Africa: Education, Health and Infrastructure Facing Demographic Challenges

On the occasion of World Population Day celebrated this Thursday, July 11, 2024, Dr. Cheikh M. Faye, Regional Director of the West Africa Office of the African Population and Health Research Center (APHRC) and concurrent Director of CountDown 2030, granted an exclusive interview to AllAfrica.

In this interview, Mr. Faye spoke about population growth in Senegal, but especially in Africa, as it is a complex phenomenon with multiple causes that the continent is currently undergoing.

Following the latest 2023 census, the total resident population of Senegal is estimated at 18,126,390 people. What are the challenges and impacts of this new figure on the country’s demographic development?

The 2023 census, which estimates the total resident population of Senegal at 18,126,390 people, presents several significant challenges and impacts on the country’s demographic development. For example:

• First, there is greater pressure on infrastructure and public services, particularly a growing demand for housing, schools, healthcare facilities, and roads. The government’s ability to meet these needs will be crucial to ensure harmonious development.
• Second, health issues need to be considered: Ensuring universal health coverage will become an increasingly arduous task. It will be necessary to strengthen healthcare infrastructure and guarantee access to care for all, including maternal and child care, family planning, and the fight against infectious diseases.
• Finally, education and employment must be integrated: We are facing a very young population, with 75% under the age of 35. It is therefore imperative to strengthen educational systems and create job opportunities to mitigate unemployment and reduce social exclusion. Investments in education and vocational training remain essential to prepare young people for the labor market.

Regarding the impacts, we can mention environmental challenges and rapid urbanization (in fact, it is projected that nearly 65% of the Senegalese population will live in cities by 2050; currently, it is around 45%). Our natural resources are under greater pressure, notably access to water, energy, and arable land. It is essential to promote sustainable practices to protect the environment and ensure climate resilience.

Therefore, the results of the 2023 census provide an opportunity to reassess and strengthen Senegal’s demographic development policies. They call for concerted actions and strategic investments to transform these challenges into opportunities for sustainable development.

What is the demographic urgency that Senegal faces, particularly in Dakar, Thiès, and Diourbel, where nearly half of the population is concentrated, as well as in rural areas facing acute migration problems?

Senegal is facing several demographic urgencies, notably in the regions of Dakar, Thiès, and Diourbel, where nearly half of the population is concentrated, as well as in rural areas experiencing massive migration. These urgencies can be addressed from several perspectives:

• The urgency of managing this rapid urbanization and urban overcrowding. Public services such as water, electricity, housing, health, and education are often insufficient to meet the growing demand.
• The expansion of slums and precarious housing in these regions has already increased health risks and social vulnerability. Therefore, it is urgent to rethink urban planning and the development of adequate infrastructure to improve living conditions.
• Our health system must adapt to better meet these needs. The challenge here is to ensure that vulnerable populations living in these slums and peri-urban areas have access to basic healthcare and are not exposed to diseases related to unsanitary conditions, overcrowding, etc.
• The issue of transport and urban mobility to reduce time spent in traffic jams. While the BRT and TER seem to play a positive role in this regard, these services are limited to Dakar, and significant efforts remain to be made.
• Air and water pollution, as well as inadequate waste management. It is crucial to implement sustainable development policies to protect the environment.

Senegal would benefit from adopting an integrated approach to managing these urgencies, particularly in the regions of Dakar, Thiès, and Diourbel. This includes sustainable urban planning, strengthening infrastructure and public services, revitalizing rural areas, and implementing strong environmental policies. Collaboration between the government, local communities, and international partners is essential to address these challenges and ensure balanced and sustainable development of the country.

In Dakar, population growth is very high compared with other regions. What measures should be taken to relieve the capital of this demographic boom?

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As the Director of the Countdown to 2030 Initiative, do you have any actions to propose to the new Senegalese government for achieving universal health coverage for women and children?

The Countdown to 2030 Initiative, which I lead, is a global partnership among academics, UN agencies, regional and national institutions, and civil society. It aims to accelerate progress towards achieving the Sustainable Development Goals (SDGs) related to health, particularly those concerning maternal, neonatal, and child health (MNCH). This initiative builds upon the previous Countdown to 2015, which focused on tracking and advocating for progress towards the Millennium Development Goals (MDGs).

We work to maximize evidence and strengthen countries’ capacities to analyze, interpret, and use empirical data—from surveys to health facility and system data—to monitor coverage levels, trends, and inequalities. Countdown 2030 leverages national collaborative teams comprising a public health or academic institution from the country and MNCH analysts from the Ministry of Health, working in collaboration with the GFF and other global stakeholders.

Our research has led us to propose several key actions that we believe will help governments, including that of Senegal, achieve universal health coverage for women and children.

Specifically, we propose: 

• Strengthening health systems: It is crucial to improve existing infrastructure and build new health facilities, especially in rural areas. This includes health centers, hospitals, and specialized clinics for maternal and child care.
• Training and recruiting healthcare staff: Increasing the number of qualified health professionals, including midwives, nurses, and doctors. Initiatives to retain healthcare personnel in rural areas are also essential.
• Expanding health insurance programs to cover all women and children, thereby reducing financial barriers to accessing healthcare.
• Implementing programs to provide free or low-cost healthcare for women and children, particularly for vulnerable groups. This includes maternal, neonatal, and child health services, as well as family planning.
• Strengthening vaccination programs to ensure all children receive essential vaccines, thereby reducing infant mortality and preventing avoidable diseases.
• Implementing nutrition programs for pregnant women and young children to combat malnutrition and ensure healthy development. This includes promoting exclusive breastfeeding for the first six months.
• Launching awareness campaigns on the importance of healthcare for women and children. Using traditional media and social networks to reach a broad audience and promote healthy behaviors.
• Integrating health education into school curricula to teach young people about the importance of reproductive and child health, as well as disease prevention practices.
• Encouraging collaboration among the government, the private sector, NGOs, and international partners to mobilize resources and share expertise. Partnerships can help expand the reach of health initiatives and improve their effectiveness.

The International Population Day will be celebrated on July 11th. In your opinion, what are the causes and consequences of the demographic growth that Africa is experiencing, and what are the socio-economic impacts related to it?

The rapid demographic growth in Africa is a complex phenomenon with multiple causes and profound consequences. Among the causes, it is worth noting:

• High birth rate: Africa has one of the highest birth rates in the world. Large families are common, often due to cultural and social factors that value big families in certain countries.

• Decrease in infant mortality combined with increased life expectancy: Improvements in healthcare, vaccination, and nutrition have led to a significant reduction in infant mortality, thereby increasing the number of survivors, which is a good thing. Additionally, advances in healthcare have also increased life expectancy, contributing to population growth.

• Limited access to family planning: In many parts of Africa, access to family planning services and contraceptives is limited, contributing to high birth rates.

Regarding the consequences of demographic growth, it is important to note that the pressure on natural resources is real, including water, land, and energy. Overexploitation of these resources can lead to environmental degradation. High unemployment and underemployment can lead to social and economic instability. Healthcare, education, and housing systems are often overwhelmed, unable to meet the growing demand. Finally, migration from rural to urban areas increases, leading to rapid urbanization and the formation of slums with precarious living conditions.

As for the impacts, the labor market becomes more complex, particularly for young people who are not sufficiently trained, raising the issue of youth employability. Ensuring that children and young people acquire the necessary skills to participate in the economy becomes increasingly challenging.

In summary, demographic growth in Africa presents both challenges and opportunities. It is crucial that governments and development partners implement integrated strategies to manage this growth sustainably by investing in education, healthcare, infrastructure, and promoting inclusive economic growth.

What impact will this scourge have on future generations? 

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What solutions do you recommend to deal with this?

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Regarding public health, do you have programs for addressing issues affecting African populations?

The African Population and Health Research Center (APHRC) is a leading research and policy institution, generating evidence, strengthening research and related capacities within the African R&D ecosystem, and engaging policymakers to inform health and development action.

As a global research center led by Africans and invested in creating a sustainable impact, our work focuses on three programmatic areas:

• Research: Our teams align their research programs with global and continental development priorities. We provide independent evidence to support policy and program development and implementation in Africa.

• Policy Engagement & communications: The Center establishes relationships with decision-making bodies and key individuals at local, national, regional, and global levels to ensure that the data provided is timely and relevant for interventions and public policies tailored to the needs of countries and populations.

• Research & Researchers Capacity Strengthening: Through strategic partnerships, the Center strives to develop African leadership in research by strengthening institutional and individual capacities and building a critical mass of researchers capable of meaningfully engaging with policymakers in the development, review, and implementation of policies and programs relevant to the continent’s development.

Examples include our doctoral fellowship program CARTA [https://cartafrica.org/] and numerous short courses we offer to young African researchers and students on topics such as: research methodology and data analysis; scientific writing and fundraising; geographic information systems (GIS) and spatial analysis; policy advocacy and communication; health systems research, among others.

What impact will population growth have on achieving the continent’s sustainable development goals?

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