Millennium Development Goals
Carla AbouZahrCarla AbouZahrCoordinator, Statistics, Monitoring and AnalysisCoordinator, Statistics, Monitoring and AnalysisDepartment of Health Statistics and InformaticsDepartment of Health Statistics and Informatics
World Health Editors NetworkWorld Health Editors NetworkGeneva 18 May 2008Geneva 18 May 2008
Summary
Some good newsSome good news Some mixed Some mixed Continuing challenges - mortalityContinuing challenges - mortality Understanding the nature of the problemUnderstanding the nature of the problem What needs to be done byWhat needs to be done by
CountriesCountries Development partnersDevelopment partners WHOWHO
In 2006, childhood deaths fell below 10 millionIn 2006, childhood deaths fell below 10 million
Measles immunization increased since 1990Measles immunization increased since 1990
Underweight prevalence has declined:Underweight prevalence has declined:58 countries on track to achieve MDG158 countries on track to achieve MDG1
76 developing countries on track to reach MDG 76 developing countries on track to reach MDG target on safe drinking watertarget on safe drinking water
Use of insecticide treatment bed nets has increased Use of insecticide treatment bed nets has increased But coverage far short 60% Abuja Declaration targetBut coverage far short 60% Abuja Declaration target
The number of people living with HIV The number of people living with HIV continues to rise continues to rise but is lower than previously estimatedbut is lower than previously estimated
Child mortality: few countries will achieve MDG 4
*MDG4 = 4.3% annual reductionSource:Christopher MurrayInstitute for Health Metrics and Evaluation
Progress toward MDG4Rapid progress is possible.Further analysis of these “well performing” countries under way.No country in sub-Saharan
Africa
The 10 countries with least progress are in sub-Saharan Africa
Contextual factorsHigh HIV prevalenceConflict
Infections and diarrhoea kill most under 5sInfections and diarrhoea kill most under 5sBut one in three deaths occurs in 1st month But one in three deaths occurs in 1st month
Source: WHO, World Health Report 2005
Malnutrition
MDG5: Risk of pregnancy and childbirth UNICEF, UNFPA, World Bank estimates for 2005
None of these countries are in
sub-Saharan Africa or South
Asia
Even among the ten “best
performers”
7 have ratios over 100
12 of 13 countries with highest MMRs are in sub-Saharan Africa
Progress toward MDG5
High HIV prevalence (>5%, 8/10)
Armed conflict (2/10)
Interventions able to be scheduled routinely (antenatal care) Interventions able to be scheduled routinely (antenatal care) have higher coverage than those needing functional have higher coverage than those needing functional health systems and 24-hour availability health systems and 24-hour availability (care during delivery, treatment of childhood illnesses)(care during delivery, treatment of childhood illnesses)
Of 18 life-saving interventions for mothers and children, Of 18 life-saving interventions for mothers and children, only vaccinations are reaching 80% coverageonly vaccinations are reaching 80% coverage
Failures in coverage of care
The poor are least likely to access care:The poor are least likely to access care:Unmet need for care (coverage gap) Unmet need for care (coverage gap) higher for poorest than for richesthigher for poorest than for richest
What can countries do?
Invest in health systems Recognize that health services often contribute
to increasing inequities Remove financial barriers (user fees, etc) Prioritize diseases of the poor Deploy/improve services where the poor live Employ appropriate delivery channels Monitor implementation, coverage and impact
with an equity lens
What can the development community do?
Invest in health systems Embed health in social and economic
planning; multisectoral response Ensure long-term predictable aid Hold all partners accountable for their
performance against international agreements
What will WHO do?
Strengthen health situation and trends monitoring: global health observatory
Equity focus: poverty, gender, geography Cause-specific mortality trends. Monitor global health initiatives and their
impact on health services. Enhance understanding of data limitations
and need for investments in health information systems
World Health Statistics 2008
Country-by-country health indicators
Ten highlights in global health
Understanding the data and estimates
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