Africa’s Great Success Story: Child Mortality Declines at Record Pace Irrespective of Birthrates

By Lucia Muchova | May 30, 2012

In the past two decades, the African continent has seen some of the most impressive falls in child mortality rates, defined as the number of deaths of children under 5 per 1,000 live births. At the rate of more than 4.4% average decline a year, 12 countries are in good shape to meet the millennium development goal (MDG) of reducing child mortality rate by two thirds, according to The Economist.

The most remarkable declines were observed in Senegal, Rwanda and Kenya, each seeing child mortality drop by more than 8% a year. World Bank expert Gabriel Demombynes refers to “a tremendous success story that has only barely been recognized,” with the top rates showing the fastest decline in child mortality in the world for the past 30 years.

Two things are worth noting about this encouraging African phenomenon: (1) there is no single obvious cause and (2) child mortality has been falling across the board regardless of birthrates. This will seem counter-intuitive to those who believe that the road to development must inevitably lead through reducing population growth. The Economist writes:

The striking thing about the falls is how widespread they have been. They have happened in countries large and small, Muslim and Christian, and in every corner of the continent. The three biggest successes are in east, west and central Africa.

You might expect that countries which reduced their birth rates the most would also have cut child mortality comparably. This is because such countries have moved furthest along the demographic transition from poor, high-fertility status to richer, low-fertility status. But it turns out that is only partly true. Senegal, Ethiopia and Ghana all reduced fertility and child mortality a lot. But Kenya and Uganda also did well on child deaths, though their fertility declines have stalled recently. So it cannot all be just about lower birth rates. Liberia, where fertility remains high, did badly on child mortality—but so did low-fertility places such as Namibia and Lesotho. The link between mortality and broader demographic change seems weak.

Instead, a combination of economic growth, better governance and improvements in public health, particularly provision of mosquito nets to prevent malaria, seem to have a more significant impact. Mass immunizations for children and fewer conflicts probably played a role, too.

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