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High Infant Mortality in Sub-Saharan Africa: Causes and Solutions

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Infant mortality is the death of infants or children under one year of age. The World Health Organization (WHO) defines infant mortality rate as the total number of infant deaths in a region per 1,000 live births.

The infant mortality rate not only measures infant survival but also gives us information about the state of infant and maternal health and the state of the overall health of society (1,2).

In 1990, the global infant mortality rate was 64 per 1,000 live births. Since then, improvements in the economic, social, and environmental conditions, and access to healthcare services have reduced the rate to 27 per 1,000 live births in 2020 worldwide (3).

However, with an infant mortality rate of 50 per 1,000 live births in 2020, the infant mortality rate is still high in Sub-Saharan Africa (4). Several factors are responsible for the high infant mortality rate in this African region.

Causes of High Infant Mortality Rate

Several thousands of children in Sub-Saharan Africa die within the first 4 weeks of their life, while many others are stillborn.

As a result, the 2030 Agenda for Sustainable Development set out 17 major Sustainable Development Goals (SDGs) in 2015, and out of these, SDG3.2 deals with reducing the mortality rate of children under the age of 5 years (5).

Although developed countries have been successful in reducing this mortality rate, under-developed regions like Sub-Saharan Africa are still faced with high infant and under-five mortality rates.

On top of that, statistics reveal that Sub-Saharan Africa accounts for nearly half of neonatal deaths worldwide (5). Therefore, infant mortality is higher in Africa compared to other regions (6).

Some of the causes of the high rate of infant deaths in Sub-Saharan Africa are birth asphyxia, low weight, preterm birth, and infections.

These four main factors account for 87% of child deaths in the African region. Moreover, neonatal hypothermia also increases the risk of death in infants (5).

Studies have also revealed that the risk of infant death is higher in low-birth-weight infants as they are more likely to suffer from hypoglycemia, neonatal sepsis, and hypothermia at birth.

Teenage pregnancy and short birth intervals also increase infant mortality. However, infants who get immediately breastfed show a lower risk of death (7).

Furthermore, the place of delivery also affects the infant’s survival. The infants born at a health facility have a lower risk of death since the mother and infant both get appropriate delivery care, vaccination, and other health care services (7).

Another factor contributing to the high infant mortality rate in Sub-Saharan Africa is the low health expenditure compared with other regions of the world (8).

Additionally, undernutrition, poor water, hygiene, and sanitary conditions, and poor household environmental conditions also increase the risk of death in children under the age of 5 years.

When children live in these poor conditions, they become vulnerable to illnesses like malaria, gastroenteritis, diarrhea, acute lower respiratory infections, and pneumonia due to exposure to pathogens (9).

Several underlying social determinants are contributing to the high infant mortality rate in Sub-Saharan Africa.

These include poverty, low levels of paternal and maternal education, and lower access to quality health care. In addition to that, neonatal health doesn’t receive sufficient attention despite the high number of infant deaths in the region.

It is important to note that due to the lack of accurate and reliable information about the number of infant deaths in Sub-Saharan Africa, hundreds of infant deaths go unregistered (6).

Possible Solutions

The following are some measures to lower the infant mortality rate in Sub-Saharan Africa:

Increasing Access to Healthcare Services

Almost two-thirds of infant deaths could be prevented in Sub-Saharan Africa if the mothers and infants have access to quality healthcare services and a small number of interventions.

These include the provision of birth care by experienced attendants, treatment of infant illnesses, antenatal care, and postnatal care.

Unfortunately, the coverage of these effective interventions is currently low (6). Increasing the coverage of these interventions will significantly reduce infant mortality (12).

Improvement of Sanitary and Hygiene Conditions

Although it is not easy to improve water, sanitary, and hygiene conditions, it’s necessary to save the people living in Sub-Saharan Africa, especially children, from various diseases and infections.

Also, there is a need to set up small clinics in carefully chosen locations to make access to vaccines easier for people (10).

The Use of Technology

The use of technology could save the lives of children and mothers in underdeveloped regions. Since most primary healthcare centers are not easily accessible, the on-time delivery of healthcare services to children and mothers becomes a huge challenge.

However, by leveraging smartphone technology, necessary and reliable nutrition care and other services will be made accessible to more children.

The policymakers and stakeholders of the region should also pay attention to factors like preceding birth intervals, breastfeeding status, and teen pregnancy (7).

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Increasing Healthcare Expenditure

Unless the healthcare expenditure is increased, the infant mortality rate can’t be lowered in Sub-Saharan Africa. African governments need to improve health infrastructure and increase healthcare expenditure to improve the living and health conditions of the people in this region.

The healthcare in Sub-Saharan Africa is among the worst in the world and despite poverty, a shocking 50% of the health expenditure is financed via out-of-pocket payments by individuals (11).

Addressing Nutritional Deficit and Improving Household Conditions

There’s a need to address the nutritional deficit and household environmental pollution in Sub-Saharan Africa to reduce the infant and under-five mortality rates in the region.

When children are provided with better household conditions, the government will be able to lower the infant mortality rate to less than 25 deaths per 1000 live births by 2030 (9).


Infants and women are important to us and their surrounding communities. It’s for this reason, that The Emmanuel Osemota Foundation (EOF), has instituted programs and steps to reduce infant mortality rates in Sub-Saharan Africa, with focus on Nigeria.

EOF provides access to healthcare, education for pregnant women, mosquito nets, antenatal care sessions, medications/healthcare for women during and after pregnancy, and empowerment programs for locals in Nigeria.

Let’s join to reduce the infant mortality rates in our local communities by clicking here.

We thank you for your donation!


Written by: Emmanuel J. Osemota


  1. (2022). Infant Mortality Rate (per 1000 Live Births). World Health Organization. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3138
  2. (2019). Infant Mortality. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm#:~:text=Infant%20mortality%20is%20the%20death,for%20every%201%2C000%20live%20births.
  3. The World Bank. (2020). Mortality Rate, Infant (per 1,000 Live Births). The World Bank. https://data.worldbank.org/indicator/SP.DYN.IMRT.IN?end=2020&start=1960
  4. The World Bank. (2020). Mortality Rate, Infant (per 1,000 Live Births). The World Bank. https://data.worldbank.org/indicator/SP.DYN.IMRT.IN?end=2020&locations=ZG&start=1990
  5. Pisoni, G. B., Gaulis, C., Suter, S., Rochat, M. A., Makohliso, S., Roth-Kleiner, M., … & Schönenberger, K. (2022). Ending Neonatal Deaths from Hypothermia in Sub-Saharan Africa: Call for Essential Technologies Tailored to the Context. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.851739
  6. Mason, E. Newborns in Sub-Saharan Africa: How to Save These Fragile Lives. UN Chronicle. United Nations. https://www.un.org/en/chronicle/article/newborns-sub-saharan-africa-how-save-these-fragile-lives#:~:text=Birth%20asphyxia%2C%20preterm%20birth%20and,of%20newborn%20deaths%20in%20Africa.
  7. Tiruneh, S. A., Zeleke, E. G., & Animut, Y. (2021). Time to Death and its Associated Factors Among Infants in Sub-Saharan Africa Using the Recent Demographic and Health Surveys: Shared Frailty Survival Analysis. BMC Pediatrics, 21(1), 1-13. https://doi.org/10.1186/s12887-021-02895-7
  8. Kiross, G. T., Chojenta, C., Barker, D., & Loxton, D. (2020). The Effects of Health Expenditure on Infant Mortality in Sub-Saharan Africa: Evidence from Panel Data Analysis. Health Economics Review, 10(1), 1-9. https://doi.org/10.1186/s13561-020-00262-3
  9. Amegah, A. K. (2020). Improving Child Survival in Sub-Saharan Africa: Key Environmental and Nutritional Interventions. Annals of Global Health, 86(1). http://doi.org/10.5334/aogh.2908 
  10. Steffen, D. R. (2018). Infant Mortality: Sub-Saharan Africa. Global Issues in Public Health. https://digitalcommons.augustana.edu/pubh100issues/11/?utm_source=digitalcommons.augustana.edu%2Fpubh100issues%2F11&utm_medium=PDF&utm_campaign=PDFCoverPages
  11. (2022). Health Care in Africa: IFC Report Sees Demand for Investment. International Finance Council. https://www.ifc.org/wps/wcm/connect/news_ext_content/ifc_external_corporate_site/news+and+events/healthafricafeature#:~:text=Health%20care%20in%20Sub%2DSaharan,minimum%20for%20basic%20health%20care.
  12. Shoo, R. Reducing Child Mortality – The Challenges in Africa. UN Chronicle. United Nations. https://www.un.org/en/chronicle/article/reducing-child-mortality-challenges-africa

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