Some countries of West/Central Africa have made stunning improvements in the rate of exclusive breastfeeding of infants in the first six months of life.
Exclusive breastfeeding rates in the region increased fivefold – from 4 per cent to 22 per cent – during the period 1990–2004, with similar improvements in individual countries. Yet the region posts the lowest rate of exclusive breastfeeding in the developing world.
West/Central Africa – the region with the highest under-five mortality rate in the world – has managed to make some progress since 1990 in reducing the prevalence of underweight among its children, but it is insufficient to reach the MDG target.
Of the five countries on track, Congo has the lowest proportion of underweight children (14 per cent). In the Gambia, the proportion of underweight children has reduced from 26 per cent in 1996 to 17 per cent in 2000.
Seven countries are improving, although not fast enough to meet the MDG target. Nigeria is improving at a rate of 2.2 per cent a year, yet due to its large population its proportion of underweight children still dominates regional statistics. Rates of exclusive breastfeeding and vitamin A supplementation coverage are notably low, but Nigeria has become the first country in the region to attain universal salt iodization.
Five countries have remained unchanged or deteriorated in terms of child nutrition. Burkina Faso and Niger have the highest rates of underweight, although Burkina Faso has a high rate of vitamin A supplementation. Cameroon has been going backwards, yet it still has among the lowest regional rates of children underweight.
In Sierra Leone the high proportion of low-birthweight infants (23 per cent) and low proportion of infants exclusively breastfed (4 per cent) contribute to the country’s under-five mortality rate, which is the highest in the world.
While the almost fivefold increase in exclusive breastfeeding in West/Central Africa between 1990 and 2004 is encouraging, the region still has the lowest rate worldwide (20 per cent). Rates are remarkably low in five countries, with Chad (2 per cent) and Niger (1 per cent) the worst off. In only three countries are more than half of infants exclusively breastfed for the first six months.
Anaemia remains a major threat, and a number of countries have conducted surveys that show unacceptable rates in children and mothers.27 The regional prevalence of wasting in children is 10 per cent. However, this average hides significant disparities. Wasting in the Sahelian countries affects more than 1 million children.
27 Demographic and Health Surveys (DHS) for Burkina Faso (2003), Cameroon (2004), Ghana (2003), Mali (2001) and Senegal (2005), and National Anaemia Survey (Guinea, 2000), analysed by the UNICEF Regional Office for West and Central Africa.