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Cervical Cancer Undermines Gender Equality in Africa

Patricio V. Marquez's picture

This blog post is co-authored with: Sheila Dutta

The 2012 World Development Report (WDR) “Gender Equality and Development” found that, while many disadvantages faced by women and girls have shrunk thanks to development, major gaps remain.

A significant gap is the excess female mortality in many low- and middle income countries, especially in childhood and during reproductive years. Cervical cancer —a preventable condition that usually results from a viral infection by the human papillomavirus (HPV) that is generally sexually transmitted— is one of the leading causes of premature death and ill health among women in sub-Saharan Africa.  As the figure shows, the Eastern, Western and Southern African regions have the highest incidence rates of cervical cancer in the world.  Rates exceed 50 per 100,000 populations and age-standardized mortality exceeds 40 per 100,000 populations. 

Can Tanzania afford 100 million citizens in 2035?

Kristoffer Welsien's picture

Let's think together: Every week the World Bank team in Tanzania wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a couple of questions. This post is also published in the Tanzanian newspaper The Citizen every Sunday.

Tanzania has experienced an exceptionally high population growth – from 11 million in 1963 to over 45 million in 2012. Among the factors that have contributed to this increase –one of the fastest in the world– is the falling mortality rate. Life expectancy in Tanzania has increased over the past two decades from 50 to 58 years. 

In addition, Tanzanian women have continued to have many children (5.4 per woman in 2010), which is higher than Kenya and Rwanda (4.6) as well as other sub-Saharan countries with the exception of Uganda.
Since 1991, this rate has only declined by 13 percent in Tanzania against 26 and 31 percent in Rwanda and Kenya, respectively.  Several other factors have also contributed to the high population growth rate that Tanzania is experiencing:

Is this a woman's world? Gender equality in Tanzania

Waly Wane's picture

Let's think together:Every week the World Bank team in Tanzania wants to stimulate an evidence-based debate by sharing data from recent official surveys and ask you a few questions. These posts are also published in the Tanzanian newspaper The Citizen every Sunday.

Tanzanian families have been doing things differently of late. More of them have been sending their daughters to primary school and more women have become heads of families with increasing financial responsibilities. Increasingly too, more women are involved in the political arena today.  These trends can also be found in most countries in the world but they are especially visible in Tanzania as reflected by the following statistics.

Country policy and institutional assessment: How well are African countries doing?

Punam Chuhan-Pole's picture

Every year, the World Bank’s country teams and sector experts assess the quality of IDA countries’ policy and institutional framework across 16 dimensions to measure their strenght and track progess.  

The latest country policy and institutional assessment (CPIA) results show that despite difficult global economic conditions, the quality of policies and institutions in a majority of Sub-Saharan African countries remained stable or improved in 2011.

DOWNLOAD the indicators here: www.worldbank.org/Africa/CPIA

For several countries the policy environment is the best in recent years. Of the 38 African countries with CPIA scores, 13 saw an improvement in the 2011 overall score by at least 0.1. Twenty countries saw no change, and five witnessed a decline of 0.1 or more. The overall CPIA score for the region was unchanged at 3.2.  

In short, despite a challenging global economic environment, African countries continued to pursue policies aligned with growth and poverty reduction. 

What will it take to end poverty in Africa?

Shanta Devarajan's picture

My colleague Jim Kim has launched a social media campaign on what it will take to end global poverty (please send your solutions via twitter to #ittakes.) I was reminded of a blog post I did about four years ago entitled “Ending poverty in Africa and elsewhere”. 

My answer then and now is:  Overcome government failure.  By “government failure,” I don’t mean that governments are evil or even that they are incompetent or ill-intentioned.  Analogous to “market failure,” government failure refers to a situation where the particular incentives in government lead to a situation that is worse than what was intended with the intervention.  

For instance, governments finance and provide primary education so that poor children can have access to learning.  But if teachers are paid regardless of whether they show up for work, and politicians rely on teachers to run their political campaigns, the result is absentee teachers and poor children who don’t know how to read or write—precisely the opposite of what was intended.  We see similar government failures in health care, water supply, sanitation, electricity, transport, labor markets and trade policy.

Africa’s Learning Crisis

Shanta Devarajan's picture

Hardly a week goes by without someone pointing out that, despite being enrolled in school, many of Africa’s primary school-age children don’t seem to be learning very much. 

Today’s salvo is from the Brookings Institution’s Center for Universal Education, whose Africa Learning Barometer estimates that 61 million children (half of the primary school-age population) “will reach their adolescent years without being able to read, write or perform basic numeracy tasks.”  

Last week, my colleagues Elizabeth King and Ritva Reinikka called on Africa’s education system to “put learning first for all students.”  We have documented disappointing learning outcomes in Tanzania on this blog.  Despite being a middle-income country and having substantially increased public spending on education, South Africa’s performance in standardized tests is below the average for African countries.

Kenya’s education dividend

Wolfgang Fengler's picture

Despite positive news and the talk of an African “renaissance,” many still doubt whether the continent is ready for take-off. Rapid population growth and the resulting “youth bulge” remain major concerns in a context of widespread un(der)employment. How can a country like Kenya create one million jobs each year, just to accommodate new entrants into the labor force? 

 

But young people don’t just need jobs, they also create them. Therefore, what matters most is to make sure that the education system delivers the skills needed in emerging economies, and incubates entrepreneurs. In turn, as people become more educated and healthier, they will have fewer children. This is already happening: As Kenya continues to welcome about a million new citizens each year, family size is slowly declining. 

Tanzania: Let's think together

Jacques Morisset's picture

Every Sunday the World Bank in Tanzania in collaboration with the newspapwer The Citizen want to stimulate your thinking by sharing data from recent official surveys and ask you a few questions. 

Are all Tanzania children really going to school?

Over the past decade, Tanzania has been close to reaching almost its universal primary education targets according to official statistics. However, when Tanzanian households were asked directly in recent surveys, they reported that: 

 

  • 17% of their seven to thirteen year-olds were not attending school 
  • 30% of the seven or eight year-olds in rural areas were not attending school and as much as 45% for those in the poorest quintile
  • 45% of those of the seven or eight year-olds not attending school in the rural areas are among the poorest people
  • About 1/3 (400,000) of the 1.2 million seven-year-olds are out of school, with rural boys less likely to go to school than girls.

 

Those responses warrant a number of questions:

The politics of service delivery

Shanta Devarajan's picture

Teachers in Tanzania are absent 23 percent of the time; doctors in Senegal spend an average of 39 minutes a day seeing patients; in Chad, 99 percent of non-wage public spending in health disappears before reaching the clinics.

These and other service delivery failures have been widely documented since the 2004 World Development Report, Making Services Work for Poor People.

But why do these failures persist?  Because they represent a political equilibrium where politicians and service providers (teachers, doctors, bureaucrats) benefit from the status quo and will therefore resist attempts at improving services.  For instance, teachers are often the campaign managers for local politicians.  They work to get the politician elected, in return for which they get a job from which they can be absent. Powerful medical unions ensure that their members can work in the private sector and neglect their salaried government jobs.  The losers are the poor, whose children don't learn to read and write, or get sick and die because the public clinic is empty.

Thou shall not die: Reducing maternal deaths in sub-Sahara Africa

Patricio V. Marquez's picture

Mother and child in South Sudan There is growing optimism in the development community that the dawn of the “African Century” may be upon us.  The reasons for this optimism are real.  Over the last decade, six of the world's 10 fastest-growing economies were in Africa, and substantial political and social progress has been achieved.  

But I would say that the potential for this development may be undermined if the everyday tragedy of preventable maternal deaths continues unabated across the continent. 

 

The recently-released report “Trends in Maternal Mortality: 1990 to 2010. WHO, UNICEF, UNFPA and The World Bank estimates” paints a dramatic picture. Overall, close to 60% of global maternal deaths occur in sub-Saharan Africa, and at 500 maternal deaths per 100,000 live births, the region has the highest maternal mortality ratio (MMR) in the world, well above Southern Asia (220), Oceania (200), South-eastern Asia (150), and Latin America and the Caribbean (80).

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