Arnab paul

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Arnab paul

  1. 1. Millennium Development goals<br />Arnab Paul<br /> PU 5502<br /> International Health <br />1<br />
  2. 2. Outline<br />Introduction: India's demography, health <br /> systems and data<br />The Millennium Development Goals(MDG).<br />MDG 4 and Indicators<br />Trends and data<br />Policy and programmes<br />Challenges<br />Recommendations and Conclusion<br />2<br />
  3. 3. Introduction<br />The Millennium Development Goals (MDGs) are eight goals to be achieved by 2015 that respond to the world's main development challenges, the focus being the human dimension. <br />The MDGs are drawn from the actions and targets contained in the Millennium Declaration that was adopted by 189 nations.<br />3<br />
  4. 4. Goal 4<br />Reduction of child mortality by two thirds, between 1990 and 2015<br /> Indicators<br />Under-five mortality rate <br />Infant Mortality rate <br />Proportion of 1 year-old children immunised against measles. <br />4<br />
  5. 5. TARGET .. which will have to be achieved by 2015, is nearly 42 per 1000 live births. <br />The trend for projecting estimates for 2015 suggest India is likely to fall short of the U5MR level of 42 by about 28 percentage points<br />5<br />
  6. 6. Under 5 Mortality Rate 1998-99. Inter state variation<br />Source : MDG COUNTRY REPORT 2009<br />6<br />
  7. 7. Under 5 Mortality rate 2005 -06..Inter state variation<br />Source : MDG COUNTRY REPORT 2009<br />7<br />
  8. 8. Infant mortality rate<br /> IMR 80 per thousand live births in 1990 <br /> IMR reduced to 53 in 2008. <br /> Target to reduce IMR to <br /> 26.7 per thousand live births by 2015. <br /> Projections<br />If trend continues, can only take India to an IMR level of about 46 by 2015, short of the target by 20.<br /> High rate of infancy deaths in India is largely attributed to very high share (66% in 2007) of neo‐natal deaths.<br />8<br />
  9. 9. Infant mortality rate.. Trend<br />9<br />
  10. 10. Early Childhood Mortality Rates<br />More than half of deaths to children who die in the first five years of life occur in the first month after birth<br />10<br />
  11. 11. MDG India Country Report 2009<br />11<br />
  12. 12. MDG India Country report 2009<br />12<br />
  13. 13. Determinants of child mortality in India<br />Disease <br />Diarrhoea<br />Acute respiratory infection (ARI) ~ 30 % child deaths<br />Vaccine Preventable disease<br />Malnutrition<br />79.2 % of under 3 year olds suffer from Iron Deficient Anaemia<br /> ( Source : National Family Health Survey III, 2005-06 )<br />13<br />
  14. 14. One Year Olds Immunised against Measles<br />14<br />
  15. 15. Immunisation<br />Coverage<br />1992-93 ... 42 %<br />2007-08... 69.6%<br />Projected <br />By 2015 ~ 97 %<br />However 4 big states,like Bihar, Chattishgarh, Rajasthan, U.P will only be able to cover 60 % going by its current pace.<br />15<br />
  16. 16. <ul><li>Drop-outs between the first and third doses of DPT and polio vaccine are a substantial problem
  17. 17. Less than half of children age 12-23 months are fully vaccinated
  18. 18. Vaccination coverage has improved in most states, but there has been a notable decrease in vaccination coverage in several states</li></ul>16<br />
  19. 19. Government Policy and programs<br />Universal Immunisation program 1985<br />Diarrhoeal Disease Control Program<br />Acute Respiratory Infection Control Program<br /> ¬ merged with Child survival and safe motherhood program 1992<br />Reproductive and child health program <br /> ( RCH )launched in 1997, second phase launched in 2005<br />17<br />
  20. 20. Current Issues and Challenges<br />Limited Resources<br /> * India spends only 5% of GDP on healthcare. <br />Ineffective primary health care delivery<br />Poor health care financing<br />Poverty<br />Poor health information management and data collection<br />18<br />
  21. 21. Recommendation<br />Health intervention programmes should focus on illiterate mothers and on households that are poor.<br />Since, immunization of pregnant women against tetanus has a substantial effect in reducing neonatal mortality. <br />Family health programmes should be strengthened to provide this basic health-care service to all pregnant women.<br />19<br />
  22. 22. Recommendation<br />Girls experience a higher level of child morbidity and mortality ¬¬ Eliminating gender differences in mortality rates would significantly reduce infant and child mortality overall<br />The educational level of mothers tends to have a strong effect on the mortality of young children, as discussed in the NFHS report <br />Pandey et al. (1998)<br />20<br />
  23. 23. Recommendation<br />Number of major interventions required <br />improved access to antenatal, neonatal care<br />Immunization<br />nutritional supplementation<br />Increasing the literacy rate among the female child.<br />Targeting interventions <br />21<br />
  24. 24. Conclusion<br />By 2015<br />U5MR – will be short by more than 28<br />IMR - will be short by more than 20<br />India can achieve 97 % immunization coverage and more by 2015 if the current trend continues with adequate political will, funding and strategic implementation of policies and programmes.<br />22<br />
  25. 25. Thank You !<br />23<br />

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