Background While sub-Saharan Africa (SSA) has one of the world’s highest rates of violence against children, regional trends have not been systematically analyzed.

Objective This study highlights the past 30-year trends in mortality and morbidity of interpersonal violence against children, its demographic distribution and association with specific risk factors.

Methods Using the Global Burden of Disease, Injuries, and Risk Factors 1990–2019 data, we analyzed trend changes in deaths and disability-adjusted life-years (DALYs) attributed to interpersonal violence injuries in children 0 to 19 years in 46 SSA countries. Age-standardised rates per 100 000 population were compiled by type of violence and sub-region with 95% uncertainty intervals (UIs), and associations between sociodemographic index (SDI)/alcohol consumption per capita and child interpersonal violence assessed using Pearson coefficient correlations.

Results Deaths and DALYs per 100,000 population from child violence-related injuries in SSA declined from 4.0 (95% UI: 3.3–4.9) to 3.1 (95% UI: 2.3–3.9) and 334.9 (95% UI: 276.4–407.7) to 260.3 (95% UI: 197.9–321.9) respectively from 1990 to 2019 (reductions of 22.5% and 22.3%). Southern SSA had the highest deaths/DALYs rates for each type of physical violence (sharp object/firearm/other) and Central SSA for sexual violence. In 2019, neither deaths nor DALYs due to child interpersonal violence correlated with country SDI and income level but did correlate with alcohol consumed per capita.

Conclusions SSA rates of child interpersonal violence deaths and DALYs decreased in the past decades, mainly due to major decreases in Southern SSA and yet large country-level differences remain in 2019. There is a need for a prevention agenda tailoring region-wide drivers of violence in line with Agenda 2063 of the African Union.