Investing in the future: Addressing challenges faced by 's young population.

40th Session of the Commission on Population and Development

Nyovani Madise African Population and Health Research Center

1 Outline of Presentation

• Why invest in Africa’s young people?

• Health - RH, HIV and AIDS

• Education

• Education – population - health

2 Why Invest in Young People?

• Human Capital= Population x Health X Education

• Young people have the greatest potential for change.

• Large proportion of population

3 Africa’s Youthful Population fuelled by High Fertility 6

5

4

3

2

1

Number of childrenNumber per woman 0 n a ca a a a c i e ric fr b Asi A rth Ame Oceania SS Afri o Carib n N Lati North America 4 Source: World Population Datasheet 2005. Africa’s0.7 growing young population

0.6

0.5

0.4 15-24 years

0.3 Proportion 0.2 5-14 years

0.1 0-4 years 0

0 0 90 195 196 1970 1980 19 2000 2010 2020 2030 2040 2050

Source: Compiled from UN World Population 5 Prospects, 2006 Revision. The Health of Young People Matters

6 Young People’s Health

• Historically African infants and babies have high disease and mortality burden • Youth have low disease burden BUT increasing due to – Reproductive ill-health – Teen pregnancies – STI infections – HIV and AIDS

7 Sexual behaviour among 15-19 yr-olds

Females 39

Ghana 21

Malawi 28

Uganda 37

Males Burkina Faso 25

Ghana 10

Malawi 38

Uganda 32

0% 20% 40% 60% 80% 100%

Never had sexHad sex but not in last 12 monthsHad sex in last 12 months 8 Source: National Surveys of Adolescents 2004 But they are ill-protected against consequences

Unmarried females aged 15-19 years

59 61 70 54 55 60 46 40 39 50 35 40 30 20 10 0

Burkina Faso Ghana Malawi Uganda Current use of any method of contraceptionCondom use in last 3 months

9 Source: National Surveys of Adolescents 2004 Many births to mothers under age 20 were wanted later or not at all: West Africa (DHS data)

Benin 20 0

Burkina Faso 17 1

Côte d'Ivoire 34 1

Ghana 37 21 Birth was wanted later

Guinea 13 1

Mali 16 2 Birth was not wanted at all Mauritania 21 5

Niger 10 1

Nigeria 9 7

Senegal 27 1

Togo 48 4

0 10203040506070 10 (cont’d) East and Southern Africa (DHS data)

Ethiopia 20 11

Eritrea 28 5

Kenya 26 21

Lesotho 8 41

Madagascar 3 11 Birth was Malawi 15 18 wanted later Mozambique 1 23 Namibia 32 34 Birth was not Rwanda 8 wanted at all 15 13 66 Uganda 9 23 United Republic of Tanzania 5 15 Zambia 22 17 Zimbabwe 3 37 0 20406080100

11 High HIV prevalence among young Africans

Lesotho Lesotho

Zambia Zambia

Malaw i Malaw i

Kenya Kenya

Tanzania Tanzania

Uganda Uganda Males Females Cameroon Cameroon

Cote d'Ivoire Cote d'Ivoire

Ghana Ghana

Mali Mali

Ethiopia Ethiopia

Burkina Faso Burkina Faso

0102030 0 5 10 15 20 25 30

15-24 Males 25-49 Males 15-24 Females 25-49 Females12 Proportion of deaths to females aged 100% 15-29 years by cause 90% 80% 70% 60% 50% 40% 30% 62.4 41.1 46.3 20% 2005 2015 2030 10% 0%

TB HIV/AIDS Other causes

13 Compiled from WHO Burden of Disease Statistics Proportion of deaths to males aged 15-29 years by cause 100% 90% 80% 70% 60% 50% 40% 30% 30.5 38.6 20% 25.3 10% 0% 2005 2015 2030

TB HIV/AIDS Other causes

14 Compiled from WHO Burden of Disease Statistics A Synergistic Response for Family Planning and HIV services

• Higher HIV infection rates among young people especially females (3:1 ratio) • More than 25% of girls have started childbearing by age 19 in many African countries)

15 Education Matters

16 Investing in young people: education

Education: has intrinsic value in itself but also key determinant of • Health, • Population change - fertility, mortality, migration • Economic development

17 Young people need opportunities for schooling

• DHS data (2000-2005) on young people aged 6-10 years attending school:

– 59% where there is no free primary education

– 74% where there is free primary education

18 Making education affordable

Primary Attendance, by Wealth. Malawi DES (2000)

1 0.91 0.85 0.9 0.81 0.8 0.73 0.74 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 Lowest Second Middle Fourth Highest 19 Differential in secondary education by wealth status

Secondary Attendance, by Wealth. Malawi DES (2000)

0.25 0.23

0.2

0.15

0.1 0.07 0.06 0.04 0.05 0.03

0 Lowest Second Middle Fourth Highest 20 Gender differences persist especially for secondary education

Ratio of females-to-males in School by 1.20 Age in Selected African Countries

1.00 0.97 0.80 0.79 0.60

0.40

0.20 6-15 year-olds 16-20 year-olds 0.00

21 Source: DHS surveys, 2000-2005 Education matters

• Make education affordable

• Reduce the difference in school attendance between females and males

• Other forms of education – Skills development – Sex education

• Information for behavioural change 22 Education-Population

• Lower fertility

E,g, Average fertility of African woman Without education = XXX Primary =XXX Secondary =XXX

• Longer birth spacing (34 months for secondary educated women compared with 28 for those without education).

23 Education-Health

• Lower child mortality – 7% reduction for infants of primary educated women – 30% for secondary educated

• Better nutritional status

• Lower prevalence of infectious childhood illnesses

• Higher use of health facilities (delivery, immunization, curative services)

24 The Education-Health Link

Use of health facility for delivery, by woman's education level

100 78

80 50 60

40 28

20

0

None Primary Secondary+

25 Summary

Africa’s young people

+ Investments in health +

+ Education

= Human Development

26 Thank you for your attention

27