1 Investing in the future: Addressing challenges faced by Africa's young population. 40 th Session of the Commission on Population and Development Nyovani Madise African Population and Health Research Center
Dec 23, 2015
1
Investing in the future: Addressing challenges faced by Africa's young
population.
40th Session of the Commission on Population and Development
Nyovani MadiseAfrican Population and Health Research Center
2
Outline of Presentation
• Why invest in Africa’s young people?
• Health - RH, HIV and AIDS
• Education
• Education – population - health
3
Why Invest in Young People?
• Human Capital= Population x Health X Education
• Young people have the greatest potential for change.
• Large proportion of population
4
Africa’s Youthful Population fuelled by High Fertility
0
1
2
3
4
5
6
Nu
mb
er
of
ch
ild
ren
per
wo
man
Source: World Population Datasheet 2005.
5
Africa’s growing young population
Source: Compiled from UN World Population Prospects, 2006 Revision.
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
Pro
po
rtio
n
0-4 years
5-14 years
15-24 years
6
The Health of Young People Matters
7
Young People’s Health
• Historically African infants and babies have high disease and mortality burden
• Youth have low disease burden BUT increasing due to – Reproductive ill-health – Teen pregnancies– STI infections– HIV and AIDS
8
Sexual behaviour among 15-19 yr-olds
Source: National Surveys of Adolescents 2004
39
21
28
37
25
10
38
32
0% 20% 40% 60% 80% 100%
Burkina Faso
Ghana
Malawi
Uganda
Burkina Faso
Ghana
Malawi
Uganda
Never had sex Had sex but not in last 12 months Had sex in last 12 months
Males
Females
9
But they are ill-protected against consequences
Source: National Surveys of Adolescents 2004
Unmarried females aged 15-19 years
5955
39
6154
4035
46
0
10
20
30
40
50
60
70
Burkina Faso Ghana Malawi Uganda
Current use of any method of contraception Condom use in last 3 months
10
Many births to mothers under age 20 were wanted later or not at all: West Africa (DHS data)
20
17
34
37
13
16
21
10
9
27
48
0
1
1
21
1
2
5
1
7
1
4
0 10 20 30 40 50 60 70
Benin
Burkina Faso
Côte d'I voire
Ghana
Guinea
Mali
Mauritania
Niger
Nigeria
Senegal
Togo
Birth was wantedlater
Birth was notwanted at all
11
(cont’d) East and Southern Africa (DHS data)
20
28
26
8
11
18
23
34
15
66
23
15
17
37
11
5
21
41
3
15
1
32
8
13
9
5
22
3
0 20 40 60 80 100
Ethiopia
Eritrea
Kenya
Lesotho
Madagascar
Malawi
Mozambique
Namibia
Rwanda
South Africa
Uganda
United Republic of Tanzania
Zambia
Zimbabwe
Birth waswanted later
Birth was notwanted at all
12
High HIV prevalence among young Africans
0 10 20 30
Burkina Faso
Ethiopia
Mali
Ghana
Cote d'Ivoire
Cameroon
Uganda
Tanzania
Kenya
Malaw i
Zambia
Lesotho
15-24 Males 25-49 Males
0 5 10 15 20 25 30
Burkina Faso
Ethiopia
Mali
Ghana
Cote d'Ivoire
Cameroon
Uganda
Tanzania
Kenya
Malaw i
Zambia
Lesotho
15-24 Females 25-49 Females
Males Females
13
Proportion of deaths to females aged 15-29 years by cause
Compiled from WHO Burden of Disease Statistics
41.1 46.362.4
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2005 2015 2030
TB HIV/AIDS Other causes
14
Proportion of deaths to males aged 15-29 years by cause
Compiled from WHO Burden of Disease Statistics
25.3 30.5 38.6
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2005 2015 2030
TB HIV/AIDS Other causes
15
A Synergistic Response for Family Planning and HIV services
• Higher HIV infection rates among young people especially females (3:1 ratio)
• More than 25% of girls have started childbearing by age 19 in many African countries)
16
Education Matters
17
Investing in young people: education
Education: has intrinsic value in itself but also key determinant of
• Health,
• Population change - fertility, mortality, migration
• Economic development
18
Young people need opportunities for schooling
• DHS data (2000-2005) on young people aged 6-10 years attending school:
– 59% where there is no free primary education
– 74% where there is free primary education
19
Making education affordable
Primary Attendance, by Wealth. Malawi DES (2000)
0.73 0.740.81
0.850.91
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Lowest Second Middle Fourth Highest
20
Differential in secondary education by wealth status
Secondary Attendance, by Wealth. Malawi DES (2000)
0.03
0.060.04
0.07
0.23
0
0.05
0.1
0.15
0.2
0.25
Lowest Second Middle Fourth Highest
21
Gender differences persist especially for secondary education
Source: DHS surveys, 2000-2005
Ratio of females-to-males in School by Age in Selected African Countries
0.97
0.79
0.00
0.20
0.40
0.60
0.80
1.00
1.20
6-15 year-olds 16-20 year-olds
22
Education matters
• Make education affordable
• Reduce the difference in school attendance between females and males
• Other forms of education – Skills development– Sex education
• Information for behavioural change
23
Education-Population
• Lower fertility
E,g, Average fertility of African woman Without education = XXXPrimary =XXXSecondary =XXX
• Longer birth spacing (34 months for secondary educated women compared with 28 for those without education).
24
Education-Health
• Lower child mortality– 7% reduction for infants of primary educated women– 30% for secondary educated
• Better nutritional status
• Lower prevalence of infectious childhood illnesses
• Higher use of health facilities (delivery, immunization, curative services)
25
The Education-Health Link
Use of health facility for delivery, by woman's education level
28
50
78
0
20
40
60
80
100
None Primary Secondary+
26
Summary
Africa’s young people
+ Investments in health +
+ Education
= Human Development
27
Thank you for your attention