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  • 1. Millennium Development goals
    Arnab Paul
    PU 5502
    International Health
    1
  • 2. 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
  • 3. 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
  • 4. 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
  • 5. 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
  • 6. Under 5 Mortality Rate 1998-99. Inter state variation
    Source : MDG COUNTRY REPORT 2009
    6
  • 7. Under 5 Mortality rate 2005 -06..Inter state variation
    Source : MDG COUNTRY REPORT 2009
    7
  • 8. 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
  • 9. Infant mortality rate.. Trend
    9
  • 10. 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
  • 11. MDG India Country Report 2009
    11
  • 12. MDG India Country report 2009
    12
  • 13. 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
  • 14. One Year Olds Immunised against Measles
    14
  • 15. 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
  • 16.
    • Drop-outs between the first and third doses of DPT and polio vaccine are a substantial problem
    • 17. Less than half of children age 12-23 months are fully vaccinated
    • 18. Vaccination coverage has improved in most states, but there has been a notable decrease in vaccination coverage in several states
    16
  • 19. 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
  • 20. 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
  • 21. 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
  • 22. 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
  • 23. 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
  • 24. 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
  • 25. Thank You !
    23