Africa experiencing some of the biggest falls in child mortality ever seen

 

(from The Economist)

It is, says Gabriel Demombynes, of the World Bank’s Nairobi office, “a tremendous success story that has only barely been recognised”. Michael Clemens of the Centre for Global Development calls it simply “the biggest, best story in development”. It is the huge decline in child mortality now gathering pace across Africa.

According to Mr Demombynes and Karina Trommlerova, also of the World Bank, 16 of the 20 African countries which have had detailed surveys of living conditions since 2005 reported falls in their child-mortality rates (this rate is the number of deaths of children under five per 1,000 live births). Twelve had falls of over 4.4% a year, which is the rate of decline that is needed to meet the millennium development goal (MDG) of cutting by two-thirds the child-mortality rate between 1990 and 2015 (see chart). Three countries—Senegal, Rwanda and Kenya—have seen falls of more than 8% a year, almost twice the MDG rate and enough to halve child mortality in about a decade. These three now have the same level of child mortality as India, one of the most successful economies in the world during the past decade.

The decline in African child mortality is speeding up. In most countries it now falling about twice as fast as during the early 2000s and 1990s. More striking, the average fall is faster than it was in China in the early 1980s, when child mortality was declining around 3% a year, admittedly from a lower base.

The only recent fall comparable to the largest of those in Africa occurred in Vietnam between 1985-90 and 1990-95, when child mortality fell by 37%—and even that was slower than in Senegal and Rwanda. Rwanda’s child-mortality rate more than halved between 2005-06 and 2010-11. Senegal cut its rate from 121 to 72 in five years (2005-10). It took India a quarter of century to make that reduction. The top rates of decline in African child mortality are the fastest seen in the world for at least 30 years.

The striking thing about the falls is how widespread they have been. They have happened in countries large and small, Muslim and Christian, and in every corner of the continent. The three biggest successes are in east, west and central Africa. The success stories come from Africa’s two most populous countries, Nigeria and Ethiopia, and from tiddlers such as Benin (population: 9m).

You might expect that countries which reduced their birth rates the most would also have cut child mortality comparably. This is because such countries have moved furthest along the demographic transition from poor, high-fertility status to richer, low-fertility status. But it turns out that is only partly true. Senegal, Ethiopia and Ghana all reduced fertility and child mortality a lot. But Kenya and Uganda also did well on child deaths, though their fertility declines have stalled recently. So it cannot all be just about lower birth rates. Liberia, where fertility remains high, did badly on child mortality—but so did low-fertility places such as Namibia and Lesotho. The link between mortality and broader demographic change seems weak.

What makes a bigger difference, Mr Demombynes argues, is some combination of broad economic growth and specific public-health policies, notably the increase in the use of insecticide-treated bednets (ITNs) which discourage mosquitoes, which cause malaria.

Kenya is a test case. It has cut the rate of infant mortality (deaths of children under one year old) by more than any other country. It has had healthy economic growth (4.8% a year in 2005-10) and a functioning democracy, albeit after horrendous post-election violence in 2008. But Mr Demombynes noticed something else: it increased the use of treated bednets from 8% of all households in 2003 to 60% in 2008. Using figures on the geographical variation of malaria, he calculated that half the overall drop in Kenya’s infant mortality can be explained by the huge rise in the use of ITNs in areas where malaria is endemic.

Bednets are often taken as classic examples of the benefits of aid, since in the past they were pioneered by foreign charities. Consistent with the view that aid is vital, Jeffrey Sachs, an American economist, recently claimed that a big drop in child mortality in his Millennium Villages project (a group of African villages that his Earth Institute of Columbia University, New York, is helping) is the result of large increases in aid to villagers. In fact, argues Mr Demombynes, the mortality decline in these villages was no better than in the countries as a whole.

The broad moral of the story is different: aid does not seem to have been the decisive factor in cutting child mortality. No single thing was. But better policies, better government, new technology and other benefits are starting to bear fruit. “This will be startling news for anyone who still thinks Africa is mired in unending poverty and death,” says Mr Clemens. But “that Africa is slipping quickly away.”

Religious leaders of Israel discuss their commonalities

An imam, a priest and a rabbi walk into a yeshiva. This is not the beginning of a joke, but the account of a unique conference held on Wednesday afternoon in Yeshivat Ma’aleh Gilboa, close to the Galilee region in the North.

Forty religious leaders from the Muslim, Christian, Druse, Bahai, Ahmadi and Jewish faiths based in the North gathered at the yeshiva to discuss matters of religion and society, as well as coexistence in Israel in general, and in the Galilee in particular.

During the five-hour event, the rabbis, imams, priests and assorted religious leaders engaged in joint study sessions dealing with the issue of the gap between religious study and societal improvement, while the yeshiva students also had a chance to ask questions of the different clerical guests.

The conference was a joint initiative of the yeshiva and the Department of Minorities of the Interior Ministry and was also intended to help establish relations and communications between local religious leaders.

Rabbi Yehudah Gilad, one of the two codeans of the yeshiva and a former MK for Meimad, said that the goal of the conference was to create an understanding that the different religious communities living in Israel all descended from the patriarch Abraham and as such, share much common ground.

“Because of this fact, and because we all live in the same country, it’s important for religious leaders, the students of our yeshiva and society at large to get to know each other better,” Gilad told The Jerusalem Post after the conference.

Asked about the difficulties in engaging with other faiths and communities given the often conflicting claims of competing religions, Gilad said that the issue is not relevant to the broader goal of the initiative.

“We’re not conducting a conversation to reconcile the differences between religions, the idea here is to go about making the society in which we all live better for us all,” he said. “The Rambam [Maimonides] said that Islam and Christianity are part of the process leading to the final arrival of the Messiah, because they have spread monotheism around the world and led to a diminution in paganism, so that they have in fact had a very important contribution to humanity.”

Gilad added that the different religious communities in Israel face similar challenges such as how to convey religious values and inspiration to the next generation, and the struggle against negative aspects of Western society such as widely accessible pornography on the Internet, modesty and respect for the institution of the family.

During the question and answer session, students from the yeshiva had the opportunity to pose questions to the different religious leaders, including enquiries about how to pass on religious traditions to coming generations and questions to the Druse leaders about their close connection to the Jewish people.

One student asked to what extent the different clergymen who participated in the event actually influenced their respective communities. In response, some of the Arab leaders said they represent the silent majority of the Arab community, as opposed to organizations like the Islamic Movement and the Arab MKs who are an unrepresentative, yet extremely loud group.

In response to a question about how to convey religious values to the next generation, Father Emile Shoufani, a peace activist, educator and winner of the UNESCO Prize for Peace Education, argued that religion needs to be more open to youth and modernity and asserted that religious establishments and institutions have created a barrier to these objectives.

Odeh Muhammad Sharif of Haifa, the head of the Ahmadi Islamic community in Israel, told the Post that the event was an important initiative to promote the notion that religious communities can live together peacefully and harmoniously.

“If we believe in one God and that he created all mankind in his image, then we need to show concern for everyone, regardless of their faith. We need to care for their security, their wellbeing, that they have food to eat and can live in happiness.

“Religious differences have been made by man,” he continued, “but if we believe that God is the sovereign of all creation, who made one sun for us all, and food and water to share and whom we strive to become close to, then it becomes apparent that conflict between religions is actually a conflict against God who wants us to live in peace.”