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A Child Survival Report Card: Number 1, 2004 View All Reports >
Sub-Saharan Africa: Countries where child mortality has stayed the same or risen, 1990-2002 Angola
Botswana
Burundi
Cameroon
Central African Republic
Côte d'Ivoire
Democratic Republic of the Congo
Kenya
Liberia
Mauritania
Rwanda
Sao Tome and Principe
Somalia
South Africa
Swaziland
United Republic of Tanzania
Zambia
Zimbabwe
Forty-two per cent of the children who die before they are five are in sub-Saharan Africa.

Here, the AARR has slowed sharply, falling from 1.3 per cent in 1960-1990 to just 0.3 per cent in the 1990-2002 period.

In 18 countries in the region, the under-five mortality rate has either stayed the same or worsened since 1990.

The causes
Although poor perinatal conditions are still the main cause of infants' dying in the region, infections and diseases are the main killers of children under five. HIV/AIDS is responsible for 8 per cent of all under-five deaths in the region, more than double the global average.

The under-five mortality rates in most of the sub-Saharan countries appear to be less affected by household wealth than in other developing regions. This is in part explained by the high levels of absolute poverty still prevailing in these countries, which are translated into the lack of adequate and essential services at the household level, and lack of health infrastructure and basic resources. However, children born into the poorest 20 per cent of the population are 1.7 times more likely to die before the age of five than the wealthiest 20 per cent, with an excess under-five mortality rate of 80 deaths per thousand live births (181 vs. 100 respectively).

The greatest challenge
Sub-Saharan Africa faces the greatest challenge of any region in meeting MDG 4. The region will need to raise its AARR to 8.2 per cent, almost double the rate originally required, if it is to make the 2015 target.

SUB-SAHARAN AFRICA
CountryU5MR 1990U5MR 2002MDG target(a) 2015Progress(b) 1990-2002Requirement 2002-2015
Botswana 58 110 19 -5.3 13.4
Zimbabwe 80 123 27 -3.6 11.8
Swaziland 110 149 37 -2.5 10.8
Kenya 97 122 32 -1.9 10.2
Cameroon 139 166 46 -1.5 9.8
Cote d'Ivoire 155 176 52 -1.1 9.4
South Africa 60 65 20 -0.7 9.1
Rwanda 178 183 59 -0.2 8.7
Zambia 189 192 63 -0.1 8.6
Tanzania, United Rep. of 163 165 54 -0.1 8.5
Burundi 190 190 63 0.0 8.5
Central African Rep. 180 180 60 0.0 8.5
Congo, Dem. Rep. of the 205 205 68 0.0 8.5
Liberia 235 235 78 0.0 8.5
Mauritania 183 183 61 0.0 8.5
Sao Tome and Principe 118 118 39 0.0 8.5
Somalia 225 225 75 0.0 8.5
Angola 260 260 87 0.0 8.4
Gabon 92 91 31 0.1 8.4
Congo 110 108 37 0.2 8.3
Burkina Faso 210 207 70 0.1 8.3
Chad 203 200 68 0.1 8.3
Nigeria 190 183 63 0.3 8.2
Sierra Leone 302 284 101 0.5 8.0
Togo 152 141 51 0.6 7.9
Senegal 148 138 49 0.6 7.9
Uganda 160 141 53 1.1 7.5
Mali 250 222 83 1.0 7.5
Guinea-Bissau 253 211 84 1.5 7.1
Mozambique 235 197 78 1.5 7.1
Ethiopia 204 171 68 1.5 7.1
Benin 185 156 62 1.4 7.1
Niger 320 265 107 1.6 7.0
Gambia 154 126 51 1.7 6.9
Madagascar 168 136 56 1.8 6.8
Ghana 126 100 42 1.9 6.7
Namibia 84 67 28 1.9 6.7
Mauritius 25 19 8 2.3 6.4
Seychelles 21 16 7 2.3 6.4
Malawi 241 183 80 2.3 6.3
Equatorial Guinea 206 152 69 2.5 6.1
Lesotho 120 87 40 2.7 6.0
Guinea 240 169 80 2.9 5.8
Comoros 120 79 40 3.5 5.2
Cape Verde 60 38 20 3.8 4.9
Eritrea 147 89 49 4.2 4.6
 

Countries whose AARR has matched or exceeded the implied MDG target in 1990-2002 are shown as shaded.


(a)

Millennium Development Goal 4 set each country the task of reducing the under-five child mortality rate by two thirds between 1990 and 2015.


(b)

The speed of progress in reducing the U5MR is measured here by calculating the average annual reduction rate (AARR). Unlike the comparison of absolute changes, the AARR reflects the fact that the lower limits to U5MR are approached only with increasing difficulty. The AARR is calculated on an exponential basis, which assumes a continuous, exponential reduction between two points in time. It does not take into account the intermediate values of the series. To achieve a two-thirds reduction between 1990 and 2015 requires a progress rate of 4.4 per cent or higher.

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