The analysis highlights the major social, demographic and economic issues affecting the 13 districts of the Northern region. The findings of the study have major for the districts, the region as well as the country.
There is clear evidence that the population growth rate of 2.8 per cent per annum, for the region as a whole, is not sustainable, given the limits to the resources available. The region is already one of the most deprived in the nation. The large proportion of children, under the age of 15 years, corresponds to a high dependency ratio. The lack of schools, housing facilities, health care services and industrial activity only serve to compound the problems already facing the districts.
The substantial decline in the levels of childhood mortality is an indication that past child survival initiatives are achieving the intended results. Despite this, however, the level of childhood mortality is still very high in all districts. Similarly, the level of fertility is also high, despite evidence suggesting a declining trend. These trends have significant implications for fertility control.
The results of the analysis suggest that most of the districts in the region are largely rural, with Agriculture, Forestry and Hunting as the main sources of employment. The lack of significant industrial activities limits the economic opportunities available to young people. This has resulted in large-scale migration of the youth to the more industrialized regions in the south of the country. It has also limited the attractiveness of the region to highly trained professionals. The fact that most of the employed population are in the informal sector has serious consequences for revenue generation and mobilization.
The availability of educational and vocational facilities is limited in all the districts. Even where facilities are available, they are located at considerable distances, away from localities. As a consequence, the majority of children have to travel more than 10 kilometres to get to school. This may lead to a high school drop out rate, or at best affect school attendance, learning and performance. In general, a majority of adults have less than basic school education and only a small proportion can read and write.
General services, such as telephone and postal services are relatively scarce in all districts. This severely limits communication between the districts within the region and between the region and other regions in the country. Moreover, it limits commerce and affects the location of industries in the region.
Access to clinics and hospitals is confined to a few communities within districts. In many cases, residents of the communities have to travel considerable distances to have access to these facilities. As such, maternal and child welfare services, among others, are not readily available. Individuals requiring emergency medical services, such as women with labour complications or children with acute emergencies are, therefore, at increased risk of dying before arriving at health facilities.
The quality of housing is generally poor in all the districts. The main materials are mud for walls and floors, and thatch for roofing. Most dwelling units have no electricity, running water or modern and improved toilet facilities. Cooking and lighting are, therefore, largely dependent on kerosene and wood. The poor state of housing and the lack of basic facilities and services have serious implications for the health of the population. In addition, they constitute sources of avoidable hardship. For instance, women often have to travel great distances to fetch firewood, with serious consequences for the quality of child care. Other consequences include greater exposure to potential environmental hazards and risk factors on the health and well being of children.
The composition of typical households in the region is large and complex, even among the most urbanized segments of the population. The presence of a large number of dependent consumers has an income-diluting effect with important consequences on the ability of families to meet all their health and social needs. Education and basic amenities such as access to potable water, electricity and sanitation may all be compromised in the interest of family consumption. This has adverse consequences on the health of the members, especially the very young ones.
The findings present a number of challenges for policy makers. A rapid rate of population growth without corresponding improvement in overall development has potential negative consequences for the region. Considerable effort must, therefore, be put in reducing the rate of population growth. Such effort should include expanded education for girls and the promotion of smaller family sizes. Other steps to be taken include the facilitation of access to affordable family planning services.
The indications so far are that childhood mortality has declined substantially. As a consequence, it is reasonable to expect the more recent childhood intervention programmes such as the Community-based Health Programming and Services (CHPS) initiative to result in further decline in mortality. Programmes of immunization should aim at expanding coverage through maximizing the opportunities available for immunizing children. Nutritional programmes should be introduced in schools to improve growth of children of school-going age.
The main economic opportunities are limited to subsistence farming, hunting and forestry. As a result, the youth migrate in large numbers, usually to the south of the country, where relatively wider choices are available. Policies need to be directed at facilitating the establishment of appropriate industries that can effectively exploit the raw materials available in the region. Improvement in the postal and other communication services should be such as to support commercial activities and enhance trade between the region and other regions of the country. Other possibilities include the introduction of micro-credit facilities to encourage the establishment of small-scale industrial activities. The limited enrolment in vocational institutions is a source of worry. Well-established vocational educational institutions should be provided with incentives to facilitate their ability to establish branches in the region.
The issue of access to education is central to future development of the region. While it is clear that substantial progress has been made, there are still wide differentials in level of access. In many of the districts, the level of education is low. Much more needs to be done to encourage school attendance. Substantial investment must be made in improving access and the provision of classroom facilities. Efforts must be made at increasing the level of awareness of the benefits of education, especially female education. Teachers must be given special incentives to encourage them to accept postings to the region. The GET fund could be a source of such inducements.
The general well-being of the population is predicated on the quality of the living environment. More should be done to improve the quality of housing, access to good drinking water, toilet facilities and more efficient sources of energy. The design of houses should aim at reducing over-crowding and pollution. The use of firewood in a climate that is semi-arid has immense environmental consequences. Policies should, therefore, be directed at introducing more efficient energy sources such as electricity and gas. L.P. gas cylinders need to be produced in smaller sizes to enable households to purchase L.P. gas, in smaller quantities at a time, since in the long run L.P gas is cheaper than charcoal. Another incentive to use L.P. gas is to introduce, for a wide scale use, a variety of L.P. gas operated household equipments such as refrigerators, lamps, etc
The distance to a health facility is critical to service delivery. The goal should be to have a clinic within easy reach of every community. Where such provisions are unlikely at the present time, efforts must be made to provide some form of cheap emergency transportation system within each community. This may take the form of rickshaw bikes as used in other countries. Other measures include the creation of special incentives for health workers willing to relocate to deprived areas.