Mothers and children in sub-Saharan Africa

Every year in sub-Saharan Africa, 265,000 mothers die in childbirth and 4.5 million children die before the age of 5 from preventable causes.

There’s nothing more primal or profound that our collective societal feelings for mothers and children. And yet, in some parts of the world, mothers and children continue to suffer mightily in ways that are difficult to understand. The Population Reference Bureau (PRB) tried to shed some light on the causes and effects today, by hosting an online discussion about mothers and children in sub-Saharan Africa, one of the most stressed and poorest spots on the globe. The PRB discussion is a follow-up to a U.S. congressional briefing on this topic, held in June 2009 in Washington, D.C.

A full transcript of the web discussion is posted here. John Bongaarts and Nafissatou Diop led the discussion. They are both with an international, non-profit NGO called the Population Council.

And they said that, every year in sub-Saharan Africa, 265,000 mothers die in childbirth and 4.5 million children die before the age of 5 from preventable causes. At the same time, sub-Saharan Africa is experiencing fertility rates among the highest in the world. Mothers dying, children dying and yet more children being born. Why?

John Bongaarts mentioned several reasons why married women in this part of the world don’t use contraception. He said the desired family size here is typically around five (5.4 children per woman is average), so some women simply want more children. He also mentioned women who may not want to get pregnant, but don’t use contraception due to fear of side effects, lack of knowledge and access, costs and opposition from self, spouse or others. Quality health care, counseling and appropriate media messages can help in this case, he said.

In an already stressed region of the world, more children mean more adverse effects. Yet the reverse is also true, according to Bongaarts. Reductions in fertility can make important contributions to economic growth through several mechanisms.

First, he said, according a recent UN report, “for every dollar spent in family planning, between 2 and 6 dollars can be saved in interventions aimed at achieving other development goals.”

Second, he said, as women spend less time on childcare, they can become wage earners outside the family – thus boosting income and reducing poverty.

Finally, he said, “fertility decline leads to a so-called demographic dividend which refers to a rise in the rate of economic growth due to a rising share of working age people in a population. Reduced fertility also increases expenditures on children’s education and health, and encourages savings thus giving economic growth a further boost.”

No discussion of sub-Saharan Africa and population growth would be complete without a mention of the ongoing HIV/AIDS epidemic. Sub-Saharan Africa is home to over 70% of the total world HIV-positive population, according to the website In today’s PRB discussion of Africa, though, population experts said that this continent’s rapid population growth more than offsets the deaths due to AIDS.

The conclusion: in spite of these challenges, family planning continues to be one of the best opportunities to improve the health of mothers and children throughout Africa.

View a webcast of the briefing (time: 39 minutes), featuring John Bongaarts, Nafissatou Diop, and Jotham Musinguzi, regional director of Partners in Population and Development, Africa Regional Office in Uganda.

But I would not give you false hope
On this strange and mournful day
When the mother and child reunion
Is only a motion away,
Oh the mother and child reunion
Is only a motion away … – Paul Simon

Deborah Byrd