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Mortality

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The WHO African Region heads the list of WHO Regions in respect of mortality rates, as well as in the area of life expectancy at birth. It is alone among all WHO Regions in showing an increase in mortality rates between 1990 and 2008. The 2008 mortality rate in the WHO African Region of 392:1000 population is an increase from 1990 estimates of 371:1000, again demonstrating that other factors are at play, including:

  • the overall population increase in these years across the Region
  • the impact on mortality of wars, civil conflict and emergencies
  • the widespread effects of the HIV/AIDS epidemic.

It should also be borne in mind that regional averages can mask individual country performance and that exceptionally high mortality rates in a limited number of countries will drive the regional average upward.

Countries with a large increase in mortality per 1000 population between 1990 and 2008[1]
Countries that have achieved a significant decrease in mortality per 1000 population, 1990 and 2008[1]

The WHO African Region mortality rates are well ahead of the more densely populated WHO South-East Asia Region, where mortality rates in 2008 stood at 218:1000, down from 274:1000 in 1990. Disaggregated by sex, the male mortality rate in the WHO African Region was 412:1000 in 2008, compared with 374:1000 for women. Again, compared with the WHO South-East Asia Region, with male mortality rates of 252:1000 and female rates of 183:1000, these figures are very high and demonstrate that health, social and economic factors combine in Africa to generate early and excessive deaths.

The tables show African countries where a significant change between1990 and 2008 mortality rates has taken place. All figures are taken from the WHO African Region's Atlas of health statistics, 2011.[1]

Vulnerable groups

Mortality rates of infants and children aged under 5 years and maternal mortality rates are of special relevance to health status. In each of these categories, the WHO African Region’s figures show improvements since 1990, although they remain considerably higher than the rates for these groups in other WHO Regions. Antenatal care coverage in particular has advanced, with a regional average of 44% against the global figure of 48%.

Globally, the infant mortality rate stood at 42:1000 live births in 2009, compared with almost double this figure in the WHO African Region (80:1000 in 2009).

The WHO African Region has succeeded in lowering the mortality rate in children aged under 5 years between 1990, when it stood at 179:1000 live births, and 2009 when it had been reduced to 127:1000. While representing a move in the right direction, much progress is still needed to approach the rates of other WHO Regions. The WHO Eastern Mediterranean Region has the next highest mortality rate to the WHO African Region for mortality in this group, and has narrowed the gap from 104:1000 live births in 1990 to 72:1000 in 2009. Globally, the 2009 mortality rate for children aged under 5 years in 2009 was 60:1000 live births.

In the WHO African Region, the diseases causing the highest mortality rates in children aged under 5 years of age are diarrhoeal disease (18%), pneumonia (17%) and malaria (16%).[2]

The drop in the maternal mortality ratio from 850:100 000 live births in 1990 to 620:100 000 in 2008 represents some progress, but remains unacceptably high and demonstrates that grave obstacles remain in this area. A woman living in sub-Saharan Africa still has a 1 in 16 risk of dying due to pregnancy or childbirth. Many of these women will be adolescent mothers. The figures for the WHO African Region are again nearly double those of other WHO Regions with the next highest maternal mortality figures being the WHO Eastern Mediterranean Region. Globally, the maternal mortality ratio has been reduced from 400:100 000 live births in 1990 to 260:100 000 in 2008.

On a country basis, it is noteworthy that for the countries with the highest rates of maternal mortality per 100 000 live births (Chad, Guinea Bissau, Liberia) the degree of change from 1990 to 2008 is relatively small. Against this, some African countries, including Equatorial Guinea, Eritrea, Malawi and Rwanda, have achieved a large reduction during this period. Therefore, it is difficult to obtain an accurate understanding by examining only regional averages. What is clear is that the WHO African Region is very unlikely to meet the Millennium Development Goal target for reduction in maternal mortality by 2015.

References

  1. 1.0 1.1 1.2 Health situation analysis in the African Region. Atlas of health statistics, 2011 (pdf 2.9Mb). Brazzaville, World Health Organization, Regional Office for Africa, 2011
  2. Distribution of causes of death among children aged < 5 years. Brazzaville, World Health Organization African Region, Health Statistics Profile, 2008