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