Why is Southern Africa’s economic growth the worst of all Africa’s regions, while East Africa is number one?
With an economic growth rate exceeding its population growth, Africa should be achieving economic development advances – but that is not the case. Poverty remains widespread, and there are huge differences in performance between the continent’s five regions. This is influenced by geographic location, structures of individual economies, commodity dependence, regional political dynamics, and resilience to global shocks.
In the African Development Bank’s African Economic Outlook 2023, East and Southern Africa’s economic growth rates stand out (see graph). Over the 2021-25 period, Southern Africa is the continent’s worst regional performer, while East Africa is number one. In fact, projected growth rates indicate that East Africa will accelerate while Southern Africa will continue to underperform
How do these two regions compare? Of the 13 countries in Southern Africa, 69% are middle-income economies. In contrast, only 38% of East Africa’s 13 nations hold middle-income status, with most still classified as low-income. The general notion that low-income countries tend to grow faster than middle-income countries could favour East African economies in their growth trajectory. But that is not enough to fully explain the two regions’ varied performance.
The broad structures of the two regional economies differ. Ten East African countries are non-resource-intensive economies, versus seven in Southern Africa. Both regions have one oil-exporting country – South Sudan in East Africa and Angola in Southern Africa.
Southern Africa dominates with five economies rich in non-oil resources, while East Africa has only two. The fact that East African countries are less exposed to global commodity booms and busts in their economic structure may benefit the region. This is evidenced by the 2023 Macroeconomic Performance and Outlook report, which indicates that from 2021-24, non-resource-intensive economies tended to grow faster than the other categories.
Southern Africa contributes 22% to Africa’s gross domestic product (GDP), while East Africa’s contribution rose from 14% in 2018 to 17% in 2022. A 2023 Euromonitor article reported that East Africa’s contribution to continental GDP is projected to account for as much as 29% by 2040. This projected growth in the region’s GDP depends on a continued high-growth path in this part of Africa.
Apart from the influence of the global economy, shocks and geopolitical events, regional dynamics and neighbouring countries’ performance have strong knock-on effects. In the case of Southern Africa, South Africa and Angola together account for 75% of the region’s output. In East Africa, four economies – Ethiopia, Kenya, Tanzania and Uganda – account for around 84% of the region’s output (see map diagrams).
Even though all the economies are exposed to global geopolitical shocks and continued global uncertainties, East African countries tend to be more resilient than those in Southern Africa in terms of growth.
Underperformance in Southern Africa could predominantly be attributed to the stagnation of South Africa’s economy and its impact on the region. The numerous political, structural, and macroeconomic challenges in South Africa and other countries in the region affect physical and social infrastructure. This reduces productivity and constrains domestic demand.
Botswana and Mauritius have above average long-term growth performances, with higher growth expectations for Mozambique and Zambia. Despite this, Southern Africa’s economic growth is expected to be insufficient to carry the region forward significantly. Moreover, Southern Africa is plagued by high external debt burdens, poverty, inequality, and especially youth unemployment.
In contrast, East Africa’s robust economic performance is driven by the strong showing of seven of the region’s 13 countries. Rwanda, Ethiopia, Uganda, Tanzania, Djibouti, Kenya and Seychelles are the highest performers, with average growth rates of over 5%. Rwanda was one of the key sustainable growth success stories with a growth rate exceeding 7% on average annually. These impressive results benefit the rest of East Africa despite Somalia and Sudan’s political instability.
Several key policy decisions drive economic growth in East Africa: the Look East Policy of embracing China, investment in road and communications infrastructure, support for agriculture, and prioritising connectivity and trade within the region.
Mega infrastructure projects cover roads, ports, airports, railways, dams, bridges, hydropower projects and crude oil pipelines. Examples include Kenya’s 592km Standard Gauge Railway, a train line between Addis Ababa and Djibouti, Uganda’s Karuma Hydropower Project, Tanzania’s newly planned Bagamoyo Port, the Bugesera International Airport Expressway in Rwanda, and South Sudan’s Juba International Airport.
The region is now reaping the benefits of these infrastructure projects, even though financial arrangements with China remain complex.
A large part of East Africa’s growth is driven by the service sector. Government spending and strategic investments have supported in-country connectivity and intraregional trade. With a rising middle class, regional demand for banking, insurance and healthcare is also increasing. East Africa is known for its agricultural exports, and the modernisation of agricultural production was a crucial part of government spending. Djibouti, for example, improved its transport infrastructure to become an interregional logistics and trade hub.
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Although Southern and East Africa are exposed to the effects of climate change, skills shortages and unemployment, continued growth and development in the two will depend on internal and regional growth dynamics.
While East Africa is on a positive, sustainable growth path, Southern Africa is stagnating. Growth and development in these two regions will depend on the extent to which the economies can individually and collectively navigate their growth trajectories. Southern Africa should focus on political and policy certainty, macroeconomic stability and enhanced regional cooperation to address its lagging growth.
This article was first published in the ISS’ African Futures and Innovation blog, Africa Tomorrow.
Elsabé Loots, Professor of Economics, Faculty of Economic and Management Sciences, University of Pretoria
Source: allafrica.com
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Inside Tanzania’s Life-Saving Birthcare Model
Tanzania is winning the battle against maternal and newborn deaths, as the latest numbers reveal a significant decline.
“Tanzania is committed to reducing maternal and newborn mortality and ensuring safe deliveries as part of the national development plan. The Safer Births Bundle of Care is one of the key strategies supporting this effort,” said Dr. Benjamin Kamala, the Senior Research Scientist at Haydom Lutheran Hospital and Principal Investigator for the program, leading its implementation across five regions in Tanzania.
A groundbreaking study published in the New England Journal of Medicine shows that the innovative health program in Tanzania – centered on regular, on-the-job training for healthcare workers – reduced maternal deaths by 75% and early newborn deaths by 40%. The three-year study, conducted across 30 high-burden healthcare facilities in Tanzania, tracked approximately 300,000 mother-baby pairs under the Safer Births Bundle of Care (SBBC) programme. The programme focuses on improving care for mothers and babies during the day of birth, the critical time when a woman goes into labor and delivers her baby.
Maternal health is a key focus of the United Nations Sustainable Development Goals (SDGs), specifically Target 3.1, which aims to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030.
Tanzania’s program combines continuous, simulation-based training for frontline healthcare workers alongside innovative clinical tools to improve labour monitoring (fetal heart rate monitoring) and newborn resuscitation.It also uses data to drive ongoing improvements, ensuring that healthcare workers have the skills, confidence, and competence to manage birth-related complications for both mothers and newborns.
“We work closely with healthcare workers, equipping them with the necessary tools to improve the quality of care, ensuring they can effectively manage both mothers and babies during and after childbirth,” Dr. Kamala said, which helps them build on over a decade of innovative research and collaboration to improve care during childbirth.
“To give you a sense of the scale of the burden of maternal and newborn mortality in Tanzania when the Safer Births Bundles of Care program was in early development in 2015/16, there were around 556 maternal deaths per 100,000 live births and 25 neonatal deaths per 1,000 live births,” he said.
The published study demonstrates the “transformative impact” of the Safer Births Bundle of Care program conducted across 30 hospitals in five high-burden regions of Tanzania, where there were about 300,000 mother-baby pairs.
Maternal deaths at the start of the program were recorded at 240 per 100,000 live births, with postpartum hemorrhage and hypertensive disorders being the leading causes of death, he said. Over the 24-month study period, this number dropped to approximately 60 per 100,000 live births, representing a 75% reduction. The number of newborn deaths – which are primarily due to breathing difficulties and complications related to prematurity – declined by 40% – from 7 deaths per 1,000 live births to 4 deaths per 1,000 live births.
“These results are remarkable,” Dr. Kamala said.
According to Dr. Kamala, the 75% reduction in maternal deaths was not expected, and a key lesson was the important role of the in-situ team simulations – including for postpartum bleeding – with reflective debriefings that trained facilitators led.
“This seems to be a major part of the success of the program,” he said. “We are delighted by these results and hope that other countries adopt and scale the Safer Births Bundle of Care program… Beyond the numbers, the Safer Births Bundle of Care program has fostered a dramatic culture shift in our healthcare system,” he said. “Healthcare workers are now more confident and better equipped to handle birth-related complications for both mothers and babies.”
Maternal death drop
Dr. Kamala attributed the 60-70% reduction in newborn deaths in Geita and Manyara to several factors.
“Firstly, Manyara was the first site for implementation, giving the region more time to adapt and experience the impact of the program. Most importantly, both regions had a high burden of stillbirths and neonatal deaths, making them ideal targets for focused intervention. As a result, newborn deaths decreased by 60-70%, showcasing a clear positive impact on newborn survival,” he said.
Dr. Kamala said another possible explanation is the differences in the culture of practices, where some health facilities reported inaccurate data due to the fear of blame and shame. However, with the project’s implementation, reporting became more accurate after mplementation. Some regions, such as Tabora, reported an increase in the number of referrals to the study hospitals from other care centers after the program was implemented. These were more likely to be late admissions, which increase the likelihood of poor health outcomes, he said.
After the implementation of the program, there was a 40% decrease in newborn deaths within the first 24 hours after birth, according to the study.
Dr. Kamala said Tanzania’s remarkable progress in reducing maternal mortality by 80% is driven by strategic investments and innovative programs focused on improving maternal and child survival rates.
“Over 2,000 new healthcare facilities have been developed, free health services are being provided to expectant mothers and children under the age of five, and emergency obstetric care – including better transport to hospitals in rural areas are helping to ensure timely, life-saving interventions.
“Most importantly, the Ministry of Health works in collaboration with healthcare workers, hospitals, and development partners to strengthen the skills of frontline healthcare workers, which has been a key factor in driving this progress.
“Political leadership, alongside strategic partnerships and financing, has been crucial in driving progress in maternal and newborn health,” he said.
The program was made possible by the support of the Global Financing Facility for Women, Children, and Adolescents, Norad, UNICEF, and Laerdal Global Health, as well as the Ministry of Health and Haydom Lutheran Hospital. Their partnership and investment enabled the scaling of the Safer Births Bundle of Care to 30 hospitals and supported the research. “The government has now scaled the program to over 150 sites, and there are plans for further expansion to three regions this year and then nationally,” he said.
Dr. Kamala outlined key policy recommendations for other governments can adopt to prioritize maternal health.
“Firstly, it focuses on cost-effective and relatively simple interventions that are essential to preventing maternal and newborn deaths. For example, stronger primary healthcare that is delivered in the community and a well-trained healthcare workforce are also critical. Additionally, working in close collaboration with national, regional, and local health authorities is key.”
He said Tanzania’s approach, where the Safer Births Bundle of Care program was successfully scaled and sustained by aligning the initiative with national guidelines for obstetrical and newborn care. In addition, the creation of mentorship programs and regular supervision has helped to sustain the results.
Looking ahead
Tanzania now plans to expand to three new regions in 2025, followed by a nationwide rollout.
The success of the program has attracted interest from other countries, with Botswana, Ethiopia, Lesotho, and Namibia expressing interest in adapting the program to their healthcare system. In Nigeria, the program has already been launched in two states, Gombe and Borno, marking a significant step in its scaling.
Source: allafrica.com
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