Transcript Slide 1

World Health Editors Network
Millennium Development Goals
Carla AbouZahr
Department of Health Statistics and Informatics
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 WHO reporting on the health-related MDGs
 Summary progress
 How are the data put together?
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WHO reporting on the health-related MDGs
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At the 2008 World Health Assembly, WHO Member States tasked the Organization
to provide an annual update on progress towards the health-related MDGs,
starting in 2009 – the halfway mark between 2000 and 2015.

The vehicle for WHO reporting on health data is the annual publication World
Health Statistics which brings together statistics on over 100 indicators covering
mortality, morbidity, health service use, risk factors, inequalities

World Health Statistics 2009 year includes a supplement on the health-related
MDGs, available in six languages. Includes both regional averages and individual
country data where available

Currently available data show that while some countries have made impressive
gains in achieving health-related targets, others are falling behind. Often the
countries making the least progress are those affected by high levels of HIV/AIDS,
economic hardship or conflict.
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MDG Goal 1: Target 1.C: Halve the proportion of
people who suffer from hunger (underweight)
 Globally, percentage of children under five suffering from undernutrition declined from 27% in 1990 to 20% in 2005.
 Estimated 112 million children remain underweight
 Highest levels (25%+): Afghanistan, Angola, Bangladesh. Burkina
Faso, Burundi, Cambodia, Chad, DR Congo, Eritrea, Ethiopia, India,
Lao PDR, Madagascar, Mali, Myanmar, Nepal. Niger, Pakistan,
Sierra Leone, Somalia, Sudan, Timor-Leste,
 Making progress: Angola, Bangladesh, Cambodia, Egypt, Eritrea,
Ghana, Haiti, Honduras, Malawi, Mali, Mozambique, Nigeria,
Pakistan, Rwanda, Senegal, Uganda, Tanzania, Viet Nam
 Stalled or worsening: Bolivia, Burkina Faso, Chad, Comorros,
Dominican Republic, Guinea, India, Kenya, Madagascar, Morocco,
Nepal. Togo, Zimbabwe
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MDG Goal 4: Target 4. A:
Reduce child mortality by two thirds
 Globally, deaths of child under 5 declined from 12.5 million in 1990
to 9 million in 2007, a 27% decline.
 Huge range in child mortality rates across countries: maximum
estimated rates 262 per 1000, minimum 2 per 1000
 Average for high income countries 7 per 1000; low income countries
126 per 1000
 Reductions achieved through use of insecticide-treated mosquito
nets for malaria, oral rehydration therapy for diarrhoea, increased
access to vaccines for a number of infectious diseases and improved
water and sanitation.
 Pneumonia and diarrhoea continue to kill 3.8 million children aged
under five each year, despite the fact that both conditions are
preventable and treatable.
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Trends in under 5 mortality by WHO region,
1990-2007
200
Deaths per 1000 live births
180
160
140
120
1990
2000
2007
100
80
60
40
20
0
AFR
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EMR
SEA
WPR
AMR
EUR
Inequalities in under 5 mortality:
comparing wealthiest and poorest households
250
200
150
Poorest
Richest
100
50
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MDG Goal 5: Improve maternal health
 No new global estimates since 2005
 Global, maternal mortality ratio of 400 maternal deaths per 100 000
live births in 2005 has barely changed since 1990.
 536 000 women die in pregnancy or childbirth each year
 Most deaths in Sub-Saharan Africa where the maternal mortality
ratio is 900 per 100,000 births and where there has been no
measurable improvement since 1990.
 A woman in Africa may face a lifetime risk of death during pregnancy
and childbirth as high as one in 26, compared with only one in 7,300
in the developed regions.
 There are, however, positive signs of progress in some countries in
Asia and Latin America and the Caribbean.
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Risk of pregnancy and childbirth
UNICEF, UNFPA, World Bank estimates for 2005
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Improvements in maternal health care but
continuing unmet need
 Globally, the proportion of women receiving antenatal care
(at least on visit) increased from one in two in 1990 to
three in four in 2007. But in 2007, less than half of
pregnancy women received the minimum 4 visits required
 Globally, contraceptive use increased from 59% in the
early 1990s to 63% during 2000-2006. But continuing
unmet need especially in low and lower middle income
countries
 Use of skilled health care at delivery increased globally
from 61% to 65%
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Use of skilled attendant at delivery by WHO region
and country income group, 1990s and 2000-2008
100
90
80
70
60
50
1990s
2000-2008
40
30
20
10
0
low
income
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lower
middle
income
AFR
SEA
EMR
WPR
EUR
AMR
Use of skilled attendant at delivery by
household wealth groups, selected countries
Chad 2004
Colombia 2005
Gabon 2000
Nepal 2006
Indonesia 2002/03
Pakistan 2006-07
India 2005-06
Births attended by skilled health personnel (%)
100
80
60
40
20
0
Poorest
Richest
Household wealth quintile
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MDG Goal 6:
Combat HIV/AIDS, malaria, and other diseases
 HIV/AIDS
 Globally, the percentage of adults living with HIV stable since 2000 but 2.7
million new infections during 2007.
 More than 96% of these new infections are in low and middle income
countries
 About 15% in children under 15 years of age
 About 85% in adults aged 15 years and older of whom:
almost 50% are among women
about 40% are among young people (15-24)
 Deaths continue to rise in East and Southern Africa.
 The use of antiretroviral therapy increased; during 2007, about 1 million more
people living with HIV received antiretroviral treatment.
 But only about a third of the estimated 9.7 million people in developing
countries who need the treatment were actually receiving it.
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Estimated adult (15–49 years) HIV prevalence rate (%)
globally and in Sub-Saharan Africa, 1990–2007
8
7
Sub-Saharan Africa
6
5
Adult HIV
prevalence 4
rate (%)
3
2
Global
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1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
2
MDG Goal 6:
Combat HIV/AIDS, malaria, and other diseases
 Tuberculosis
 The MDG target for reducing the incidence of tuberculosis was met globally in
2004 and incidence has continued to fall slowly since then.
 Success in eradicating tuberculosis rests on early detection of new cases and
treatment using DOTS. Data on treatment success rates indicate consistent
improvements with rates rising from 79% in 1990 to 85% in 2006.
 Multi-drug resistant tuberculosis a challenge in former Soviet Union countries,
while the lethal dual combination infection of HIV and tuberculosis an issue
for sub-Saharan African countries.
 Malaria
 Malaria control efforts are beginning to pay off with significant increases in the
proportion of children sleeping under insecticide treated mosquito nets.
 Although it is still too early to register global changes in impact, 27 countries
(including five in Africa) have reported a reduction of up to 50% in the number
of cases of malaria between 1990 and 2006.
 In 2006, the number of cases was estimated to be 250 million globally.
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MDG 7: Halve the proportion of people without sustainable
access to safe drinking water and basic sanitation.
 From 1990–2006, estimated people with access to safe drinkingwater rose from 4.1 billion to 5.7 billion, an increase of 1.6 billion.
 However, 900 million still had to rely on water from “unimproved
sources” such as surface water or an unprotected dug well.
 Since 1990, 1.1 billion people in developing regions have improved
sanitation. In 1990, just under 3 billion had access to sanitation,
which rose to more than 4 billion by 2006.
 Despite this progress, in 2006 some 2.5 billion did not have access
to improved sanitation and 1.2 billion had to use open defecation.
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MDG 8, Target 8 E: Access to affordable essential
medicines in developing countries.
 Access to affordable essential drugs remains poorly
measured. Data from about 30 developing countries show
that the proportion of the population with access to
affordable essential drugs is improving.
 However, availability of selected medicines at health
facilities was only 35% in the public sector and 63% in the
private sector.
 Lack of medicines in the public sector often means
patients have no choice but to purchase medicines
privately.
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How does WHO compile health statistics in
World Health Statistics 2009?
 WHO compiles health statistics from publications and databases
maintained by its technical programmes and regional offices.
 The statistics are generated from multiple sources using different
data collection methods, including household surveys, routine
reporting by health services, civil registration and censuses, and
disease surveillance systems.
 In estimating country values, regional offices and technical
programmes apply peer-review methods and consult with experts
around the world. This process is intended to enhance data quality
and ensure transparency in the application of adjustment factors in
order to maximize comparability across countries and over time.
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