MDGs achivements in healthcare sector in inda

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

2. Plan of presentation
1. Introduction.
2. MDGs.
3. Achievements in Health related MDG.
4. MDGs to SDGs.
5. Main Key drivers in achieving the Targets
6. References.
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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.
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4. Representing ambitious moral and practical commitments, the
MDG’s called for the action to
1. Eradicate extreme poverty and hunger.
2. Achieve universal primary education.
3. Promote gender equality and empower women.
4. Reduce child mortality.
5. Improve maternal mortality.
6. Combat HIV/AIDS, malaria and other diseases.
7. Ensure environmental Sustainability.
8. Develop a global partnership for development.
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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.
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6. HEALTH IN MDG ACHIEVEMENTS
1: ERADICATE EXTREME POVERTY AND HUNGER.
2 targets and 4 indicators.
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7. TARGET 1: Halve, between 1990 and 2015, the proportion of
people whose income is less than one dollar a day.
1. Indicator 1A: Poverty Headcount Ratio (percentage of
population below the national poverty line).
2. Indicator 2: Poverty Gap Ratio.
3. 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.
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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
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Per Capita Income/month
URBAN AREA
RURAL AREA
Rs1000/
Rs816/
• Rs4080/monthRural
• Rs5000/monthUrban

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)
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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
• Himachal Pradesh
• TripuraVery close
to MDG
target
• Jharkhand, Madhya
Pradesh, Bihar,
• Haryana, Meghalaya,
Rajasthan, Gujarat
and Uttar Pradesh.
Too low
states
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Status: In progress

11. GOAL4- REDUCE CHILD MORTALITY
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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
1/3rd 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:
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112.5
47.7
0
50
100
150
1990 2015
Under 5 mortality Rate
Under 5MR

13. 80
38
34
0
10
20
30
40
50
60
70
80
90
1990 2015 2016
Infant Mortality Rate
IMR
32.7
83
0
10
20
30
40
50
60
70
80
90
1990 2017
Proportion(%) of 1 year old children
immunized for Measles
% of children immunised for Measeles
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Source: Park’s Textbook of Preventive and social Medicine-25th edition: Health related MDGs
in India.

14. 6/30/2020 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.
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16. Goal5-IMPROVE MATERNAL HEALTH
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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:
1. Adolescent birth rate.
2. Antenatal care visits
3. Contraceptive prevalence rates.
4. Unmet need for family planning
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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
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19. 420
167
0
200
400
600
1990 2015
MMR
MMR
0
55
84
0
20
40
60
80
100
1990 2010 2016
Proportion of births attend by skilled
personal
birth attend by skilled personal
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%
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Source: Park’s Textbook of Preventive and social Medicine-25th edition: Health related MDGs
in India.

20. 6/30/2020 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 1995-20036/30/2020 21
ART
receiving
patients
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%
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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
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24. NOTIFIED TB CASES
INCREASE BY 16%
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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%
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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%
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27. Source: NFHS -4 (2015-16), M/o Health and Family Welfare
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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.
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STATUS: Achieved

29. MDGs to SDGs
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30. Main Key drivers in achieving the Targets
1. Broad-based and employment-creating economic growth.
2. Adequate allocation of resources towards the social sectors and
basic services.
3. Strong design and effective implementation of MDG related
programs.
4. Creating basic infrastructure for better access and delivery of MDG
related services.
5. Women’s empowerment
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31. References
1. Park’s Textbook of Preventive and social Medicine-25th edition.
2. Millennium Development Goals -Final Country Report of
India.2018
3. Sample Registration system , Office of Registrar General of India.
4. NFHS -4 (2015-16), M/o Health and Family Welfare.
5. TB India 2017.
6. Directorate of National Vector Born Diseases Control Programme.
7. United Nations Country Team – India; India and the MDGs Report
2015; : Achievement of the Millennium Development Goals by
India: Key Drivers
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32. THANK YOU
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