Three women with obstetric fistula await repairs.
Population growth outpaces economic gains
Sub-Saharan Africa faces serious political, economic and social challenges. With an annual growth rate of 2.2 per cent, the region's population increased from 906 million in 2005 to 1.1 billion in 2010.
The average African is poorer now
Twenty years of an almost 3 per cent annual population growth has outpaced economic gains, leaving Africans on average 22 per cent poorer than they were in the mid 1970s.
Greater economic growth needed
Despite improved economic performance in recent years, the overall gross domestic product growth rate is below the 6 to 8 per cent that is required over a 10-year period in order to achieve the Millennium Development Goals.
AIDS affects life expectancy
Life expectancy has decreased sharply due to AIDS.
Census data needs to be priorized
The lack of access to information and reliable data on population issues has been an obstacle to sustainable development. Only 43 per cent of the region's countries has undertaken national population and housing censuses. Ensuring the collection of, analysis of and access to data needs to be a top priority in the coming decade.
Large-scale migrations for economic and political reasons
The large-scale migration of people trying to escape poverty and political instability is a serious issue. A contributing factor is the rapid increase of new entrants into the labour market because of the large youth population.
Rapid birth rate and unemployment
High fertility rates are outpacing the capacity of economies to generate enough jobs. Even in cases where slowing fertility is about to bring a demographic bonus, the lack of employment opportunities will make it difficult for countries to capitalise on the positive dependency ratios that accompany the early stages of a demographic transition.
AIDS is an emergency
Sub-Saharan Africa remains the region most affected by the AIDS epidemic. About half of African countries have declared AIDS an emergency. Yet in spite of an unprecedented global response, the rate and scale of implementation of programmes remain low.
Women and youths bear the brunt
Only about 10 per cent of people have access to condoms. HIV continues to escalate; over 22 million Africans are living with HIV. In contrast to other regions, the majority of people (61 per cent) living with HIV are women. Young people account for half of the 1.7 million new infections (2007 figures).
Too many die in childbirth
The maternal mortality ratio is unacceptably high. Forty per cent of all pregnancy-related deaths worldwide occur in Africa. On average, 500 women die per 100,000 live births.
High unmet need for contraception
About 22,000 African women die each year from unsafe abortions, reflecting a high unmet need for contraception. Contraceptive use among women varies from 50 per cent in the southern sub-region to less than 10 per cent in Central and West Africa.
Women and girls are worst off
The feminisation of AIDS and poverty, low literacy rates for girls, the low representation of women in decision-making structures, gender-based violence and inadequate allocation of resources to gender issues are obstacles to development. The Maputo Plan of Action, which promotes an integrated approach to sexual and reproductive health and reproductive rights, will be the focus of future activities, including in conflict and post-conflict situations.