Achieving the health-related MDGs in the Western Pacific Region 2012

Achieving the health-related Millennium Development Goals in the Western Pacif ic Region

2012 1

4

5

6

7

“These Millennium Development Goals are a promise of world leaders.

They’re a blueprint to help those most vulnerable and poorest people, to lift them out of poverty.

This promise must be met.”

—UN Secretary-General Ban Ki-moon

8

The Millennium Development Goals zz

In 2000, eight Millennium Development Goals (MDGs) were established and adopted by 189 heads of state in the United Nations Millennium Declaration.

zz

There are three years left before the 2015 deadline.

Some countries have achieved their goals, while others have much work to do to reach the targets.

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After 2015, efforts must be sustained to achieve the original goals and to overcome new health challenges such as noncommunicable diseases, mental health disorders, injuries and the consequences of violence.

1

Health MDGs scorecard for WHO regions World

Africa

Americas

Eastern Mediterranean

Europe

South-East Asia

Western Pacific

57

119

18

68

14

57

19

Measles immunization

85

76

93

85

95

79

97

Maternal mortality

210

480

63

250

20

200

49

Skilled birth attendant

69

48

93

59

98

59

91

63

24

75

42

71

58

80

HIV/AIDS prevalence2

0.8

4.7

0.5

0.2

0.4

0.3

0.1

Malaria mortality

12

94

0.1

2.5

0

2.9

0.2

TB treatment

87

80

76

88

68

89

93

Water

89

63

96

85

98

90

92

Sanitation

63

34

87

66

92

43

69

Under-5 mortality 4

per 1000 live births (2010)

% coverage (2010)

per 100 000 live births (2010) 5

% births (2005–2011)

Contraceptive use

% married women aged 15–49 (2005–2010) % adults aged 15–49 (2010) 6

per 100 000 population (2008)

% success rate (2009)

7

% using improved sources (2010)

% using improved facilities (2010) On track

Insufficient progress

Off track

Refer to page 16 for health MDGs scorecard colour code criteria

Source: World Health Statistics 2012

2

The scorecards reveal clear priorities

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Countries and areas in the Western Pacific Region are making remarkable progress towards achieving the health-related MDGs. Several gaps still remain.

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There are large disparities in progress both between and within countries.

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An estimated 12 000 maternal deaths and 467 000 child deaths occurred in the Region in 2010. Further reduction of maternal and child death remains a high priority in most low- and middle-income countries.

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New infections and AIDS-related deaths in the Region have stabilized over the last five years, whereas prevalence of HIV has increased slightly since 2000 as more people living with HIV are obtaining antiretroviral treatment.

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Weak health systems, health inequities and difficulties in sustaining gains are some of the factors that will affect achieving the MDG targets.

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Achieving universal coverage to ensure people can access quality health services without facing catastrophic financial expenses is key to sustaining progress for all MDGs.

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Health MDGs scorecard for LMICs* in the Western Pacific Region (with population ≥ 250 000)

4

Solomon Islands

Viet Nam

29

27

23

60

79

73

96

63

230

99

93

59

99

99

40

62

70

84

38

–

66

36

51

35

80

0.1

0.2

0.5

<0.1

0.9

<0.1

–

0.4

<0.1

–

0.4

0.1

–

9.2

<0.1

2.5

<0.1

95

95

94

93

78

88

72

89

88

92

Water10

64

91

98

67

100

82

40

92

–

95

Sanitation10

31

64

83

63

96

51

45

74

–

76

China

Fiji

Lao PDR

Malaysia

Mongolia

Under-5 mortality3

51

18

17

54

6

32

61

Measles immunization4

93

99

82

69

95

98

Maternal mortality5

250

37

26

470

29

Skilled birth attendant6

71

96

100

37

51**

85

–

HIV/AIDS prevalence2, 7

0.5

0.1

Malaria mortality8

0.9

TB treatment9

per 1000 live births (2010)

% coverage (2011)

per 100 000 live births (2010) 5

% births (2006–2010)

Contraceptive use6

% married women aged 15–49 (2005–2008) % adults aged 15–49 (2009) 6

per 100 000 population (2010)

% success rate (2009)

7

Papua New Philippines Guinea

Cambodia

% using improved sources (2010)

% using improved facilities (2010) On track

Insufficient progress

Off track

Refer to page 16 for health MDGs scorecard colour code criteria

* LMICs – Low- and middle-income countries ** Cambodia Demographic Health Survey 2010

4

Health MDGs scorecard for LMICs* in the Western Pacific Region (with population < 250 000)

4

Cook Islands

Kiribati

Marshall Islands, the

Micronesia, the Fed. States of

Nauru

Niue

Palau

Samoa

Tonga

Tuvalu

Vanuatu

Under-5 mortality3

9

49

26

42

40

22

19

20

16

33

14

Measles immunization4

89

90

89

92

100

100

80

67

99

98

92

Maternal mortality5

–

–

–

100

–

–

–

100

110

–

110

100

98

86

100

97

100

100

81

98

93

74

–

36

45

–

36

–

33

29

–

31

38

HIV/AIDS prevalence2, 7

–

–

–

–

–

–

–

–

–

–

–

Malaria mortality8

–

–

–

–

–

–

–

–

–

–

0

TB treatment9

–

97

84

88

–

–

75

90

83

88

96

Water10

–

–

94

–

88

100

85

96

100

98

90

100

–

75

–

65

100

100

98

96

85

57

per 1000 live births (2010)

% coverage (2011)

per 100 000 live births (2010) 5

Skilled birth attendant6 % births (2006–2010)

Contraceptive use6

% married women aged 15–49 (2000–2009) % adults aged 15–49 (2009) 6

per 100 000 population (2010)

% success rate (2009)

7

% using improved sources (2010)

Sanitation10

% using improved facilities (2010)

Due to very small population size and low incidence and prevalence of some diseases, there are no estimates for some indicators; small population size also makes classification of progress towards MDG targets infeasible.

* LMICs – Low- and middle-income countries

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The nutritional status of children under 5 years has improved.

MDG 1 Eradicate extreme poverty and hunger

1

Undernutrition remains an important public health problem and obesity is increasing.

MDG target: Halve, between 1990 and 2015, the proportion of people who suffer

from hunger

The prevalence of underweight children under 5 has been further reduced in the LMICs in the Western Pacific Region.

Chronic undernutrition prevails in under-5 children in the majority of countries.

At least one third of countries have a growing problem of overweight in children.

Acute malnutrition is still a significant problem in several countries in the Region.

Figure 1. Prevalence of underweight children under 5 years of age (%) in LMICs in the Western Pacific Region, 1983 –2011.

Earliest data available Cambodia China

2011 2010

Malaysia

2006 1992 2005

Philippines

1983 2008

2007

Viet Nam Vanuatu

1993

1990

Papua New Guinea

Solomon Islands

1996

2006

2005

Target

1990

Lao PDR

Mongolia

Latest data available

1990

1989 2008

1993

1996 2007

0% 10% 20% 30% 40% 50%

Source: Global Health Observatory database. Geneva, WHO, Accessed September 2012 (http://apps.who.int/ghodata/)

Figure 2. Prevalence of stunting and overweight among children under 5 years of age (%) in selected countries in the Western Pacific Region, 1981-2011.

Australia Cambodia China Fiji Japan Kiribati Lao PDR Malaysia Mongolia Nauru Papua New Guinea Philippines Samoa Singapore Solomon Islands Tuvalu Vanuatu Viet Nam

0

8.2 40.9

1.9 9.4

6.6 2.2

4.3 8.3

2.9

34.4

15.9

47.6

1.3 17.2

5.5

27.5

14.2

Overweight*

24.0

2.8

32.3

3.3

2.6

4.4

6.4 6.2 32.8

2.5 6.3

10.0 25.9

4.7

30.5

3.0

0

Stunted*

43.9

3.4

10

20

30

40

50

Source: Global Health Observatory database. Geneva, WHO, Accessed September 2012 (http://apps.who.int/ghodata/). * Latest available data from the period 1981-2011

Interventions should focus on improving nutrition and alleviating hunger in the underserved and hard-to-reach populations, and especially on children, adolescents and women.

Breast feeding

Low birth weight (LBW)

Anaemia in women and children

In 8 of 13 Western Pacific countries reporting, exclusive breastfeeding rate is <50%, although the norm should be about 95% in all countries.

Maternal nutrition should be improved to reduce LBW rates, which are now more than 3 times the norm in 18 of 31 countries reporting.11

Fortification, supplementation, deworming and improved diets can greatly reduce anaemia, which is still >20% in pregnant women11 and preschoolers12 in about half the countries reporting.

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4

MDG 4 Reduce child mortality MDG target: Reduce by two thirds, between 1990 and 2015, the under-5 mortality rate

Measles incidence in the Western Pacific Region has substantially decreased to 11.6 per million population in 2011.

Twenty-five countries have already achieved measles elimination as of the end of 2011.

Figure 3: Proportion of 1-year-old children immunized against measles in LMICs in the Western Pacific Region, 2011.

Child mortality in the Western Pacific Region has been significantly reduced.

Malaysia and Mongolia have achieved MDG 4 targets, while China, the Lao People’s Democratic Republic, Cambodia, the Philippines and Viet Nam are most likely to reach the targets by 2015.

Figure 4 . Under-5 mortality rate (per 1000 live births), 1990 baseline, 2015 target and progress to date, in LMICs with ≥ 250 000 population in WPR. Cambodia China

≥ 90% coverage < 90% coverage

10

30

17

Lao PDR Malaysia

Measles immunization reaching:

48

18 16

Fiji

18

Mongolia

32

Papua New Guinea

Viet Nam

107 36 61

30

Philippines Solomon Islands

145

54

48 6 6

121

51

40

27

15 17

59

29

20

23

90

1990 baseline

45

2010 2015 Target

51

Source: Levels & Trends in Child Mortality Report 2011. Estimates developed by the UN Interagency Group for Child Mortality Estimation, 2011.

In the Western Pacific Region, 54% of under-five child deaths occurred during the neonatal period.

The leading causes of under-five mortality in the Region are pneumonia, preterm birth complications and birth asphyxia.

All maps in the document are stylized and not to scale. The boundaries and names shown and the designations used on this map do not imply the expression of an opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or areas or its authorities, or concerning the delimitation of its frontiers or boundaries.

White lines on maps represent approximate border line for which there may not yet be full agreement. © WHO 2012. All rights reserved.

Table 1: Causes of under-5 mortality in the Western Pacific Region, 2010 Prematurity

Focus should be on reaching more remote, underserved populations with services for essential newborn care; timely antibiotic treatment for pneumonia; and maintaining the gains in immunization coverage.

Pneumonia Birth asphyxia Congenital anomalies Injuries Diarrhoea

17% 16% 14% 12% 9% 4%

Neonatal sepsis Measles Malaria HIV/AIDS Others

Source: Global Health Observatory database. Geneva, WHO, accessed September 2012 (http://apps.who.int/ghodata/)

3% 1% 0% 0% 22% 7

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MDG 5 Improve maternal health MDG target: Reduce by three quarters, between 1990 and 2015, the maternal

mortality ratio

There is a decreasing trend in the maternal mortality ratio (MMR) of most countries in the Region. The MMR of the Lao People’s Democratic Republic, Cambodia and Papua New Guinea are still high.

Figure 5. Trends in Maternal mortality ratio (per 100 000 live births) in LMICs with ≥ 250 000 population in the Western Pacific Region, 1990-2010.

1800

Access to skilled birth attendants and family planning services are critical to the achievement of MDG 5

Proportion of births attended by skilled health personnel (%) ≥ 85%

60%–85% <60%

Maternal mortality ratio

Figure 6. Proportion of deliveries assisted by skilled birth attendants in LMICs in the Western Pacific Region, 2005-2011.

1600

1600

1990 2000

1400

2010

1200 1000

870

830

800 600

510

400

470

200 0

390

250 120

Cambodia

61 37

China

32 31 26

Fiji

Lao PDR

53 39 29

120 96 63

Malaysia

Mongolia

310 230

170

240 120 99

Papua Philippines New Guinea

150 120

93

Solomon Islands

100 59

Viet Nam

Source: Trends in maternal mortality: 1990 to 2010. Estimates developed by WHO, UNICEF, UNFPA and The World Bank. WHO, 2012.

Contraceptive prevalence remains low in some low- and middle-income countries in the Region.

Figure 7. Contraceptive prevalence rate in LMICs with ≥ 250 000 population in the Western Pacific Region, 2005-2010 Source: World Health Statistics 2012

51a

Cambodia China

85

Lao PDR

38

Mongolia

Increased efforts are needed for better maternal health care and to address perinatal health problems, especially for poor and vulnerable populations.

Improving accountability for financial resources and health outcomes is critical to reach the objectives of the Global Strategy for Women’s and Children’s Health.

66

Papua New Guinea

36

Philippines

51

Solomon Islands

35

Viet Nam

80 0

Source: World Health Statistics 2012

20 a

40 60 Contraceptive prevalence rate (%) Cambodia Demographic Health Survey 2010

80

100

8

6

MDG 6 Combat HIV/AIDS, malaria and other diseases MDG target: Have halted by 2015 and begun to reverse the spread of HIV/AIDS

Malaria Malaria mortality and morbidity have

been steeply declining since 1990 in 10 endemic countries in the Region.

Figure 9. Areas with artemisinin resistance development in the Mekong subregion.

There are 1.3 million people living with HIV and AIDS in the Western Pacific Region, and only 43% of people in need of antiretroviral therapy have access to ARV in 2010.

HIV / AIDS

Figure 8. HIV prevalence rate among population aged 15-49 years in LMICs with ≥ 250 000 population in the Western Pacific Region, 1990-2009.

1.60

Cambodia

1.40

HIV prevalence

1.20 1.00

Papua New Guinea

0.80 0.60

Malaysia

0.40 0.20 0.00

China 1990

1995

Viet Nam

Mongolia 2000

Lao PDR Philippines

Fiji 2005

2009 2010

Source: Global Health Observatory database. Geneva, WHO, accessed September 2012 (http://apps.who. int/ghodata/)

The Region has a relatively low HIV prevalence, and the epidemic has shown signs of stabilizing.

Condom use and coverage of preventive interventions for mostat-risk populations are increasing but still not enough.

Access of population groups to services such as antiretroviral therapy remains low in most low- and middle-income countries.

Rates of TB in the Region have dropped significantly since 1990. The challenge remains to find and cure TB in high risk groups and vulnerable populations that lack access to care.

Tuberculosis

NB: Circles: old data (<Oct 2011) Triangles: new data (Nov 2011)

Threats to sustaining the gains made in malaria control include the development of artemisinin resistance in Cambodia and Viet Nam (Figure 9) and dwindling financial resources in many endemic countries.

Figure 10. Distribution of notified MDR-TB cases in WPR, 2010.

Multidrug-resistant and extensively drug-resistant TB threatens gains achieved in the last decade.

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7

MDG 7 Ensure environmental sustainability

The Region has already reached the targets for use of improved drinking water sources and sanitation facilities.

MDG target: Halve, by 2015, the proportion of people without sustainable access to

safe drinking water and basic sanitation

Access to improved drinking water sources and improved sanitation facilities is still very low in many countries, especially in rural areas.

Strong political leadership and commitment are needed to further improve the coverage of drinking water and sanitation

Figure 11. Proportion of population using an improved drinking-water source in LMICs by residence type, 2010.10 Cambodia

Cambodia

China

China Cook Islands

Cook Islands Fiji

Fiji

Lao PDR

Lao PDR

Malaysia

Malaysia

Marshall Islands

Marshall Islands

Mongolia

Mongolia

Nauru

Nauru

Niue

Niue

Palau

Palau

Papua New Guinea

Papua New Guinea

Philippines

Philippines

Samoa

Samoa

Tonga

Tonga

Tuvalu

Tuvalu

Vanuatu

Vanuatu

Urban Rural

Viet Nam 0

8

Figure 12. Proportion of population using improved sanitation facility in LMICs by residence type, 2010.10

20

Urban Rural

Viet Nam 40

60

80

100

0

20

40

60

80

100

MDG 8 Develop a global partnership for development MDG target: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing

countries

Availability and access to affordable quality-assured essential medicine needs further improvement in most low- and middle-income countries in the Region.

Adequate financing is key to ensuring availability of essential medicines, which is consistently lower in the public than in the private sector.

Weak enforcement of medicine regulations results in the sale of counterfeit and substandard medicine.

Majority of the LMICs had an updated medicines list and had developed national medicines policies.

10

Improving equity on MDGs

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Health is a human right for all. Governments play a crucial role developing policies and plans to promote health among populations that are most in need.

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Health inequities are widening. Reducing health inequities can be achieved by analyzing how groups in countries may benefit disproportionately from policies and programmes; addressing social determinants of health; and expanding access to primary health care with adequate financial protection.

Figure 13. Overall progress but increasing disparities: Under-five mortality - rural/urban rates, selected countries.

Note: Years indicate the year of DHS. Data for Papua New Guinea have yet to be officially released.

Source: UNESCAP, UNDP, ADB. Achieving the Millennium Development Goals in an era of global uncertainty: AsiaPacific Regional Report 2009/10. Bangkok, United Nations, 2010. Available online at: http://www.mdgasiapacific.org/ files/shared_folder/documents/Regional_MDG_Report_2009-10.pdf[accessed 20 July 2010].

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Relatively high costs and direct out-of-pocket payments impede access to and lower coverage of MDG-related services and increase poverty.

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Other barriers to accessing quality services in addition to costs facing those with the greatest need include remoteness, low level of knowledge, and other sociocultural issues.

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Monitoring health equity can be achieved by disaggregating and analyzing information by income, sex, ethnicity and other relevant stratifiers to track changes in progress of MDGs in different groups.

11

Universal health coverage and the Millennium Development Goals

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Universal health coverage means that all people have access to quality health services when needed without facing catastrophic financial expenses.

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Universal coverage ensures that the population is adequately covered by financial arrangements to ensure access to needed health care services.

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Universal coverage requires access to a continuum of integrated people-centred health services at every stage of each individualâ&#x20AC;&#x2122;s life.

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Universal coverage promotes the provision of a timely delivered package of services that are of good quality and value.

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Universal coverage is essential to the achievement of all the health-related MDGs.

12

Civil registration and vital statistics (CRVS) underpin MDGs

Lack of progress in improving CRVS is â&#x20AC;&#x153;the single most critical development failure over the past 30 years.â&#x20AC;? â&#x20AC;&#x201D;Richard Horton, The Lancet 2007

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Civil registration and vital statistics (CRVS) systems are the best population and demographic data source for providing inputs for 42 out of the 60 MDG indicators.

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Functioning CRVS systems improve the accuracy, completeness and timeliness of mortality statistics and enhances monitoring of burden of disease.

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Counting births and deaths, with medically certified cause of death, is achievable with careful integration of events occurring in health facilities with those captured through the civil registration process within communities.

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Strengthening CRVS requires leadership and coordination across multiple sectors, including health, statistics, and civil registration.

13

Tables MDG 1

MDG 4

Prevalence of underweight children (%) WHO Regions

1983– 1999

MDG 5

Infant mortality rate per 1000 live births

2005– 2011

2015 Target

1990

Under-5 mortality rate per 1000 live births

Measles immunization % coverage

2010

2015 Target

1990

2010

2015 Target

1990

Proportion of births attended by skilled health personnel (%)

Maternal mortality ratio per 100 000 live births

Contraceptive prevalence rate (%)

2010

1990

2000

2010

2015 Target

1990 – 1999

2005– 2011

1990– 1999

2005– 2010

Africa

…

…

…

104

75

35

172

119

57

58

76

820

720

480

205

…

48

…

24

Americas

…

…

…

34

14

11

42

18

14

80

93

100

80

63

25

…

93

…

75

Eastern Mediterranean

…

…

…

74

51

25

100

68

33

66

85

430

360

250

108

…

59

…

42

Europe

…

…

…

27

12

9

33

14

11

83

95

44

29

20

11

…

98

…

71

South-east Asia

…

…

…

78

44

26

111

57

37

59

79

590

370

200

148

…

59

…

58

Western Pacific

…

…

…

37

16

12

48

19

16

94

97

140

77

49

35

…

91

…

80

World

…

…

…

61

40

20

88

57

29

73

85

400

320

210

100

…

69

…

63

1983– 1999

2005– 2011

2015 Target

1990

2010

2015 Target

1990

2010

2015 Target

1990

2011

1990

2000

2010

2015 Target

1990– 1999

2006– 2010

1990– 1999

2000– 2010

Cambodia

43

29

21

87

43

29

121

51

40

34

93

830

510

250

208

34

71

20

51

China

13

3

6

38

16

13

48

18

16

98

99

120

61

37

30

89

96

84

85

Fiji

7

…

3

25

15

8

30

17

10

84

82

32

31

26

8

99

100

…

…

Lao PDR

40

32

20

100

42

33

145

54

48

32

69

1600

870

470

400

7

37

20

38

Malaysia

22

13

11

15

5

5

18

6

6

70

95

53

39

29

13

81

99

55

…

Mongolia

11

5

5

76

26

25

107

32

36

92

98

120

96

63

30

99

99

60

66

Papua New Guinea

25

18

12

65

47

22

90

61

30

67

60

390

310

230

98

51

40

26

36

Philippines

30

21

15

42

23

14

59

29

20

85

79

170

120

99

43

53

62

49

51

Countries with ≥ 250 000 population

Solomon Islands

16

12

8

36

23

12

45

27

15

70

73

150

120

93

38

85

70

…

35

Viet Nam

37

20

18

37

19

12

51

23

17

88

96

240

100

59

60

77

84

72

80

1983– 1999

2005– 2011

2015 Target

1990

2010

2015 Target

1990

2010

2015 Target

1990

2011

1990

2000

2010

2015 Target

1990– 1999

2006– 2010

1990– 1999

2000– 2010

Cook Islands

…

…

…

17

8

6

20

9

7

67

89

…

…

…

…

…

100

…

…

Kiribati

11

…

…

64

39

21

87

49

29

75

90

…

…

…

…

…

98

…

36

Marshall Islands

…

…

…

40

22

13

51

26

17

52

89

…

…

…

…

…

86

…

45

Micronesia, Fed. States of

…

…

…

44

34

15

56

42

19

81

92

140

130

100

…

…

100

…

…

Nauru

…

5

…

32

32

11

40

40

13

…

100

…

…

…

…

…

97

…

36

Niue

…

…

…

12

19

4

14

22

5

99

100

…

…

…

…

…

100

…

…

Palau

…

…

…

27

15

9

33

19

11

98

80

…

…

…

…

…

100

…

33

Samoa

2

…

0.9

23

17

8

27

20

9

89

67

260

150

100

…

…

81

…

29

Tonga

…

…

…

21

13

7

25

16

8

86

99

67

87

110

…

…

98

…

…

Tuvalu

…

2

…

44

27

15

57

33

19

95

98

…

…

…

…

93

…

31

Vanuatu

11

12

5

31

12

10

39

14

13

66

92

120

110

…

…

74

…

38

Countries with < 250 000 population

220

14

Tables MDG 6`

MDG 7

HIV prevalence rate (%) among population aged 15–49 years

Malaria mortality rate per 100 000 population

Tuberculosis treatment success rate (%)

Proportion of population using improved drinking-water source (%) National

Urban

Proportion of population using improved sanitation facility (%)

Rural

National

Urban

Rural

1990

1995

2000

2010

2006

2008

2000

2009

1990

2010

2015 Target

1990

2010

1990

2010

1990

2010

2015 Target

1990

2010

1990

2010

Africa

…

…

3.0

4.7

104

94

71

80

50

63

75

84

84

36

50

29

34

65

47

46

21

25

Americas

…

…

0.3

0.5

0.5

0.1

76

76

91

96

96

97

99

75

86

80

87

90

88

91

60

74

Eastern Mediterranean

…

…

0

0.2

7.5

2.5

81

88

84

85

92

95

93

72

77

52

66

76

84

85

31

51

Europe

…

…

0.1

0.4

…

0

75

68

96

98

98

99

99

89

95

91

92

96

94

94

83

88

South-east Asia

…

…

0.2

0.3

2.1

2.9

50

89

71

90

86

89

95

65

87

25

43

63

55

64

15

33

Western Pacific

…

…

0

0.1

0.3

0.2

90

93

71

92

86

97

98

58

86

36

69

68

64

80

22

60

World

…

…

0.5

0.8

17

12

69

87

76

89

88

95

96

62

81

49

63

75

76

79

27

46

1990

1995

2000

2009

2005

2010

1995

2009

1990

2010

2015 Target

1990

2010

1990

2010

1990

2010

2015 Target

1990

2010

1990

2010

0.5

1.4

1.3

0.5

2.0

0.9

91

95

31

64

66

48

87

29

58

9

31

55

36

73

5

20

WHO Regions

Countries with ≥ 250 000 population Cambodia China

…

…

…

0.1

<0.1

<0.1

93

95

67

91

84

97

98

56

85

24

64

62

48

74

15

56

Fiji

<0.1

<0.1

<0.1

0.1

…

…

86

94

84

98

92

94

100

77

95

61

83

81

90

94

40

71

Lao PDR

<0.1

<0.1

<0.1

0.2

1.3

0.4

70

93

45*

67

72

…

77

…

62

26*

63

63

…

89

…

50

Malaysia

0.1

0.3

0.4

0.5

0.1

0.1

69

78

88

100

94

94

100

82

99

84

96

92

88

96

81

95

Mongolia

<0.1

<0.1

<0.1

<0.1

…

…

74

88

54

82

77

74

100

27

53

49*

51

75

…

64

…

29

Papua New Guinea

<0.1

0.1

0.4

0.9

12.2

9.2

56

72

41

40

71

89

87

32

33

47

45

74

78

71

42

41

Philippines

<0.1

<0.1

<0.1

<0.1

0.2

<0.1

60

89

85

92

93

93

93

77

92

57

74

79

69

79

45

69

…

…

…

…

7.5

2.5

65

88

…

…

…

…

…

…

…

…

…

…

98

98

…

…

<0.1

0.1

0.2

0.4

<0.1

<0.1

89

92

57

95

79

88

99

49

93

37

76

69

63

94

30

68

1990

1995

2000

2009

2005

2010

1995

2009

1990

2010

2015 Target

1990

2010

1990

2010

1990

2010

2015 Target

1990

2010

1990

2010

Cook Islands

…

…

…

…

…

…

100

…

94

…

…

99

98

87

…

96

100

98

100

100

91

100

Kiribati

…

…

…

…

…

…

87

97

48

…

…

76

…

33

…

26

…

…

36

…

21

…

Marshall Islands

…

…

…

…

…

…

25

84

95

94

98

94

92

97

99

64

75

82

77

83

41

53

Micronesia, Fed. States of

…

…

…

…

…

…

80

88

89

…

…

93

…

87

…

29

…

…

55

…

20

…

Nauru

…

…

…

…

…

…

…

…

98

88

99

98

88

…

…

66

65

83

66

65

…

…

Niue

…

…

…

…

…

…

…

…

100

100

100

100

100

100

100

100

100

100

100

100

100

100

Palau

…

…

…

…

…

…

67

75

80

85

90

73

83

96

96

65

100

83

78

100

36

100

Samoa

…

…

…

…

…

…

80

90

89

96

95

97

96

87

96

99

98

100

100

98

99

98

Tonga

…

…

…

…

…

…

75

83

100

100

100

100

100

100

100

96

96

98

98

98

96

96

Tuvalu

…

…

…

…

…

…

…

88

90

98

95

92

98

89

97

80

85

90

86

88

76

81

Vanuatu

…

…

…

…

4.5

0

85

96

62

90

81

94

98

55

87

…

57

…

…

64

…

54

Solomon Islands Viet Nam

Countries with < 250 000 population

*Data applies to 2000

15

Health MDGs scorecard colour code for the Western Pacific Region

4

On Track

Insufficient Progress

Off Track

Achieved at least 75% of MDG target

Achieved at least 50% of MDG target

Achieved less than 50% of MDG target

≥ 90%

< 90%

N/A

Achieved at least 75% of MDG target

Achieved at least 50% of MDG target

Achieved less than 50% of MDG target

Skilled birth attendant

≥ 85%

60% – 84%

< 60%

Contraceptive use

≥ 60%

30% – 59%

< 30%

Decreased or no change between 2000 and 2010

Decreased or no change between 2000 and 2010

Decreased or no change between 2000 and 2009

Decreased or no change between 2000 and 2009

Decreased or no change between 2000 and 2009

Significantly decreased

High with little change or decrease

High with no change or increase

≥ 85%

70% – 84%

< 70%

Achieved at least 75% of MDG target Achieved at least 75% of MDG target

Achieved at least 50% of MDG target Achieved at least 50% of MDG target

Achieved less than 50% of MDG target Achieved less than 50% of MDG target

Under-5 mortality per 1000 live births

Measles immunization % coverage

Maternal mortality per 100 000 live births 5

% births

% married women aged 15–49

WHO Regions: HIV/AIDS prevalence % adults aged 15–49 6

Malaria mortality

per 100 000 population

TB treatment success rate % 7

Water

% using improved sources

Sanitation

% using improved facilities

Decreased or no change between 2000 and 2010 LMICs in WPR:

16

Data sources 1 World Health Statistics 2012 [http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf].

2 Global Health Observatory Data Repository [http://apps.who.int/ghodata/?vid=360].

3 Levels & Trends in Child Mortality Report 2011. Estimates developed by the UN Interagency Group for Child Mortality Estimation, 2011.

4 WHO/UNICEF Joint Reporting Form (JRF) on immunization. UNICEF and WHO, 2012.

5 Trends in maternal mortality: 1990 to 2010. Estimates developed by WHO, UNICEF, UNFPA and The World Bank. Geneva, WHO, 2012.

6 Global Health Observatory database. Geneva, WHO. (http://apps.who.int/ghodata/).

7 UNAIDS Report on the global AIDS epidemic 2010 [http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf].

8 World Health Organization. National malaria control programme reports. Submitted by countries to the WHO Western Pacific Regional Office. Manila, WHO, 2012.

9 Global TB database. Geneva, WHO, 2012 (http://www.who.int/tb/country/global_tb_database/en/).

10 WHO/UNICEF Joint Monitoring Programme for water and supply and sanitation. Progress on drinking-water and sanitation: 2012 update report. UNICEF and WHO, 2012.

11 Western Pacific Country Health Information Profiles 2011. Manila, World Health Organization Regional Office for the Western Pacific, 2011. Available from: [http://www.wpro. who.int/publications/PUB_9789290614913.htm].

12 Worldwide prevalence of anaemia 1993â&#x20AC;&#x201C;2005 : WHO global database on anaemia. Geneva, WHO, 2008.

17