At least 1 in 3 children under-five in Africa were stunted in 2011

Child Malnutrition in Africa

Significant progress in exclusive breastfeeding in many African countries

West Africa 38 %

Eastern Africa 42 %

North Africa 28 %

Central Africa 36 %

Southern Africa 35 %

Stunting hampers cognitive development of young children which under-mines learning ability later in life. The effects of stunting are irreversible.

Approaches to prevent stunting Interventions should focus on the critical 1,000 days window including pregnancy and before a child turns two and include: • Improving women’s nutrition, especially

before, during and after pregnancy.

• Early and exclusive breastfeeding.

• Timely, safe, appropriate and high-quality complementary food.

• Appropriate micronutrients interventions.

• Infectious diseases, such as diarrhoea, pneumonia, malaria, etc. are important determinants of stunting.

• Access to safe drinking water, basic sanitation and practicing appropriate hygiene behavior greatly reduces the risk of some of these infectious diseases.

Stunting prevalence (%)

In Africa, boys are more likely to be stunted than girls

Source for all charts: UNICEF global databases 2013, based on DHS, MICS, and other national surveys 2007-2011

Five countries in Africa have more than 5 percent severe wasting

Ratio of stunting (girls to boys) among children under-five years , countries in Africa, data range 2007-2011

Year % severely wasted

South Sudan 2010 10

Nigeria 2008 7

Chad 2010 6

Mali 2006 6

Sudan 2010 5

Children aged 0-59 months who are below minus three standard deviations from median weight–for-height of the WHO standard reference population, African countries

Proportion of children aged 0-59 months who are below minus two standard deviations from median height-for-age of the WHO Child Growth Standard. Data range : 2007-2011

Girls are more stunted than boys

Boys are more stunted than girls

%

% %

% or more

%

1 3 4 3

35

24 30

11

29

48 54

19

62

44

83

13

27 32 34 34 37

41 48 50 51 52

61 69 72

85

0

20

40

60

80

100

Nigeria('90,'08)

Niger('92,'10)

Sierra Leone('00,'10)

CentralAfrican

Republic('95,'10)

Liberia('99,'10)

DemocraticRepublic ofthe Congo('95,'10)

Mozambique('97,'11)

Guinea('99,'08)

UnitedRepublic of

Tanzania('96,'10)

Madagascar('97,'09)

Ethiopia('00,'11)

Zambia('96,'07)

Burundi('00,'10)

Malawi('00,'10)

Rwanda('92,'10)

% c

hild

ren

exc

lusi

vely

bre

astf

ed

(<6

mo

nth

s), a

rou

nd

199

5 an

d

aro

un

d 2

011

Trends in % of infants (<6 months) who are exclusively breastfed, around 1995 and 2011

Total (Around 1995)Total (Around 2011)

Parity

0.7

0.8

0.9

1.0

1.1

1.2

~ 1995

~ 2011

HIV/AIDS and Malaria in Africa

An estimated 3.1 million children under 15 years were living with HIV in Africa as of 2011; about 10 per cent of which were newly infected, mainly through mother-to-child transmission of HIV

Key facts: • Although progress has been made in Africa to

increase the prevention of mother to child transmission (PMTCT) of HIV/AIDS and increasing pediatric anti-retroviral therapy (ART) coverage, much more progress is needed.

• In 2011, around 300,000 children were newly infected with HIV in Africa.

• Across Africa, about 3% of all under-five deaths are caused by HIV/AIDS, and in Southern Africa, an estimated 11% of under-five deaths are attributed to HIV/AIDS.

• Although some progress has been made, ARV coverage for PMTCT varied from 8% in North Africa to 80% in Southern Africa in 2011.

Source: WHO/UNICEF/UNAIDS, Towards the Elimination of Mother-to-child Transmission of HIV and Keeping Their Mothers Alive: Abbreviated Progress Report 2012, preliminary report.

Source: UNICEF global databases 2013, based on DHS, MICS, and other national surveys as of May 2013

Major progress during the last decade in the use of Insecticide Treated Nets (ITNs) among children

• During the last decade, the proportion of children sleeping under ITNs in sub-Saharan Africa increased from less than 5 per cent to over a third (37%).

• Countries in Africa are focused on increasing coverage for ITN use among children in the most equitable manner: mass campaigns which strive for universal coverage to ensure that everyone is reached.

Children under-five sleeping under ITNs in Africa, 2000 and 2012

Coverage of Prevention of Mother To Child Transmission (PMTCT) and pediatric Anti-Retroviral Therapy (ART) coverage ; African regions, 2011 (%)

Malaria case management in endemic countries

• The use of Rapid Diagnostic Tests (RDT) to confirm malaria infection before starting treatment is still low

• In most endemic countries, less than 50% of febrile children under-five who receive anti-malarials are treated with artemisinin-based combination therapy (ACT).

8

15

26

14

38

11

52

21

80

40

58

27

Coverage of the most effective ARVs for PMTCT Pediatric ART coverage

North Africa

West Africa

Central Africa

Eastern Africa

Southern Africa

AFRICA

0

20

40

60

80

100

Pe

rcen

tage

Percentage of girls and women aged 15 to 49 years who have undergone FGM/C and percentage of girls and women aged 15 to 49 years who have heard about FGM/C and think the practice should continue

% girls and women aged 15to 49 years who haveundergone FGM/C

% girls and women aged 15to 49 years who have heardabout FGM/C and think thepractice should continue

Birth registration, child marriage and Female Genital Mutilation/Cutting (FGM/C)

The birth of less than half of children in Eastern and West Africa has been registered

In Central Africa, 1 in 2 young women were married or in union before age 18; nearly 1 in 5 of whom were married or in union before age 15

In almost all countries, prevalence of female genital mutilation/cutting is greater than support for continuing the practice

Source for all charts: UNICEF global databases 2013, based on DHS, MICS, and other national surveys 2002-2011

Number of women 20-24 years old who were first married or in union before age 18, by sub-region

West Africa 2.3 mn

Eastern Africa 2.2 mn

Central Africa 456,000

Southern Africa 442,000

North Africa 258,000 11

3

7

10

15

18

23

14

20

27

26

31

World

North Africa

Southern Africa

Eastern Africa

West Africa

Central Africa

Percentage of women 20-24 years old who were first married or in union before ages 15 and 18, by region

Married or in union before age 15 Married or in union between ages 15 and 18

31

44

53 54

87

Eastern Africa West Africa Central Africa Southern Africa North Africa

Percentage of children under five who are registered

More than 125 million girls and women alive today have undergone some form of FGM/C in 29 countries across Africa and the Middle East. Another 30 million girls are at risk of being cut in the next decade.

Education in Africa

Only 5 out of 53 African countries have reached Universal Primary Education

Sources: UNICEF global databases, 2013 and UNESCO Institute of Statistics databases, 2013

56

45

53

80 87

64

87 89 91 96

0

20

40

60

80

100

West Africa Eastern Africa Central Africa South Africa North Africa

Primary Net Enrolment Rates by sub-regions 1999 and 2010

1999

2010

Primary school enrolment in West Africa lags behind the other African regions

Key facts: • Over half of the world’s out-of-school children

(30 million) live in Africa. • Girls are more likely to be out of school than

boys. • Children with disabilities are over-represented in

the out-of-school population. • Progress in reducing the out-of-school children

population has slowed down since 2005. • Many children fail to complete the full primary

circle and fail to master basic literacy and numeracy skills.

In Africa, boys are more likely to be enrolled in primary school than girls

Net enrolment/attendance rate, 2010

Net enrolment/ attendance rate, 2010

Gender parity index of Net Enrolment Rate, African countries

30 million of the world’s out-of school children live in Africa

Even if they progress through the grades, many primary school children do not acquire basic knowledge and skills % of cohort who reach grade 4 and achieve a minimal education level

0

20

40

60

80

100

Did not reach grade 4

Reached grade 4

Reached grade 4 and achieved minimum level of learning

Note: The definition of minimum learning levels differs between the two surveys, the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) and the Programme of Analysis of Education Systems of the CONFEMEN (PASEC) and thus the results are not comparable. Source: EFA Global Monitoring Report 2012

SACMEQ, 2007 PASEC, 2004 - 2008

Primary school age Out-of-School children, by sex, sub-Saharan Africa, 2011

16 million girls Out-of-School

(54%)

14 million boys Out-of-School

(46%)

0.7

0.8

0.9

1

1.1

1.2

Girls are more likely to be enrolled

Boys are more likely to be enrolled

Parity

<70% 70 – 84% 85 – 94% 95 – 100% Missing value

48

90

114

113

86

89

35

90

162

155

206

172

147

83

0 50 100 150 200 250

World

Africa

Central Africa

West Africa

Eastern Africa

Southern Africa

North Africa1990

2012

Malaria 13% AIDS 3%

Injury 4%

Meningitis 2%

Measles 1%

Other 19%

Pneumonia (post-neonatal) 14%

Pneumonia (neonatal) 3%

Preterm birth complications 12%

Birth asphyxia 9%

Sepsis/meningitis/tetanus 6%

Congenital abnormalities 2%

Other neonatal 1%

Diarrhoea (neonatal) 1%

Diarrhoea (post-neonatal) 10%

Pneumonia 17%

Neonatal 34%

Diarrhoea 10%

Malaria 13%

All Other 22%

All regions in Africa have experienced marked declines in under-five mortality since 1990 In Africa, mortality rates among children under-five years of age (U5MR) have decreased by 45 per cent from 162 deaths per 1,000 live births in

1990, to 90 in 2012, but still half of the world's 6.6 million under-five deaths occur in Africa.

Child Mortality in Africa

Pneumonia, malaria and diarrhoea account for 40% of all under-five deaths in Africa

Under-five mortality rate (deaths per 1,000 live births) and number of under five deaths by sub-region, 2012

Source: UNICEF analysis based on IGME and WHO & CHERG 2013

Distribution of under-five deaths in Africa by cause, 2012

West Africa 1,386,000

Central Africa 197,000

Eastern Africa 1,136,000

North Africa 187,000

Southern Africa 428,000

Half of the world's 6.6 million under-five deaths are in Africa

Close to 600,000 measles deaths averted by vaccination in sub-Saharan Africa, since 2000

50

55

60

65

70

75

80

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Esti

mat

ed d

eath

s

Sub-Saharan Africa

Estimated measles deaths in absence of vaccination

Estimated measles deaths Immunization (MCV4) coverage

Measles coverage and deaths averted

Under-five mortality rate, 1990 & 2012

Under-five deaths per 1,000 live births

Under-five mortality rate

Source : Adapted from Simons et al. (Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data. Lancet 2012;379:2173-78) with updated measles mortality data through 2011 obtained from Dr Robert Perry, World Health Organization, Geneva, Switzerland.

Globally, almost half of the under-five deaths are attributable to malnutrition

• Africa still has the highest under-five mortality rates in the world and half of the world's 6.6 million under-five deaths are in Africa.

• Pneumonia, malaria and diarrhoea account for 40% of all under-five deaths in Africa.

• At least 1 in 3 children under-five in Africa were stunted in 2011.

• Africa accounts for about 60 per cent of all maternal deaths in the world.

• In 2011, there were an estimated 3.1 million children under 15 years living with HIV in Africa.

• In 2010, there were 219 million malaria cases in Africa leading to approximately 660,000 malaria deaths.

• Less than half of children under-five in Eastern and Western Africa have been registered at birth.

• 236 million people in Africa practiced open defecation in 2011.

Ch

ildre

n in

Afr

ica

Key

sta

tist

ics

on

ch

ild s

urv

ival

, pro

tect

ion

an

d d

eve

lop

me

nt

The child population in Africa is burgeoning; by 2050, 1 in every 3 children under 18 will be African

Between 2010 and 2025, the child population of sub-Saharan Africa will rise by 130 million.

From around 2030, sub-Saharan Africa will be the single region with the greatest number of children under 18.

By 2050, 1 in every 3 births and almost 1 in every 3 children under 18 will be African

0

10

20

30

40

50

1950 1970 1990 2010 2030 2050

Po

pu

lati

on

(in

mill

ion

s)

CEE/CIS East Asia and PacificIndustrialized countries Latin America and CaribbeanMiddle East and North Africa South AsiaSub-Saharan Africa

Source of chart: You, D., and D. Anthony. “Generation 2025: The critical importance of understanding demographic trends for the children of the 21st century”. UNICEF Occasional Paper, no. 1, September 2012.

Prepared by: UNICEF Data & Analytics Division of Policy and Strategy September 2013 (with updated U5MR estimates)

Find the latest statistics on children in Africa at the

UNICEF-Statistics website: www.childfinfo.org

Key Statistics

Sub-Saharan Africa

South Asia

East Asia and Pacific

Number of births by UNICEF regions, 1950 - 2050

Every Child Counts

@U

NIC

EF/NYH

Q2010

-2802/Asselin

Drinking Water and Sanitation in Africa

Since 1990, 351 million people gained access to an improved drinking water source in Africa.

In Africa only 40% of the population uses an improved sanitation facility; the population without access grew by 212 million despite 200 million people gaining access

Key facts: • Drinking water coverage in Africa in-

creased from 56% in 1990, to 67% in 2011.

• This rate of progress is not sufficient to meet the continent’s MDG drinking water target of 78% by 2015.

• Just over a quarter (26%) of the African population enjoys the convenience and associated health benefits of a piped drinking water supply on premises.

• Over the period 1990-2011 Africa’s population grew from 411 million people to just over 1 billion. While 351 million gained access to an improved drinking water source, the population without access increased from 280 million in 1990, to 340 million in 2011.

• Open defecation rates in Eastern Africa declined most

from 40% in 1990, to 25% in 2011. • West and Central Africa made the least progress on

sanitation. • In Southern Africa one-fifth (19%) of the population still

practices open defecation. • Malawi, Angola, Ethiopia and Benin registered declines

in open defecation rates of 25 percentage points or more since 1990.

1990 2011 1990 2011 1990 2011 1990 2011 1990 2011 1990 2011 Eastern West Central Southern North AFRICA Africa Africa Africa Africa Africa

Co

vera

ge (

%)

Drinking water coverage trends in Africa and sub-regions, 1990-2011

Sanitation coverage trends in Africa and sub-regions, 1990-2011

Co

vera

ge (

%)

31

57

93 80

6

26

45

54

Malawi Angola Ethiopia Benin

1990

2011

Pe

rcen

tage

(%

)

Source for all charts: UNICEF global databases 2013, based on DHS, MICS, and other national surveys 2007-2011

1990 2011 1990 2011 1990 2011 1990 2011 1990 2011 1990 2011 Eastern West Central Southern North AFRICA Africa Africa Africa Africa Africa

Open defecation rates 1990 & 2011, selected countries

Open defecation Improved facilities Shared facilities Unimproved facilities

Piped on premises Other improved sources Unimproved sources Surface water

14 12

33 19

29

29 29

23

25

23 19

18

24

22

32

19 21 12

30

13

30

42 37

56

43

54

33

38

33

41

53

72

8 10 12 11

7 13

31 36

23 26

3 3

22 10

25

10 17 8

20 11

11

4

37

35

18 22

26

29 13

15

21

21 5

6

9

15

21 24 9

14

11

13

12

16

63

78

14 25

27 26 31 33

44

53

35 40

40

25 34

28 34

24 32

23

Maternal Health in Africa

- Globally, the maternal mortality ratio (MMR) declined from 400 maternal deaths per 100,000 live births in 1990 to 210 in 2010 - In sub-Saharan Africa the maternal mortality ratio is 500 per 100,000 live births. - Africa accounts for about 60 percent of all maternal deaths in the world, largely due to limited access to emergency obstetric care and

insufficient maternal care during pregnancy and delivery.

Africa has the highest number of maternal deaths

Antenatal care during pregnancy with skilled health personnel is essential to ensure both mother and baby’s well-being

The improvement of maternal health outcomes requires key interventions:

• Assistance from skilled health personnel at delivery.

• Improved access to emergency obstetric care

• A minimum of four visits for antenatal care in order to ensure the well-being of mother and babies.

• Expanding access to information, counseling and supplies for a wide range of contraceptive methods.

• Lowering birth rates among adolescents

• Antiretroviral therapy to all pregnant women who need it.

West Africa 45% Eastern Africa

51%

Central Africa 62%

Southern Africa*

Source for all charts: UNICEF global databases 2013, based on DHS, MICS, and other national surveys as of May 2013

North Africa 67%

72

86 91

76

84

33

45

68

40

53

West Africa Central Africa North Africa sub-SaharanAfrica

World

Urban

rural

Note: Data coverage were insufficient to calculate urban and rural estimates for Eastern and Southern Africa. Note: Data coverage was insufficient to calculate regional estimate for Southern Africa.

Skilled delivery care higher in urban than in rural areas

Skilled attendance at birth

% %

Note: Data coverage was insufficient to calculate regional estimates for Eastern Africa in 1990.

Antenatal care: % of women (aged 15-49) attended at least once during pregnancy by skilled health personnel (doctor, nurse or midwife)

Skilled attendance at birth: % of births attended by skilled health personnel (doctor, nurse or midwife), country data with regional estimates , Data range 2006 - 2011

% or more

%

Two out of five babies in Africa are born without support from skilled health attendant

Skilled attendance at birth: % of births attended by skilled health personnel (doctor, nurse or midwife), African regions by area of residence, 2011

81

79

95

91

82

79

68

63

69

90

-

77

50

59

World

Sub-Saharan Africa

Southern Africa

Eastern Africa

Central Africa

North Africa

West Africa

~1990

~2011

Rural