Child survival in sub-Saharan Africa : taking stock

The mortality rate among young children in sub-Saharan Africa reveals a crisis that needs to be addressed urgently. While the number of under-five death outside of Africa between 1960 and 2000 fell from 18.1 million to 6.4 million (65 %) annually, under-five deaths in Africa increased from 2.3 million to 4.5 million (96%). With the technology to address the principal causes of child death now available at modest cost and being applied successfully in other regions, the situation in Africa represents a devastating commentary on the failure of African countries and the global community to address this basic humanitarian issue.

To understand the growing gap between Africa and the world better, the USAID's Bureau for Africa commissioned its Support for Analysis and Research in Africa (SARA) Project to undertake this analysis of child health trends and USAID programming in Sub-Saharan countries. The purpose of the review was to identify how USAID could improve the effectiveness of its contribution to improving child health in Africa. In conducting this study, the SARA team reviewed mortality patterns and health intervention coverage data in Africa. In 13 countries, the team interviewed Mission health officers and other child health experts about USAID child survival investments and programming approaches, program results, constraint, and enabling factors. The authors assume that the decrease of donor interest in child survival is one of the main reasons for the weak programmatic response of African governments. Many interventions do not reach a significant portion of the under-five population.