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Lives on the line: reducing under-five child mortality rates in Africa

Dereje Ketema Wolde's picture
As countries all across Africa recognize International Day of the African Child today, I thought it would be a timely opportunity to blog about the progress of under-five child mortality rates over the past two decades.  But first, some data for us to understand the big picture:
  • On a global level, the rate of under-five child mortality has been cut in half, from 90 deaths per 1,000 live births in 1990 to 48 per 1,000 in 2012.  The estimated annual number of under-five deaths has fallen from 12.6 million to 6.6 million over the same period.
  • Since 1990, 216 million children worldwide have died before their fifth birthday — more than the current total population of Brazil, the world's fifth most populous country.
  • Disparities between children in the high-income and low-income countries have narrowed, but many gaps still remain.  Case in point: In Luxembourg, the under-five mortality rate is just 2 deaths per 1,000 live births; in Sierra Leone, it is 182 deaths per 1,000 births.

As we stand a year away from the Millennium Development Goal (MDG) 4 – which aims to reduce the global under-five child mortality rate by two-thirds between 1990 and 2015 – the pace of reduction would have needed to quadruple in 2013-2015 to achieve this goal, according to the United Nations Children's Fund's (UNICEF's) Committed to Child Survival: A Promised Renewed – Progress Report 2013.

A closer look at regional rates
Now let's take a look at the regional and country level data by viewing the World Development Indicators (WDI) 2014 and the indicator under-five mortality rate. The WDI also features a short progress report on MDG 4, which complements the detailed analysis of the World Bank Group's Global Monitoring Report.  This report uses the same methodology to assess whether countries are on track or off track to meet the 2015 targets.

Sub-Saharan Africa (SSA), where one in ten children die before the age of five, faces the biggest challenges in achieving MDG 4, followed by South Asia.  The SSA region reduced its child mortality rate by 45% during 1990 to 2012, the only region to reduce its under-five mortality rate by less than half during this time.  SSA also lags behind other regions in its pace of decline in the total number of under-five deaths.

Figure 1

The Angola paradox: Development aid in a "wealthy" country

Thomas Dickinson's picture



Preparing a recent project mission to Angola, I came across the country’s latest accomplishment: a gigantic new refinery to consolidate its national oil industry. Looking at that massive structure, I was hit with a sudden thought: if they can pull off such an enormous and complex feat of engineering, what do they need me for?

Measuring Development Success in Difficult Environments

Laura Ralston's picture

The challenge of moving from conflict and fragility to resilience and growth is immense. More than half of the countries counted as low income have experienced conflict in the last decade. Twenty per cent of countries emerging from civil conflict return to violence in one year and 40% in five years.

While the use and production of reliable evidence has become more common in much of the international development debate and in many developing countries, these inroads are less prevalent in fragile and conflict-affected situations (FCS). Programming and policy making in countries affected by conflict and prone to conflict is often void of rigorous evidence or reliable data. It is easy to argue, and many do, that it is impossible to conduct rigorous evaluations of programs in conflict-affected states. However, in spite of the very real challenges in these environments, such evaluations have been conducted and have contributed valuable evidence for future programming, for example in Afghanistan, the DRC, Colombia, northern Nigeria and Liberia.

My unit Center for Conflict Security and Development, (CCSD) is teaming up with the Department of Impact Evaluation (DIME), as well as the International Initiative for Impact Evaluation (3ie), and Innovations for Poverty Action (IPA), in a series of activities to enhance the evidence base on development approaches to peace- and state-building challenges. A first goal is to scope out where our evidence base is thinnest: what are the programs and interventions that remain least tested, but have theories of change suggesting great potential? We are hoping to take stock of what we and other donor institutions have been doing in this area of development, and map this into what we have learnt and what we most need to learn more about. USIP, USAID, IRC as well as leading academics in this field and IEG, are kindly helping in this endeavor, and we hope to be able to share some initial findings at our fragility forum later this year.

The King Baudouin African Development Prize

Kristina Nwazota's picture
The King Baudouin Foundation has just announced that it is accepting nominations for its 2014-2015 African Development Prize. The Prize awards innovative initiatives that help local communities take development into their own hands and that improve quality of life. The Prize is worth 150.000 Euros and is awarded every other year. Previous winners include women's rights advocate Bogaletch Gebre of Ethiopia and Dr.

Relaunching Africa Can and Sharing Africa’s Growth

Francisco Ferreira's picture

Dear Africa Can readers, we’ve heard from many of you since our former Africa Chief Economist Shanta Devarajan left the region for a new Bank position that you want Africa Can to continue highlighting the economic challenges and amazing successes that face the continent. We agree.

Today, we are re-launching Africa Can as a forum for discussing ideas about economic policy reform in Africa as a useful, if not essential, tool in the quest to end poverty in the region.

You’ll continue to hear from many of the same bloggers who you’ve followed over the past five years, and you’ll hear from many new voices – economists working in African countries and abroad engaging in the evidence-based debate that will help shape reform. On occasion, you’ll hear from me, the new Deputy Chief Economist for the World Bank in Africa.

We invite you to continue to share your ideas and challenge ours in pursuit of development that really works to improve the lives of all people throughout Africa.

Here is my first post. I look forward to your comments.

In 1990, poverty incidence (with respect to a poverty line of $1.25) was almost exactly the same in sub-Saharan Africa and in East Asia: about 57%. Twenty years on, East Asia has shed 44 percentage points (to 13%) whereas Africa has only lost 8 points (to 49%). And this is not only about China: poverty has also fallen much faster in South Asia than in Africa.

These differences in performance are partly explained by differences in growth rates during the 1990s, when emerging Asia was already on the move, and Africa was still in the doldrums. But even in the 2000s, when Africa’s GDP growth picked up to 4.6% or thereabouts, and a number of countries in the region were amongst the fastest-growing nations in the world, still poverty fell more slowly in Africa than in other regions. Why is that?

The Fight to End Wildlife Crime Is a Fight for Humanity

Valerie Hickey's picture

Available in ไทย

Elephants in Kenya. Curt Carnemark/World Bank

Elephant ivory is on the march. Not elephants, but their ivory. The elephants are left bloodied and dead on the range. So are many rangers who work to protect a country’s natural capital. In the past 10 years, over 1,000 rangers have been murdered in 35 countries alone; the International Ranger Federation tell us that as many as 5,000 may have been murdered worldwide in that time.
 

At the CITES COP – the Conference of the Parties to the Convention on International Trade in Endangered Species – the halls in Bangkok ring loud with concern for the elephants and other charismatic species, particularly rhinos, that are being exterminated across Africa in pursuit of private profit, at the expense of communities that rely on nature for their food, shelter, start-up capital, and safety net in a warming world.


So why should the World Bank care? Our concern is to build strong economies and healthy communities by revving the engine of inclusive green growth as we prepare countries and communities for the impacts of climate change.

What does this have to do with elephant ivory you ask? Simply put, we cannot achieve our dream of a world without poverty without taking account of the rise in wildlife crime.

Climate Lessons from a Hotter Arab World

Rachel Kyte's picture

Photo credit: Curt Carnemark/World Bank

This week in Doha, the marble corridors of the Qatar National Convention Center resonate with voices from around the world. Over half way through the UN Climate Change Conference, as ministers arrive and the political stakes pick up, a sense of greater urgency in the formal negotiations is almost palpable. But in the corridors, negotiations are already leading to deals and dreams and action on the ground.

UN Secretary-General Ban Ki-moon opened the discussions by saying we need optimism, because without optimism there are no results. He reminded us all that Superstorm Sandy was a tragic awakening. He reiterated the call for a second commitment period of the Kyoto Protocol, a global agreement and 100 billion in climate finance by 2020.

Meanwhile our focus was firmly on the region ...

Circumcision and smoking bans: Can policies nudge people toward healthy behaviors?

Patricio V. Marquez's picture

Walking through river. Mali. Photo: © Curt Carnemark / World Bank

The scaling up of voluntary medical male circumcision, particularly in high HIV prevalence settings, is a highly cost-effective intervention to fight the epidemic—randomized controlled trials have found a 60% protective effect against HIV for men who became circumcised.

But, the supply of this medical service is just one part of the picture. Without active involvement from individuals and communities to deal with social and cultural factors that influence service acceptability, the demand for this common surgical procedure will be low.

Indeed, on a recent visit to Botswana, a country with high HIV prevalence and low levels of male circumcision, my World Bank colleagues and I had a good discussion with the National HIV/AIDS Commission about ways to address the low uptake of voluntary, safe male circumcision services in spite of a well-funded program by the government.  It was obvious to all that if the demand for, and uptake of, this service were not strengthened through creative mechanisms that foster acceptance, ownership, and active participation of individuals and community organizations, the program would not help control the spread of HIV through increased funding of facilities, equipment, and staff alone.

So, what do we need to do to ensure that need, demand, utilization, and supply of services are fully aligned to improve health conditions?

Malaria is a preventable and treatable disease, but for how long?

Maryse Pierre-Louis's picture

www.worldbank.org/malaria

This year, on World Malaria Day, April 25, the global health community has reason to celebrate. Indeed, thanks to substantial investments from partners and countries over the last decade, the scorecard on malaria reports good news:  a reduction of more than 50% in confirmed malaria cases or malaria admissions and deaths in recent years in at least 11 countries south of the Sahara, and in 32 endemic countries outside of Africa. Overall, the number of deaths due to malaria is estimated to have decreased from 985,000 in 2000 to 655,000 in 2010. 

The fact that an estimated 1.1 million African children were saved from the deadly grip of malaria over the last decade is an extraordinary achievement. By the end of 2010, a total of 289 million insecticide-treated nets were delivered to sub-Saharan Africa, enough to cover 76% of the 765 million persons at risk.

Over the past 5 years, four countries were certified as having eliminated malaria: Morocco, Turkmenistan, the UAE and Armenia.  In southern Africa, health ministers of eight countries -- Botswana, Namibia, South Africa, Swaziland, Angola, Mozambique, Zambia, Zimbabwe--have developed a regional strategy to progress towards E8 malaria elimination status.  

A strong leader and a good idea!

Cristina Santos's picture

Maria Ines, Head teacher of Tchinducuto, and Director of ZIP 6, Namibe, AngolaLeadership can be exercised in many ways and a lot has been written about leadership and empowerment, and about the need to strengthen both in Africa. Very recently, I came across a true female leader, a simple woman with a strong personality, excellent communication and problem-solving skills, and great determination. In sum, all the things we consider to be the basis for good leadership.

She is not a politician or the head of a big company. She is a school teacher in a poor area in the southern province of Namibe, Angola. Her school is part of a group called ZIP (zone of pedagogical influence), and although her school is the poorest among the three in the group, she was chosen as the group’s leader.

In Angola and many places in Africa, parents must purchase report cards which teachers then fill in to send home. In the following account Maria Ines, Head teacher of Tchinducuto, and Director of ZIP 6, describes how her school revamped the purchasing process and found a way to earn money for the students.


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