UNITED NATIONS
ECONOMIC AND SOCIAL COUNCIL
Original: ENGLISH
ECONOMIC COMMISSION FOR AFRICA Sixteenth meeting of the Technical
Preparatory Committee of the Whole Addis Ababa, Ethiopia
24-28 April 1995
ECONOMIC COMMISSION FOR AFRICA Thirtieth session of the Commission/
twenty-first meeting of the Conference of Ministers Addis Ababa, Ethiopia 1-4 Mav 1995
Human Development in Africa,
1995 Report
UNITED NATIONS
ECONOMIC AND SOCIAL COUNCIL
E/ECA/CM.21/8 30 March 1995 Original: ENGLISH
ECONOMIC COMMISSION FOR AFRICA Sixteenth meeting of the Technical
Preparatory Committee of the Whole Addis Ababa, Ethiopia
24-28 April 1995
ECONOMIC COMMISSION FOR AFRICA Thirtieth session of the Commission/
twenty-first meeting of the Conference of Ministers Addis Ababa, Ethiopia 1-4 May 1995
Human Development in Africa,
1995 Report
CONTENTS
I. INTRODUCTION ...
A. The consensus of human development . . . . 1
B. Objectives of the human development in Africa report ... 6
II. HUMAN DEVELOPMENT: CONCEPT AND MEASUREMENT . . 9
A. The concept of human development ... 9
B. Measuring human development ... 10
HI. THE STATE OF HUMAN DEVELOPMENT IN AFRICA ... 14
IV. GOALS FOR THE CHILD 17
A. The state of Africa's children ... 17
B. Commitments made to Africa's children .... 18
C. Progress in realizing the commitment to Africa's children . . 20
D. Challenges and potential for the future ... 23
E. Lessons learned in the pursuit of goals for children . . .25
V. HEALTH FOR ALL BY THE YEAR 2000 29
A. The state of health in Africa ... 29
B. The Goal of Health for All by the Year 2000 .... 30
C. Africa's record with reference to health for all . ... 31
D. Looking ahead: Challenges and prospects .... 37
VI. BASIC EDUCATION FOR ALL BY THE YEAR 2000 ... 40
A. The state of education in Africa ... 40
B. The World Conference on Education for All . . . 41
C. Review of achievements since Jomtien ... 43
D. Challenges and prospects ... 44
VII. LOOKING AHEAD 49
Boxes Pages
1. A new paradigm of development 3
2. Africa's major human and social development objectives 5
3. Accelerating the social, economic and political empowerment of women:
Critical areas of concern 7
4. The economic and social situation in Africa in 1994 16
5. Consensus of Dakar: Targets for child survival and development
by the end of 1995 21
6. Dakar/Ngor Declaration: Targets for the child and mother 22
7. From bullets to vaccines: Peace dividends for African children? 26
8. The incidence of disease in Africa 30
9. A policy framework towards health for all 33
10. Improvement of women's health, reproductive health including family planning
and integrated population programmes: Proposed remedial actions 36 11. Inadequate access of women to education, training, science and technology:
Proposed remedial actions 42
12. The human dimension of structural adjustment programmes:
Five areas for priority action 50
13. Reversing the decline in sub-Saharan Africa 52
14. Looking ahead 53
A. The consensus on human development
1. The principle that human beings should be at the centre of development policies and strategies has now attained the status of an axiom. For too long, the dominant thinking had been that high growth rates of per capita income are sufficient to guarantee poverty alleviation, more employment and an equitable distri bution of the gains of growth. The pursuit of fast growth rates therefore became the greatest preoccupation of both economists and policy makers.
2. It took years of growth without development in a large number of countries to question the validity of this premise. In country after country, we observed growth rates in per capita income parallel with worsening poverty, growing unemployment and widening disparities in the distribution of income and wealth. In other words, growth in per capita income seldom translated into poverty reduction, less unemployment and a fairer distribution of the larger output of goods and services that growth made possible.
Such a process, whatever else it might be called, does not deserve the name development, because develop ment must mean an improvement in the quality of life of the vast majority of a country's population, not merely that of a privileged stratum. There is something perverse about tacking the label development to a process that marginalizes millions of human beings.
3. To be sure, this does not suggest that growth is unnecessary or irrelevant. In fact, while growth without development is a relatively widespread phenomenon, it is inconceivable to bring about development without growth. For the goals of poverty alleviation, employment creation, universal basic service access and greater equity can only be ensured on the basis of a more bountiful output. The point is that higher growth rates, in and of themselves., do not automatically guarantee the attainment of these objectives.
4. The cardinal lesson, therefore, is that these objectives and many others — including democratic governance, respect for human rights, popular participation, gender equality, environmental conservation and protection, etc. — need to be explicitly built into the development paradigm. The tradeoffs between these objectives and growth, on which much ink has flowed in traditional theory, have been found to be either non-existent or not as stark as they are often made to be. There is thus a broad consensus of profes sional thinking, if not unanimity, that growth and the other objectives need to be pursued in tandem, not regarded as irreconcilable categories.
5. This is the intellectual background against which UNDP launched its first Human Development Report in 1990. That human beings should be at the centre of development was, to be sure, an idea that had been gaining wide currency even before that event. However, the launching of the report was of historic significance, because it gave the notion of human development an institutional base; conferred on it the moral authority of the United Nations; set the tone and created a momentum for public discourse on development issues; and galvanized informed opinion to focus on human beings as the centre of development. In short, it has without doubt contributed significantly to the emergence of a global consensus on the centrality of
human development.
6. Africa, too, shares in this global consensus. Indeed, it can legitimately claim to have contributed to its crystallization. The imperative of human development was recognized as far as back as the early
1980s. For instance, one African report provided a critique of
conventional approaches and strategies of development that overemphasized the growth aspects, assumed the automatic redistribution of the benefits of growth, and relegated the social and other dimensions ofdevelopment to the secondary level Not only have these stra tegies ... failed to achieve the goal that they were designed to achieve but they have also led to unintended and highly undesirable consequences such as the growth of economic and
social inequalities, growingpoverty, unemployment, political instability, crimes and serious
threats to both persons and property,1
1. The lesson from this situation was drawn by an ECA/OAU report, which argued that with a relatively modest GNP, the quality oflifefor the people as a whole can be improved considerably by the introduction of appropriate structures, participatory development pro grammes, and determined effort at equitable distribution of national resources.!
8. Other regional documents too are replete with references that underscore the primacy of human development. In this regard, mention could be made of the Lagos Plan ofAction (1980), which stressed the
importance ofhuman resource development for sustained growth and development, and Africa's Priority Pro grammeforEconomic Recovery and the United Nations Programme ofActionfor African Economic Recovery and Development (both developed in 1985), which further reinforced the importance of human development for Africa's economic recovery and social transformation.39. Particularly noteworthy are the landmark Khartoum Declaration (1988) and the African Charterfor Popular Participation in Development and Transformation (1990), two watershed documents on human development in Africa. In the words of the former document,
Since the human being is the centre ofall development, the human condition is the onlyfinal measure ofdevelopment. Improving that condition is essentialfor the poor and vulnerable human beings who comprise the majority ofthe peoples ofAfrica. Africa's men and women are the mainfactors and endsfor whom and by whom any programme and implementation
must be justified,4
10. In reference to the tendency to emphasize the purely economic aspects of development to the neglect of human considerations, the Khartoum Declaration stated:
Production and other aspects ofeconomic development — especially distribution — are of crucial importance. Production by the poor is vital ifthey are to become more able to meet at least their basic needs. But it is just as important who produces what. Production of food, of basic consumer goods, of agricultural inputs and construction materials, of basic services such as health, education, and pure water, as well as of exports are central to improving the human condition. Unsustainable imbalances do matter.
Nutrition imbalances are as crucial as trade imbalances. High infant mortality requiresjust as immediate and as serious an attention as high rates of inflation or huge budget deficits.
Ultimately, the trade, inflation and budget imbalances are serious obstacles to development because they are barriers to enabling the poor to produce more; to the vulnerable to surviv ing and rehabilitating themselves; and to the state and the society achieving universal access to basic services.S
Box 1
A NEW PARADIGM OF DEVELOPMENT
"Since the human being is the centre of all development, the human condition is the only final measure of development. Improving that condition is essential for the poor and vulnerable human beings who comprise the majority of our peoples in Africa. Africa's men and women are the main factors and the ends for whom and by whom any programme and implementation of development must be justified.
ECA, The Khartoum Declaration, Addis Ababa, 1988, p. 17.
"nations cannot be built without the popular support and full participation of the people, nor can the
economic crisis be resolved and the human and economic conditions improved without the full and effective contribution, creativity and popular enthusiasm of the vast majority of the people. After all,
it is to the people that the very benefits of development should and must accrue."ECA, African Charter for Popular Participation in Development and Transformation, Addis Ababa,
1990* p. 17.
"The ultimate goal of development in Africa is to ensure the overall well-being of the people through a sustained improvement in their living standards. It is this quintessential human aspect of development that underlies all other objectives that Africa will have to pursue, be they economic, social, cultural or political ... the urgency of alleviating mass poverty and of increasing the welfare of the African people is rooted not simply in the humanistic or altruistic aspects of development. It is predicated, above all, on the rational proposition that development has to be engineered and sustained by the people them selves through their full and active participation. Development should not be undertaken on behalf of a people; rather it should be the organic outcome of a society's value system, its perceptions, its
concerns and its endeavours."
ECA, African Alternative Framework to Structural Adjustment Programmes for Socio-Economic Recovery and Transformation, Addis Ababa, 1989, p. 19.
"To address the growing challenge of human security, a new development paradigm is needed that puts people at the centre of development, regards economic growth as a means and not an end, protects the life opportunities of future generations as well as the present generations and respects the natural systems on which all life depends. Such a paradigm of development enables all individuals to enlarge their human capabilities to the full and to put those capabilities to their best use in all fields — economic, social, cultural and political. It also protects the options of unborn generations. It does not run down the natural resource base needed for sustaining development in the future. In the final analysis, sustainable human development is pro-people, pro-jobs and pro-nature. It gives the highest priority to poverty reduction, productive employment, social integration and environmental regenera tion ... It also recognizes that not much can be achieved without a dramatic improvement in the status of women and the opening of all economic opportunities to women. And sustainable human develop ment empowers people — enabling them to design and participate in the processes and events that shape their lives."
UNDP, Human Development Report 1994, p. 4.
11 • The primacy of human development was also underlined by the African Charterfor Popular Parti
cipation in Development and Transformation: P
We ... have no doubt that at the heart of Africa's development objectives must lie the ultimate and overriding goal of human-centred development that ensures the overall well- being ofthe people through sustained improvement in their living standards and thefull and
Activeparticipation ofthepeople in charting their developmentpolicies, programmes and
processes and contributing to their realization. We furthermore observe that given the
current worldpolitical and economic situation, Africa is beingfurther marginalized in world
affairs, both geo-politically and economically. African countries must realize that more than ever before, their greatest resource is their people and that it is through their active andfull participation that Africa can surmount the difficulties that lie ahead,612. These documents have not only been adopted by the ECA Conference of Ministers and the OAU Heads of State and Government, but have also been endorsed by the United Nations General Assembly This orientation was farther reinforced in the African Alternative Framework to Structural Adjustment Pro grammesfor Soao-Economic Recovery and Transformation! and the Kilimanjaro Programme ofAction for Popu'Jation and Self-Reliant Development* The central message of the documents, i.e., that development
^t I human/ceifred' has found reinforcement in three recent major World Bank reports9 and in
s human development reports, published annually since 1990.
13. The United Nations itself set up an Inter-Agency Task Force in 1989, whose major initiative was the preparation of a Regional Frameworkfor Human Resources Development and Utilization in Africa 10 The Framework stresses the urgent need for a broad-based and comprehensive effort to strengthen the capa city for human development in each African country. It also provides a set of policy programmes and guide lines for translating the objectives of human resource development and utilization into action measures at the national, subregional, regional and international levels, including guidance on the formulation monitoring and evaluation ofhuman resource development and utilization programmes in line with Africa's development
goals and strategies.
14. A notable further development in this regard was the ECA Conference of African Ministers respon sible for Human Development which, at its first meeting in January 1994 adopted the African Common Posi
tion on Human and Social Development in Africa, in preparation for the World Summit on Social Develop ment, which took place in Copenhagen, Denmark in March 1995. This document articulated an actionable agenda, whose major premises were enunciated as follows:Reversal of Africa's unfavourable human and social conditions requires nothing less than a reorientation of the whole basis of development in the region. Such reorientation must build upon and strengthen indigenous capacities and capabilities and instill self-confidence.
In all this, the empowerment ofthe people, including women and youth, as agents ofpositive change, must be a necessary accompaniment. What is needed is a comprehensive and inte grated strategy ofdevelopment and structural transformation in which human development
concerns mustform the core. 11
Box 2
AFRICA'S MAJOR HUMAN AND SOCIAL DEVELOPMENT OBJECTIVES
Putting the well-being of people at the centre of all development initiatives, policies and programmes and effectively developing and utilizing human resources
Ensuring the effective implementation of the recommendations of the Dakar/Ngor Declaration on Population, Family and Sustainable Development
Ensuring that population policies and programmes are formulated with the involvement of the people and implemented in coordination with policies aimed at sustainable and accelerated development Giving due attention and priority to the social implications of market-based strategies of economic
management
Investing in human resource development especially in such areas as education, health, social services and housing; and promotion of food self-sufficiency and security
Providing a conducive environment for entrepreneurship and enterprise development leading to the generation of productive employment and income
Providing viable opportunities for the productive utilization of developed human capacities and capabi lities
Fostering peace, political stability and social integration; and overcoming the legacies of apartheid Paying special attention to the needs of vulnerable groups
Eradication of injustice and all forms of poverty and destitution to ensure social justice
Enhancing participatory democracy and mobilization of the people to realize their needs in social development and to achieve self-reliance
Establishing legislative and structural institutions for the implementation of social development
programme
ECA, African Common Position on Human and Social Development in Africa, January 1994, pp. 17- 18.
15. The actionable agenda addressed issues of poverty alleviation; productive employment and income generation; social integration, peace and political stability; and democratization and popular participation in development.
16. The most recent document to address the issue of human development with particular focus on women and the mainstreaming of gender-sensitive policies, plans and programmes is the African Platform for Actionll on the advancement of women. This document defines eleven critical areas towards which action must be directed in order to accelerate the social economic and political empowerment of women at
all levels and at all stages of their lives (see box 3). It was adopted by the Ministers responsible for women s affairs at the fifth African Regional Conference on Women in Dakar, Senegal in November 1994.
17 Thus, the documents referred to above clearly demonstrate ECA's recognition of and commitment to human-focused development in Africa. It is in this sense that one can talk of an African consensus on the centrality of human development. The emergence of such a consensus is particularly important for Africa, a region that has been the most marginalized by the development process and whose human develop
ment agenda is therefore the most challenging in the world.
B- Objectives of the human development in Africa report
18. The necessity of the human development in Africa report was born out of this supremely challenging
African agenda. The present report is the first of what is expected to be a series, appearing every-two years,
that will be devoted to issues of human development in Africa.19. The series has a number of inter-linked objectives. In the first place, it seeks to inform policy makers, academics and those engaged in development tasks about the human situation in Africa. By singling out crucial issues for each report, it will attempt to paint on a broad canvas the human condition in Africa.
Since the issues are legion, what is sought is not comprehensive coverage of each and all of them within the compass of a single report, but to address selected issues in a given report and to deal with them in depth.
Thus, this inaugural issue will be devoted to the themes of "goals for the child", "health for all" and "basic education for all". Given the compelling urgency of these tasks, their selection for treatment in the first issue of the series requires no defence. Future issues will focus on problems of poverty alleviation, produc tive employment and income generation, food and nutrition, women, popular participation, and human
rights.
20. A second objective of the series is to sensitize policy makers and the international community to the magnitude of the human development tasks in Africa and to galvanize them into action. The effectiveness of policies depends to a large extent on the quality of information on which they are based. But information by itself is obviously not enough. This is what lends urgency to the task of sensitization. By selecting issues of most immediate concern and by focusing on them, the series hopes to play a catalytic role in spurring
action.
21. ^ Thirdly, the series hopes to monitor developments regarding the human situation in Africa, paying attention to both progress and constraints in improving the quality of life in the region. To do this effec tively would require the building up of a considerable data base, country by country as well as regionally.
This is obviously a formidable task, but one of extreme urgency as well.
22. Fourth, the series aspires to be not only an important source of information, and analysis regarding human development in Africa because, crucial as information is, its utility will be highly constrained if it is not subjected to careful analysis. In this connection, in addition to being a useful compendium of data on the human situation in Africa, the series aspires to devote itself to an examination of concepts, policies and strategies with a view to helping evolve a uniquely African perspective that draws on global experience, but is also rooted in African realities. Out of such a perspective, it is hoped, will emerge policies and
strategies tailored to African conditions.
Box 3
ACCELERATING THE SOCIAL, ECONOMIC AND POLITICAL EMPOWERMENT OF WOMEN: CRITICAL AREAS OF CONCERN
Women's poverty, insufficient food security and lack of economic empowerment;
Inadequate access to education, training, science and technology;
Women's vital role in culture, the family and socialization;
Improvement of women's health, reproductive health including family planning and population-related
programmes;
Women's relationship and linkages to environment and natural resource management;
Involvement of women in the peace process;
The political empowerment of women;
Women's legal and human rights;
Mainstreaming of gender-disaggregated data;
Women, communication, information and the arts;
The girl-child.
ECA, African Platform for Action, 1994, p. 7.
23. No doubt, all these are ambitious goals. There are no illusions that they are easily or rapidly achievable. But they need to be approached seriously, even if the first steps are bound to be tentative and halting. ECA's mandate and the gravity of the human situation in Africa make the launching of the series an imperative that cannot be deferred. We hope that this first issue will provide a basis on which to build and make refinements, so that the series will eventually emerge as an important source of information and analysis on human development in our region.
References
1. African Centre for Applied Research and Training in Social Development (ACARTSOD), Report of the Expert Group Meeting on the African Centre for Applied Research and Training in Social Development, Tripoli, 1980, p. 5.
2. ECA/OAU, "Social trends and major social development problems in Africa", Addis Ababa, 1985,
p. 12.
3. Organization of African Unity (OAU), Vie Lagos Plan ofAction. Geneva: International Institute of Labour Studies, 1982; OAU, Africa's Priority Programme for Economic Recovery, 1986-1990.
Addis Ababa: OAU, 1986; and United Nations, United Nations Programme of Action for Africa's Economic Recovery and Development, 1986-1990. New York: United Nations, 1986.
4. ECA, The Khartoum Declaration, Addis Ababa, 1988, p. 17.
5. Ibid., pp. 17-18.
6. ECA, African Charterfor Popular Participation in Development and Transformation. Addis Ababa
1990, p. 18.
7. ECA, African Alternative Framework to Structural Adjustment Programmes for Socio-Economic Recovery and Transformation, Addis Ababa, 1989.
8. ECA, Kilimanjaro Programme of Action for African Population and Self-Reliant Development,
Arusha, 1984.
9. World Bank, Sub-Saharan Africa. From Crisis to Sustainable Growth: A Long-term Perspective Study. Washington, D.C.: World Bank, 1989; World Development Report 1990: Poverty.
Washington, D.C.: World Bank, 1990; and World Development Report 1993: Investing in Health Washington, D.C.: World Bank, 1993.
10. ECA, "A regional framework for human resources development and utilization in Africa" Addis
Ababa: ECA, 1990.
11. ECA, "African Common Position on Human and Social Development in Africa". Addis Ababa 1994, p. 20. E/ECA/PHSD/MC/94/5.
II. HUMAN DEVELOPMENT; CONCEPT AND MEASUREMENT A. The concent of human development
24. The basic premise of human development, broadly defined by UNDP as a process of enlarging human choices, is — as indicated in the introduction — that people must be at the centre of development.
This definition, being concise, may not convey fully the breadth and multi-dimensionality of the concept, which includes, among others, access to income adequate to make a decent standard of living affordable, a long and healthy life, knowledge, political freedom, the guarantee of human rights and personal security, gender equality, absence of discrimination on the basis of religion, ethnicity or race, and full participation in all affairs of the community. In other words, human development is about the quality of life in both its material and non-material aspects. While growth in per capita income is indispensable for making most of these goals possible, it in no way automatically translates into human development.
25. Defined in these terms, human development is both an end and a means to an end. It is an end because its various ingredients are desirable in and of themselves. Thus, it brooks no debate that people desire to lead a long and healthy life, to have access to food, clothing and shelter, to enjoy the benefits of education, to be free and secure, and to have a say in decisions that affect their lives and their communities.
This is what makes human development an end in itself whose pursuit requires no elaborate rationalization.
26. Perhaps what needs greater emphasis is that it is also a means to an end. For too long in the past, economic theories had tended to overemphasize the role of physical capital in development and to neglect the significance of the human factor. Today, however, there is a solid professional consensus that human capital plays an equal, if not a greater, role in the development process. It is almost invariably the case that countries that have achieved the fastest rates of growth are those that have invested most in their people, especially in health, nutrition and education. The link between these factors and productivity — which is the basis of growth — has been sufficiently demonstrated.
27. Moreover, investing in people makes possible a more efficient use of other resources, especially physical capital and natural resources. Further, the benefits of investment in human capital are likely to be more evenly distributed than those from other types of investment, provided that reaching large segments of the population is a conscious strategy. It is also true that the various components of human capital tend to reinforce each other. For instance, the complementarities among nutrition, primary health care and educa tion are obvious, as are those between women's education, their health and that of their children, fertility and life expectancy. Therefore, the pursuit of human development acquires cardinal importance not merely because it is inherently desirable but also because it has much to contribute in accelerating the process of economic growth.
28. To sum up, human development contributes directly to the well-being of people; ensures a more equitable distribution of the benefits of growth; maximizes the linkages between various types of investment in human beings; calls for the effective participation of people in the process of development; and permits a more efficient exploitation of physical capital and other resources.
29. In an age in which sustainable development has become a global objective, it also needs to be pointed out that human development makes significant contributions to sustainability in an economic, social and ecological sense. It is now universally recognized that sustainable development means meeting the needs of the present generation without compromising those of future generations. Economically, this means that current consumption should not be at the expense of intolerable debt for future generations. Socially, there should be sufficient investment made in the social services such as health and education so that future genera tions will not inherit a social debt. Ecologically, the present generation should not engage in irresponsible exploitation of natural resources that brings about adverse consequences for future generations.
30. It is obvious from the foregoing that the concept of human development is much broader than
economic and social development as traditionally conceived. It encompasses these but goes much beyond them. It is — as pointed out earlier — about widening people's choices in every sphere of life.B. Measuring human development
31. Although the concept of human development is fairly straightforward, its measurement is a compli cated task. The concern with measurement arises from the need to monitor progress in human development
Hence the necessity of constructing a handy index, however imperfect it may be.32. With growing uneasiness with per capita income as a measure of development, there have been several attempts to develop a fuller and more meaningful index. For instance, the social indicators approach which evolved in the 1960s, was expected to provide a more informed and sound basis for planning socio-
economic development and monitoring progress in human development. The major attempts to construct composite indices of development include, among others, "the level of living index" (LLI) developed byDrewnowski and Scott; "the development index" (DI) of McGranahan and others; Morris's "physical quality
of life index" (PQLI); and UNDP's "human development index" (HDI).l33. Levels of living or living standards have long been a topic of social research. For example a United Nations report on defining and measuring levels of living for development planning was published as early as 1954. However, it was not until the late 1960s that the results of the research programme of the United
Nations Research Institute for Social Development (UNRISD) were published.34. The very first attempt to develop a composite index was by Drewnowski and Scott, who came out in 1966 with a level of living or welfare index for a sample of 20 countries.2 The LLI covered a wide range of components of basic needs—physical and cultural. Since it was difficult to obtain data on the various components of social indicators, the applicability of the LLI turned out to be rather limited, and the exercise
was abandoned.
35. The study by McGranahan and his colleagues3 attempted to select the best available indicators of
social and economic development; establish the relationship among these indicators at different levels of development; and combine them into a composite index of development or a "general index" of socio- economic development (GI). The GI was intended to serve as a better indicator than per capita national income for certain purposes of analysis and planning. It was based on 18 core social and economic indicators, sifted from an initial examination of 73 social and economic variables for 115 countries. The major finding of the study was that development is an interrelated phenomenon in which the different social and economic factors change and grow together over the long run. However, while the GI is essentially a measure of those characteristics that distinguish more developed from less developed countries, it is not a measure of human welfare or of the quality of life.36. The work on living standards received a boost following the recommendations of the ILO's World Employment Conference in 1976, whose essence was that the main objective of development efforts should be the satisfaction of basic needs. ILO's work focused on the identification and measurement of core basic needs, as well as the establishment of targets and elaboration of strategies for their achievement.4 The basic needs approach also included an important element — that of people's participation in development as an objective of policy as well as an indicator of progress in this regard. The World Bank also initiated work on basic needs, albeit confined to selected core basic needs. This was done with a view to identifying and elaborating the role that the World Bank can play in this area.5
37. Probably the best known work of the 1970s in the area of measuring social performance was Morris's physical quality of life index (PQLI).6 This composite index is based on three simple indicators:
infant mortality, life expectancy, and literacy. This measure, with a maximum score of 100, gives equal
weight to each of the three indicators. The PQLI indirectly reflects the effects on human development of
investment in health services, water and sewage systems, quality of food and nutrition, education, housing, and changes in income distribution. One positive aspect of the PQLI is that it helped redirect attention away from growth, toward a broader concept of human development. It also helped development professionals and international aid agencies gain new insights into the human aspects of development.38 However, the PQLI has been criticized as an indicator of social development, in relation to both the
choice of indicators as well as the weight assigned to different indicators.7 The inadequacy and the lack of
even the basic social data in many developing countries limit the usefulness of this measure. Furthermore,the PQLI gives disproportionate weight to longevity, as two of the three indicators, infant mortality and life
expectancy are related to it. Also, the equal weight given to each of the indicators is arbitrary and not based on any obvious rationale. Finally, the PQLI treats economic and social measures or indicators separately, instead of combining them in a composite index.39. It is against this background that UNDP's human development index (HDI) must be seen. Ideally, whatever measure is chosen should attempt to capture the multi-dimensionality of the concept of human development; in other words, it should include as many variables as possible. However, such compre hensiveness is virtually unattainable. In the first place, some of the components (for example, political freedom, personal security) do not lend themselves to easy quantification. Secondly, even for variables that are readily quantifiable (e.g., distribution of income) the statistics may not be available or reliable. Thirdly, the inclusion of too may variables may make the construction of a single, convenient measure impossible.
40. It is for these reasons that UNDP has confined its HDI to only three variables: longevity, education and the standard of living. Longevity, measured by life expectancy at birth, is not only desirable in itself but is also closely associated with such variables as health and nutrition. As such, its inclusion is nbt contro versial. Also beyond question is the desirability of including education. UNDP takes education to mean literacy and mean years of schooling, an approximation which has had its critics. For living standards, the proxy used is per capita income (actually adjusted purchasing power parity). Although the necessity of including the standard of living is not debatable, there has been much criticism of how effectively per capita
income can be used for this purpose.
41. The procedure used for computing HDI begins by defining a measure of deprivation for each country with respect to all three variables. For this purpose, the latest UNDP report has established maxima and minima for each variable. The second step is one of defining an average deprivation indicator, which is done by taking a simple average of the three indicators. Finally, HDI is calculated by subtracting the average deprivation index from 1. The greater the HDI, the better off a country is supposed to be with respect to human development. With HDI, one has a convenient way of measuring a country's level of human development, making international comparisons, and monitoring progress over time. Comparisons of country rankings by HDI and per capita income have also proved instructive, lending further support to the argument that growth does not necessarily bring about human development.
42. However, HDI is beset by a large number of problems. First, there is some confusion over what it is supposed to measure. It is obviously not a normative measure, with an HDI of 1 being a target to aspire to. Even with a figure close to 1, there is still much to be done in improving human development.
The interpretation of HDI figures is therefore something that needs to be handled with care.
43. Second, it is restrictive in the sense that it excludes such important variables as human freedom.
This is a limitation of which the formulators of HDI are well aware. In fact, there have been attempts to construct a separate human freedom index. However, the difficulties of such an exercise are quite obvious.
This is partly because freedom does not lend itself to ready quantification, and partly because, in environ ments of rapid political change, the state of human freedom is rather volatile and could shift from one extreme to another almost overnight.
44. Third, there is some uneasiness with respect to the choice of indicators for the variables chosen.
Thus, the use of life expectancy at birth for longevity has been questioned, alternatives suggested being infant mortality, life expectancy at one year, or under-five mortality. It has been argued that for developing countries in particular these measures make more sense than life expectancy at birth. Likewise, the wisdom of using adult literacy and mean years of schooling (with relative weights of two to one) as proxies for education has been questioned. With respect to literacy, for instance, one issue is that literacy figures make no difference between recorded and functional literacy, and can therefore be misleading. Secondly, in a population heavily dominated by tbe young, the wisdom of using adult literacy rates has been questioned.
With respect to average years of schooling, it has been contended that since performance does not change substantially within short periods, it may be more instructive to use school enrolment ratios. Although there is some merit hi these criticisms, it has not yet been demonstrated that the alternatives suggested would be more enlightening than the approach currently used.
45. Fourth, the figures used for the three variables are national averages, which could conceal important distributional issues between income groups, genders and regions. It is therefore necessary to disaggregate the HDI to give a clearer idea of the situation of women, the pattern of income distribution, and regional disparities. This is a legitimate criticism, and UNDP has attempted to accommodate it. For countries for which data are available, HDI figures disaggregated on the basis of income distribution and gender have been constructed. Yet it must be recognized that such an exercise is virtually impossible where disaggregated data are unavailable. Gender-adjusted HDI figures are available for only four African countries (and only for 19 developing countries world-wide) on account of data unavailability.
46. Fifth, the wisdom of assigning equal weights to all three variables has been questioned. However, since no compelling case has been presented for using a different system of weighting, equal weighting continues to be used.
47. However, even with these limitations, HDI is arguably the best currently available measure of human development that we have and is particularly suited for Africa. The proper course, therefore, is not to dismiss it but to use it with full awareness of its limitations and to continue to refine it so that it will become a more satisfactory yardstick by which to measure human development. It also needs to be supplemented by other indicators of human development. The fact that the measure is being continuously refined and supplemented by a wealth of additional indicators demonstrates that it can serve a useful purpose as a rough and ready measure of human development, especially when supplemented by other measures, such as the gender development index (GDI) for Africa presented in this report (see tables 16-18).8
48. The gender development index elaborated here is an attempt to summarize the current situation of individual countries in an easily understood index — a simple ranking of countries according to their level of gender development. It covers 17 gender relevant indicators. These are clustered in five groups;
environment, health, education, political participation and participation in the labour market. Many important issues are not covered, either due to lack of statistics or difficulties of measurement. These lacuna include, amongst others, issues related to the legal status of women, domestic and societal violence against women, a range of economic concerns, and many issues related to empowerment of women. Even within the clusters mentioned above, a more complete statistical coverage is needed. Nevertheless, it is hoped that the GDI presented here, building as it does on previous work in this area, including the gender adjusted human development index (GA-HDI) and the index of women's advancement (IWA),9 will provide useful additional information and may also serve as an additional building block for future work in this vital area.
The GDI presented here differs somewhat from previous work in this area, in two ways. Firstly, it covers a rather wider range of data that is now available. Secondly, it uses median analysis which facilitates a rela tively stable result, even if data is missing for some indicators for some countries.
49. Table 16 presents the basic data on 17 gender-relevant statistical indicators for African countries.
For each of the indicators selected, countries were ranked from best to worst. The results of this ranking
process are presented in table 17. In table 18, the analysis compares the rankings of countries in terms of the GDI with rankings in terms of the summary indicators most commonly used by major United Nations agencies: the human development index (UNDP), the USMR (UNICEF) and GNP per capita (the World
Bank).
References
1. For a useful treatment of issues related to the concept and measurement of human development. See also United Nations Conference on Trade and Development (UNCTAD), The Least Developed Countries 1993-1994 Report (New York: United Nations, 1994), pp. 161-166.
2. J. Drewnowski and W. Scott. The Level ofLiving Index. Geneva: United Nations Research Institute for Social Development, Report No. 4, September 1966.
3. D.V. McGranahan et al. Contents and Measurement of Socio-economic Development. New York:
Praeger Publishers, 1972.
4. ILO. Employment, Growth and Basic Needs: A One World Problem. Geneva, 1976.
5. S. Burki and M. ul Haq. "Meeting basic needs: An overview". World Development, February 1981.
6. M.D. Morris. Measuring the Condition of the World's Poor: The Physical Quality of Life Index.
New York: Pergamon, 1979.
7. See, for example, J. Forrester. World Dynamics. Cambridge, Massachusetts: Wright Allen Press, 1971; and J. Silber. "ELL (The Equivalent Length of Life) or another attempt at measuring development." World Development, January 1983.
8. Based on Mahesh Patel, A Gender Development Indexfor Africa, UNICEF ESARO Working Paper 1005, November 1994.
9. Krishna Ahooja-Patel, "Gender distance among countries11, Economic and Political Weekly, February 13, 1993.
IH. THE STATE OF HUMAN DEVELOPMENT IN AFRICA
50. So much has been said and written on the dire human situation in Africa that yet another attempt in this regard is bound to invite tedium. The most recent attempt by ECA in this regard is the African Common Position on Human and Social Development in Africa,! to which reference was made earlier. In fact, that document mav usefully be read as a companion to this report. Therefore, instead of reciting the well-known facts, it would be best to define the challenges in the starkest terms. For this to be done properly, however, a cursory review of some of the most salient facts is indispensable.
51. Put simply, the human situation is alarming, has been so for several years now, and — if historical trends continue — it would be impossible to see any light at the end of the tunnel even with the strongest dosage of optimism. Most alarming is the threat to human security. Following UNDP's Human Develop ment Report 1994, it is useful to distinguish between two aspects of human security. In one sense, "it means protection from sudden and hurtful disruptions in the pattern of daily life". In this sense, human insecurity in Africa has assumed daunting proportions, so much so that even sheer survival can no longer be taken for granted by millions of Africans. The colossal human tragedy in Rwanda is but the most glaring example of the threat to human security. Other examples of recent armed conflicts threatening human security are those in Burundi, Somalia, Liberia, Angola, Mozambique and the Sudan, to mention only the most well- known instances. Of a different order, though no less disquieting, are the tensions that have engulfed Algeria and Egypt. But, to a greater or lesser degree, the threat to human security is present in many African countries. It is estimated that there are 6 million African refugees, accounting for half of the world's total, and that about 20 million are internally displaced. When the very survival of millions of people is cast in serious doubt, then all other problems, including that of grinding poverty, pale into insignificance.
52. In another sense, human security "means safety from such chronic threats as hunger, disease and repression". Essentially, this kind of insecurity is intimately linked with poverty, and for most of those who survive the "loud" disasters, poverty — however measured — continues to be the most dominant reality.
One such composite measure that can be conveniently used, as indicated in chapter II, in UNDP's HDI.
Thus, of the 55 countries in UNDP's "low human development" category for 1992, 41 are African countries.
Even more revealing is that of the 25 countries appearing at the bottom of this category, 22 (i.e., 88 per cent) are African countries. Of the 52 African countries, there is not a single one in the "high human development" category; and only 11 have made it to the "medium human development" roll (see table 1 for country data).
53. Telling as these statistics are, there is also much that they conceal. For instance, 54 per cent of the African people are estimated to live in absolute poverty, i.e., without access to the most elementary necessi ties of life. And there are countries in which the percentage of the (see table 12) population "living" in such a state of degradation reaches 80 per cent and more (see table 12). To make matters worse, Africa is the only region in the world in which the number of those living in absolute poverty is projected to increase in the foreseeable future.
54. Such a staggering record of crushing poverty is partially due to the dismal economic performance of the region. The continent for which the 1980s was a lost development decade now faces the grim prospects of repeating that record in the 1990s. African economies, instead of growing, seem to be back pedalling.
55. No less significant is the fact that whatever growth has been achieved has proved a conspicuous failure in creating adequate employment and better livelihoods. Thus, all the statistics pertaining to employ ment are disquieting. Conservative estimates put urban unemployment in Africa at between one-fifth and one-fourth of the labour force; in fact, in a number of countries the figures are much higher. What lends these statistics a peculiar viciousness is that most of the unemployed are educated youth. Unemployment
cheats them of their future, as it were. Gender inequalities in employment are also serious and result in a
major loss of human potential across the continent.
56 The tasks of poverty alleviation and employment creation are obviously intertwined because it would be'impossible to make a dent in poverty without expanding opportunities for .^ <^W™*;
Unfortunately, the challenge is made infinitely more complicated by structural adjustment programmes, (SAPs) which in a number of countries have resulted in net losses, not net creation, ot jobs.
57 When one adds to this the depressing statistics on food security, health and nutrition, education and' other social services (see tables 1 to 10); the havoc wreaked by the combined onslaught of unchecked popula tion growth and environmental degradation; the resort to arms in settling disputes; and the reversal ot.
whatever gains had been achieved in the march towards democracy; the gravity of the human situation in
Africa emerges in all its enormity. It is thus revealing that of the seven common types of threats to human
security — economic, food, health, environmental, personal, community and political — there is not a single one that is not of considerable significance for Africa.58 This is not to suggest that the picture is universally bleak or that no advances have been made No one for instance, should belittle the significance of the end of apartheid in South Africa; the possibility of
durable peace in countries such as Mozambique; and the experiments with democratic governance in somecountries however fragile such experiments may be. Nor should one belittle the gains made in human
development As can be seen from the annex tables, there has been some progress. For instance, lite expectancy has risen by more than 11 years and infant mortality declined by 40 per cent within one generation. Likewise, the percentage of the population with access to safe water has increased by almost 20 per cent in about 15 years and adult literacy has increased by 23 per cent between 1970 and 1992. Gender
inequalities, in access to primary education are disappearing rapidly, and have vanished in many countries.As the GDI in table 16 indicates, in all African countries for which data is available, female life expectancy is now greater than that of males. Secondly, although trend data are not so readily available, representation of women in political life seems to be increasing rapidly. These achievements are solid, perhaps dramatic, given the dire circumstances within which they were attained.
59 The point, however, is that such instances of progress are few and far between. The negative side of'the ledger is in fact much weightier because - in spite of progress - the overall situation is still
desperate. Life expectancy is about 53 years, or a quarter century lower than that of the high income countries The population with access to health services, safe water and sanitation is only about 64, 56 and 41 per cent respectively. In the sphere of education, only 52 per cent of adults are literate, and the overall school enrolment ratio falls short of 39 per cent (see table 2 for data on individual countries). While gender
inequalities in access to primary education are decreasing, retention rates are still very much lower tor girlsthan for boys.
60 With respect to child survival and development too, the statistics make grim reading. The under-five
mortality rate is 148 per 1,000 live births; 24 per cent of children are underweight; the maternal mortality rate is 620 per 1,000 live births; and less than 50 per cent of births are attended by medical personnel (see
table 6).
Box 4
THE ECONOMIC AND SOCIAL SITUATION IN AFRICA IN 1994
Preliminary data available at the United Nations Economic Commission for Africa on the state of African national economies in 1994 point to a modest increase in the regional economic growth rate During 1994 African economic output has grown by 2.8 per cent, up from 1.1 per cent in 1993 and - 0.3 per cent in 1992. This notwithstanding, income per head is still declining and the region is
continuing to lose ground both in absolute and relative terms. Over the period 1990-1994 GDP has infact declined at a rate of 1.5 per cent per annum. Over this period, the proportion of the population
living under conditions of poverty has increased at an even faster rate. This applies to both rural areaswhere the economy continued to decline and the cities where efforts at fostering growth and job crea
tion in the industrial and service sectors have yielded poor results.
Even though the region has posted its fastest growth rate in five years, Africa's share of aggregate world economic output has continued to shrink, in spite of the fact that its population growth rate is
roughly twice that of the world. Africa has also continued to fall behind the other developing regions which are now accepted as engines of world economic growth.ECA, Preliminary Assessment of the Performance of the African Economy in 1994 and Prospects for
1995, Addis Ababa 1995, p. 1.
61. The record of relative progress is less than consistent. Thus, the overall school enrolment ratio declined between 1980 and 1990. Moreover, military expenditure as a ratio of combined health and educa
tion expenditure rose from less than 30 per cent in 1960 to more than 49 per cent in 1990-1991 (see table13). It should also be noted that even where there has been progress in terms of percentages, the population
growth rate has been such that, in absolute numbers, the number of people in deprivation is greater thanwhat it was several years back. Therefore, the African situation with respect to human development is the
stuff of which despair is made.
62. Yet despair is a sentiment Africa's millions can ill afford. The region's problems are largely of human making, and there is no reason why they cannot be solved by committed leadership and proper policies. It is the purpose of this report to call attention to these challenges and the possibilities by
concentrating on the crucial areas of child survival and development, health and education. In each of these areas, we begin by recalling the commitments made: Goals for the Child (the World Summit for ChildrenSeptember 1990); and the International Conference on Assistance to African Children (ICAAC) the Consensus of Dakar, November 1992); Health for All (the Alma Ata Declaration, 1978); and Basic Educa
tion for AH (the World Declaration on Education for All, Jomtien, Thailand, March 1990). An attempt isthen made to review progress since those commitments were made and to identify remaining challenges In other words, the attempt is to evaluate Africa's track record in these vital spheres of human development!
63. As the reader will no doubt be aware, the exercise has been rendered difficult by the paucity of
comprehensive and up-to-date data. The evaluation undertaken must therefore be read with this lacuna inmind.
References
1. ECA, African Common Position on Human and Social Development in Africa, Addis Ababa, 1995.
IV. GOALS FOR THE CHILD1
A. The state of Africa's children
64. If human development lies at the centre of the development process, then the well-being of children and women is, in turn, central to human development. Children are the hope for and the most energetic builders of the future. And the fate of children is inseparable from that of mothers, which is what makes
it impossible to discuss one of the two constituencies in isolation from the other.
65. Africa's development in this regard is a checkered record of undeniable achievements and frustrating setbacks, with the net balance clearly demonstrating a massive backlog of problems and unmet challenges.
66. On several indicators, progress for African children has been achieved at a speed unparalleled in human history. These are offset, however, by the magnitude of the task that still remains, as well as by recent setbacks and growing threats, as demonstrated by the following examples:
(a) Between 1960 and 1992, 18 African countries reduced their child mortality rates by more than 50 per cent and most others by more than one-third. Four North African countries have more than halved their child mortality rates in the last 10 years alone. Median under-five mortality rates in Africa as a whole fell by almost half, from about 280 deaths per 1,000 live births in 1960 to 165/1000 in 1991.
Median crude death rates fell from 24 to 16 over the same period, while life expectancy increased from 41 to 51 years (see table 4);
(b) But at the same time, about 5 million young African children still die every year, or almost 14,000 per day. And those countries which started with the highest mortality rates have, generally, made the least progress in reducing them;
(c) In at least 23 African countries, over two-thirds of the population now has access to basic health services. In particular, the spread through these services of three inexpensive interventions — child immunization, antibiotics and oral rehydration therapy — save the lives of almost 3 million African children each year, and enable others to be sick less often and so grow better, learn better and work more productively in adult life;
(d) But while 28 African countries more than doubled their child immunization levels in the 1980s, levels fell back in 30 African countries in 1991-1992. In 18 countries, the decline exceeded 10 per cent, although in 10 of these it has been fully or partially clawed back;
(e) The dramatic progress in reducing child mortality rates in Africa is now slowing almost everywhere, and in some countries has begun to be reversed, by the AIDS pandemic. AIDS is now overtaking measles and malaria as a leading killer of children. A child born to an HIV-infected mother has a one in three chance of being born with the virus. Four-fifths of children born with HIV will die before their fifth birthday;
(f) Despite the common external media image of the starving African child, severe malnutrition affects no more than 1 or 2 per cent of Africa's children;
(g) But invisible, moderate forms of malnutrition stunt the physical and mental growth of over 30 per cent of children in Africa. Calorie and micro-nutrient deficiencies are mainly to blame. But about 15 per cent of African children are malnourished in the womb, and are born weighing less than 2,5 kg. The cause is not lack of food alone. Overworked and poorly nourished women — in many cases affected by iron deficiency anaemia — are unable to give birth to and raise well-nourished children. Curtailed breastfeeding, poor weaning and child feeding practices are also factors leading to a peak of under-nutrition in the second
year of life. Frequent illnesses such as diarrhoea and malaria, coupled with inadequate health services and an unhealthy environment, also contribute heavily to malnutrition. The poor nutritional status of nearly half of Africa's women and children represents a massive loss of today's and tomorrow's productive potential;
(h) Iodine deficiencies are a widespread problem, with about 150 million people in 38 African countries living in areas with such deficiencies. The situation is urgent both because of the dramatic conse quences — stillbirths, goitre, lowering of learning potential, possible mental retardation — and the avail ability of a simple, low-cost solution — adding of iodine to commercially traded salt. A dozen African countries are now taking action to control iodine deficiency disorders through this means, and many more are actively considering support to salt producers and/or the regulation of traded salt;
(i) Education — good quality, basic education for all — is Africa's trump card in the struggle for development. It is the key element of "investing in people". Gross primary school enrolment rates have risen from about 30 per cent in 1960 to around 70 per cent now. The gap between boys and girls in access to schooling at primary level has drastically narrowed (although it remains considerable in some countries, and is still very wide at secondary and tertiary levels) (see tables 9 and 10 in the annex);
(j) But this "trump card" is being only partially played. Far too many children leave school too early. In North Africa, less than 80 per cent and in sub-Saharan Africa less than 50 per cent of all children complete at least four years of primary school — probably the minimum needed to obtain permanent literacy and numeracy. This dropout rate points to considerable inefficiencies in the primary school system.
Some of the factors are the low quality of tuition — linked to inadequate funding for teacher remuneration and school materials and overcrowded classrooms — which reduces the perceived value of education among parents; language difficulties in the early years; lack of opportunities for community and parental involve ment; and ill-health and under-nutrition among pupils. At secondary level, girls who become pregnant are often not assisted to return to school after giving birth. And, increasingly, AIDS-related sickness and death among parents and relatives are "push-out" factors for school-age children; and
(k) Finally, millions of African children find themselves in especially difficult circumstances due to the scourges of war, displacement and AIDS. At least 15 African countries have each over 100,000 dis placed citizens — perhaps 20 million in these countries alone. Of these, the large majority are children and women. These figures are compounded by the growing numbers of children attempting to earn a living on city streets, many of them with parents lost to AIDS.
67. In short, in spite of considerable progress, the plight of Africa's children remains grave.
B. Commitments made to Africa's children (a) The World Summit for Children
68. On 30 September 1990, an unusually large number of world leaders, who had congregated at United Nations Headquarters in New York, adopted a declaration on the survival, protection and development of children. They also agreed upon a Plan of Action which called for concerted national and international efforts for the achievement, in all countries, of the following major goals by the year 2000:
(a) Reduction of 1990 under-5 child mortality rates by one third or to a level of 70 per 1,000 live births, whichever is the greater reduction;
(b) Reduction of maternal mortality rates by half of 1990 levels;
(c) Reduction of severe and moderate malnutrition among the under-5 children by one half of 1990 levels;
(d) Universal access to safe drinking water and to sanitary means of excreta disposal;
(e) Universal access to basic education and completion of primary education by at least 80 per
cent of primary school-age children;
(f> Reduction of the adult illiteracy rate to at least half its 1990 level (the appropriate age group to be determined in each country), with emphasis on female literacy; and
(g) Protection of children in especially difficult circumstances, particularly in situations of armed
conflict.
69 The Plan also articulated specific supporting/sectoral goals in the areas of women's health and educa tion; nutrition; child health; water and sanitation; basic education; and children in difficult circumstances.
70. With respect to action at the national level, the governments that participated at the World Summit, and those that subsequently signed the Declaration, committed themselves to the following actions:
(a) To prepare, before the end of 1991, national programmes of action for the implementation
of the Summit for Children goals;
(b) To give priority, in the context of national plans and programmes, to the goals of child
survival, protection and development;
(c) To give priority to these goals in terms of resource allocation and to promote programs aimed at enhancing them in times of economic austerity and structural adjustment;
(d) To mobilize all sectors of society to ensure progress in the implementation of these goals;
(e) To establish appropriate mechanisms for the regular and timely collection, analysis and publication of data required to monitor the well-being of children;
(f) To review current arrangements for responding to natural and man-made disasters with a view to enhancing national capacity for coping with them; and
(g) To intensify research efforts directed at new technical and technological breakthroughs, more effective social mobilization and better delivery of existing social services.
71. Although the Plan of Action adopted by the Summit was global in scope, it was not meant to be a mandatory agenda but a framework for action by individual countries, each of which was expected to formu late its own program of action for implementing the declaration of the World Summit.
72. The Summit also expressed a commitment "to promote earliest possible ratification of the Convention on the Rights of the Child". This Convention, which "provides a new opportunity to make respect for children's rights and welfare truly universal", was adopted by the United Nations General Assembly on 20 November 1989. The rights referred to are those of the survival, development and protection of children
everywhere.
(b) The Consensus of Dakar
73. An important regional follow-up to the World Summit was the International Conference on Assistance to African Children (ICAAC), organized by OAU and held in Dakar in November 1992. At this Conference, 46 African countries, as well as a wide range of cooperating partners and NGOs, including
