Adolescent Boys and Girls in Africa: Their Demography, Behavioural Outcomes, Determinants and Consequences

  • Nicole De WetEmail author
  • Khuthala Mabetha
  • Palesa Mataboge


Adolescents in sub-Saharan Africa hold particular social and economic development potential. This sub-group will grow into future parents, leaders and employers driving the sub-continent forward. However, they face a myriad of challenges not limited to healthcare, education and future employment opportunities. In order to better prepare sub-Saharan Africa for the future needs of these maturing individuals, there is a need to know more about who adolescents are. The purpose of this study is to examine the changing composition, fertility and mortality patterns of adolescents in sub-Saharan Africa. Guided by the social determinants of health framework, the study uses demographic and health surveys and census data from six sub-Saharan African countries. Frequency distributions, rates, population pyramids, age-specific fertility and mortality rates and regression models are used to profile adolescents in the region. In all countries, adolescents are highly concentrated in rural areas. Furthermore, the probability of adolescent fertility is higher in rural than urban areas. However, adolescent mortality is higher in urban compared to rural areas. In conclusion, concentrated efforts should be made on addressing the needs of adolescents in rural areas to achieve a healthy and successful transition to adulthood.


  1. Alleyne, G., Binagwaho, A., Haines, A., Jahan, S., Nugent, R., Rojhani, A., Stuckler, D., & Lancet NCD Action Group. (2013). Embedding non-communicable diseases in the post-2015 development agenda. The Lancet, 381(9866), 566–574.CrossRefGoogle Scholar
  2. Aryal, K. K., Mehata, S., Neupane, S., Vaidya, A., Dhimal, M., Dhakal, P., Rana, S., Bhusal, C. L., Lohani, G. R., & Paulin, F. H. (2015). The burden and determinants of non communicable diseases risk factors in Nepal: Findings from a Nationwide STEPS survey. PLoS One, 10(8), e0134834.CrossRefGoogle Scholar
  3. Axelson, D., Goldstein, B., Goldstein, T., Monk, K., Haifeng, Y., Hickey, M. B., Sakolsky, D., Diler, R., Hafeman, D., & Merranko, J. (2015). Diagnostic precursors to bipolar disorder in offspring of parents with bipolar disorder: A longitudinal study. American Journal of Psychiatry, 172(7), 638–646.CrossRefGoogle Scholar
  4. Blum, R. W. (2007). Youth in sub-Saharan Africa. Journal of Adolescent Health, 41(3), 230–238.CrossRefGoogle Scholar
  5. Bongaarts, J., & Casterline, J. (2013). Fertility transition: Is sub-Saharan Africa different? Population and Development Review, 38(s1), 153–168.CrossRefGoogle Scholar
  6. Bradshaw, D., Steyn, K., Levitt, N., & Nojilana, B. (2011). Non communicable diseases: A race against time. Cape Town: Medical Research Council South Africa.Google Scholar
  7. Branson, N., Hofmeyr, C., & Lam, D. (2014). Progress through school and the determinants of school dropout in South Africa. Development Southern Africa, 31(1), 106–126.CrossRefGoogle Scholar
  8. Brière, F. N., Rohde, P., Seeley, J. R., Klein, D., & Lewinsohn, P. M. (2014). Comorbidity between major depression and alcohol use disorder from adolescence to adulthood. Comprehensive Psychiatry, 55(3), 526–533.CrossRefGoogle Scholar
  9. Carneiro, P., Meghir, C., & Parey, M. (2013). Maternal education, home environments, and the development of children and adolescents. Journal of the European Economic Association no., 11(s1), 123–160.CrossRefGoogle Scholar
  10. Chandra-Mouli, V., McCarraher, D. R., Phillips, S. J., Williamson, N. E., & Hainsworth, G. (2014). Contraception for adolescents in low and middle income countries: Needs, barriers, and access. Reproductive health no., 11(1), 1.CrossRefGoogle Scholar
  11. CSDH. (2007). A conceptual framework for action on the social determinants of health. Geneva: CSDH/WHO Wanless. Edited by WHO.Google Scholar
  12. Dalal, S., Beunza, J. J., Volmink, J., Adebamowo, C., Bajunirwe, F., Njelekela, M., Mozaffarian, D., Fawzi, W., Willett, W., & Adami, H.-O. (2011). Non-communicable diseases in sub-Saharan Africa: What we know now. International Journal of Epidemiology, 40(4), 885–901.CrossRefGoogle Scholar
  13. De Wet, N. (2016). Pregnancy and death: An examination of pregnancy-related deaths among adolescents in South Africa. South African Journal of Child Health, 10(3), 151–155.CrossRefGoogle Scholar
  14. Di Cesare, M., Khang, Y.-H., Asaria, P., Blakely, T., Cowan, M. J., Farzadfar, F., Guerrero, R., Ikeda, N., Kyobutungi, C., & Msyamboza, K. P. (2013). Inequalities in non-communicable diseases and effective responses. The Lancet, 381(9866), 585–597.CrossRefGoogle Scholar
  15. Dufur, M. J., Hoffmann, J. P., Braudt, D. B., Parcel, T. L., & Spence, K. R. (2015). Examining the effects of family and school social capital on delinquent behavior. Deviant Behavior, 36(7), 511–526.CrossRefGoogle Scholar
  16. Essau, C. A., Lewinsohn, P. M., Olaya, B., & Seeley, J. R. (2014). Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of Affective Disorders, 163, 125–132.CrossRefGoogle Scholar
  17. Ezeh, A. C., Mberu, B. U., & Emina, J. O. (2009). Stall in fertility decline in eastern African countries: Regional analysis of patterns, determinants and implications. Philosophical Transactions of the Royal Society B: Biological Sciences., 1532(364), 2991–3007.CrossRefGoogle Scholar
  18. Fatusi, A. O., & Hindin, M. J. (2010). Adolescents and youth in developing countries: Health and development issues in context. Journal of Adolescence, 33(4), 499–508.CrossRefGoogle Scholar
  19. Fedewa, M. V., Gist, N. H., Evans, E. M., & Dishman, R. K. (2014). Exercise and insulin resistance in youth: A meta-analysis. Pediatrics, 133(1), e163–e174.CrossRefGoogle Scholar
  20. Fernando, S. (2010). Mental health, race and culture. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
  21. Filmer, D., & Fox, L. (2014). Youth employment in sub-Saharan Africa. Washington, DC: World Bank Publications.CrossRefGoogle Scholar
  22. Ford, C. A., Bearman, P. S., & Moody, J. (1999). Foregone health care among adolescents. JAMA, 282(23), 2227–2234.CrossRefGoogle Scholar
  23. Garcia, M. H., & Fares, J. (Eds.). (2008). Youth in Africa’s labor market. Washington, DC: World Bank Publications.Google Scholar
  24. Garenne, M., Tollman, S., Kahn, K., Collins, T., & Ngwenya, S. (2001). Understanding marital and premarital fertility in rural South Africa. Journal of Southern African Studies, 27(2), 277–290.CrossRefGoogle Scholar
  25. Hayward, K. (2004). City limits: Crime, consumer culture and the urban experience. London: Routledge.Google Scholar
  26. Helman, C. G. (2007). Culture, health and illness. New York: CRC Press.Google Scholar
  27. Hervish, A, & Clifton, D. (2012). Status report: Adolescents and young people in sub-Saharan Africa. Opportunities and challenges.Google Scholar
  28. Ibrahim, M. M., & Damasceno, A. (2012). Hypertension in developing countries. The Lancet, 380(9841), 611–619.CrossRefGoogle Scholar
  29. Kabiru, C. W., Izugbara, C. O., & Beguy, D. (2013). The health and wellbeing of young people in sub-Saharan Africa: An under-researched area? BMC International Health and Human Rights, 13(1), 11.CrossRefGoogle Scholar
  30. Kara, R., & Maharaj, P. (2015). Childbearing among young people in South Africa: Findings from the National Income Dynamics Study. Southern African Journal of Demography, 16(1), 57.Google Scholar
  31. Kaufman, C. E., De Wet, T., & Stadler, J. (2001). Adolescent pregnancy and parenthood in South Africa. Studies in Family Planning, 32(2), 147–160.CrossRefGoogle Scholar
  32. Kiragu, K. (2001). Youth and HIV/AIDS: Can we avoid catastrophe? Population Reports. Series L: Issues in World Health, (12), 40.Google Scholar
  33. Klepinger, D. H., Lundberg, S., & Plotnick, R. D. (1995). Adolescent fertility and the educational attainment of young women. Family Planning Perspectives, 27, 23–28.CrossRefGoogle Scholar
  34. Leclerc-Madlala, S. (2002). On the virgin cleansing myth: Gendered bodies, AIDS and ethnomedicine. African Journal of AIDS Research, 1(2), 87–95.CrossRefGoogle Scholar
  35. Loaiza, E., & Liang, M. (2013). Adolescent pregnancy: A review of the evidence. New York: UNFPA.Google Scholar
  36. Lobel, T. E., Nov-Krispin, N., Schiller, D., Lobel, O., & Feldman, A. (2004). Gender discriminatory behavior during adolescence and young adulthood: A developmental analysis. Journal of Youth and Adolescence, 33(6), 535–546.CrossRefGoogle Scholar
  37. Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., Abraham, J., Adair, T., Aggarwal, R., & Ahn, S. Y. (2013). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the global burden of disease study 2010. The Lancet, 380(9859), 2095–2128.CrossRefGoogle Scholar
  38. Marsella, A. J., & White, G. (2012). Cultural conceptions of mental health and therapy (Vol. 4). New York: Springer.Google Scholar
  39. Mulkeen, A. (2005). Teachers for rural schools: A challenge for Africa. Africa region World Bank. Washington, DC: World Bank.Google Scholar
  40. National Research Council. (1993). Social dynamics of adolescent fertility in sub-Saharan Africa. Washington, DC: National Academies Press.Google Scholar
  41. Ncube, M., & Lufumpa, C. L. (2014). The emerging middle class in Africa. London: Routledge.Google Scholar
  42. Nishimura, M., & Yamano, T. (2013). Emerging private education in Africa: Determinants of school choice in rural Kenya. World Development, 43, 266–275.CrossRefGoogle Scholar
  43. Okojie, C. E. E. (2003). Employment creation for youth in Africa: The gender dimension. Jobs for Youth: National Strategies for Employment Promotion, 15–16.Google Scholar
  44. Owusu-Acheampong, E., & Williams, A. A. (2015). Dearth of teachers in rural basic schools: Implications on human resource development in the Amenfi West District, Ghana. British Journal of Education, (3), 32–42.Google Scholar
  45. Patel, V. (1995). Explanatory models of mental illness in sub-Saharan Africa. Social Science & Medicine, 40(9), 1291–1298.CrossRefGoogle Scholar
  46. Patton, G. C., Coffey, C., Sawyer, S. M., Viner, R. M., Haller, D. M., Bose, K., Vos, T., Ferguson, J., & Mathers, C. D. (2009). Global patterns of mortality in young people: A systematic analysis of population health data. The Lancet, 374(9693), 881–892.CrossRefGoogle Scholar
  47. Patton, G. C., Sawyer, S. M., Santelli, J. S., Ross, D. A., Afifi, R., Allen, N. B., Arora, M., Azzopardi, P., Baldwin, W., & Bonell, C. (2016). Our future: A lancet commission on adolescent health and wellbeing. The Lancet, 387(10036), 2423–2478.CrossRefGoogle Scholar
  48. Population Reference Bureau. (2017). The demographic dividend in Africa relies on investment in the reproductive health and rights of adolescents and youth. Washington: Population Reference Bureau.Google Scholar
  49. Powell, P. W., Chen, R., Kumar, A., Streisand, R., & Holmes, C. S. (2013). Sociodemographic effects on biological, disease care, and diabetes knowledge factors in youth with type 1 diabetes. Journal of Child Health Care, 17(2), 174–185.CrossRefGoogle Scholar
  50. Rossouw, L., Burger, R., & Burger, R. (2012). The fertility transition in South Africa: A retrospective panel data analysis. Stellenbosch: Department of Economics and Bureau for Economic Research, Stellenbosch University.Google Scholar
  51. South African Human Rights Commission, & United Nations Children’s Fund. (2016). Global goals for every child: Progress and disparities among children in South Africa. Pretoria: South African Human Rights Commission/United Nations Children’s Fund.Google Scholar
  52. Statistics South Africa. (2016). Vulnerable groups series I: The social profile of youth, 2009–2014.Google Scholar
  53. Statistics South Africa. (2018). Demographic profile of Adolescents in South Africa. Pretoria: Statistics South Africa.Google Scholar
  54. UNAIDS. (2000). Report on the global HIV/AIDS epidemic (UNAIDS/00.13E). Geneva: UNAIDS.Google Scholar
  55. UNAIDS. (2015, July). 2014 HIV and AIDS estimates.Google Scholar
  56. UNDP. (2011). Gender equality and women’s empowerment in public administration: Mali case study.Google Scholar
  57. UNICEF. (2011). Opportunity in Crisis: Preventing HIV from early adolescence to young adulthood. UNICEF.Google Scholar
  58. United Nations Population Fund. (2015). Adolescents and youth. New York: United Nations Population Fund.Google Scholar
  59. Verkuyl, D. A. A. (1995). Practising obstetrics and gynaecology in areas with a high prevalence of HIV infection. The Lancet, 346(8970), 293–296.CrossRefGoogle Scholar
  60. Viner, R. M., Coffey, C., Bloem, P., Costello, A., Santelli, J., & Patton, G. C. (2011). 50-year mortality trends in children and young people: A study of 50 low-income, middle-income and high-income countries. The Lancet, 377(9772), 1162.CrossRefGoogle Scholar
  61. WHO. (2009). Global burden of disease. Projections of mortality and burden of disease, 2002–2030. edited by World Health Organisation.
  62. WHO. (2010). Fact File: 10 facts on adolescent health 2010. Available from
  63. WHO. (2012). World Health Organization, Global Health estimates 2012. Geneva: WHO.Google Scholar
  64. Winskell, K., Miller, K. S., Allen, K. A., & Obong’o, C. O. (2016). Guiding and supporting adolescents living with HIV in sub-Saharan Africa: The development of a curriculum for family and community members. Children and Youth Services Review, 61, 253–260.CrossRefGoogle Scholar
  65. Wood, K., & Jewkes, R. (2006). Blood blockages and scolding nurses: Barriers to adolescent contraceptive use in South Africa. Reproductive Health Matters, 14(27), 109–118.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Nicole De Wet
    • 1
    Email author
  • Khuthala Mabetha
    • 1
  • Palesa Mataboge
    • 1
  1. 1.Demography and Population Studies Programme, Schools of Public Health and Social SciencesUniversity of the WitwatersrandJohannesburgSouth Africa

Personalised recommendations