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• In Africa, mortality rates among children under five decreased by 45 per cent between 1990 and 2012, but still half of the world's 6.6 million under-five deaths occur in Africa. • Pneumonia, malaria and diarrhoea account for 40% of all under-five deaths in Africa. • At least 1 in 3 children under five in Africa were stunted in 2011. • In 2012, there were an estimated 2.9 million children under 15 years living with HIV in Sub-Saharan Africa.

• Over half of the world’s out-ofschool children (33 million) live in Africa. • The population in Africa with access to an improved drinking source more than doubled from 1990 to 2012. • There has been major progress in the last decade in the use of insecticidetreated nets among children.

Every Child Counts

The child population in Africa is burgeoning; by 2050, 1 in every 3 children under 18 will be African Number of births by UNICEF regions, 1950 - 2050 50

Sub-Saharan Africa

40 Population (in millions)

Key statistics on child survival, protection and development

Children in Africa

UNICEF/NYHQ2012-1060/Noorani

Key Statistics

South Asia

30 East Asia and Pacific

By 2050, 1 in every 3 births and almost 1 in every 3 children under 18 will be African

20

Between 2010 and 2025, the child population of sub-Saharan Africa will rise by 130 million.

10

0 1950

1970

1990

CEE/CIS Industrialized countries Middle East and North Africa Sub-Saharan Africa

2010

2030

2050

East Asia and Pacific Latin America and Caribbean South Asia

Source: You, D., and D. Anthony. “Generation 2025: The critical importance of understanding demographic trends for the children of the 21st century”. UNICEF Occasional Paper, no. 1, September 2012.

Prepared by: UNICEF Data & Analytics Division of Policy and Strategy February 2014

From around 2030, sub-Saharan Africa will be the single region with the greatest number of children under 18.

Find the latest statistics on children in Africa at the UNICEF-Statistics website: www.childinfo.org

Note: Maps in this brochure are stylized and not to scale. They do not reflect a position by UNICEF on the legal status of any country or territory or the deliminatation of any frontiers. The final boundary between the Republic of the Sudan and the Republic of South Sudan has not yet been determined.


Child Malnutrition in Africa Stunting in Africa: falling far behind other regions

Key facts:

Millions of under-fives stunted, by region, 1990-2012 and Percentage of under-fives stunted, by region, 1990-2012 (%)

Stunting, or being too short for one’s age, is linked with irreversible long term consequences; it diminishes chances of succeeding in school and of living healthy and productive lives.

800

50

48%

700

42%

600

40%

40

Africa is the only region with nearly negligible changes in the percentage (%) of stunted children since 1990.

35%

500

Millions of stunted under-fives (bar)

While other regions have halved the number of stunted children, Africa has increased by one third (due both to population growth and minimal progress in reduction of the percentage of stunted children). There are stark disparities between the richest and poorest in most AU sub-regions.

30

25%

25%

400

25% 20

300

14

LAC

13%

192 Asia

7 91

46 Africa

59

Proportion of stunted under-fives (line)

200 100 0

1990

1995

2000

2005

2010

10

0

2012

Stunting disparities are greatest in Western Africa Percentage of under-fives stunted (moderate and severe), by wealth quintile, 2007-2012 (%)

Exclusive breastfeeding

● poorest quintile ● richest quintile --- gap

60

14.3 million

Non-exclusively breastfed infants could be at a substantially greater risk of death from diarrhoea than exclusively breastfed infants. 24.3

24.3 million newborns in the African Union were not exclusively breastfed in 2012

newborns in the African Union were exclusively breastfed in 2012

48

50

48

48 45

40

30 30

Rapid progress in exclusive breastfeeding is possible and needs to be prioritized

28

25

20

27

26

17 10 0 Western Africa

0.5

Central Africa

Southern Africa

Eastern Africa

Northern Africa

5.5

Recent advances in 7 African countries show that rapid progress in exclusive breastfeeding is possible Trends in the percentage of infants 0-5 months old that are exclusively breastfed, in well-performing countries, 2005-2012 (%)

Well-performing countries Significant (> 15 percentage point) increases in the last 5 years

100

Additional well-performing countries Current high (>50 per cent) achievement 88

90 80

71

69

70

62

60 62

60 50 38

38

40 27

16

20

10 4

8

45

49

57

52

41

28

25

23

50

35

32

30

10

48

46

85

19

16

11

11

0 Niger ('08, '09, '10, '12)

Sierra Leone ('05, '08, '10)

Burkina Faso Guinea Bissau ('09, '11, '12) ('06, '11)

Mauritania ('07, '08, '09, '10)

Togo ('06, '08, '11)

Burundi ('05, '10)

United Republic of Tanzania ('05, '10)

Ethiopia ('05, '11)

Source for all charts: UNICEF global databases 2014, based on DHS, MICS, and other national surveys; UNICEF, World Bank, WHO Joint Malnutrition Estimates, 2013.

Uganda ('06, '11)

Malawi ('06, '10)

Rwanda ('05, '10)


HIV/AIDS and Malaria in Africa An estimated 2.9 million children under 15 years were living with HIV in Sub-Saharan Africa as of 2012; about 10 per cent of which were newly infected, mainly through mother-to-child transmission of HIV Coverage of Prevention of Mother To Child Transmission (PMTCT) and pediatric Anti-Retroviral Therapy (ART) coverage, by region, 2012 (%)

Key facts: • Although progress has been made in Africa to increase the prevention of mother to child transmission (PMTCT) of HIV and increasing pediatric anti-retroviral therapy (ART) coverage, much more progress is needed.

100

Western Africa Central Africa Northern Africa

80

81

Eastern Africa Southern Africa AFRICA

60

63

40

• In 2012, around 230,000 children were newly infected with HIV in Sub-Saharan Africa.

63

46

43 35

32

30

30 20

16

15

18

0 Coverage of the most effective ARVs for PMTCT

Pediatric ART coverage

Source: UNAIDS, UNICEF, WHO, 2013 Global AIDS Response Progress Reporting, and UNAIDS, Report on the Global AIDS Epidemic, 2013

• Across Africa, about 3% of all under-five deaths are caused by HIV/AIDS, and in Southern Africa, an estimated 11% of under-five deaths are attributed to HIV/AIDS. • Although some progress has been made, ARV coverage for PMTCT varied from 30% in Western Africa to 81% in Southern Africa in 2012.

Major progress during the last decade in the use of Insecticide Treated Nets (ITNs) among children •

During the last decade, the proportion of children sleeping under ITNs in sub-Saharan Africa increased from less than 5 per cent to over a third.

In Madagascar and the United Republic of Tanzania, coverage increased from less than 3 per cent to over 70 per cent.

Mass campaigns for distribution of ITNs are used to ensure that everyone is reached.

Children under-five sleeping under ITNs in Africa, early 2000s and around 2012

Around 2012 Early 2000s

Malaria case management in endemic countries •

The use of Rapid Diagnostic Tests (RDT) to confirm malaria infection before starting treatment is still low.

In most endemic countries, less than 50 per cent of febrile children under-five who receive anti-malarials are treated with artemisinin-based combination therapy (ACT), the recommended first line antimalarial drug.

Less than 10% 10-24% 25-50% 51-80% Not malaria endemic Data not available

Source: UNICEF global databases 2014, based on DHS, MICS, and other national surveys


Child marriage, birth registration and Female Genital Mutilation/Cutting (FGM/C) Nearly four in ten young women in Africa were married or in union before age 18

Countries with high levels of child marriage tend to have high levels of early childbearing

Percentage of women aged 20-24 years who were first married or in union before ages 15 and 18, by region, 2005-2012 (%)

Percentage of women aged 20-24 who were first married or in union by age 18, and who gave birth by age 18, in African countries with available data, 2005-2012 (%)

9

Southern Africa

31 16

Western Africa

Northern Africa

24

10

Eastern Africa

2

60

29 Women who gave birth by age 18

12

Central Africa

27

10

40

20

Each dot represents one country

World (excluding China)

11

23

0

0 10 20 30 40 50 Married or in union by age 15 Married or in union between ages 15 and 18

FGM/C is concentrated in a swath of countries from the Atlantic Coast to the Horn of Africa Percentage of girls and women aged 15-49 years who have undergone FGM/C, by regions within countries

0

20

40

60

Women first married or in union by age 18

• More than 125 million girls and women alive today have undergone some form of FGM/C in 29 countries across Africa and the Middle East. • Another 30 million girls are at risk of being cut in the next decade. • In most countries where FGM/C is practiced, the majority of women and men think it should end.

Levels of birth registration vary widely across Africa, from a low of 3 per cent in Somalia to a high of 99 per cent in Algeria, Tunisia and Egypt Percentage of children under age five whose births are registered; by region, and highest and lowest countries, 2005-2012 (%) 100

92

91

91

95

Percentage of children under age five whose births are registered, 2005-2012 (%)

99

80 59 60

40 16

20

14 4

3 0 Eastern Africa

Central Africa

Western Africa

Southern Africa

Regional average Country with the lowest birth registration level Country with the highest birth registration level

Northern Africa

Less than 25% 25-50% 51-75% 76-90% Above 90% Data not available

Source for all charts: UNICEF global databases 2014, based on DHS, MICS, other national surveys, censuses and vital registration systems

80


Education in Africa Key facts: • Over half of the world’s out-of-school children (33 million) live in Africa. • Girls are more likely to be out of school than boys. • Children with disabilities are over-represented in the out-of-school population. • Progress in reducing the out-of-school children population has slowed down since 2005. • Many children fail to complete a full primary education and fail to master basic literacy and numeracy skills.

In Africa, boys are more likely to be enrolled in primary school than girls Gender parity index of primary enrolment, girls as a percentage of boys, African countries, 2008-2012 1.2

Girls more likely to be enrolled 1.1

Parity

1.0 0.9 0.8

Boys more likely to be enrolled 0.7 Each marker represents the GPI of one country 0.6

Progress in primary enrolment has stagnated in recent years 100

100

90

90

80

80

70

70

60 50

60

46

44

43

41

50

39

40

37

35

33

32

33

34

40

33

30

30

20

20

10

10

0

0 2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

Out-of-school boys of primary school age

Out-of-school children primaryschool schoolage age, Total Out-of-school girls ofofprimary

Adjusted primary net enrolment rate for boys

Adjusted primary net enrolment rate total

Only twelve African countries are near achieving universal primary education Net enrolment/attendance rate, 2007-2012

2011

2012

2013

2014

Out-of-school population of primary school age (millions)

Adjusted net enrolment rate (%)

Primary school adjusted net enrolment rate (%) and out-of-school population of primary school age (millions) in Africa by sex, 2000-2011

2015

Adjusted primary net enrolment rate for girls

Even if they progress through the grades, many primary school children do not acquire basic knowledge and skills Percent of cohort who reach grade 4 and achieve a minimal education level 100

SACMEQ, 2007

PASEC, 2004 - 2008

80 60 40 20 0

Net enrolment/ attendance rate <70% 70 – 84% 85 – 94% 95 – 100% Data not available Sources for above charts and map: UNICEF global databases, 2014 and UNESCO Institute for Statistics databases, 2013

Did not reach grade 4 Reached grade 4 Reached grade 4 and achieved minimum level of learning Note: The definition of minimum learning levels differs between the two surveys, the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) and the Programme of Analysis of Education Systems of the CONFEMEN (PASEC) and thus the results are not comparable. Source: EFA Global Monitoring Report 2012


Child Mortality in Africa All regions in Africa have experienced marked declines in under-five mortality since 1990 In Africa, mortality rates among children under five (U5MR) have decreased by 45 per cent from 162 deaths per 1,000 live births in 1990 to 90 in 2012, but still half of the world's 6.6 million under-five deaths occur in Africa. Under-five mortality rate, 1990-2012

Under-five mortality rate by country (deaths per 1,000 live births) and number of under five deaths by sub-region, 2012

Northern Africa

74

24

70

Southern Africa

Western Africa 1,386,000

2012 148

90

206

Western Africa

Eastern Africa 790,000

1990

167

Eastern Africa

Northern Africa 98,000

113

Central Africa

165 131

Central Africa 631,000 Africa

Under-five mortality rate

World

Southern Africa 427,000

162

90

48 0

50

90

100

150

200

250

Under-five deaths per 1,000 live births

Pneumonia, malaria and diarrhoea account for 40% of all under-five deaths in Africa Distribution of under-five deaths in Africa by cause, 2012 Pneumonia (neonatal) 3% Pneumonia (postneonatal) 14%

Preterm birth complications 12%

Pneumonia 17% Neonatal 34% All Other 22%

Other 19%

Birth asphyxia 9%

Sepsis/meningitis/ tetanus 6%

Diarrhoea 10%

Despite declining rates, neonatal deaths are growing as a share of under-five deaths, amid faster progress in reducing mortality in the post-neonatal period Age distribution of under-five deaths, Africa, 1990-2012 100%

Child deaths (ages 1 to 4)

80%

60%

Post-neonatal deaths (1-11 months)

Congenital abnormalities 2% 40% Other neonatal 1%

Measles 1%

Malaria 13%

Meningitis 2% Injury 4% AIDS 3%

Malaria 13%

Diarrhoea (neonatal) 1%

20%

Neonatal deaths (first month)

Diarrhoea (postneonatal) 10%

Globally, almost half of all under-five deaths are attributable to malnutrition Source: UNICEF analysis based on IGME 2013 and WHO & CHERG 2013

34%

27%

0%

1990

1995

2000

2005

2010


Drinking Water and Sanitation in Africa The population with access to an improved drinking water source in Africa more than doubled, from 351 million in 1990 to 746 million in 2012 Improved drinking water coverage in Africa, 2012 (%) Western Africa

Southern Africa

Eastern Africa

Central 3 Africa 3

Key facts:

North Africa

Gambia Sierra Leone Cape Verde

90 Botswana

97

Mauritius

100 Sao Tomé & Pr.

97

Egypt

99

89 South Africa

95

Seychelles

96 Gabon

92

Tunisia

97

Ghana

87 Namibia

92

Djibouti

92 Congo

75

Algeria

84 84

Burkina Faso

82

Malawi

85

Uganda

75

Burundi

75

Morocco

Côte d’Ivoire

80

Lesotho

81

Rwanda

71

Cameroon

74

Mauritania 50

Benin

76

Zimbabwe

80

Kenya

Senegal

75

Swaziland

Liberia

74

Zambia

Guinea

74

Angola

74 63 54

Guinea-Bissau 74

Mozambique49

Mali

67

Comoros ND

Nigeria

64

Eritrea ND

Sierra Leone 60

Somalia ND

Togo

South Sudan ND

Niger

60

62

Sudan

Chad

55

• This rate of progress is not sufficient to meet the continent’s MDG drinking water target of 78% by 2015.

Libya ND

68

CAR

• Drinking water coverage in Africa increased from 56% in 1990 to 69% in 2012.

• Just over a quarter (27%) of the African population enjoys the convenience and associated health benefits of a piped drinking water supply on premises.

51

Tanzania 53

DR Congo46

Ethiopia 52

Equatorial Guinea ND

Madagascar 50

• The population without access to an improved drinking water source increased from 279 million in 1990 to 389 million in 2010, and then decreased to 338 million in 2012.

52

ND= No data

In Africa only 39% of the population uses an improved sanitation facility; the population without access grew by 239 million despite 214 million people gaining access since 1990 Open defecation rates in Eastern Africa declined most from 45% in 1990 to 27% in 2012. Western and Central Africa made the least progress on sanitation. In Southern Africa 18% of the population still practices open defecation. Malawi, Angola, Ethiopia and Benin registered declines in open defecation rates of 25 percentage points or more since 1990. Sierra Leone, Sudan and Tanzania registered an increase in open defecation rates (see below).

• • •

Sanitation coverage trends in Africa, sub-regions and urban and rural areas, 1990-2012

(Coverage %)

100

90

80

71 19 21

60

25 34

40 40

23

32

20

46

Eastern Africa

Central Africa

Southern Africa

38

28 18

15

21

Africa

29 16

24

14

78

229

63

2012

53 44Rural

9 14

12

9

112 15

13 9

Northern Africa

13

Urban

(millions)

24

40

39

34

6

1990

37

32

11 (millions)

54

23

32 49 38

5

2012

57

12

0 Western Africa

66

2012

15

1990 80

Percentage (%)

24 34

25

26 24

Open defecation rates, selected countries, 1990-2012 92

28

1990

25 186

27

26

31

33

35

40 205

196

99 1990

Source for all charts: WHO/UNICEF JMP, 2014 Update (forthcoming – April 2014)

2012 Improved facilities

Shared facilities

Unimproved facilities

Open defecation


Maternal Health in Africa Africa has the highest number of maternal deaths, despite steady declines since 1990 • • •

Globally, the maternal mortality ratio (MMR) declined from 400 maternal deaths per 100,000 live births in 1990 to 210 in 2010 In sub-Saharan Africa the MMR was 500 per 100,000 live births in 2010, a 41% decline from 850 in 1990. Sub-Saharan Africa accounted for 56 per cent of all maternal deaths in the world in 2010, largely due to limited access to emergency obstetric care and insufficient maternal care during pregnancy and delivery.

Antenatal care during pregnancy with skilled health personnel is essential to ensure both mother and baby’s well-being

Improvement in maternal health outcomes requires key interventions:

Antenatal care: Women aged 15-49 attended at least once during pregnancy by skilled health personnel (doctor, nurse or midwife), 1990-2012 (%) Around 1990

• A minimum of four visits for antenatal care in order to ensure the well-being of the mother and the baby.

Around 2000

Western Africa

Around 2012 Northern Africa

Eastern Africa

• Assistance from skilled health personnel at delivery. • Improved access to emergency obstetric care

Southern Africa

• Expanded access to information, counseling and supplies for a wide range of contraceptive methods.

Africa

World 0

20

40

60

80

100

• Antiretroviral therapy to all pregnant women who need it.

Note: Data coverage was insufficient to calculate regional estimates for Central Africa.

Skilled delivery care coverage is higher in urban than in rural areas

Nearly half of babies in Africa are born without assistance support from skilled health personnel

Skilled attendance at birth: Births attended by skilled health personnel (doctor, nurse or midwife), African regions by area of residence, 2008-2012 (%)

Skilled attendance at birth: Births attended by skilled health personnel (doctor, nurse or midwife), 2006-2012 (%)

100 89

91 87 80

80 80 67 68

60 61

54 40 42

41

20

29

0 Eastern Africa

Western Africa

Central Africa

Northern Africa

Africa

World

Note: Data coverage was insufficient to calculate regional estimates for Southern Africa.

Source for all charts: UNICEF global databases 2014, based on DHS, MICS, and other national surveys

Skilled attendance at birth >80% 60 – 79% 40 – 59% <40% Data not available


Africa brochure 2013 final