Youth, Regional SRHR Commitments, Family planning and the Demographic Dividend

1. Youth, Regional SRHR Commitments, Family planning and the Demographic Dividend By Dr Ademola Olajide Head of Division, HNP African Union Commission

2. Background • The OAU was formed with the principal aim of facilitating the liberation African states from colonialism; • As the majority of States found themselves independent, they were confronted with challenges to development; • The OAU consequently transited to the African Union with a vision of a “peaceful, prosperous and integrated Africa, driven by its citizens and playing its role on the global arena;

3. Background contd • The AU therefore recognized the role of the continent’s citizens, that the most strategic resources available to the continent was it’s human resources; • In response to the international commitments that seek to address the challenges to human capital development (such as the ICPD and MDGs); the Union proceeded to undertake continental commitments;

4. ICPD • International Conference on Population and Development – Cairo 1994. • Identified the inter-relationship between population and development on a holistic basis, highlighting the centrality of reproductive health to that interaction. • A Programme of Action (ICPD PoA) was agreed upon for implementation by 179 countries with targets set for 2015

5. ICPD • ICPD consensus starts with respect for national sovereignty and for human rights. • Goals include universal access to education and health care, including reproductive health—family planning services; safe motherhood; treatment and prevention of sexually transmitted infections including HIV/AIDS, and protection from violence. • Others also include empowering women and guaranteeing their access to education, health care and work outside the home.

6. MDGs • 189 nations committed themselves to transforming the lives of the world’s people including reducing by half the number of people living in extreme poverty. • However poverty cannot and will not be eradicated without achieving ICPD goals such as Universal access to education and Reproductive Health Care.

7. Continental Policy Framework on SRHR • CAMH2 (Gaborone – 2005) recognized that African countries were not likely to achieve the MDGs without significant improvements in the Sexual and Reproductive Health and Rights of the people of Africa • Adopted the Continental Policy Framework on Sexual and Reproductive Health and Rights which was later endorsed by AU Heads of State in January 2006.

8. Continental Framework contd • The continental framework addresses the reproductive health and rights challenges faced by Africa; • It calls for strengthening the health sector component by increasing resource allocation to health, mainstreaming gender issues into socio-economic development programmes and SRH commodity security;

9. MPoA • A short term plan (2010) for the Operationalisation of the Continental Policy Framework (extended to 2015). • Nine action areas: Integration of sexual and reproductive health (SRH) services into PHC, repositioning family planning, developing and promoting youth-friendly services, unsafe abortion, quality safe motherhood, resource mobilization, commodity security and monitoring and evaluation. • The Plan is premised on SRH in its fullest context as defined at ICPD/PoA 1994 taking into account the life cycle approach addressing all the elements of SRHR as articulated by ICPD.

10. Challenges to the implementation of MPoA • Generally - Inadequate resources, weak health systems, HRH issues, inequities in access, weak multisector response (and poor coordination), low priority accorded to health in national development plans (limited health financing), unfavourable legislation, socio-cultural factors and inadequate monitoring and evaluation systems/data. • Gender issues, anchored strongly on social cultural factors have remained a significant challenge underpinning sub-optimal delivery of results

11. Africa’s Socio-economic context • Africa continues to have one of the highest population growth rates globally; • Africa is the youngest continent, with almost 200 million people aged between 15 and 24; • Africa is currently experiencing a ‘youth bulge’, with about 42 per cent of the entire population is under the age of 15

12. Africa’s Socio-economic context • Africa as a whole has recorded reductions in child mortality by about 33% and maternal mortality by about 41% since 1990; • However the current figures for child and maternal mortality remain high on the continent; • The bulk of the world’s chronic under-nutrition (more than 80%) is borne by 24 countries, half of which are in Africa;

13. Africa’s Socio-economic context • Economic growth in Africa has averaged over 5 per cent per annum during 2000 and 2009; • One in four Africans live in Country that has averaged about 4% economic growth over the last decade; • Soaring prices for commodities such as oil and minerals have helped lift GDP since 2000; • Commodities accounted for only about a third of the newfound growth.The rest resulted from internal structural changes that have spurred the broader domestic economy;

14. Africa’s Socio-economic context • Expanding labour force > 500 million people of working age, (> 1.1 billion by 2040) —more than in China or India—lifting GDP growth; • Africa with a large share of the world’s naturally resources, 60% of the global uncultivated arable land should be able to turn this potential (1 in 5 of the planet’s young person) to sustainable and equitable growth;

15. Significance of the youth • Adolescent pregnancy is a significant challenge in Africa and the risk of child and maternal morbidity and mortality increases; • Adolescent pregnancy has the potential to increase the population momentum; • Adolescent SRHR challenges negatively impact the development of human capital necessary to promote sustainable socio-economic development;

16. Significance of the youth • The quality of Africa’s “youth capital” will determine the trajectory of the continent and her nation state’s development; • Access to SRHR services including family remains critical to addressing some of Africa’s most intractable development challenges;

17. Concept of Demographic Dividend • Rapid and sustainable economic growth as consequence of a demographic transition from high fertility and high mortality to low fertility and low mortality equilibrium; reducing the dependency ratio and increasing the size of the working age population; • This large cohort of working age population presents the opportunity to stimulate economic growth – demographic dividend;

18. Concept of Demographic Dividend

19. Fertility Total fertility as a measure of fertility is defined as the total number of children a woman would bear if fertility rates remained the same during her lifetime. Total fertility rate of Africa and its sub-regions(4) All regions in Africa have a TFR above replacement levels

20. Fertility and Africa’s demographic dividend • The reductions in fertility rate in Africa is yet to reach levels that experts believe can optimize harnessing the demographic dividend; • Several factors account for fertility reduction including urbanization, modernization, education etc; as economic conditions of women increase fertility rates will reduce; • Also as fertility rates reduce, economic conditions of women improve; therefore increased update of FP remains critical

21. Mortality Mortality plays a key role in the demographic dividend. “Demographic transition” refers to the change from high and unpredictable mortality and fertility to low and stable mortality and fertility rates. (6)

22. Mortality reduction and Demographic Dividend in Africa; • Mortality reduction across Africa as a whole falls below the target set by the Millennium Development Goals; • Mortality reduction requires not just a strengthening of the health system but also deliberate attention to issues of SRHR of all population segments; especially FP (for youth) which has been shown to be associated directly with mortality reduction;

23. Harnessing the “DD” for Africa’s transformation • The demographic dividend has been described as that one-time jump in economic growth consequent upon increased economic output of the productive population; • Focused policies must therefore be implemented to improve the quality of that crop of human capital as well create opportunities for their productive engagement in economic activities;

24. EDUCATION POPULATION STRUCTURE DEMOGRAPHIC DIVIDEND HEALTH GOVERNANCE ECONOMICS Harnessing the demographic dividend

25. Strategies to harness a Demographic Dividend in Africa • Promote gender equality, equity and empowerment of women (50%); • Improve access to Qualitative Education - Each year of schooling is associated with an increase in wages (10% or more); • Enhance health status including access to FP services and information;

26. Strategies to harvest from the Demographic Dividends in Africa - 2 • Strengthen Food and Nutrition Security; - one in five children in Africa is moderately or severely underweight, with significant economic losses (COHA); • Facilitate Policy Coherence; e.g. promote decent jobs for young persons, between 2000 and 2008 Africa created 73 million jobs but only 16 million jobs were created for young people 15 and 24;

27. Conclusion • As African states experience current economic growth rates; efforts must be consciously undertaken to optimize the demographic window currently open to the continent; • As African economies prepare to soar, we must remember the African proverb; “the quality of a bird’s flight depends on the quality of it’s meal before take off”

28. Merci beaucoup