Transcript Document

PRESENTATION
Background of the National MICS Survey
Putting the National MICS results into the
context of the HSMTDP
Key Findings:
Maternal Health
Child Health
Nutrition
NHIS
Water and Sanitation
Conclusions
BACKGROUND
The Ghana National MICS (with an enhanced
Malaria module and biomarker) was conducted
by the Ghana Statistical Service with financial
and technical support from:
 National Malaria Control Programme/GHS
 Navrongo Research Centre
 USAID/CDC/ICF-MACRO
 UNICEF
 Government of Japan
 UNFPA
 A lot of technical support from other DPs, UN
Agencies and MDAs
BACKGROUND
 2010 Census Sampling Frame was used, and a total of
12,250 Households were sampled;
 4 Regions (Upper East, Upper West, Northern and
Central) were oversampled to provide more precise data
 4 Questionnaires were used: HH, Women 15-49 yrs,
Children 0-5 yrs, and Men 15-59 years;
 Anthropometry, Malaria/Anaemia testing for children
under-5 yrs, and salt was tested (Rapid test kits, and
titration);
 Survey methodology similar to that of Demographic and
Health Survey (DHS), therefore, data is comparable;
 Presentation only captures a few core indicators, and
additional results will be available in the next one month.
OBJECTIVES OF THE MICS
 Provide more current information for assessing the
situation of children and women, and reporting on country
progress on achieving the GSGDA goals/targets, the MDGs
and the reporting requirements of other local and
international development declarations and agenda;
 Provide much-needed data on practices used to treat
malaria among children under-five and the use of specific
anti-malarial medications, bednet coverage and use,
coverage of IPTP for pregnant women, treatment practices
for childhood fever, and prevalence of malaria and anaemia
among children age 6-59 months;
 Provide baseline data for the new United Nations
Development Framework (UNDAF) (2012 -2016).
National MICS in the context of
HSMTDP
 MICS 2011 provides a mid-term snapshot on
progress on key HSMTDP 2010-2013 strategic
objectives
 HO1: Bridge equity gaps in access to health care and
ensure sustainable financing arrangements that protect the
poor
 HO3: Improve access to quality maternal, neonatal, child
and adolescent health and nutrition services
 MICS 2011 provides nationally representative data
that can inform development of next health sector
medium term plan.
MATERNAL HEALTH
In aggregate, positive trends in maternal care
indicators, although disparities exist……..
120
Maternal Care Indicators
100
Per Cent
80
82
86
89
92
95 96.7
84.7
78.2
Target is
80% for
2013
Target is
60% for
2013
69.4
58.9
60
68.4
62.3
59
40
40
44
44
47
20
0
ANC from health
ANC from health
Skilled assistance at delivery
professional, at least one professional, 4 or more visits
visit
GDHS 1988
GDHS 1993
GDHS 1998
GDHS 2003
GDHS 2008
MICS 2011
Skilled deliveries still a challenges to many
women in the northern region….
2008
Upper
West
46%
2011
Upper East
47%
Ratio of highest to
lowest is 1:2.43
Target: 1:1.8 (2011)
Was: 1:3.1 (2008)
Northern
27%
Brong Ahafo
66%
Western
62%
Central
54%
Greater Accra
84%
Northern
37%
Brong Ahafo
64%
Volta
54%
Ashanti
73% Eastern
61%
Upper
West
60%
Upper East
67%
Key
Below
50%
51-70%
Above
70%
Volta
64%
Ashanti
74% Eastern
78%
Western Central
65%
63%
Greater Accra
90%
The richer, educated and urban residents
benefiting more from skilled deliveries…
NATIONAL
68.4
WEALTH QUINTILE
Richest
Fourth
Middle
Second
Poorest
98.3
86.0
70.2
55.0
40.2
MOTHER EDUCATION
Secondary +
Middle/JSS
Primary
None
98.1
79.4
66.2
54.5
RESIDENCE
Urban
Rural
88.2
53.9
.0
20.0
40.0
60.0
80.0
100.0
120.0
Assistance by TBAs during delivery
reducing, but still high in some regions…
Upper
West
13%
Assistance during Delivery
60
50
40
30
20
10
0
54
44
Upper East
4%
Northern
33%
30
11 13
16
2 1
2008 DHS
2 1
8
12
3 3
Brong Ahafo
11%
Volta
11%
Ashanti
12% Eastern
12%
2011 MICS
Key
Above 30%
20-30%
Below20%
Western
25%
Central
30%
Greater Accra
5%
PNC for mother and child fairly high,
although not uniform across regions…
100
97
90
80
92
88
88
95
88
88
87
88
76
70
87
72
79
72
60
75
86
85
83
73
82
77
63
50
40
30
20
10
0
Western
Central
Greater
Accra
Volta
Eastern
Asante
PNC for the newborn
Brong
Ahafo
Northern
Upper
East
Upper
West
PNC for the mother
Total
The richer, educated and urban residents
benefiting more from PNC…
TOTAL
WEALTH QUINTILE
Richest
Fourth
Middle
Second
Poorest
MOTHER'S EDUCATION
Secondary +
Middle/JSS
Primary
None
RESIDENCE
Rural
Urban
0
10
20
30
PNC for the mother
40
50
60
70
PNC for the newborn
80
90
100
Progress seen over time in prevention
of malaria in pregnant women…
% of pregnant women receiving at least 2 doses of
IPTp
100.0
90.0
80.0
76.1
74.1
70.0
74.1
60.0
63.0
62.5
59.8
30.0
45.7
40.5
37.3
31.0
40.8
40.3
43.7
43.7
34.2
29.4
27.9
27.7
25.0
20.0
10.0
52.5
50.8
45.5
67.1
63.8
63.7
50.0
40.0
70.2
70.2
67.8
18.1
16.1
27.5
26
21.9
.0
Western Central Greater
Accra
Volta
Eastern Ashanti Brong Northern Upper
Ahafo
East
MICS 2006
DHS 2008
MICS 2011
Upper
West
National
Use of modern contraceptives
increasing….
Use of modern methods
50
45
40
35
30
29
25
20
24
15
10
5
0
17
13
27
22
26
21
16
17
27
23
22
16
13
6
19
14
2122
23
17
2008
2011
1 in 4 women in Ghana has unmet
need for Contraception
80.0
Unmet need for Contraception
70.0
60.0
50.0
37.9
40.0
30.0
20.0
10.0
.0
35.3
29.8
25.1
22.6
19.7
22.4
27.3
30.4
26.3
28.0
26.4
CHILD HEALTH
Some gains made in immunization, but
nearly 1 in 4 children missing out on
vital immunization by age 1
120
% of Children fully immunized by age 1
100
94.2
97.8
92.1
90.7
80
93.0
81.4
80.1
75.5
60
Target for Penta by age 1yr
is 91% by 2013
88.5
77.7
79.9
77.3
76.5
64.4
59.9
40
20
0
BCG
OPV 3
MICS 2006
Penta3
DHS 2008
Measles
MICS 2011
All
vaccinations
Increased no. of children sleeping under
ITNs, but well below the national target of
70% by 2013
100
% of Children under-5 yrs who slept under an ITN
90
LLIN Campaigns took
place in these Regions
80
70
60
50
40
30
20
10
0
Western Central
MICS 2006
DHS 2008
MICS 2011
11.5
35.5
32.7
19.8
18.9
27.7
Greater
Accra
16.3
17.2
22.1
Volta
21.5
40.4
70.7
MICS 2006
Eastern Ashanti
24.9
35.7
60.2
21.8
25.3
31.2
Brong
Ahafo
25.7
50
41.3
DHS 2008
Northern
21.9
11.2
41.8
Upper
East
39.3
36.8
45.0
MICS 2011
Upper
West
37.1
34
46.9
Total
21.8
28.2
39.0
NUTRITION
Concerted efforts required to promote
breastfeeding…..
Timely initiation of breastfeeding
(1hr)
100
Exclusive breastfeeding
100
90
80
90
80
70
70
60
60
50
50
40
46
46
35
54
46
30
10
10
0
0
2006 MICS
31
20
20
2003 DHS
53
40
52
30
63
2008 DHS
2011 MICS
7
1993 DHS 1998 DHS 2003 DHS 2006 MICS 2008 DHS 2011 MICS
Exclusive Breastfeeding Target is 70% by 2012
Some reduction in malnutrition rates, but still
more than 1 in 5 children in Ghana is stunted….
Nutritional Status of Children under-5 yrs
60
50
Target for
U/W is 8% for
2013
Per Cent
40
30
34
35
31
28
20
23
22.8
20
18
14 13.4
10
9
10
8
9
6.2
0
Stunting
1988
Wasting
1993
1998
2003
Underweight
2008
2011
Wide disparities in malnutrition across regions
and poverty quintiles - Stunting
2011
2008
Upper
West
25%
Upper East
36%
UE and
Northern well
above
national
Target of 23%
Northern
32%
Brong Ahafo
25%
Upper
West
23%
Volta
27%
Central
34%
Northern
37%
Brong Ahafo
19%
Volta
22%
Ashanti
22% Eastern
21%
Ashanti
27% Eastern
38%
Western
27%
Upper East
32%
Key
Greater Accra
14%
Above 30%
20-30%
Below20%
Western
23%
Central
23%
Greater Accra
14%
NATIONAL HEALTH
INSURANCE
At least 60% of children have NHIS in
Ghana…
NHIS Membership for Children under-5 yrs
100
90
80
70
60
50
40
30
20
10
0
Yes, card seen
Yes card not seen
NHIS for women 15-49 yrs…
100.0
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Yes, card seen
Yes card not seen
NHIS for men 15-59 yrs…
100.0
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Yes, card seen
Yes card not seen
WATER, SANITATION
AND HYGIENE
Percentage of population with Improved
Source of Drinking Water
100.0
90.0
90.5
60.0
50.0
40.0
30.0
20.0
10.0
.0
88.6
85.6
80.0
70.0
National average is 80%,
also the Target for 2013
4 regions fall below the National
average
80.5
80.4
86.0
78.3
76.5
71.5
92.0
90.7
68.4
69.8
68.6
61.8
56.4
92.1
Access to improved sanitation still a challenge,
with wide disparities across regions…….
100
% of Population with access to improved sanitary facilities
90
80
70
Sanitation
Target is 21%
by 2013
60
50
54
40
46
43
30
20
29
22
20
23
10
13
16
13
15
6
0
Open defecation
Unimproved facilities
1990
2008
Shared facilities
2011
Improved facilities
Population with NO sanitation facilities quite
high in the north…….
Upper East
87%
Upper
West
71%
Northern
72%
Brong Ahafo
16%
Volta
25%
Ashanti
10%
Eastern
6%
Western
12%
Central
15%
Key
Above 25%
10-25%
Below 10%
Greater Accra
9%
Majority of the unserved are the poorest, and
those living in rural areas…….
100
90
92
91
86
80
79
70
60
92
70
69
56
50
40
38
30
20
10
0
21
15
9
Rural
5
Urban
8
15
9
Poorest Second Middle Fourth Richest
Water
Sanitation
Total
Conclusions
Progress has been made overall, but worrying
geographic and socio-economic disparities persist.
 Current increased focus on deprived regions should
continue while watching out for other regions that may
also be vulnerable.
MDG4
Coverage of key child survival interventions show
improvement-immunization, malaria prevention,
undernutrition
However more efforts are needed to enable equitable
attainment of MDG 4 for all children in Ghana
CONCLUSIONS (CONTD.)
 MDG5
 Progress on coverage of key interventions- family planning and skilled
delivery
 However MDG target unlikely to be achieved at current pace and without
strategic focus on structural bottlenecks
 MAF-operational plan currently under development presents a huge
opportunity to address these bottlenecks.
 NHIS
 Important tool for MDG attainment that needs further scale -up in
coverage for all but particularly for the poorest populations.
 ‘All hands on deck’ needed for the last lap to MDG 4 and 5 goals