Transcript Regional Conference “Maternal Health in South Asia

Millennium Development Goals
A South – Asian Perspective
August 13, 2005
By: Dr. Yasmeen Sabeeh Qazi
Senior Program Advisor
Packard Foundation
GENESIS & SYNTHESIS:
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MDGs emerged as an agreed Development Agenda in
September 2000 in UN sponsored Millennium Summit
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147 World leaders agreed to a global compact – MDGs
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Further supported by G8 countries in 2003
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Considered as a quantifiable “Development Agenda”
emerging from the series of conferences in 1990s on
Development
ESSENCE:
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Eight Goals
Each goal - a specific commitment to reverse the spread
of poverty and disease by 2015
Supported by an “Action Plan” with 18 quantifiable
targets combating:
Poverty
Hunger
Disease
Illiteracy
Environmental Degradation
Discrimination against women
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Goals assign clear responsibilities to rich countries to
provide developing countries
More Aid
Fairer terms of trade
Meaningful Debt Relief
UNDP Human Development Report 2003 provides most
comprehensive analysis to date of:
Status of Global Campaign
Concrete Policy Reforms
Resource commitments needed to make these goals a
reality by 2015
Challenges:
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More than a billion people still struggle to survive on less
than a dollar a day
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Most of them lack access to basic health services & safe
drinking water
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Globally one child out of five does not complete primary
school
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In much of the developing world, the HIV/AIDS pandemic
continues to spread unchecked
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Nearly 800 million people or 15% of world’s population,
suffer from chronic hunger
Challenges:
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If current trend continues, South Asia and Sub-Saharan
Africa will not meet the target by 2015
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In Sub-Saharan Africa, a child has only a one-in-three
chances of completing primary school
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And one-in four school aged children in South Asia are
not being educated
Half a million women die in pregnancy or childbirth each
year ,or one every minute of a day
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A woman in Sub-Saharan Africa is 100 times more likely
to die in pregnancy or childbirth than is a women in
Western Europe
South – Asian Perspective:
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South Asia with GNI per capita at $460 is home to nearly
40% of world’s poor living on less than dollar a day
Since 1990, region has experienced rapid GDP growth,
averaging 5.4% a year
This growth has helped to reduce the consumption
poverty rate substantially
India has reduced poverty rate by 5 – 10 % since 1990
Only exception is Pakistan where poverty has stagnated
at around 33% using national poverty lines
Challenges remain on measurement of consistent
poverty trends & has created a debate on measuring
poverty trends in the 1990s
Encouraging success in reduction of
mortality in children under five
 Rates has reduced substantially between
1990 and 2002 – from 130 to 95 per 1000
live birth
 Especially IMR is significantly reduced in
Bangladesh; from 144 to 73 per 1000 live
births
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MDG 1 : Eradicate extreme poverty and hunger
Target 1: Halve, between 1990 & 2015 the proportion
of people whose income is less than one
dollar a day
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People living on less than 1 dollar a day in South Asia is 428 million (31.1%)
in 2001 compared to 462 million (40.1%) in 1990
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People living on less than 2 dollar a day in South Asia is 1,059 million
(76.9%) compared to 958 million (85.5%) in 1990
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Greatest number of poor people live in South Asia, but the proportion of
poor is highest in Sub – Saharan Africa, where slow economic growth has
left millions at the margins of survival
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If projected growth remains on track, global poverty rates will fall to 12.7
percent- less than half the 1990 level- and 363 million more people will avert
extreme poverty
Source: World Bank Data
MDG 1: Eradicate Extreme Poverty &
Hunger
Target 2: Halve between 1990 & 2015 the proportions
of people who suffer from hunger
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Malnutrition plays a role in more than half of all child
deaths
Prevalence rates of underweight children have been
falling in most regions, but too slowly to achieve 2015
targets
In many regions the number of hungry people continues
to grow
In South Asia however, progress in the prevalence rates
of underweight children have been fast, the malnutrition
rates declining by 25%
However the rates of malnutrition in general population
remains high in South Asia
MDG 2: Achieve Universal Primary
Education
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Target 3: Ensure that, by 2015 children every where,
boys and girls alike, will be able to complete a full course
of primary schooling
According to World Bank study, only 37 of 155
developing countries analyzed have achieved universal
primary education
Based on 1990s trends, another 32 are likely to achieve
that goal
But 70 countries risk not reaching the goal unless
progress is accelerated
South Asia has chronically low enrollment & completion
rates and completion rates in Middle East and North
Africa stagnated in 1990s
Primary Completion rate average primary School only
MDG 3: Promote Gender Equality and
Empower Women:
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Target 4: Eliminate gender disparity in primary and
secondary education, preferably by 2005, and to all
levels of education no later than 2015
The differences between boys and girls schooling are
greatest in regions with the lowest primary school
completion rates and lowest average incomes
In South Asia girls enrollment in Primary schools is 12
points lower than boys
And only 61% of girls complete primary school compared
with 86% of boys
Gender disparity at school is still serious in many SubSaharan African and South Asian countries
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Beyond schooling the gender disparity in literacy is
widespread, impinging on women empowerment
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Gender disparity in labor market is observed throughout
the world in different proportion
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Of the 109 countries with data for late 1990s,only 18 had
a share of women equal or slightly higher than that of
men
Over the last decade there has been only a small
progress, globally, in gender equality in wage
employment in the non – agriculture sector
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Ratio of girls to boys in primary and secondary
education
MDG 4: Reduce Child Mortality
Target 5 : Reduce by two thirds, between 1990 and
2015, the under five Mortality rate
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Child mortality is closely linked to poverty
In 2002, the average under five mortality rates were:
-121 deaths per 1000 live births in low- income countries
- 40 in lower middle income countries
- 22 in upper-middle-income countries
- 7 or less in high-income countries
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In 2002 : 48 countries had child mortality rates greater
than 100 and 15 countries have greater than 200
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Mortality rates for children under 5 dropped by 15
percent since 1990, but the rates remain high in
developing countries
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More than 10 million children die each year in
the developing world, vast majority from
preventable causes
In developing countries 1 child in 10 dies before
its 5th birthday, compared with 1 in 143 in high –
income countries
At current rates of progress only a few countries
will likely to achieve this MDG of reducing child
mortality to one – third of their 1990 levels
Just as child deaths are the result of many
causes, reducing child mortality will require
multiple, complimentary interventions
Under– Five mortality rate
MDG 5: Improve Maternal Health
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Target 6 : Reduce by three quarters, between 1990
and 2015, the maternal mortality ratio
Worldwide, more than 50 million women suffer from poor
reproductive health and serious pregnancy – related
illnesses and disability
Every year more than 500,000 women die from
complications of pregnancy and child birth.
Most of these deaths occur in Asia, but the risk of dying
is highest in Africa
In developing countries, only about half of deliveries are
attended by professional health staff
In South East Asia currently 35% births are attended by
skilled attendants
The extreme risk of dying from pregnancy or
child birth in South East Asia is 1 in 140
Lifetime Risk of Maternal Death, 2000
MDG 6: Combat HIV/AIDS, Malaria and
other diseases
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Target 7 : Have halted by 2015 & begun to reverse the
spread of HIV/AIDS
In 2003, 36 million adults and 2 million children were
living with HIV/AIDS
66% of these cases are in Sub-Saharan Africa
Almost a million new cases in South & East Asia , where
more than 7 million people are living with HIV/AIDS
HIV strikes at youth - women are particularly vulnerable
More than half of those newly infected with HIV are
between 15 and 24 year old - 13% for males and 6% for
females
East Asia have the lowest rates of known infected cases
Youths Living with HIV/AIDS
Target 7 : Have halted by 2015 and begun to reverse
the incidence of malaria and other major diseases
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WHO estimates that 300 – 500 million cases of Malaria
occur every year, leading to 1.1 million deaths
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90% of all cases occur in Sub-Saharan Africa & may
account for as much as 25% of child mortality
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Tuberculosis kills around 2 million people a year, most of
them 15-45 years old
Each year there are about 3 million new cases in South
East Asia
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Incidence of Tuberculosis
MDG 7: Ensure Environmental Sustainability
Target 9: Integrate the principles of sustainable
development into country policies and programmes &
reverse the losses of environmental resources
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Forest cover 20% of land in South Asia and about 30%
of all land around the world
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Forest shrank by 95 million hectares in the last decade,
the minimum change is however in South Asia, Middle
East & North Africa
Total Energy Use
Carbon Dioxide Emissions
Target 10 : Halve by 2015 the proportion of people
without sustainable access to safe drinking water and
basic sanitation
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Access to safe water has improved in last decade but in
2000, 1.2 billion people still lacked access to an
improved water source
Out of this, 40% are in East Asia & Pacific and 25% in
Sub-Saharan Africa
Meeting MDGs will require providing about 1.5 billion
people with access to safe water and 2 billion with
access to basic sanitation facilities between 2000 and
2015
Population with access to an improved water
source (%)
Target 11 : Have achieved by 2020 a significant
improvement in the lives of at least 100 million slum
dwellers
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Slums are the stage to the most acute scenarios of
urban poverty, physical & environmental deprivation
Approx. one-third of the Urban Population globally live in
these conditions
Where available, trend data indicate that this problem is
worsening
In case of no major interventions it is expected that 924
million slum dwellers in 2001 will grow to 1.5 billion by
2020 [UN-HABITAT]
MDG 8: Build a Global Partnership for Development
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Goal 8 complements the first 7 goals and has 7 targets
(12-18)
It calls for an open, rule-based trading and financial system
More generous AID to countries committed to poverty
reduction
Relief for debt problems of developing countries
It draws attention to problems of least developed land locked
countries & small island states
Calls for co-operation with private sector to address youth
unemployment
Ensure access to affordable, essential drugs
Make available the benefits of new technologies
Monterrey Consensus: In March 2002, leaders from
developing and high income countries agreed on new
strategies for attacking global poverty in Monterrey, Mexico
Commitment was made to increase official development
assistance in real term by about 16 billion a year by 2006
What will it take to achieve the Millennium
Development Goals?
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Political will , commitment & focus
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Monitoring the process
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Economies need to grow to provide jobs & more income
for poor people
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Health & Education system must deliver services to
everyone, men & women, rich & poor
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Infrastructure has to work and be accessible to all
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Policies need to empower people to participate in the development process
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Fortify partnerships with private sector to complement & supplement
government programs
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Prioritization and context setting in development work at each country level
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Overcoming financial, human and institutional resource constraints
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Increased resources & new financial commitments by the wealthiest nations
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While sustained growth would be necessary for poverty reduction,
concomitant improvement in institutional delivery mechanisms will be
essential for achieving progress in all other dimensions of MDGs.
Thank You . . .