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Arnab paul
 

Arnab paul

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    Arnab paul Arnab paul Presentation Transcript

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