Millenium development goals

MDGs achivements in healthcare sector in inda

1. PRESENTATION ON MILLENIUM DEVELOPMENT GOALS Presented BY DR.G.HARI PRAKASH MPH 1 st year SCHOOL OF PUBLIC HEALTH DEPARTMENT OF COMMUNITY MEDICINE JSS MEDICAL COLLEGE MYSURU. 24-Oct-19 1 MODERATOR DR.PRAVEEN KULKARNI ASSOCIATE PROFESSOR DEPT. OF COMMUNITY MEDICINE JSS MEDICAL COLLEGE MYSURU.

2. Plan of presentation Introduction. MDGs. Achievements in Health related MDG. MDGs to SDGs . Main Key drivers in achieving the Targets References. 24-Oct-19 2

3. INTRODUCTION In September 2000 the UN General Assembly adopted the Millennium declarations, establishing a global partnership of countries & development partners committed to 8 voluntary development goals to be achieved by 2015. The MDGs helped in bringing out a much needed focus and pressure on basic development issues, which in turn led the governments at national and sub national levels to do better planning and implement more intensive policies and programs. The MDGs consisted of eight goals, and these eight goals addressed multiple development issues. 24-Oct-19 3

4. Representing ambitious moral and practical commitments, the MDG’s called for the action to Eradicate extreme poverty and hunger. Achieve universal primary education. Promote gender equality and empower women. Reduce child mortality. Improve maternal mortality. Combat HIV/AIDS, malaria and other diseases. Ensure environmental Sustainability. Develop a global partnership for development. 24-Oct-19 4

5. Targets and Indicators: Eighteen (18) targets were set as quantitative benchmarks for attaining the MDGs. The United Nations Development Group (UNDG) in 2003 provided a framework of 53 indicators which are categorized according to targets, for measuring the progress towards individual targets. Inter-Agency and Expert Group (IAEG ) has revised framework on MDGs came into effect in 2008 has 8 goals, 21 targets and 60 indicators. 3 of 8 MDGs are focused on health, while health is also a component of several other MDG’s- Nutrition, Water & sanitation. 24-Oct-19 5

6. HEALTH IN MDG ACHIEVEMENTS 1: ERADICATE EXTREME POVERTY AND HUNGER . 2 targets and 4 indicators. 24-Oct-19 6

7. TARGET 1: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day. Indicator 1A: Poverty Headcount Ratio (percentage of population below the national poverty line). Indicator 2: Poverty Gap Ratio. Indicator 3: Share of poorest quintile in national consumption TARGET 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger. 4. Indicator 4: Prevalence of underweight children under three years of age. 24-Oct-19 7

8. The Poverty Head Count Ratio (PHCR) is the proportion of population whose per-capita income/consumer expenditure is below the official thresholds i.e , ‘Poverty Line’ set by the National Government. The latest official poverty estimates are available for 2011-12. Thus a family of 5 the all India poverty line in terms of consumption expenditure is 24-Oct-19 8 Per Capita Income/month URBAN AREA RURAL AREA Rs1000/ Rs816/

9. TARGET 1: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day Proportion of population below poverty line 21.92% (2011-12) Poverty Gap Ratio Rural: 5.05 , Urban: 2.7 (2011-12) Share of poorest quintile in national consumption (URP method) Rural: 9.1, Urban: 7.1 (2011-12) 25%(1991) 24-Oct-19 9 TARGET 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger: Proportion of under weight children of below 3 years - 33.7% (2015-16) 53.4%(1990) Status: Achieved

10. Source: National Family Health survey, M/o Health & Family Welfare 24-Oct-19 10 Status: In progress

11. GOAL4- REDUCE CHILD MORTALITY 24-Oct-19 11 TARGET 5 : Reduce by two-thirds, between 1990 and 2015, the Under- Five Morality Rate Indicator: Under- Five Mortality Rate The Under-Five Mortality Rate (U5MR) is the probability (expressed as a rate per 1,000 live births) of a child born in a specified year dying before reaching the age of five if subject to current age-specific mortality rates. Majority of the under five deaths are neonatal deaths which are mainly due to complications and infections happened during birth. Status: Nearly achieved

12. Deaths among Pregnant women, children and adolescents that are preventable 1/3 rd of global burden of Premature Mortality. MMR in Developing countries(19times higher) > Developed countries. Children in developing countries are 8 times more likely to die before they reach 5 years of age. Under-5 mortality rate: 24-Oct-19 12

13. 24-Oct-19 13 Source: Park’s Textbook of Preventive and social Medicine-25 th edition: Health related MDGs in India.

14. 24-Oct-19 14

15. Source: National Family Health Survey, M/o Health and Family Welfare The least developing countries continue to face the greatest challenges in improving maternal and child health are poor coverage & quality of health care services and public health interventions, inadequate water & sanitation, poor infrastructures, low food security & limited education and economic opportunity. 24-Oct-19 15

16. Goal5-IMPROVE MATERNAL HEALTH 24-Oct-19 16 TARGET 6: Reduce by three quarters, between 1990 and 2015, the Maternal Mortality Rate. The Maternal Mortality Ratio is the number of women who die from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. Indicator: Maternal Mortality Ratio Status: In progress

17. MMR is the second leading cause of death among women aged 15-49 years after HIV. Globally women faces 1/180 lifetime risk of dying due to maternal causes-hemorrhage, hypertensive disorder, sepsis and abortion. MDG-5B: Target of achieving access to universal reproductive health was only added in year 2007. It includes: Adolescent birth rate. Antenatal care visits Contraceptive prevalence rates. Unmet need for family planning 24-Oct-19 17 Improvement in these areas leads to decreases maternal mortality

18. Source: M/o Health and Family Welfare Source: Sample Registration System, Office of Registrar General of India 24-Oct-19 18

19. Adolescelent birth rate 1990-NA 2010-2015- 31.5% Antenatal care coverage 1990-NA 2010-2015- 50 Unmet need for family planning 1990-NA 2006-2013- 21% 24-Oct-19 19 Source: Park’s Textbook of Preventive and social Medicine-25 th edition: Health related MDGs in India.

20. 24-Oct-19 20 Source: NFHS - 4

21. New HIV infection was decreased by 40% between 2000-2014 estimated 3.5million cases to 2.1 million by 2014. 800000 14.9million ART averted 7.6million deaths b/w 1995-2003 24-Oct-19 21 ART receiving patients 2003 2014 Status: Achieved

22. HIV prevalence among young adults: 15-24yrs(%)- 1990-NA. 15-49Yrs(%)- 2012(M)- 0.1 2012(F)- 0.1 Malaria: 6.2million deaths have been averted between 2000 and 2015, primarily under 5 years of age in sub Saharan Africa. Global malaria incidence-37% Mortality – 58%. Use of ITN in 2000- 2% 2015- 68% 24-Oct-19 22

23. Prevalence and death rates associated with Tuberculosis: India accounts for one fourth of the global TB burden. In 2015, an estimated 28 lakh cases occurred and 4.8 lakh people died due to TB. As per the WHO Global TB report, the TB burden of India vis –a – vis global is as follows Estimates of TB burden 2015 Global India Incidence of TB cases 104 lakh 28 lakh Mortality of TB 14 lakh 4.8 lakh Incidence HIV TB 11.7 lakh 1.1 lakh Mortality of HIV TB 3.9 lakh 37,000 MDR -TB 4.8 lakh 1.3 lakh Source: TB India 2017 24-Oct-19 23

24. NOTIFIED TB CASES INCREASE BY 16% 24-Oct-19 24 On the Decline: A/c to WHO 2019 edition of Global TB Report 2017 2018 Total TB Incidence 27.4lak 26.9lak TB Incidence per 100,000 popln 204 199 %of cases tested for rifampicin resistance among new pts 32% 46% %of cases tested for rifampicin resistance among previously treated pts 91% 82% In India 2.69M cases emerging in 2018, 2.15M cases were reported to GOI and 540,000 pts were unreported

25. TARGET 9: Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources The world has now met the target relating to access safe drinking water. Proportion of population(%) using biomass fuels -1990 – NA. 2013 – 64% 24-Oct-19 25 STATUS: Inprogress

26. Target-10: Halve by 2015 the proportion of people without sustainable access to safe drinking water. proportion of population(%) without sustainable access to safe drinking water in Rural areas = 1990 – 61% 2011 – 87% Urban areas = 1990 – 88% 2012 – 93% Target-11: By 2020 to have achieved a significant improvement in the lives of at least 100 million slum dwellers. Proportion of urban population with access to improved sanitation 1990 – 44% 2011 – 60% 24-Oct-19 26

27. Source: NFHS -4 (2015-16), M/o Health and Family Welfare 24-Oct-19 27

28. TARGET 18 : In cooperation with the private sector, make available the benefits of new technologies, especially information and communications. Proportion of population access to affordable essential drugs on an sustainable basis 1990 – NA 1997 - 80 It is generally agreed that MDG’s have been a success, more influential and achieved under public recognition. There are several targets where progress has been limited and there remains unfinished agenda to complete work on health MDGs. These unfinished agenda is reflected in the SDGs. 24-Oct-19 28 STATUS: Achieved

29. MDGs to SDGs 24-Oct-19 29

30. Main Key drivers in achieving the Targets B road-based and employment-creating economic growth . Adequate allocation of resources towards the social sectors and basic services. Strong design and effective implementation of MDG related programs. Creating basic infrastructure for better access and delivery of MDG related services. Women’s empowerment 24-Oct-19 30

31. References Park’s Textbook of Preventive and social Medicine-25 th edition. Millennium Development Goals -Final Country Report of India.2018 Sample Registration system , Office of Registrar General of India. NFHS -4 (2015-16), M/o Health and Family Welfare. TB India 2017. Directorate of National Vector Born Diseases Control Programme . United Nations Country Team – India; India and the MDGs Report 2015; : Achievement of the Millennium Development Goals by India: Key Drivers 24-Oct-19 31

32. THANK YOU 24-Oct-19 32