Syndicate content

Africa's great strides towards the MDGs

Gabriel Demombynes's picture

This week’s Millennium Summit has given data mavens like myself motivation to take a second look at the development indicators for the countries where they work.

For Kenya (my current focus, along with Sudan) a rich source of information is the recently published report for the 2008-09 Demographic and Health Survey.

Below I’ve graphed several indicators from the Kenya DHS from 1998, 2003, and 2008-09. We see that there have been substantial gains along several lines. School attendance rates rose with the introduction of free primary education earlier in the decade. Vaccination rates increased sharply between 2003 and 2008. Access to improved water sources also expanded, and phone access jumped as the mobile revolution hit Kenya.






















The picture for children’s health outcomes is mixed. The rate of child malnutrition dropped only slightly. At the same, child mortality rates plunged by 36%, from 115 per 1000 in 2003 to 74 per 100 in 2008. One of my current research projects is to examine the likely drivers of this spectacular improvement.

Broadly, the two main candidates are economic growth and improvements in health care and other interventions. A look at the national-level trends doesn’t seem to support the economic growth hypothesis; although Kenya did experience strong economic growth for most of the period, if fewer children were dying because families were wealthier and better able to take care of their children’s material needs, we would expect to see substantially lower rates of child malnutrition.

On the other hand, we might think that credit for the decline in child mortality should go to anti-malaria interventions. There has been a huge increase in the use of insecticide-treated bed nets, and various pieces of evidence suggest malaria rates have gone down. But this can’t be the whole story, because child mortality rates have declined even in areas of Kenya that don’t have malaria. This leaves us with a bit of a puzzle that I will tackle in the next few months. 

It’s striking that the child mortality decline is not limited to Kenya. In the figure below I’ve plotted child mortality rates using DHS data for all sub-Saharan African countries for which a DHS has been conducted since 2006. In every single one, child mortality rates have dropped markedly in recent years. (I produced these figures using the DHS STATcompiler tool.)



















This bit of positive news brings to mind the related much broader findings of the new book Emerging Africa: How 17 Countries Are Leading the Way by Steven Radelet, who demonstrates that the experiences of sub-Saharan African countries have been diverse and that many countries in the region have experienced steady economic growth, improved governance, and decreased poverty since the mid-1990s.

Radelet (2010) argues that five fundamental changes have driven the broader turnaround in the “emerging African countries” that he profiles: 1) more democratic and accountable governments, 2) more sensible economic policies, 3) the end of the debt crisis and major changes in relationships with the international community, 4) new technologies that are creating new opportunities for business and political accountability, and 5) a new generation of policymakers, activists, and business leaders.

Radelet’s case matches my sense of Kenya, which is much more positive now than before I moved to Nairobi a year ago. While I don’t want to minimize the challenges the country faces, there are many reasons to be optimistic about Kenya’s future including the overwhelming recent approval of Kenya’s new constitution, the spectacular expansion of home-grown mobile money transfer systems, the tremendous dynamism of the private sector, and the improvements in human development indicators I highlighted at the beginning of this post. 

I think many people have the impression that all of Africa is permanently mired in poverty. But the reality in the ground is much different: great strides are being taken in Kenya and in many other places on the continent.


Gabriel: I don't think you can reject the growth-child survival link in Kenya based on the observation that child under-nutrition rates did not decline during the period of rapid economic growth. Under-nutrition rates often don't respond to economic growth. There are several reasons, but one is that, as their income grows, poor people often buy better-tasting food, which is not necessarily more nutritous. It doesn't follow, though, that they don't take better care of their kids in other ways, including safer water and sanitation practices, and treatment for acute illness. So it could be that the explanation for Kenya's rapid child mortality decline is still its rapid economic growth.

Submitted by Ibrahim Adam on
Sudan is one of only a handful of countries in SSA that has made the jump to middle-income status (surely the purpose of the whole thrust of Western aid to SSA?); and that's not purely down to Sudan's oil endowments either; note that other SSA countries have oil but remain stuck firmly in the low-income status. Sudan has even managed to do that with one (two?) hands tied behind its back: 1) No IDA credits since 93 2) No IMF loans since '85 3) No foreign debt relief from either the WBG, the IMF, the Paris Club or London Club. 4) No grants or even soft loans to the central govt from Western creditor nations since '89; and 5) A thicket of sanctions that blocks trade and investment with 1/4 of the global economy: the USA (which has been mimicked by most Western members of the G20). Amazing. Yet, Sudan's lessons to the rest of Africa on kick-starting private sector-lead sustainable economic growth are routinely ignored by an embarrassed (?) international development community(yes, we have income inequality and a geographically uneven distribution of wealth - but which country in SSA hasn't??? And I bet Sudan's Gini coefficient is around the mean in SSA). In other words, it's amazing that Sudan has not been included in Mr. Radelet's '17 (GDP growth in Sudan has surpassed all of those in teh chosen 17 for at least 15 years). Why is that?? An amazing oversight - and it certainly hasn't been lost on the rest of Africa who come in their droves to see how Sudan has managed to do it. Guess Mr. Radelet has fallen prey to the caricature of Sudan that exists in the US and other Western media and the analyst community. But, then again, that' would be quite like Shanta himself. Why do I say that?? Check out Shanta's amazingly brazen NYT letter to the editor in May 2010; here it is: Shanta had the audacity (stress) to pile in against a NYT article lauding Sudan's stellar economic performance - even though the WBG hasn't provided ONE BEAN in official lending to Sudan for SEVENTEEN YEARS!!! Shanta, a question don't you think that's had an effect on poverty reduction in Sudan??? Shame on you, Shanta, for not considering that the WBG has NO MORAL AUTHORITY to comment publicly on Sudan's economic performance when the WBG has cut Sudan adrift from official lending for nearly 20 years. That's bad judgment, Shanta, in extremis. Ibrahim Adam - just another ordinary Sudanese Live-and-direct from Sudan

@Shanta: What I described in the blog post is just my preliminary reflections on the child mortality question for Kenya. I completely agree that we can't rule out the growth story based just on the fact that child malnutrition hasn't declined. In the full paper, we're planning to use census data to look at how changes in mortality rates at the local level correlate with changes in a wealth index. @Ibrahim Adam: Thanks for your comment. Let me just offer a few clarifications. First, the book by Steven Radelet is not a World Bank book, and Mr. Radelet does not work at the World Bank. He is at the Center for Global Development, a private think tank not associated with the World Bank. Second, if you click on the link in my post and read the brief about the book, you'll see that the reason Radelet does not place Sudan among his 17 "emerging countries" is because he argues that oil exporting nations have different dynamics, so he places ALL the oil exporting nations in a separate category. Third, I would note that the World Bank has an ongoing program of engagement in Sudan. You can read about this at the Bank's Sudan website: Some highlights on that page include a major study--the recent Sudan Country Economic Memorandum--and the recent visit to Sudan by Obiageli Ezekwesili, the World Bank’s Africa Region Vice President.

Add new comment