PERSPECTIVE  
Niger J Paed 2012;39 (2):46 -50  
Rodrigues OP  
Socio- economic development and  
child survival  
DOI:http://dx.doi.org/10.4314/njp.v39i2.1  
Received: 6th December 2011  
Accepted: 6th December 2011  
Abstract: Of the 8.8million deaths  
of children under 5 in the world in  
investments are increasing, the Afri-  
can economy lacks adequate human  
resources, institutions, and physical  
infrastructures to ensure the growth  
that would improve child survival.  
African countries have the challenge  
of finding solutions for economic  
growth and development to enhance  
child survival. Possible ways include  
avoiding the commodity trap; reduc-  
ing reliance on Official Development  
Assistance (ODA); and mobilizing  
domestic resource and stopping capi-  
tal flight. prudent and judicious use  
of available resources and implemen-  
tation of measures that address the  
structural causes of poverty, can im-  
prove child survival even in the pre-  
vailing conditions.  
2
008, 4.5million were from Africa,  
(
)
Rodrigues OP  
especially West and Central Africa.  
Also, high maternal mortality rates,  
low life expectancy, and increasing  
food prices make the attainment of  
the Millennium Development Goals  
related to child survival unlikely for  
Sub-Saharan Africa.  
Department of Child Health,  
University of Ghana Medical  
School,  
P.O.Box 4236, Accra, Ghana,  
Email: onikerodrigues@yahoo.co.uk  
Soon after independence in the  
1
950's and 60's many African  
countries suffered political unrest,  
social upheaval and economic insta-  
bility with military coups and or  
civil wars, leaving 20 million inter-  
nally displaced or refugees, and  
adversely affecting child survival  
by the 1980's.  
Though the potential for economic  
growth exists and foreign  
Introduction  
contrasted with one out of every 48,000 Irish women.  
The Under 5 Mortality Rate (U5MR) in Sweden is 3  
compared with 219 in Liberia. The life expectancy at  
birth for a child born in Japan today is 83yrs against 48  
years for Nigeria or Sierra Leone.2 And the list goes on.  
In 2000, the countries of the world ratified 8 targets to  
be met by 2015 - the Millennium Development Goals  
A nation's socio-economic development is intricately  
linked with the survival of its children, as some statistics  
comparing developed nations with the developing show.  
Africa has a young population with 70% of her one  
billion people aged 30 years or less. The Gross Na-  
tional Income per person (GNI) in 2007 for Sub-  
1
4
(MDG's).  
saharan Africa was a mere $1109, compared with  
2
$
40772 for Industrialized countries ; 53% of the popula-  
Millennium Development Goals 1,4,5, and 6 are directly  
related to child survival. MDG1 aims to eradicate ex-  
treme poverty and hunger; MDG4, to reduce by two-  
thirds, the under-5 mortality rate (U5MR); MDG5 to  
reduce by three-quarters the maternal mortality rate  
(MMR), MDG6 to combat HIV/AIDS, malaria and  
other serious diseases. Sub-Saharan Africa is least on  
course to achieve any of the goals.  
tion live below the international poverty line of US$1.25  
per day; the Official Development Assistance (ODA)  
inflow in Ghana in 2007 was US$1151 millions, com-  
pared with a negative inflow (outflow) of US$-131 in  
Saudi Arabia. Of the 8.8 million deaths of children un-  
der -5 in the world in 2008, 4.5 million were from Af-  
rica. and while many countries in Asia and the Middle  
East and North Africa had shown a marked decline, in  
under- 5 mortality, West and Central Africa had actu-  
ally shown an increase.  
Figure 1 shows the relative trend of un5der 5 deaths in  
Africa, compared with Asia, since 1970.  
In parts of sub-Saharan Africa, more than 900 women  
die for every 100,000 live births, compa3red to just 8 per  
1
00,000 in the industrialised world. In Niger one  
woman out of every seven is likely to die from a preg-  
nancy related cause during the course of her life time,  
4
7
Fig 1: Under 5 Mortality in Africa and The World 1970  
Table 1: Ten countries with the highest child mortality  
to 2008  
and their recent conflicts.  
Country  
U5MR  
Conflict  
(
deaths  
Under 5deaths (millions) 1970-2008  
per1,000  
12  
live Births)  
Africa  
1
0
m
i
Sub-Saharan Africa  
Sierra Leone  
Angola  
Afghanistan  
Niger  
Liberia  
Mali  
Chad  
Equatorial Guinea  
D.R Congo  
Burkina Faso  
270  
260  
257  
253  
235  
217  
209  
206  
205  
204  
1991-2000  
1975–2002  
1978–ongoing  
1992–1997  
1989–2003  
1990–1994  
1988–ongoing  
No armed conflicts  
8
6
4
2
0
l
Eastern and Southern  
Africa  
l
i
West and Central  
Africa  
o
n
s
Middle East and  
North Africa  
Asia  
1996–2001  
No armed conflicts  
South Asia  
Source Save The Children : Why Equity Matters 2008.  
1
/13/2  
012  
WACP- AGSM 2010/OPR  
4
The 1980's and 1990's brought multiple transitions,  
from one-party to multi-party rule, from government-  
commanded economies to free markets, from apartheid  
to multi-racial rule. But a few countries went from  
peace to war, leaving 20 million Africans as internally  
displaced people and external refugees. All these had  
negative effect on the economy and ultimately on child  
survival.  
Source : UNICEF The State of the World's Children  
Special Edition 2010  
So how did we get here? Africa in history  
A trip down memory lane would help to answer the  
question “How did we get here?' In the 1950's and 60's  
African nations achieved independence with great en-  
thusiasm. However the euphoric ‘wind of change' soon  
became a 'hurricane of chaos' with power-hungry, des-  
potic or inept Heads of States and their one-party de  
facto rule, nationalization of industries, and other atroci-  
ties. This opened the way for military men to cease  
power in one country after another. The sword became  
mightier than the pen, from the Democratic Republic of  
Congo in 1960 to the human tragedies of Rwanda, Dar-  
fur - Sudan, Zimbabwe, Liberia, and Sierra Leone. Of  
the 85 coups in 33 countries between 1952 and 2000, 42  
The African economy in the 1990's grew by 2.2%, indi-  
cating a turn around, but on the downside. there were  
structural weaknesses in all key areas: inadequate ca-  
pacities in human resources, institutions, and physical  
infrastructures. The United Nations Committee on Trade  
and Development (UNCTAD) Economic Development  
in Africa report for 2001 stated that “African countries  
faced four main challenges: to accelerate and broaden  
economic growth; to achieve a sustainable balance in  
the population-food-environment nexus; to achieve  
good governance and put an end to conflicts; to cope  
with globalization and attain international competitive-  
ness. They also had four main handicaps which are  
scarce economic resources, climatic uncertainties, un-  
certain world market developments with free market  
economies w8ith no protectionist policies , and heavy  
indebtedness”.  
6
were in West Africa. . This was a recipe for social up-  
heaval and economic instability as few military men  
were able to transform themselves into effective states-  
men. In addition, some countries became engaged in  
civil war, while others were overcome by natural disas-  
ters all of which adversely affected child survival. In-  
deed, of the 10 countries with the highest mortality in  
2
008, nine were in Africa, eight had armed conflict, and  
all had military coups and governments.  
“In order to ensure that Africa will be able to reduce  
poverty by half by 2015, in line with the MDGs, at the  
very least growth levels will have to double to some 7%-  
to-8% per annum for the next decade, the financial re-  
quirements of which are incompatible with present and  
projected levels of debt servicing. It is in this context  
that the Report concludes that under present conditions,  
the M8DGs will remain elusive for the African conti-  
nent”.  
At the beginning of the millennium, Africa had a num-  
ber of problems, oil and non-oil commodity prices of  
which 80% of Africa's trade consisted had declined.  
4
8
1
2
For every dollar that flowed into Sub-saharan Africa  
SSA),$1.50 flowed out to the rest of the world due to  
the 8% now expected to achieve the MDG's. African  
countries have the challenge of finding ways of solving  
the triple problems of slow economic growth, high and  
rising unemployment and increasing poverty in a time of  
global economic crisis. Unless this can be done expedi-  
tiously, the African child will remain disadvantaged and  
his survival threatened. The United Nation's Economic  
Report for Africa for 2010 suggests a number of ways  
all of which if implemented would have a beneficial  
effect on child survival in the sub region. These are as  
follows:  
(
debt repayments, thus making Africa a net creditor to  
the rest of the world. African economies had insufficient  
resources to invest in its own people and businesses.  
Protectionism by advanced countries and exchange rate  
misalignments meant poor access to world markets for  
African producers despite rapid trade liberalization. It  
was with such uncertainty that African nations entered  
the new millennium and ratified the MDG's.  
The 2001 UNCTAD report stated that “Africa was  
poorer than two decades earlier due to declining aid and  
terms of trade, mounting debt, ineffective structural ad-  
justment policies. Her per capita income was 10% be-  
low 1980 level; 28 million Africans faced severe food  
Avoiding the commodity trap. Sub- Saharan Africa's  
heavy dependence on exports of primary commodities  
and low value-added products have been partly to blame  
for her poor performance in world trade. In 2004, Africa  
lost out on the boom merchandise trading when Asia's  
economy grew by 5% while non-oil commodity trade  
8
shortages. Many of these were children too young to  
fend for themselves.  
1
3
only grew by 0.6%.  
Africa must find thus, a way to  
Against the odds however, Africa grew faster than any  
other developing region in 2001, reflecting better macro-  
economic management, strong agricultural production,  
and the cessation of conflicts in several countries. But  
the rate of growth was not enough for achievement of  
any of the MDG's which were related to child survival.  
Thus poor economic growth negatively affects child  
survival.  
add value to her commodities moving into higher-value  
exports by upgrading technology and improving produc-  
tivity. It can be done. Botswana's prudent management  
of her diamond resources, made her the fastest growing  
economy in the 1w4 orld between gaining independence  
1966 and 1980, a middle income country with a  
U5MR of 31, GNI $6470, able to provide 10 years free  
education for her children. Sierra Leone's diamonds on  
the other hand have scarcely benefitted her people15. Her  
U5MR stood at 194, and the GNI at $320 in 2010.  
9
Where are we now? Sub Saharan Africa today  
Despite all the challenges however, from 2004 and  
Reduced reliance on Official Development Assistance  
(ODA) : Africa has relied heavily on ODA's (foreign  
aid). In 2008, ODA's to Africa grew by 11%, bu1t6 with  
the credit crunch, was expected to fall in 2010. The  
decline has implications for achieving the MDG's, and  
so on child survival. In addition, a lot of Africa's scarce  
resources has gone into servicing debts, and also the  
terms and conditions for many such loans were unfa-  
vourable17 for socio- economic development and  
growth.  
2
008, sub Saharan Africa's annual economic growth  
averaged 5%, mainly due to o0il exports, until the global  
1
economic downturn of 2008. During the same period,  
considerable progress was made in some areas affecting  
child survival, such as reduction in U5MR from 160 in  
2
006 to 145 in 2007, increased primary school enrol-  
ment, measles vaccination, use of insecticide-treated bed  
nets, reductions in HIV prevalence rates in some coun-  
tries, and improvements in some aspects of gender  
equality. Maternal mortality ratios (MMR's) have been  
stagnant. In 2005, the ratio stood at 900 per 100 000 live  
births, with some countries' MMRs exceeding 1000 per  
Development- enhancing policy on Foreign Direct  
Investments (FDI's): FDI's could be a way of bringing  
in funding for development into the economy without  
incurring more debt. For such funds to be useful to de-  
velop the country however the products must be linked  
to the rest of the economy. At present, with most FDI's  
the products are taken in their raw state out of the coun-  
try with the investors making huge profits with no bene-  
fit to the nations' economy. The UNCTAD report of  
2005 called for a “rethinking of the one-sided emphasis  
on attracting FDI and its replacement with a more bal-  
anced and more strategic approach tailored to African  
socio-ec1o7nomic conditions and development chal-  
lenges.”  
1
Leone, Liberia, Guinea Bissau, and Nigeria).  
00 000 live births, (including Chad, N1i3ger Sierra  
About 80 per cent of maternal deaths are preventable if  
women have access to essential maternity and basic  
health care services. Without the achievement of MDG  
5
, any success with MDG 4 remains hollow. In addition  
there has been very limited headway with poverty and  
hunger reduction, and the many disparities due to gender  
income, and disability. In 2009 the effects of the global  
recession became evident in Africa. On economic de-  
velopment, there was among other things, a si1g1nificant  
deceleration in growth and high unemployment.  
Domestic resource mobilization; Mobilizing "hidden"  
African domestic financial resources can be done in a  
number of ways, such as improving tax collection, for-  
malization of the informal sector economic activities,  
and channeling more workers remittances through the  
formal banking systems. In 2004 officially recorded  
Where are we going -what can Africa do for the fu-  
ture?  
In 2010, Africa's Gross Domestic Product (GDP) was  
expected to increase to 4.3% which still fell far short of  
4
9
remittances alone reached $16 billion. 18 Such remit-  
tances are usually stable sources of income, they do not  
generate debt, have no conditions attached, and are sub-  
ject to fewer 'leakages'.  
Table 2: Wealth and Survival Index for selected African  
Countries 2005 .  
Country  
GNI per capita U5MR Excess  
Mortality  
Stopping Capital flight: If these funds were used for  
productive investments at home, they could create jobs  
and provide the incomes of large segments of the popu-  
lation now unemployed or underemployed. It has been  
estimated that the stock of capital flight from Africa is  
higher than the stock of the continent´s debt.  
Guinea  
Ghana  
Sudan  
Côte  
d’Ivoire  
Senegal  
Mali  
Burkina  
Faso  
2,316  
2,480  
2083  
1,648  
165  
119  
90  
66.57  
24.13  
-13.96  
12.83  
129  
1,792  
1,033  
1,213  
119  
218  
203  
7.21  
77.52  
70.89  
Strengthening regional economic integration for Af-  
rica's development: This would help build stronger  
and more resilient economies promote African econo-  
mies.  
Nigeria  
1,128  
194  
58.08  
Eritrea  
Kenya  
Togo  
Sierra Leone 806  
Niger  
1,109.  
1240  
1506  
78  
120  
-58.81  
-10.97  
-9.86  
117.58  
100.94  
-35.56  
162.00  
Increased South-South collaboration: offers new op-  
portunities for transforming African economies linking  
up with China, Brazil, and India.  
111  
271  
256  
122  
260  
781  
744  
2335  
Climate change issues - integration of issues into  
national decision making: Climate change is a global  
phenomenon affecting all countries but more so the  
poor, vulnerable countries of Africa and elsewhere that  
are the least responsible for it. The issues need to be  
given a higher level of political priority and integrated  
into national decision-making so as to reduce the nega-  
tive effects on resources, livelihoods and the wider econ-  
omy.  
Tanzania  
Angola  
Source: Save the Children lives Why Equity matters  
Conclusion  
However, while child survival is intimately linked with  
socio-economic development, economic growth alone  
will not improve child survival. in other words, nations  
do not have to wait for favourable economic conditions  
to promote child survival issues. Prudent and judicious  
use of available resources and implementation of meas-  
ures that address the structural causes of poverty, can  
improve child survival even in the prevailing condi-  
tions. This is well-demonstrated by the Save the Chil-  
More effort is needed for African policy makers to im-  
prove child survival. For the sake of the survival and  
development of the African Child, policy makers in sub-  
Saharan Africa need to be men and women of vision  
who see that the future of the sub- continent depends on  
the survival and proper development of the children in-  
habiting it today.  
Conflict of interest: none  
Funding : None.  
1
9
dren's Wealth and Survival Index , which shows how  
countries perform on child mortality in relation to their  
level of income).  
In Table 2, the 'excess mortality ' column represents the  
difference between a country's actual child mortality and  
the 'expected' mortality rate given its income level. It  
shows that countries with comparable levels of income  
can differ markedly in their performance on child sur-  
vival. For example, in 2005 Ghana's GNI per capita was  
Acknowledgements  
I wish to thank Dr. William Obeng and Dr. Jonathan  
Aboagye for their help in preparing this paper.  
$
2480, with Angola's only marginally lower at $2335.  
But Ghana's U5M rate was just 119 per 1000 com-  
pared with Angola's 260, which was more than double  
Ghana's.  
5
0
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