Last week’s print edition of the Economist reports “the best story in development,” which describes huge declines in child mortality across Africa. Too often, good stories about Africa are buried in the back pages of newspapers and magazines. In this case, the headline is sensationalist but true. The trends of child mortality in a majority of African countries are cause for celebration.
The article reports that in 16 of 20 countries which have detailed reporting since 2005, falls in child mortality have been observed. In 12 of those countries, the rates have been high enough to meet the Millennium Development Goal to cut child mortality by two-thirds by 2015. And in 3 countries, the rates have been twice the MDG rate. Most notably, these rates are higher than what was seen in the past decades by China and India – and the fastest seen in the world for at least 30 years.
So what’s the cause for this success? The reasons are not clear – or at least there is no simple answer. Declining fertility rates in some of these countries could be part of the success, but it is not a necessary component since some countries have reported stagnant fertility while also reporting declining child mortality. One of the common factors seems to be increased use of insecticide-treated bednets resulting in the decrease of deaths caused by malaria. While not reported by the Economist, but as Rob Yates at the Department for International Development (DFID) pointed out, one of the success factors could be that many of these countries have eliminated user fees for health services, especially for women and children.
The Economist takes the view that the moral of this story is that foreign aid was not the single contributing factor in this rapid decline. I would take a slightly different stance. While foreign aid may not have been the deciding factor, it certainly was part of the picture, and therefore should get at least partial credit for the good news.
I would venture to say that the moral of this story points to success not as a silver bullet, but as a formula. Good government policies for public health coupled with well-channeled budgets (yes, supplemented by foreign aid) can, and do, make a difference. Too often we try in vain to find a single success factor that, when replicated, will give us our desired outcome. But development is a confluence of factors that create an environment of success. Perhaps policy-makers and development strategists are less like scientists and more like chefs: good development policy is a recipe that must be carefully tweaked to culture and environment.