On the Causes of Excess Female Mortality Across African States

This is from a new paper by Siwan Anderson and Debraj Ray:

In this paper, we explore how the phenomenon of missing females is distributed across Africa. We consider two age groups: zero to 14 years old, and 15 to 59 years old. With such high overall mortality rates in Africa, these two age groups comprise almost all of the excess female deaths on the continent. Overall, there are more than 1.7 million excess female deaths each year in Africa. Expressed as a fraction of the female population, the African numbers are significantly higher than their Chinese or Indian counterparts. Roughly 425,000 of these excess female deaths in Africa are in the younger age category (zero to 14 years old), while the remaining 1.3 million are in the older age category (15 to 59 years old). There is substantial regional variation in excess female mortality across the continent. In both age groupings, the largest numbers are in West Africa. In the younger age group there are almost 200,000 excess female deaths in a given year in that region, and more than 450,000 in the older age category. East Africa is next, with close to 100,000 excess female deaths at the younger ages each year, and almost 400,000 in the older age category. By comparison, North Africa has the lowest excess female mortality, with roughly 100,000 excess deaths each year across the two age categories. Although excess female mortality is extremely high in Southern Africa in the older age group, by contrast there is virtually no excess female mortality in this region for the younger age category. Likewise, relative to other regions, excess female mortality is lower in the younger age category compared with the older in East Africa.

Our methodology also allows us to explore which diseases are primarily responsible for this extreme excess female mortality across Africa. In the younger age category, almost all of these excess deaths are from infectious and parasitic diseases and respiratory infections. A primary cause of excess young female deaths is malaria, with roughly 110,000 excess female deaths from this cause alone each year. The secondary major cause is respiratory infections, with around 95,000 excess female deaths each year; then diarrhoeal diseases, with approximately 77,000 excess young female deaths each year. In the older age category, HIV is the primary killer. There are close to 800,000 excess female deaths from HIV each year across Africa, with the largest proportions found in Southern and East Africa. Maternal mortality is also a major cause, particularly in East and West Africa. There are close to 400,000 excess female deaths from this cause each year.

H/T Charles Kenny.


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