HEALTH AND FAMILY PLANNING IN AFRICA

 

Family Planning

Over the last 15 years Africa has experienced the most rapid reduction in fertility rates that the world has ever seen. Nevertheless, fertility rates are still higher than anywhere else in the world, with annual population growth of 2.7%. Africa's population is likely to nearly double between 1997 and 2020, from about 614 million to more than 1.1 billion.

Africa's population is young: nearly half of all Africans are under age 15. This demographic reality places tremendous burdens on family incomes, the region's potential for economic growth and a range of social structures--such as educational and health systems. A promising trend suggests that population growth is slowing in several African countries. Botswana, Kenya and Zimbabwe are in the midst of this transition. Fertility in Kenya, for example, dropped more than 20% in just four years with the help of USAID programs; in Zimbabwe fertility decreased 33% over 10 years. Ghana, Malawi, Madagascar, Tanzania, and Zambia, though at earlier stages of the transition, appear to be moving along the same path.

 

Children’s Health

USAID is one of the leaders in the effort to improve child survival, working closely with a variety of other bilateral and multilateral donors. These collaborative efforts have resulted in remarkable advances.

Twenty years ago, fewer than 5% of children in developing countries were immunized against measles, diphtheria, polio, and tuberculosis--now, more than 80% are immunized. Immunization coverage has increased by 10% in the region over the past three years. There was a 60% decline in reported measles cases and a 77% reduction in measles deaths in 1996. USAID and the World Health Organization helped 100 million children below age five receive two supplemental doses of oral polio vaccine. As a result, no poliovirus was isolated in East Africa, including Southern Uganda, Kenya, Tanzania, and Zambia, or throughout Southern Africa. Over the last 10 years alone, death rates for children under 5 have declined by 25% in Africa. Declines in infant mortality continue on the continent, although infant mortality rates in the region are almost twice those found in Asia and Latin America.

 

HIV/AIDS

Unfortunately, AIDS is also reversing many improvements in infant mortality rates and life expectance--AIDS is expected to decrease life expectancy in some countries by as much as 20 years by the year 2000.

USAID’s global AIDS prevention program provides education in behavior change and other interventions for more than 15 million people vulnerable to HIV infection. It has trained more than 150,000 educators and counselors and has distributed 400 million condoms.

 

Malaria

USAID participated in multinational efforts to prevent and treat malaria by launching the Africa Integrated Malaria initiative in Kenya, Malawi and Zambia. In partnership with the World Health Organization, USAID has helped 18 countries adopt systems to evaluate and monitor malaria control. The agency has helped 39 countries establish or revise malaria control plans.

 

Other Advances

Drawing on American research capabilities, and in close partnership with other U.S. agencies and international donors, USAID continued to contribute to improving the approaches and technology used in developing countries. In 1996, the vaccine vial monitor--a simple heat-sensitive tag that indicates whether a vaccine has been kept cold as necessary or not--that was developed by USAID in partnership with the Program for Appropriate Technology in Health and other private sector partners, became required on all vials of oral polio vaccine procured through UNICEF. The World Health Organization estimates that the monitors will reduce vaccine wastage by almost 50% and save $10 million to $12 million a year.

USAID supported field tests showed that vitamin A supplementation, given to infants at birth, can reduce mortality by as much as 64% in the first year of life.