Trends and Subregional Inequalities in Communicable, Maternal, Neonatal, and Nutritional Diseases in Sub-Saharan Africa, 1990–2023: A Systematic Analysis for the Global Burden of Disease Study 2023.
1
Public Health, Somali national university, Mogadishu, Somalia
Popul. Med. 2026;8(Supplement Supplement 1):A521
ABSTRACT
BACKGROUND:
Despite substantial advances in global health over recent decades, communicable, maternal, neonatal, and nutritional (CMNN) diseases remain the predominant causes of premature mortality and disability in Sub-Saharan Africa. However, the extent and pace of progress have varied significantly across subregions and disease categories, perpetuating significant health inequalities.
METHODS:
This study analyzed data from the Global Burden of Disease (GBD) 2023 Study to estimate age-standardized mortality and disability-adjusted life year (DALY) rates for all CMNN causes across 46 countries spanning four subregions of Sub-Saharan Africa (Western, Central, Eastern, and Southern) from 1990 to 2023. Cause-specific mortality was modeled using the Cause of Death Ensemble model (CODEm), non-fatal outcomes were estimated by DisMod-MR 2.1, and age-standardization was performed using the GBD reference population. Annualized percentage changes were calculated using log-linear regression, and subregional disparities were assessed using absolute and relative differences in rates.
RESULTS:
Between 1990 and 2023, age-standardized CMNN DALY rates in Sub-Saharan Africa declined by 57.6%, and mortality rates fell by 54.6%. The most pronounced reductions were observed in enteric infections and tuberculosis, with malaria also showing substantial improvement. In contrast, declines in HIV/AIDS-associated DALYs were minimal, and HIV/AIDS mortality increased by 11%. Persistent subregional inequities were identified, with Central and Western Africa bearing the highest CMNN burden, whereas Eastern and Southern Africa experienced greater reductions in both DALYs and mortality.
CONCLUSIONS:
Substantial overall progress has been achieved in reducing the CMNN disease burden across sub-Saharan Africa, largely reflecting the impact of targeted interventions and health system improvements. Nonetheless, enduring subregional disparities and modest declines in HIV/AIDS, maternal, and neonatal outcomes underscore the urgent need for renewed, equity-focused health strategies. Accelerating progress toward Sustainable Development Goal 3 in the region will require strengthening primary healthcare, reinvigorating disease control initiatives, and channeling resources to high-burden subregions.
Despite substantial advances in global health over recent decades, communicable, maternal, neonatal, and nutritional (CMNN) diseases remain the predominant causes of premature mortality and disability in Sub-Saharan Africa. However, the extent and pace of progress have varied significantly across subregions and disease categories, perpetuating significant health inequalities.
METHODS:
This study analyzed data from the Global Burden of Disease (GBD) 2023 Study to estimate age-standardized mortality and disability-adjusted life year (DALY) rates for all CMNN causes across 46 countries spanning four subregions of Sub-Saharan Africa (Western, Central, Eastern, and Southern) from 1990 to 2023. Cause-specific mortality was modeled using the Cause of Death Ensemble model (CODEm), non-fatal outcomes were estimated by DisMod-MR 2.1, and age-standardization was performed using the GBD reference population. Annualized percentage changes were calculated using log-linear regression, and subregional disparities were assessed using absolute and relative differences in rates.
RESULTS:
Between 1990 and 2023, age-standardized CMNN DALY rates in Sub-Saharan Africa declined by 57.6%, and mortality rates fell by 54.6%. The most pronounced reductions were observed in enteric infections and tuberculosis, with malaria also showing substantial improvement. In contrast, declines in HIV/AIDS-associated DALYs were minimal, and HIV/AIDS mortality increased by 11%. Persistent subregional inequities were identified, with Central and Western Africa bearing the highest CMNN burden, whereas Eastern and Southern Africa experienced greater reductions in both DALYs and mortality.
CONCLUSIONS:
Substantial overall progress has been achieved in reducing the CMNN disease burden across sub-Saharan Africa, largely reflecting the impact of targeted interventions and health system improvements. Nonetheless, enduring subregional disparities and modest declines in HIV/AIDS, maternal, and neonatal outcomes underscore the urgent need for renewed, equity-focused health strategies. Accelerating progress toward Sustainable Development Goal 3 in the region will require strengthening primary healthcare, reinvigorating disease control initiatives, and channeling resources to high-burden subregions.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
