The Americas: A Region of Extremes Social Inequalities: A Barrier to Exercising the Right to Health Dr. Mirta Roses Periag...
Content <ul><li>Wide gaps among and within the Region of the Americas </li></ul><ul><li>The weight of social determinants:...
Wide gaps among and within the Region of the Americas
Demographic Transition in the Americas
Demographic Transition in the Americas
The Aging Process in the Region Source:   Regional Health Observatory, PAHO.
Life Expectancy at Birth - Subregions of the Americas <ul><li>Key points: </li></ul><ul><li>Total Fertility Rate (TFR)   d...
The reality check: Life Expectancy vs. Spending
The most unequal Region in the world Pan American Health Organization BO NI EC MX UY CR VE SV PA AR PY BR CO RD GT CL PE H...
Inequities in health: Towards a working definition   <ul><li>The term inequity as used in WHO documents </li></ul><ul><li>...
Source:  ECLAC, Indigenous and Afro-descendent Peoples of Latin America and the Caribbean:    Socio-demographic Data for P...
Total fertility rate, indigenous and non-indigenous population  Selected countries of the Americas, ~2000   Note:  The cou...
Adolescent Birth Rate- Region of the Americas Nicaragua is 2.5 times higher compared with Cuba The difference between the ...
International Aid for Population Activities by Components of ICPD*  Latin American and Caribbean, 1997-2007 -En Millones d...
Proportion of deaths by age groups and cause of death in  Country groups according to income Classification of countries a...
Diabetes Mortality Rates * Age group (50 to 69)  Selected countries of the Americas. (2004, 2005 and 2006 lad) Source:   M...
Source:   Mortality Database, PAHO/HSD/HA and World Bank Premature mortality due to Cerebrovascular Disease by  Gross Nati...
* Per 100.000 pop 0 20 40 60 80 Mortality Rate 50 - 69 Venezuela Uruguay United States Puerto Rico Peru Paraguay Panama Me...
The weight of social determinants
<ul><li>Population of Latin America and the Caribbean: 582 million (2009) </li></ul><ul><li>27% without regular access to ...
Social exclusion in health and environment Source:  PAHO Basic Indicators Pan American Health Organization
Coefficient of linear correlation= - 0.63 More  access to improved sanitation, less Infant Mortality Source:  PAHO Basic I...
Women aged 30-49 years  Source:  ENDEMAIN, Ecuador-INEC 2004 ; DHS -2002 Guatemala Proportion of Women never screened for ...
In Bolivia the highest 20% income is 36 times the lowest 20% More inequality is related to higher infant and maternal mort...
Some countries have progressed decreasing the IMR in low level social economic groups  Latin America and Caribbean: Infant...
Infant Mortality Rate: Indigenous, Afro and other Populations  Selected Countries of the Americas. Census 2000 Source:  PA...
Source:  Wilkinson & Pickett, The Spirit Level (2009) The Prevalence of Mental Illness is Higher in More Unequal Rich Coun...
National health expenditure on health in LAC: magnitude and trends Source:  National Health Expenditure Data base. HSS/PAH...
Public source health expenditure as % of GDP  Canada, LAC and USA. Selected periods 1960-2006
PAHO’s Role to tackle health inequities
<ul><li>We are an Organization with: </li></ul><ul><li>Vision of Health in the Americas </li></ul><ul><li>Values of Equity...
PAHO Framework for Action <ul><li>Reducing the Gap </li></ul><ul><li>Ensuring Access </li></ul><ul><li>Achieving Results  ...
We have to think in: Similar  situations  among  countries Specific  situations in  each  country
Focus Priority Country Intermediate Country Highly Developed Country Framework for Technical Cooperation Each Country has ...
PAHO’s Commitment with the MDGs
Goal: <ul><li>It was launched to address the dangerous    & unjust illusion resulting from averages    in health statistic...
Amazonia Altiplano El Chaco La Mosquitia Transnational Territories
Monitoring Regional Progress
Vital and Health Statistics Data in the Americas Coverage and Quality <ul><li>In the Region there are: data with  good  qu...
<ul><li>The regional report lists the countries according to their  vital and health statistics situation, revealing  wide...
<ul><li>Quality of VS . Affect the countries in a more homogeneous manner, specially at the local level. Lack of informati...
Health and Vital Statistics: Regional Situation Source:  Health and Vital Statistics Regional Evaluation
32 countries studied 19 (59%) - good quality and    coverage data 6 (19%) - medium data quality 7 (22%) - poor or very poo...
Mortality Data has improved Source:  Regional Health Observatory / PAHO The proportion of unknown cause of death are decre...
Without good data for monitoring the MDGs,  different agencies or researchers are  making estimates for the Region What is...
Variability is observed more often in small populations MDG Infant Mortality Rate:  Forecasting is difficult for countries...
red:  repetitions Forecasting is difficult for countries with limited data blue: too few observations Country 1996 1997 19...
<ul><li>The analysis described has led to the consideration of  lines of action in the following areas: </li></ul><ul><li>...
<ul><li>For the technical point of view: </li></ul><ul><li>Develop uniform standards, procedures, and classifications; </l...
National Basic Indicators pamphlets
Special Populations Key  Countries PAHO Vision Equity Pan-Americanism Technical  Priorities Consensus and coordination has...
Thank you
Upcoming SlideShare
Loading in …5
×

Paho social inequities in the americas 2001 eng

1,633 views

Published on

Dr. Roses, PAHO Director, presentation on Social Inequalities in health in the Region of the Americas.
PAHO's Regional Health Observatory (RHO
Pan American health Organization (PAHO)

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,633
On SlideShare
0
From Embeds
0
Number of Embeds
684
Actions
Shares
0
Downloads
37
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Comentario: la EVN está determinada por la inversión Per cápita en salud? Países con menos gasto Per cápita (como Cuba) presentan una EV similar a Suiza, EUA. Es obvio que faltan elementos vitales como la solidaridad, la APS, para garantizar un acceso justo a los servicios de salud.
  • Unplanned pregnancy is a problem: over 50% are unplanned (Caribbean 62%, South America 63%,  Central America and Mexico 43% ); 65% of women in a relationship use modern contraceptive methods and 22% of all pregnancies end in abortion (24% in South America, 17% in Central America and 23% in the Caribbean. This graphic illustrates international aid and its reduction in the areas of Family Planning Services, among others. ( Source : UNFPA)
  • The Mortality Profile of the Region has been changing during the last decades : In some countries the chronic degenerative type conditions (diseases) and external causes (accidents and homicides), have displaced the communicable diseases; Pneumonia and influenza remain among the leading causes of mortality in some countries; Ischemic heart diseases and cerebrovascular diseases are among the leading causes of death, particularly among women; Malignant neoplasm of lung and prostate are leading causes in mortality in men; Assaults (homicides) are among the top three causes of death in the male population in various subregions.
  • Si bien es cierto que la mortalidad infantil también ha bajado significativamente en las poblaciones discriminadas, persisten diferencias importantes entre los indígenas, los afrodescendientes y el resto de la población, así como entre el campo y la ciudad: la incidencia de la mortalidad entre los niños indígenas y afrodescendientes sigue siendo mayor, tanto en las zonas rurales como en las urbanas
  • RD-2005. En la reunión participaron los Directores de ambas instituciones que respondieron la Guía, los puntos focales de AIS en los países, y representantes de organismos internacionales. La principal recomendación de la RD-2005 fue la necesidad de diseñar un plan de fortalecimiento de naturaleza regional que facilitara el desarrollo de análisis nacionales y la generación de un plan de actividades de seguimiento en el futuro. Se asignó a la OPS el rol coordinador de esa gestión y armonizador de los planes nacionales en un planteo conjunto que se denominaría Plan de Acción para el Fortalecimiento de las Estadísticas Vitales y de Salud de los países de las Américas . Para mayores detalles puede verse: OPS/OMS (2006). Reunión de Directores Nacionales de Estadística y Directores de Estadísticas de Salud de los países de las Américas (RD-2005) Buenos Aires, 21-22 de Noviembre de 2005. Trabajo en Grupos. Relatoría . Washington; OPS/OMS (2006). Reunión de Directores Nacionales de Estadística y Directores de Estadísticas de Salud de los países de las Américas (RD-2005) Buenos Aires, 21-22 de Noviembre de 2005. Informe Final preliminar . Washington; y OPS/OMS (2005). Reunión de Directores (RD-2005). Guía para la discusión del trabajo de grupos. Varios documentos . Washington.
  • RD-2005. En la reunión participaron los Directores de ambas instituciones que respondieron la Guía, los puntos focales de AIS en los países, y representantes de organismos internacionales. La principal recomendación de la RD-2005 fue la necesidad de diseñar un plan de fortalecimiento de naturaleza regional que facilitara el desarrollo de análisis nacionales y la generación de un plan de actividades de seguimiento en el futuro. Se asignó a la OPS el rol coordinador de esa gestión y armonizador de los planes nacionales en un planteo conjunto que se denominaría Plan de Acción para el Fortalecimiento de las Estadísticas Vitales y de Salud de los países de las Américas . Para mayores detalles puede verse: OPS/OMS (2006). Reunión de Directores Nacionales de Estadística y Directores de Estadísticas de Salud de los países de las Américas (RD-2005) Buenos Aires, 21-22 de Noviembre de 2005. Trabajo en Grupos. Relatoría . Washington; OPS/OMS (2006). Reunión de Directores Nacionales de Estadística y Directores de Estadísticas de Salud de los países de las Américas (RD-2005) Buenos Aires, 21-22 de Noviembre de 2005. Informe Final preliminar . Washington; y OPS/OMS (2005). Reunión de Directores (RD-2005). Guía para la discusión del trabajo de grupos. Varios documentos . Washington.
  • RD-2005. En la reunión participaron los Directores de ambas instituciones que respondieron la Guía, los puntos focales de AIS en los países, y representantes de organismos internacionales. La principal recomendación de la RD-2005 fue la necesidad de diseñar un plan de fortalecimiento de naturaleza regional que facilitara el desarrollo de análisis nacionales y la generación de un plan de actividades de seguimiento en el futuro. Se asignó a la OPS el rol coordinador de esa gestión y armonizador de los planes nacionales en un planteo conjunto que se denominaría Plan de Acción para el Fortalecimiento de las Estadísticas Vitales y de Salud de los países de las Américas . Para mayores detalles puede verse: OPS/OMS (2006). Reunión de Directores Nacionales de Estadística y Directores de Estadísticas de Salud de los países de las Américas (RD-2005) Buenos Aires, 21-22 de Noviembre de 2005. Trabajo en Grupos. Relatoría . Washington; OPS/OMS (2006). Reunión de Directores Nacionales de Estadística y Directores de Estadísticas de Salud de los países de las Américas (RD-2005) Buenos Aires, 21-22 de Noviembre de 2005. Informe Final preliminar . Washington; y OPS/OMS (2005). Reunión de Directores (RD-2005). Guía para la discusión del trabajo de grupos. Varios documentos . Washington.
  • De esta manera, los objetivos del Plan de Acción son: Desarrollar y mantener actualizados mecanismos de evaluación y análisis para el diagnóstico de la situación de las estadísticas vitales y de salud de los países. Contribuir a que los países desarrollen e implementen planes permanentes de monitoreo de la calidad de las estadísticas vitales y de salud que contribuya al fortalecimiento de los sistemas de información. Mapear la existencia de problemas (necesidades) y soluciones (buenas prácticas) a nivel de países, grupos de países, la organización y otras agencias multilaterales. Orientar la producción, difusión y el uso de prácticas en el campo del mejoramiento de las estadísticas vitales y de salud de los países. Fomentar la cooperación horizontal entre países y entre grupos subregionales. Facilitar el desarrollo de acciones coordinadas entre países, grupos de países, la Organización y diferentes agencias internacionales en el campo del fortalecimiento de los sistemas de información, con vistas a evitar dispersión en el uso de recursos humanos, económicos y financieros. Contribuir a la movilización de recursos para el apoyo y sostenimiento de actividades de fortalecimiento propias de los países o de grupos de países. Asistir técnicamente a los países en el campo del análisis y evaluación de las estadísticas vitales y de salud y desarrollar productos para uso colectivo. [1] En este sentido, adhiere y hace propios la meta, objetivos y principios de la Red Métrica de Salud (Health Metrics Network), alianza mundial orientada a los sistemas sanitarios que promueve normas a nivel mundial para el desarrollo y el desempeño de aquellos En este sentido, ver el documento “A Framework and Standards for Country Health Information System Development. Health Metrics Network (HMN). World Health Organization (WHO). Geneve. 2006”.
  • De esta manera, los objetivos del Plan de Acción son: Desarrollar y mantener actualizados mecanismos de evaluación y análisis para el diagnóstico de la situación de las estadísticas vitales y de salud de los países. Contribuir a que los países desarrollen e implementen planes permanentes de monitoreo de la calidad de las estadísticas vitales y de salud que contribuya al fortalecimiento de los sistemas de información. Mapear la existencia de problemas (necesidades) y soluciones (buenas prácticas) a nivel de países, grupos de países, la organización y otras agencias multilaterales. Orientar la producción, difusión y el uso de prácticas en el campo del mejoramiento de las estadísticas vitales y de salud de los países. Fomentar la cooperación horizontal entre países y entre grupos subregionales. Facilitar el desarrollo de acciones coordinadas entre países, grupos de países, la Organización y diferentes agencias internacionales en el campo del fortalecimiento de los sistemas de información, con vistas a evitar dispersión en el uso de recursos humanos, económicos y financieros. Contribuir a la movilización de recursos para el apoyo y sostenimiento de actividades de fortalecimiento propias de los países o de grupos de países. Asistir técnicamente a los países en el campo del análisis y evaluación de las estadísticas vitales y de salud y desarrollar productos para uso colectivo. [1] En este sentido, adhiere y hace propios la meta, objetivos y principios de la Red Métrica de Salud (Health Metrics Network), alianza mundial orientada a los sistemas sanitarios que promueve normas a nivel mundial para el desarrollo y el desempeño de aquellos En este sentido, ver el documento “A Framework and Standards for Country Health Information System Development. Health Metrics Network (HMN). World Health Organization (WHO). Geneve. 2006”.
  • Paho social inequities in the americas 2001 eng

    1. 1. The Americas: A Region of Extremes Social Inequalities: A Barrier to Exercising the Right to Health Dr. Mirta Roses Periago , PAHO Director [Bethesda, MD. 16 September 2010.]
    2. 2. Content <ul><li>Wide gaps among and within the Region of the Americas </li></ul><ul><li>The weight of social determinants: health and environment </li></ul><ul><li>PAHO’s Role to tackle health inequities </li></ul><ul><ul><li>Make them visible </li></ul></ul><ul><ul><li>Go beyond national averages </li></ul></ul><ul><ul><li>Strengthen health information systems </li></ul></ul><ul><ul><li>Empower the most unfavored </li></ul></ul>
    3. 3. Wide gaps among and within the Region of the Americas
    4. 4. Demographic Transition in the Americas
    5. 5. Demographic Transition in the Americas
    6. 6. The Aging Process in the Region Source: Regional Health Observatory, PAHO.
    7. 7. Life Expectancy at Birth - Subregions of the Americas <ul><li>Key points: </li></ul><ul><li>Total Fertility Rate (TFR) declined from 1995 to 2007. </li></ul><ul><li>Life Expectancy at Birth (LEB) increased from 1995 to 2007. </li></ul><ul><li>Decreasing trend of family size and increased years of life expectancy of the population. </li></ul><ul><li>Countries are reducing their gaps in both indicators due to the intervention of maternal and child care and family planning programs. </li></ul><ul><li>Countries lagging far behind : Haiti, Bolivia, Honduras, Guatemala, Paraguay </li></ul>Source: Basic Indicators Information System. PAHO/WHO; 2010 Pan American Health Organization
    8. 8. The reality check: Life Expectancy vs. Spending
    9. 9. The most unequal Region in the world Pan American Health Organization BO NI EC MX UY CR VE SV PA AR PY BR CO RD GT CL PE HN Latin America 0.40 0.45 0.50 0.55 0.60 0.65 0.40 0.45 0.50 0.55 0.60 0.65 2002 2008 Countries in which inequality decreased Countries in which inequality Increased
    10. 10. Inequities in health: Towards a working definition <ul><li>The term inequity as used in WHO documents </li></ul><ul><li>refers to: </li></ul><ul><li>Differences in health which are not only unnecessary and avoidable but, in addition, are considered unfair and unjust . </li></ul>Source: The concepts and principles of equity and health by Margaret Whitehead.2000. WHO. Pan American Health Organization
    11. 11. Source: ECLAC, Indigenous and Afro-descendent Peoples of Latin America and the Caribbean: Socio-demographic Data for Policies and Programs . Santiago, Chile, 2006 Inequalities in Life Expectancy at Birth Indigenous and non-indigenous populations, by sex, Panama, 2000 census Pan American Health Organization SEX ETHNIC ORIGIN Indigenous peoples Non-indigenous peoples Male 61.1 69.6 Female 63.6 75.1
    12. 12. Total fertility rate, indigenous and non-indigenous population Selected countries of the Americas, ~2000 Note: The countries are shown in descending order of the TFR in the indigenous population. Source : ECLAC. Indigenous and Afro-descendent Peoples of Latin America and the Caribbean: Socio-demographic Data for Policies and Programs . Santiago, Chile: 2006. Fertility Rate: Indigenous population and non-indigenous population Pan American Health Organization
    13. 13. Adolescent Birth Rate- Region of the Americas Nicaragua is 2.5 times higher compared with Cuba The difference between the extremes is 5 times Source: PAHO Basic Indicators Pan American Health Organization
    14. 14. International Aid for Population Activities by Components of ICPD* Latin American and Caribbean, 1997-2007 -En Millones de Dólares US -Los Datos de 2007 son Provisionales Family Planning Services - In US$ Million - 2007 provisional data Data Analysis and Collection Reproductive Health Services HIV/AIDS and STD *ICPD: International Conference on Population and Development
    15. 15. Proportion of deaths by age groups and cause of death in Country groups according to income Classification of countries according World Bank income criteria Source: PAHO Basic Indicators
    16. 16. Diabetes Mortality Rates * Age group (50 to 69) Selected countries of the Americas. (2004, 2005 and 2006 lad) Source: Mortality Database. PAHO/HSD/HA * per 100.000 pop 0 50 100 150 200 Venezuela Uruguay United States Puerto Rico Peru Paraguay Panama Mexico Ecuador Cuba Costa Rica Colombia Chile Canada Brazil Bolivia Argentina Mexico and Paraguay have a higher risk of death from Diabetes compared to others Mortality rates 50-69
    17. 17. Source: Mortality Database, PAHO/HSD/HA and World Bank Premature mortality due to Cerebrovascular Disease by Gross National Income in the Americas (Circa 2006) * Occurrence of death in age ≤ 64 years old
    18. 18. * Per 100.000 pop 0 20 40 60 80 Mortality Rate 50 - 69 Venezuela Uruguay United States Puerto Rico Peru Paraguay Panama Mexico Ecuador Cuba Costa Rica Colombia Chile Canada Brazil Bolivia Argentina Cervical Cancer Rates * Age group 50-69 Selected countries of the Americas (2004, 2005 and 2006 lad) Cervical Cancer still a problem in the Region. We have to look at the quality of the data Pan American Health Organization
    19. 19. The weight of social determinants
    20. 20. <ul><li>Population of Latin America and the Caribbean: 582 million (2009) </li></ul><ul><li>27% without regular access to basic health services: 135 million </li></ul><ul><li>46% without health insurance, public or private: 230 million </li></ul><ul><li>USA: 44 million without social protection in health </li></ul><ul><li>685,000 children without a complete vaccination scheme </li></ul><ul><li>17% of births in LAC attended by unskilled health personnel </li></ul>Social Exclusion in Latin America and the Caribean Pan American Health Organization
    21. 21. Social exclusion in health and environment Source: PAHO Basic Indicators Pan American Health Organization
    22. 22. Coefficient of linear correlation= - 0.63 More access to improved sanitation, less Infant Mortality Source: PAHO Basic Indicators
    23. 23. Women aged 30-49 years Source: ENDEMAIN, Ecuador-INEC 2004 ; DHS -2002 Guatemala Proportion of Women never screened for Cervical Cancer Ecuador and Guatemala Women aged 15-49 years Indigenous Other Mestizo White Indigenous Ladino
    24. 24. In Bolivia the highest 20% income is 36 times the lowest 20% More inequality is related to higher infant and maternal mortality rates Maternal Mortality Ratio Infant and Maternal Mortality Rates are higher in more unequal countries Infant Mortality Ratio Source: PAHO Basic Indicators
    25. 25. Some countries have progressed decreasing the IMR in low level social economic groups Latin America and Caribbean: Infant Mortality Rates Educational level of mothers. Circa 1990 and 2005. (Selected countries) Source : ECLAC, based on data from the database of Indicators for the Action Plan of the “ICPD”, www.cepal.org/celade and national reports on demographics and health for Bolivia (DHS 2008) and Brazil (PNDS 2006) ECLAC 2007.
    26. 26. Infant Mortality Rate: Indigenous, Afro and other Populations Selected Countries of the Americas. Census 2000 Source: PAHO/ECLAC/CELADE. Special census micro-data process. 2000. Indigenous Total Afro Other Countries IMR
    27. 27. Source: Wilkinson & Pickett, The Spirit Level (2009) The Prevalence of Mental Illness is Higher in More Unequal Rich Countries
    28. 28. National health expenditure on health in LAC: magnitude and trends Source: National Health Expenditure Data base. HSS/PAHO. Changes in the composition of the National Health Expenditure. Latin America and the Caribbean, 1980 – 2005 Central Government Out of pocket expenditure Local Government Public Insurance Private Insurance 1980 1995 1990 1995 1998-2000 2004-05 National health expenditure as percentage of the GDP
    29. 29. Public source health expenditure as % of GDP Canada, LAC and USA. Selected periods 1960-2006
    30. 30. PAHO’s Role to tackle health inequities
    31. 31. <ul><li>We are an Organization with: </li></ul><ul><li>Vision of Health in the Americas </li></ul><ul><li>Values of Equity and Pan-Americanism </li></ul><ul><li>Focus on: </li></ul><ul><ul><li>Key Countries </li></ul></ul><ul><ul><li>Special Populations </li></ul></ul><ul><ul><li>Technical Priorities </li></ul></ul>Our Core Commitments Special Populations Key Countries PAHO Vision Equity Pan-Americanism Technical Priorities
    32. 32. PAHO Framework for Action <ul><li>Reducing the Gap </li></ul><ul><li>Ensuring Access </li></ul><ul><li>Achieving Results </li></ul>Facing new challenges Addressing the unfinished agenda Protecting achievements
    33. 33. We have to think in: Similar situations among countries Specific situations in each country
    34. 34. Focus Priority Country Intermediate Country Highly Developed Country Framework for Technical Cooperation Each Country has a specific situation in the Framework Addressing the unfinished agenda Protecting achievements Facing new challenges
    35. 35. PAHO’s Commitment with the MDGs
    36. 36. Goal: <ul><li>It was launched to address the dangerous & unjust illusion resulting from averages in health statistics </li></ul><ul><li>To make the most neglected communities seen and heard as we attempt to meet the targets of the MDGs </li></ul><ul><li>Working with the Ministries of Health and national and local governments, we are calling for intersectoral action for participatory local development. </li></ul>
    37. 37. Amazonia Altiplano El Chaco La Mosquitia Transnational Territories
    38. 38. Monitoring Regional Progress
    39. 39. Vital and Health Statistics Data in the Americas Coverage and Quality <ul><li>In the Region there are: data with good quality and data with very poor quality </li></ul>
    40. 40. <ul><li>The regional report lists the countries according to their vital and health statistics situation, revealing wide disparities among countries and even within them . </li></ul><ul><li>These findings make it possible to pinpoint the areas requiring greater attention and targeting (at geographical and sectoral level) processes associated with health care, vital records systems, etc. </li></ul><ul><li>Coverage . Vital statistics (VS) situation was relatively better in 7 of 26 countries, which exhibited broad coverage (over 85%) throughout their national territory. At the other extreme, however, 7 countries recorded barely 50% of these events. This means: only one out of every two births or deaths are recorded. (under recording affects special groups of population) </li></ul>Health and Vital Statistics: Regional Situation
    41. 41. <ul><li>Quality of VS . Affect the countries in a more homogeneous manner, specially at the local level. Lack of information on mother’s age, child’s birthweight, place of residence, socioeconomic characteristics of people involved in events, the attribution of ill-defined cause of death or failure to state the cause, make it difficult for countries to know the true levels of risk and burden of disease or to determine the epidemiogical profiles of mortality . </li></ul><ul><li>In the area of morbidity, resources and health services statistics , countries also exhibit wide disparities. </li></ul>Health and Vital Statistics: Regional Situation
    42. 42. Health and Vital Statistics: Regional Situation Source: Health and Vital Statistics Regional Evaluation
    43. 43. 32 countries studied 19 (59%) - good quality and coverage data 6 (19%) - medium data quality 7 (22%) - poor or very poor data quality Mortality Data
    44. 44. Mortality Data has improved Source: Regional Health Observatory / PAHO The proportion of unknown cause of death are decreasing
    45. 45. Without good data for monitoring the MDGs, different agencies or researchers are making estimates for the Region What is the problem with estimates? We need good information
    46. 46. Variability is observed more often in small populations MDG Infant Mortality Rate: Forecasting is difficult for countries with a small population Country 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Belize 21.2 17.9 14.3 18.4 19.6 17.2 Grenada 19.5 14.3 17.6 19.6 11.1 7.3 Cayman Islands 9.1 1.6 13.7 4.8 6.4 7.0 8.7 8.3 1.3 Turks and Caicos 9.7 8.2 7.3 0.0 14.5 4.3 1.8 Virigin Islands (RU) 10.8 9.5 9.2 31.3 11.2 28.3 7.2 22.7 25.1 22.4 Saint Kitts & Nevis 13.9 14.3 17.6 15.3 13.5 21.7 14.1 Saint Vincent and the Grenadines 17.2 24.2 15.7 19.2 18.1 17.8 15.7 26.2 Saint Lucia 15.0 12.0 16.7 13.5 16.2 15.0 Trinidad and Tobago 16.2 17.1 18.5 21.1 18.5 24.2 24.0 16.5
    47. 47. red: repetitions Forecasting is difficult for countries with limited data blue: too few observations Country 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Anguilla 35.5 5.2 0 0 Netherlands Antilles 12.6 12.3 Aruba 6.5 1.5 Bermuda 3.6 0 0 Jamaica 19.9 21.09 Bolivia 67 54 54 54 54 54 El Salvador 35 35 35 25 25 25 25 21.5 Guatemala 48 39 39 39 39 39 39 Haiti 80.3 80.3 80.3 80.3 80.3 57 57 Honduras 34 34 34 34 34 23 23 23 23 23 23 Montserrat 0 0 25.0 0 0 0 23.8 0 Nicaragua 45.2 31 31 31 31 31 33 Peru 33.3 33.3 33.3 33.3 33.4 33.4 33.4 21 21 21 21
    48. 48. <ul><li>The analysis described has led to the consideration of lines of action in the following areas: </li></ul><ul><li>Preparation or expansion of situation analyses in each country. </li></ul><ul><li>Creation of an interinstitutional team to make a diagnosis and devise a plan in each country. </li></ul><ul><li>The priorization of greater coverage (thematic, geographical, sectoral), and improvements in quality and timeliness of availability and dissemination of data. </li></ul><ul><li>To prepare a national plan in countries (POA) </li></ul><ul><li>To harmonize the national plan in a regional plan (PSVHS) </li></ul>Way forward
    49. 49. <ul><li>For the technical point of view: </li></ul><ul><li>Develop uniform standards, procedures, and classifications; </li></ul><ul><li>Develop methodologies for the analysis and dissemination of data; </li></ul><ul><li>Train and upgrade the skills of personnel; </li></ul><ul><li>Utilize appropriate, up-to-date computer technology for the production, processing, and dissemination of data; </li></ul><ul><li>Promote horizontal cooperation and a clear definition of best practices and strategies for providing the most appropriate technical assistance, based on available budgets and the national and international capacity to mobilize resources. </li></ul>Way forward
    50. 50. National Basic Indicators pamphlets
    51. 51. Special Populations Key Countries PAHO Vision Equity Pan-Americanism Technical Priorities Consensus and coordination has increased Organization of Americas States (OAS) Foundations/ Private sector We Are Not Alone On Our Journey... NGO’s Bi/Multi-Laterals
    52. 52. Thank you

    ×