BackgroundDespite the sharp decline in global under-5 deaths since 1990, uneven progress has been achieved across and within countries. In sub-Saharan Africa (SSA), the Millennium Development Goals (MDGs) for child mortality were met only by a few countries. Valid concerns exist as to whether the region would meet new Sustainable Development Goals (SDGs) for under-5 mortality. We therefore examine further sources of variation by assessing age patterns, trends, and forecasts of mortality rates.Methods and findingsData came from 106 nationally representative Demographic and Health Surveys (DHSs) with full birth histories from 31 SSA countries from 1990 to 2017 (a total of 524 country-years of data). We assessed the distribution of age at death through the following new demographic analyses. First, we used a direct method and full birth histories to estimate under-5 mortality rates (U5MRs) on a monthly basis. Second, we smoothed raw estimates of death rates by age and time by using a two-dimensional P-Spline approach. Third, a variant of the Lee–Carter (LC) model, designed for populations with limited data, was used to fit and forecast age profiles of mortality. We used mortality estimates from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) to adjust, validate, and minimize the risk of bias in survival, truncation, and recall in mortality estimation. Our mortality model revealed substantive declines of death rates at every age in most countries but with notable differences in the age patterns over time. U5MRs declined from 3.3% (annual rate of reduction [ARR] 0.1%) in Lesotho to 76.4% (ARR 5.2%) in Malawi, and the pace of decline was faster on average (ARR 3.2%) than that observed for infant (IMRs) (ARR 2.7%) and neonatal (NMRs) (ARR 2.0%) mortality rates. We predict that 5 countries (Kenya, Rwanda, Senegal, Tanzania, and Uganda) are on track to achieve the under-5 sustainable development target by 2030 (25 deaths per 1,000 live births), but only Rwanda and Tanzania would meet both the neonatal (12 deaths per 1,000 live births) and under-5 targets simultaneously. Our predicted NMRs and U5MRs were in line with those estimated by the UN IGME by 2030 and 2050 (they overlapped in 27/31 countries for NMRs and 22 for U5MRs) and by the Institute for Health Metrics and Evaluation (IHME) by 2030 (26/31 and 23/31, respectively). This study has a number of limitations, including poor data quality issues that reflected bias in the report of births and deaths, preventing reliable estimates and predictions from a few countries.ConclusionsTo our knowledge, this study is the first to combine full birth histories and mortality estimates from external reliable sources to model age patterns of under-5 mortality across time in SSA. We demonstrate that countries with a rapid pace of mortality reduction (ARR ≥ 3.2%) across ages would be more likely to achieve the SDG mortality targets. However, the lower pace of neonatal mortality reduction would prevent most countries from achieving those targets: 2 countries would reach them by 2030, 13 between 2030 and 2050, and 13 after 2050.

This database presents HNP data by wealth quintile since 1990s to present. It covers more than 70 indicators, including childhood diseases and interventions, nutrition, sexual and reproductive health, mortality, and other determinants of health, for more than 90 low- and middle-income countries. The data sources are Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS).

Vulnerable population identified by the nutritional status of children (weight for age and weight for height) as indicators for food security, in sample of households in West Africa study area. Data based on DHS and MICS surveys. In defining vulnerability, WFP (2009) and IFPRI (2012) have been followed and combined with indicators for food security with health indicators that signal vulnerability in a physical sense. IFPRI's Global Hunger Index uses three indicators to measure hunger: the number of adults being undernourished, the number of children that have low weight for age, and child mortality. Other classifications of food security use the variety of the diet as an indicator, combined with anthropometric data on children. However, in the DHS data there were no information available on child mortality, nor on dietary composition. Given these data limitations, data on nutritional status of women (Body Mass Index, BMI) for women and children (weight for age and weight for height) have been used as indicators for food security. These data were combined with data on morbidity among adults and children, specifically the occurrence of malaria, cough, and diarrhea. Combinations of indicators have led to a classification of households as being very vulnerable, vulnerable, nearly vulnerable and not vulnerable.

This data set was produced in the framework of the "Climate change predictions in Sub-Saharan Africa: impacts and adaptations (ClimAfrica)" project, Work Package 5 (WP5). More information on ClimAfrica project is provided in the Supplemental Information section of this metadata.

This study in WP5 aimed to identify, locate and characterize groups that are vulnerable for climate change conditions in two country clusters; one in West Africa (Benin, Burkina Faso, Côte d’Ivoire, Ghana, and Togo) and one in East Africa (Sudan, South Sudan and Uganda). Data used for the study include the Demographic and Health Surveys (DHS) , the Multi Indicator Cluster Survey (MICS) and the Afrobarometer surveys for the socio-economic variables and grid level data on agro-ecological and climatic conditions.

Data publication: 2013-08-01

Supplemental Information:

ClimAfrica was an international project funded by European Commission under the 7th Framework Programme (FP7) for the period 2010-2014. The ClimAfrica consortium was formed by 18 institutions, 9 from Europe, 8 from Africa, and the Food and Agriculture Organization of United Nations (FAO).

ClimAfrica was conceived to respond to the urgent international need for the most appropriate and up-to-date tools and methodologies to better understand and predict climate change, assess its impact on African ecosystems and population, and develop the correct adaptation strategies. Africa is probably the most vulnerable continent to climate change and climate variability and shows diverse range of agro-ecological and geographical features. Thus the impacts of climate change can be very high and can greatly differ across the continent, and even within countries.

The project focused on the following specific objectives:

1. Develop improved climate predictions on seasonal to decadal climatic scales, especially relevant to SSA;

2. Assess climate impacts in key sectors of SSA livelihood and economy, especially water resources and agriculture;

3. Evaluate the vulnerability of ecosystems and civil population to inter-annual variations and longer trends (10 years) in climate;

4. Suggest and analyse new suited adaptation strategies, focused on local needs;

5. Develop a new concept of 10 years monitoring and forecasting warning system, useful for food security, risk management and civil protection in SSA;

6. Analyse the economic impacts of climate change on agriculture and water resources in SSA and the cost-effectiveness of potential adaptation measures.

The work of ClimAfrica project was broken down into the following work packages (WPs) closely connected. All the activities described in WP1, WP2, WP3, WP4, WP5 consider the domain of the entire South Sahara Africa region. Only WP6 has a country specific (watershed) spatial scale where models validation and detailed processes analysis are carried out.

Contact points:

Metadata Contact: FAO-Data

Resource Contact: Lia van Wesenbeeck

Resource Contact: Ben Sonneveld

Resource constraints:

copyright

Online resources:

Weight for age <-3DS, % of population - Distribution in sample of households in West Africa

Weight for age -2SD --3SD, % of population - Distribution in sample of households in West Africa

Weight for age -2SD--0, % of population - Distribution in sample of households in West Africa

Weight for age >0SD, % of population - Distribution in sample of households in West Africa

A spatially explicit assessment of specific vulnerabilities of the food system due to climate change and the identification of their causes; Technical report

Scenarios of major production systems in Africa

Climafrica - Climate Change Predictions In Sub-Saharan Africa: Impacts And Adaptations