Elsevier

Journal of Adolescent Health

Volume 41, Issue 3, September 2007, Pages 230-238
Journal of Adolescent Health

Review article
Youth in Sub-Saharan Africa

https://doi.org/10.1016/j.jadohealth.2007.04.005Get rights and content

Abstract

Sub-Saharan Africa is going through rapid social, political, and economic transformations that have a profound impact on youth. The present review explores trends and outcomes as they relate to education, family formation and sexual and reproductive health and the interrelationships among these areas. It is based on both published and unpublished reports.

Over the past 20 years, school enrollment has increased for much of the subcontinent; although the gender gap has narrowed, females remain educationally disadvantaged. Likewise, marriage is occurring later today than a generation ago, posing new challenges of out-of-wedlock births, clandestine abortions, and an increased likelihood of engaging in premarital sex. So, too, although there has been a slowing of the population growth in much of the region, in many countries of sub-Saharan Africa, the population is doubling every 30 years. Although acquired immunodeficiency syndrome is the predominant cause of death among youth, maternal mortality remains a major risk of death for youth—in some countries 600 times greater than that of peers in the industrialized world.

Section snippets

Education

One of the most significant changes in SSA over the past generation has been the increase in the education of its young people and most specifically young women. In 1980, 19% of males in SSA were enrolled in secondary school, as were 10% of females. Twenty years later, it was 29% of males and 23% of females [5]. Although a positive trend, it is in fact a much more modest gain than in the rest of the developing world [6].

The strong link between the amount of education attained and a wide range

Family Formation

School enrollment and age of family formation are closely intertwined for the younger the age of marriage the lower the educational achievement. For West and Middle Africa there has been a substantial decline in marriage among young women 15–19 years old and 20–24 years old (there are no comparable declines for men in that region of SSA). In Eastern and Southern Africa, although the changes for young females marrying are less dramatic, fewer young women marry today compared with years past.

Mortality

In SSA, acquired immunodeficiency syndrome (AIDS) is the leading cause of death among youth 15–29 years of age [29]. Today, nearly 12 million youth are living with HIV worldwide, of who 9 million are in SSA [30]. Although AIDS is clearly on the agendas of many nations in SSA, youth's role in the epidemic is often unacknowledged. Young people account for approximately half of all new infections [31].

Although the overall prevalence of HIV within SSA is higher than any other region of the world,

Sexual and Reproductive Morbidity

Beyond AIDS and obstetrical complications, reproductive health related conditions are a major cause of morbidity among young women in SSA. Specifically, the WHO estimates that in “high mortality countries” (including all of SSA), among women 15–29 years of age sexual and reproductive health problems account for 63% of Disability Adjusted Life Years (DALYs), of which 37% is due to AIDS.

Individual behaviors

Three studies from SSA explored the relationships among risky, non-sexual behaviors and sexual initiation among adolescents [46], [47], [48]. What emerge are six factors that are significantly interrelated: early sexual activity, weapon carrying, attending discos/clubs, smoking cigarettes, using drugs, and using alcohol. In Zambia, for example, adolescents who used alcohol are almost two times more likely to have had sex [46], [47]. In Kenya, the relationship between alcohol and sexual

Conclusion

Youth in SSA are experiencing rapid social change, with fewer resources than the rest of either the developing or industrialized world. Child survival has allowed more young people to emerge into adolescence; however, in SSA, these youth are poorer, have less education, have more rapid population growth, have higher maternal mortality, have greater HIV prevalence, and have fewer vocational options than anywhere else in the world. This does not need to remain their reality; but it will require a

Acknowledgments

This work was supported in part through the William H. Gates Sr. Endowment, Johns Hopkins Bloomberg School of Public Health, and The World Bank.

References (59)

  • T.P. Schultz

    Why governments should invest more to educate girls

    World Develop

    (2002)
  • Engendering Development: Through Gender Equality in Rights, Resources and Voice

    (2001)
  • Liebbrandt M, Mlastsheni C. Youth in Sub-Saharan Labour Markets. Presented at the DPRU-TIPS-Cornell University Forum on...
  • N. O'Higgins

    Youth Unemployment and Employment Policy: A Global Perspective

    (2001)
  • Schultz TP. Evidence of Returns to Schooling in Africa from Household Surveys: Monitoring and Restructuring the Market...
  • C. Lloyd

    Growing Up Global: The Changing Transitions to Adulthood in Developing Countries

    (2005)
  • I.V.S. Mullis et al.

    TIMSS 1999 International Mathematics Report: Findings from IEA's Repeat of the Third International Mathematics and Science Study at the Eighth Grade

  • J. Raynor et al.

    The girl's stipend program in Bangladesh

    J Educ Int Develop

    (2006)
  • Moulton J, Mundy K, Welmond M. Paradigm lost? The implementation of basic education reforms in sub-Saharan Africa....
  • Lacey M. Primary schools in Kenya, fees Abolished, are filled to overflowing. New York Times (January 7, 2003),...
  • B. Bruns et al.

    Achieving Universal Primary Education by 2015: A Chance for Every Child

    (2003)
  • C.B. Lloyd et al.

    High fertility and children's schooling in Ghana: Sex differences in parental contributions and educational outcomes

    Population Studies

    (1994)
  • Lam D, Marteleto L. Small families and large cohorts: The impact of the demographic transition on schooling in Brazil....
  • B. Mensch

    The transition to marriage

  • C. Enel et al.

    Migration and marriage change: A case study of Mlomp, a Joola village in rural Senegal

  • W.W. Karanja

    The phenomenon of outside wives: Some reflections on the possible influence on fertility

  • Clingnet R. On dit que la polygamie est morte, vive la polygamie! In: D. Parkin D, Nyamwaya D (eds). Transformations of...
  • A.J. Gage et al.

    The changing dynamics of family formation: Women's status and nuptiality

  • J. Ensminger et al.

    Changing social norms: Common property, Bridewealth and clan exogamy

    Curr Anthropol

    (1997)
  • Cited by (82)

    View all citing articles on Scopus
    View full text