DHS COMPARATIVE

REPORTS 32

INDICATORS OF CHILD DEPRIVATION 

IN SUB-SAHARAN AFRICA: LEVELS AND 

TRENDS FROM THE DEMOGRAPHIC AND 

HEALTH SURVEYS

DECEMBER 2013

This publication was produced for review by the United States Agency for International Development (USAID). The report was prepared by

Mariano J. Kanamori of C-Salud, Florida International University, USA, and Thomas Pullum of ICF International, Calverton, Maryland, USA.
The MEASURE DHS project assists countries worldwide in the collection and use of data to monitor and 

evaluate population, health, nutrition, and HIV/AIDS programs. Funded by the United States Agency for 

International Development (USAID) under Contract No. GPO-C-00-03-00002-00, MEASURE DHS is 

implemented by ICF International, Calverton, Maryland. 

The main objectives of the MEASURE DHS project are: 

• To provide decisionmakers in survey countries with information useful for informed policy 

choices 

• To expand the international population and health database 

• To advance survey methodology 

• To develop in participating countries the skills and resources necessary to conduct high-quality 

demographic and health surveys 

Additional information about the MEASURE DHS project is available on the Internet at

http://www.measuredhs.com or by contacting ICF International, MEASURE DHS, 11785 Beltsville

Drive, Suite 300, Calverton, MD 20705, USA; Telephone: 1-301-572-0200, Fax: 1-301-572-0999, 

E-mail: reports@measuredhs.com. 
DHS Comparative Reports No. 32 

Indicators of Child Deprivation 

in Sub-Saharan Africa: Levels and Trends 

from the Demographic and Health Surveys 

Mariano J. Kanamori 1

Thomas Pullum 2

ICF International 

Calverton, Maryland, USA 

December 2013 

1 C-Salud, Florida International University, USA 

2 ICF International, Calverton, Maryland, USA 

Corresponding author: Mariano J. Kanamori, C-Salud, Florida International University, Miami, Florida, 

USA; Phone: 305.348.0435; E-mail: mkanamor@fiu.edu 
Acknowledgments 

The authors would like to acknowledge the support provided by the MEASURE DHS project and 

the United States Agency for International Development. Helpful comments on a previous draft were 

provided by Sarah Lilley and Jane Fox. 

Editor: Wade Rinehart 

Document production: Yuan Cheng 

This study was carried out with support provided by the United States Agency for International 

Development (USAID) through the MEASURE DHS project (#GPO-C-00-08-00008-00) and by the 

United States Centers for Disease Control and Prevention (CDC) through the contract on 

Communications and Integrated Marketing Strategies, Media Services, and Database Support to the 

Office on Smoking and Health, Health Communications Branch (#200-2008-F-26188). The views 

expressed are those of the authors and do not necessarily reflect the views of USAID or the United States 

Government. 

Recommended citation: 

Kanamori, J. Mariano, and Thomas Pullum. 2013. Indicators of Child Deprivation in Sub-Saharan 

Africa: Levels and Trends from the Demographic and Health Surveys. DHS Comparative Reports No. 32. 

Calverton, Maryland, USA: ICF International. 
iii 

Contents 

Tables ..............................................................................................................................................v 

Figures ......................................................................................................................................... vii 

Maps ............................................................................................................................................ xii 

Preface ........................................................................................................................................ xiii 

Executive Summary .......................................................................................................................xv 

1 Introduction and Methods ..........................................................................................................1 

1.1 Methods............................................................................................................................ 1 

1.2 Data .................................................................................................................................. 2 

1.3 Definition of Variables .................................................................................................... 2 

2 Food Deprivation .......................................................................................................................9 

2.1 Wasting ............................................................................................................................ 9 

2.2 Stunting .......................................................................................................................... 10 

2.3 Underweight ................................................................................................................... 11 

3 Health Deprivation ...................................................................................................................33 

3.1 Expanded Program on Immunization ............................................................................ 33 

3.2 Diarrhea .......................................................................................................................... 34 

3.3 Medical Treatment of Diarrhea ...................................................................................... 36 

4 Water and Sanitation Deprivation ............................................................................................59 

4.1 Use of Surface Water ..................................................................................................... 59

4.2 15-Minute Walk to the Water Source ............................................................................ 60

4.3 Lack of Access to Any Sanitation Facilities Whatsoever in or near Their Homes ........ 62

5 Shelter Deprivation ..................................................................................................................87 

5.1 Living in Houses with Mud Floors ................................................................................ 87

5.2 Living in Houses without Electricity ............................................................................. 88

6 Education Deprivation ...........................................................................................................107 

6.1 Children Who Have Received No Primary or Secondary Education .......................... 107

6.2 Children Not Currently Enrolled in School ................................................................. 108

6.3 School Dropouts........................................................................................................... 109
iv 

7 Discussion ..............................................................................................................................137 

7.1 Food Deprivation ......................................................................................................... 137

7.2 Health Deprivation ....................................................................................................... 137

7.3 Water and Sanitation Deprivation ................................................................................ 138

7.4 Shelter Deprivation ...................................................................................................... 139

7.5 Education Deprivation ................................................................................................. 139

References ....................................................................................................................................141 
v 

Tables 

Table 1.1 Sample size, by child’s age, in demographic and health surveys, sub-Saharan 

Africa, 2000-2011 ..........................................................................................................5 

Table 1.2 Sample size by sex of the child, region of residence, and sex and age of head 

of household ...................................................................................................................7 

Table 2.1 Percentage of children less than age 5 who are wasted, by country, sex of 

child, and region of residence as well as sex and age of head of household ...............13 

Table 2.2 Percentage of children less than age 5 who are stunted, wasted, or 

underweight, by country and year of data collection ...................................................14 

Table 2.3 Percentage of children less than age 5 who are stunted, by country, sex of 

child, and region of residence as well as sex and age of head of household ...............15 

Table 2.4 Percentage of children less than age 5 who are underweight, by country, sex 

of child, and region of residence as well as sex and age of head of household ...........16 

Table 3.1 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations, by country, sex of child, and region of residence as well 

as sex and age of head of household ............................................................................38 

Table 3.2 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations, who had diarrhea in the two weeks prior to the survey, or 

who have had diarrhea in the two weeks prior to the survey for which no 

medical advice was obtained, by country and year of data collection .........................39 

Table 3.3 Percentage of children less than age 5 who had diarrhea in the two weeks prior 

to the survey, by country, sex of child, and region of residence as well as sex 

and age of head of household.......................................................................................40 

Table 3.4 Percentage of children less than age 5 who had diarrhea in the two weeks prior 

to the survey for which no medical advice was obtained, by country, sex of 

child, and region of residence as well as sex and age of head of household ...............41 

Table 4.1 Percentage of children who live in households that use surface water, by 

country, sex of child, and region of residence as well as sex and age of head of 

household .....................................................................................................................63 

Table 4.2 Percentage of children who live in households that use surface water, who 

have more than a 15-minute walk to the water source, or who do not have 

access to any sanitation facilities whatsoever in or near their homes, by 

country, child's age, and year of data collection ..........................................................64 
vi 

Table 4.3 Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country, sex of child, and region of residence as 

well as sex and age of head of household ....................................................................69 

Table 4.4 Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes, by country, sex of 

child, and region of residence as well as sex and age of head of household ...............70 

Table 5.1 Percentage of children who live in houses with mud floors, by country, sex of 

the child, and region of residence as well as sex and age of head of household .........90 

Table 5.2 Percentage of children who live in houses with mud floors or without 

electricity, by country, child's age, and year of data collection ...................................91 

Table 5.3 Percentage of children who live in houses without electricity, by country, sex 

of child, and region of residence as well as sex and age of head of household ...........95 

Table 6.1 Percentage of children age 7-17 who have no education, who are not currently 

enrolled in school, and who have dropped out of school, by country and 

child's age ...................................................................................................................111 

Table 6.2 Percentage of children age 7-17 with no education, by country, sex of child, 

and region of residence as well as sex and age of head of household .......................112 

Table 6.3 Trends in percentage of children age 7-17 who have no primary or secondary 

education, who are not attending school, or who have dropped out of school, 

by country and child's age ..........................................................................................113 

Table 6.4 Percentage of children age 7-17 not enrolled in school, by country, sex of 

child, and region of residence as well as sex and age of head of household .............116 

Table 6.5 Percentage of children age 7-17 who have dropped out of school, by country, 

sex of child, and region of residence as well as sex and age of head of 

household ...................................................................................................................118 
vii 

Figures 

Figure 2.1 Percentage of children less than age 5 who are wasted, by country and the 

child's sex ...................................................................................................................17 

Figure 2.2 Percentage of children less than age 5 who are wasted, by country and region 

of residence .................................................................................................................18 

Figure 2.3 Percentage of children less than age 5 who are wasted, by country and the 

sex of the household head ..........................................................................................19 

Figure 2.4 Percentage of children less than age 5 who are wasted, by country and the 

age of the household head ..........................................................................................20 

Figure 2.5 Changes in the percentage of children less than age 5 who are wasted .....................21 

Figure 2.6 Changes in the percentage of children less than age 5 who are wasted .....................21 

Figure 2.7 Percentage of children less than age 5 who are stunted, by country and the 

child's sex ...................................................................................................................22 

Figure 2.8 Percentage of children less than age 5 who are stunted, by country and the 

region of residence .....................................................................................................23 

Figure 2.9 Percentage of children less than age 5 who are stunted, by country and the 

sex of the household head ..........................................................................................24 

Figure 2.10 Percentage of children less than age 5 who are stunted, by country and the 

age of the household head ..........................................................................................25 

Figure 2.11 Changes in the percentage of children less than age 5 who are stunted .....................26 

Figure 2.12 Changes in the percentage of children less than age 5 who are stunted .....................26 

Figure 2.13 Comparison of the percentage of children less than age 5 who are 

underweight, by country and the child's sex ...............................................................27 

Figure 2.14 Comparison of the percentage of children less than age 5 who are 

underweight, by country and region of residence ......................................................28 

Figure 2.15 Comparison of the percentage of children less than age 5 who are 

underweight, by country and the sex of the household head ......................................29 

Figure 2.16 Comparison of the percentage of children less than age 5 who are 

underweight, by country and the age of the household head .....................................30 

Figure 2.17 Changes in the percentage of children less than age 5 who are underweight ............31 

Figure 2.18 Changes in the percentage of children less than age 5 who are underweight ............31 

Figure 3.1 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations, by country and the child's sex ....................................................42 
viii 

Figure 3.2 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations, by country and the region of residence ......................................43 

Figure 3.3 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations, by country and the sex of the household head ...........................44 

Figure 3.4 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations, by country and the age of the household head ...........................45 

Figure 3.5 Changes in the percentage of children less than age 5 who have not received 

any of the eight EPI immunizations ..........................................................................46 

Figure 3.6 Changes in the percentage of children less than age 5 who have not received 

any of the eight EPI immunizations ...........................................................................46 

Figure 3.7 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the child's sex .....................................................47 

Figure 3.8 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the region of residence .......................................48 

Figure 3.9 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the sex of the household head ............................49 

Figure 3.10 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the age of the household head ............................50 

Figure 3.11 Changes in the percentage of children less than age 5 who had diarrhea in the 

two weeks prior to the survey .....................................................................................51 

Figure 3.12 Changes in the percentage of children less than age 5 who had diarrhea in the 

two weeks prior to the survey .....................................................................................51 

Figure 3.13 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained, by country and 

the child's sex..............................................................................................................52

Figure 3.14 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained, by country and 

the region of residence ...............................................................................................53 

Figure 3.15 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained, by country and 

the sex of the household head .....................................................................................54 

Figure 3.16 Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained, by country and 

the age of the household head ....................................................................................55 
ix 

Figure 3.17 Changes in the percentage of children less than age 5 who had diarrhea in the 

two weeks prior to the survey for which no medical advice was obtained ................56 

Figure 3.18 Changes in the percentage of children less than age 5 who had diarrhea in the 

two weeks prior to the survey for which no medical advice was obtained ................56 

Figure 4.1 Percentage of children who live in households that use surface water, by 

country and the child's sex..........................................................................................71 

Figure 4.2 Percentage of children who live in households that use surface water, by 

country and region of residence .................................................................................72 

Figure 4.3 Percentage of children who live in households that use surface water, by 

country and the sex of the household head .................................................................73 

Figure 4.4 Percentage of children who live in households that use surface water, by 

country and the age of the household head ................................................................74 

Figure 4.5 Changes in the percentage of children who live in households that use surface 

water ...........................................................................................................................75 

Figure 4.6 Changes in the percentage of children who live in households that use surface 

water ...........................................................................................................................75 

Figure 4.7 Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and the child's sex ...........................................76 

Figure 4.8 Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and region of residence ...................................77 

Figure 4.9 Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and the sex of the household head ..................78 

Figure 4.10 Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and the age of the household head ..................79 

Figure 4.11 Changes in the percentage of children who had more than a 15-minute walk 

to the water source ......................................................................................................80 

Figure 4.12 Changes in the percentage of children who had more than a 15-minute walk 

to the water source ......................................................................................................80 

Figure 4.13 Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes, by country and the 

child's sex ...................................................................................................................81 

Figure 4.14 Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes, by country and region 

of residence .................................................................................................................82 
x 

Figure 4.15 Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes, by country and the sex 

of the household head .................................................................................................83 

Figure 4.16 Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes, by country and the age 

of the household head .................................................................................................84 

Figure 4.17 Changes in the percentage of children who did not have access to any 

sanitation facilities whatsoever in or near their homes ..............................................85 

Figure 4.18 Changes in the percentage of children who did not have access to any 

sanitation facilities whatsoever in or near their homes ..............................................85 

Figure 5.1 Percentage of children who live in a house with mud flooring, by country and 

the child's sex..............................................................................................................96

Figure 5.2 Percentage of children who live in a house with mud flooring, by country and 

region of residence .....................................................................................................97 

Figure 5.3 Percentage of children who live in a house with mud flooring, by country and 

the sex of the household head .....................................................................................98 

Figure 5.4 Percentage of children who live in a house with mud flooring, by country and 

the age of the household head ....................................................................................99 

Figure 5.5 Changes in the percentage of children who live in a house with mud flooring .......100 

Figure 5.6 Changes in the percentage of children who live in a house with mud flooring .......100 

Figure 5.7 Percentage of children who live in a house without electricity, by country and 

the child's sex ...........................................................................................................101 

Figure 5.8 Percentage of children who live in a house without electricity, by country and 

region of residence ...................................................................................................102 

Figure 5.9 Percentage of children who live in a house without electricity, by country and 

the sex of the household head ...................................................................................103 

Figure 5.10 Percentage of children who live in a house without electricity, by country and 

the age of the household head ..................................................................................104 

Figure 5.11 Changes in the percentage of children who live in a house without electricity .......105 

Figure 5.12 Changes in the percentage of children who live in a house without electricity .......105 

Figure 6.1 Percentage of children age 7-17 with no education, by country and sex of the 

child ..........................................................................................................................119 

Figure 6.2 Percentage of children age 7-17 with no education, by country and region of 

residence ...................................................................................................................120 
xi 

Figure 6.3 Percentage of children age 7-17 with no education, by country and sex of the 

household head .........................................................................................................121 

Figure 6.4 Percentage of children age 7-17 with no education, by country and age of the 

household head .........................................................................................................122 

Figure 6.5 Changes in the percentage of children age 7-17 who have received no 

primary or secondary education ...............................................................................123 

Figure 6.6 Percentage of children age 7-17 not enrolled in school, by country and sex of 

the child ....................................................................................................................124 

Figure 6.7 Percentage of children age 7-17 not enrolled in school, by country and region 

of residence ...............................................................................................................125 

Figure 6.8 Percentage of children age 7-17 not enrolled in school, by country and sex of 

the household head ...................................................................................................126 

Figure 6.9 Percentage of children age 7-17 not enrolled in school, by country and age of 

the household head ...................................................................................................127 

Figure 6.10 Changes in the percentage of children age 7-17 who are not currently 

enrolled in school .....................................................................................................128 

Figure 6.11 Changes in the percentage of children age 7-17 who are not currently 

enrolled in school .....................................................................................................128 

Figure 6.12 Percentage of children age 7-17 who dropped out of school, by country and 

the sex of the child ....................................................................................................129 

Figure 6.13 Percentage of children age 7-17 who dropped out of school, by country and 

region of residence ...................................................................................................130 

Figure 6.14 Percentage of children age 7-17 who dropped out of school, by country and 

sex of the household head ........................................................................................131 

Figure 6.15 Percentage of children age 7-17 who dropped out of school, by country and 

age of the household head ........................................................................................132 

Figure 6.16 Changes in the percentage of children age 7-17 who dropped out of school ...........133 
xii 

Maps 

Map 2.1 Percentage of children less than age 5 who are wasted ..................................................32 

Map 2.2 Percentage of children less than age 5 who are stunted ..................................................32 

Map 2.3 Percentage of children less than age 5 who are underweight .........................................32 

Map 3.1 Percentage of children less than age 5 who have not received any of the eight 

EPI immunizations ..........................................................................................................57 

Map 3.2 Percentage of children less than age 5 who had diarrhea in the two weeks prior 

to the survey ....................................................................................................................57 

Map 3.3 Percentage of children less than age 5 who had diarrhea in the two weeks prior 

to the survey for which no medical advice was obtained ...............................................57 

Map 4.1 Percentage of children who live in households that use surface water ...........................86 

Map 4.2 Percentage of children who live in households that are more than a 15-minute 

walk to the water source .................................................................................................86 

Map 4.3 Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes ...................................................86 

Map 5.1 Percentage of children who live in houses with mud floors .........................................106 

Map 5.2 Percentage of children who live in houses without electricity .....................................106 

Map 6.1 Percentage of children age 7-12 with no education ......................................................134 

Map 6.2 Percentage of children age 13-17 with no education ....................................................134 

Map 6.3 Percentage of children age 7-12 not enrolled in school ................................................134 

Map 6.4 Percentage of children age 13-17 not enrolled in school ..............................................134 

Map 6.5 Percentage of children age 7-12 who have dropped out of school ...............................135 

Map 6.6 Percentage of children age 13-17 who have dropped out of school .............................135 
xiii 

Preface 

One of the most significant contributions of the MEASURE DHS program is the creation of an 

internationally comparable body of data on the demographic and health characteristics of populations in 

developing countries. 

The DHS Comparative Reports series examines these data across countries in a comparative 

framework. The DHS Analytical Studies series focuses on specific topics. The principal objectives of both 

series are to provide information for policy formulation at the international level and to examine 

individual country results in an international context. Comparative Reports are primarily descriptive, 

while Analytical Studies take a more analytical approach. 

The Comparative Reports series covers a variable number of countries, depending on the 

availability of data sets. Where possible, data from previous DHS surveys are used to evaluate trends over 

time. Each report provides detailed tables and graphs organized by region. Survey-related issues such as 

questionnaire comparability, survey procedures, data quality, and methodological approaches are 

addressed as needed. 

It is anticipated that the availability of comparable information for a large number of developing 

countries will enhance the understanding of analysts and policymakers regarding important issues in the 

fields of international population and health. 

Sunita Kishor 

Project Director 

xv 

Executive Summary 

Access to basic human needs is essential to the development of children’s full potential. This 

comparative report focuses on deprivation of basic human needs among children in sub-Saharan Africa. It 

examines disparities and illustrates changes in the prevalence of African children’s exposure to 

deprivation. The data come from DHS surveys conducted in 30 countries between 2000 and 2011. 

This report covers deprivation in five areas: food, health, water and sanitation, shelter, and 

education. It reports on indicators of deprivation among all children in these countries and in trends in 

these indicators. In addition, this report examines whether, and how much, the prevalence of deprivation 

in each country differs by the sex of the child, rural or urban residence, the sex of the head of the 

household in which the child lives, and the age of the head of the household (<50 years old versus age 50 

and older). Knowing of these differences may help policymakers to focus strategies for improvements. 

Prevalence of deprivation 

Food: In all countries reporting, at least one-fourth of children are stunted (that is, too short for 

their age), indicating chronic malnutrition. 

Health: In nearly half of countries, more than 40% of children had received no vaccinations. In 

all but one country, almost 40% to over 80% of children who had diarrhea in the two weeks before the 

latest survey received no medical advice. 

Water and sanitation: The percentage of children’s households using surface water, which may 

be polluted, varies widely, from less than 10% in six countries to close to 50% or more in four countries. 

Shelter: In 16 of 24 countries, more than half of children live in homes with mud floors; only two 

countries have rates under 20%. In all countries the homes of more than half the children have no 

electricity, and in 18 of 24 countries the rate exceeds 80%. 

Education: In 10 of 19 countries with data, less than 15% of children have no education. In nine 

of these countries less than 20% of children are not in school. In Burkina Faso and Mali, however, more 

than half of children have no schooling and more than half are not currently in school. 

Disparities in a country: What makes a difference? 

Disparities by sex of child: In every country underweight and stunting were more common 

among boys than girls, while in three-quarters of the countries girls were less likely than boys to receive 

medical care for diarrhea. Many countries had differences between boys and girls in the percentages 

lacking education, The pattern across countries was mixed, but in five countries—Benin, Chad, Cote 

d’Ivoire, Guinea, and Nigeria—girls who lacked education exceeded boys by 10 percentage points or 

more. 

Rural-urban discrepancies: Rural areas are worse off than urban areas in most all countries for 

nearly most indicators. In every country rural areas posted higher rates of wasting, stunting, underweight, 

no EPI vaccination (except Burundi), no sanitation facilities, living more than 15 minutes walk from a 

water source (except Liberia), mud floors, and no electricity. The difference was less pervasive for 

diarrhea: Urban areas fared better than rural in half the countries. The percentage of children 7 to 17 years 

old who did not enroll in school was at least one percentile point higher in rural areas than in urban areas 

(except in Rwanda, Swaziland, and Uganda). We also found geographic disparities in the percentage of 

children who dropped out of school in Burkina Faso and Madagascar, where the differences were at least 

6 percentile points higher in rural areas than in urban areas. 
xvi 

Sex of head of household: The sex of the head of the child’s household made a difference to 

many indicators. The pattern was mixed, but living with a male head of household was commonly 

associated with higher percentages for deprivation in more instances than living with a female head of 

household. Living with a male head of household meant a higher percentage of receiving no vaccinations 

in 14 countries, having no primary or secondary education in 18 countries, and lacking medical advice for 

recent diarrhea and living in a house with a mud floor in two-thirds of countries. Living with a male head 

of household also meant a higher percentage of children using surface water (Benin, Ethiopia, Ghana, 

Guinea, Liberia and Madagascar); without access to any sanitation services (Senegal, Burkina Faso, 

Benin, and Ghana); without electricity (Senegal); and not enrolled in school (Benin, Burkina Faso, 

Cameroon, Nigeria, and Senegal). Living with a female head of household was most often linked with a 

higher percentage of stunting (in 11 countries); underweight (one-third of these countries); recent diarrhea 

(in 13 countries); and children not enrolled in school (Chad). 

Age of the head of household: As with sex, the age of the head of household made a difference 

to a number of deprivation indicators, but the pattern was mixed. For example, living with a head of 

household age 50 or older meant a greater percentage of stunting in 7 countries; underweight in half of the 

countries; no vaccinations in 17 countries; use of surface water (Cameroon, Kenya, Namibia and Nigeria); 

living more than a 15-minute walk from the primary water source (Namibia); living in a house with mud 

flooring (Namibia, Lesotho and Zambia); no electricity (Namibia and Uganda); no school (Benin, 

Burkina Faso, Ghana, Liberia, Madagascar, Mali, Niger and Tanzania); and dropping out of school 

(Burkina Faso). 

Trends in deprivations 

Over the past 13 years, a number of countries have made substantial progress in reducing the 

prevalence of deprivation in particular areas. Others have suffered setbacks. 

Food: Burkina Faso, Ethiopia, and Rwanda made the greatest progress in reducing stunting—by 

nearly eight percentage points or more. In Benin and Senegal, however, the situation worsened. 

Health: Many countries substantially decreased the percentage of children with no 

immunizations—Burkina Faso, Tanzania, and Uganda by over 30 percentage points. In contrast, the 

percentage in Zambia increased comparably. Burkina Faso, Kenya, Lesotho, Malawi, Nigeria, and 

Rwanda all decreased, by close to 20 percentage points or more, the percentage of children not receiving 

medical advice when they had diarrhea. 

Water: Burkina Faso, Ghana, Kenya, Madagascar, and Malawi decreased the percentage of 

children using ground water by more than five percentage points. In contrast, the percentage using ground 

water increased by nearly 29 percentage points in Ethiopia, and increases also were large in Rwanda and 

Zimbabwe. Senegal decreased by over 28 percentage points the percentage of children living more than a 

15-minute walk from their water source. Lesotho, Mali, and Nigeria made improvements of about 15 to 

19 percentage points. 

Sanitation: Ethiopia decreased the percentage of children with no access to sanitation facilities 

by nearly 25 percentage points. 

Shelter: In Mozambique the percentage of children living in homes with mud floors decreased by 

more than 15 percentage points. The percentage of children in homes with electricity increased by about 

10 to 12 percentage points in Ghana, Mozambique, and Senegal. 

Education: Burkina Faso, Ethiopia, and Zambia decreased the percentage not in school by 15 to 

almost 19 percentage points. Benin, Ghana, Kenya, Senegal, and Zambia reduced their school drop-out 

rates among children age 13 to 17 by at least six percentage points. 
1 

1 Introduction and Methods 

Focusing on the deprivation of children’s basic human needs is imperative. More than half of the 

children in developing countries—more than one billion in all—suffer from deprivation in one or more of 

the following areas: health, water, sanitation, education, food, information, and shelter (Gordon, 2003). 

The problem is most severe in sub-Saharan Africa, where the rate of children suffering from at least one 

of these forms of deprivation reaches over 80% in some countries (Gordon, 2003). The problem is worst 

in rural areas, where in some sub-Saharan African countries more than 90% of children are deprived of 

one or more basic human needs. The high percentage of children in sub-Saharan Africa that experience 

each of these deprivations shows the alarming dimensions of the crisis. As estimated in 2003, 62% are 

deprived of shelter (198 million), 53% of water (167 million), 30% of education (50 million), 24% of 

health (84 million), and 19% of food (20 million) (Gordon, 2003). 

This comparative report focuses on deprivation of basic human needs among children, defined as 

the condition of observable and demonstrable disadvantage that some children experience in relation to 

their counterparts at community, societal, or national levels (Townsend, 1987). Attaining their basic needs 

is essential if children are to achieve their full potential (Minujin, 2006). Global health leaders should take 

child deprivation into account in the growing dialogue on anti-poverty policies and in the current debate 

on the definition of poverty (Minujin, 2006). To address this concern, this report examines disparities and 

illustrates changes in the prevalence of African children’s exposure to deprivation from 2000 to 2011. 

This document summarizes data from the Demographic and Health Surveys (DHS) collected on 

deprivation in five areas: food, water and sanitation, health, shelter, and education. The work of Gordon et 

al. (2003) guided the selection of these topics. 

The following are the specific aims of this study: 

• for each African country, to describe levels and changes in the prevalence of children’s 

exposure to each type of vulnerability 

• to determine for each country the extent to which children’s exposure to each type of 

vulnerability differed by the child’s sex and region of residence as well as the age and gender 

of the head of household. 

1.1 Methods 

Cross-sectional analyses were performed using nationally representative data from DHS surveys. 

The DHS project, initiated in 1984, has a key mandate to collect information on demographic, health, and 

nutrition indicators. Funded mainly by the United States Agency for International Development (USAID), 

the DHS survey has been administered in more than 90 developing countries around the world. In 

conducting a survey within a country, DHS staff work with an implementing agency (e.g., a national 

statistics office, ministry of health, or university) and provide technical assistance for the implementation 

of the survey, data analysis, report writing, and dissemination. 

The DHS survey uses a multi-stage, stratified sampling design, with households as the sampling 

unit. Within each sample household, all women and men meeting the eligibility criteria are eligible to be 

interviewed. Because the surveys are not self-weighting, survey weights are calculated to account for 

unequal selection probabilities as well as survey non-response. With weights applied, survey findings 

represent the full target populations. 
2 

1.2 Data 

Analyses were performed using DHS data collected in 30 countries from 2000 to 2011. Two 

types of data files were included: 

• The Household Listing Data – Household Member Recode (PR) files. These files have

one record for every household member and include variables such as sex, age, education, 

orphanhood, height and weight measurement, and hemoglobin level. The PR files also 

include the characteristics of the households where the child lived or was visiting. The unit of 

analysis (case) is the household member. 

• The Children (KR) files. These files have one record for every interviewed woman’s child 

born in the five years preceding the survey and contain information related to the mother’s 

pregnancy and postnatal care and the child’s immunization and health. The KR files include 

data on the mother of each of these children. The unit of analysis (case) is the child born to an 

interviewed woman in the preceding five years (age 0-59 months). 

All countries included in this report are in sub-Saharan Africa, 11 countries are in the eastern 

region, 4 in the middle region, 3 in the southern region, and 10 in the western region. Table 1.1 lists the 

countries included in this report, the year(s) of fieldwork, and the sample sizes for each country survey by 

children’s ages. Table 1.2 reports these same samples according to the child’s sex, urban or rural 

residence, and the sex and age (<50 or ≥50 years) of the head of household. Not all countries collected 

data on all variables addressed in this report. The prevalence of each deprivation measurement was 

calculated using the most recent DHS data. Changes over time were calculated for countries that had DHS 

information available from two different data collection years. 

1.3 Definition of Variables 

This report covers five areas of child deprivation: food, water and sanitation, health, shelter, and 

education. 

Food deprivation 

This document identifies children suffering from food deprivation as those who were stunted, 

wasted, or underweight (more than −2 standard deviations below the reference population median). 

Analyzes were performed using data on children less than age 5 from the Household Member Recode 

(PR) files. The following DHS variables were used:

• stunted: hc5 

• wasted: hc11 

• underweight: hc8 

Water and sanitation deprivation 

Households and children in households who were using surface water or had more than a 15 

minute walk to their water source were considered severely deprived of water. The rationale for these 

dichotomous measures is that surface water can occasionally become polluted and unsafe, and a 15-

minute walk to a water source (30 minutes round trip) means that it is highly likely that the child will 

have access to only a very limited quantity of water at home (Gordon, 2003). Children severely deprived 

of sanitation were defined as those who did not have access to any sanitation facilities whatsoever in or 

near their homes, including any connection to a public sewer, connection to a septic system, pour-flush 
3 

latrine, simple pit latrine, ventilated improved pit latrine, service or bucket latrines where excreta are 

removed manually, public latrines, or open latrine. Analyzes were performed using data on children less 

than age 5 from the Household Member Recode (PR) files. The following DHS variables were used:

• Use of surface water: hv201 

• More than a 15-minute walk to their water source: hv204 

• Lack of access to any sanitation facilities whatsoever in or near their homes: hv205 

Health deprivation 

Children severely deprived of health needs included children who had not received any of the 

eight EPI immunizations, who had diarrhea in the last two weeks, or who had diarrhea in the last two 

weeks without obtaining medical advice. Since immunizations start soon after birth, all children are 

eligible to meet the condition of having had no immunizations. Fully immunized status was not used; this 

would have excluded a large proportion of the children, since, following the recommended immunization 

schedule, no six-month-old is fully immunized (Gordon, 2003). Analyzes were performed using the data 

from the children (KR) files: 

• have not received any of the eight EPI immunizations: h0, h2, h3, h4, h5, h6, h7, h8, and h9. 

• had diarrhea in the last two weeks: h11 

• had untreated diarrhea in the two weeks prior to the survey for which no medical advice was 

obtained: h12z 

Shelter deprivation 

This section includes analyses of children who lived in a dwelling that had a mud floor or that did 

not have electricity. Analyzes were performed using data on children less than age 18 from the 

Household Member Recode (PR) files. The following DHS variables were used: 

• dwelling that had a mud floor: hv213 

• dwelling that did not have electricity: hv206 

Education deprivation 

This section analyzes whether children ages 7 through 17 have received no education, were not 

attending school during the year of the interview, or had dropped out of school (had not attended school 

for the last two years). Analyzes were performed using data from the Household Member Recode (PR) 

files. The following DHS variables were used:

• have received no education: hv129, hv105 

• were not attending school during the year of the interview: hv121, hv105 

• had dropped out of school: hv105, hv121, hv125 

Variables for stratified analyses 

Analyses were stratified using the following sociodemographic characteristics: 
4 

Sex of the child: male / female: hv104 

Age of the child: 0-4, 5-9, 10-14, 15-17: hv105 

 0-6, 7-17: hv105 

Region of residence of the child: rural / urban: hv024

Sex of the head of the household: male / female: hv219 

Age of the head of the household: less than age 50 / age 50 or more: hv220 

Analyses 

The first analysis describes the percentage of the child population in each country considered 

vulnerable in each of the five categories.of deprivation. Then, analyses are presented separately by the 

child’s sex, region of residence, and the sex and age of the head of household. Finally, changes over time 

are calculated for countries that have data from two data collection years. All data were weighted to 

ensure that nationally representative estimates were obtained. All analyses were conducted using Stata/SE 

13. There may be trivial discrepancies in the percentages between tables because of rounding. 

The structure of this document 

Chapter 2 through Chapter 6 present information for each type of deprivation. Each chapter 

includes a brief literature review as well as the results of the analyses. First, the country prevalence of 

each component of deprivation is provided. Second, child’s sex and regional disparities are presented. 

Third, tables present the prevalence of each component of the specific deprivation by the sex and age of 

the household head. Fourth, changes over time in the prevalence of each deprivation component are 

provided. Chapter 7 presents the conclusions of this study. Tables, figures, and maps are not interspersed 

with the text, but are placed at the end of each chapter for easier reference. 
5 

Table 1.1. Sample size, by child’s age, in demographic and health surveys, sub-Saharan Africa, 

2000-2011 

Country 

Year of 

data 

collection 

Age of the child (in years) 

0-4 5-9 10-14 15-17 0-17 7-12 13-17 7-17 

Benin 2001 5,268 5,159 4,259 1,573 16,260 5,872 3,075 8,947 

2006 16,298 15,358 12,340 4,812 48,808 16,939 9,187 26,127 

Burkina Faso 2003 10,159 9,738 8,313 4,107 32,317 11,059 7,252 18,311 

2010 14,830 13,852 11,531 4,515 44,728 15,572 8,711 24,283 

Burundi 2010 7,651 6,288 5,443 2,892 22,274 6,843 5,101 11,944 

Cameroon 2004 8,375 7,538 7,021 3,425 26,359 8,935 6,064 14,999 

2011 12,189 11,079 9,228 4,467 36,963 12,674 7,659 20,333 

Chad 2004 5,500 5,321 4,005 1,729 16,554 5,683 3,120 8,803 

Congo 

(Brazzaville) 

2005 5,133 4,218 4,247 2,180 15,778 5,035 3,919 8,954 

Congo 

Democratic 

Republic 

2007 9,076 7,655 6,639 2,815 26,185 8,393 5,390 13,782 

Cote d’Ivoire 2005 3,834 3,624 3,097 1,577 12,132 3,784 2,884 6,668 

Ethiopia 2005 10,898 11,624 10,378 4,412 37,312 13,767 8,196 21,963 

2011 12,098 12,888 11,403 4,996 41,385 15,084 9,166 24,251 

Ghana 2003 3,691 3,686 3,697 1,529 12,603 4,420 3,061 7,481 

2008 5,874 6,287 5,753 2,747 20,661 7,210 5,107 12,317 

Guinea 2005 6,224 6,644 5,654 2,198 20,720 7,709 4,190 11,899 

Kenya 2003 6,034 5,423 5,396 2,566 19,418 6,412 4,750 11,162 

2008-09 6,045 5,863 5,304 2,348 19,560 6,698 4,331 11,029 

Lesotho 2004 4,331 4,679 5,355 2,946 17,311 5,972 5,214 11,186 

2009 4,695 4,902 5,542 3,083 18,222 6,146 5,387 11,533 

Liberia 2007 6,074 5,554 4,553 1,657 17,837 6,099 3,385 9,485 

Madagascar 2003-04 6,533 6,288 5,653 2,146 20,620 7,173 4,279 11,452 

2008-09 13,247 13,952 12,456 5,383 45,038 16,176 9,952 26,128 

Malawi 2004 10,802 9,380 8,906 3,278 32,367 11,377 6,515 17,892 

2010 19,843 19,862 17,153 7,515 64,372 22,168 13,783 35,951 

Mali 2001 12,302 11,064 9,442 3,503 36,310 12,456 6,914 19,370 

2006 13,933 12,332 10,134 4,553 40,951 13,490 8,284 21,775 

Mozambique 2003 10,334 9,855 8,124 3,515 31,828 11,060 6,483 17,543 

2011 10,889 10,013 8,711 3,613 33,227 11,635 6,641 18,275 

Namibia 2000 4,615 4,783 4,554 2,129 16,082 5,651 3,916 9,567 

2006-07 5,647 5,437 5,585 2,959 19,628 6,483 5,332 11,815 

Niger 2006 9,402 8,928 6,709 2,217 27,256 9,720 4,426 14,146 

Nigeria 2003 5,990 5,303 4,439 2,209 17,942 6,047 3,779 9,826 

2008 25,903 23,237 18,166 8,005 75,312 25,270 14,462 39,732 

Rwanda 2005 8,210 7,243 6,416 3,321 25,191 8,186 5,930 14,116 

2010 9,074 8,653 7,375 3,770 28,872 9,659 6,564 16,222 

(Continued...)
6 

Table 1.1. – Continued

Country 

Year of 

data 

collection 

Age of the child (in years) 

0 to 4 5 to 9 10 to 14 15 to 17 0 to 17 7 to 12 13 to 17 7 to 17 

Sao Tomé 

and Príncipe 

2008-09 2,120 1,975 1,856 868 6,819 2,289 1,609 3,898 

Senegal 2005 10,822 9,509 8,587 4,578 33,495 10,885 7,898 18,783 

2010-11 12,562 11,274 9,448 4,431 37,716 12,364 7,991 20,355 

Sierra Leone 2008 6,738 7,175 6,889 1,603 22,404 8,047 4,671 12,718 

Swaziland 2006-07 3,316 3,224 3,447 1,792 11,779 3,962 3,216 7,177 

Tanzania 2004-05 8,713 7,176 6,557 2,982 25,429 8,294 5,548 13,842 

2010 8,331 7,625 6,730 3,100 25,786 8,500 5,748 14,248 

Uganda 2006 8,643 7,802 7,147 2,808 26,401 9,042 5,496 14,539 

2011 8,502 7,737 6,738 2,946 25,923 8,776 5,404 14,180 

Zambia 2001-02 6,569 6,172 5,351 2,415 20,508 7,041 4,420 11,460 

2007 6,472 5,585 5,303 2,085 19,446 6,533 4,195 10,729 

Zimbabwe 2005-06 5,930 6,360 6,195 2,801 21,285 7,368 5,360 12,728 

2010-11 6,083 5,692 5,811 2,562 20,148 7,046 4,780 11,826 
7 

Table 1.2. Sample size by sex of the child, region of residence, and sex and age of head of 

household 

Country 

Year of 

data 

collection

Sex of the child 

Region of 

residence 

Sex of 

household head 

Age of 

household head 

Male Female Urban Rural Male Female 

Less 

than 

age 50 

Age 50 

or more

Benin 2001 8,295 7,955 5,533 10,727 13,715 2,545 13,137 3,123 

2006 25,148 23,657 17,285 31,523 40,684 8,124 41,384 7,424 

Burkina Faso 2003 16,616 15,696 4,891 27,426 30,458 1,859 25,130 7,187 

2010 22,861 21,867 8,386 36,342 41,376 3,352 36,506 8,222 

Burundi 2010 10,862 11,411 1,924 20,349 17,492 4,781 20,282 1,991 

Cameroon 2004 13,334 13,014 12,099 14,259 21,085 5,274 21,654 4,705 

2011 18,483 18,480 16,141 20,822 29,329 7,634 29,615 7,348 

Chad 2004 8,351 8,200 3,192 13,362 14,295 2,260 14,408 2,146 

Congo 

(Brazzaville) 

2005 7,874 7,904 7,798 7,980 12,345 3,433 13,326 2,452 

Congo 

Democratic 

Republic 

2007 13,253 12,931 10,942 15,243 21,567 4,618 23,448 2,737 

Cote d’Ivoire 2005 6,019 6,113 4,766 7,366 10,021 2,111 9,969 2,163 

Ethiopia 2005 19,090 18,222 3,510 33,803 31,306 6,007 31,574 5,739 

2011 20,819 20,566 6,081 35,303 33,363 8,022 35,050 6,335 

Ghana 2003 6,454 6,150 4,804 7,799 8,696 3,908 10,008 2,595 

2008 10,433 10,228 8,277 12,384 14,331 6,330 17,226 3,436 

Guinea 2005 10,501 10,219 5,840 14,881 18,047 2,673 15,507 5,213 

Kenya 2003 9,884 9,533 3,085 16,333 13,238 6,180 16,965 2,453 

2008-09 9,884 9,676 2,908 16,652 12,964 6,596 16,722 2,838 

Lesotho 2004 8,810 8,501 2,558 14,753 11,240 6,071 12,728 4,582 

2009 9,024 9,198 3,655 14,567 12,100 6,122 13,673 4,549 

Liberia 2007 9,042 8,795 6,561 11,276 12,249 5,588 15,549 2,288 

Madagascar 2003-04 10,572 10,039 4,092 16,528 17,293 3,327 18,172 2,448 

2008-09 22,941 22,097 5,374 39,664 37,306 7,732 40,267 4,771 

Malawi 2004 16,079 16,288 4,608 27,759 24,593 7,774 27,999 4,368 

2010 31,973 32,399 9,117 55,256 47,300 17,073 55,540 8,832 

Mali 2001 18,141 18,165 9,075 27,235 33,324 2,986 30,255 6,055 

2006 20,608 20,343 11,631 29,320 37,145 3,806 33,473 7,478 

Mozambique 2003 16,048 15,780 10,334 21,494 24,672 7,156 27,938 3,890 

2011 16,403 16,824 9,773 23,454 22,425 10,801 29,418 3,809 

Namibia 2000 7,835 8,245 4,187 11,895 8,493 7,587 10,658 5,425 

2006-07 9,788 9,839 6,862 12,766 9,824 9,804 14,027 5,602 

Niger 2006 13,814 13,442 4,513 22,743 22,936 4,320 21,178 6,078 

Nigeria 2003 9,087 8,856 5,826 12,116 15,831 2,111 14,776 3,166 

2008 38,290 37,019 23,337 51,975 65,639 9,673 62,330 12,982 

(Continued...)
8 

Table 1.2. – Continued

Country 

Year of 

data 

collection

Sex of the child 

Region of 

residence 

Sex of 

household head 

Age of 

household head 

Male Female Urban Rural Male Female 

Less 

than 

age 50 

Age 50 

or more

Rwanda 2005 12,543 12,647 3,620 21,570 17,805 7,385 22,428 2,762 

2010 14,508 14,364 3,394 25,478 20,615 8,258 25,913 2,959 

Sao Tomé 

and Príncipe 

2008-09 3,498 3,322 3,448 3,372 4,123 2,696 5,997 823 

Senegal 2005 16,697 16,797 12,987 20,508 26,833 6,662 22,938 10,557 

2010-11 18,909 18,806 14,704 23,012 29,976 7,740 24,872 12,844 

Sierra Leone 2008 11,392 11,011 7,093 15,311 17,375 5,029 16,917 5,486 

Swaziland 2006-07 5,874 5,905 1,840 9,939 5,179 6,599 8,263 3,516 

Tanzania 2004-05 12,833 12,596 5,411 20,019 20,120 5,309 21,274 4,155 

2010 12,822 12,963 5,279 20,507 20,247 5,539 21,211 4,575 

Uganda 2006 13,071 13,330 2,910 23,491 18,984 7,417 22,773 3,628 

2011 13,113 12,809 3,114 22,809 18,620 7,303 22,601 3,322 

Zambia 2001-02 10,260 10,248 7,066 13,442 16,573 3,935 17,777 2,731 

2007 9,573 9,873 6,387 13,059 15,370 4,076 17,142 2,304 

Zimbabwe 2005-06 10,728 10,554 5,538 15,747 12,548 8,737 16,926 4,358 

2010-11 10,081 10,067 5,128 15,020 10,744 9,404 16,567 3,581 
9 

2 Food Deprivation 

The first Millennium Development Goal (MDG), eradicating extreme poverty and hunger, as well 

as Goals 4 and 5, the reduction of child mortality and the improvement of maternal health, all recognize 

the crucial importance of adequate nutrition. Food deprivation is a major cause of disability and mortality; 

it is the top cause of the global burden of disease, as evidenced by its association with 53% of deaths in 

children under five years throughout the world (Bryce et al., 2005; Ezzati, 2003; Muller and Krawinkel, 

2005; World Bank, 2006). In low-income and middle-income countries, stunting, severe wasting, and 

intrauterine growth retardation account for 2.2 million deaths each year and 21% of disability-adjusted 

life-years (DALYs) for children younger than 5 years (Black et al., 2008). 

Food deprivation affects children, the global society, and future generations (GranthamMcGregor et al., 2007; Ramakrishnan et al., 1999; Victora et al., 2000). Child undernutrition has been 

linked to negative health consequences later in life, including impaired cognitive development, poor 

educational outcomes, and low human capital formation (Lanigan and Singhal, 2009; Victora et al., 

2008). Food deprivation among children is associated with having parents with little education, living in 

an impoverished household, experiencing food insecurity, having a mother with depression, living in a 

rural area, receiving inadequate feeding, having a mother who lacks decision-making autonomy, living in 

an area where food is expensive, having many siblings under five years old, and having a mother who had 

a short previous birth interval (Bhutta et al., 2008; Engebretsen et al., 2008; Muller and Krawinkel, 2005; 

Wachs, 2008; Wachs et al., 2005). In Ghana Ehrhardt et al. (2006) found that food deprivation was a 

fundamental contributor to malaria-associated morbidity and anemia—a finding that suggests the need for 

comprehensive and concomitant nutrition and malaria-control programs. 

This chapter focuses on children less than age 5 and includes three anthropometric measures of 

nutrition: weight-for-height (WHZ) to measure wasting, height-for-age (HAZ) to measure stunting, and 

weight-for-age (WAZ) to measure underweight. Like the World Health Organization (WHO) Global 

Database on Child Growth and Malnutrition (WHO, 2013), we used a Z-score cut-off point of <−2 

standard deviations (SD) to classify low weight-for-height, low height-for-age, and low weight-for-age as 

moderate and severe undernutrition. 

2.1 Wasting

The term wasting refers to a process, usually associated with starvation and/or disease, that leads 

to substantial weight loss. Wasting is calculated by comparing a child’s weight-for-height with a 

reference population of well-nourished, healthy children. Researchers often use wasting to assess the 

severity of emergencies because of its strong relationship to mortality (WFP, 2013). 

Table 2.1 shows that the prevalence of wasting among children less than age 5 ranged from about 

2% in Rwanda and Zimbabwe to around 13% in Mali and Burkina Faso. Niger and Nigeria had wasting 

prevalence above 10% (see Map 2.1). All four countries with a prevalence of wasting above 10% are 

located in western Africa. 

Sex and geographic disparities 

Overall, there were no major sex disparities related to wasting in sub-Saharan Africa (see Figure 

2.1). The largest differences occurred in Kenya and Niger, where the wasting prevalence was 

approximately 2 percentage points higher for boys than for girls. 

As Figure 2.2 shows, in general, there was a lower prevalence of wasting among children in 

urban areas than in rural areas of sub-Saharan Africa. This difference was most pronounced in Cameroon, 

Ethiopia, Namibia, and Nigeria, countries where the prevalence of wasting in urban areas was at least 4 
10 

percentage points higher in rural areas than in urban areas (see Table 2.1). The inverse situation occurred 

in Liberia, where the prevalence of wasting was 8% in urban areas and 6% in rural areas--a discrepancy 

of 3 percentage points. 

The role of the household head’s sex and age 

Overall, there were no marked differences in the wasting prevalence by the sex and age of the 

household head in sub-Saharan Africa (see Figures 2.3 and 2.4). The difference by sex of head of 

household was substantial only in Nigeria, where the wasting prevalence was 13% for children living with 

a male household head and 9% for children living with a female household head (a difference of 4 

percentage points) (see Table 2.1). In Rwanda the wasting prevalence for children living with a household 

head less than age 50 (2%) was lower than that of children living with a household head who was at least 

age 50 (6%), a difference of 3 percentage points. 

Variations during the last 13 years 

The most important progress in reducing the wasting prevalence, in terms of percentage points, 

took place in Burkina Faso and Zimbabwe (see Table 2.2). The wasting prevalence in Burkina Faso was 

19% in 2003 and 14% in 2010, a decrease of 5 percentage points. In Zimbabwe the reduction between 

surveys was 4 percentage points (2005-06: 6% and 2010-11: 3%). The opposite shift occurred in Mali and 

Nigeria, where rates of wasting increased by about 3 percentage points (Mali 2001: 11% and 2006: 14%; 

Nigeria 2003: 9% and 2008: 12%) (see Figures 2.5 and 2.6). 

2.2 Stunting

The term stunting refers to shortness-for-age; an indicator of chronic malnutrition calculated by 

comparing the height-for-age of a child with a reference population of well-nourished, healthy children. 

Stunting could be a sign of failure to attain linear growth potential as a consequence of suboptimal health 

and/or nutritional conditions (WFP, 2013; WHO, 1995). 

As Table 2.3 indicates, the stunting prevalence in Africa ranged from 50% in Niger and 51% in 

Burundi to 22% in Senegal. The Democratic Republic of Congo, Madagascar, and Malawi, as well as 

Niger and Burundi, had stunting prevalence above 40% (see Map 2.2.). 

Sex and geographic disparities 

In all countries, the prevalence of stunting among children less than age 5 was higher for males 

than for females (see Figure 2.7). This sex disparity was 6 percentage points higher for males than 

females in Burundi and 5 percentage points higher for males than females in Benin, Liberia, and Malawi 

(see Table 2.3). 

In every country the stunting prevalence in rural areas was higher than that in urban areas (see 

Figure 2.8). This difference was most pronounced among children in Burundi and Niger, where the 

stunting prevalence was 20 percentage points greater in rural areas than in urban areas. The country of 

Sao Tomé and Príncipe had the lowest geographic variation—2 percentage points higher in rural than 

urban areas; see Table 2.3).

The role of the household head’s sex and age 

The sex of the household head played an important role in stunting prevalence, but the pattern 

was not consistent across countries. The stunting prevalence was at least one percentage point higher for 

children living with a male household head in 8 countries, but at least 1 percentage point higher for 
11 

children living with a female household head in 11 countries (see Figure 2.9). In Nigeria the stunting 

prevalence was 6 percentage points higher for children living with a male rather than a female household 

head (37% versus 31%) (see Table 2.3). In Burkina Faso (30% versus 26%) and Senegal (23% versus 

19%), the stunting prevalence was approximately 4 percentage points higher for children living with a 

male rather than a female household head. The inverse situation occurred in such countries as the 

Democratic Republic of Congo (39% versus 46%) and Senegal (23% versus 19%), where the stunting 

prevalence was 7 and 4 percentage points higher for children living with a female household head. 

The data also revealed differences in the stunting prevalence by the age of the household head, 

but again the pattern was not consistent across countries. We compared children living with household 

heads younger than age 50 with those residing with household heads who were at least age 50. In seven 

countries the stunting prevalence was at least one percentage point higher for children living with a 

household head age 50 or older. In 12 countries the stunting prevalence was at least one percentage point 

higher for children living with a household head younger than age 50 (see Figure 2.10). 

We found the largest differences—at least 5 percentage points greater for a child living with an 

older household head—in Congo (Brazzaville) (25% versus 32%) and Kenya (29% versus 34%). In 

contrast, in Niger (51% versus 46%) and Uganda (29% versus 24%), the stunting prevalence was 

approximately five percentage points higher for children living with a household head younger than age 

50. 

Variations during the last 13 years 

Overall, sub-Saharan Africa experienced a decrease in the prevalence of stunting. The greatest 

reductions—at least 7 percentage points—occurred in Ethiopia (2005: 47% and 2011: 39%) and Zambia 

(2001-02: 47% and 2007: 39%) (see Table 2.2). In the other direction, only Benin (2001: 31% and 2006: 

38%) and Senegal (2005: 16% and 2010-11: 22%) experienced increases in the prevalence of stunting 

that measured at least 6 percentage points (see Figures 2.11 and 2.12). 

2.3 Underweight

One can determine whether a child is underweight by comparing the weight-for-age of the child 

with that of a reference population of well-nourished, healthy children. An underweight child is in danger 

of having a low body mass relative to his or her chronological age. (Body mass is a function of both 

height and weight. Thus, the categorization of underweight does not distinguish between a child who is 

low in weight relative to his/her height and a child who is short relative to his/her age but normal in 

weight-for-height (WFP, 2013; WHO, 1995).) 

As Table 2.4 shows, the prevalence of underweight among children less than age 5 in subSaharan Africa ranged from 13% in Zimbabwe to 44% in Niger. Burkina Faso, Burundi, Ethiopia, 

Guinea, Mali, Niger, and Nigeria had underweight prevalence above 30% (see Map 2.3). 

Sex and geographic disparities 

In every country, the prevalence of underweight was higher for males (see Figure 2.13) and 

children in rural areas than for females and children in urban areas (see Figure 2.14). Lesotho experienced 

the largest disparity by child’s sex. The underweight prevalence in Lesotho was 19% among male 

children and 14% among female children, a difference of 5 percentage points (see Table 2.4). 

Niger had the most pronounced geographic disparity. The prevalence of underweight in Niger 

was 27% in urban areas and 47% in rural areas, a discrepancy of 20 percentage points (see Table 2.4). 

The geographic disparity was also substantial in Ethiopia—20% in urban areas and 37% in rural areas, a 
12 

difference of 16 percentage points. Burkina Faso, Burundi, Cameroon, Mali, and Nigeria also had an 

underweight prevalence that was at least 10 percentage point higher in rural than in urban areas. 

The role of the household head’s sex and age 

In one-third of these sub-Saharan African countries, the prevalence of underweight was higher for 

children living with a female household head than for children living with a male household head (see 

Figure 2.15). Namibia experienced the most variation, with an underweight prevalence of 28% among 

children living with a male household head and 20% among children living with a female household 

head, a difference of 8 percentage points (see Table 2.4). 

The prevalence of underweight was higher for children living with a household head at least age 

50 in half of these countries (see Figure 2.16). Burundi (household head under age 50: 34% versus 

household head age 50 or older: 40%) and Namibia (20% versus 26%) had the largest variation—around 

six percentage points (see Table 2.4). 

Variations during the last 13 years 

As Table 2.4 indicates, in the last 13 years the prevalence of underweight has decreased in all 18 

countries with two surveys, with the exception of Kenya. The greatest reductions occurred in Burkina 

Faso (2003: 38% and 2010: 30%), Rwanda (2005: 23% and 2010: 15%), and Zambia (2001-02: 28% and 

2007: 19%), a difference of more than 7 percentage points in each case (see Figures 2.17 and 2.18). 
Table 2.1. Percentage of children less than age 5 who are wasted, by country, sex of child, and region of residence as well as sex and 

age of head of household a 

Sex of the child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male 

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 7.4 6.8 -0.6 6.4 7.5 1.1 7.3 6.0 -1.3 6.9 9.1 2.2 7.1 Burkina Faso 14.4 12.8 -1.6 11.5 14.0 2.5 13.6 13.4 -0.2 13.6 13.8 0.2 13.6 

Burundi 5.2 4.9 -0.3 4.3 5.1 0.8 4.9 5.5 0.6 5.0 4.8 -0.2 5.0 Cameroon 5.4 4.0 -1.4 2.6 6.2 3.6 5.0 3.1 -1.9 4.9 3.1 -1.8 4.7 Ethiopia 9.4 7.5 -1.9 4.7 9.0 4.3 8.8 6.9 -1.9 8.6 7.5 -1.1 8.5 Ghana 8.2 7.6 -0.6 6.1 9.0 2.9 8.3 7.0 -1.3 8.0 7.3 -0.7 7.9 Guinea 10.3 8.9 -1.4 8.5 9.9 1.4 9.8 7.5 -2.3 9.3 10.9 1.6 9.6 Kenya 6.8 4.8 -2.0 4.5 6.0 1.5 6.1 5.1 -1.0 5.7 6.1 0.4 5.8 Lesotho 3.6 3.0 -0.6 2.7 3.4 0.7 3.1 3.7 0.6 3.2 3.6 0.4 3.3 Liberia 6.4 6.3 -0.1 8.2 5.6 -2.6 6.9 5.2 -1.7 6.5 5.1 -1.4 6.4 Malawi 4.1 3.4 -0.7 2.2 4.0 1.8 3.8 3.4 -0.4 3.7 4.1 0.4 3.8 Mali 13.8 12.9 -0.9 11.9 13.9 2.0 13.3 14.3 1.0 13.3 14.1 0.8 13.4 Mozambique 5.1 4.7 -0.4 3.2 5.6 2.4 4.9 4.8 -0.1 5.0 3.4 -1.6 4.9 Namibia 6.3 7.2 0.9 4.0 8.0 4.0 6.2 7.3 1.1 6.2 8.3 2.1 6.7 Niger 11.4 9.2 -2.2 8.3 10.7 2.4 10.1 11.4 1.3 10.1 11.2 1.1 10.3 Nigeria 12.8 12.0 -0.8 9.8 13.6 3.8 12.9 8.6 -4.3 12.7 10.2 -2.5 12.4 Rwanda 3.0 1.9 -1.1 2.7 2.4 -0.3 2.2 3.4 1.2 2.3 5.5 3.2 2.5 Senegal 8.5 9.0 0.5 8.2 9.1 0.9 8.6 9.0 0.4 8.8 8.6 -0.2 8.7 Tanzania 4.5 3.8 -0.7 4.6 4.0 -0.6 4.1 4.1 0.0 4.1 4.1 0.0 4.1 Uganda 3.8 3.4 -0.4 3.2 3.7 0.5 3.8 3.1 -0.7 3.7 1.9 -1.8 3.6 Zambia 5.2 4.4 -0.8 3.8 5.1 1.3 4.6 5.5 0.9 4.8 4.7 -0.1 4.8 Zimbabwe 3.0 2.3 -0.7 2.3 2.8 0.5 2.6 2.7 0.1 2.5 3.8 1.3 2.7 Note: Children who are more than −2 standard deviations below the reference population median are defined as wasted. a There may be trivial discrepancies between tables because of rounding error. 

13 
Table 2.2. Percentage of children less than age 5 who are stunted, wasted, or underweight, by country and year of data collection a

Year of data 

collection Wasted Stunted Underweight 

Country Year 1 Year 2 Year 1 Year 2 

Comparison 

Year 2−Year1 Year 1 Year 2 

Comparison 

Year 2−Year1 Year 1 

Year 

2 

Comparison 

Year 2−Year1 

Benin 2001 2006 7.4 7.2 -0.2 31.0 38.4 7.4 23.1 22.7 -0.4 Burkina Faso 2003 2010 18.6 13.6 -5.0 38.8 30.0 -8.8 37.7 30.4 -7.3 Cameroon 2004 2011 5.1 4.6 -0.4 31.8 27.8 -3.9 18.0 17.7 -0.4 Ethiopia 2005 2011 10.6 8.5 -2.1 46.6 39.0 -7.7 38.5 34.8 -3.7 Ghana 2003 2008 7.1 8.0 0.9 29.9 23.4 -6.4 22.1 17.6 -4.5 Kenya 2003 2008-09 5.6 5.8 0.3 30.4 29.7 -0.8 19.9 20.4 0.5 Lesotho 2004 2009 4.2 3.4 -0.9 38.1 32.0 -6.1 19.8 16.5 -3.3 Malawi 2004 2010 5.1 3.8 -1.4 47.8 41.5 -6.3 22.1 17.8 -4.3 Mali 2001 2006 10.5 13.5 2.9 38.4 34.1 -4.3 33.3 31.7 -1.6 Mozambique 2003 2011 4.0 4.9 0.9 41.0 36.9 -4.1 23.7 19.5 -4.2 Namibia 2000 2006-07 9.2 6.8 -2.4 23.7 24.3 0.6 24.1 21.5 -2.6 Nigeria 2003 2008 9.4 12.4 3.0 38.6 36.8 -1.8 28.9 27.2 -1.6 Rwanda 2005 2010 4.0 2.5 -1.5 45.5 37.2 -8.3 22.6 15.4 -7.2 Senegal 2005 2010-11 7.6 8.7 1.0 16.4 22.4 6.0 17.4 22.9 5.5 Tanzania 2004-05 2010 3.0 4.1 1.1 37.7 35.4 -2.3 21.9 20.6 -1.2 Uganda 2006 2011 5.4 3.6 -1.8 32.5 28.5 -4.0 20.7 17.2 -3.5 Zambia 2001-02 2007 5.0 4.8 -0.2 46.8 39.4 -7.4 28.2 19.4 -8.8 Zimbabwe 2005-06 2010-11 6.4 2.7 -3.7 29.3 26.3 -3.1 16.7 13.3 -3.3 Note: Children suffering from food deprivation are those who are stunted, wasted, or underweight (more than -2 standard deviations below the reference population median). a There may be trivial discrepancies between tables because of rounding error. 

14 
Table 2.3. Percentage of children less than age 5 who are stunted, by country, sex of child, and region of residence as well as sex and age of 

head of household a

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 40.8 35.6 -5.2 32.7 41.3 8.6 38.3 37.9 -0.4 37.9 41.4 3.5 38.3 Burkina Faso 31.6 28.0 -3.6 17.7 32.3 14.6 30.2 26.1 -4.1 29.9 29.1 -0.8 29.8 Burundi 54.0 47.3 -6.7 31.0 52.6 21.6 50.9 49.9 -1.0 50.7 51.0 0.3 50.8 Cameroon 29.2 26.4 -2.8 17.5 35.5 18.0 28.2 25.6 -2.6 28.0 26.4 -1.6 27.7 Congo (Brazzaville) 27.8 24.3 -3.5 22.4 29.2 6.8 25.8 27.4 1.6 25.2 31.6 6.4 26.1 Congo Democratic Republic 

42.6 37.7 -4.9 31.9 45.6 13.7 39.0 45.8 6.8 40.4 36.3 -4.1 40.1 

Ethiopia 39.5 38.1 -1.4 26.0 40.6 14.6 38.8 39.1 0.3 38.7 39.6 0.9 38.8 Ghana 24.1 22.5 -1.6 17.3 27.1 9.8 23.2 23.7 0.5 23.0 25.4 2.4 23.3 

Guinea 36.6 33.1 -3.5 22.4 38.5 16.1 34.7 36.4 1.7 35.2 33.3 -1.9 34.9 Kenya 30.7 28.4 -2.3 21.5 31.2 9.7 28.9 31.4 2.5 29.1 34.4 5.3 29.6 

Lesotho 34.4 29.5 -4.9 25.0 33.4 8.4 30.9 34.4 3.5 32.0 31.9 -0.1 32.0 

Liberia 37.8 31.9 -5.9 25.9 38.9 13.0 35.2 34.5 -0.7 35.1 34.1 -1.0 35.0 Madagascar 47.7 43.0 -4.7 37.1 46.4 9.3 45.2 46.3 1.1 45.9 38.6 -7.3 45.4 Malawi 44.5 38.7 -5.8 34.7 42.8 8.1 41.5 42.4 0.9 41.7 39.2 -2.5 41.6 

Mali 35.4 32.6 -2.8 23.8 38.0 14.2 34.2 31.9 -2.3 34.1 33.1 -1.0 34.0 

Mozambique 37.9 35.4 -2.5 28.9 39.6 10.7 37.2 35.4 -1.8 36.9 33.5 -3.4 36.6 Namibia 25.2 23.2 -2.0 20.2 26.1 5.9 23.5 24.9 1.4 23.3 26.8 3.5 24.2 

Niger 51.3 48.5 -2.8 31.3 53.2 21.9 49.6 51.8 2.2 50.9 45.9 -5.0 50.0 

Nigeria 38.5 35.0 -3.5 27.4 41.2 13.8 37.4 31.3 -6.1 36.7 37.1 0.4 36.8 

Rwanda 38.6 35.7 -2.9 20.5 39.4 18.9 37.2 37.1 -0.1 37.2 36.9 -0.3 37.1 

Sao Tomé and Príncipe 

25.5 24.7 -0.8 24.2 26.2 2.0 25.3 24.8 -0.5 25.3 22.4 -2.9 25.1 

Senegal 23.2 21.5 -1.7 15.1 27.0 11.9 23.3 18.9 -4.4 22.8 21.6 -1.2 22.4 Sierra Leone 35.5 31.6 -3.9 26.3 36.2 9.9 33.3 34.6 1.3 33.2 34.9 1.7 33.5 Swaziland 26.5 21.9 -4.6 18.0 25.4 7.4 23.8 24.5 0.7 22.9 27.5 4.6 24.2 Tanzania 37.3 33.6 -3.7 25.6 37.8 12.2 35.2 36.5 1.3 35.4 35.5 0.1 35.4 

Uganda 30.7 26.1 -4.6 14.3 30.5 16.2 28.8 27.3 -1.5 28.8 23.6 -5.2 28.4 Zambia 41.4 37.3 -4.1 33.4 41.7 8.3 39.4 39.2 -0.2 39.1 42.7 3.6 39.3 

Zimbabwe 28.1 24.2 -3.9 22.2 27.4 5.2 25.2 27.4 2.2 26.1 26.6 0.5 26.1 

Note: Children who are more than −2 standard deviations below the reference population median are defined as stunted. 

a There may be trivial discrepancies between tables because of rounding error. 

15 
Table 2.4. Percentage of children less than age 5 who are underweight, by country, sex of child, and region of residence as well as sex 

and age of head of household a

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 24.2 20.9 -3.3 18.2 24.9 6.7 22.8 20.9 -1.9 22.1 26.9 4.8 22.6 Burkina Faso 31.0 29.6 -1.4 19.7 32.4 12.7 30.6 27.5 -3.1 30.2 31.0 0.8 30.3 Burundi 35.6 32.3 -3.3 21.8 35.1 13.3 33.6 35.6 2.0 33.7 39.7 6.0 34.0 

Cameroon 18.1 17.1 -1.0 9.4 23.9 14.5 18.6 12.7 -5.9 18.4 13.3 -5.1 17.6 Ethiopia 35.1 33.8 -1.3 20.3 36.5 16.2 34.8 32.9 -1.9 34.6 33.3 -1.3 34.5 Ghana 17.8 17.1 -0.7 14.2 19.5 5.3 17.6 17.2 -0.4 17.0 20.6 3.6 17.5 Guinea 27.0 24.9 -2.1 18.6 28.1 9.5 26.2 23.4 -2.8 26.0 25.7 -0.3 25.9 Kenya 20.7 19.8 -0.9 12.5 21.8 9.3 20.8 18.9 -1.9 20.1 22.0 1.9 20.2 Lesotho 18.9 13.8 -5.1 13.0 17.1 4.1 16.9 15.2 -1.7 16.5 16.0 -0.5 16.4 Liberia 24.3 23.1 -1.2 21.0 24.9 3.9 24.3 22.4 -1.9 23.7 24.0 0.3 23.7 Malawi 19.0 16.7 -2.3 14.8 18.4 3.6 17.6 20.2 2.6 17.8 17.4 -0.4 17.8 Mali 32.5 30.7 -1.8 24.1 34.5 10.4 31.6 32.0 0.4 32.0 28.7 -3.3 31.6 Mozambique 20.2 18.3 -1.9 13.8 21.3 7.5 19.3 19.0 -0.3 19.6 15.5 -4.1 19.2 Namibia 21.9 20.8 -1.1 15.2 24.3 9.1 19.7 23.1 3.4 19.7 25.8 6.1 21.4 

Niger 44.8 43.8 -1.0 27.3 47.3 20.0 43.9 46.2 2.3 44.7 42.8 -1.9 44.3 Nigeria 28.0 26.3 -1.7 19.2 30.9 11.7 28.0 20.2 -7.8 27.5 24.7 -2.8 27.2 Rwanda 16.1 14.5 -1.6 9.7 16.1 6.4 15.0 16.3 1.3 15.1 19.5 4.4 15.3 

Senegal 23.0 22.9 -0.1 17.6 26.4 8.8 23.8 19.7 -4.1 23.0 23.0 0.0 23.0 Tanzania 21.5 19.7 -1.8 15.6 21.9 6.3 20.2 22.6 2.4 20.7 20.1 -0.6 20.6 Uganda 17.6 16.4 -1.2 9.2 18.2 9.0 16.9 17.3 0.4 17.2 14.3 -2.9 17.0 Zambia 20.9 17.9 -3.0 16.8 20.4 3.6 19.5 19.0 -0.5 19.1 23.3 4.2 19.4 Zimbabwe 14.2 12.4 -1.8 10.2 14.3 4.1 13.2 13.4 0.2 13.0 15.3 2.3 13.3 

Note: Children who are more than −2 standard deviations below the reference population median are defined as underweight. a There may be trivial discrepancies between tables because of rounding error. 

16 
17 

7.4

14.4

5.2

5.4

9.4

8.2

10.3

6.8

3.6

6.4

4.1

13.8

5.1

6.3

11.4

12.8

3.0

8.5

4.5

3.8

5.2

3.0

6.8

12.8

4.9

4.0

7.5

7.6

8.9

4.8

3.0

6.3

3.4

12.9

4.7

7.2

9.2

12.0

1.9

9.0

3.8

3.4

4.4

2.3

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.1. Percentage of children less than age 5 who are wasted, 

by country and the child's sex

Male Female
18 

6.4

11.5

4.3

2.6

4.7

6.1

8.5

4.5

2.7

8.2

2.2

11.9

3.2

4.0

8.3

9.8

2.7

8.2

4.6

3.2

3.8

2.3

7.5

14.0

5.1

6.2

9.0

9.0

9.9

6.0

3.4

5.6

4.0

13.9

5.6

8.0

10.7

13.6

2.4

9.1

4.0

3.7

5.1

2.8

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.2. Percentage of children less than age 5 who are wasted, 

by country and region of residence

Urban Rural
19 

7.3

13.6

4.9

5.0

8.8

8.3

9.8

6.1

3.1

6.9

3.8

13.3

4.9

6.2

10.1

12.9

2.2

8.6

4.1

3.8

4.6

2.6

6.0

13.4

5.5

3.1

6.9

7.0

7.5

5.1

3.7

5.2

3.4

14.3

4.8

7.3

11.4

8.6

3.4

9.0

4.1

3.1

5.5

2.7

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.3. Percentage of children less than age 5 who are wasted , 

by country and the sex of the household head

Male Female
20 

6.9

13.6

5.0

4.9

8.6

8.0

9.3

5.7

3.2

6.5

3.7

13.3

5.0

6.2

10.1

12.7

2.3

8.8

4.1

3.7

4.8

2.5

9.1

13.8

4.8

3.1

7.5

7.3

10.9

6.1

3.6

5.1

4.1

14.1

3.4

8.3

11.2

10.2

5.5

8.6

4.1

1.9

4.7

3.8

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.4. Percentage of children less than age 5 who are wasted , 

by country and the age of the household head

Less than 50 yo 50 yo or more
21 

7.4

18.6

5.1

10.6

7.1

5.6

4.2

5.1

10.5

7.2

13.6

4.6

8.5 8.0

5.8

3.4 3.8

13.5

-0.2

-5.0

-0.4

-2.1

0.9 0.3

-0.9 -1.4

2.9

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Malawi Mali

Figure 2.5. Changes in the percentage of children less than age 5 who are wasted

Year 1 Year 2 Comparison Year 2-Year1

20012006

20042011

20052011

20032008

2003

2008-09

20032010

20042009

20042010

20012006

4.0

9.2 9.4

4.0

7.6

3.0

5.4 5.0

6.4

4.9

6.8

12.4

2.5

8.7

4.1

3.6

4.8

2.7

0.9

-2.4

3.0

-1.5

1.0 1.1

-1.8

-0.2

-3.7

-6.0

-4.0

-2.0

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 2.6. Changes in the percentage of children less than age 5 who are wasted

Year 1 Year 2 Comparison Year 2-Year1

20032008

20052010

2005

2010-11

2004-05

201020062011

2001-02

2007

2005-062010-11

20032011

2000

2006-07
22 

40.8

31.6

54.0

29.2

27.8

42.6

39.5

24.1

36.6

30.7

34.4

37.8

47.7

44.5

35.4

37.9

25.2

51.3

38.5

38.6

25.5

23.2

35.5

26.5

37.3

30.7

41.4

28.1

35.6

28.0

47.3

26.4

24.3

37.7

38.1

22.5

33.1

28.4

29.5

31.9

43.0

38.7

32.6

35.4

23.2

48.5

35.0

35.7

24.7

21.5

31.6

21.9

33.6

26.1

37.3

24.2

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Benin

Burkina Faso

Burundi

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.7. Percentage of children less than age 5 who are stunted, 

by country and the child's sex

Male Female
23 

32.7

17.7

31.0

17.5

22.4

31.9

26.0

17.3

22.4

21.5

25.0

25.9

37.1

34.7

23.8

28.9

20.2

31.3

27.4

20.5

24.2

15.1

26.3

18.0

25.6

14.3

33.4

22.2

41.3

32.3

52.6

35.5

29.2

45.6

40.6

27.1

38.5

31.2

33.4

38.9

46.4

42.8

38.0

39.6

26.1

53.2

41.2

39.4

26.2

27.0

36.2

25.4

37.8

30.5

41.7

27.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Benin

Burkina Faso

Burundi

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.8. Percentage of children less than age 5 who are stunted, 

by country and the region of residence

Urban Rural
24 

38.3

30.2

50.9

28.2

25.8

39.0

38.8

23.2

34.7

28.9

30.9

35.2

45.2

41.5

34.2

37.2

23.5

49.6

37.4

37.2

25.3

23.3

33.3

23.8

35.2

28.8

39.4

25.2

37.9

26.1

49.9

25.6

27.4

45.8

39.1

23.7

36.4

31.4

34.4

34.5

46.3

42.4

31.9

35.4

24.9

51.8

31.3

37.1

24.8

18.9

34.6

24.5

36.5

27.3

39.2

27.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Benin

Burkina Faso

Burundi

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.9. Percentage of children less than age 5 who are stunted, 

by country and the sex of the household head

Male Female
25 

37.9

29.9

50.7

28.0

25.2

40.4

38.7

23.0

35.2

29.1

32.0

35.1

45.9

41.7

34.1

36.9

23.3

50.9

36.7

37.2

25.3

22.8

33.2

22.9

35.4

28.8

39.1

26.1

41.4

29.1

51.0

26.4

31.6

36.3

39.6

25.4

33.3

34.4

31.9

34.1

38.6

39.2

33.1

33.5

26.8

45.9

37.1

36.9

22.4

21.6

34.9

27.5

35.5

23.6

42.7

26.6

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Benin

Burkina Faso

Burundi

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.10. Percentage of children less than age 5 who are stunted, 

by country and the age of the household head

Less than 50 yo 50 yo or more
26 

31.0

38.8

31.8

46.6

29.9 30.4

38.1

47.8

38.4 38.4

30.0

27.8

39.0

23.4

29.7 32.0

41.5

34.1

7.4

-8.8

-3.9

-7.7 -6.4

-0.8

-6.1 -6.3

-4.3

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Malawi Mali

Figure 2.11. Changes in the percentage of children less than age 5 who are stunted

Year 1 Year 2 Comparison Year 2-Year1

2001200620032010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

 

41.0

23.7

38.6

45.5

16.4

37.7

32.5

46.8

29.3

36.9

24.3

36.8 37.2

22.4

35.4

28.5

39.4

26.3

-4.1

0.6

-1.8

-8.3

6.0

-2.3

-4.0

-7.4

-3.1

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 2.12. Changes in the percentage of children less than age 5 who are stunted

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
27 

24.2

31.0

35.6

18.1

35.1

17.8

27.0

20.7

18.9

24.3

19.0

32.5

20.2

21.9

44.8

28.0

16.1

23.0

21.5

17.6

20.9

14.2

20.9

29.6

32.3

17.1

33.8

17.1

24.9

19.8

13.8

23.1

16.7

30.7

18.3

20.8

43.8

26.3

14.5

22.9

19.7

16.4

17.9

12.4

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.13. Comparison of the percentage of children less than age 5 who are 

underweight, by country and the child's sex

Male Female
28 

18.2

19.7

21.8

9.4

20.3

14.2

18.6

12.5

13.0

21.0

14.8

24.1

13.8

15.2

27.3

19.2

9.7

17.6

15.6

9.2

16.8

10.2

24.9

32.4

35.1

23.9

36.5

19.5

28.1

21.8

17.1

24.9

18.4

34.5

21.3

24.3

47.3

30.9

16.1

26.4

21.9

18.2

20.4

14.3

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.14. Comparison of the percentage of children less than age 5 who are 

underweight, by country and region of residence

Urban Rural
29 

22.8

30.6

33.6

18.6

34.8

17.6

26.2

20.8

16.9

24.3

17.6

31.6

19.3

19.7

43.9

28.0

15.0

23.8

20.2

16.9

19.5

13.2

20.9

27.5

35.6

12.7

32.9

17.2

23.4

18.9

15.2

22.4

20.2

32.0

19.0

23.1

46.2

20.2

16.3

19.7

22.6

17.3

19.0

13.4

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.15. Comparison of the percentage of children less than age 5 who are 

underweight, by country and the sex of the household head

Male Female
30 

22.1

30.2

33.7

18.4

34.6

17.0

26.0

20.1

16.5

23.7

17.8

32.0

19.6

19.7

44.7

27.5

15.1

23.0

20.7

17.2

19.1

13.0

26.9

31.0

39.7

13.3

33.3

20.6

25.7

22.0

16.0

24.0

17.4

28.7

15.5

25.8

42.8

24.7

19.5

23.0

20.1

14.3

23.3

15.3

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 2.16. Comparison of the percentage of children less than age 5 who are 

underweight, by country and the age of the household head

Less than 50 yo 50 yo or more
31 

23.1

37.7

18.0

38.5

22.1

19.9 19.8

22.1

33.3

22.7

30.4

17.7

34.8

17.6

20.4

16.5 17.8

31.7

-0.4

-7.3

-0.4

-3.7 -4.5

0.5

-3.3 -4.3

-1.6

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Malawi Mali

Figure 2.17. Changes in the percentage of children less than age 5 

who are underweight

Year 1 Year 2 Comparison Year 2-Year1

2001200620032010

20042011

20052011

200320082003

2008-09

20042009

20042010

20012006

 

23.7 24.1

28.9

22.6

17.4

21.9

20.7

28.2

16.7

19.5

21.5

27.2

15.4

22.9

20.6

17.2

19.4

13.3

-4.2

-2.6 -1.6

-7.2

5.5

-1.2

-3.5

-8.8

-3.3

-15.0

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 2.18. Changes in the percentage of children less than age 5 

who are underweight

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
32 

Map 2.1 Percentage of children less than age 5 

who are wasted 

Map 2.2 Percentage of children less than age 5 

who are stunted 

Map 2.3 Percentage of children less than age 5 

who are underweight 
33 

3 Health Deprivation 

3.1 Expanded Program on Immunization 

Even though immunization is one of the most cost-effective public health strategies for reducing 

child morbidity and mortality; in 2010 about 1.5 million people died worldwide from diseases that could 

have been prevented with vaccinations (Bloom, 2011; Centers for Disease Control and Prevention, 2006). 

African governments in particular face multiple barriers that limit levels of child vaccination, including 

the need for vaccine promotion campaigns, irregular demand for immunization, problems with quality of 

service delivery, public mistrust of the health system, insufficient personnel, insufficient access to 

vaccines, timeliness of vaccinations, lack of infrastructure, and insufficient program monitoring and 

evaluation (Rainey et al., 2011; Wiysonge et al., 2012). On the level of the individual, researchers have 

associated the lack of immunization with poverty, uneducated parents, insufficient parental access to the 

media, and mothers with little health-seeking behavior (Favin et al., 2012). Clustering effects for nonimmunization are present at both community and country levels, which is to say that children in the same 

community tend to have similar immunization status (Favin et al., 2012). 

The eight recommended EPI vaccines include the following: 

• the BCG vaccine, which protects against tuberculosis (TB) and is given only once 

• the oral polio vaccine (OPV), given in four doses numbered 0 to 3 

• the diphtheria, pertussis, tetanus vaccine (DPT), combined in a single preparation with the 

hepatitis B vaccine and the Haemophilus influenzae type B vaccine to constitute the 

pentavalent vaccine, and given to children in three doses 

• the measles vaccine, given only once 

This section focuses on children less than age 5 who did not receive any of the eight vaccines 

included in the WHO Expanded Program on Immunization (EPI). Since immunizations start soon after 

birth, any child, regardless of age, could be counted in the category of those who received no 

immunizations. Because of the recommended vaccination schedule, no six month old is fully immunized. 

For this reason, we did not include the fully immunized status (nine EPI vaccines) in the report, because it 

excluded a large proportion of the children (Gordon et al., 2003). 

As shown in Map 3.1, there were wide inter- and intra-country differences in the percentage of 

children who did not receive any of the EPI vaccines. The percentage of children who did not receive any 

vaccine ranged from 11% in Rwanda to 77% in Ethiopia (see Table 3.1). Over half of the children in 

seven sub-Saharan African countries had not received any vaccines. This problem was most severe in 

Ethiopia, Niger, Nigeria, and Zambia, where more than 70% of children had not received any vaccine. 

Rwanda (11%) and Burundi (14%) had the lowest percentage of children who had not received any EPI 

vaccines. 

Sex and geographic disparities 

Overall, the percentages of boys and girls who had not received any EPI vaccines were similar in 

these countries (Table 3.1, Figure 3.1). Only Zimbabwe and Liberia showed as much as a two percentage 

point difference between the sexes. 

In every country except Burundi, the percentage of children who had not received any EPI 

vaccine was higher in rural areas than in urban areas (Figure 3.2). This inequality was most pronounced in 

Ethiopia, Liberia, Niger, and Nigeria, all with percentage point differences of 25 or more between urban 
34 

and rural children (Table 3.1). This geographic disparity was absent in Burundi, where 14% of children in 

urban areas and 14% in rural areas had not received any EPI vaccine. 

The role of the household head’s sex and age 

In over half of these countries, the percentage of children who had not received any EPI vaccine 

was lower for children living with a female household head than for children living with a male 

household head (Figure 3.3). This difference proved most pronounced in Benin (8 percentage points), 

Cameroon (9 percentage points), and Nigeria (11 percentage points) (see Table 3.1). Conversely, the 

percentage of children who had not received any EPI vaccines was four percentage points higher for 

children living with a female household head than with a male household head in Guinea and Uganda and 

six percentage points higher in Madagascar. The difference between children living with a female 

household head and those living with a male household head was less than one percentage point in 

Ethiopia, Lesotho, Namibia, Niger, Zambia, and Zimbabwe. 

In 17 countries the percentage of children who had not received any EPI vaccines was higher for 

those living with a household head at least age 50 than for children living with a household head who was 

younger than age 50 (Figure 3.4). This difference was most pronounced in Kenya (10 percentage points) 

and Madagascar (8 percentage points) (see Table 3.1). The percentages of children in Benin, Burkina 

Faso, Guinea, Lesotho, and Tanzania who had not received any EPI vaccines differed less than one 

percentage point by the age of the head of household. 

Variations during the last 13 years 

With two exceptions, every country saw a reduction in the percentage of children who had not 

received any EPI vaccines. The exceptions were Zambia (2001-02: 40% and 2007: 70%, an increase of 31 

percentage points) and Benin (2001: 41% and 2006: 46%, an increase of 4 percentage points) (see Table 

3.2). Lesotho did not experience any change between 2004 and 2009. Substantial reductions—more than 

30 percentage points—in the percentage of children who had not received any EPI vaccines took place in 

Burkina Faso (2003: 56% and 2010: 23), Tanzania (2004-05: 63% and 2010: 26%), and Uganda (2006: 

82% and 2011: 41%) (see Figures 3.5 and 3.6). 

3.2 Diarrhea 

Diarrhea1 is one of the principal causes of morbidity and mortality among children in the 

developing world (Kosek et al., 2003). Infectious diarrhea, the most common form of diarrhea worldwide, 

may result from one of several viruses (e.g., rotavirus, enteric adenovirus, norovirus, enteroviruses, 

caliciviruses, and astroviruses), bacteria (e.g., enterotoxigenic Escherichia coli (ETEC) and 

Campylobacter jejuni), or protozoa (e.g., Cryptosporidium parvum, Giardia lamblia, and Entamoeba 

histolytica) (Cooke, 2010; Nkrumah and Nguah, 2011; Vilchez et al., 2009). Non-infectious diarrhea may 

originate from toxins, poisons, drugs, or food allergens (Njume and Goduka, 2012). 

Each year an estimated nine million children around the world, most of them less than age 5, die 

due to diarrhea (WHO, 2009). Worldwide, more young children die from diarrhea than from malaria, 

acquired immunodeficiency syndrome (AIDS), and tuberculosis combined (Mwambete and Joseph, 

 

1

 According to Guerrant et al. (2001), “Diarrhea is an alteration in a normal bowel movement characterized by an 

increase in the water content, volume, or frequency of stools. A decrease in consistency (i.e., soft or liquid) and an 

increase in frequency of bowel movements to >3 stools per day have often been used as a definition for 

epidemiological investigations. Infectious diarrhea is diarrhea due to an infectious etiology, often accompanied by 

symptoms of nausea, vomiting, or abdominal cramps. Acute diarrhea is an episode of diarrhea of <14 days in 

duration. Persistent diarrhea is diarrhea of ≥14 days in duration. 
35 

2010). Acute diarrhea can lead to severe dehydration; persistent diarrhea can predispose children to 

malnutrition and make them more vulnerable to other infectious diseases (Briend, 1990; Peterson Zwane 

and Kremer, 2007). HIV status; the socioeconomic status of the family; and community factors such as 

immunization coverage, health care access, and the quality of water and the availability of sanitation 

services all can have great impact on diarrheal mortality and childhood nutrition (Kosek et al., 2003). 

Findings from randomized, controlled trials suggested that vaccination, breastfeeding, and micronutrient 

supplementation can reduce the incidence of diarrhea, and, when diarrhea occurs, oral rehydration therapy 

can reduce the risk of dehydration (Peterson Zwane and Kremer, 2007). 

As Table 3.3 indicates, in the two weeks before the survey, the prevalence of diarrhea among 

children less than age 5 was quite different across countries, ranging from 8% in Madagascar to 25% in 

Burundi. Seven countries—Burundi, Cameroon, Ghana, Liberia, Niger, Senegal, and Uganda—

experienced a level of child diarrhea above 20% (see Map 3.2). 

Sex and geographic disparities 

Overall, we did not find child’s sex disparities related to child diarrhea (see Figure 3.7). However, 

in Guinea (males: 18% and females: 15%) and Zimbabwe (males: 15% and females: 13%), the prevalence 

of diarrhea was two percentage points higher for boys than for girls (see Table 3.3). 

In half of the countries, the prevalence of diarrhea among children less than age 5 was higher in 

rural areas than in urban areas (see Figure 3.8). Five countries had a diarrhea prevalence that was at least 

four percentage points higher in rural areas than in urban areas—Burundi (urban: 22% and rural: 26%), 

Cameroon (urban: 19% and rural: 24%), Ghana (urban: 18% and rural: 22%), Mali (urban: 10% and rural: 

15%), and Niger (urban: 18% and rural: 22%). In contrast, in Senegal (urban: 24% and rural: 20%) and 

Tanzania (urban: 19% and rural: 14%), the prevalence of diarrhea was at least four percentage points 

higher in urban areas (see Table 3.3). 

The role of the household head’s sex and age 

In 13 of 23 countries, the diarrhea prevalence was higher for children living with a female 

household head than for children living with a male household head (see Figure 3.9). This difference was 

more than 3 percentage points higher in three countries—Rwanda (13% versus 16%), Senegal (21% 

versus 24%), and Tanzania (15% versus 17%) (see Table 3.3). The inverse situation occurred in Nigeria 

and Cameroon. In Nigeria the prevalence of diarrhea was 3 percentage points higher among children 

living with a male household head (11% versus 8%). This difference was more extreme in Cameroon, 

where the diarrhea prevalence was 23% for children living with a male household head and 17% for 

children living with a female household head, a difference of 7 percentage points. 

In Burundi, Kenya, and Uganda, the age of the household head played an important role in the 

prevalence of diarrhea among children less than age 5 (see Figure 3.10). As Table 3.3 shows, in Burundi 

the percentage who had had diarrhea in the past two weeks was 25% for children whose head of 

household was younger than age 50 and 31% for children whose head of household was at least age 50 (a 

difference of 6 percentage points). In Uganda 24% of children who lived with a household head younger 

than age 50 had had diarrhea recently, compared with 30% of those who lived with an older head of 

household—a difference of 6 percentage points. 

Variations during the last 13 years 

Six countries—Cameroon, Ghana, Kenya, Namibia, Tanzania, and Zimbabwe—have experienced 

an increase in the prevalence of diarrhea among children less than age 5 (see Table 3.2). This increase 
36 

was more than four percentage points in Cameroon (2004: 17% and 2011: 22%) and Ghana (2003: 16 % 

and 2008: 21%) (see Figures 3.11 and 3.12). 

3.3 Medical Treatment of Diarrhea 

Seeking medical care for a child’s diarrhea is important because some treatments, such as 

antimicrobial chemotherapy, can shorten both bacterial excretion and the duration of the illness 

(Mandomando et al., 2007). Oral rehydration salt (ORS) and zinc tablets, when administered 

appropriately, are useful, cost-effective primary interventions for reducing diarrhea morbidity (Aggarwal 

et al., 2007; Bhatnagar et al., 2004; Fontaine, 2006; Gregorio et al., 2007). Unfortunately, however, many 

children do not obtain these medical treatments, even in areas where these services are available (Fischer 

Walker et al., 2009). In some instances people living in economically deprived neighborhoods are less 

likely than others to seek medical care (Aremu et al., 2011). A study by Aremu et al. (2011) that used 

DHS data from 11 countries in sub-Saharan Africa suggested that highly educated caregivers are more 

likely to utilize medical centers to manage childhood diarrhea. A major concern related to the treatment of 

diarrhea is that diarrheal pathogens are becoming resistant to antimicrobial agents; and some of the 

treatments for diarrhea, such as oral rehydration solutions, may not decrease the quantity of stool or the 

length of the disease. To address these issues, clinicians are employing combination therapies for 

managing diarrheal diseases, but that translates into an increased pill burden and longer therapy (Bardhan, 

2007; Njume and Goduka, 2012). 

As Map 3.3 shows, in 21 of 23 countries, at least 4 of every 10 children who had diarrhea in the 

two weeks prior to the survey did not receive medical advice. Benin (79%), Cameroon (76%), Mali 

(82%), and Niger (83%) had the highest percentages of children whose parents who did not seek medical 

advice (see Table 3.4). Malawi (38%) had the lowest percentage. 

Sex and geographic disparities 

In 17 of 23 countries, the percentage of children who did not receive medical advice was higher 

for girls than for boys (see Figure 3.13). This difference was greatest—at least 6 percentage points—in 

Rwanda (females: 66% and males: 60%), Lesotho (females: 50% and males: 43%), and Mali (females: 

86% and males: 79%) (see Table 3.4). 

Two-thirds of the sub-Saharan African countries experienced rural−urban disparities in the use of 

medical treatment for diarrhea (see Figure 3.14). Geographic disparities in lack of receiving medical 

advice for diarrhea were greatest—at least 15 percentage points—in Niger (urban: 70% and rural: 85%), 

Mali (urban: 70% and rural: 85%), Madagascar (urban: 50% and rural: 68%), Guinea (urban: 57% and 

rural: 78%), and Ethiopia (urban: 47% and rural: 70%) (see Table 3.4). 

The role of the household head’s sex and age 

In two-thirds of these sub-Saharan African countries, the percentage of children who did not 

receive medical advice for diarrhea was higher for children living with a male head of household than for 

children living with a female head of household (see Figure 3.15). This difference was greatest—more 

than 6 percentage points—in Mozambique (46% versus 40%), Guinea (74% versus 67%), Cameroon 

(77% versus 70%), and Nigeria (58% versus 47%) (see Table 3.4). The situation was reversed in Ghana 

(56% versus 62%) and Rwanda (61% versus 69%), where the percentage of children who did not receive 

medical advice was at least 6 percentage points higher for children living with a female head of household 

than for children living with a male head of household. 

In half of these sub-Saharan African countries, the percentage of children who did not receive 

medical advice for diarrhea was higher for children living with a household head younger than age 50 
37 

than for those living with an older head of household (see Figure 3.16). This difference was most 

pronounced—more than 16 percentage points—in Mozambique (45% versus 29%) and Namibia (44% 

versus 28%) (see Table 3.4). In contrast, in Rwanda the percentage of children who did not receive 

medical advice for diarrhea was 10 percentage points higher for children living with an older household 

head (62% if the head of household was younger versus 72% if the head of household was older). In 

Senegal and Lesotho the percentage of children who did not receive medical advice for their diarrhea was 

similar regardless of the household head’s age. 

Variations during the last 13 years 

The percentage of children who had diarrhea in the two weeks prior to the survey and did not 

receive medical advice decreased in every sub-Saharan African country except Benin (see Table 3.2). 

Burkina Faso (2003: 82% and 2010: 53%) and Malawi (2004: 67% and 2010: 38%) showed the largest 

decreases in percentage points (about 30 points) (see Figures 3.17 and 3.18). 
Table 3.1. Percentage of children less than age 5 who have not received any of the eight EPI immunizations, by country, sex of child, and 

region of residence as well as sex and age of head of household 

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 44.9 46.0 1.1 36.6 50.1 13.5 46.4 38.5 -7.9 45.4 46.3 0.9 45.4 Burkina Faso 22.3 23.1 0.8 18.8 23.5 4.7 22.9 20.4 -2.5 22.7 22.5 -0.2 22.7 Burundi 14.2 13.4 -0.8 14.1 13.8 -0.3 14.1 12.4 -1.7 13.6 19.6 6.0 13.8 Cameroon 41.3 41.3 0.0 29.6 49.9 20.3 42.8 33.6 -9.2 41.0 43.4 2.4 41.3 Ethiopia 76.8 76.5 -0.3 55.1 79.8 24.7 76.7 76.8 0.1 76.5 78.6 2.1 76.7 Ghana 29.6 28.0 -1.6 25.5 30.9 5.4 29.3 27.4 -1.9 28.4 32.2 3.8 28.8 Guinea 59.5 60.2 0.7 45.2 64.0 18.8 59.4 63.7 4.3 59.9 59.5 -0.4 59.8 Kenya 30.3 29.5 -0.8 24.8 31.0 6.2 29.2 31.7 2.5 29.2 38.9 9.7 29.9 Lesotho 33.6 34.1 0.5 31.3 34.5 3.2 33.8 33.7 -0.1 33.7 34.3 0.6 33.8 

Liberia 64.0 61.8 -2.2 44.7 70.7 26.0 63.8 60.8 -3.0 63.0 61.8 -1.2 62.9 Madagascar 40.3 38.9 -1.4 24.1 41.5 17.4 38.8 44.8 6.0 39.2 47.1 7.9 39.6 Malawi 22.1 21.7 -0.4 19.2 22.3 3.1 22.0 21.5 -0.5 21.8 23.6 1.8 21.9 Mali 49.3 52.1 2.8 38.6 55.2 16.6 50.4 53.4 3.0 50.3 54.8 4.5 50.7 

Mozambique 34.2 33.8 -0.4 24.9 37.4 12.5 34.9 31.9 -3.0 34.2 31.2 -3.0 34.0 Namibia 25.1 24.8 -0.3 21.9 26.9 5.0 25.1 24.8 -0.3 24.5 26.9 2.4 25.0 Niger 76.0 74.9 -1.1 48.4 80.5 32.1 75.6 74.9 -0.7 75.3 76.4 1.1 75.5 Nigeria 72.6 72.1 -0.5 54.4 80.4 26.0 73.4 62.2 -11.2 72.1 74.9 2.8 72.3 

Rwanda 9.8 11.6 1.8 8.9 10.9 2.0 10.3 12.3 2.0 10.8 8.5 -2.3 10.7 Senegal 28.3 29.2 0.9 24.5 31.4 6.9 29.6 25.4 -4.2 29.0 28.4 -0.6 28.8 

Tanzania 25.3 27.2 1.9 11.3 30.0 18.7 26.4 25.8 -0.6 25.5 31.9 6.4 26.3 

Uganda 41.2 41.6 0.4 33.8 42.5 8.7 40.5 44.6 4.1 41.0 47.4 6.4 41.4 Zambia 70.4 70.1 -0.3 64.2 72.6 8.4 70.2 70.6 0.4 70.1 72.7 2.6 70.2 Zimbabwe 48.1 45.3 -2.8 41.4 48.7 7.3 46.3 47.2 0.9 46.4 49.7 3.3 46.7 

38 
Table 3.2. Percentage of children less than age 5 who have not received any of the eight EPI immunizations, who had diarrhea in the 

two weeks prior to the survey, or who have had diarrhea in the two weeks prior to the survey for which no medical advice was obtained, by country and year of data collection

Year of data 

collection 

Have not received any of the 

eight EPI immunizations 

Had diarrhea in the two weeks 

prior to the survey 

Had diarrhea in the two weeks 

prior to the survey for which no 

medical advice was obtained 

Country Year 1 Year 2 Year 1 Year 2 

Comparison 

Year 2−Year1 Year 1 Year 2 

Comparison

Year 2−Year1 Year 1 

Year 

2 

Comparison 

Year 2−Year1 

Benin 2001 2006 41.1 45.5 4.4 13.9 9.3 -4.6 75.8 79.2 3.4 Burkina Faso 2003 2010 55.5 22.7 -32.8 21.3 15.1 -6.2 82.2 52.8 -29.4 Cameroon 2004 2011 46.9 41.3 -5.5 17.4 22.3 4.9 78.6 76.4 -2.2 Ethiopia 2005 2011 84.9 76.7 -8.1 18.3 13.9 -4.5 77.6 67.8 -9.8 Ghana 2003 2008 37.1 28.9 -8.2 15.9 20.5 4.6 74.1 58.0 -16.1 

Kenya 2003 2008-09 43.2 30.1 -13.1 16.6 17.3 0.6 70.5 51.1 -19.3 

Lesotho 2004 2009 34.0 33.8 -0.2 14.7 11.9 -2.7 70.1 46.2 -23.9 Madagascar 2003-04 2008-09 50.0 39.7 -10.4 10.1 8.5 -1.6 69.3 65.2 -4.2 Malawi 2004 2010 38.6 21.9 -16.7 22.9 17.9 -5.0 67.0 37.6 -29.4 Mali 2001 2006 69.6 50.7 -18.9 18.9 13.9 -5.0 88.0 82.3 -5.6 Mozambique 2003 2011 46.7 34.1 -12.7 14.5 11.5 -3.0 50.7 44.3 -6.4 Namibia 2000 2006-07 33.1 25.0 -8.1 14.0 14.4 0.4 50.4 40.8 -9.6 Nigeria 2003 2008 83.0 72.2 -10.8 19.6 10.5 -9.0 76.4 56.9 -19.5 Rwanda 2005 2010 25.7 10.7 -15.0 14.5 13.5 -1.0 84.8 62.7 -22.1 Senegal 2005 2010-11 46.0 28.8 -17.2 23.4 21.4 -2.0 78.3 65.4 -12.9 Tanzania 2004-05 2010 63.3 26.3 -37.0 13.3 15.0 1.7 51.8 46.6 -5.2 Uganda 2006 2011 81.7 41.5 -40.2 27.3 24.8 -2.5 29.8 27.7 -2.1 Zambia 2001-02 2007 39.5 70.4 30.9 21.9 16.0 -6.0 57.0 40.7 -16.3 Zimbabwe 2005-06 2010-11 59.4 46.8 -12.6 12.9 14.1 1.2 69.8 65.1 -4.7 

39 
Table 3.3. Percentage of children less than age 5 who had diarrhea in the two weeks prior to the survey, by country, sex of child, and 

region of residence as well as sex and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 9.8 8.7 -1.1 7.9 9.9 2.0 9.3 9.3 0.0 8.9 13.0 4.1 9.3 Burkina Faso 15.1 14.9 -0.2 16.5 14.7 -1.8 14.9 16.3 1.4 14.9 15.9 1.0 15.0 

Burundi 25.2 25.4 0.2 21.5 25.7 4.2 25.2 26.0 0.8 25.1 30.8 5.7 25.3 Cameroon 22.8 21.3 -1.5 18.9 24.4 5.5 23.1 16.5 -6.6 22.2 20.9 -1.3 22.0 Ethiopia 14.5 12.7 -1.8 11.2 14.0 2.8 13.6 14.1 0.5 13.7 12.8 -0.9 13.7 Ghana 20.2 20.5 0.3 17.9 21.9 4.0 20.0 21.5 1.5 20.4 20.6 0.2 20.4 Guinea 17.7 15.2 -2.5 15.9 16.6 0.7 16.5 16.3 -0.2 16.4 17.0 0.6 16.5 Kenya 18.1 16.2 -1.9 18.3 16.9 -1.4 17.6 16.0 -1.6 16.3 27.1 10.8 17.1 Lesotho 12.1 11.5 -0.6 11.3 11.9 0.6 12.1 10.8 -1.3 11.5 13.3 1.8 11.8 

Liberia 21.8 21.2 -0.6 20.7 21.9 1.2 21.5 21.5 0.0 21.3 23.8 2.5 21.5 Madagascar 8.8 8.1 -0.7 11.7 8.1 -3.6 8.3 9.6 1.3 8.4 8.9 0.5 8.4 Malawi 18.7 17.0 -1.7 18.7 17.7 -1.0 18.0 17.0 -1.0 17.8 17.6 -0.2 17.8 Mali 14.0 13.5 -0.5 9.8 15.2 5.4 13.6 15.8 2.2 13.8 12.9 -0.9 13.7 Mozambique 11.7 10.9 -0.8 12.5 10.9 -1.6 11.4 11.1 -0.3 11.3 11.1 -0.2 11.3 Namibia 13.5 15.1 1.6 15.1 13.8 -1.3 13.3 15.5 2.2 14.1 15.1 1.0 14.3 Niger 20.9 22.1 1.2 18.1 22.1 4.0 21.3 22.7 1.4 21.4 21.8 0.4 21.5 Nigeria 11.0 10.0 -1.0 8.2 11.5 3.3 10.8 8.0 -2.8 10.6 9.8 -0.8 10.5 Rwanda 14.2 12.6 -1.6 14.1 13.4 -0.7 12.9 15.6 2.7 13.4 15.1 1.7 13.4 

Senegal 21.8 20.7 -1.1 23.8 19.7 -4.1 20.7 23.6 2.9 21.0 21.8 0.8 21.3 Tanzania 15.7 14.3 -1.4 18.8 14.1 -4.7 14.6 17.1 2.5 15.3 13.2 -2.1 15.0 Uganda 25.2 23.9 -1.3 23.7 24.7 1.0 24.1 26.2 2.1 24.2 29.9 5.7 24.6 

Zambia 16.1 15.7 -0.4 17.9 15.1 -2.8 16.2 14.7 -1.5 15.9 16.0 0.1 15.9 Zimbabwe 15.2 12.9 -2.3 16.3 13.2 -3.1 13.9 14.2 0.3 13.8 16.6 2.8 14.0 

40 
Table 3.4. Percentage of children less than age 5 who had diarrhea in the two weeks prior to the survey for which no medical advice was 

obtained, by country, sex of child, and region of residence as well as sex and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 79.0 79.6 0.6 78.8 79.4 0.6 79.6 76.5 -3.1 78.4 86.5 8.1 79.3 Burkina Faso 51.0 54.6 3.6 47.1 54.1 7.0 52.6 54.8 2.2 52.3 56.8 4.5 52.7 

Burundi 42.3 42.9 0.6 46.5 42.3 -4.2 42.0 45.3 3.3 42.6 42.0 -0.6 42.6 Cameroon 75.0 77.9 2.9 70.4 79.8 9.4 77.3 70.3 -7.0 76.9 73.0 -3.9 76.4 Ethiopia 67.9 67.6 -0.3 47.4 70.2 22.8 68.4 64.3 -4.1 67.5 72.5 5.0 67.8 Ghana 59.5 56.4 -3.1 62.3 55.8 -6.5 56.3 62.2 5.9 57.6 61.6 4.0 58.0 Guinea 72.1 74.2 2.1 56.7 77.5 20.8 73.7 67.1 -6.6 72.6 75.1 2.5 73.0 Kenya 49.4 53.3 3.9 51.9 51.1 -0.8 52.4 48.0 -4.4 51.4 49.9 -1.5 51.2 Lesotho 43.1 49.9 6.8 43.6 47.1 3.5 46.7 45.5 -1.2 46.4 46.4 0.0 46.4 

Liberia 46.7 51.0 4.3 46.2 49.8 3.6 49.4 47.3 -2.1 48.1 55.0 6.9 48.8 Madagascar 64.6 65.9 1.3 50.3 67.8 17.5 65.1 66.0 0.9 65.1 67.5 2.4 65.2 Malawi 38.3 36.7 -1.6 43.7 36.5 -7.2 38.0 35.5 -2.5 37.1 46.1 9.0 37.5 Mali 78.8 86.2 7.4 69.8 85.4 15.6 82.1 85.5 3.4 82.5 81.2 -1.3 82.4 Mozambique 44.5 44.4 -0.1 34.4 48.7 14.3 46.3 39.8 -6.5 45.4 28.8 -16.6 44.4 Namibia 38.6 42.7 4.1 37.4 43.0 5.6 40.8 40.7 -0.1 44.3 27.9 -16.4 40.8 Niger 82.3 83.5 1.2 69.5 84.9 15.4 82.8 83.4 0.6 83.6 78.5 -5.1 82.9 Nigeria 56.8 57.3 0.5 48.6 59.7 11.1 57.8 47.1 -10.7 56.7 60.1 3.4 57.0 Rwanda 59.8 66.0 6.2 67.1 62.0 -5.1 60.8 69.1 8.3 62.1 72.4 10.3 62.7 Senegal 64.6 66.6 2.0 65.9 65.3 -0.6 66.7 61.6 -5.1 65.4 65.7 0.3 65.5 Tanzania 45.4 47.9 2.5 41.7 48.2 6.5 47.3 43.7 -3.6 46.4 48.0 1.6 46.6 

Uganda 29.0 26.5 -2.5 29.7 27.5 -2.2 27.7 28.1 0.4 28.4 19.3 -9.1 27.8 Zambia 40.3 41.0 0.7 42.4 39.9 -2.5 40.6 41.3 0.7 40.3 46.4 6.1 40.7 Zimbabwe 66.5 63.5 -3.0 64.0 65.7 1.7 67.2 62.4 -4.8 65.9 59.2 -6.7 65.1 

41 
42 

44.9

22.3

14.2

41.3

76.8

29.6

59.5

30.3

33.6

64.0

40.3

22.1

49.3

34.2

25.1

76.0

72.6

9.8

28.3

25.3

41.2

70.4

48.1

46.0

23.1

13.4

41.3

76.5

28.0

60.2

29.5

34.1

61.8

38.9

21.7

52.1

33.8

24.8

74.9

72.1

11.6

29.2

27.2

41.6

70.1

45.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.1. Percentage of children less than age 5 who have not received any of 

the eight EPI immunizations, by country and the child's sex

Male Female
43 

36.6

18.8

14.1

29.6

55.1

25.5

45.2

24.8

31.3

44.7

24.1

19.2

38.6

24.9

21.9

48.4

54.4

8.9

24.5

11.3

33.8

64.2

41.4

50.1

23.5

13.8

49.9

79.8

30.9

64.0

31.0

34.5

70.7

41.5

22.3

55.2

37.4

26.9

80.5

80.4

10.9

31.4

30.0

42.5

72.6

48.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.2. Percentage of children less than age 5 who have not received any of 

the eight EPI immunizations, by country and the region of residence

Urban Rural
44 

46.4

22.9

14.1

42.8

76.7

29.3

59.4

29.2

33.8

63.8

38.8

22.0

50.4

34.9

25.1

75.6

73.4

10.3

29.6

26.4

40.5

70.2

46.3

38.5

20.4

12.4

33.6

76.8

27.4

63.7

31.7

33.7

60.8

44.8

21.5

53.4

31.9

24.8

74.9

62.2

12.3

25.4

25.8

44.6

70.6

47.2

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.3. Percentage of children less than age 5 who have not received any of 

the eight EPI immunizations, by country and the sex of the household head

Male Female
45 

45.4

22.7

13.6

41.0

76.5

28.4

59.9

29.2

33.7

63.0

39.2

21.8

50.3

34.2

24.5

75.3

72.1

10.8

29.0

25.5

41.0

70.1

46.4

46.3

22.5

19.6

43.4

78.6

32.2

59.5

38.9

34.3

61.8

47.1

23.6

54.8

31.2

26.9

76.4

74.9

8.5

28.4

31.9

47.4

72.7

49.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.4. Percentage of children less than age 5 who have not received any of 

the eight EPI immunizations, by country and the age of the household head

Less than 50 yo 50 yo or more
46 

41.1

55.5

46.9

84.9

37.1

43.2

34.0

50.0

38.6

69.6

45.5

22.7

41.3

76.7

28.9 30.1

33.8

39.7

21.9

50.7

4.4

-32.8

-5.5 -8.1 -8.2

-13.1

-0.2

-10.4

-16.7 -18.9

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Benin (2001

vs. 2005)

Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 3.5. Changes in the percentage of children less than age 5 who have not received 

any of the eight EPI immunizations 

Year 1 Year 2 Comparison Year 2-Year1

20012006

20042011

20052011

20032008

2003

2008-09

20032010

20042009

20042010

20012006

46.7

33.1

83.0

25.7

46.0

63.3

81.7

39.5

59.4

34.1

25.0

72.2

10.7

28.8 26.3

41.5

70.4

46.8

-12.7

-8.1 -10.8

-15.0 -17.2

-37.0 -40.2

30.9

-12.6

-60.0

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 3.6. Changes in the percentage of children less than age 5 who have not received 

any of the eight EPI immunizations

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-052005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
47 

9.8

15.1

25.2

22.8

14.5

20.2

17.7

18.1

12.1

21.8

8.8

18.7

14.0

11.7

13.5

20.9

11.0

14.2

21.8

15.7

25.2

16.1

15.2

8.7

14.9

25.4

21.3

12.7

20.5

15.2

16.2

11.5

21.2

8.1

17.0

13.5

10.9

15.1

22.1

10.0

12.6

20.7

14.3

23.9

15.7

12.9

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.7. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the child's sex

Male Female
48 

7.9

16.5

21.5

18.9

11.2

17.9

15.9

18.3

11.3

20.7

11.7

18.7

9.8

12.5

15.1

18.1

8.2

14.1

23.8

18.8

23.7

17.9

16.3

9.9

14.7

25.7

24.4

14.0

21.9

16.6

16.9

11.9

21.9

8.1

17.7

15.2

10.9

13.8

22.1

11.5

13.4

19.7

14.1

24.7

15.1

13.2

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.8. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the region of residence

Urban Rural
49 

9.3

14.9

25.2

23.1

13.6

20.0

16.5

17.6

12.1

21.5

8.3

18.0

13.6

11.4

13.3

21.3

10.8

12.9

20.7

14.6

24.1

16.2

13.9

9.3

16.3

26.0

16.5

14.1

21.5

16.3

16.0

10.8

21.5

9.6

17.0

15.8

11.1

15.5

22.7

8.0

15.6

23.6

17.1

26.2

14.7

14.2

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina

Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.9. Percentage of children less than age 5 who had diarrhea in the two weeks prior 

to the survey, by country and the sex of the household head

Male Female
50 

8.9

14.9

25.1

22.2

13.7

20.4

16.4

16.3

11.5

21.3

8.4

17.8

13.8

11.3

14.1

21.4

10.6

13.4

21.0

15.3

24.2

15.9

13.8

13.0

15.9

30.8

20.9

12.8

20.6

17.0

27.1

13.3

23.8

8.9

17.6

12.9

11.1

15.1

21.8

9.8

15.1

21.8

13.2

29.9

16.0

16.6

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.10. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey, by country and the age of the household head

Less than 50 yo 50 yo or more
51 

13.9

21.3

17.4

18.3

15.9 16.6

14.7

10.1

22.9

18.9

9.3

15.1

22.3

13.9

20.5

17.3

11.9

8.5

17.9

13.9

-4.6

-6.2

4.9

-4.5

4.6

0.6

-2.7

-1.6

-5.0 -5.0

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

25.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 3.11. Changes in the percentage of children less than age 5 who had diarrhea 

in the two weeks prior to the survey

Year 1 Year 2 Comparison Year 2-Year1

2001200620032010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

14.5 14.0

19.6

14.5

23.4

13.3

27.3

21.9

12.9

11.5

14.4

10.5

13.5

21.4

15.0

24.8

16.0

14.1

-3.0

0.4

-9.0

-1.0

-2.0

1.7

-2.5

-6.0

1.2

-15.0

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

25.0

30.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 3.12. Changes in the percentage of children less than age 5 who had diarrhea 

in the two weeks prior to the survey

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
52 

79.0

51.0

42.3

75.0

67.9

59.5

72.1

49.4

43.1

46.7

64.6

38.3

78.8

44.5

38.6

82.3

56.8

59.8

64.6

45.4

29.0

40.3

66.5

79.6

54.6

42.9

77.9

67.6

56.4

74.2

53.3

49.9

51.0

65.9

36.7

86.2

44.4

42.7

83.5

57.3

66.0

66.6

47.9

26.5

41.0

63.5

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.13. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained, 

by country and the child's sex

Male Female
53 

78.8

47.1

46.5

70.4

47.4

62.3

56.7

51.9

43.6

46.2

50.3

43.7

69.8

34.4

37.4

69.5

48.6

67.1

65.9

41.7

29.7

42.4

64.0

79.4

54.1

42.3

79.8

70.2

55.8

77.5

51.1

47.1

49.8

67.8

36.5

85.4

48.7

43.0

84.9

59.7

62.0

65.3

48.2

27.5

39.9

65.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.14. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained,

by country and the region of residence

Urban Rural
54 

79.6

52.6

42.0

77.3

68.4

56.3

73.7

52.4

46.7

49.4

65.1

38.0

82.1

46.3

40.8

82.8

57.8

60.8

66.7

47.3

27.7

40.6

67.2

76.5

54.8

45.3

70.3

64.3

62.2

67.1

48.0

45.5

47.3

66.0

35.5

85.5

39.8

40.7

83.4

47.1

69.1

61.6

43.7

28.1

41.3

62.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.15. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained, 

by country and the sex of the household head

Male Female
55 

78.4

52.3

42.6

76.9

67.5

57.6

72.6

51.4

46.4

48.1

65.1

37.1

82.5

45.4

44.3

83.6

56.7

62.1

65.4

46.4

28.4

40.3

65.9

86.5

56.8

42.0

73.0

72.5

61.6

75.1

49.9

46.4

55.0

67.5

46.1

81.2

28.8

27.9

78.5

60.1

72.4

65.7

48.0

19.3

46.4

59.2

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 3.16. Percentage of children less than age 5 who had diarrhea in the two weeks 

prior to the survey for which no medical advice was obtained,

by country and the age of the household head

Less than 50 yo 50 yo or more
56 

75.8

82.2

78.6 77.6

74.1 70.5 70.1 69.3 67.0

88.0

79.2

52.8

76.4

67.8

58.0

51.1

46.2

65.2

37.6

82.3

3.4

-29.4

-2.2

-9.8

-16.1

-19.3

-23.9

-4.2

-29.4

-5.6

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 3.17. Changes in the percentage of children less than age 5 who had diarrhea 

in the two weeks prior to the survey for which no medical advice was obtained

Year 1 Year 2 Comparison Year 2-Year1

2001200620032010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

50.7 50.4

76.4

84.8

78.3

51.8

29.8

57.0

69.8

44.3

40.8

56.9

62.7 65.4

46.6

27.7

40.7

65.1

-6.4

-9.6

-19.5 -22.1

-12.9

-5.2

-2.1

-16.3

-4.7

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 3.18. Changes in the percentage of children less than age 5 who had diarrhea 

in the two weeks prior to the survey for which no medical advice was obtained

Year 1 Year 2 Comparison Year 2-Year1

200320112005

2010-11

20032008

20052010

2004-052005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
57 

Map 3.1 Percentage of children less than age 5 

who have not received any of the eight EPI 

immunizations 

Map 3.2 Percentage of children less than age 5 

who had diarrhea in the two weeks prior to the 

survey 

Map 3.3 Percentage of children less than age 5 

who had diarrhea in the two weeks prior to the 

survey for which no medical advice was 

obtained 

59 

4 Water and Sanitation Deprivation 

This chapter presents stratified percentages of children considered severely deprived of water 

because they lived in households that used surface water or had more than a 15-minute walk to their water 

source. The rationales for these two measures is that surface water can become polluted and thus 

dangerous, and a 15-minute walk to a water source (30 minutes round trip) means that the child likely will 

have access to only a severely limited quantity of water at home (Gordon et al., 2003). 

Information regarding sanitation deprivation focuses on the percentage of children who do not 

have access to any sanitation facilities in or near their homes, including any connection to a public sewer 

or connection to a septic system or access to a pour-flush latrine, simple pit latrine, ventilated improved 

pit latrine, service or bucket latrines where excreta are removed manually, public latrines, or open 

latrines. We conducted the analyses using data for children up to age 17. 

4.1 Use of Surface Water 

To reduce diarrheal disease and, consequently, child mortality, the Millennium Development 

Goals call for reducing by half the proportion of people without sustainable access to safe drinking water 

(Peterson Zwane and Kremer, 2007). One-sixth of the world's population (884 million people) have no 

access to improved sources of drinking water such as piped household water connections, public 

standpipes, boreholes, protected dug wells, protected springs, or rainwater collection (Mara, 2003; WHO 

and UNICEF, 2010). People without access to improved sources of drinking water generally use surface 

water instead, including water from dams, rivers, and streams. Unfortunately, surface water is frequently 

contaminated with pathogens, including bacteria, viruses, and parasites, due to contact with human and 

livestock waste (Effler et al., 2001; Fong and Lipp, 2005; Kistemann et al., 2002; Peterson Zwane and 

Kremer, 2007). For this reason, surface water often transmits waterborne and water-related diseases when 

used for domestic purposes. 

The use of surface water for human consumption is a global health concern because there are 

approximately 3.5 billion episodes of diarrhea per year and 1.87 million childhood deaths per year 

worldwide linked to waterborne and water-related diseases (Arnold and Colford, 2007; Boschi-Pinto et 

al., 2008; Effler et al., 2001; Fong and Lipp, 2005; Kistemann et al., 2002; Peterson Zwane and Kremer, 

2007). According to the United Nations World Water Development Report 3: Water in a Changing 

World, more than half of malnutrition cases in Africa result from recurring diarrhea or intestinal nematode 

infections resulting from consuming contaminated water. In the developing world several recent 

epidemics related to the lack safe drinking water have resulted from toxigenic Vibrio cholerae, 

Salmonella, Shigella, Escherichia coli pathotypes, Cryptosporidium, and Giardia (Bielaszewska et al., 

2011; Centers for Disease Control and Prevention, 2012; Chigor et al., 2012; Mills-Robertson et al., 2003; 

Stewart-Tull, 2001; Zahid et al., 2008). 

Our analyses found vast differences among sub-Saharan countries in the percentage of children 

less than age 18 who used surface water (see Map 4.1). For instance, less than 2% of children used 

surface water in Senegal and Niger. In contrast, more than 60% of children in Burundi and 50% in 

Rwanda used surface water (see Table 4.1). 

Sex and geographic disparities 

Overall, we did not find child’s sex disparities related to the use of surface water in sub-Saharan 

Africa (see Figure 4.1). We did find geographic disparities, however (see Figure 4.2). In all these 

countries a higher percentage of children used surface water in rural areas than in urban areas. Geographic 

disparities were greatest in Burundi (urban: 15% and rural: 72%) and Ethiopia (urban: 8% and rural: 
60 

64%)—differences of more than 50 percentage points. In Kenya (urban: 6% and rural: 51%) and 

Madagascar (urban: 7% and rural: 55%), the disparity was over 45 percentage points. 

The role of the household head’s sex and age 

The percentage of children using surface water was at least five percentage points higher for 

children living with a male household head than for children living with a female household head in six 

countries—Benin (12% versus 7%), Ethiopia (58% versus 48%), Ghana (15% versus 8%), Guinea (28% 

versus 20%), Liberia (23% versus 15%), and Madagascar (51% versus 43%) (see Table 4.1 and Figure 

4.3). 

Additionally, the percentage of children using surface water was at least three percentage points 

higher for children living with a household head at least age 50 than for children living with a younger 

household head in four countries—Cameroon (25% versus 29%), Kenya (44% versus 48%), Namibia (7% 

versus 14%), and Nigeria (23% versus 27%) (see Table 4.1 and Figure 4.4). 

Variations during the last 13 years 

Ethiopia, with an increment of 29 percentage points, experienced the greatest increase in the 

percentage of children less than age 18 that used surface water (2005: 29% and 2011: 57%) (see Table 

4.2). Other countries that experienced relatively large increases included Rwanda, with an increase of 11 

percentage points (2005: 52% and 2010: 11%) and Zimbabwe, with an increase of 8 percentage points 

(2005-06: 3% and 2010-11: 11%). 

Conversely, Madagascar experienced the greatest decrease on the continent, from 61% in 2003-

04 to 51% in 2008-09, a 11 percentage point decrease (see Figures 4.5 and 4.6). An additional five 

countries—Burkina Faso, Ghana, Kenya, Madagascar, and Malawi—experienced a decrease in use of 

surface water of more than 5 percentage points. 

4.2 15-Minute Walk to the Water Source 

Collecting water from a source away from the household incurs three primary costs: health 

damage resulting from the physical burden of carrying water; the expenditure of energy on carrying 

water; and the opportunity cost of time spent fetching water (Rosen and Vincent, 1999). 

Women and girls, who are usually the water carriers, also experience health and safety risks when 

exposed to water-based diseases at the water source (e.g., schistosomiasis) and diseases spread by insects 

at or near the water source; because of the increased likelihood of accidents, drowning, attack, and assault 

at and on the way to and from the water source; as well as skeletal damages from carrying heavy loads of 

water frequently over long periods of time (Rosen and Vincent, 1999). Also, studies have found an 

association between other child health issues and living far from a primary water source. For instance, a 

cross-sectional study of children less than 36 months of age in the Kilimanjaro region of Tanzania found 

that long distance to a water source independently predicted a child’s categorization as underweight 

(Abubaka et al., 2012). In Amhara, Oromiya, and the Southern Nations, Nationalities, and Peoples Region 

of Ethiopia, the time taken to collect water was related to malaria risk (Ayele et al., 2012). 

There was a large variation in the percentage of children under age 18 living more than a 15 

minute walk from a water source in sub-Saharan Africa. These percentages ranged from 12% in Mali to 

70% in Uganda and 70% in Ethiopia and Rwanda (see Map 4.2). More than half of children in Chad, 

Mozambique, Tanzania, Malawi, and Burundi must walk more than 15 minutes to their water source (see 

Table 4.3). 
61 

Sex and geographic disparities 

In general, there was no sex disparities related to the distance to the water source in sub-Saharan 

Africa (see Figure 4.7). In Chad, however, the percentage of children who were living more than a 15-

minute walk from the water source was more than 2 percentage points higher for females (58%) than for 

males (56%) (see Table 4.3). 

In every country with the exception of Liberia, a greater proportion of rural children than urban 

children lived more than a 15-minute walk from a water source (see Figure 4.8). Geographic disparities of 

at least 40 percentage points were seen in Kenya (urban: 14% and rural: 54%), Uganda (urban: 32% and 

rural: 76%), Niger (urban: 14% and rural: 55%), and Ethiopia (urban: 31% and rural: 76% (see Table 

4.3). The urban-rural difference was the reverse in Liberia: 18% of children in urban areas and 12% of 

children in rural areas lived more than a 15-minute walk from the water source (a difference of 6 

percentage points). 

The role of the household head’s sex and age 

Whether children with a male or a female head of household were more likely to live more than a 

15-minute walk from the primary water source varied across the countries (see Figure 4.9). In eight 

countries the percentage living far from water was at least one percentage point higher for children living 

with a male household head (see Table 4.3). In nine countries the percentage was at least one percentage 

point higher for children living with a female household head. 

Major differences by sex of head of household appeared in Ghana (male household head: 32% 

versus female household head: 22%) and Senegal (18% versus 7%) (see Figure 4.9). Additionally, the 

difference between children living with a male or female household head was more than 70 percentage 

points in Kenya (male household head: 47% and female household head: 55%) and Zimbabwe (34% and 

41%). 

The age of the household head was especially important in Namibia. The percentage of children 

living more than a 15-minute walk from the primary water source was 16 percentage points higher for 

children living with a household head at least age 50 (39%) than for their counterparts who lived with a 

younger head of household (23%) (see Table 4.3 and Figure 4.10 ). 

Variations during the last 13 years 

Benin, Cameroon, Ethiopia, and Rwanda all experienced large increases in the percentage of 

children living more than a 15-minute walk from a primary water source (see Figures 4.11 and 4.12). This 

increase—10 percentage points—was most evident in Ethiopia, where the percentage increased from 61% 

in 2005 to 70% in 2011 (see Table 4.2). 

Senegal demonstrated a major improvement in the percentage of children living more than a 15-

minute walk from the primary water source, with a reduction of 28 percentage points from 2005 (44%) to 

2010-11 (17%). Other countries that experienced important reductions—more than 15 percentage 

points—included Lesotho (2004: 55% and 2009: 39%), Mali (2001: 29% and 2006: 12%), and Nigeria 

(2003: 53% and 2008: 35%). 
62 

4.3 Lack of Access to Any Sanitation Facilities Whatsoever in or near Their 

Homes 

The aim of Millennium Development Goal 7 is to reduce by half the proportion of people without 

basic sanitation facilities by 2015 (WHO, 2009). It has been calculated that, to meet this goal, countries in 

sub-Saharan Africa would need to spend an estimated 0.9 percent of their gross domestic product (GDP) 

annually in the sector—0.5 percent for new infrastructure, 0.2 percent for rehabilitation of existing assets, 

and 0.2 percent for operation and maintenance (Morella et al., 2008). 

Lack of sanitation is a serious global health problem, affecting 2.5 billion people, particularly the 

poor and disadvantaged, who must defecate openly, a practice that places them at higher risk of disease 

transmission (UNICEF/WHO Joint Monitoring Program, 2012). About 10% of the total global disease 

burden is attributable to unsafe water, sanitation, and hygiene. Researchers have associated illnesses 

related to inadequate sanitation with about 3.6 million deaths each year (Pruss-Ustun et al., 2008). 

There was large variation in the percentage of children without access to any sanitation facilities 

in sub-Saharan Africa (see Map 4.3). This percentage ranged from less than 3% in Burundi and Rwanda 

to 81% in Niger (see Table 4.4). Two of every three children in Burkina Faso, Chad, and Niger did not 

have access to any sanitation facilities in or near their homes. In Namibia and Liberia more than half of 

children under 18 years of age did not have access to any sanitation services. 

Sex and geographic disparities 

In general, there were no disparities related to children’s sex in their access to sanitation facilities 

(see Figure 4.13). Lack of sanitation facilities was more common for boys than girls by about two 

percentage points in Burkina Faso (males: 68% and females: 65%), Ghana (males: 27% and females: 

24%), and Liberia (males: 56% and females: 54%) (see Table 4.4). 

In all of these sub-Saharan African countries, rural children were more likely than urban children 

to lack access to any sanitation facilities (see Figure 4.14). This geographic disparity was most marked—

at least 60 percentage points—in Burkina Faso (urban: 15% and rural: 79%), Chad (17% and 85%), 

Namibia (17% and 82%), and Niger (19% and 93%) (see Table 4.4). 

The role of the household head’s sex and age 

In four countries the percentage of children without access to any sanitation services was more 

than 11 percentage points higher for children living with a male household head than for children living 

with a female household head—Senegal (male household head: 21% and female household head: 10%), 

Burkina Faso (68% and 56%), Benin (69% and 57%), and Ghana (29% and 17%) (see Figure 4.15). In 

Namibia 76% percent of children living with a household head older than age 50 did not have access to 

any sanitation facilities, compared with 53% of those living with a younger head of household—a 

difference of 23 percentage points (see Figure 4.16 and Table 4.4). 

Variations during the last 13 years 

Ethiopia achieved the largest reduction (23 percentage points) in the percentage of children who 

do not have access to any sanitation facilities, from 66% in 2005 to 43% in 2011 (see Table 4.2). Other 

countries that experienced a reduction of more than 5 percentage points included Burkina Faso (2003: 

73% and 2010: 68%), Lesotho (2004: 51% and 2009: 41%), Malawi (2004: 16% and 2010: 11%), and 

Mozambique (2003: 50% and 2011: 43%) (see Figures 4.17 and 4.18). Only Nigeria (2003: 25% and 

2008: 31%) and Tanzania (2004-05: 17% and 2010: 19%) experienced increases in the percentage of 

children who did not have access to any sanitation facilities. 
Table 4.1. Percentage of children who live in households that use surface water, by country, sex of child, and region of residence as well 

as sex and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 11.0 10.8 -0.2 5.5 13.8 8.3 11.7 6.5 -5.2 10.6 12.4 1.8 10.9 Burkina Faso 8.1 7.7 -0.4 0.8 9.5 8.7 7.9 7.6 -0.3 8.1 6.8 -1.3 7.9 Burundi 67.8 66.8 -1.0 14.7 71.8 57.1 67.3 67.3 0.0 67.2 68.0 0.8 67.3 

Cameroon 26.3 25.6 -0.7 11.8 36.8 25.0 25.7 27.0 1.3 25.2 29.1 3.9 26.0 Chad 17.6 19.3 1.7 3.9 21.9 18.0 17.9 21.5 3.6 18.5 18.2 -0.3 18.4 Ethiopia 56.4 55.1 -1.3 8.1 63.9 55.8 57.5 48.3 -9.2 55.6 56.2 0.6 55.7 Ghana 13.6 12.5 -1.1 2.7 20.0 17.3 15.2 8.3 -6.9 13.2 12.7 -0.5 13.1 Guinea 27.6 27.0 -0.6 3.7 36.5 32.8 28.4 20.0 -8.4 27.0 28.2 1.2 27.3 Kenya 45.2 44.4 -0.8 6.2 51.4 45.2 44.0 46.4 2.4 44.3 47.7 3.4 44.8 

Lesotho 14.4 13.4 -1.0 5.0 16.0 11.0 14.7 12.2 -2.5 13.6 14.5 0.9 13.9 

Liberia 20.8 20.0 -0.8 1.0 31.4 30.4 22.9 14.9 -8.0 20.5 20.0 -0.5 20.4 Madagascar 49.7 48.7 -1.0 7.1 54.9 47.8 50.5 43.1 -7.4 49.1 50.3 1.2 49.2 Malawi 5.4 5.5 0.1 1.8 6.0 4.2 5.6 5.0 -0.6 5.5 5.4 -0.1 5.4 Mali 4.2 4.0 -0.2 0.9 5.4 4.5 4.1 4.4 0.3 3.9 5.0 1.1 4.1 Mozambique 15.9 16.1 0.2 3.2 21.3 18.1 17.4 13.1 -4.3 15.6 18.7 3.1 16.0 Namibia 9.5 9.0 -0.5 0.4 13.9 13.5 9.0 9.5 0.5 7.3 14.0 6.7 9.2 Niger 1.4 1.4 0.0 0.1 1.7 1.6 1.4 1.4 0.0 1.2 2.1 0.9 1.4 Nigeria 23.8 22.6 -1.2 7.1 30.3 23.2 22.8 26.1 3.3 22.5 26.8 4.3 23.2 

Rwanda 62.9 63.7 0.8 30.7 67.6 36.9 62.5 65.2 2.7 63.1 65.3 2.2 63.3 

Senegal 1.3 1.1 -0.2 0.1 1.9 1.8 1.4 0.3 -1.1 1.2 1.3 0.1 1.2 Tanzania 27.7 26.1 -1.6 8.8 31.5 22.7 27.3 25.4 -1.9 26.8 27.2 0.4 26.9 Uganda 13.1 13.0 -0.1 1.9 14.6 12.7 13.1 12.9 -0.2 12.8 14.3 1.5 13.0 Zambia 21.6 21.3 -0.3 1.1 31.3 30.2 22.5 17.8 -4.7 21.2 23.2 2.0 21.5 Zimbabwe 10.8 10.7 -0.1 0.9 14.0 13.1 11.2 10.2 -1.0 10.4 12.3 1.9 10.7 

63 
Table 4.2. Percentage of children who live in households that use surface water, who have more than a 15-minute walk to the 

water source, or who do not have access to any sanitation facilities whatsoever in or near their homes, by country, child's age, 

and year of data collection

Child's age 

Year of data 

collection 

Households using surface 

water 

More than 15 minute 

walk to water source 

No access to any 

sanitation facilities 

whatsoever in or near 

home 

Country Value 1 Year 2 Year Year 1 Year 2

Comparison 

Year 2−Year 1 Year 1 Year 2

Comparison 

Year 2−Year 1 Year 1 Year 2

Comparison 

Year 2−Year 1

Benin 0-17 2001 2006 12.3 10.9 -1.5 30.4 34.2 3.8 69.2 67.2 -2.0 Benin 0- 4 2001 2006 13.6 11.8 -1.7 30.8 35.3 4.5 72.6 68.8 -3.7 

Benin 5- 9 2001 2006 12.9 11.7 -1.2 30.3 35.4 5.1 71.2 70.3 -1.0 Benin 10-14 2001 2006 11.4 9.8 -1.7 30.4 33.0 2.6 66.3 65.0 -1.3 Benin 15-17 2001 2006 8.8 7.7 -1.1 29.7 29.9 0.2 58.8 57.2 -1.6 Benin 0-17 2001 2006 13.4 11.9 -1.5 30.4 35.5 5.1 72.7 69.7 -3.0 Burkina Faso 0-17 2003 2010 13.7 7.9 -5.8 47.3 43.7 -3.5 71.7 66.5 -5.1 Burkina Faso 0- 4 2003 2010 14.8 8.0 -6.8 47.2 43.7 -3.4 73.1 67.9 -5.2 Burkina Faso 5- 9 2003 2010 14.2 8.5 -5.8 48.0 43.8 -4.1 74.5 68.2 -6.3 Burkina Faso 10-14 2003 2010 12.6 7.4 -5.2 46.6 44.5 -2.1 69.6 65.8 -3.7 Burkina Faso 15-17 2003 2010 12.0 6.8 -5.2 47.3 41.4 -5.9 65.9 59.0 -6.9 Burkina Faso 0-17 2003 2010 14.5 8.2 -6.3 47.5 43.8 -3.7 73.3 68.1 -5.2 Cameroon 0-17 2004 2011 29.4 26.0 -3.4 38.6 40.0 1.4 7.5 7.9 0.4 Cameroon 0- 4 2004 2011 29.9 27.0 -2.9 38.9 40.9 2.0 8.7 8.4 -0.3 Cameroon 5- 9 2004 2011 29.9 26.5 -3.4 39.1 41.0 1.9 8.1 8.8 0.7 Cameroon 10-14 2004 2011 29.8 25.4 -4.4 38.4 39.5 1.1 6.8 7.1 0.4 Cameroon 15-17 2004 2011 26.3 23.0 -3.3 36.7 35.8 -0.9 4.8 5.8 1.0 Cameroon 0-17 2004 2011 30.1 26.6 -3.5 38.7 40.7 2.0 8.6 8.6 0.0 Ethiopia 0-17 2005 2011 27.8 55.7 27.9 60.0 69.5 9.5 64.0 39.6 -24.5 Ethiopia 0- 4 2005 2011 28.5 57.1 28.6 60.5 70.1 9.5 66.6 43.2 -23.4 Ethiopia 5- 9 2005 2011 28.1 57.3 29.2 60.6 70.9 10.4 64.9 40.3 -24.6 Ethiopia 10-14 2005 2011 27.8 55.0 27.2 60.7 68.4 7.7 63.4 37.2 -26.1 Ethiopia 15-17 2005 2011 25.6 50.1 24.6 55.5 66.5 10.9 56.9 33.9 -23.0 Ethiopia 0-17 2005 2011 28.5 57.3 28.8 60.7 70.3 9.6 66.1 42.9 -23.2 

(Continued...) 

64 
Table 4.2. – Continued

Child's age Data collection 

Households use surface 

water 

Had more than a 15 minute

walk to the water source 

Do not have access to 

any sanitation facilities 

whatsoever in or near 

their homes 

Country Value 1 Year 2 Year Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1

Ghana 0-17 2003 2008 21.7 13.1 -8.6 37.5 29.0 -8.5 27.9 25.3 -2.6 Ghana 0- 4 2003 2008 23.6 14.2 -9.5 38.3 29.3 -9.0 30.6 26.8 -3.9 Ghana 5- 9 2003 2008 22.9 13.6 -9.3 37.5 29.9 -7.7 30.2 26.1 -4.1 Ghana 10-14 2003 2008 20.5 12.6 -7.9 37.0 28.5 -8.5 25.7 23.9 -1.8 Ghana 15-17 2003 2008 17.2 10.7 -6.5 36.4 27.3 -9.1 21.5 23.4 1.9 Ghana 0-17 2003 2008 23.6 14.1 -9.5 38.5 29.9 -8.7 30.7 26.8 -3.8 Kenya 0-17 2003 2008-09 52.4 44.8 -7.6 62.0 48.4 -13.6 20.9 17.1 -3.8 Kenya 0- 4 2003 2008-09 52.1 45.0 -7.1 59.2 47.1 -12.0 21.5 18.4 -3.0 Kenya 5- 9 2003 2008-09 51.9 45.0 -6.8 61.8 47.6 -14.2 22.2 17.6 -4.6 Kenya 10-14 2003 2008-09 53.3 44.6 -8.7 64.3 50.4 -14.0 20.6 16.4 -4.2 Kenya 15-17 2003 2008-09 52.2 44.1 -8.1 63.8 49.2 -14.7 17.1 13.9 -3.2 Kenya 0-17 2003 2008-09 52.0 45.2 -6.8 59.6 47.0 -12.6 21.6 18.3 -3.3 Lesotho 0-17 2004 2009 8.0 13.9 5.8 55.2 39.5 -15.7 46.7 39.8 -6.9 Lesotho 0- 4 2004 2009 8.9 14.3 5.4 55.6 39.3 -16.2 51.2 41.4 -9.7 Lesotho 5- 9 2004 2009 7.5 13.9 6.5 54.9 40.8 -14.1 49.0 42.6 -6.4 Lesotho 10-14 2004 2009 8.1 13.9 5.7 54.5 39.2 -15.3 44.4 38.8 -5.6 Lesotho 15-17 2004 2009 7.5 13.0 5.5 56.6 38.0 -18.6 40.9 34.9 -6.0 Lesotho 0-17 2004 2009 8.4 14.1 5.7 55.2 39.2 -16.1 51.0 41.3 -9.7 Madagascar 0-17 2003-04 2008-09 58.2 49.2 -9.0 26.5 19.0 -7.5 49.9 46.3 -3.5 Madagascar 0- 4 2003-04 2008-09 61.2 50.8 -10.5 27.7 19.8 -8.0 52.9 50.6 -2.3 Madagascar 5- 9 2003-04 2008-09 59.3 50.9 -8.4 26.9 19.2 -7.7 49.9 47.8 -2.1 Madagascar 10-14 2003-04 2008-09 56.1 47.2 -8.9 24.7 18.3 -6.4 48.0 43.2 -4.8 Madagascar 15-17 2003-04 2008-09 51.1 45.7 -5.4 25.7 18.1 -7.7 45.5 39.2 -6.2 Madagascar 0-17 2003-04 2008-09 61.1 50.6 -10.5 27.4 19.7 -7.8 52.4 50.1 -2.3 Malawi 0-17 2004 2010 11.9 5.4 -6.4 59.1 58.0 -1.0 14.7 10.3 -4.5 Malawi 0- 4 2004 2010 12.1 5.6 -6.5 58.9 58.1 -0.8 15.9 10.9 -5.0 Malawi 5- 9 2004 2010 12.0 5.4 -6.6 59.2 58.9 -0.3 15.5 10.3 -5.2 Malawi 10-14 2004 2010 11.3 5.5 -5.8 58.8 57.7 -1.2 13.6 10.1 -3.5 

(Continued...) 

65 
Table 4.2. – Continued

Child's age Data collection 

Households use surface 

water 

Had more than a 15 minute

walk to the water source 

Do not have access to 

any sanitation facilities 

whatsoever in or near 

their homes 

Country Value 1 Year 2 Year Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1

Malawi 15-17 2004 2010 12.2 5.1 -7.1 59.8 56.3 -3.5 11.6 8.8 -2.8 Malawi 0-17 2004 2010 12.2 5.5 -6.7 59.1 58.3 -0.8 15.9 10.8 -5.1 Mali 0-17 2001 2006 4.9 4.1 -0.7 29.9 11.5 -18.5 20.8 19.5 -1.3 Mali 0- 4 2001 2006 4.9 4.2 -0.7 28.8 11.2 -17.6 21.7 19.3 -2.4 

Mali 5- 9 2001 2006 4.5 4.3 -0.2 30.0 11.7 -18.3 22.0 20.4 -1.6 

Mali 10-14 2001 2006 4.9 3.9 -1.0 31.6 11.3 -20.3 19.6 19.6 0.1 

Mali 15-17 2001 2006 5.8 4.1 -1.7 29.2 11.9 -17.2 17.3 17.5 0.2 

Mali 0-17 2001 2006 4.8 4.2 -0.6 29.1 11.5 -17.6 22.0 19.7 -2.4 Mozambique 0-17 2003 2011 15.4 16.0 0.6 60.4 54.7 -5.7 47.2 40.3 -6.9 Mozambique 0- 4 2003 2011 17.1 16.5 -0.6 60.8 56.2 -4.6 49.6 43.2 -6.3 Mozambique 5- 9 2003 2011 16.4 16.0 -0.4 61.4 55.8 -5.6 50.6 41.9 -8.7 Mozambique 10-14 2003 2011 14.1 16.1 2.0 60.6 53.6 -7.0 45.1 37.6 -7.5 Mozambique 15-17 2003 2011 10.7 14.2 3.5 55.8 49.9 -5.9 35.3 33.5 -1.8 Mozambique 0-17 2003 2011 17.1 16.2 -0.9 61.2 56.2 -5.0 50.0 43.0 -7.1 Namibia 0-17 2000 2006-07 7.5 9.2 1.7 37.3 27.3 -10.0 62.4 59.3 -3.2 Namibia 0- 4 2000 2006-07 7.6 9.3 1.7 34.8 27.1 -7.7 63.1 61.5 -1.6 Namibia 5- 9 2000 2006-07 7.7 9.0 1.2 38.6 27.2 -11.3 63.5 59.2 -4.3 Namibia 10-14 2000 2006-07 8.0 9.7 1.7 38.6 29.0 -9.6 62.3 59.1 -3.2 Namibia 15-17 2000 2006-07 6.0 8.7 2.7 37.4 24.6 -12.8 58.7 55.2 -3.5 Namibia 0-17 2000 2006-07 7.7 9.2 1.5 35.6 26.8 -8.9 63.9 61.4 -2.5 Namibia 0-17 2000 0.0 0.0 Nigeria 0-17 2003 2008 23.0 23.2 0.2 52.9 35.6 -17.3 24.5 31.2 6.6 Nigeria 0- 4 2003 2008 21.6 22.6 1.0 52.5 35.0 -17.5 24.2 30.5 6.3 Nigeria 5- 9 2003 2008 23.5 23.5 0.0 53.5 35.9 -17.6 25.6 31.8 6.2 Nigeria 10-14 2003 2008 24.1 23.6 -0.5 53.3 35.9 -17.5 24.2 31.3 7.1 Nigeria 15-17 2003 2008 23.4 23.5 0.1 51.5 35.8 -15.7 23.2 31.0 7.8 

Nigeria 0-17 2003 2008 22.0 22.8 0.8 52.8 35.1 -17.7 24.7 30.9 6.2 

(Continued...) 

66 
Table 4.2. – Continued

Child's age Data collection 

Households use surface 

water 

Had more than a 15 minute

walk to the water source 

Do not have access to 

any sanitation facilities 

whatsoever in or near 

their homes 

Country Value 1 Year 2 Year Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1

Rwanda 0-17 2005 2010 52.2 63.3 11.1 65.6 69.5 3.9 3.3 1.2 -2.1 Rwanda 0- 4 2005 2010 51.6 62.4 10.7 65.8 67.5 1.8 3.5 1.3 -2.2 Rwanda 5- 9 2005 2010 52.0 64.5 12.5 65.4 70.6 5.1 3.5 1.3 -2.2 Rwanda 10-14 2005 2010 53.1 64.0 11.0 65.5 70.5 5.0 3.1 1.0 -2.0 Rwanda 15-17 2005 2010 52.7 61.4 8.7 65.8 69.5 3.7 2.5 0.8 -1.7 Rwanda 0-17 2005 2010 51.7 63.0 11.4 65.7 68.4 2.7 3.5 1.3 -2.2 Senegal 0-17 2005 2010-11 1.1 1.2 0.1 43.8 15.7 -28.1 23.9 18.7 -5.2 Senegal 0- 4 2005 2010-11 1.1 1.4 0.3 44.2 16.2 -27.9 25.8 19.7 -6.1 Senegal 5- 9 2005 2010-11 1.2 1.3 0.0 43.8 17.0 -26.9 25.5 20.1 -5.4 Senegal 10-14 2005 2010-11 0.9 1.1 0.2 43.9 14.9 -29.0 22.7 18.0 -4.6 Senegal 15-17 2005 2010-11 0.8 0.6 -0.1 42.1 12.7 -29.4 18.8 13.9 -4.9 Senegal 0-17 2005 2010-11 1.2 1.3 0.1 44.2 16.7 -27.6 25.9 20.0 -5.9 Tanzania 0-17 2004-05 2010 25.0 26.9 1.8 61.0 57.6 -3.3 15.0 17.3 2.3 Tanzania 0- 4 2004-05 2010 25.7 27.4 1.7 61.3 58.6 -2.7 17.4 19.0 1.6 Tanzania 5- 9 2004-05 2010 24.8 28.2 3.4 61.3 59.3 -2.0 14.6 17.5 2.9 Tanzania 10-14 2004-05 2010 24.2 26.5 2.3 61.0 56.5 -4.5 13.3 16.4 3.2 Tanzania 15-17 2004-05 2010 25.3 23.0 -2.3 59.1 53.5 -5.6 12.7 14.0 1.3 Tanzania 0-17 2004-05 2010 25.5 27.9 2.4 61.5 58.9 -2.6 16.9 18.6 1.8 Uganda 0-17 2006 2011 11.7 13.0 1.3 80.3 70.3 -10.0 12.0 10.0 -1.9 Uganda 0- 4 2006 2011 12.7 12.9 0.2 79.8 67.8 -12.0 13.0 11.0 -2.0 Uganda 5- 9 2006 2011 11.6 13.4 1.8 81.9 71.3 -10.6 12.8 10.5 -2.2 Uganda 10-14 2006 2011 10.7 13.1 2.5 80.6 72.7 -7.9 10.8 9.6 -1.1 Uganda 15-17 2006 2011 11.8 12.2 0.4 76.5 69.4 -7.1 9.8 7.1 -2.8 Uganda 0-17 2006 2011 12.6 13.2 0.7 80.3 68.8 -11.4 13.0 11.0 -2.0 Zambia 0-17 2001-02 2007 19.4 21.5 2.0 40.8 34.0 -6.8 27.3 24.4 -2.9 Zambia 0- 4 2001-02 2007 20.9 23.6 2.8 40.5 36.1 -4.4 30.3 27.2 -3.1 Zambia 5- 9 2001-02 2007 18.8 22.9 4.1 41.0 34.7 -6.3 26.6 25.6 -1.0 Zambia 10-14 2001-02 2007 18.9 19.3 0.4 41.2 32.8 -8.4 26.0 22.9 -3.2 

(Continued...) 

67 
Table 4.2. – Continued

Child's age Data collection 

Households use surface 

water 

Had more than a 15 minute

walk to the water source 

Do not have access to 

any sanitation facilities 

whatsoever in or near 

their homes 

Country Value 1 Year 2 Year Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1 Year 1 Year 2

Comparison 

Year 2-Year1

Zambia 15-17 2001-02 2007 18.2 16.2 -1.9 40.1 28.7 -11.4 23.9 16.6 -7.3 Zambia 0-17 2001-02 2007 20.2 23.4 3.3 40.8 35.5 -5.3 29.4 27.0 -2.4 Zimbabwe 0-17 2005-06 2010-11 3.1 10.7 7.6 42.9 34.9 -8.0 35.9 31.6 -4.3 Zimbabwe 0- 4 2005-06 2010-11 3.1 11.2 8.2 41.2 33.9 -7.3 37.2 32.3 -5.0 Zimbabwe 5- 9 2005-06 2010-11 3.1 11.0 8.0 43.4 35.7 -7.7 37.0 33.3 -3.7 Zimbabwe 10-14 2005-06 2010-11 3.1 10.3 7.1 45.3 36.1 -9.2 36.4 32.0 -4.4 Zimbabwe 15-17 2005-06 2010-11 3.1 9.9 6.8 40.1 33.2 -6.9 29.5 25.3 -4.2 Zimbabwe 0-17 2005-06 2010-11 3.0 11.1 8.1 41.4 34.1 -7.4 37.2 32.5 -4.8 

68 
Table 4.3. Percentage of children who live in households that are more than a 15-minute walk to the water source, by country, sex of 

child, and region of residence as well as sex and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 34.8 33.6 -1.2 22.0 40.9 18.9 34.7 31.5 -3.2 34.0 35.4 1.4 34.2 Burkina Faso 44.3 43.1 -1.2 27.9 47.4 19.5 44.2 38.2 -6.0 44.2 41.5 -2.7 43.7 Burundi 61.6 63.1 1.5 25.9 65.8 39.9 62.5 61.9 -0.6 62.1 65.2 3.1 62.4 Cameroon 40.2 39.7 -0.5 29.1 48.3 19.2 40.4 38.4 -2.0 39.3 42.5 3.2 40.0 Chad 56.0 58.3 2.3 43.3 59.0 15.7 56.9 58.7 1.8 57.4 55.0 -2.4 57.1 Ethiopia 69.8 69.1 -0.7 31.3 76.0 44.7 70.3 66.1 -4.2 69.2 71.0 1.8 69.5 Ghana 29.4 28.5 -0.9 15.2 38.2 23.0 31.9 22.4 -9.5 28.6 30.9 2.3 29.0 

Guinea 35.5 35.4 -0.1 24.3 38.4 14.1 35.3 36.6 1.3 35.4 35.8 0.4 35.5 

Kenya 48.7 48.1 -0.6 13.8 54.3 40.5 47.6 50.0 2.4 47.3 54.5 7.2 48.4 

Lesotho 39.6 39.3 -0.3 16.7 45.2 28.5 39.3 39.7 0.4 38.3 42.9 4.6 39.5 

Liberia 14.2 14.4 0.2 18.2 12.1 -6.1 14.8 13.2 -1.6 14.4 13.9 -0.5 14.3 Madagascar 18.7 19.3 0.6 10.5 20.2 9.7 18.7 20.3 1.6 18.7 21.5 2.8 19.0 

Malawi 58.2 57.8 -0.4 35.5 61.7 26.2 57.4 59.9 2.5 57.5 61.3 3.8 58.0 

Mali 12.0 10.9 -1.1 9.7 12.2 2.5 11.4 12.4 1.0 11.1 13.2 2.1 11.5 

Mozambique 54.8 54.6 -0.2 27.7 66.1 38.4 55.0 54.1 -0.9 54.8 54.2 -0.6 54.7 Namibia 27.6 27.0 -0.6 3.3 40.3 37.0 25.2 29.4 4.2 22.8 38.8 16.0 27.3 

Niger 47.8 48.2 0.4 13.5 54.7 41.2 47.9 48.4 0.5 48.6 45.8 -2.8 48.0 

Nigeria 35.8 35.3 -0.5 27.3 39.2 11.9 35.8 34.0 -1.8 35.0 38.2 3.2 35.6 Rwanda 69.6 69.3 -0.3 42.3 73.1 30.8 68.8 71.0 2.2 68.9 74.2 5.3 69.5 

Senegal 15.9 15.5 -0.4 5.0 22.6 17.6 17.9 7.1 -10.8 15.6 15.9 0.3 15.7 

Tanzania 58.2 57.1 -1.1 35.2 63.4 28.2 57.4 58.3 0.9 57.2 59.5 2.3 57.6 

Uganda 70.4 70.3 -0.1 31.5 75.6 44.1 71.4 67.6 -3.8 70.1 71.7 1.6 70.3 Zambia 34.5 33.5 -1.0 14.2 43.8 29.6 34.1 33.6 -0.5 33.5 37.9 4.4 34.0 Zimbabwe 35.4 34.5 -0.9 8.3 44.1 35.8 34.0 36.1 2.1 33.6 41.0 7.4 34.9 

69 
Table 4.4. Percentage of children who live in households that do not have access to any sanitation facilities whatsoever in or near their 

homes, by country, sex of child, and region of residence as well as sex and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 68.1 66.2 -1.9 39.5 82.4 42.9 69.2 57.0 -12.2 66.2 72.8 6.6 67.2 Burkina Faso 67.6 65.4 -2.2 14.7 78.5 63.8 67.4 55.7 -11.7 66.2 68.2 2.0 66.5 Burundi 2.8 2.7 -0.1 1.8 2.9 1.1 2.5 3.8 1.3 2.7 3.1 0.4 2.8 Cameroon 7.7 8.1 0.4 1.7 12.7 11.0 8.7 4.9 -3.8 7.6 8.9 1.3 7.9 Chad 72.3 72.3 0.0 17.4 85.4 68.0 72.1 73.5 1.4 72.3 72.5 0.2 72.3 Ethiopia 40.1 39.0 -1.1 18.1 43.3 25.2 39.4 40.2 0.8 39.7 38.7 -1.0 39.6 Ghana 26.6 24.0 -2.6 7.9 37.0 29.1 29.1 16.6 -12.5 24.1 31.2 7.1 25.3 Guinea 27.6 27.4 -0.2 2.6 37.3 34.7 26.9 31.7 4.8 28.7 23.9 -4.8 27.5 Kenya 17.9 16.2 -1.7 1.5 19.8 18.3 16.2 18.8 2.6 16.3 21.8 5.5 17.1 Lesotho 40.3 39.3 -1.0 5.8 48.4 42.6 40.7 38.1 -2.6 39.0 42.4 3.4 39.8 

Liberia 56.4 53.8 -2.6 29.0 70.3 41.3 56.2 52.8 -3.4 54.9 56.8 1.9 55.1 Madagascar 46.3 46.4 0.1 12.1 51.0 38.9 45.6 49.7 4.1 45.7 51.9 6.2 46.3 

Malawi 10.4 10.1 -0.3 2.8 11.5 8.7 8.6 14.9 6.3 10.1 11.5 1.4 10.3 Mali 20.0 19.0 -1.0 6.8 24.6 17.8 19.4 20.3 0.9 19.1 21.6 2.5 19.5 Mozambique 40.2 40.3 0.1 14.8 50.9 36.1 40.7 39.4 -1.3 40.7 36.8 -3.9 40.3 Namibia 59.7 58.8 -0.9 17.0 82.0 65.0 55.2 63.3 8.1 52.6 75.8 23.2 59.3 Niger 80.5 80.6 0.1 19.2 92.7 73.5 79.8 84.7 4.9 80.3 81.3 1.0 80.5 

Nigeria 31.9 30.4 -1.5 11.8 39.9 28.1 30.7 34.4 3.7 30.5 34.4 3.9 31.2 Rwanda 1.3 1.1 -0.2 0.9 1.2 0.3 0.9 2.0 1.1 1.1 1.5 0.4 1.2 Senegal 18.7 18.7 0.0 1.8 29.5 27.7 21.0 10.0 -11.0 19.7 16.8 -2.9 18.7 

Tanzania 17.7 16.9 -0.8 2.3 21.1 18.8 16.7 19.6 2.9 16.7 19.8 3.1 17.3 Uganda 9.7 10.4 0.7 2.0 11.1 9.1 9.2 12.1 2.9 9.8 11.5 1.7 10.0 Zambia 24.1 24.8 0.7 1.9 35.5 33.6 23.0 29.7 6.7 23.8 29.2 5.4 24.4 Zimbabwe 31.8 31.4 -0.4 1.6 41.8 40.2 31.8 31.3 -0.5 31.3 33.0 1.7 31.6 

70 
71 

11.0

8.1

67.8

26.3

17.6

56.4

13.6

27.6

45.2

14.4

20.8

49.7

5.4

4.2

15.9

9.5

1.4

23.8

62.9

1.3

27.7

13.1

21.6

10.8

10.8

7.7

66.8

25.6

19.3

55.1

12.5

27.0

44.4

13.4

20.0

48.7

5.5

4.0

16.1

9.0

1.4

22.6

63.7

1.1

26.1

13.0

21.3

10.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.1. Percentage of children who live in households that use surface water, 

by country and the child's sex

Male Female
72 

5.5

0.8

14.7

11.8

3.9

8.1

2.7

3.7

6.2

5.0

1.0

7.1

1.8

0.9

3.2

0.4

0.1

7.1

30.7

0.1

8.8

1.9

1.1

0.9

13.8

9.5

71.8

36.8

21.9

63.9

20.0

36.5

51.4

16.0

31.4

54.9

6.0

5.4

21.3

13.9

1.7

30.3

67.6

1.9

31.5

14.6

31.3

14.0

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.2. Percentage of children who live in households that use surface water, 

by country and region of residence

Urban Rural
73 

11.7

7.9

67.3

25.7

17.9

57.5

15.2

28.4

44.0

14.7

22.9

50.5

5.6

4.1

17.4

9.0

1.4

22.8

62.5

1.4

27.3

13.1

22.5

11.2

6.5

7.6

67.3

27.0

21.5

48.3

8.3

20.0

46.4

12.2

14.9

43.1

5.0

4.4

13.1

9.5

1.4

26.1

65.2

0.3

25.4

12.9

17.8

10.2

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.3. Percentage of children who live in households that use surface water,

by country and the sex of the household head

Male Female
74 

10.6

8.1

67.2

25.2

18.5

55.6

13.2

27.0

44.3

13.6

20.5

49.1

5.5

3.9

15.6

7.3

1.2

22.5

63.1

1.2

26.8

12.8

21.2

10.4

12.4

6.8

68.0

29.1

18.2

56.2

12.7

28.2

47.7

14.5

20.0

50.3

5.4

5.0

18.7

14.0

2.1

26.8

65.3

1.3

27.2

14.3

23.2

12.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.4. Percentage of children who live in households that use surface water,

by country and the age of the household head

Less than 50 yo 50 yo or more
75 

12.3 13.7

29.4 27.8

21.7

52.4

8.0

58.2

11.9

4.9

10.9

7.9

26.0

55.7

13.1

44.8

13.9

49.2

5.4 4.1

-1.5

-5.8

-3.4

27.9

-8.6 -7.6

5.8

-9.0

-6.4

-0.7

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 4.5. Changes in the percentage of children who live in households 

that use surface water

Year 1 Year 2 Comparison Year 2-Year1

20012006

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

20032010

15.4

7.5

23.0

52.2

1.1

25.0

11.7

19.4

3.1

16.0

9.2

23.2

63.3

1.2

26.9

13.0

21.5

10.7

0.6 1.7 0.2

11.1

0.1

1.8 1.3 2.0

7.6

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 4.6. Changes in the percentage of children who live in households 

that use surface water

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
76 

34.8

44.3

61.6

40.2

56.0

69.8

29.4

35.5

48.7

39.6

14.2

18.7

58.2

12.0

54.8

27.6

47.8

35.8

69.6

15.9

58.2

70.4

34.5

35.4

33.6

43.1

63.1

39.7

58.3

69.1

28.5

35.4

48.1

39.3

14.4

19.3

57.8

10.9

54.6

27.0

48.2

35.3

69.3

15.5

57.1

70.3

33.5

34.5

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.7. Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and the child's sex

Male Female
77 

22.0

27.9

25.9

29.1

43.3

31.3

15.2

24.3

13.8

16.7

18.2

10.5

35.5

9.7

27.7

3.3

13.5

27.3

42.3

5.0

35.2

31.5

14.2

8.3

40.9

47.4

65.8

48.3

59.0

76.0

38.2

38.4

54.3

45.2

12.1

20.2

61.7

12.2

66.1

40.3

54.7

39.2

73.1

22.6

63.4

75.6

43.8

44.1

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.8. Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and region of residence

Urban Rural
78 

34.7

44.2

62.5

40.4

56.9

70.3

31.9

35.3

47.6

39.3

14.8

18.7

57.4

11.4

55.0

25.2

47.9

35.8

68.8

17.9

57.4

71.4

34.1

34.0

31.5

38.2

61.9

38.4

58.7

66.1

22.4

36.6

50.0

39.7

13.2

20.3

59.9

12.4

54.1

29.4

48.4

34.0

71.0

7.1

58.3

67.6

33.6

36.1

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.9. Percentage of children who live in households that are more than a 15-minute 

walk to the water source, by country and the sex of the household head

Male Female
79 

34.0

44.2

62.1

39.3

57.4

69.2

28.6

35.4

47.3

38.3

14.4

18.7

57.5

11.1

54.8

22.8

48.6

35.0

68.9

15.6

57.2

70.1

33.5

33.6

35.4

41.5

65.2

42.5

55.0

71.0

30.9

35.8

54.5

42.9

13.9

21.5

61.3

13.2

54.2

38.8

45.8

38.2

74.2

15.9

59.5

71.7

37.9

41.0

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.10. Percentage of children who live in households that are more than 

a 15-minute walk to the water source, by country and the age of the household head

Less than 50 yo 50 yo or more
80 

30.4

47.3

38.6

60.0

37.5

62.0

55.2

26.5

59.1

29.9

34.2

43.7

40.0

69.5

29.0

48.4

39.5

19.0

58.0

11.5

3.8

-3.5

1.4

9.5

-8.5

-13.6 -15.7

-7.5

-1.0

-18.5

-30.0

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 4.11. Changes in the percentage of children who had more than a 15-minute walk 

to the water source

Year 1 Year 2 Comparison Year 2-Year1

2001200620032010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

60.4

37.3

52.9

65.6

43.8

61.0

80.3

40.8 42.9

54.7

27.3

35.6

69.5

15.7

57.6

70.3

34.0 34.9

-5.7

-10.0

-17.3

3.9

-28.1

-3.3

-10.0

-6.8 -8.0

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 4.12. Changes in the percentage of children who had more than a 15-minute walk 

to the water source

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
81 

68.1

67.6

2.8

7.7

72.3

40.1

26.6

27.6

17.9

40.3

56.4

46.3

10.4

20.0

40.2

59.7

80.5

31.9

1.3

18.7

17.7

9.7

24.1

31.8

66.2

65.4

2.7

8.1

72.3

39.0

24.0

27.4

16.2

39.3

53.8

46.4

10.1

19.0

40.3

58.8

80.6

30.4

1.1

18.7

16.9

10.4

24.8

31.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.13. Percentage of children who live in households that do not have access to any 

sanitation facilities whatsoever in or near their homes, by country and the child's sex

Male Female
82 

39.5

14.7

1.8

1.7

17.4

18.1

7.9

2.6

1.5

5.8

29.0

12.1

2.8

6.8

14.8

17.0

19.2

11.8

0.9

1.8

2.3

2.0

1.9

1.6

82.4

78.5

2.9

12.7

85.4

43.3

37.0

37.3

19.8

48.4

70.3

51.0

11.5

24.6

50.9

82.0

92.7

39.9

1.2

29.5

21.1

11.1

35.5

41.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.14. Percentage of children who live in households that do not have access to 

any sanitation facilities whatsoever in or near their homes,

by country and region of residence

Urban Rural
83 

69.2

67.4

2.5

8.7

72.1

39.4

29.1

26.9

16.2

40.7

56.2

45.6

8.6

19.4

40.7

55.2

79.8

30.7

0.9

21.0

16.7

9.2

23.0

31.8

57.0

55.7

3.8

4.9

73.5

40.2

16.6

31.7

18.8

38.1

52.8

49.7

14.9

20.3

39.4

63.3

84.7

34.4

2.0

10.0

19.6

12.1

29.7

31.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.15. Percentage of children who live in households that do not have access to 

any sanitation facilities whatsoever in or near their homes,

by country and the sex of the household head

Male Female
84 

66.2

66.2

2.7

7.6

72.3

39.7

24.1

28.7

16.3

39.0

54.9

45.7

10.1

19.1

40.7

52.6

80.3

30.5

1.1

19.7

16.7

9.8

23.8

31.3

72.8

68.2

3.1

8.9

72.5

38.7

31.2

23.9

21.8

42.4

56.8

51.9

11.5

21.6

36.8

75.8

81.3

34.4

1.5

16.8

19.8

11.5

29.2

33.0

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 4.16. Percentage of children who live in households that do not have access to 

any sanitation facilities whatsoever in or near their homes, 

by country and the age of the household head

Less than 50 yo 50 yo or more
85 

69.2 71.7

7.5

64.0

27.9

20.9

46.7

49.9

14.7

20.8

67.2 66.5

7.9

39.6

25.3

17.1

39.8

46.3

10.3

19.5

-2.0

-5.1

0.4

-24.5

-2.6 -3.8

-6.9

-3.5 -4.5

-1.3

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 4.17. Changes in the percentage of children who did not have access 

to any sanitation facilities whatsoever in or near their homes

Year 1 Year 2 Comparison Year 2-Year1

200120062003201020042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

47.2

62.4

24.5

3.3

23.9

15.0

12.0

27.3

35.9

40.3

59.3

31.2

1.2

18.7 17.3

10.0

24.4

31.6

-6.9

-3.2

6.6

-2.1

-5.2

2.3

-1.9 -2.9 -4.3

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 4.18. Changes in the percentage of children who did not have access

to any sanitation facilities whatsoever in or near their homes

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-052005-062010-11

201020062011

2001-2

2006-07

2000

2006-07
86 

Map 4.1 Percentage of children who live in 

households that use surface water 

Map 4.2 Percentage of children who live in 

households that are more than a 15-minute walk 

to the water source 

Map 4.3 Percentage of children who live in 

households that do not have access to any 

sanitation facilities whatsoever in or near their 

homes 
87 

5 Shelter Deprivation 

This chapter focuses on two household characteristics: dwellings with mud floors and homes that 

do not have electricity. The analyses included data on children up to 17 years of age. 

5.1 Living in Houses with Mud Floors 

The growing number and size of slums worldwide demonstrates that the slums are crucial 

elements of contemporary urbanization in developing countries (Morakinyo et al., 2012). Over 640 

million children in the developing world live in overcrowded homes or dwellings with mud floors 

(UNICEF, 2005). Researchers have found an association in sub-Saharan Africa between living in houses 

with mud floors and health and nutritional problems. Dumba et al. (2008) found in the Luweero district of 

Uganda that, among children under age 5, living in a house with a mud floor was associated with the risk 

of having helminth infection. Ainsworth and Semali (2000), studying children under the age of 60 months 

in the Kagera region of Tanzania, found an association between a recent adult death in households with a 

dirt floor and substantially higher child morbidity. Ainsworth and Semali also found that better housing 

(e.g., having a concrete, tiled, or wooden floor instead of a dirt floor) was the only household-level 

socioeconomic variable with a strongly positive relationship to children’s weight-for-height. Children in 

households with concrete, wood, or tile floors had weight-for-height z-scores 0.2 SD higher than children 

in households with dirt floors. Finally, a recent study by Mohammed and Tamiru (2013) in Arba Minch 

Zuria, southern Ethiopia, found that children under five years old living in houses with mud floors were 

more likely to have diarrhea than their counterparts living in houses with cement floors. 

In sub-Saharan Africa the percentage of children under 18 years of age who lived in houses with 

mud floors was very inconsistent, from 16% in Madagascar to 95% in Chad (see Map 5.1). In Burundi 

and Ethiopia 9 of every 10 children lived in a house with mud floors (see Table 5.1). Three of every four 

children lived in houses with mud floors in Malawi, Mali, Niger, Tanzania, and Uganda. More than half 

of children in Burkina Faso, Guinea, Kenya, Liberia, Mozambique, Namibia, and Zambia, as well, lived 

in houses with mud floors. 

Sex and geographic disparities 

Generally, there were no child sex disparities related to living in a house with a mud floor (see 

Figure 5.1). However, in four countries—Cameroon, Kenya, Liberia, and Tanzania—the percentage of 

children living in houses with mud floors was about 2 percentage points higher for boys than girls (see 

Table 5.1). 

In every country the percentage of children living in houses with mud floors was higher in rural 

areas than in urban areas (see Figure 5.2). This disparity reached more than 60 percentage points in 

Guinea, Kenya, Liberia, and Namibia, and in Zambia the difference was 70 percentage points. In Burkina 

Faso, Burundi, Cameroon, Malawi, Niger, Tanzania, and Uganda as well, the difference exceeded 50 

percentage points (see Table 5.1). 

The role of the household head’s sex and age 

In two-thirds of these sub-Saharan African countries, the percentage of children living in houses 

with mud floors was higher for children living with a male rather than a female head of household (see 

Figure 5.3). This difference was about 15 percentage points in four countries—Burkina Faso (male 

household head: 60% and female household head: 44%), Guinea (56% and 40%), Nigeria (43% and 

28%), and Senegal (41% and 22%) (see Table 5.1). The inverse appeared in Namibia, where the 

percentage of children living in a house with mud floors was nearly 10 percentage points higher for 
88 

children living with a female household head than for children living in a male headed household (61% 

compared with 51%). 

In three countries the percentage of children living in houses with mud floors was much higher 

for children living with a household head at least 50 years old than for children living with a younger 

household head—Namibia (difference of 28 percentage points), Lesotho (17 percentage points), and 

Zambia (11 percentage points) (see Figure 5.4 and Table 5.1). 

Variations during the last 13 years 

Ghana (3 percentage points), Nigeria (4 percentage points), and Zambia (3 percentage points) 

experienced an increase on the percentage of children living in houses with mud flooring (see Figures 5.5 

and 5.6). In the other countries the percentage of children living in houses with mud floors decreased. As 

for changes by age group, in Zambia the percentage among children five to nine years old increased by 7 

percentage points (2001-02: 59% and 2007: 66%). In contrast, among those ages 15-17, the percentage 

decreased by 7 percentage points (2001-02: 57% and 2007: 50%) (see Table 5.2). Overall, Mozambique 

experienced the greatest decrease, from 72% in 2003 to 56% in 2011, a reduction of 15 percentage points. 

5.2 Living in Houses without Electricity 

Today, 1.3 billion people in the world do not have access to electricity (United Nations 

Foundation, 2013). According to the International Energy Agency, more than four-fifths of these people 

live in rural areas, and more than 95% live in sub-Saharan Africa or developing areas in Asia (United 

Nations Foundation, 2013). The use of clean fuels such as gas and electricity for cooking—instead of 

biomass fuels, charcoal, and kerosene—is crucial to reduce important health risks affecting developing 

countries, such as respiratory diseases (acute respiratory infections, chronic obstructive pulmonary 

disease, tuberculosis, and asthma), low birth weight, cataracts, and blindness (Bruce et al., 2000; 

Kilabuko and Nakai, 2007). A study using DHS data from six francophone countries in Central and West 

sub-Saharan Africa suggested that the most important contributors to the rural-urban gap in infant 

mortality rates are environmental factors such as lack of electricity, an unsafe source of drinking water, 

and the poor quality of housing materials (van de Poel et al., 2009). The impact of these disadvantageous 

environmental conditions on infant mortality rates in rural areas reflects a lack of community-level 

infrastructure and the inability of some households to exploit the infrastructure when available. 

The United Nations (2013) has identified five areas in which promoting electricity in developing 

countries is crucial: 

• Education: Electricity provides heating, cooling, and lighting so students can learn. Schools 

can stay open later and provide a space for students to study and for teachers to prepare. 

• Health care: Health care workers and facilities need electricity to refrigerate vaccines, 

sterilize instruments, and power equipment and to provide light for procedures that cannot 

wait until daytime (e.g., when a pregnant woman goes into labor at night). 

• Business: Businesses need electricity for lighting, to run machinery, and to power 

communications technologies. 

• Agriculture: Electricity enables farmers to increase efficiency in the production, processing, 

and storage of crops. 

• Communities: Electricity helps strengthen communities. For example, lighting makes 

communities safer at night, and electricity can pump and filter water to provide clean 

drinking water. 
89 

In sub-Saharan Africa the percentage of children living in houses without electricity was very 

high (see Map 5.2)—above 75% in the majority of countries. Nine of every 10 children lived in houses 

without electricity in Burkina Faso, Burundi, Chad, Liberia, Malawi, Niger, Rwanda, and Uganda. Only 

two countries, Ghana and Senegal, had rates below 50% (see Table 5.3). 

Sex and geographic disparities 

There was no sex disparities related to having electric power at home (see Figure 5.7). In every 

country, however, a higher percentage of rural children than urban children live in houses without 

electricity (see Figure 5.10). This discrepancy was greatest—about 75 percentage point—in Ethiopia and 

Zimbabwe. Liberia (a difference of 6 percentage points) had the smallest geographic disparity (see Table 

5.3). 

The role of the household head’s sex and age 

The sex of the household head mattered only in Senegal. The percentage of children living 

without electricity was 53% for children living with a male household head and 27% for their 

counterparts living with a female household head, a difference of 26 percentage points (see Figure 5.9 and 

Table 5.3). 

In Namibia and Uganda the percentage of children without electricity was much higher for 

individuals living with a household head age 50 or older than for children living with a younger 

household head (see Figure 5.10). In Namibia this difference reached 29 percentage points (58% and 

87%) (see Table 5.3). Zimbabwe exhibits the inverse pattern: 69% of children in households with heads 

younger than 50 years old lived in houses without electricity compared with 87% of children living with a 

younger household head—a difference of 19 percentage points. 

Variations during the last 13 years 

In most countries the percentage of children living in homes without electricity dropped between 

surveys—by about 10 percentage points in Ghana (2003: 59% and 2008: 48%), Lesotho (2004: 96% and 

2009: 86%), Mozambique (2003: 90% and 2011: 79%), and Senegal (2005: 58% and 2010-11: 48%) (see 

Table 5.2). In contrast, the percentage of children living in houses without electricity increased in 

Madagascar (2 percentage points more) and Nigeria (4 percentage points more) (see Figures 5.11 and 

5.12). 
Table 5.1. Percentage of children who live in houses with mud floors, by country, sex of the child, and region of residence as well as sex 

and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 45.0 44.2 -0.8 24.0 56.0 32.0 46.0 37.6 -8.4 43.7 49.7 6.0 44.6 Burkina Faso 59.3 57.8 -1.5 14.9 68.6 53.7 59.8 43.9 -15.9 58.3 59.9 1.6 58.6 Burundi 89.0 88.7 -0.3 38.3 93.6 55.3 89.2 87.7 -1.5 88.5 92.2 3.7 88.9 Cameroon 50.3 48.3 -2.0 18.9 72.9 54.0 50.2 46.0 -4.2 47.8 55.5 7.7 49.3 Chad 95.0 95.1 0.1 78.8 98.9 20.1 95.0 95.5 0.5 95.2 93.6 -1.6 95.0 Ethiopia 90.5 89.0 -1.5 54.6 95.8 41.2 90.6 86.5 -4.1 89.6 90.9 1.3 89.8 Ghana 19.0 17.2 -1.8 4.6 27.2 22.6 21.3 10.9 -10.4 17.4 21.4 4.0 18.1 

Guinea 54.1 54.5 0.4 9.6 71.8 62.2 56.4 40.0 -16.4 55.1 51.8 -3.3 54.3 Kenya 68.5 66.5 -2.0 14.1 76.9 62.8 67.1 68.5 1.4 66.2 75.5 9.3 67.6 Lesotho 39.8 38.0 -1.8 3.9 47.7 43.8 38.4 39.8 1.4 34.8 51.3 16.5 38.9 Liberia 55.2 52.9 -2.3 15.8 76.3 60.5 56.0 49.6 -6.4 54.0 54.5 0.5 54.0 Madagascar 16.0 16.1 0.1 8.3 17.1 8.8 16.3 15.1 -1.2 16.4 13.3 -3.1 16.1 Malawi 77.8 78.2 0.4 32.4 85.6 53.2 76.7 81.8 5.1 77.8 79.6 1.8 78.0 Mali 76.5 75.1 -1.4 43.9 88.5 44.6 76.4 70.0 -6.4 75.1 78.8 3.7 75.8 Mozambique 56.8 55.8 -1.0 31.8 66.5 34.7 57.3 54.3 -3.0 56.5 55.0 -1.5 56.3 Namibia 56.2 55.9 -0.3 16.3 77.3 61.0 51.1 61.0 9.9 48.2 75.7 27.5 56.0 Niger 88.2 87.6 -0.6 40.8 97.3 56.5 87.5 90.6 3.1 87.4 90.0 2.6 88.0 Nigeria 41.3 40.2 -1.1 12.3 53.6 41.3 42.6 28.4 -14.2 40.4 42.6 2.2 40.8 

Rwanda 82.3 82.9 0.6 43.8 87.8 44.0 81.7 84.7 3.0 82.3 85.4 3.1 82.6 Senegal 37.4 36.5 -0.9 14.4 51.4 37.0 40.8 22.2 -18.6 37.1 36.8 -0.3 37.0 

Tanzania 73.2 71.3 -1.9 25.3 84.3 59.0 71.5 74.8 3.3 71.0 77.8 6.8 72.2 Uganda 75.9 74.9 -1.0 24.3 82.4 58.1 76.3 73.1 -3.2 74.9 79.0 4.1 75.4 Zambia 63.8 63.1 -0.7 16.5 86.5 70.0 62.8 65.9 3.1 62.2 72.7 10.5 63.5 Zimbabwe 33.4 33.8 0.4 2.3 44.3 42.0 36.6 30.1 -6.5 33.5 34.3 0.8 33.6 

90 
Table 5.2. Percentage of children who live in houses with mud floors or without electricity, by country, child's age, and year of data 

collection

Child's age Data collection House with mud flooring House without electricity 

Country Value 1 Year 2 Year Year 1 Year 2 

Comparison 

Year 2-Year1 Year 1 Year 2 

Comparison 

Year 2-Year1 

Burkina Faso 0-17 2003 2010 62.0 58.6 -3.4 91.4 90.4 -1.0 Burkina Faso 0- 4 2003 2010 64.3 59.4 -4.8 93.2 91.6 -1.7 

Burkina Faso 5- 9 2003 2010 64.1 60.0 -4.1 92.7 92.0 -0.7 Burkina Faso 10-14 2003 2010 59.6 57.8 -1.8 90.1 89.5 -0.6 Burkina Faso 15-17 2003 2010 56.4 53.3 -3.1 86.4 84.0 -2.4 Cameroon 0-17 2004 2011 53.6 49.3 -4.3 57.0 52.0 -5.0 

Cameroon 0- 4 2004 2011 56.9 49.9 -7.0 59.8 53.6 -6.1 

Cameroon 5- 9 2004 2011 56.5 51.8 -4.7 60.6 55.3 -5.4 

Cameroon 10-14 2004 2011 51.6 49.2 -2.4 55.0 50.4 -4.6 Cameroon 15-17 2004 2011 43.5 41.8 -1.6 46.5 42.8 -3.7 Ethiopia 0-17 2005 2011 93.1 89.8 -3.3 90.5 84.3 -6.1 Ethiopia 0- 4 2005 2011 94.7 91.1 -3.6 92.7 86.4 -6.3 

Ethiopia 5- 9 2005 2011 93.8 91.0 -2.8 92.1 86.3 -5.7 

Ethiopia 10-14 2005 2011 92.8 88.1 -4.7 89.7 82.8 -6.9 

Ethiopia 15-17 2005 2011 88.0 87.2 -0.7 82.5 77.8 -4.7 

Ghana 0-17 2003 2008 15.2 18.1 2.9 59.2 47.6 -11.5 Ghana 0- 4 2003 2008 16.6 19.0 2.4 64.0 49.9 -14.1 

Ghana 5- 9 2003 2008 16.0 19.4 3.4 61.4 50.1 -11.3 

Ghana 10-14 2003 2008 14.3 16.9 2.6 56.7 45.2 -11.6 Ghana 15-17 2003 2008 11.8 15.9 4.0 48.0 42.2 -5.8 Kenya 0-17 2003 2008-09 71.1 67.6 -3.6 90.3 85.9 -4.3 

Kenya 0- 4 2003 2008-09 72.0 68.1 -3.8 89.5 85.6 -3.9 

(Continued...) 

91 
Table 5.2. – Continued

Child's age Data collection House with mud flooring House without electricity 

Country Value 1 Year 2 Year Year 1 Year 2 

Comparison 

Year 2-Year1 Year 1 Year 2 

Comparison 

Year 2-Year1 

Kenya 5- 9 2003 2008-09 72.1 66.9 -5.1 90.3 86.2 -4.0 Kenya 10-14 2003 2008-09 71.3 68.6 -2.6 91.5 86.3 -5.2 

Kenya 15-17 2003 2008-09 66.8 65.3 -1.5 89.5 85.2 -4.3 

Lesotho 0-17 2004 2009 43.1 38.9 -4.2 95.6 86.4 -9.2 

Lesotho 0- 4 2004 2009 47.0 40.4 -6.6 96.4 87.5 -9.0 

Lesotho 5- 9 2004 2009 45.1 40.9 -4.3 96.3 86.6 -9.8 

Lesotho 10-14 2004 2009 41.0 38.7 -2.2 95.2 86.4 -8.8 

Lesotho 15-17 2004 2009 38.1 33.9 -4.2 94.0 84.6 -9.5 

Madagascar 0-17 2003-04 2008-09 18.2 16.1 -2.2 84.5 86.4 1.9 

Madagascar 0- 4 2003-04 2008-09 18.4 17.0 -1.4 87.2 88.5 1.3 

Madagascar 5- 9 2003-04 2008-09 18.7 16.5 -2.2 85.2 87.7 2.5 Madagascar 10-14 2003-04 2008-09 18.7 15.2 -3.5 82.9 85.0 2.1 

Madagascar 15-17 2003-04 2008-09 15.2 14.5 -0.7 78.6 81.5 2.9 

Malawi 0-17 2004 2010 79.6 78.0 -1.5 93.4 92.0 -1.4 

Malawi 0- 4 2004 2010 82.4 80.8 -1.6 94.6 92.9 -1.7 Malawi 5- 9 2004 2010 80.4 78.9 -1.5 93.9 92.7 -1.2 

Malawi 10-14 2004 2010 77.6 76.5 -1.0 92.4 91.5 -0.9 Malawi 15-17 2004 2010 73.3 71.8 -1.5 90.7 88.5 -2.2 Mali 0-17 2001 2006 79.9 75.8 -4.1 88.0 83.6 -4.4 

Mali 0- 4 2001 2006 81.6 76.3 -5.3 89.5 84.5 -5.1 

Mali 5- 9 2001 2006 82.4 77.4 -5.0 89.7 85.3 -4.4 

Mali 10-14 2001 2006 78.0 75.3 -2.7 86.7 82.8 -3.9 

Mali 15-17 2001 2006 70.7 71.0 0.4 81.0 78.3 -2.8 

(Continued...) 

92 
Table 5.2. – Continued

Child's age Data collection House with mud flooring House without electricity 

Country Value 1 Year 2 Year Year 1 Year 2 

Comparison 

Year 2-Year1 Year 1 Year 2 

Comparison 

Year 2-Year1 

Mozambique 0-17 2003 2011 71.7 56.3 -15.4 89.7 78.7 -11.0 

Mozambique 0- 4 2003 2011 74.4 58.5 -15.9 91.7 81.2 -10.5 Mozambique 5- 9 2003 2011 74.5 57.5 -16.9 91.3 80.6 -10.7 Mozambique 10-14 2003 2011 70.1 54.8 -15.3 88.3 76.8 -11.6 Mozambique 15-17 2003 2011 59.3 49.9 -9.4 82.5 70.6 -11.8 Namibia 0-17 2000 2006-07 64.8 56.0 -8.8 73.3 66.3 -7.0 

Namibia 0- 4 2000 2006-07 63.0 54.9 -8.1 73.8 67.9 -6.0 

Namibia 5- 9 2000 2006-07 65.3 56.1 -9.3 73.3 65.9 -7.4 

Namibia 10-14 2000 2006-07 67.1 58.4 -8.7 73.8 66.7 -7.1 

Namibia 15-17 2000 2006-07 63.0 53.5 -9.5 70.6 63.0 -7.6 

Nigeria 0-17 2003 2008 36.9 40.8 3.9 50.3 54.5 4.3 

Nigeria 0- 4 2003 2008 38.9 42.3 3.4 51.1 55.3 4.3 Nigeria 5- 9 2003 2008 39.0 42.5 3.5 52.7 56.3 3.6 Nigeria 10-14 2003 2008 34.0 39.4 5.4 48.6 53.2 4.6 

Nigeria 15-17 2003 2008 32.1 34.1 2.0 45.6 49.9 4.3 

Rwanda 0-17 2005 2010 86.3 82.6 -3.7 95.4 91.2 -4.2 

Rwanda 0- 4 2005 2010 87.4 84.5 -2.9 95.7 92.0 -3.7 

Rwanda 5- 9 2005 2010 86.4 83.4 -3.1 95.4 91.8 -3.6 

Rwanda 10-14 2005 2010 86.0 81.7 -4.3 95.6 90.7 -4.9 

Rwanda 15-17 2005 2010 84.2 78.1 -6.1 94.1 88.9 -5.2 

Senegal 0-17 2005 2010-11 37.4 37.0 -0.4 57.8 47.8 -9.9 

Senegal 0- 4 2005 2010-11 38.7 37.4 -1.3 60.0 49.1 -10.9 

(Continued...) 

93 
Table 5.2. – Continued

Child's age Data collection House with mud flooring House without electricity 

Country Value 1 Year 2 Year Year 1 Year 2 

Comparison 

Year 2-Year1 Year 1 Year 2 

Comparison 

Year 2-Year1 

Senegal 5- 9 2005 2010-11 40.4 39.0 -1.4 61.0 50.5 -10.5 Senegal 10-14 2005 2010-11 36.0 36.2 0.2 56.0 46.5 -9.5 

Senegal 15-17 2005 2010-11 31.0 32.4 1.4 49.1 40.1 -9.0 

Tanzania 0-17 2004-05 2010 77.1 72.2 -4.8 91.1 88.7 -2.4 Tanzania 0- 4 2004-05 2010 79.1 74.7 -4.5 92.4 90.1 -2.3 Tanzania 5- 9 2004-05 2010 78.0 74.0 -4.0 91.4 90.3 -1.1 Tanzania 10-14 2004-05 2010 76.0 71.3 -4.8 90.6 88.2 -2.4 

Tanzania 15-17 2004-05 2010 71.2 63.5 -7.7 87.5 81.9 -5.6 

Uganda 0-17 2006 2011 80.3 75.4 -4.9 93.6 90.8 -2.8 

Uganda 0- 4 2006 2011 83.0 75.6 -7.4 94.1 89.9 -4.2 Uganda 5- 9 2006 2011 81.6 76.5 -5.1 94.6 91.4 -3.2 Uganda 10-14 2006 2011 78.7 75.8 -2.9 93.4 92.3 -1.1 

Uganda 15-17 2006 2011 72.9 70.9 -2.0 90.0 88.4 -1.6 

Zambia 0-17 2001-02 2007 60.9 63.5 2.6 80.3 81.0 0.8 Zambia 0- 4 2001-02 2007 65.9 68.9 3.1 84.4 85.2 0.8 

Zambia 5- 9 2001-02 2007 59.0 66.0 7.0 78.7 82.4 3.6 

Zambia 10-14 2001-02 2007 58.7 59.5 0.8 78.4 78.4 0.0 Zambia 15-17 2001-02 2007 56.7 50.1 -6.6 77.1 71.1 -6.0 Zimbabwe 0-17 2005-06 2010-11 38.3 33.6 -4.7 71.8 71.8 0.0 Zimbabwe 0- 4 2005-06 2010-11 39.8 34.2 -5.7 70.8 70.5 -0.3 

Zimbabwe 5- 9 2005-06 2010-11 39.6 35.4 -4.2 72.5 73.0 0.6 Zimbabwe 10-14 2005-06 2010-11 38.8 33.9 -4.9 74.0 74.2 0.2 Zimbabwe 15-17 2005-06 2010-11 31.0 27.6 -3.3 67.4 67.1 -0.4 

94 
Table 5.3. Percentage of children who live in houses without electricity, by country, sex of child, and region of residence as well as sex 

and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Burkina Faso 91.3 89.4 -1.9 53.9 98.9 45.0 91.2 81.0 -10.2 90.4 90.4 0.0 90.4 Burundi 94.9 94.6 -0.3 51.5 98.8 47.3 94.7 94.9 0.2 94.5 97.1 2.6 94.7 

Cameroon 52.2 51.8 -0.4 14.1 81.3 67.2 54.2 43.5 -10.7 49.8 60.8 11.0 52.0 Chad 95.9 96.0 0.1 80.2 99.7 19.5 95.8 97.1 1.3 96.0 96.1 0.1 96.0 Ethiopia 85.2 83.5 -1.7 19.8 95.5 75.7 86.1 77.1 -9.0 83.7 87.9 4.2 84.3 Ghana 48.8 46.4 -2.4 18.1 67.3 49.2 50.7 40.7 -10.0 46.1 55.0 8.9 47.6 Guinea 80.7 80.4 -0.3 39.1 96.8 57.7 80.8 78.6 -2.2 80.7 80.2 -0.5 80.5 Kenya 86.7 85.1 -1.6 40.1 93.9 53.8 84.6 88.6 4.0 84.6 94.1 9.5 85.9 

Lesotho 86.7 86.1 -0.6 52.5 94.9 42.4 85.8 87.6 1.8 85.0 90.6 5.6 86.4 

Liberia 97.1 96.5 -0.6 93.2 98.9 5.7 97.0 96.4 -0.6 96.5 98.9 2.4 96.8 Madagascar 86.8 86.1 -0.7 34.3 93.5 59.2 86.8 84.6 -2.2 86.5 86.3 -0.2 86.4 Malawi 91.8 92.1 0.3 65.2 96.4 31.2 90.9 95.0 4.1 91.5 95.0 3.5 92.0 

Mali 84.8 82.4 -2.4 52.6 96.0 43.4 84.4 76.1 -8.3 82.9 86.6 3.7 83.6 Mozambique 79.2 78.2 -1.0 42.5 93.8 51.3 79.4 77.3 -2.1 78.4 81.1 2.7 78.7 Namibia 66.5 66.0 -0.5 21.8 90.2 68.4 61.8 70.7 8.9 57.9 87.3 29.4 66.3 

Niger 90.6 90.4 -0.2 50.8 98.4 47.6 89.9 93.5 3.6 90.4 90.9 0.5 90.5 

Nigeria 54.9 54.1 -0.8 16.3 71.7 55.4 55.4 48.2 -7.2 54.1 56.8 2.7 54.5 Rwanda 91.1 91.3 0.2 57.4 95.7 38.3 90.4 93.3 2.9 90.7 95.8 5.1 91.2 

Senegal 48.4 47.3 -1.1 12.0 70.7 58.7 53.2 27.0 -26.2 48.1 47.3 -0.8 47.8 

Tanzania 89.2 88.1 -1.1 56.2 97.0 40.8 88.0 91.3 3.3 88.0 92.1 4.1 88.7 

Uganda 91.1 90.5 -0.6 51.8 96.1 44.3 90.7 91.0 0.3 90.2 95.1 4.9 90.8 

Zambia 81.3 80.7 -0.6 48.7 96.9 48.2 80.1 84.5 4.4 79.9 89.1 9.2 81.0 

Zimbabwe 72.7 71.0 -1.7 16.4 90.8 74.4 71.4 72.4 1.0 68.5 87.4 18.9 71.8 

95 
96 

45.0

59.3

89.0

50.3

95.0

90.5

19.0

54.1

68.5

39.8

55.2

16.0

77.8

76.5

56.8

56.2

88.2

41.3

82.3

37.4

73.2

75.9

63.8

33.4

44.2

57.8

88.7

48.3

95.1

89.0

17.2

54.5

66.5

38.0

52.9

16.1

78.2

75.1

55.8

55.9

87.6

40.2

82.9

36.5

71.3

74.9

63.1

33.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.1. Percentage of children who live in a house with mud flooring,

by country and the child's sex

Male Female
97 

24.0

14.9

38.3

18.9

78.8

54.6

4.6

9.6

14.1

3.9

15.8

8.3

32.4

43.9

31.8

16.3

40.8

12.3

43.8

14.4

25.3

24.3

16.5

2.3

56.0

68.6

93.6

72.9

98.9

95.8

27.2

71.8

76.9

47.7

76.3

17.1

85.6

88.5

66.5

77.3

97.3

53.6

87.8

51.4

84.3

82.4

86.5

44.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.2. Percentage of children who live in a house with mud flooring,

by country and region of residence

Urban Rural
98 

46.0

59.8

89.2

50.2

95.0

90.6

21.3

56.4

67.1

38.4

56.0

16.3

76.7

76.4

57.3

51.1

87.5

42.6

81.7

40.8

71.5

76.3

62.8

36.6

37.6

43.9

87.7

46.0

95.5

86.5

10.9

40.0

68.5

39.8

49.6

15.1

81.8

70.0

54.3

61.0

90.6

28.4

84.7

22.2

74.8

73.1

65.9

30.1

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.3. Percentage of children who live in a house with mud flooring,

by country and the sex of the household head

Male Female
99 

43.7

58.3

88.5

47.8

95.2

89.6

17.4

55.1

66.2

34.8

54.0

16.4

77.8

75.1

56.5

48.2

87.4

40.4

82.3

37.1

71.0

74.9

62.2

33.5

49.7

59.9

92.2

55.5

93.6

90.9

21.4

51.8

75.5

51.3

54.5

13.3

79.6

78.8

55.0

75.7

90.0

42.6

85.4

36.8

77.8

79.0

72.7

34.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.4. Percentage of children who live in a house with mud flooring,

by country and the age of the household head

Less than 50 yo 50 yo or more
100 

62.0

53.6

93.1

15.2

71.1

43.1

18.2

79.6 79.9

58.6

49.3

89.8

18.1

67.6

38.9

16.1

78.0 75.8

-3.4 -4.3 -3.3

2.9

-3.6 -4.2 -2.2 -1.5

-4.1

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 5.5. Changes in the percentage of children who live in a house with mud flooring

Year 1 Year 2 Comparison Year 2-Year1

20032010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

71.7

64.8

36.9

86.3

37.4

77.1

80.3

60.9

38.3

56.3 56.0

40.8

82.6

37.0

72.2

75.4

63.5

33.6

-15.4

-8.8

3.9

-3.7

-0.4

-4.8 -4.9

2.6

-4.7

-40.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 5.6. Changes in the percentage of children who live in a house with mud flooring

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
101 

91.3

94.9

52.2

95.9

85.2

48.8

80.7

86.7

86.7

97.1

86.8

91.8

84.8

79.2

66.5

90.6

54.9

91.1

48.4

89.2

91.1

81.3

72.7

89.4

94.6

51.8

96.0

83.5

46.4

80.4

85.1

86.1

96.5

86.1

92.1

82.4

78.2

66.0

90.4

54.1

91.3

47.3

88.1

90.5

80.7

71.0

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.7. Percentage of children who live in a house without electricity,

by country and the child's sex 

Male Female
102 

53.9

51.5

14.1

80.2

19.8

18.1

39.1

40.1

52.5

93.2

34.3

65.2

52.6

42.5

21.8

50.8

16.3

57.4

12.0

56.2

51.8

48.7

16.4

98.9

98.8

81.3

99.7

95.5

67.3

96.8

93.9

94.9

98.9

93.5

96.4

96.0

93.8

90.2

98.4

71.7

95.7

70.7

97.0

96.1

96.9

90.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.8. Percentage of children who live in a house without electricity,

by country and region of residence

Urban Rural
103 

91.2

94.7

54.2

95.8

86.1

50.7

80.8

84.6

85.8

97.0

86.8

90.9

84.4

79.4

61.8

89.9

55.4

90.4

53.2

88.0

90.7

80.1

71.4

81.0

94.9

43.5

97.1

77.1

40.7

78.6

88.6

87.6

96.4

84.6

95.0

76.1

77.3

70.7

93.5

48.2

93.3

27.0

91.3

91.0

84.5

72.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.9. Percentage of children who live in a house without electricity,

by country and the sex of the household head

Male Female
104 

90.4

94.5

49.8

96.0

83.7

46.1

80.7

84.6

85.0

96.5

86.5

91.5

82.9

78.4

57.9

90.4

54.1

90.7

48.1

88.0

90.2

79.9

68.5

90.4

97.1

60.8

96.1

87.9

55.0

80.2

94.1

90.6

98.9

86.3

95.0

86.6

81.1

87.3

90.9

56.8

95.8

47.3

92.1

95.1

89.1

87.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Burkina Faso

Burundi

Cameroon

Chad

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Tanzania

Uganda

Zambia

Zimbabwe

Figure 5.10. Percentage of children who live in a house without electricity,

by country and the age of the household head

Less than 50 yo 50 yo or more
105 

91.4

57.0

90.5

59.2

90.3

95.6

84.5

93.4

88.0 90.4

52.0

84.3

47.6

85.9 86.4 86.4

92.0

83.6

-1.0

-5.0 -6.1

-11.5

-4.3

-9.2

1.9

-1.4

-4.4

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

120.0

Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 5.11. Changes in the percentage of children who live in a house

without electricity 

Year 1 Year 2 Comparison Year 2-Year1

2002003

2010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

89.7

73.3

50.3

95.4

57.8

91.1 93.6

80.3

71.8

78.7

66.3

54.5

91.2

47.8

88.7 90.8

81.0

71.8

-11.0

-7.0

4.3

-4.2

-9.9

-2.4 -2.8

0.8 0.0

-20.0

0.0

20.0

40.0

60.0

80.0

100.0

120.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 5.12. Changes in the percentage of children who live in a house 

without electricity 

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
106 

Map 5.1 Percentage of children who live in 

houses with mud floors 

Map 5.2 Percentage of children who live in 

houses without electricity 
107 

6 Education Deprivation 

In sub-Saharan Africa education is crucial to poverty reduction; improvement in gender equality, 

health, and nutrition; reductions in infant and child mortality; and decreases in the prevalence of 

HIV/AIDS (Bhargave, 2005; Bloom and Canning, 2004; Fotso et al., 2009). Studies have found that food 

insecurity adversely affects academic performance among children because it is associated with high 

absenteeism, sickness, low academic performance, and negative social behaviors (Frongillo et al., 2006). 

Exposure to violence has also been identified as a risk factor for low school enrolment and for dropout 

(Terefe, 1997). In contrast, school enrollment is associated with later sexual initiation and condom use 

(Nyamukapa, 2008; Katz, 2006; Magnani et al, 2002; Zambuko and Mturi; 2005). The association 

between safer sexual behavior and both school attendance and educational achievement is based on the 

rationale that children attending school are more motivated than their out-of-school peers to avoid the 

negative consequences of engaging in unprotected sex, such as unintended pregnancy and HIV infection. 

Educated children also may have more exposure to HIV prevention and sexual education resources and be 

more likely to understand the content of these materials (Jukes et al., 2008). 

6.1 Children Who Have Received No Primary or Secondary Education 

As Maps 6.1 and 6.2 indicate, the percentage of children with no education varies greatly among 

sub-Saharan African countries, ranging from 3% in Lesotho to 54% in Ethiopia and 64% in Burkina Faso. 

Table 6.1 shows the stratification of the percentages by the children’s ages; these data reveal that this 

problem was more severe for younger children. For instance, 56% of Ethiopian children age 7-12 had no 

education compared with 33% of children ages 13-17, a difference of more than 20 percentage points. In 

Zimbabwe 8% of children age 7-12 but only 1% of children age 13-17 had no education. The percentage 

of children with no education was at least 10 percentage points higher for children age 7-12 than for their 

older counterparts in Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, and Tanzania (see Table 

6.1). 

Sex and geographic disparities 

Overall, we found disparities by sex in the percentage of children age 0-17 without education (see 

Table 6.2). This percentage was higher for males in some countries and for females in other countries (see 

Figure 6.1). For instance, the greatest difference occurred in Niger, where 55% of males and 69% of 

females had not received a primary or secondary education, a difference of 14 percentage points. The 

percentage of children without education was about 10 percentage points higher for females than for 

males in Mali (males: 49% and females: 58%), Guinea (41% and 51%), and Benin (23% and 34%). The 

inverse situation occurred, but was less marked, in Kenya (males: 12% and females: 10%) and Lesotho 

(4% and 2%). 

In every country except for Sao Tomé and Príncipe, the percentage of children age 0-17 without a 

primary or secondary education was higher in rural areas than in urban areas (see Figure 6.2). However, 

this difference was very diverse across the countries, from 2 percentage points in Lesotho to 52 

percentage points in Burkina Faso. The difference was more than 30 percentage points in Senegal (urban: 

17% and rural: 48%), Guinea (21% and 57%), Ethiopia (13% and 51%), and Niger (29% and 69%) as 

well as Burkina Faso (see Table 6.2). 

The role of the household head’s sex and age 

In 18 countries the percentage of children without a primary or secondary education was at least 

one percentage point higher for children living with a male rather than a female head of household (see 

Figure 6.3). We did not find the inverse situation in any sub-Saharan African country. The largest 

discrepancies, around 20 percentage points, occurred in Burkina Faso (living with a male household head: 
108 

65% versus living with a female household head: 44%) and Nigeria (30% versus 12%) (see Table 6.2). In 

Benin, Cameroon, and Senegal, the percentage of children without a primary or secondary education was 

around 10 percentage points higher for children living with a male household head. 

Overall, we found that the percentage of children without primary or secondary education was 

either not associated with the age of the head of household or was higher for children living with a 

household head 50 years or older rather than with a younger household head (see Figure 6.4 and Table 

6.2). The percentage of children without a primary or secondary education was at least 5 percentage 

points higher for children living with an older head of household in Mali (52% versus 58%), Liberia (52% 

versus 58%), Benin (27% versus 34%), and Burkina Faso (62% versus 70%). In 10 countries there was no 

association between the age of the household head and differences in the percentage of children without 

primary or secondary education: Congo (Brazzaville), Lesotho, Mozambique, Namibia, Rwanda, Sao 

Tomé and Príncipe, Senegal, Uganda, Zambia, and Zimbabwe. 

Variations during the last 13 years

In every country the percentage of children without a primary or secondary education decreased 

during the last 13 years. This decline was most evident—at least six percentage points—in Benin (2001: 

36% and 2006: 29%), Mali (2001: 60% and 2006: 54%), Namibia (2000: 15% and 2006-07: 9%), and 

Zambia (2001-2: 23% and 2007: 14%) (see Figure 6.5 and Table 6.3). 

6.2 Children Not Currently Enrolled in School 

The percentage of children not enrolled in school also varied greatly among countries, ranging 

from 7% in Kenya to 52% in Burkina Faso (see Maps 6.3 and 6.4). Four of every 10 children in Senegal 

were not enrolled in school during the data collection period (see Table 6.1). Approximately one-third of 

children were not enrolled in school in Benin and Ethiopia. Overall, the percentage of children not 

enrolled in school was higher for children age 13-17 than for their younger counterparts. This difference 

rose to over 20 percentage points in Tanzania and Zimbabwe and was more than 30 percentage points in 

Madagascar. In 21 countries the percentage of children age 0-17 not enrolled in school at the time of the 

study was at least one percentage point higher for females than for males. In five countries this percentage 

was at least one percentage point higher for males than females, while in four countries, the percentages 

were similar between the sexes. 

Sex and geographic disparities 

The greatest differences, by child sex, in the percentage of children age 0-17 who were not 

enrolled in school occurred in Benin (males: 29% and females: 40%), Chad (51% and 66%), Cote 

d’Ivoire (40% and 51%), Guinea (42% and 53%), and Niger (59% and 73%)—all differences of at least 

10 percentage points (see Figure 6.6 and Table 6.4). 

We found no geographic disparities in Rwanda, Swaziland, and Uganda (see Figure 6.7). In the 

rest of the countries, however, the percentage of children who did not enroll in school was at least one 

percentage point higher in rural areas than in urban areas. This difference was at least 33 percentage 

points higher in Burkina Faso (urban: 25% and rural: 59%), Guinea (23% and 59%), and Niger (37% and 

72%) (see Table 6.4). The percentage of children not enrolled in school was also at least 20 percentage 

points higher in rural areas than in urban areas in Chad, Ethiopia, Liberia, Mali, Nigeria, Senegal, and 

Sierra Leone. 
109 

The role of the household head’s sex and age 

The sex of the household head played an important role in the percentage of children not in 

school (see Figure 6.8). This percentage was at least five percentage points higher for children living with 

a male household head in five countries (Benin, Burkina Faso, Cameroon, Nigeria, and Senegal). The 

greatest discrepancy occurred in Nigeria, where the percentage of children not enrolled in school was 19 

percentage points higher for children living with a male household head (32%) than for children living 

with a female household head (13%). A difference at least five percentage points higher for children 

living with a female household head occurred only in Chad (see Table 6.4). In Kenya, Mozambique, Sao 

Tomé and Príncipe, and Zimbabwe, the sex of the child made no difference to the percentages not 

enrolled in school. 

In nine countries the percentage of children not enrolled in school was at least five percentage 

points higher for children living with a household head 50 years of age or older than for those living with 

a younger head of household: Benin (33% versus 40%), Burkina Faso (51% versus 57%), Cote d’Ivoire 

(44% versus 52%), Ghana (15% versus 22%), Liberia (44% versus 50%), Madagascar (26% versus 33%), 

Mali (56% versus 62%), Niger (64% versus 72%), and Tanzania (23% versus 29%) (see Figure 6.9). 

There were no significant associations between the age of the household head and differences in the 

percentage of children not enrolled in school in the Democratic Republic of Congo, Ethiopia, Lesotho, 

Namibia, Sao Tomé and Príncipe, and Senegal (differences of less than 1 percentage point) (see Table 

6.4). 

Variations during the last 13 years 

In every country in sub-Saharan Africa, the percentage of children age 7-17 not enrolled in school 

decreased by at least one percentage point and in some countries substantially more. Ethiopia (2005: 51% 

and 2011: 35%) and Zambia (2001-02: 33% and 2007: 18%) experienced the largest decreases, at least 15 

percentage points (see Table 6.3). 

The decrease in the percentage of children not enrolled in school was much greater among 

younger children than among their older counterparts in Ethiopia (children age 7-12: 20 percentage points 

and children age 13-17: 10 percentage points), Ghana (children age 7-12: 16 percentage points and 

children age 13-17: 6 percentage points), and Mozambique (age 7-12 years old: 9 percentage points and 

age 13-17: 2 percentage points). The inverse situation occurred in two countries, Kenya (children age 7-

12: 3 percentage points and children age 13-17: 11 percentage points) and Rwanda (children age 7-12: 4 

percentage points and children 13-17: 19 percentage points) (see Figures 6.10 and 6.11). 

6.3 School Dropouts 

Overall, the percentage of children age 7-12 who had dropped out of school was very low, not 

reaching more than 4% in any of these countries except Burkina Faso (7%). As might be expected, the 

percentage of older children, age 13-17, who had dropped out of school was higher, ranging from less 

than 4% in Kenya to 35% in Burkina Faso (see Table 6.1). The highest percentages were seen in Burkina 

Faso, Madagascar, and Rwanda, where one of every three children age 13-17 had dropped out (see Maps 

6.5 and 6.6). 

Sex and geographic disparities 

Overall, we did not find major disparities between the sexes in the percentages who had dropped 

out of school (see Figure 6.12). The greatest differences—about three percentage points—occurred in the 

Democratic Republic of Congo (males: 7% and females: 10%), Liberia (males: 2% and females: 5%), and 

Niger (males: 10% and females: 13%). The inverse situation occurred in Lesotho, where the percentage of 
110 

children who had dropped out of school was 3 percentage points higher for males (10%) than for females 

(7%) (see Table 6.5). 

We found geographic disparities of at least six percentage points in the percentage of children 

who had dropped out of school in Burkina Faso (urban: 13% and rural: 21%) and Madagascar (urban: 9% 

and rural: 15%). We found smaller discrepancies, three to four percentage points, in Mali (urban: 5% and 

rural: 9%), Democratic Republic of Congo (urban: 7% and rural: 11%), and Zimbabwe (urban: 5% and 

rural: 9%) (see Figure 6.13 and Table 6.5). 

The role of the household head’s sex and age 

Overall, there was no association between the sex of the household head and major differences in 

the percentage of children who dropped out of school (see Figure 6.14). In Burkina Faso children in a 

household whose head was age 50 or older were over five percentage points more likely to have dropped 

out than children in households headed by a younger person (24% versus 17%) (see Table 6.5). 

Variations during the last 13 years 

Reductions of at least six percentage points in the percentage of children age 7-17 years who 

dropped out school took place only in Benin (2001: 20% and 2006: 14%), Ghana (2003: 14% and 2008: 

7%), Kenya (2003: 11% and 2008-09: 4%), and Zambia (2001-02: 20% and 2007: 9%) (see Table 6.3 and 

Figure 6.16). 
111 

Table 6.1. Percentage of children age 7-17 who have no education, who are not currently 

enrolled in school, and who have dropped out of school, by country and child's age

Country 

No primary or secondary 

education 

Not currently enrolled in 

school Dropped out of school 

Age 

7-12 

Age 

13-17 

Age 

7-17 

Age 

7-12 

Age 

13-17 

Age 

7-17 

Age 

7-12 

Age 

13-17 

Age 

7-17 

Benin 29.7 26.5 28.6 32.3 38.0 34.3 2.7 13.5 6.6 

Burkina Faso 64.9 62.3 63.9 48.1 59.5 52.2 6.8 34.6 18.3 

Cameroon 13.7 8.3 11.7 15.1 23.1 18.1 1.5 13.4 6.1 

Ethiopia 55.7 32.8 47.1 37.8 31.1 35.2 1.8 7.1 4.3 

Ghana 24.5 6.5 17.1 12.1 21.8 16.1 0.9 7.4 4.0 

Kenya 16.5 2.8 11.1 5.5 8.8 6.8 0.1 3.9 1.7 

Lesotho 3.4 2.3 2.9 5.9 20.6 12.7 

Madagascar 12.3 10.7 11.7 16.8 44.3 27.2 3.6 31.9 14.4 

Malawi 7.6 3.4 6.0 8.8 19.2 12.8 1.3 10.3 4.8 

Mali 54.7 51.6 53.5 55.8 59.2 57.1 2.3 14.2 7.0 

Mozambique 30.1 14.1 24.2 23.7 32.4 26.9 2.2 14.8 7.5 

Namibia 13.2 3.7 8.9 6.9 13.4 9.9 1.0 6.2 3.5 

Nigeria 30.9 19.8 26.9 28.9 28.3 28.7 1.4 7.4 3.8 

Rwanda 16.5 7.3 12.6 9.8 18.8 13.4 1.9 28.8 13.9 

Senegal 36.4 33.8 35.4 38.0 45.7 41.0 2.2 15.4 7.5 

Tanzania 29.4 14.0 23.2 16.1 36.3 24.3 1.4 12.3 6.3 

Uganda 12.0 3.0 8.6 7.4 15.0 10.3 0.7 10.2 4.5 

Zambia 21.2 3.2 14.1 19.2 16.0 17.9 1.4 9.0 4.8 

Zimbabwe 8.4 0.7 5.2 4.4 24.0 12.3 0.9 15.8 7.4 
Table 6.2. Percentage of children age 7-17 with no education, by country, sex of child, and region of residence as well as sex and age of 

head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 23.3 34.4 11.1 18.7 34.3 15.6 30.3 21.4 -8.9 27.3 33.9 6.6 28.6 Burkina Faso 60.1 67.8 7.7 20.6 72.3 51.7 65.2 44.2 -21.0 61.8 69.8 8.0 63.9 Cameroon 9.5 13.9 4.4 4.0 18.0 14.0 13.5 5.4 -8.1 11.1 13.5 2.4 11.7 Congo (Brazzaville) 

3.4 4.2 0.8 1.7 6.0 4.3 3.6 4.5 0.9 3.8 3.9 0.1 3.8 

Congo Dem. Rep. 

14.2 20.0 5.8 9.0 23.1 14.1 17.0 16.8 -0.2 16.8 18.1 1.3 17.0 

Ethiopia 45.3 49.1 3.8 12.9 51.3 38.4 48.1 43.1 -5.0 46.7 48.8 2.1 47.1 Ghana 17.2 17.0 -0.2 10.5 21.7 11.2 19.3 12.5 -6.8 16.3 20.3 4.0 17.1 Guinea 40.8 50.5 9.7 20.5 56.9 36.4 46.4 41.0 -5.4 45.1 46.9 1.8 45.6 Kenya 12.1 10.1 -2.0 7.0 11.7 4.7 11.5 10.4 -1.1 10.8 12.4 1.6 11.1 Lesotho 4.2 1.6 -2.6 1.5 3.2 1.7 3.2 2.4 -0.8 2.7 3.5 0.8 2.9 Liberia 51.6 53.1 1.5 35.5 64.5 29.0 53.8 49.1 -4.7 51.5 57.8 6.3 52.3 Madagascar 12.3 11.1 -1.2 2.1 13.1 11.0 11.6 12.1 0.5 11.1 15.9 4.8 11.7 Malawi 6.6 5.4 -1.2 2.4 6.6 4.2 5.9 6.4 0.5 5.8 7.0 1.2 6.0 Mali 49.1 57.9 8.8 34.4 61.4 27.0 54.0 49.2 -4.8 52.3 57.5 5.2 53.5 Mozambique 20.8 27.8 7.0 11.9 30.8 18.9 24.6 22.7 -1.9 24.1 24.4 0.3 24.2 Namibia 9.6 8.2 -1.4 6.7 10.1 3.4 10.0 7.8 -2.2 9.0 8.6 -0.4 8.9 Niger 54.9 69.0 14.1 29.3 68.9 39.6 62.7 57.6 -5.1 60.0 67.1 7.1 61.9 Nigeria 24.0 29.8 5.8 11.2 34.0 22.8 29.5 11.7 -17.8 27.2 25.5 -1.7 26.9 Rwanda 13.0 12.2 -0.8 10.7 12.9 2.2 13.2 11.5 -1.7 12.7 12.3 -0.4 12.6 Sao Tomé and Príncipe 

2.0 1.8 -0.2 2.5 1.4 -1.1 1.8 2.1 0.3 1.8 2.6 0.8 1.9 

Senegal 36.1 34.8 -1.3 17.1 48.1 31.0 37.5 27.7 -9.8 35.6 35.1 -0.5 35.4 Sierra Leone 27.1 29.2 2.1 13.6 36.1 22.5 28.9 25.7 -3.2 27.4 30.0 2.6 28.1 Swaziland 4.7 3.5 -1.2 2.8 4.3 1.5 4.5 3.8 -0.7 3.3 5.8 2.5 4.1 Tanzania 23.8 22.7 -1.1 12.5 26.4 13.9 23.9 21.1 -2.8 22.9 24.7 1.8 23.2 Uganda 8.6 8.6 0.0 4.2 9.2 5.0 8.5 8.8 0.3 8.6 8.6 0.0 8.6 Zambia 14.1 14.1 0.0 6.4 18.5 12.1 14.2 14.0 -0.2 14.2 13.9 -0.3 14.1 Zimbabwe 5.6 4.7 -0.9 2.6 6.1 3.5 5.7 4.6 -1.1 5.1 5.5 0.4 5.2 

112 
Table 6.3. Trends in percentage of children age 7-17 who have no primary or secondary education, who are not attending school, 

or who have dropped out of school, by country and child's ageCountry 

Child's age 

Data collection 

No primary or secondary 

education Not attending school Dropped out of school 

Year 1 Year 2 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 1 

Year 

1 

Year 

2 

Comparison 

Year 2−Year1 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 1

Benin 7-17 2001 2006 36.4 28.6 -7.9 44.3 34.3 -10.0 10.3 6.6 -3.7 Benin 7-12 2001 2006 36.2 29.7 -6.4 40.6 32.3 -8.3 5.5 2.7 -2.8 Benin 13-17 2001 2006 37.0 26.5 -10.5 51.5 38.0 -13.4 19.5 13.5 -6.1 Burkina Faso 7-17 2003 2010 71.0 52.2 -18.9 Burkina Faso 7-12 2003 2010 67.6 48.1 -19.5 Burkina Faso 13-17 2003 2010 76.3 59.5 -16.8 Cameroon 7-17 2004 2011 13.1 11.7 -1.4 19.5 18.1 -1.5 6.4 6.1 -0.2 Cameroon 7-12 2004 2011 15.4 13.7 -1.7 16.2 15.1 -1.1 1.7 1.5 -0.2 Cameroon 13-17 2004 2011 9.6 8.3 -1.3 24.5 23.1 -1.5 12.9 13.4 0.5 Ethiopia 7-17 2005 2011 51.3 35.2 -16.1 Ethiopia 7-12 2005 2011 57.3 37.8 -19.6 Ethiopia 13-17 2005 2011 41.2 31.1 -10.1 Ghana 7-17 2003 2008 20.2 17.1 -3.1 27.6 16.1 -11.5 7.3 4.0 -3.3 Ghana 7-12 2003 2008 26.2 24.5 -1.7 27.9 12.1 -15.9 1.7 0.9 -0.8 Ghana 13-17 2003 2008 11.6 6.5 -5.0 27.2 21.8 -5.5 14.0 7.4 -6.6 Kenya 7-17 2003 2008-09 15.2 11.1 -4.1 12.8 6.8 -6.0 5.3 1.7 -3.5 Kenya 7-12 2003 2008-09 21.1 16.5 -4.6 8.0 5.5 -2.5 0.6 0.1 -0.5 Kenya 13-17 2003 2008-09 7.3 2.8 -4.5 19.4 8.8 -10.5 10.7 3.9 -6.8 Lesotho 7-17 2004 2009 5.6 2.9 -2.7 15.5 12.7 -2.8 Lesotho 7-12 2004 2009 7.1 3.4 -3.6 9.3 5.9 -3.4 Lesotho 13-17 2004 2009 3.9 2.3 -1.6 22.7 20.6 -2.2 Madagascar 7-17 2003-04 2008-09 17.2 11.7 -5.5 30.6 27.2 -3.4 15.1 14.4 -0.7 Madagascar 7-12 2003-04 2008-09 16.8 12.3 -4.6 20.1 16.8 -3.3 3.6 3.6 0.0 

(Continued...)

113 
Table 6.3. – Continued

Country 

Child's age 

Data collection 

No primary or secondary 

education Not attending school Dropped out of school 

Year 1 Year 2 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 1 

Year 

1 

Year 

2 

Comparison 

Year 2−Year1 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 1

Madagascar 13-17 2003-04 2008-09 17.8 10.7 -7.1 48.3 44.3 -4.0 34.6 31.9 -2.7 Malawi 7-17 2004 2010 8.8 6.0 -2.8 16.6 12.8 -3.8 6.3 4.8 -1.5 Malawi 7-12 2004 2010 10.6 7.6 -2.9 13.3 8.8 -4.5 1.7 1.3 -0.4 Malawi 13-17 2004 2010 5.7 3.4 -2.3 22.5 19.2 -3.3 14.0 10.3 -3.7 Mali 7-17 2001 2006 59.8 53.5 -6.3 63.5 57.1 -6.4 7.2 7.0 -0.2 Mali 7-12 2001 2006 59.0 54.7 -4.3 60.9 55.8 -5.1 2.9 2.3 -0.7 Mali 13-17 2001 2006 61.3 51.6 -9.7 68.2 59.2 -9.0 15.5 14.2 -1.2 Mozambique 7-17 2003 2011 32.3 26.9 -5.5 Mozambique 7-12 2003 2011 33.2 23.7 -9.4 Mozambique 13-17 2003 2011 31.0 32.4 1.5 Namibia 7-17 2000 2006-07 14.9 8.9 -6.0 12.6 9.9 -2.7 4.0 3.5 -0.5 Namibia 7-12 2000 2006-07 21.1 13.2 -7.9 10.5 6.9 -3.6 1.3 1.0 -0.3 Namibia 13-17 2000 2006-07 5.9 3.7 -2.3 15.5 13.4 -2.1 7.2 6.2 -1.0 Nigeria 7-17 2003 2008 27.8 26.9 -0.9 30.3 28.7 -1.6 4.1 3.8 -0.3 Nigeria 7-12 2003 2008 31.3 30.9 -0.4 29.4 28.9 -0.4 0.8 1.4 0.6 Nigeria 13-17 2003 2008 22.1 19.8 -2.3 31.9 28.3 -3.6 8.8 7.4 -1.3 Rwanda 7-17 2005 2010 23.8 13.4 -10.4 Rwanda 7-12 2005 2010 13.5 9.8 -3.8 Rwanda 13-17 2005 2010 38.0 18.8 -19.3 Senegal 7-17 2005 2010-11 39.7 35.4 -4.3 47.7 41.0 -6.7 11.6 7.5 -4.1 Senegal 7-12 2005 2010-11 39.1 36.4 -2.6 41.4 38.0 -3.5 2.7 2.2 -0.5 Senegal 13-17 2005 2010-11 40.6 33.8 -6.7 56.3 45.7 -10.6 24.2 15.4 -8.8 Tanzania 7-17 2004-05 2010 26.0 24.3 -1.8 Tanzania 7-12 2004-05 2010 23.3 16.1 -7.2 Tanzania 13-17 2004-05 2010 30.0 36.3 6.3 

(Continued...)

114 
Table 6.3. – Continued

Country 

Child's age 

Data collection 

No primary or secondary 

education Not attending school Dropped out of school 

Year 1 Year 2 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 1 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 

1 

Year 

1 

Year 

2 

Comparison 

Year 2−Year 1

Uganda 7-17 2006 2011 12.9 10.3 -2.7 Uganda 7-12 2006 2011 9.0 7.4 -1.7 Uganda 13-17 2006 2011 19.3 15.0 -4.3 Zambia 7-17 2001-02 2007 22.9 14.1 -8.7 32.9 17.9 -15.0 11.2 4.8 -6.4 Zambia 7-12 2001-02 2007 31.6 21.2 -10.4 33.3 19.2 -14.1 3.5 1.4 -2.1 Zambia 13-17 2001-02 2007 8.9 3.2 -5.8 32.4 16.0 -16.3 20.3 9.0 -11.3 

Zimbabwe 7-17 2005-06 2010-11 14.6 12.3 -2.2 Zimbabwe 7-12 2005-06 2010-11 6.3 4.4 -1.8 Zimbabwe 13-17 2005-06 2010-11 26.0 24.0 -2.0 

115 
Table 6.4. Percentage of children age 7-17 not enrolled in school, by country, sex of child, and region of residence as well as sex and age 

of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 28.7 40.4 11.7 24.9 39.8 14.9 35.7 28.5 -7.2 32.9 40.4 7.5 34.3 Burkina Faso 50.2 54.2 4.0 25.2 59.0 33.8 52.9 43.8 -9.1 50.6 57.1 6.5 52.2 Burundi 24.0 25.5 1.5 18.9 25.3 6.4 24.5 25.7 1.2 24.6 26.0 1.4 24.8 Cameroon 14.8 21.5 6.7 10.0 24.7 14.7 20.0 11.6 -8.4 17.0 21.8 4.8 18.1 Chad 50.8 66.1 15.3 36.1 64.2 28.1 57.6 63.6 6.0 57.7 62.6 4.9 58.5 Congo (Brazzaville) 

11.0 12.6 1.6 9.9 13.7 3.8 11.3 13.2 1.9 11.2 14.8 3.6 11.8 

Cote d'Ivoire 39.6 50.6 11.0 40.6 48.4 7.8 46.0 42.2 -3.8 43.6 52.3 8.7 45.2 Dem. Rep. of Congo 

24.3 32.6 8.3 18.8 35.6 16.8 27.9 30.1 2.2 28.2 29.1 0.9 28.3 

Ethiopia 35.9 34.6 -1.3 15.3 39.1 23.8 35.8 33.1 -2.7 35.2 35.5 0.3 35.2 Ghana 15.4 16.7 1.3 13.5 17.9 4.4 17.6 12.9 -4.7 14.6 22.3 7.7 16.1 Guinea 42.4 53.0 10.6 23.0 58.7 35.7 48.4 43.1 -5.3 47.1 49.1 2.0 47.6 Kenya 6.2 7.3 1.1 5.9 6.9 1.0 6.8 6.8 0.0 6.2 9.3 3.1 6.8 Lesotho 16.4 9.2 -7.2 7.0 14.2 7.2 13.4 11.6 -1.8 12.7 12.9 0.2 12.7 Liberia 42.4 47.4 5.0 29.6 56.0 26.4 46.2 42.0 -4.2 44.0 50.4 6.4 44.9 Madagascar 26.6 27.9 1.3 13.0 29.3 16.3 27.0 28.1 1.1 26.4 33.0 6.6 27.2 Malawi 12.5 13.0 0.5 9.6 13.3 3.7 12.2 14.1 1.9 12.1 15.8 3.7 12.8 Mali 52.6 61.6 9.0 37.9 65.1 27.2 57.6 53.0 -4.6 55.8 61.5 5.7 57.1 Mozambique 25.1 28.6 3.5 15.5 32.0 16.5 27.0 26.6 -0.4 26.3 30.2 3.9 26.9 Namibia 11.0 8.7 -2.3 8.1 10.8 2.7 11.4 8.3 -3.1 9.8 10.1 0.3 9.9 Niger 59.4 72.9 13.5 37.3 72.4 35.1 66.8 62.3 -4.5 64.1 71.6 7.5 66.1 Nigeria 25.7 31.8 6.1 12.8 36.0 23.2 31.5 12.7 -18.8 29.1 27.5 -1.6 28.7 Rwanda 13.9 12.9 -1.0 12.8 13.5 0.7 12.5 15.1 2.6 12.9 16.3 3.4 13.4 Sao Tomé and Príncipe 

13.6 12.6 -1.0 12.5 13.7 1.2 12.9 13.4 0.5 13.0 13.7 0.7 13.1 

Senegal 41.2 40.8 -0.4 24.4 52.4 28.0 42.7 34.8 -7.9 41.0 41.1 0.1 41.0 Sierra Leone 29.3 32.7 3.4 15.1 39.7 24.6 31.6 29.0 -2.6 30.2 33.1 2.9 31.0 Swaziland 11.9 11.9 0.0 11.4 12.0 0.6 13.5 10.7 -2.8 10.8 14.5 3.7 11.9 

(Continued...)

116 
Table 6.4. – Continued

Sex of the child Region of residence 

Sex of the household 

head Age of the household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Tanzania 23.7 24.8 1.1 16.2 26.5 10.3 23.6 26.3 2.7 23.1 28.7 5.6 24.3 Uganda 9.3 11.3 2.0 10.2 10.3 0.1 9.7 11.5 1.8 9.9 12.4 2.5 10.3 Zambia 16.1 19.7 3.6 11.1 21.8 10.7 17.6 19.2 1.6 17.7 19.2 1.5 17.9 Zimbabwe 12.2 12.5 0.3 11.0 12.8 1.8 12.3 12.4 0.1 11.7 14.8 3.1 12.3 

117 
Table 6.5. Percentage of children age 7-17 who have dropped out of school, by country, sex of child, and region of residence as well as 

sex and age of head of household

Sex of child Region of residence Sex of household head Age of household head 

Country 

Male 

( a ) 

Female 

( b ) 

Comparison 

( b ) - ( a ) 

Urban 

( c ) 

Rural 

( d ) 

Comparison 

( d ) - ( c ) 

Male

( e ) 

Female 

( f ) 

Comparison 

( f ) - ( e ) 

Less than 

age 50 

( g ) 

Age 50 

or more

( h ) 

Comparison 

( h ) - ( g ) 

All 

children 

Benin 5.9 7.5 1.6 6.4 6.7 0.3 6.3 7.5 1.2 6.3 8.0 1.7 6.6 Burkina Faso 19.3 17.0 -2.3 13.4 21.0 7.6 18.4 17.7 -0.7 16.9 23.5 6.6 18.3 Cameroon 4.9 7.5 2.6 5.3 7.0 1.7 6.4 5.2 -1.2 5.5 8.3 2.8 6.1 Congo (Brazzaville) 

6.1 7.0 0.9 6.5 6.7 0.2 6.4 7.1 0.7 6.1 9.1 3.0 6.6 

Congo Dem. Rep. 

7.3 10.3 3.0 6.8 10.5 3.7 8.6 9.3 0.7 8.8 8.1 -0.7 8.7 

Ethiopia 4.3 4.4 0.1 3.0 4.6 1.6 4.2 5.0 0.8 4.1 5.2 1.1 4.3 Ghana 3.4 4.5 1.1 3.6 4.2 0.6 3.5 4.8 1.3 3.8 4.7 0.9 4.0 Guinea 3.2 5.8 2.6 3.7 4.9 1.2 4.5 3.6 -0.9 4.4 4.2 -0.2 4.4 Kenya 1.4 2.1 0.7 3.4 1.5 -1.9 1.8 1.7 -0.1 1.6 2.2 0.6 1.7 Lesotho 9.6 6.6 -3.0 5.6 8.5 2.9 8.0 8.3 0.3 7.7 9.2 1.5 8.1 Liberia 1.6 4.5 2.9 2.9 3.2 0.3 2.9 3.2 0.3 2.9 3.9 1.0 3.0 Madagascar 13.2 15.6 2.4 8.9 15.3 6.4 14.3 14.7 0.4 14.0 17.1 3.1 14.4 Malawi 4.4 5.3 0.9 4.5 4.9 0.4 4.6 5.4 0.8 4.6 6.1 1.5 4.8 Mali 6.1 8.1 2.0 4.9 8.5 3.6 7.1 6.5 -0.6 6.6 8.6 2.0 7.0 Mozambique 6.8 8.3 1.5 5.9 8.6 2.7 7.3 8.2 0.9 7.4 8.3 0.9 7.5 Namibia 4.2 2.8 -1.4 2.8 3.9 1.1 3.8 3.2 -0.6 3.4 3.8 0.4 3.5 Niger 9.7 12.6 2.9 11.0 10.8 -0.2 11.0 10.3 -0.7 10.0 13.8 3.8 10.9 Nigeria 3.7 3.9 0.2 2.6 4.5 1.9 3.9 3.1 -0.8 3.8 3.8 0.0 3.8 Rwanda 13.3 14.5 1.2 13.2 14.0 0.8 13.1 15.2 2.1 13.6 15.9 2.3 13.9 Sao Tomé and Príncipe 

10.3 9.3 -1.0 9.1 10.7 1.6 9.9 9.8 -0.1 9.9 9.7 -0.2 9.9 

Senegal 7.1 7.9 0.8 7.8 7.2 -0.6 7.5 7.7 0.2 7.2 8.2 1.0 7.5 Sierra Leone 3.2 4.7 1.5 2.5 4.9 2.4 3.8 4.1 0.3 3.7 4.3 0.6 3.9 Swaziland 3.7 3.9 0.2 4.1 3.7 -0.4 4.6 3.1 -1.5 3.7 3.9 0.2 3.8 Tanzania 5.6 7.0 1.4 7.4 5.9 -1.5 6.1 6.7 0.6 6.4 5.5 -0.9 6.3 Uganda 4.1 5.0 0.9 5.9 4.4 -1.5 4.2 5.2 1.0 4.2 6.1 1.9 4.5 Zambia 3.3 6.2 2.9 4.0 5.3 1.3 4.6 5.2 0.6 4.6 5.6 1.0 4.8 Zimbabwe 7.2 7.6 0.4 4.5 8.5 4.0 7.6 7.2 -0.4 7.1 8.7 1.6 7.4 

118 
119 

23.3

60.1

9.5

3.4

14.2

45.3

17.2

40.8

12.1

4.2

51.6

12.3

6.6

49.1

20.8

9.6

54.9

24.0

13.0

2.0

36.1

27.1

4.7

23.8

8.6

14.1

5.6

34.4

67.8

13.9

4.2

20.0

49.1

17.0

50.5

10.1

1.6

53.1

11.1

5.4

57.9

27.8

8.2

69.0

29.8

12.2

1.8

34.8

29.2

3.5

22.7

8.6

14.1

4.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.1. Percentage of children age 7-17 with no education,

by country and sex of the child

Male Female
120 

18.7

20.6

4.0

1.7

9.0

12.9

10.5

20.5

7.0

1.5

35.5

2.1

2.4

34.4

11.9

6.7

29.3

11.2

10.7

2.5

17.1

13.6

2.8

12.5

4.2

6.4

2.6

34.3

72.3

18.0

6.0

23.1

51.3

21.7

56.9

11.7

3.2

64.5

13.1

6.6

61.4

30.8

10.1

68.9

34.0

12.9

1.4

48.1

36.1

4.3

26.4

9.2

18.5

6.1

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.2. Percentage of children age 7-17 with no education,

by country and region of residence

Urban Rural
121 

30.3

65.2

13.5

3.6

17.0

48.1

19.3

46.4

11.5

3.2

53.8

11.6

5.9

54.0

24.6

10.0

62.7

29.5

13.2

1.8

37.5

28.9

4.5

23.9

8.5

14.2

5.7

21.4

44.2

5.4

4.5

16.8

43.1

12.5

41.0

10.4

2.4

49.1

12.1

6.4

49.2

22.7

7.8

57.6

11.7

11.5

2.1

27.7

25.7

3.8

21.1

8.8

14.0

4.6

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.3. Percentage of children age 7-17 with no education,

by country and sex of the household head

Male Female
122 

27.3

61.8

11.1

3.8

16.8

46.7

16.3

45.1

10.8

2.7

51.5

11.1

5.8

52.3

24.1

9.0

60.0

27.2

12.7

1.8

35.6

27.4

3.3

22.9

8.6

14.2

5.1

33.9

69.8

13.5

3.9

18.1

48.8

20.3

46.9

12.4

3.5

57.8

15.9

7.0

57.5

24.4

8.6

67.1

25.5

12.3

2.6

35.1

30.0

5.8

24.7

8.6

13.9

5.5

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.4. Percentage of children age 7-17 with no education,

by country and age of the household head

Less than 50 yo 50 yo or more
123 

36.4

13.1

20.2

15.2

5.6

17.2

8.8

59.8

14.9

27.8

39.7

22.9

28.6

11.7

17.1

11.1

2.9

11.7

6.0

53.5

8.9

26.9

35.4

14.1

-7.9

-1.4 -3.1 -4.1 -2.7

-5.5

-2.8

-6.3 -6.0

-0.9

-4.3

-8.7

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Figure 6.5. Changes in the percentage of children age 7-17 who have received no primary 

or secondary education

Year 1 Year 2 Comparison Year 2-Year1

20032008

2000

2006-07

2005

2010-11

2003

2008-09

20042009

20042010

20012006

2003-042008-09

20012006

20032010

20032008

2001-01

2007
124 

28.7

50.2

24.0

14.8

50.8

11.0

39.6

24.3

35.9

15.4

42.4

6.2

16.4

42.4

26.6

12.5

52.6

25.1

11.0

59.4

25.7

13.9

13.6

41.2

29.3

11.9

23.7

9.3

16.1

12.2

40.4

54.2

25.5

21.5

66.1

12.6

50.6

32.6

34.6

16.7

53.0

7.3

9.2

47.4

27.9

13.0

61.6

28.6

8.7

72.9

31.8

12.9

12.6

40.8

32.7

11.9

24.8

11.3

19.7

12.5

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Congo Brazzaville

Cote d'Ivoire

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.6. Percentage of children age 7-17 not enrolled in school,

by country and sex of the child

Male Female
125 

24.9

25.2

18.9

10.0

36.1

9.9

40.6

18.8

15.3

13.5

23.0

5.9

7.0

29.6

13.0

9.6

37.9

15.5

8.1

37.3

12.8

12.8

12.5

24.4

15.1

11.4

16.2

10.2

11.1

11.0

39.8

59.0

25.3

24.7

64.2

13.7

48.4

35.6

39.1

17.9

58.7

6.9

14.2

56.0

29.3

13.3

65.1

32.0

10.8

72.4

36.0

13.5

13.7

52.4

39.7

12.0

26.5

10.3

21.8

12.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Congo Brazzaville

Cote d'Ivoire

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.7. Percentage of children age 7-17 not enrolled in school,

by country and region of residence

Urban Rural
126 

35.7

52.9

24.5

20.0

57.6

11.3

46.0

27.9

35.8

17.6

48.4

6.8

13.4

46.2

27.0

12.2

57.6

27.0

11.4

66.8

31.5

12.5

12.9

42.7

31.6

13.5

23.6

9.7

17.6

12.3

28.5

43.8

25.7

11.6

63.6

13.2

42.2

30.1

33.1

12.9

43.1

6.8

11.6

42.0

28.1

14.1

53.0

26.6

8.3

62.3

12.7

15.1

13.4

34.8

29.0

10.7

26.3

11.5

19.2

12.4

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Congo Brazzaville

Cote d'Ivoire

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.8. Percentage of children age 7-17 not enrolled in school,

by country and sex of the household head

Male Female
127 

32.9

50.6

24.6

17.0

57.7

11.2

43.6

28.2

35.2

14.6

47.1

6.2

12.7

44.0

26.4

12.1

55.8

26.3

9.8

64.1

29.1

12.9

13.0

41.0

30.2

10.8

23.1

9.9

17.7

11.7

40.4

57.1

26.0

21.8

62.6

14.8

52.3

29.1

35.5

22.3

49.1

9.3

12.9

50.4

33.0

15.8

61.5

30.2

10.1

71.6

27.5

16.3

13.7

41.1

33.1

14.5

28.7

12.4

19.2

14.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Benin

Burkina Faso

Burundi

Cameroon

Chad

Congo Brazzaville

Cote d'Ivoire

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.9. Percentage of children age 7-17 not enrolled in school,

by country and age of the household head

Less than 50 yo 50 yo or more
128 

44.3

71.0

19.5

51.3

27.6

12.8

15.5

30.6

16.6

63.5

34.3

52.2

18.1

35.2

16.1

6.8

12.7

27.2

12.8

57.1

-10.0

-18.9

-1.5

-16.1

-11.5

-6.0

-2.8 -3.4 -3.8

-6.4

-30.0

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Benin Burkina Faso Cameroon Ethiopia Ghana Kenya Lesotho Madagascar Malawi Mali

Figure 6.10. Changes in the percentage of children age 7-17 who are 

not currently enrolled in school

Year 1 Year 2 Comparison Year 2-Year1

2001200620032010

20042011

20052011

20032008

2003

2008-09

20042009

20042010

20012006

2003-042008-09

32.3

12.6

30.3

23.8

47.7

26.0

12.9

32.9

14.6

26.9

9.9

28.7

13.4

41.0

24.3

10.3

17.9

12.3

-5.5

-2.7 -1.6

-10.4

-6.7

-1.8 -2.7

-15.0

-2.2

-20.0

-10.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Mozambique Namibia Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe

Figure 6.11. Changes in the percentage of children age 7-17 who are 

not currently enrolled in school

Year 1 Year 2 Comparison Year 2-Year1

20032011

2005

2010-11

20032008

20052010

2004-05

2005-062010-11

2010

20062011

2001-2

2006-07

2000

2006-07
129 

5.9

19.3

4.9

6.1

7.3

4.3

3.4

3.2

1.4

9.6

1.6

13.2

4.4

6.1

6.8

4.2

9.7

3.7

13.3

10.3

7.1

3.2

3.7

5.6

4.1

3.3

7.2

7.5

17.0

7.5

7.0

10.3

4.4

4.5

5.8

2.1

6.6

4.5

15.6

5.3

8.1

8.3

2.8

12.6

3.9

14.5

9.3

7.9

4.7

3.9

7.0

5.0

6.2

7.6

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.12. Percentage of children age 7-17 who dropped out of school,

by country and the sex of the child

Male Female
130 

6.4

13.4

5.3

6.5

6.8

3.0

3.6

3.7

3.4

5.6

2.9

8.9

4.5

4.9

5.9

2.8

11.0

2.6

13.2

9.1

7.8

2.5

4.1

7.4

5.9

4.0

4.5

6.7

21.0

7.0

6.7

10.5

4.6

4.2

4.9

1.5

8.5

3.2

15.3

4.9

8.5

8.6

3.9

10.8

4.5

14.0

10.7

7.2

4.9

3.7

5.9

4.4

5.3

8.5

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.13. Percentage of children age 7-17 who dropped out of school,

by country and region of residence

Urban Rural
131 

6.3

18.4

6.4

6.4

8.6

4.2

3.5

4.5

1.8

8.0

2.9

14.3

4.6

7.1

7.3

3.8

11.0

3.9

13.1

9.9

7.5

3.8

4.6

6.1

4.2

4.6

7.6

7.5

17.7

5.2

7.1

9.3

5.0

4.8

3.6

1.7

8.3

3.2

14.7

5.4

6.5

8.2

3.2

10.3

3.1

15.2

9.8

7.7

4.1

3.1

6.7

5.2

5.2

7.2

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.14. Percentage of children age 7-17 who dropped out of school, 

by country and sex of the household head

Male Female
132 

6.3

16.9

5.5

6.1

8.8

4.1

3.8

4.4

1.6

7.7

2.9

14.0

4.6

6.6

7.4

3.4

10.0

3.8

13.6

9.9

7.2

3.7

3.7

6.4

4.2

4.6

7.1

8.0

23.5

8.3

9.1

8.1

5.2

4.7

4.2

2.2

9.2

3.9

17.1

6.1

8.6

8.3

3.8

13.8

3.8

15.9

9.7

8.2

4.3

3.9

5.5

6.1

5.6

8.7

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

Benin

Burkina Faso

Cameroon

Congo Brazzaville

Dem. Rep. of Congo

Ethiopia

Ghana

Guinea

Kenya

Lesotho

Liberia

Madagascar

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Sao Tome & Pr.

Senegal

Sierra Leone

Swaziland

Tanzania

Uganda

Zambia

Zimbabwe

Figure 6.15. Percentage of children age 7-17 who dropped out of school, 

by country and age of the household head

Less than 50 yo 50 yo or more
133 

10.3

6.4

7.3

5.3

15.1

6.3

7.2

4.0 4.1

11.6 11.2

6.6 6.1

4.0

1.7

14.4

4.8

7.0

3.5 3.8

7.5

4.8

-3.7

-0.2

-3.3 -3.5

-0.7

-1.5

-0.2 -0.5 -0.3

-4.1

-6.4

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

Figure 6.16. Changes in the percentage of children age 7-17 who dropped out of school

Year 1 Year 2 Comparison Year 2-Year1

20012006

20042011

2005

2010-11

20032008

2003

2008-09

2000

2006-07

2004201020012006

2003-042008-09

20032008

2001-02

2007
134 

Map 6.1 Percentage of children age 7-12 with 

no education 

Map 6.2 Percentage of children age 13-17 with 

no education 

Map 6.3 Percentage of children age 7-12 not 

enrolled in school 

Map 6.4 Percentage of children age 13-17 not 

enrolled in school 
135 

Map 6.5 Percentage of children age 7-12 who 

have dropped out of school

Map 6.6 Percentage of children age 13-17 who 

have dropped out of school 

137 

7 Discussion 

This document summarizes data from the Demographic and Health Surveys collected from 2000 

to 2011 on deprivation in five areas: food, water and sanitation, health, shelter, and education. For each 

African country the prevalence of children’s exposure to each type of vulnerability was described. We 

also determined the extent to which children’s exposure to each type of vulnerability differed in each 

country by the child’s sex and urban or rural residence as well as the sex and age of the household head. 

7.1 Food Deprivation 

Wasting. The data revealed no major sex disparities related to wasting in sub-Saharan Africa. 

There was a lower prevalence of wasting for children in urban areas than in rural areas, however. Such 

disparities were most pronounced in Cameroon, Ethiopia, Namibia, and Nigeria. Overall, the wasting 

prevalence did not vary by the sex and age of the household head in these sub-Saharan African countries. 

The most important progress in reducing the prevalence of wasting, gauged in terms of percentage points, 

took place in Burkina Faso (5 percentage point reduction) and Zimbabwe (4 percentage point reduction). 

The opposite situation occurred in Mali and Nigeria—increases of about three percentage points. 

Stunting. In every country the prevalence of stunting among children less than age 5 was higher 

for males and children in rural areas than for females and children in urban areas. The sex of the 

household head played an important but inconsistent role in the prevalence of stunting. While the stunting 

prevalence was at least one percentage point higher for children living with a male household head in 8 

countries, it was at least one percentage point higher for children living with a female household head in 

11 countries. The age of the household head also made a difference—again, an inconsistent difference—

to the prevalence of stunting. In seven countries the prevalence of stunting was at least one percentage 

point higher for children living with a household head age 50 or older. In 12 countries the inverse was 

true. Overall, sub-Saharan Africa experienced a decrease in the prevalence of stunting. The highest 

reductions, at least seven percentage points, occurred in Ethiopia and Zambia. 

Underweight. In every country the prevalence of underweight was higher for males and children 

in rural areas than for females and children in urban areas. Lesotho experienced the largest disparity by 

sex—19% for male children and 14% for female children. Niger had the most pronounced geographic 

disparity—27% in urban areas and 47% in rural areas. In one-third of these sub-Saharan African 

countries, the prevalence of underweight was higher for children living with a female household head 

than for children living with a male household head. In half of the countries the underweight prevalence 

was higher for children living with a household head at least 50 years of age. Every country (with the 

exception of Kenya) experienced a decrease in the prevalence of underweight during the last 13 years. 

7.2 Health Deprivation 

Expanded program on immunization. Overall, the percentages of children who did not receive 

any of the eight EPI vaccines were similar among boys and girls in these countries. In every country 

except Burundi, the percentage of children who had not received any of the EPI vaccines was higher in 

rural areas than in urban areas. In 14 of the 23 countries included in this report, the percentage of children 

who had not received any of the EPI vaccines was lower for children living with a female household head 

than for children living with a male household head. As for age of head of household, in 17 countries the 

percentage of children who had not received any of the EPI vaccines was higher for individuals living 

with a household head who was at least 50 years of age than for children living with a younger head of 

household. With the exception of Zambia (31 percentage point increase) and Benin (4 percentage point 

increase), every country in the study demonstrated a reduction in the percentage of children who had not 

received any of the EPI vaccines. 
138 

Diarrhea. Overall, we did not find sex disparities related to rates of child diarrhea. In half of 

these countries, the diarrhea prevalence for children less than age 5 was lower in urban areas than in rural 

areas. In 13 of 23 countries, the prevalence of diarrhea was higher for children living with a female 

household head than for children living with a male household head. In Burundi, Kenya, and Uganda, the 

age of the household head played an important role in diarrhea prevalence among children less than age 5. 

In six countries—Cameroon, Ghana, Kenya, Namibia, Tanzania, and Zimbabwe—the prevalence of 

diarrhea among children less than age 5 increased between surveys in the last 13 years. This increase was 

more than four percentage points in Cameroon and Ghana. 

Medical treatment of diarrhea. In 17 of 23 African countries, the percentage of children who 

did not receive medical advice for recent diarrhea was higher for girls than for boys. In two-thirds of the 

sub-Saharan African countries recent diarrhea was less likely to receive medical attention in rural areas 

than in urban areas. These disparities were greatest—at least 15 percentage points—in Ethiopia, Guinea, 

Madagascar, Mali, and Niger. In two-thirds of these sub-Saharan African countries, the percentage of 

children who did not receive medical advice for diarrhea was higher for children living with a male 

household head than for those living with a female household head. This difference was greatest—more 

than six percentage points–in Mozambique, Guinea, Cameroon, and Nigeria. In half of these countries, 

the percentage of children who did not receive medical advice was higher for children living with a 

household head younger than 50 years old than for children living with an older household head. The 

percentage of children who had diarrhea in the two weeks prior to the survey and did not receive medical 

advice decreased between surveys in every sub-Saharan African country except Benin (increase of 3.8 

percentage points). 

7.3 Water and Sanitation Deprivation 

Use of surface water. Overall, we did not find sex disparities related to the use of surface water 

in sub-Saharan Africa. However, we did find geographic disparities. In these countries a higher 

percentage of children in rural areas used surface water than in urban areas. The percentage of children 

using surface water was at least five percentage points higher for children living with a male household 

head than for children living with a female household head in Benin, Ethiopia, Ghana, Guinea, Liberia, 

and Madagascar. Additionally, the percentage of children using surface water was at least three 

percentage points higher for children living with a household head at least 50 years old than for children 

living with a younger head of household head in Cameroon, Kenya, Namibia, and Nigeria. Ethiopia, with 

an increment of 29 percentage points, experienced the greatest increase in the percentage of children who 

used surface water. Other countries that experienced relatively significant increases included Rwanda (11 

percentage points) and Zimbabwe (8 percentage points). In contrast, Madagascar experienced the greatest 

decrease on the continent (11 percentage points). An additional five countries (Burkina Faso, Ghana, 

Kenya, Madagascar, and Malawi) also experienced a decrease of more than five percentage points in the 

percentage of children using surface water. 

15 minute walk to the water source. There were no sex disparities related to the percentages of 

children who had to walk 15 minutes or more to their water source. In every country except Liberia, this 

percentage was higher in rural areas than in urban areas. Whether the percentage of children living more 

than a 15 minute walk from the primary water source was higher for children living with a male or a 

female household head varied across these countries. The age of the household head was especially 

important in Namibia, where the percentage of children living more than a 15 minute walk from the 

primary water source was 16 percentage points higher for children living with a household head at least 

50 years of age than for those who lived with a younger household head. Over the last 13 years large 

increases in the percentage of children living more than a 15 minute walk from a primary water source 

occurred in Benin, Cameroon, Ethiopia, and Rwanda. This increase was most evident in Ethiopia, at 10 
139 

percentage points. Senegal showed a major decrease in the percentage of children living more than a 15 

minute walk from the primary water source (28 percentage point decrease). 

Lack of access to any sanitation facilities whatsoever in or near their homes. Overall, there 

were no sex disparities related to children’s access to sanitation facilities. In all of the sub-Saharan 

African countries, the percentage of children who did not have access to any sanitation facilities was 

higher in rural areas than in urban areas. In Benin, Burkina Faso, Ghana, and Senegal, the percentage of 

children without access to any sanitation services was more than 11 percentage points higher for children 

living with a male household head than for children living with a female household head. Ethiopia 

experienced the largest reduction (23 percentage points) in the percentage of children who do not have 

access to any sanitation facilities. Other countries that experienced reductions of more than five 

percentage points included Burkina Faso, Lesotho, Malawi, and Mozambique. Only Nigeria, with a 6 

percentage point increase, and Tanzania, with a 2 percentage point increase, experienced increases in the 

percentage of children who did not have access to any sanitation facilities. 

7.4 Shelter Deprivation 

Living in houses with mud floors. Overall, there were no sex disparities related to living in a 

house with a mud floor. However, we found large rural-urban differences. In every country a higher 

percentage of children lived in houses with mud floors in rural areas than in urban areas. In two-thirds of 

these countries, the percentage living in houses with mud floors was higher for children living with a male 

rather than a female household head. This difference was about 15 percentage points in Burkina Faso, 

Guinea, Nigeria, and Senegal. The inverse situation occurred in Namibia, a 10 percentage point 

difference. The percentage living in houses with mud floors was much higher for children living with a 

household head at least 50 years old than for children living with a younger head of household in Namibia 

(28 percentage point higher), Lesotho (17 percentage points higher), and Zambia (11 percentage points 

higher). Three countries—Ghana (3 percentage points), Nigeria (4 percentage points), and Zambia (3 

percentage points)—experienced an increase on the percentage of children living in houses with mud 

floors. In the rest of countries explored in this study, the percentage of children living in houses with mud 

floors decreased. 

Living in houses without electricity. Overall, there were no sex disparities with regard to having 

electric power at home. In every country, however, the percentage of children living in houses without 

electricity was higher in rural areas than in urban areas. The sex of the household head mattered in 

Senegal, where the percentage living without electricity was 53% for children living with a male 

household head and 27% for children living with a female household head. In Namibia and Uganda the 

percentage without electricity was slightly higher (2 percentage points) among children living with a 

household head age 50 or older than for children living with a younger household head. In nearly all these 

countries, the percentage living in houses without electric power decreased. In Nigeria, however, the 

percentage of children living in houses without electricity increased by 4 percentage points. Madagascar 

experienced an increase of 2 percentage points. 

7.5 Education Deprivation 

Children who have received no primary or secondary education. Overall, there were 

inconsistent differences related to a child’s sex in the percentage ages 0 to 17 years without education. In 

some countries the percentage was higher for males; in others, for females. For instance, the greatest 

difference occurred in Niger, where 55% of males and 69% of females had no education, a difference of 

14 percentage points. The percentage of children without education was about 10 percentage points 

higher for females than males in Benin, Guinea, and Mali. The inverse situation, but less marked, 

occurred in Kenya and Lesotho, where a higher proportion of male children than female children had no 
140 

education by two percentage points. In every country except Sao Tomé and Príncipe, the percentage of 

children under 18 years old without education was higher in rural areas than in urban areas 

In 18 countries the percentage without a primary or secondary education was at least one 

percentage point higher for children living with a male rather than a female head of household. We did 

not find the inverse situation in any sub-Saharan Africa country. In some countries the age of the 

household head was not associated with children’s lack of education. In other countries the percentage 

without education was higher among children living with a household head 50 years or older. In every 

country the percentage of children without education has decreased during the last 13 years. 

Children not currently enrolled in school. By sex, the greatest differences in the percentage of 

children up to age 17 years who were not enrolled in school occurred in Benin, Chad, Cote d’Ivoire, 

Guinea, and Niger, where the percentage was at least 10 points higher for females than for males. We 

found no rural-urban disparities in Rwanda, Swaziland, or Uganda. In the rest of the countries, however, 

the percentage of children who were not enrolled in school was at least one percentage point higher in 

rural areas than in urban areas. The sex of the household head played an important role in the percentage 

of children not enrolled in school. In five countries—Benin, Burkina Faso, Cameroon, Nigeria, and 

Senegal—this percentage was at least five percentage points higher for children in a male-headed 

household. By comparison, only in Chad was this percentage at least five percentage points higher for 

children living with a female head of household. In nine countries the percentage of children not enrolled 

in school was at least five percentage points higher for children living with a household head 50 years or 

older than those living with a household head less than age 50. In every country in sub-Saharan Africa the 

percentage of children age 7-17 not enrolled in school decreased by at least one percentage point during 

the last 13 years. Ethiopia and Zambia experienced the greatest decrease—at least 15.0 percentage points. 

School dropouts. Overall, the percentage of children age 7-12 who had dropped out of school 

was very low, reaching no more than 3.6% in any country except Burkina Faso (7%), but at age 13-17 

dropout rates rise, ranging from less than 4% in Kenya to nearly 35% in Burkina Faso. Dropout rates were 

similar for the two sexes. However, we found geographic disparities in the percentage of children who 

dropped out of school in two countries. In Burkina Faso and Madagascar dropout rates were at least six 

percentage points higher in rural areas than in urban areas. There was no association between the sex of 

the household head and the percentage of children who dropped out of school. In Burkina Faso the 

percentage of dropout rates was higher for children living in female-headed households than for children 

in male-headed households (24% versus 17%). Reductions of at least six percentage points in the 

proportion of children age 7-17 who dropped out school occurred in Benin, Ghana, Kenya, and Zambia. 

In summary, this report provides information on the current status and trends on five types of 

deprivation: food, water and sanitation, health, shelter, and education. Several important findings will 

help in the design and evaluation of programs and help program planners and policymakers to achieve 

national objectives. First, in many sub-Saharan African countries, greater effort is needed to reduce sex 

and geographic disparities related to children’s deprivation. In some cases programs also should address 

the role that the age and sex of the household head plays in the percentage of children experiencing these 

deprivations. Despite overall reductions in the exposure to some of these types of deprivation, some 

countries are still struggling to make and sustain improvements. 
141 

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