The importance for the MDG4 and MDG5 of addressing reproductive health issues during the second decade of life: review and analysis from times series data of 51 African countries.

Addressing adolescent sexual and reproductive health issues are central to efforts for reducing childhood and maternal mortality embedded in MDG4 and MDG5. This paper reviews these issues in Africa and uses statistical methods for measuring changes to analyze recent and comparable time series data from 51 African countries. The contribution of adolescent fertility to total fertility and mortality remains quite high. Delayed marriage is occurring concomitantly with postponement of sexual debut among unmarried adolescents. Six African countries are likely to achieve the MGD4 and five are likely to reach the target for the MDG5; the majority of sub-Saharan African countries will fall short of achieving these goals, not even by 2100 for many at current rates of change in progress indicators. Implementing ground-breaking nationally owned mortality-reduction schemes covering preconceptional and interconceptional periods and well-functioning comprehensive health-care system secured by sustained commitments and financial investments in health and social services are urgently needed, in order to repeal trends of further undoing successes achieved so far or slowing recent progress, thus hastening the pace of child and maternal mortality decline.