four years are likely to see many families at risk, with poverty and privation becoming more widespread. To avert these risks a number of urgent and determined measures will need to be taken by African Governments 'to safeguard the welfare of their popula­ tions. 2. This chapter surveys recent trends and problems in selected social sectors. This survey should be viewed against the background of recent developments in the demographic base, and in agriculture and food production (reviewed in chapters VII and IV respectively), and also against the background of the growing un­ employment, underemployment and mass poverty discussed extensive­ ly in the "Survey of economic and social conditions in Africa" for 1978-1979 (E/CN.l4/743/Part I). B. Health and nutrition 3. There have been significant inprovements in those countries with comprehensive maternal and child health programmes, but the majority of people still have no easy access to modern medical, facilities. Mortality rates in Africa continues to be high, especially among infants and young children under 5. 4. Medical and paramedical personnel are still in very short supply, and the majority are still concentrated in the large ur­ ban· centres. Between 1960 and 1977 the number of people per physic ian was almost halved, but the ratio is still very high, and variations between countries are quite marked. North Africa has the lowest ratios: Egypt, for example, had one physician for about l, BOO persons in 1977, whereas the figures for Ethiopia, the Upper Volta and Burundi were 75,320, 49,810 and 45,020. The number of people per nurse is much lower, but is still quite high. Here again there are wide variations. In Mauritius, the Congo, Ghana and Kenya, for example, the ratios are 641,800, 860 and 1,090 respectively; On the otl1er hand the figures for Rwan­ da, the Niger and Uganda were 10,490, 5,270 and 43,000. 139 E/ECA/CH.9/5 
**Analysis**
The text discusses the social sector trends and problems in Africa, specifically focusing on health, nutrition, and the availability of medical personnel. It highlights the disparities in access to healthcare and medical facilities across different countries in Africa. The text does not mention economic development, natural resources, agriculture, industry, transport, communication, international trade, science, or culture. It does touch on employment, but only in the context of unemployment and underemployment.

**Category**
Health, Employment