Why Health, Nutrition, and Early Childhood Development Can Power Growth in Central and West Africa

A child’s future does not begin at birth.

It is shaped during the first 2,000 days — from conception through age 5 — when maternal care, nutrition, early stimulation, and the strength of the health system shape brain development and physical growth.

But the opportunity does not end there.

Adolescence offers a second critical window to protect gains, support girls’ health and nutrition, and prepare the conditions for young people to learn, work, and thrive in parenthood.

This is at the heart of a future-fit health strategy for Western and Central Africa: investing early, sustaining support through adolescence, and building the human capital that will determine whether a generation drives economic growth or faces preventable setbacks.

A Region at a Turning Point

Over 200 million children will be born between 2025 and 2050

By 2050, nearly one in five young people in the world will live in Western and Central Africa.

This is one of the defining demographic shifts of our time.

In a region exposed to fragility, conflict, violence, climate shocks, and food insecurity, the choice is stark: turn this youth surge into a demographic dividend, or allow it to deepen instability, exclusion, and vulnerability to harmful influences.

The difference will come from investments made now—in health, nutrition, early childhood and adolescent wellbeing, resilient health systems, and credible pathways to decent work.

The roots of tomorrow’s jobs and security crisis are already visible.

Nearly one in ten children dies before age five.

One in three is stunted.

These are not only health and nutrition outcomes; they are early warnings of lost learning, lower productivity, weaker earnings, and higher vulnerability.

In fragile and conflict-affected settings, the cost is even higher: when young people see no path to health, nutrition, skills, income, or belonging, they are more exposed to recruitment by destabilizing networks and other negative coping strategies.

Providing and expanding health, nutrition, childcare, and community-based services can help protect them—while creating jobs, especially for women and young people, where stability is most needed.

The First 2,000 Days

The first 2,000 days shape a lifetime

Every dollar invested in nutrition can return up to 23 dollars.

The first 2,000 days—from conception to age five—are the most critical period for brain development, physical growth, and lifelong productivity.

This means investing across the full continuum of care: maternal health, safe childbirth, newborn survival, nutrition, immunization, early stimulation, and adolescent health.

This is not just a nutrition investment.

It is a human capital investment.

When countries finance quality maternal, newborn, child, adolescent health and nutrition services together, they save lives, prevent stunting, improve learning, and raise future earnings.

Investing early is not only social policy. It is economic strategy—and one of the fastest routes to healthier, more productive generations.

The Cost of Inaction

Health and nutrition gaps today become economic gaps tomorrow

Materials at the Poste de Santé (Primary Health Unit) Darou Salam, District of Fatick, Senegal. Photo: Arne Hoel/World Bank Group

Western and Central Africa carries some of the world’s heaviest health and nutrition burdens.

The region accounts for 33 percent of global child deaths, 44 percent of maternal deaths, and nearly 60 percent of malaria deaths. One in three children under five is stunted.

More than 100 outbreaks have been recorded since 2008.

Behind each statistic is a disrupted future: a child who struggles to learn, a parent who loses time and income, and a system under pressure from climate shocks, food insecurity, and conflict. Yet across the region, local leaders and health workers are showing that change is possible.

Meet Aisha and see how investing in children’s early days—from maternal care to nutrition and early stimulation—shapes their entire future and helps build stronger families, communities, and economies. When we invest in a child’s early years, the results last a lifetime.

Central African Republic

Safe beginnings save lives

Free healthcare has made childbirth safer and encouraged women to arrive earlier for care.

In Sibut, midwife Ndoumba Louise once paid for patients’ care herself. For years, she helped women give birth under conditions that made every case feel like a risk. Sometimes the only way forward was to cover costs from her own salary.

That changed with free healthcare for the most vulnerable, supported by the Health Service Delivery and System Strengthening Project (SENI-Plus). Women began coming earlier, and the ward became a safer place for births.

“Since free care was introduced, we have not lost a single mother or child here.”

Ndoumba Louise, retired midwife, Central African Republic

In the heart of the Central African Republic, targeted free healthcare services for mothers and children under five are transforming lives and strengthening communities.

Through the Health Service Delivery and System Strengthening Project, nearly 475,000 women and children have received critical care. Meet Dr. Alain Doté and his dedicated team in the district hospital of Sibut as they lead this effort.

Guinea:

Distance should not decide survival

Care closer to home replaced distance and cost with trust and support.

For Fatoumata Sow in Damakanian, childbirth once meant being alone. Her first three children were born at home, without trained medical support or care nearby.

Then, a community health center opened in her village, bringing reproductive, maternal, newborn, and child health services within reach. With her healthcare card, she no longer had to worry about paying for care, and her children are monitored regularly.

“Now, I don’t pay for care. My children are monitored regularly.”

Ghana:

Strong systems save time and lives

Digital tools and referrals help smaller clinics connect patients to faster, better care.

At the Essuowin Model Health Center in Ghana’s Ashanti Region, care reaches far beyond one clinic. Digital tools and referral networks connect smaller facilities to a stronger hub, helping patients get the right treatment sooner.

Physician Assistant Victor Ayuma sees the effect every day. More coordinated care means fewer delays and stronger confidence in the system.

“Health is wealth. If you are not sick, you can work to improve the economic growth of the community.”

Community health care in Ghana is changing.

At the Essuowin Model Health Centre in Amansie West, Physician Assistant Victor Ayuma leads a hub facility connecting rural communities to quality, affordable health services—reducing financial hardship and improving health outcomes for some of Ghana’s most vulnerable populations.

With World Bank Group support, over 1.2 million people in Ghana have accessed safe, effective, and patient-centered health services since 2023—including prevention, treatment, and care—bringing the world closer to the goal of reaching 1.5 billion people with quality, affordable health care by 2030.

Chad:

Electricity changes what care can do

Reliable power transformed childbirth, protected vaccines, and made safe care possible after dark.

In Bitkine, childbirth once happened under flashlight beams.

When night fell, visibility disappeared, and so did much of the safety that care requires.

Midwife Kaltouma Derba remembers delivering babies in that darkness.

Today, the health center is powered day and night. Rooms are lit, equipment runs steadily, and vaccines stay preserved. Electricity has become a form of health protection, not just infrastructure. Care no longer stops when the sun goes down.

The Chad Energy Access Expansion Project is distributing 145,000 subsidized solar kits to households across 23 provinces.

These kits provide affordable electricity for lighting and phone charging, reaching about 6 million people.

In the Logone Occidental province in southern Chad, this project is benefits rural areas with clean, reliable energy and supports improvements in health and education.

Republic of Congo:

A “Mamapreneur” builds care and opportunity

Trained women are turning community crèches into a service, a livelihood, and a pathway to entrepreneurship.

In Brazzaville, Jocelyne Mpila cares for toddlers at a community crèche while helping parents work nearby.

What began as support through the Social Protection and Productive Inclusion of Youth (PSIPJ) project became a pathway into childcare entrepreneurship.

Now trained as a “Mama Mobokoli,” she is part of a model that combines early childhood care with income generation for women. The crèche gives children a safe start and families an affordable, trusted place for care.

“Today, I am a childcare entrepreneur at Mama Mobokoli. Before, I didn’t have a stable job. Now, thanks to Mama Mobokoli, I feel like have a meaningful and secure job in the childcare sector as a ‘mamapreneur.’”

Meet the Mamapreneurs of Brazzaville—women entrepreneurs transforming childcare and empowering families!

Through the World Bank-financed Social Protection and Youth Productive Inclusion Project, inspiring leaders like Jocelyne Mpila have received training and startup capital to open “Mama Mobokoli” daycare centers in Brazzaville’s busiest markets.

These centers welcome children aged 1–3 years and deliver a triple impact: (1) Creating jobs and income for women entrepreneurs in the childcare sector. (2) Building human capital and preparing children for school success. (3) Enabling parents to work productively, knowing their kids are safe and cared for.

A Strategy That Connects It All

Three priorities, one future

The World Bank Group’s Health, Nutrition, and Population Strategy for Western and Central Africa provides a roadmap to make systems future fit. It helps countries strengthen services, improve financing, and prepare for shocks while supporting national leadership and regional cooperation.

The strategy builds upon a collaborative approach that brings together development partners, regional platforms, and national governments to align investments, technical support, and policy efforts. It also emphasizes multisectoral coordination across key sectors to address broader health determinants, enabling pooled financing, stronger regional responses, and integrated actions to improve health and resilience outcomes.

This approach aligns with the Health Works initiative, which helps countries expand affordable, quality care while strengthening health systems. Through nationally led reform plans, it brings partners together around shared priorities and connects health investment to jobs, human capital, and economic growth.

Three Pillars

Frontlines First

Primary care is the foundation

Frontlines First means investing where care begins: in communities and primary health systems.

This includes trained health workers, equipped facilities, and essential services for mothers and children. Nutrition is central to this agenda: it saves lives, supports healthy growth and learning, and converts early health gains into lifelong productivity.

Nutrition is also an economic investment when it is delivered beyond the health sector.

Linking health, early childhood development (ECD), social protection, education, food systems, WASH, and women’s economic empowerment improves child survival and learning while expanding productivity, incomes, and local services.

It also creates frontline jobs—from community health and nutrition to childcare, social work, agriculture, logistics, and supervision—especially for women and young people. Expanding community health and nutrition programs alone could create 800,000 jobs, while addressing workforce shortages could generate 1.4 million more.

Fixing Finance

Better spending delivers better care

Better financing means allocating more resources to primary care, improving efficiency.

It also means aligning funding with real needs and reducing the financial hardship for families.

This reflects a shift toward system-wide reform, moving away from fragmented investments toward more coordinated, long-term financing.

The goal of the Universal Health Coverage is to reach 200 million people with affordable, quality services by 2030.

Future Fit

Resilience protects lives and economies

With more than 100 outbreaks since 2008, the region must prepare for pandemics, climate shocks, and food insecurity. Emergency-ready systems protect not only lives, but also the stability of economies and communities.

Health Powers Jobs

A healthier population is a more productive workforce

Investing in nutrition, early childhood development, and primary health care is also a jobs strategy. It boosts productivity across sectors and creates employment within health, nutrition, childcare, and care services. Expanding community health and nutrition programs can create large numbers of jobs, while stronger workforce systems can generate even more.

Programs that support women and girls matter here too.  Across the region, initiatives that connect maternal and child health, nutrition, education, and livelihoods help turn care investments into broader economic opportunity.

Stories from trainees and workers show growing ambition:

When women thrive, economies grow.

When women gain skills, income, and access to care, families and economies grow.

The Word Bank is strengthening reproductive, maternal, and nutrition services for the most vulnerable populations.

Programs like SWEDD+ support women and vulnerable populations, especially young girls, by providing reproductive, maternal, and nutrition health services, particularly in rural areas. include a multisectoral approach to nutrition by coordinating interventions across sectors to fight malnutrition in all its forms and to sustainably improve the nutritional status of women, adolescent girls, and children.

The project has reached millions of women and girls, linking education, health, and employment.

In Abéché, Chad, the project funded boarding school and safe spaces continue to empower girls and young women to learn, dream bigger, and shape their own economic futures with confidence.

In Togo, the Essential Quality Health Services for Universal Health Coverage Project (SSEQCU), aims improve access to quality care, strengthen the use of health and nutrition services, and support the operationalization of universal health coverage.

“My advice to women who aren’t currently working is that there is no such thing as a “lesser” job. I started this training because I wanted to work.

During the past decade, over 2.5 million young women and girls have been given the means to build brighter futures in 9 West and Central African countries.

The Sahel Women’s Empowerment and Demographic Dividend Project (SWEDD) have invested in education, employment opportunities and health services that have had a transformational impact on the lives of women and girls and the prosperity of their communities. 

And today, SWEDD is growing. More countries are joining under the expanded SWEDD+ initiative—building on lessons learned, scaling up impact, and renewing the commitment to gender equality.

The Human Capital Equation

Health + Nutrition + Strong Systems = Human Capital + Growth

Investing in health is investing in prosperity.

Investments in health and nutrition deliver some of the highest returns in development. They reduce poverty, increase earnings, drive long-term growth, and strengthen societies. This is the foundation of human capital: a healthy, educated, and productive population.

The Human Capital Index Plus (HCI+). A child born today in Sub-Saharan Africa could earn nearly 70 percent more over their lifetime, if health, learning, and work systems functioned differently.

So what’s holding that future back?

The Choice Ahead

A Shared Future

The child born today will inherit the results of today’s decisions. With the right investments in nutrition, health systems, and opportunity, she will grow up healthy, learn, work, and contribute to her community.

Without them, the costs will echo for generations.

The choice ahead is simple: invest in health, invest in the first 2,000 days, and invest in prosperity now.