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Global Health Council 37 th Annual Conference Progress Towards the Health Related MDGs

Global Health Council 37 th Annual Conference Progress Towards the Health Related MDGs. Tessa Wardlaw. Millennium Development Goals ( MDGs ). MDG monitoring. UNICEF and WHO lead in reporting on progress towards the health related MDGs

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Global Health Council 37 th Annual Conference Progress Towards the Health Related MDGs

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  1. Global Health Council 37th Annual Conference Progress Towards the Health Related MDGs Tessa Wardlaw

  2. Millennium Development Goals (MDGs)

  3. MDG monitoring • UNICEF and WHO lead in reporting on progress towards the health related MDGs • Secretary General’s Annual Report on Progress towards the MDGs • Inter-agency groups formed to address methodological issues and harmonize data

  4. Sources of data • Population based surveys • MICS (50+ countries) • DHS (30+ countries) • Other national-level household surveys (MIS, RHS and others) • UN Interagency adjusted estimates • U5MR, MMR, immunization, water/sanitation • Other data sources

  5. Sources of data Household Survey Activity (2005 – present): MICS and DHS MICS3 Other surveys with MICS3 modules / MICS3 technical support DHS

  6. Around 1990, 30 countrieswith data on whether undernutrition was rising or falling Evolution of data collection since 1990 (MDG baseline)

  7. Today, 118 countries with data on whether undernutrition was rising or falling Evolution of data collection since 1990 (MDG baseline)

  8. MDG1 - Eradicate extreme poverty and hunger

  9. MDG1: All regions have made progress in reducing underweight prevalence Underweight (moderate and severe) prevalence among children under five, around 1990 and 2008 Source: UNICEF Global Database. Compiled from MICS, DHS and other national surveys

  10. MDG1: All regions have made progress in reducing underweight prevalence Underweight (moderate and severe) prevalence among children under five, around 1990 and 2008 17% Source: UNICEF Global Database. Compiled from MICS, DHS and other national surveys

  11. MDG1: All regions have made progress in reducing underweight prevalence Underweight (moderate and severe) prevalence among children under five, around 1990 and 2008 On track 41% On track On track 61% 41% Source: UNICEF Global Database. Compiled from MICS, DHS and other national surveys

  12. Progress towards MDG1: Reduction in underweight prevalence by half (1990 – 2015) 62 countries are on track to meet the MDG 1 targetProgress is insufficient in 34 countries and 20 countries have made no progress On track: Average annual rate of reduction (AARR) in underweight prevalence is greater than or equal to 2.6 per cent, or latest available estimate of underweight prevalence estimate is less than or equal to 5 per cent, regardless of AARR Insufficient progress: AARR is between 0.6 per cent and 2.5 per cent No progress: AARR is less than or equal to 0.5 per cent Data not available Source: UNICEF Global Database, 2010 Compiled from MICS, DHS and other national surveys

  13. MDG4 - Reduce child mortality

  14. Causes of death among under fives, 2008 (%) Tetanus Diarrhoea Congenital Pneumonia Other Globally, more than one third of child deaths are attributable to undernutrition Sepsis Asphyxia Preterm Source: WHO/CHERG, 2010

  15. Significant declines in under-five mortality rates between 1990 and 2008 in all regions Under five mortality rates for children under five (deaths per 1,000 live births), 1990 and 2008 Source: UNICEF estimates based on the work of the Inter-agency Group for Child Mortality Estimation, 2009

  16. Significant declines in under-five mortality rates between 1990 and 2008 in all regions Under five mortality rates for children under five (deaths per 1,000 live births), 1990 and 2008 28% Source: UNICEF estimates based on the work of the Inter-agency Group for Child Mortality Estimation, 2009

  17. Significant declines in under-five mortality rates between 1990 and 2008 in all regions Under five mortality rates for children under five (deaths per 1,000 live births), 1990 and 2008 > 50% Source: UNICEF estimates based on the work of the Inter-agency Group for Child Mortality Estimation, 2009

  18. Progress towards MDG4: Reduction in under-five mortality by two-thirds, 1990-2015 On track: U5MR is less than 40, or U5MR is 40 or more and the average annual rate of reduction (AARR) in the under-five mortality observed for 1990-2007 is 4.0 percent or more Insufficient progress: U5MR is 40 or more and AARR is between 1.0 per cent and 3.9 per cent No progress: U5MR is 40 or more and AARR is less than 1.0 per cent Source: UNICEF estimates based on the work of the Inter-agency Group for Child Mortality Estimation, 2009

  19. Under five mortality • Rate of decline in child mortality is accelerating: • 1990 – 2000: 1.4% per year • 2000 – 2008: 2.3% per year • Burden of child deaths concentrated in a few countries • India (21%) and Nigeria (12%) account for nearly one third of the total of under five deaths • 75% of all under-five deaths in 2008 occurred in only 8 countries • High fertility levels in Sub-Saharan Africa, together with high levels of under five mortality, have resulted in an increase in the absolute number of under five deaths (from 4.0 million in 1990 to 4.4 million in 2008).

  20. Child Survival Intervention Coverage Gains and Gaps • Progress in prevention • Sustained high coverage in interventions delivered through routine outreach services (immunization, vit A) • Rapid progress in relatively new interventions such as ITNs • Little progress for treatment • Interventions/response to acute need (pneumonia treatment, ORT, etc.)

  21. MDG5 - Improve maternal health

  22. MDG5 - Maternal mortality is highest in countries of sub-Saharan Africa and South Asia Maternal mortality ratios (MMR) per 100,000 live births (2005) Low MMR (less than 100) Moderate MMR (100 – 299) Very high MMR (550 or more) High MMR (300 – 549) Source: WHO, UNICEF, UNFPA and the World Bank, “Maternal Mortality in 2005”

  23. What progress has been made towards MDG5? MDG Required annual rate of decline IHME estimates 1990-2008 UN estimates 1990-2005 Annual average rate of change (%)

  24. Lifetime risk of maternal death • Sub-Saharan Africa: 1 in 22 • South Asia: 1 in 59 • Middle East and North Africa: 1 in 140 • East Asia/Pacific: 1 in 350 • Latin America/Caribbean: 1 in 280 • CEE/CIS: 1 in 1,300 • Industrialized countries: 1 in 8,000

  25. Increasing coverage of skilled attendance at birth across all regions

  26. Increasing coverage of skilled attendance at birth across all regions 29% 54%

  27. Increasing coverage of skilled attendance at birth across all regions

  28. Increasing coverage of antenatal care across all regions

  29. Increasing coverage of antenatal care across all regions 46% 45%

  30. Less than half of women in developing world receive ANC four or more times

  31. MDG6 - Combat HIV/AIDS, malaria and other diseases

  32. About 4.9million young people aged 15-24 were living with HIV/AIDS in developing countries in 2008 Central and Eastern Europe 70,000 East Asia & Pacific 210,000 Middle East & North Africa 89,000 Latin America & Caribbean 300,000 South Asia 250,000 Sub-Saharan Africa 4.0 million Nearly 82% of all young people living with HIV in developing countries are in sub-Saharan Africa, where young women make up nearly 70% of all young people living with HIV ♂ ♀ ♂ ♀ ♀ ♂ ♂ ♀ ♂ ♀ ♀ ♀ Female ♂ Male The size of the pie charts indicates the number of young people affected Source: UNAIDS, 2009 AIDS Epidemic Update

  33. Rapid progress in insecticide treated net use, but still falling short of global goals Percentage of children under five sleeping under insecticide-treated nets (%), all African countries for which trend data were available RBM target 2010: 80% RBM (Abuja) target 2005: 60%

  34. Malaria treatment moderately high, but many African children still using less effective medicines ACT % Source: UNICEF Global Databases, April 2010

  35. MDG7 - Ensure environmental sustainability

  36. Good progress in use of improved drinking water sources Actual drinking water quality needs more attention 8 6 12 15 7 14 13 15 14 40 16 23 26 31 9 29 51 24 13 23 13 20 20 Regional and global trends use of improved drinking water sources by UNICEF regions, 1990 - 2008 30 27 35 24 32 65 56 84 73 72 44 70 65 69 57 34 68 49 50 45 39 21 15 16 18 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 Middle East & North Africa Sub-Saharan Africa South Asia East Asia and Pacific Latin America & Caribbean CEE/CIS Developing countries World Piped onto premises Other improved drinking water sources Unimproved sources Source: UNICEF/WHO JMP 2010

  37. Modest increases in sanitation coverage • Encouraging declines in open defecation 7 6 13 12 10 9 17 17 18 45 21 27 25 18 14 32 11 67 36 14 11 11 33 14 • Regional and global trends in sanitation practices by UNICEF regions, 1990 - 2008 14 15 11 10 22 18 13 7 20 90 10 10 5 88 9 80 80 6 20 16 71 69 61 35 60 54 52 22 44 41 31 28 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 1990 2008 Sub-Saharan Africa Middle East & North Africa East Asia and Pacific Latin America & Caribbean CEE/CIS Developing countries South Asia World Improved facilities Shared and public facilities Unimproved facilities Open defecation Source: UNICEF/WHO JMP 2010

  38. International agencies, academics, governments, donors and NGOs • Focuses on effective interventions and coverage determinants • Uses country specific data to stimulate and support country progress towards achieving the health related MDGs – country profiles Partnerships – Countdown to 2015

  39. Thank you

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