The Key Ingredients Needed to Reap the Benefits of Sustainable Development Goal (SDG) 3 – Improving Child Survival and Controlling Fertility Rates

July 23, 2015

By Nicholas Ngomi, Research Officer, APHRC

For the last 15 years following the agreement of the MDGs by 193 countries through a pledge by their presidents to uphold the principles of human dignity, equality and equity, and with the aim of freeing the world from extreme poverty, there is no single political party manifesto, strategic framework or speeches by leaders that do not refer to it. As the MDGs expire by the end of this year, the pertinent question of whether the set goals were achieved or not should be the topic of discussion. Many explanations can be made, but the reality is that significant progress has been registered in a number of areas; though the progress has been uneven and some of the goals remain off-track especially in developing countries.

Many countries, for example, have registered great improvement in child survival with the global child mortality having almost halved since 1990. Birth rate on the other hand remains significantly high.  The result especially in least developed countries is the youth bulge (a population comprising of children and young adults).

In Africa, an estimated 40 percent of the population is under 15, and nearly 70 percent is under 30. However, many African countries are experiencing poor governance characterized by misplaced priorities and corruption both of which have been ruling headlines in major media houses. Very little attention is being paid to vital milestones and the impact of attaining set developments on an individual.  What is worrying is that most major media houses across the continent have headlines dominated by either politics or unsolicited methods of tackling socio-economic dynamics like alcoholism instead of taking stock of how far we are and/or whether or not we have attained the goals set a decade and a half ago.

Focus is fast shifting from MDGs to its successor, the Sustainable Development Goals (SDGs). But I dare ask, how prepared are we to benefit from the gains of SDGs for the next fifteen (15) years?

Over the last 40 years, Thailand has emerged as an economic powerhouse for South-East Asia – for reasons that I believe sub-Saharan African countries can learn from. First is to have control over variables that directly affect life expectancy at birth (child survival) and second is being in position to control fertility hence keeping population growth at bay.

Increased investment in health systems has proven to drastically improve child survival in countries like Rwanda where the likelihood of a child dying before age five was cut in half within a decade. To achieve the youth bulge, the focus should be on simple aspects including but not limited to health facility delivery assisted by skilled attendants, immunization for all, effective treatment for childhood illnesses and special attention to first-time mothers where child mortality and illnesses are highest.

Low fertility compounded by increased information or knowledge and voluntary use of contraceptives ensures that families achieve their desired size because they will make informed decisions as to when to have children and how many they can have. This, in return, will result in a large percentage of the population being between ages 25- 64 years compared to those less than 25 years. This way, we will end up with a relatively older population with better education and better health. Country’s dependency ratio, that is, the ratio of the non-working age population to the working age population will decline. At that point, attention can shift to better evidence-guided policies focusing on education opportunities, job creation and investment openings for the working age and older population. Majority of the young people will be fully engaged in income generating activities and by keeping all other factors constant, the youth bulge will transform to a demographic dividend.

Come 2016, the need for governments to align their strategies with Sustainable Development Goals (SDGs), which will serve as the core of a universal post-2015 development agenda, cannot be over-emphasized. It will be important to focus on agents of accelerated economic growth resulting from a decline in a country’s mortality and fertility hence subsequent change in the age structure of the population.

Special attention should be paid to SDGs 3 geared towards bringing to an end preventable deaths of newborns and under-five children and ensuring universal access to sexual and reproductive health care services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes.

African governments should increase proportionately their political commitment and resources for family planning and child survival. This way, they will transform their demographic prospects in just 20 years and position themselves to reap the dividends of the demographic transition.


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