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Africa's Future, Africa's Challenge compiles the latest data and viewpoints on the state of Sub-Saharan Africa's children. Topics covered include the rationale for investing in young children, policy trends in early childhood development (ECD), historical perspectives of ECD in Sub-Saharan Africa including indigenous approaches, new threats from HIV/AIDS, and the importance of fathers in children's lives. The book also addresses policy development and ECD implementation issues; presents the ECD programming experience in several countries, highlighting best practices and challenges; and evaluates the impact of ECD programs in a number of countries.

In this volume, African scholars engaged in research on the continent reflect on their recent and ongoing empirical studies. They discuss the strengths and limitations of research methods, theories, and interventions designed outside Africa to spur innovative research on the continent. And they explore how insights from African philosophical, theoretical, and empirical work can be combined with exogenous forms of knowledge to generate understanding of the processes of African children's development in ways that are responsive to local contexts and meaningful for indigenous stakeholders. A new field of African child development research is emerging in African societies, focusing on children as valued and vulnerable members of society and potential civic leaders of the future. Systematic inquiries are now designed to enhance our understanding of how African children think, to discover effective ways of communicating with them, and to inform successful strategies of promoting their health, education, and preparation for adult responsibilities in society. This is the 146th volume in this Jossey-Bass series New Directions for Child and Adolescent Development. Its mission is to provide scientific and scholarly presentations on cutting edge issues and concepts in this subject area. Each volume focuses on a specific new direction or research topic and is edited by experts from that field.

The informal sector of Sub-Saharan Africa is comprised of small and household enterprises that operate in the non-farm sector outside the protected employment of the formal wage sector. The sector was identified 40 years ago by the ILO representing a pool of surplus labor that was expected to be absorbed by future industrialization, but rather than gradually disappearing, it has become a persistent feature of the region’s economic landscape accounting for a majority of jobs created off the farm. Acknowledging its potential as a source of employment for the region’s expanding workforce and improving its productivity and earnings is recognized as a priority for poverty reduction. This study examines the role played by education and skills development in achieving this objective.Until now, few studies have used household labor force surveys to capture the skills profile of the informal sector and study how different means of skills development - formal education, technical and vocational education and training, apprenticeships, and learning on the job -- shape productivity and earnings in the informal sector as compared with the formal wage sector. This study uses household labor force surveys to look at the experience of skills development in five African countries - Ghana, Kenya, Nigeria, Rwanda, and Tanzania - that together account for one-third of the nearly 900 million persons living in SSA. The study defines the non-farm informal sector as the self-employed (own account and with workers), contributing family members, and wage workers in small and household enterprises.Of the nearly 36 million working off the farm in the five countries, 7 out of 10 are working in the informal sector. The importance of this study is its quantitative assessment of how different sources of skills development are related to the sector in which one works and the earnings received in that sector. It further highlights a set of economic constraints to acquiring skills in the small and household enterprises of the informal sector that will have to be overcome if skills are to become a means for improving productivity and earnings in this sector. The study offers a comprehensive strategy for improving employment outcomes in the informal sector through skills development with examples of successful interventions taken from international experience and the five countries.

Africa's Future, Africa's Challenge compiles the latest data and viewpoints on the state of Sub-Saharan Africa's children. Topics covered include the rationale for investing in young children, policy trends in early childhood development (ECD), historical perspectives of ECD in Sub-Saharan Africa including indigenous approaches, new threats from HIV/AIDS, and the importance of fathers in children's lives. The book also addresses policy development and ECD implementation issues; presents the ECD programming experience in several countries, highlighting best practices and challenges; and evaluates the impact of ECD programs in a number of countries.

Background: The significant public health problem in Sub-Saharan Africa of household food insecurity is an underlying cause of malnutrition in Sub-Saharan Africa. This study aims to systematically study the association between household food insecurity, dietary diversity, and stunting. Methods: This review was carried out based on the recommendations of PRISMA (2015). We searched the literature in six bibliographic databases: PubMed, EMBASE, Science Direct, Web of Science, Google Scholar, and Scopus. The research was based on studies conducted in Sub-Saharan Africa about household food insecurity, dietary diversity, and stunting and was published between 2009 and 2020. Results: Out of 2398 original articles identified, only 21 articles met the specific requirements of this review. Two-thirds of the articles selected showed that stunting was linked to household food insecurity and dietary diversity. Conclusions: This study found that household food insecurity and dietary diversity are significantly associated with stunting in Sub-Saharan Africa. This review recommends that in order to yield a sustainable fight against childhood malnutrition in Sub-Saharan Africa, reliable guidelines and strategies are needed to address these factors related to malnutrition.

Early reading interventions hold promise for increasing language and literacy development in young children and improving caregiver-child interactions. To engage rural caregivers and young children in home reading, Zambian child psychologists and education specialists developed a culturally representative, local language children's book targeted at pre-grade 1 children. We qualitatively assessed community acceptability and use of the book distributed to households with young children in two provinces of Zambia. We conducted 15 focus group discussions (FGDs) with women (n=117) who received the \"Zambian folktales adapted stories for young children\" book. A codebook was created , based on established themes in the guide; content analysis was conducted in Nvivo v12. Data were interpreted against the Theoretical Framework on Acceptability. Respondents described wide acceptability of the children's book across multiple framework constructs. Respondents believed the book was culturally appropriate for its folktale structure and appreciated the morals and lessons provided by the stories. Respondents described using the book in multiple ways including reading in one-on-one or group settings, asking the child questions about the narrative or pictures, and providing additional commentary on the actions or figures in the pictures. Respondents believed the books were helping children grow their vocabulary and early literacy skills. The book's simple vocabulary facilitated use by less educated caregivers. The primary concern voiced was the ability of low literacy caregivers to utilize the book for reading. The children's book was widely considered acceptable by rural Zambian communities. It provided a platform for an additional method of caregiver-child interactions in these households for reading, dialogue, and oral storytelling. Shared reading experiences have potentially substantial benefits for the language development and emergent literacy of young children. Programs to develop and deliver culturally acceptable books to households with limited access should be considered by governments and funders.

The long arm of childhood, with its wide-ranging influence on individuals’ life chances, highlights the importance of understanding the determinants of health in early life. Research has established that parents’ education is a major determinant of childhood health, but children across the globe increasingly experience their parents’ divorce and subsequent remarriage, raising questions of whether union instability alters these intergenerational processes. Does divorce and remarriage interfere with parents’ education benefiting their young children’s health? I explore this question in sub-Saharan Africa, a world region where parents’ education plays a major role in protecting children against severe health risks, and where young children commonly experience parental divorce and remarriage. Moreover, sub-Saharan Africa features distinct family lineage systems, affording an opportunity to explore this question in both majority matrilineal and patrilineal contexts. Analyses of Demographic and Health Survey data on 271,292 children in 30 sub-Saharan African countries offer no evidence that the high levels of union instability in the region will weaken the health benefits of parents’ education for future generations. Following divorce, children benefit from their biological parents’ education to the same degree as children with married parents—a finding that is consistent across lineage contexts. Moreover, stepfathers’ education corresponds with pronounced health benefits for their coresident stepchildren, particularly in patrilineal regions where these children benefit less dramatically from their mothers’ education. Together, the study results offer a renewed sense of the importance of parents’—including stepfathers’—education for early childhood health across diverse family structures.

We conducted a programmatic, observational cohort study with mother-infant pairs (MIPs) enrolled in prevention-of-mother-to-child-transmission (PMTCT) programs in Malawi to assess the feasibility and potential HIV-related benefits of integrating Early Childhood Development (ECD) services into PMTCT programs. Six health facilities were included in the intervention. We offered ECD counseling from the WHO/UNICEF Care for Child Development package in PMTCT waiting spaces while MIPs waited for PMTCT and broader treatment consultations. Primary outcomes were mothers’ retention in HIV care at 12 months and infant HIV testing at 6 weeks and 12 months after birth. Routine facility-level data from six comparison health facilities were collected as an adhoc standard of care comparison and used to calculate the cost of delivering the intervention. A total of 607 MIPs were enrolled in the integrated ECD-PMTCT intervention between June 2018 and December 2019. The average age of MIPs was 30 years and 7 weeks respectively. We found that 86% of mothers attended ≥ 5 of the 8 ECD sessions over the course of 12 months; 88% of intervention mothers were retained in PMTCT versus 59% of mothers in comparison health facilities, and 96% of intervention infants were tested for HIV by six weeks compared to 66% of infants in comparison health facilities. Costing data demonstrated the financial feasibility of integrating ECD and PMTCT programs in government health facilities in Malawi. Integrating ECD into PMTCT programs was feasible, acceptable, resulted in better programmatic outcomes for both mothers and infants. Further investigation is required to determine optimal delivery design for scale-up.

Background As care for preterm and low birth weight (LBW) infants improves in resource-limited settings, more infants are surviving the neonatal period. Preterm and (LBW) infants are at high-risk of nutritional and medical comorbidities, yet little is known about their developmental outcomes in low-income countries. This study evaluated the health, nutritional, and developmental status of preterm/LBW children at ages 1–3 years in Rwanda. Methods Cross-sectional study of preterm/LBW infants discharged between October 2011 and October 2013 from a hospital neonatal unit in rural Rwanda. Gestational age and birth weight were gathered from hospital records to classify small for gestational age (SGA) at birth and prematurity. Children were located in the community for household assessments in November–December 2014. Caregivers reported demographics, health status, and child development using locally-adapted Ages and Stages Questionnaires (ASQ-3). Anthropometrics were measured. Bivariate associations with continuous ASQ-3 scores were conducted using Wilcoxon Rank Sum and Kruskal Wallis tests. Results Of 158 eligible preterm/LBW children discharged from the neonatal unit, 86 (54.4%) were alive and located for follow-up. Median birth weight was 1650 grams, median gestational age was 33 weeks, and 50.5% were SGA at birth. At the time of household interviews, median age was 22.5 months, 46.5% of children had feeding difficulties and 39.5% reported signs of anemia. 78.3% of children were stunted and 8.8% wasted. 67.4% had abnormal developmental screening. Feeding difficulties ( p  = 0.008), anemia symptoms ( p  = 0.040), microcephaly ( p  = 0.004), stunting ( p  = 0.034), SGA ( p  = 0.023), very LBW ( p  = 0.043), lower caregiver education ( p  = 0.001), and more children in the household ( p  = 0.016) were associated with lower ASQ-3 scores. Conclusions High levels of health, growth, and developmental abnormalities were seen in preterm/LBW children at age 1–3 years. As we achieve necessary gains in newborn survival in resource-limited settings, follow-up and early intervention services are critical for ensuring high-risk children reach their developmental potential.

This study is based on research on secondary textbook and school library provision in Botswana, Cameroon, Cote d'Ivoire, Ghana, Kenya, Malawi, Rwanda, Tanzania, and Togo, as well as existing recent country reports on textbook provision and an extensive desk research. Considerable variations exist in Sub-Saharan African textbook requirements needed to meet secondary curriculum specifications just as significant differences exist between and within countries in regard to the average price of recommended textbooks. Some countries have no approved textbooks list. This World Bank Working Paper aims to discuss the textbook situation in Sub-Saharan Africa with a special focus on secondary textbook availability, cost and financing, distribution and publishing, and the status of school libraries. Its objective is to analyze the issues in secondary textbook and school library provision and to provide some options and strategies for improvement.