WHEN May 20091 |

World Health Editors Network

Millennium Development Goals

World Health Editors Network

Millennium Development Goals

Carla AbouZahrDepartment of Health Statistics and Informatics

Carla AbouZahrDepartment of Health Statistics and Informatics

WHEN May 20092 |

WHO reporting on the health-related MDGs

Summary progress

How are the data put together?

WHEN May 20093 |

WHO reporting on the health-related MDGsWHO reporting on the health-related MDGs

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.

WHEN May 20094 |

MDG Goal 1: Target 1.C: Halve the proportion of people who suffer from hunger (underweight)

MDG Goal 1: Target 1.C: Halve the proportion of people who suffer from hunger (underweight)

Globally, percentage of children under five suffering from under-nutrition 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

WHEN May 20095 |

MDG Goal 4: Target 4. A: Reduce child mortality by two thirds

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.

WHEN May 20096 |

Trends in under 5 mortality by WHO region, 1990-2007

Trends in under 5 mortality by WHO region, 1990-2007

0

20

40

60

80

100

120

140

160

180

200

AFR EMR SEA WPR AMR EUR

1990

2000

2007

De

ath

s p

er

10

00

live

bir

ths

WHEN May 20097 |

Inequalities in under 5 mortality:comparing wealthiest and poorest households

Inequalities in under 5 mortality:comparing wealthiest and poorest households

0

50

100

150

200

250

Burkin

a Fa

so

Cambo

dia

Bangl

ades

h

Yemen

Bolivia

Indi

a

Egypt

Philipp

ines

Armen

ia

Poorest

Richest

WHEN May 20098 |

MDG Goal 5: Improve maternal healthMDG 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.

WHEN May 20099 |

Risk of pregnancy and childbirth UNICEF, UNFPA, World Bank estimates for 2005Risk of pregnancy and childbirth UNICEF, UNFPA, World Bank estimates for 2005

WHEN May 200910 |

Improvements in maternal health care but continuing unmet need

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%

WHEN May 200911 |

Use of skilled attendant at delivery by WHO region and country income group, 1990s and 2000-2008 Use of skilled attendant at delivery by WHO region and country income group, 1990s and 2000-2008

0

10

20

30

40

50

60

70

80

90

100

lowincome

lowermiddleincome

AFR SEA EMR WPR EUR AMR

1990s

2000-2008

WHEN May 200912 |

Use of skilled attendant at delivery by household wealth groups, selected countries

Use of skilled attendant at delivery by household wealth groups, selected countries

0

20

40

60

80

100

Poorest RichestHousehold wealth quintile

Bir

ths

att

en

de

d b

y s

kil

led

hea

lth

pe

rso

nn

el (%

)

Chad 2004 Colombia 2005 Gabon 2000 Nepal 2006 Indonesia 2002/03 Pakistan 2006-07 India 2005-06

WHEN May 200913 |

MDG Goal 6: Combat HIV/AIDS, malaria, and other diseases

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 womenabout 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.

Estimated adult Estimated adult (15–49 years)(15–49 years) HIV prevalence rate HIV prevalence rate (%)(%) globally and in Sub-Saharan Africa, 1990–2007globally and in Sub-Saharan Africa, 1990–2007

Year

Adult HIV prevalence rate (%)

0

1

2

3

4

5

6

7

8

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

GlobalGlobal

Sub-Saharan AfricaSub-Saharan Africa

2

WHEN May 200915 |

MDG Goal 6: Combat HIV/AIDS, malaria, and other diseases

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.

WHEN May 200916 |

MDG 7: Halve the proportion of people without sustainable access to safe drinking water and basic sanitation.

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 drinking-water 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.

WHEN May 200917 |

MDG 8, Target 8 E: Access to affordable essential medicines in developing countries.

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.

WHEN May 200918 |

How does WHO compile health statistics in World Health Statistics 2009?

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.

WHEN May 200919 |