednets from 8% of all households in 2003 to 60% in 2008.

In conclusion, aid does not seem to have been the decisive factor in cutting child mortality. No single thing was. But a mixture of factors is what African countries need; better policies, better government, new technology and other benefits are starting to bear fruit.

A new science of population. The digressions of people power

The main concern of demographers in their heyday (the 1970s and 1980s) was high fertility and the total number of the world’s people. This was the period of “The Population Bomb”, a bestseller by a biologist, Paul Ehrlich, which argued that the world could not feed itself. An international family-planning movement sprang up. Top-down programmes attempted to control the total size of national populations. China’s one-child policy is the best known and most extreme of these.

Now though, as John May, formerly of the World Bank and now Georgetown University, shows in “World Population Policies”, the focus of demographers has switched from the overall size of populations to their composition—that is, to age groups and their relation to one another Globally, the population seems is going to become stable, thanks to the fact that the average fertility rate (the number of children a woman can expect during her lifetime) has roughly halved in the past half century, from five in the mid-1950s to 2.5. At the same time demography has become more diverse. Some countries retain extremely high fertility rates (over seven in Niger, more than in 1950); other places have seen fertility fall to ultra-low levels (less than one in Taiwan and Shanghai)

The biggest question raised by the new research is whether the world is converging demographically or diverging towards disparate futures. The UN, whose population division is the source of much basic demographic material, thinks the world is converging towards the “replacement rate” of fertility; this is 2.1, the magic number that stabilizes populations over the long term. But as Mr May shows, much of the new demography stresses the variety of countries’ experience and finds that huge changes are taking place between different age groups even when the overall size of a country is stable.

Commissione Europea, (2011), Una tabella di marcia verso un'economia competitiva a basse emissioni di carbonio nel 2050 - comunicazione della commissione al parlamento europeo, al consiglio, al comitato economico e sociale europeo e al comitato delle regioni

Gabriel Demombynes, Ritva Reinikka, (May 2012),Africa's success story: Infant mortality down”, The World Bank -

Gurría Angel, (7 Febbraio 2012), “Green Growth: Making it Happen”, Article published in Europe's World

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The Economist, (May 19th 2012), “The best story in development Africa is experiencing some of the biggest falls in child mortality ever seen, anywhere” -

Economist, (May 19th 2012), “A new science of population. The digressions of people power” -

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This article by Dario Ruggiero
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