Accelerating Equitable Achievementof the MDGs: Closing Gaps in Health and Nutrition Outcomes by United Nations ESCAP

Accelerating Equitable Achievement of the MDGs Closing Gaps in Health and Nutrition Outcomes

Contents

Foreword

vii

Acknowledgements

viii

Abbreviations

OVERVIEW Accelerating Equitable Achievement of the MDGs: Closing Gaps in Health and Nutrition Outcomes

Diagnosing disparities 'LVSDULWLHV EHWZHHQ FRXQWULHV 'LVSDULWLHV ZLWKLQ FRXQWULHV

Closing the health gaps $GGUHVV WKH VRFLDO GHWHUPLQDQWV RI KHDOWK ([SDQG DFFHVV WR SULPDU\ KHDOWK FDUH ,QWHJUDWH FKLOG DQG PDWHUQDO KHDOWK LQWR D FRQWLQXXP RI FDUH $FW RQ WKH KHDOWK QHHGV RI WKH XUEDQ SRRU 'HYLVH VXVWDLQDEOH ILQDQFLDO VWUDWHJLHV ,PSURYH WKH JRYHUQDQFH RI KHDOWK V\VWHPV (QKDQFH WKH DIIRUGDELOLW\ RI PHGLFLQHV WKURXJK JHQHULFV 6WUHQJWKHQ LQWHUQDWLRQDO SDUWQHUVKLS DQG UHJLRQDO FRRSHUDWLRQ

Mutual inspiration

CHAPTER I MDGs in Asia and the Pacific: where we stand

Asia and the Pacific on the global stage

Health â&#x20AC;&#x201C; diagnosing the deficits )HHGLQJ RXU FKLOGUHQ 3UHYHQWLQJ FKLOG GHDWKV 3UHYHQWLQJ PDWHUQDO GHDWKV 3URYLGLQJ VDIH GULQNLQJ ZDWHU (QVXULQJ DFFHVV WR EDVLF VDQLWDWLRQ

Number of people in off-track countries who will gain if targets are reached

Chapter I Endnote

CHAPTER II Diagnosing disparities

The extent of disparities

Measuring disparities between countries and over time

Why some countries do better than others in health (FRQRPLF JURZWK +HDOWK H[SHQGLWXUH %HWWHU JRYHUQDQFH 1XPEHU RI KHDOWK SHUVRQQHO *HQGHU HTXDOLW\ DQG ZRPHQÂ·V GHYHORSPHQW ,QIUDVWUXFWXUH &KLOG LPPXQL]DWLRQ 6DQLWDWLRQ DQG ZDWHU VXSSOLHV 3RSXODWLRQ JURZWK /LWHUDF\

Accounting for disparities

Disparities within countries 5DLVLQJ WKH DWWDLQPHQW OHYHOV ZKLOH UHGXFLQJ GLVSDULWLHV

Explaining disparities within countries 8UEDQ UXUDO JDSV &DVWH HWKQLFLW\ DQG ODQJXDJH JURXS 7KH LPSRUWDQFH RI HFRQRPLF VWDWXV 5HJLRQDO GLIIHUHQFHV LQ SROLFLHV DQG SURJUDPPHV

Mining the data

Chapter II Endnotes

CHAPTER III Closing the health gaps

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Mutual inspiration

Chapter III Endnotes

CHAPTER IV Way Forward

MDGs Beyond 2015

Chapter IV Endnotes

BIBLIOGRAPHY

STATISTICAL APPENDIX

Technical Note 1: MDG progress classification Technical Note 2: Factors explaining disparities between countries Technical Note 3: Accounting for disparities between countries Technical Note 4: Analysis of disparities within countries Technical Note 5: Selected MDG Indicators

81 85 88 90 97

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Foreword

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Acknowledgements

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Asia-Pacific Regional MDG Report 2011/12

OVERVIEW Accelerating Equitable Achievement of the MDGs: Closing Gaps in Health and Nutrition Outcomes

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Asia-Pacific Regional MDG Report 2011/12

OVERVIEW: Accelerating equitable achievement of the MDGs: closing the gaps in health and nutrition

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Asia-Pacific Regional MDG Report 2011/12

OVERVIEW: Accelerating equitable achievement of the MDGs: closing the gaps in health and nutrition

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CHAPTER I: MDGs in Asia and the Pacific: where we stand

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-1 â&#x20AC;&#x201C; Country groups on and off track for the MDGs

Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010; UNESCO Institute of Statistics for the education-related indicators under Goals 2 and 3, except â&#x20AC;&#x2DC;Reaching last gradeâ&#x20AC;&#x2122;.

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Asia-Pacific Regional MDG Report 2011/12

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CHAPTER I: MDGs in Asia and the Pacific: where we stand

Box I-2 â&#x20AC;&#x201C; Data on HIV

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-2 â&#x20AC;&#x201C; Countries on and off track for the MDGs

Source: Staff calculations based on the United Nations MDG Database.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-1 â&#x20AC;&#x201C; Asia and the Pacific compared with Sub-Saharan Africa and Latin America and the Caribbean

Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-2 â&#x20AC;&#x201C; The Asia-Pacific share of the developing worldâ&#x20AC;&#x2122;s deprived people

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Figure I-3 â&#x20AC;&#x201C; Progress in reducing the proportion of under-5 children underweight Country Bangladesh India Afghanistan Nepal Cambodia Lao PDR Pakistan Viet Nam Maldives Philippines Indonesia Myanmar DPR Korea Sri Lanka Thailand Uzbekistan China Bhutan Iran (Islamic Rep. of) Mongolia Vanuatu Azerbaijan Turkey Kyrgyzstan Kazakhstan Georgia Armenia

(Latest year) (2007) (2005) (2004) (2006) (2008) (2006) (2001) (2006) (2001) (2003) (2007) (2003) (2004) (2009) (2005) (2006) (2002) (2008) (1998) (2005) (2007) (2006) (2003) (2005) (2006) (2005) (2005) 0

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Source: Staff calculations based on the United Nations MDG Database. 14

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-3 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the child nutrition target &RXQWU\

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Asia-Pacific Regional MDG Report 2011/12

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CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-4 â&#x20AC;&#x201C; Progress in reducing under-5 mortality Timorâ&#x20AC;&#x201C;Leste

Lao PDR

Bangladesh Nepal

Bhutan

Pakistan

Cambodia

Tajikistan India

Myanmar Mongolia Maldives

Turkmenistan Azerbaijan

Papua New Guinea

Kiribati

Indonesia

Turkey

Uzbekistan Kyrgyzstan

Iran (Islamic Rep. of) Philippines

Tuvalu

Kazakhstan

Micronesia (F.S.)

Armenia

Viet Nam

Marshall Islands

China

Georgia

DPR Korea

Solomon Islands Nauru

Vanuatu Palau

Thailand

Sri Lanka Fiji

Samoa

Russian Federation

Tonga

Cook Islands

Malaysia Niue

Brunei Darussalam Singapore

Republic of Korea 0 ESCAP high income

100 Rate per 1,000 live births

Early achiever

On-track

Slow

150 Regressing/ No progress

Target

Note: In the high income countries of the region child mortality is only around 4 per thousand live births. Afghanistan, which is not shown in the figure, had an under-5 mortality rate of 209 in 1990 and 149 in 2010. For all countries, the latest year for which data are available is 2010. Source: Staff calculations based on the United Nations MDG Database. 16

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-4 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the under-5 mortality target &RXQWU\

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Note: The required annual percentage points reduction in rates for several Pacific island countries are: Cook Islands, 0.5; Palau, 1.6; Marshall Islands, 1.8; Tuvalu, 2.8; Niue, 3.5; Kiribati, 4.0; Nauru, 5.3. In these cases because of a lack of relevant population data it is not possible to estimate the number of additional childrenâ&#x20AC;&#x2122;s lives that would be saved. Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-5 â&#x20AC;&#x201C; Progress in reducing maternal mortality Lao PDR Bhutan

Nepal

Bangladesh Cambodia

Timorâ&#x20AC;&#x201C;Leste

Indonesia India

Maldives Pakistan

Myanmar

Papua New Guinea

DPR Korea Philippines

Viet Nam

Iran (Islamic Rep. of) Mongolia

Solomon Islands

Tajikistan China

Turkmenistan Sri Lanka

Kazakhstan Kyrgyzstan

Russian Federation

Turkey

Azerbaijan Georgia

Malaysia

Uzbekistan

Armenia

Thailand

Fiji

Brunei Darussalam Republic of Korea

Singapore 0

ESCAP high income

200

400

600

800

Ratio per 100,000 live births Early achiever

On-track

Slow

1000 Regressing/ No progress

1200 Target

Note: In the high income countries of the region maternal mortality is around 9.57 per 100,000 live births. Afghanistan, which is not shown in the figure, had a maternal mortality ratio of 1,700 in 1990 and 1,400 in 2008. For all countries, the latest year for which data are available is 2008. Source: Staff calculations based on the United Nations MDG Database.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-5 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the maternal mortality target

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Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-6 â&#x20AC;&#x201C; Progress in increasing skilled birth attendance Country Tuvalu

Fiji

Kazakhstan

Thailand

Russian Federation

Palau Niue

Cook Islands Kyrgyzstan

Republic of Korea

Brunei Darussalam

Uzbekistan

DPR Korea

Mongolia Georgia

Armenia

Turkmenistan

Marshall Islands Sri Lanka

China

Micronesia (F.S.) Malaysia

Tonga

Maldives Vanuatu

Iran (Islamic Rep. of) Solomon Islands Azerbaijan

Tajikistan Viet Nam

Samoa

Turkey

Kiribati

Papua New Guinea Philippines

Myanmar

Indonesia India

Cambodia

Timorâ&#x20AC;&#x201C;Leste

Lao PDR Pakistan Bhutan

Afghanistan Bangladesh

Nepal

(Latest year) (2007) (2008) (2006) (2009) (2008) (2008) (2008) (2006) (2006) (1997) (2009) (2006) (2009) (2008) (2005) (2007) (2006) (2007) (2007) (2008) (2008) (2007) (2008) (2009) (2007) (2005) (2007) (2006) (2007) (2006) (2009) (2008) (2008) (2006) (2008) (2007) (2008) (2008) (2005) (2010) (2006) (2007) (2007) (2008) (2009) (2006) 0

100

Percentage of total births (%) ESCAP high income

Early achiever

On-track

Slow

Regressing/ No progress

Target

Note: In the high income countries of the region the proportion of births attended by skilled health personnel is 100 per cent. Source: Staff calculations based on the United Nations MDG Database.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-6 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the skilled birth attendance target &RXQWU\

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Note: The required annual percentage points reduction in rates for several Pacific island countries are: Cook Islands, 0.19; Kiribati, 4.00; Marshall Islands, 1.57; and Tuvalu, 0.26. In these cases, because of a lack of relevant population data it is not possible to estimate the number of extra births that would be attended. Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-7 â&#x20AC;&#x201C; Progress in expanding antenatal care Country Brunei Darussalam Turkmenistan Kyrgyzstan DPR Korea Georgia Uzbekistan Kazakhstan Mongolia Kiribati Thailand Philippines Armenia Maldives Sri Lanka Papua New Guinea Iran (Islamic Rep. of) Indonesia Myanmar Tajikistan Timorâ&#x20AC;&#x201C;Leste Viet Nam China Azerbaijan Turkey India Bhutan Afghanistan Cambodia Lao PDR Bangladesh Pakistan Nepal

(Latest year) (2009) (2006) (2006) (2009) (2005) (2006) (2006) (2006) (2008) (2009) (2008) (2005) (2009) (2007) (2006) (2005) (2007) (2007) (2007) (2010) (2006) (2008) (2006) (2008) (2008) (2007) (2008) (2005) (2006) (2007) (2007) (2006) 0

Percentage of women with a live birth (%)

Early achiever

On-track

100

Regressing/ No progress

Slow

Target

Source: Staff calculations based on the United Nations MDG Database.

Table I-7 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the antenatal care target &RXQWU\

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Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Providing safe drinking water

Ensuring access to basic sanitation

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Table I-8 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the safe drinking water target &RXQWU\

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Note: The required annual percentage points reduction in rates for several Pacific island countries are: Cook Islands, 0.20; Northern Mariana Islands, 0.14; Marshall Islands, 0.50; Palau, 0.65. In these cases because of a lack of relevant population data it is not possible to estimate the number of additional people who would get access. Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-8 â&#x20AC;&#x201C; Progress in improving access to safe drinking water Country Tonga

Singapore

Niue

DPR Korea Guam

French Polynesia

Northern Mariana I. Kazakhstan

Marshall Islands Cook Islands

Russian Federation

Armenia Samoa

Thailand

Iran (Islamic Rep. of)

Bhutan

Uzbekistan Tuvalu

Maldives

Republic of Korea

Micronesia (F.S.) Malaysia Pakistan

Turkey

Philippines

Turkmenistan Palau

Georgia

Kyrgyzstan

Bangladesh

Nepal India

Indonesia

Azerbaijan

Solomon Islands

China

Sri Lanka

Tajikistan Viet Nam Mongolia Vanuatu

Myanmar

Timorâ&#x20AC;&#x201C;Leste Kiribati

Lao PDR

Papua New Guinea Cambodia

Afghanistan

(Latest year) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2005) (2008) (2008) (2005) (2008) (2000) (2008) (2008) (2008) (2008) (2008) (2005) (2008) (2008) (2008) (2008) (2005) (2005) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2005) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2005) (2008) (2008) (2008) (2008) 0

ESCAP high income

Percentage of total population (%) Early achiever

On-track

Slow

80 Regressing/ No progress

100 Target

Note: In the high income countries of the region the proportion of population using an improved drinking water source is almost 100 per cent. Source: Staff calculations based on the United Nations MDG Database.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Figure I-9 â&#x20AC;&#x201C; Progress in expanding access to basic sanitation Country Niue

Republic of Korea Singapore

Guam

Samoa

Turkmenistan

French Polynesia Tonga

Kazakhstan Georgia

Cook Islands Kyrgyzstan Tajikistan Armenia

Russian Federation

Uzbekistan Turkey

Northern Mariana I.

Malaysia

Iran (Islamic Rep. of) Tuvalu

Thailand

Sri Lanka

Palau

Maldives

Marshall Islands

Bhutan

DPR Korea Philippines Azerbaijan Mongolia

Myanmar

Papua New Guinea

China

Viet Nam Vanuatu

Bangladesh Indonesia

Timorâ&#x20AC;&#x201C;Leste

Solomon Islands

Micronesia (F.S.) Afghanistan Pakistan

Kiribati

Lao PDR India

Nepal

Cambodia

(Latest year) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2005) (2008) (2000) (2008) (2008) (2008) (2005) (2008) (2008) (2008) (2000) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2005) (2005) (2008) (2008) (2005) (2008) (2008) (2008) (2008) 0

ESCAP high income

Proportion of the population using improved sanitation facilities (%) Regressing/ Early achiever On-track Slow No progress

100 Target

Note: In the high income countries of the region the proportion of population using an improved sanitation facility is 100 per cent. Source: Staff calculations based on the United Nations MDG Database. Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Table I-9 â&#x20AC;&#x201C; Rate of progress needed for off-track countries to meet the basic sanitation target &RXQWU\

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Note: The required annual percentage points reduction in rates for several Pacific island countries are: French Polynesia, 0.14; Kiribati, 2.80; Guam, 0.07; Marshall Islands, 1.29; and Tuvalu, 0.86. In these cases because of a lack of relevant population data it is not possible to estimate the number of additional people that would gain access. Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Number of people in off-track countries who will gain if targets are reached 7KH EHQHILWV RI RII WUDFN FRXQWULHV PHHWLQJ WKH WDUJHWV RQ WKHVH KHDOWK LQGLFDWRUV DUH VXPPDUL]HG LQ 7DEOH , 7KH ILUVW FROXPQ VKRZV WKH OLNHO\ HIIHFW LI WKH FXUUHQW WUHQGV ZHUH WR FRQWLQXH 7KH VHFRQG VKRZV WKH SRWHQWLDO JDLQV 7KXV DFFHOHUDWHG SURJUHVV LQ WKH RII WUDFN FRXQWULHV DORQH ZRXOG UHGXFH WKH SUHYDOHQFH RI XQGHUZHLJKW FKLOGUHQ LQ WKHVH FRXQWULHV E\ DURXQG

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Table I-10 â&#x20AC;&#x201C; Potential gains if off-track countries can meet their targets 2Q SUHVHQW WUHQGV WKH WRWDO QXPEHU RI SHRSOH LQ RII WUDFN FRXQWULHV ZKR ZRXOG EH GHSULYHG LQ RU KDYH GLHG WKRXVDQGV 8QGHUZHLJKW FKLOGUHQ 8QGHU PRUWDOLW\ 0DWHUQDO PRUWDOLW\ 6NLOOHG ELUWK DWWHQGDQFH $QWHQDWDO FDUH Â&#x2022; YLVLW 6DIH GULQNLQJ ZDWHU %DVLF VDQLWDWLRQ

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Notes: *Cumulative number of deaths from 2011 to 2015; ** Cumulative number of deaths from 2009 to 2015. Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER I: MDGs in Asia and the Pacific: where we stand

Box I-3 â&#x20AC;&#x201C; Reproductive health

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Figure I-10 â&#x20AC;&#x201C; Progress in contraceptive prevalence rate and adolescent birth rate in Asia and the Pacific Adolescent birth rate

Contraceptive prevalence rate Asia-Pacific Excluding China and India South-East Asia South Asia Excluding India Pacific Islands Excluding Papua New Guinea North and Central Asia Excluding the Russian Federation Asia-Pacific LDCs Asia-Pacific Low Income Asia-Pacific Middle Income 0

1990

2000

100

2008

1990

100

2000

150

2008

Source: UN Population Division, DESA, 2011.

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CHAPTER II Diagnosing disparities

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Figure II-1 â&#x20AC;&#x201C; Proportion of population below $1.25 (PPP) per day, per cent, 2004 60 40 20

hi na on go l C am ia bo di In do a ne si a La o PD R M al a Ph ysia ilip pi ne s Th ai la Ti nd m or -L es te Vi et Ba Na ng m la de sh Ira I n ndi (Is a R lam ep i c M . of al ) di ve s N ep a l Pa ki st Sr an iL an ka Tu rk ey Ar m en Az i er a ba ija n G e Ka org i a za kh Ky sta n rg yz st a FeRu n de ssi ra an Ta tio n Tu jikis ta rk n m en is t U zb an ek is ta n

East and North-East Asia

South-East Asia

South and South-West Asia

North and Central Asia

Source: The United Nations MDG Database and staff estimates.

Asia-Pacific Regional MDG Report 2011/12

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D C R PR hin ep K a Br of ore un ei M Kor a D on ea ar g us ol C sa ia am la m In bo do di a La nes o ia P M D a R M lay s Ph yan ia ili ma Si ppi r ng ne a s T p Ti ha ore m ila or n - d V Le Af iet ste gh N Ba an am ng ist la an Ira d n Bh esh (Is ut la a m ic In n R dia e M po al f) di v N es Pa ep a k Sr ist l i L an an Tu ka A rk Az rme ey er ni ba a i Ka Ge jan R za org us si Ky khs ia an rg t Fe yzs an de ta r n Tu Ta atio rk jiki n m st U eni an zb st ek an is ta n M M K Fij ic a iri i ro rs b ne ha ati si ll Pa a Is (F . pu . a Ne P S.) w ala Gu u i So Sa nea lo m m oa on To Is. n Tu ga Va va nu lu at u

East and North-East Asia

East and North-East Asia South-East Asia

100

South-East Asia

100

South-East Asia

Asia-Pacific Regional MDG Report 2011/12 South and South-West Asia

South and South-West Asia

South and South-West Asia North and Central Asia

North and Central Asia

F Ki iji rib sh ati al lI S s. So am o lo m a on Is To . ng Va a nu at u

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CHAPTER II: Diagnosing disparities

Figure II-2 – Net enrolment in primary education, per cent, 2009 100

Pacific

Source: The United Nations MDG Database and staff estimates.

Figure II-3 – Infant mortality rate per 1,000 live births, 2010 103

Pacific

Source: The United Nations MDG Database and staff estimates.

Figure II-4 – Under-5 mortality rate per 1,000 live births, 2010

149

Pacific

Source: The United Nations MDG Database and staff estimates.

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32 na , PR 200 Ko 2 re M 20 a, on 0 go 4 C 2 lia am 0 , bo 05 d In 2 ia, do 00 ne 8 s La 20 ia, o 07 PD M 20 R, ya 0 n 6 Ph ma ilip 200r, pi 3 ne Th 20 s, ai 03 la n Vi 20 d, et 0 5 N Af a gh 2 m, an 00 6 Ba ista ng 20 n, la 04 de 2 sh Bh 00 , ut 7 Ira a 2 n n (Is Indi 008, a la m , 20 ic R 05 ep o M 19 f), al 9 di 8 ve N ep 200s, al 1 ,2 Pa 006 ki st Sr 2 an, i L 00 an 1 k 2 a, Tu 009 rk e Ar 20 y, m 03 en Az 2 ia er 00 , ba 5 ija n G 200 , eo 6 rg Ka za 20 ia, kh 05 Ky stan rg 20 , yz 06 st U zb 20an, ek 0 is 5 ta Va 20 n, nu 06 a 20tu, 07

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CHAPTER II: Diagnosing disparities

Figure II-5 – Maternal mortality ratio per 100,000 live births, 2008 700 1,400

600

500

400

300

200

100

East and North-East Asia

East and North-East Asia South-East Asia

South-East Asia

South-East Asia South and South-West Asia

South and South-West Asia

South and South-West Asia North and Central Asia

North and Central Asia

Pacific

Source: The United Nations MDG Database and staff estimates.

Figure II-6 – Incidence of underweight children, per cent, latest year 50

Pacific

Source: The United Nations MDG Database and staff estimates.

Figure II-7 – HIV prevalence among population 15-24 years old, per cent, 2009

1.6

1.2

0.8

0.4

Pacific

Source: The United Nations MDG Database and staff estimates.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

Cumulative per cent share: Prevalence of underweight children

Figure II-8 â&#x20AC;&#x201C; Inter-country disparity in prevalence of underweight children under 5, 1995-2005

100

1995 2000 2005

100

Cumulative per cent share: Countries Source: Staff calculation based on the United Nations MDG Database.

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CHAPTER II: Diagnosing disparities

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Table II-1 â&#x20AC;&#x201C; Gini and Theil indices of inter-country distribution of MDG indicators ,QGLFDWRU

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Source: Staff calculation based on the United Nations MDG Database.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

Figure II-9 â&#x20AC;&#x201C; Contribution to disparities by subregion, selected MDG indicators

Underweight children Infant mortality Maternal mortality HIV prevalence TB prevalence 0%

20% Central West Asia

40% East Asia

60%

The Pacific

South Asia

80% South-East Asia

100% Between

Note: Country groupings are based on subregional classification used by the Asian Development Bank: Central West Asia includes Afghanistan, Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Pakistan, Tajikistan, Turkmenistan and Uzbekistan; East Asia includes China and Mongolia; The Pacific includes Cook Islands, Fiji, Kiribati, Marshall Islands, Federated States of Micronesia, Nauru, Palau, Papua New Guinea, Samoa, Solomon Islands, Timor-Leste, Tonga, Tuvalu and Vanuatu; South Asia includes Bangladesh, Bhutan, India, Maldives, Nepal, and Sri Lanka; and South-East Asia includes Cambodia, Indonesia, Lao Peopleâ&#x20AC;&#x2122;s Democratic Republic, Malaysia, Myanmar, Philippines, Thailand and Viet Nam. Source: Staff calculation based on the United Nations MDG Database.

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CHAPTER II: Diagnosing disparities

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CHAPTER II: Diagnosing disparities

Figure II-10 – Cross-country variation in under-5 mortality explained by differences in per capita health spending 5.0

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Figure II-11 – Cross-country variation in maternal mortality explained by differences in corruption control 8.0 LAO

ln (Maternal mortality)

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Sources: The Brookings Institution, World Bank Development Economics Research Group, and the World Bank Institute, World Governance Indicators online database for corruption control index and the United Nations MDG Database for maternal mortality ratio.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

Figure II-12 â&#x20AC;&#x201C; Cross-country variation in maternal mortality explained by differences in percentage of births attended by skilled health personnel 7.0 LAO KHM BGD

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CHAPTER II: Diagnosing disparities

Figure II-13 â&#x20AC;&#x201C; Cross-country variation in child mortality explained by differences in gender development 5.0

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Figure II-14 â&#x20AC;&#x201C; Births attended by skilled health personnel and the extent of paved roads

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

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CHAPTER II: Diagnosing disparities

Figure II-15 â&#x20AC;&#x201C; Contributions to inter-country disparities for three MDG health-related indicators Underweight children Public health expenditure Access to sanitation Asia-Pacific subregion Infant mortality Immunization Access to sanitation Per capita GDP Maternal mortality Per capita GDP Access to sanitation Skilled birth attendance 0%

10%

20%

30%

40%

50%

Sources: Staff calculations based on data from the United Nations MDG Database; Asian Development Bank (ADB), Asian Development Outlook; ADB, Key Indicators (various issues); World Bank, World Development Indicators online database.

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CHAPTER II: Diagnosing disparities

Figure II-16 – Health disparities across sub-national jurisdictions in two large countries Under−5 mortality, Indonesia 2007

Skilled birth attendance, Philippines 2008 National Capital Region Central Luzon Ilocos Region CALABARZON Cordillera Admin Region Central Visayas Western Visayas Cagayan Valley Davao Peninsula Caraga Bicol Region Northern Mindanao Eastern Visayas MIMAROPA Zamboanga Peninsula SOCCSKSARGEN ARMM

DI Yogyakarta Central Java Central Kalimantan DKI Jakarta Bali East Kalimantan North Sulawesi East Java DI Aceh Bangka Belitung Jambi Riau West Java South Sumatra South Sulawesi Lampung Kep Bangka Belitung Banten West Kalimantan Papua Barat Southeast Sulawesi West Sumatra Papua Bengkulu North Sumatra Central Sulawesi Gorontalo Maluku Utara South Kalimantan East Nusa Tenggara West Nusa Tenggara Maluku Sulawesi Barat

Percentage of total births (%)

100

120

Rate per 1,000 live births

140

Note: Abbreviations in Indonesia: DI = Daerah Istimewa (special region), DKI = Daerah Khusus Ibukota (special capital region). In the Philippines: MIMAROPA, Occidental Mindoro, Marinduque, Romblon and Palawan; SOCCSKARGEN, South Cotabato, Cotabato, Sultan Kudarat, Sarangani and General Santos City; ARMM – Autonomous Region of Muslim Mindanao; CALABARZON, Cavite, Laguna, Batangas, Rizal, and Quezon. Source: Staff calculations using DHS data from respective countries and years.

Figure II-17 – Health-related disparities across jurisdictions in two small countries Skilled birth attendance, Timor−Leste 2009

Under−5 mortality, Nepal 2006 Eastern Central Western Far−western Mid−western 0

100

120

Rate per 1,000 live births

140

Dili Cova Lima Manatuto Baucau Lautem Bobonaro Viqueque Aileu Liquica Manufahi Ermera Ainaro Oecussi 0

Source: Staff calculations using DHS data from respective countries and years.

Percentage of total births (%)

Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

Table II-2 â&#x20AC;&#x201C; Factors considered to explain disparities for selected MDG indicators &KLOG PDOQXWULWLRQ

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Notes: *Two education variables are used for modelling access to improved water and sanitation. The first is the attainment level of the besteducated household member. The second is the percentage of people in the village or neighbourhood with at least primary education.

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CHAPTER II: Diagnosing disparities

Figure II-18 – Disparities and attainment in health-related MDG targets 1

nd er w

ei gh St tc un hi ld te re d n ch ild re n U nd er −5 m or ta lit Sk y ille d bi rth at An te te nd na an ta ce lc ar e >= An 1 te vi na si ta ts lc ar e >= Im 4 vi pr si ov ts ed wa te Im r pr ov ed sa ni ta tio n

Goals

East and North−East Asia

Mongolia 2005 South−East Asia

Cambodia 2005 Indonesia 2007 Lao PDR 2006 Philippines 2008 Thailand 2005 Timor−Leste 2009 Viet Nam 2006 South and South−West Asia

Bangladesh 2007 India 2005 Maldives 2009 Nepal 2006 Pakistan 2006 Turkey 2003 North and Central Asia

Armenia 2005 Azerbaijan 2006 Georgia 2005 Kazakhstan 2006 Kyrgyzstan 2005 Tajikistan 2005 Uzbekistan 2006 Pacific

Vanuatu 2007 High attainment

Medium attainment Small disparity

Low attainment

Poor attainment

Large disparity

Notes: 1) All child mortality rates are calculated using the DHS method for a five-year period before the survey. 2) Estimates using the new standards were not available in earlier surveys, therefore, the underweight and stunting status of the child were calculated using the NCHS/CDC/ WHO standard, which is different from the WHO Child Growth Standards 2006 used for the calculation of the prevalence of underweight children in Chapter 1. 3) In the case of Viet Nam for under-5 mortality, the results are based on the DHS survey from 2002. 4) See Technical Note 4 in the Statistical Appendix for details of attainment levels and disparities. 5) The levels of attainment and inequality as shown in the chart are based on household survey data from various sources. As such, the assessments of individual countries are not comparable to that based on the United Nations MDG Database. Source: Staff calculations based on data from DHS and MICS from respective countries and years.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

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CHAPTER II: Diagnosing disparities

U (c rba om n pa re d

ru ra l) W (5 ea to th lth 1 s q u in t q in t d e u i ile x nt c ile o m ) pa re Pr d h op (5 ous or t to th eh ion 1 s q u o ld o t q int m f fe u i ile e m m nt c ile o m b e a l e ) pa rs H re (c ous d om e h pa ol re d h d e to ad fe b m ei al ng Ed e) m (h uc al to igh at e i lo es on w t es l e of t l ve m ev l c ot el om he ) pa r C re (c hild d om b e p a in re g d a to bo gi y rl)

Figure II-19 â&#x20AC;&#x201C; Drivers of disparities in underweight prevalence among under-5 children

East and Northâ&#x2C6;&#x2019;East Asia Mongolia 2005 Southâ&#x2C6;&#x2019;East Asia Cambodia 2005 Lao PDR 2006 Thailand 2005 Timorâ&#x2C6;&#x2019;Leste 2009 South and Southâ&#x2C6;&#x2019;West Asia Bangladesh 2007 India 2005 Maldives 2009 Nepal 2006 Turkey 2003 North and Central Asia Armenia 2005 Azerbaijan 2006 Kazakhstan 2006 Kyrgyzstan 2005 Tajikistan 2005 Uzbekistan 2006 Pacific Vanuatu 2007

Disparity

< Change in disparity

Source: Staff calculations based on data from DHS and MICS from respective countries and years.

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CHAPTER II: Diagnosing disparities

U (c rba om n pa re d

ra l) W (5 ea to th lth 1s qu in t q int de ui ile x nt c ile om ) pa Ed re d (h uc to igh at lo es ion w t es le of t l ve m ev l c ot el om he ) pa r Sk re (c i l l l d be om ed en pa as as red sis si to tan st ed no ce ) t h at av de C in li v (c hild g e om b ry e pa in re g d a to b o gi y r l) C fo hild (c r a h be om t le av en pa as ing br red t 6 be ea t m en st o n on b fe o th re d) t h s a st av fe in d g

Figure II-20 â&#x20AC;&#x201C; Drivers of disparities in the prevalence of under-5 mortality

Southâ&#x2C6;&#x2019;East Asia Cambodia 2005 Indonesia 2007 Philippines 2008 Timorâ&#x2C6;&#x2019;Leste 2009 Viet Nam 2002 South and Southâ&#x2C6;&#x2019;West Asia Bangladesh 2007 India 2005 Maldives 2009 Nepal 2006 Pakistan 2006 Turkey 2003 North and Central Asia Armenia 2005 Azerbaijan 2006

100 0

100 0 Disparity

100 0

600

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Source: Staff calculations based on data from DHS from respective countries and years.

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CHAPTER II: Diagnosing disparities

U (c rba om n pa re d

ru ra l) W (5 ea to th lth 1s qu in t q int de ui ile x nt c ile om )

pa re d o ho p (5 us or t t to h eh ion 1s qu old o t q int m f fe ui ile em m nt c ile om be ale ) H pa rs o (c us re om e d pa hol d re h d e to ad fe b m ei al ng Ed e) m (h uc al i to gh at e lo es ion w t es le of t l ve m ev l c ot el om he ) pa r Ed re (h uc d to igh at lo es ion w t es le of t l ve fat ev l c h el om er ) pa re d

Figure II-21 â&#x20AC;&#x201C; Drivers of disparities in the coverage of antenatal care (at least one visit)

Southâ&#x2C6;&#x2019;East Asia Cambodia 2005 Indonesia 2007 Lao PDR 2006 Philippines 2008 Timorâ&#x2C6;&#x2019;Leste 2009 Viet Nam 2006 South and Southâ&#x2C6;&#x2019;West Asia Bangladesh 2007 India 2005 Maldives 2009 Nepal 2006 Pakistan 2006 Turkey 2003 North and Central Asia Armenia 2005 Azerbaijan 2006 Tajikistan 2005 Pacific Vanuatu 2007

100 0

100 0 Disparity

100 0

100

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Source: Staff calculations based on data from DHS and MICS from respective countries and years.

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

U (c rba om n pa re d

ru ra l) W (5 ea to th lth 1s qu in t q int de ui ile x nt c ile om ) pa H re o d (5 us to th eh 1s qu ol t q int d s ui ile ize nt c ile om ) pa re Pr d ho op o (5 us r to th eh tion 1s qu old o t q int m f fe ui ile em m nt c ile om be ale ) H pa r s (c ous re om e d pa hol re d h d e to ad fe b m ei Ed al ng e) m (h uc i g to h at al e lo es ion w t es l e v tl e ev l c el om ) pa re d

Figure II-22 â&#x20AC;&#x201C; Drivers of disparities in access to improved sanitation

East and Northâ&#x2C6;&#x2019;East Asia Mongolia 2005 Southâ&#x2C6;&#x2019;East Asia

Cambodia 2005

Indonesia 2007

Lao PDR 2006

Philippines 2008 Thailand 2005

Timorâ&#x2C6;&#x2019;Leste 2009

Viet Nam 2006 South and Southâ&#x2C6;&#x2019;West Asia Bangladesh 2007

India 2005

Maldives 2009

Nepal 2006

Pakistan 2006

Turkey 2003 North and Central Asia Armenia 2005

Azerbaijan 2006

Georgia 2005

Kazakhstan 2006 Kyrgyzstan 2005 Tajikistan 2005

Uzbekistan 2006 Pacific Vanuatu 2007

100 0

100 0 Disparity

100 0

100

< Change in disparity

Source: Staff calculations based on data from DHS and MICS from respective countries and years.

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CHAPTER II: Diagnosing disparities

Figure II-23 â&#x20AC;&#x201C; Under-5 children underweight, urban and rural, by household wealth, India and Nepal India 2005

Nepal 2006

100 Percentage of children under 5 (%)

Percentage of children under 5 (%)

100 80

60 40 20

80 60 40

20 0

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â&#x2C6;&#x2019;2

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Rural wealth quintiles

Source: Staff calculations based on data from DHS from respective countries and years.

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CHAPTER II: Diagnosing disparities

Figure II-24 â&#x20AC;&#x201C; Access to water and sanitation, urban and rural, by household wealth, the Philippines and Indonesia Improved water, Philippines 2008

Improved sanitation, Philippines 2008 100 Proportion of total population (%)

Proportion of total population (%)

100

80 60

20 0

40 20 0

â&#x2C6;&#x2019;3

â&#x2C6;&#x2019;2

â&#x2C6;&#x2019;1

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Improved water, Indonesia 2007

â&#x2C6;&#x2019;3

80 60

20 0

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Improved sanitation, Indonesia 2007

100 Proportion of total population (%)

60 40 20 0

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â&#x2C6;&#x2019;2

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CHAPTER II: Diagnosing disparities

Figure II-25 – Access to antenatal care, urban and rural, by household wealth, Azerbaijan and Timor-Leste Azerbaijan 2006

100

80 Percentage (%)

Percentage (%)

Timor−Leste 2009

100

60 40

0 −3

−2

−1

−3

−2

−1

Wealth index

Urban wealth quintiles

Rural wealth quintiles

Source: Staff calculations based on data from DHS from respective countries and years.

Figure II-26 – Access to skilled birth attendants, urban and rural, by household wealth, Maldives and Bangladesh Maldives 2009

100

80 Percentage (%)

Bangladesh 2007

100

0 −3

−2

−1

0 1 Wealth index

−3

Urban wealth quintiles

−2

−1

0 1 Wealth index

Rural wealth quintiles

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

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CHAPTER II: Diagnosing disparities

Figure II-27 – The potential for reducing regional disparities within countries Skilled birth attendance, India 2005

Improved water, Cambodia 2005 Prey Veng

Goa

Phnom Penh

Andhra Pradesh

Krong Preah Sihanouk & Kaoh Kong

Maharashtra

Kampong Speu

Mizoram

Kampong Chhnang

Gujarat

Kampong Thom

Tamil Nadu

Kampong Cham

Karnataka

Siem Reap

Punjab

Otdar Mean Chey

Delhi

Pursat

Manipur

Takeo

Sikkim

Kratie

Haryana

Kampot & Krong Kep

Tripura

Kandal

West Bengal

Battambang & Krong Pailin

Himachal Pradesh

Mondol Kiri & Rattanak Kiri

Orissa

Preah Vihear & Steung Treng

Chhattisgarh

Banteay Mean Chey

Rajasthan

Uttaranchal

100

Meghalaya

< Change in disparity

Disparity with Svay Rieng

Madhya Pradesh

Assam

Arunachal Pradesh Bihar

Jharkhand

Uttar Pradesh

Nagaland 0

100 Disparity with Kerala

< Change in disparity

Improved water, Mongolia 2005

Under−5 underweight, Timor−Leste 2009

Eastern

Manatuto

Khangai

Liquica

Lautem

Central

Aileu

Western 0

100 Disparity with Ulaanbaatar

< Change in disparity

Viqueque

Manufahi Baucau

Cova Lima

Ainaro

Bobonaro

Ermera

Oecussi 0

100 Disparity with Dili

< Change in disparity

Note: The lines with arrows represent the difference in the MDG indicator between the state/province/district and the best-performing jurisdiction in the country after taking into account various household and individual characteristics. They can be interpreted as the effects of differences in the policies and programmes bewteen the best-performing jurisdiction and each of the rest of the jurisdictions. Source: Staff calculations using DHS and MICS data from respective countries and years.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER II: Diagnosing disparities

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Box III-1â&#x20AC;&#x201C; Unlikely alliances for reducing HIV-related stigma

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Box III-2 â&#x20AC;&#x201C; Primary health care in China

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Asia-Pacific Regional MDG Report 2011/12

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CHAPTER III: Closing the health gaps

Box III-3 â&#x20AC;&#x201C; Expenditure on preventive and public health

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Source: Data for the most recent year with data available in the 2000-2009 period from National Health Accounts, World Health Organization (2011a).

Box III-4 â&#x20AC;&#x201C; New facilities reduce infant mortality in Bihar, India

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

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Asia-Pacific Regional MDG Report 2011/12

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CHAPTER III: Closing the health gaps

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Box III-5 â&#x20AC;&#x201C; Mongoliaâ&#x20AC;&#x2122;s success in reducing maternal mortality

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5. Devise sustainable financial strategies

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Box III-6 â&#x20AC;&#x201C; Total health expenditures as a share of gross domestic product

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Per cent

14 12 10 8 6 4 2

EA ST

NO RT HEA R ST e

A bl ic C SIA o h Br UT Mf K ina un H- o ore ei EA ng a D ST oli ar A a u C ssa SIA a l In mboam do d La ne ia o s M PD ia M ala R y Ph an ysi il m a SO Si ipp ar U ng in TH e T ap s & SO Tim ha ore o ila U TH V r-L nd -W ie es E t te Af ST Nam gh A Ba an SI ng is A Ira la tan n (Is Bhdes la u h m ic I tan R nd ep ia M . al of di ) N O N ves R P TH akepa Sr is l & i ta C EN Lan n TR Tu ka AL rke A A y Az rm SIA er en b ia Ka Ge aija R us za or n si Ky k gi an r hs a Fe gyz tan d st Tu Taera an rk jik tio m is n U en tan zb is ek tan Co PA ista ok CI n Isl FIC an M ds ar s M h K Fi icr al iri ji on l Is ba es la ti ia nd (F s N .S.) Pa au pu N ru a Ne P iue w al So G a lom S uin u on am ea Isl oa a To nds Tu nga Va va nu lu at u

Source: Data for 2009 from National Health Accounts, World Health Organization (2011a).

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CHAPTER III: Closing the health gaps

Box III-7 â&#x20AC;&#x201C; Out-of-pocket expenses as a share of private health expenditures

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Note: low (<65 per cent); medium (<65-79.9 per cent); high (80-94.9 per cent); negative change (1999-2009); large circle: zero or positive change (1999-2009).

â&#x20AC;¢

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very high (95-100 per cent). Small circle:

Source: Data for 1999-2009 from National Health Accounts, World Health Organization (2011a).

Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Figure III-1 â&#x20AC;&#x201C; Under-5 mortality and per capita expenditure on health Children under five mortality rate per 1,000 live births

501 451 401 351 301 251 201 151

y = 727.49x

-0.6293

R2 = 0.7526

101 50 1 1

100

1,000

10,000

Public health expenditure per capita, PPP (constant 2005 international $) Source: Based on World Bank Development Indicators and the United Nations MDG Indicators.

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Figure III-2 â&#x20AC;&#x201C; Association between public health expenditure and GDP, selected countries 8

Health expenditure, public (% of GDP)

100

1,000

10,000

100,000

GDP per capita, PPP (constant 2005 international $) Predicted

India

China

Indonesia

Thailand

Russian Federation

Malaysia

Japan

Source: Staff calculations based on World Bank Development Indicators and United Nations MDG Database.

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CHAPTER III: Closing the health gaps

Box III-8 â&#x20AC;&#x201C; Health expenditure gaps

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Health expenditure gaps, as per cent of GDP Singapore Indonesia Brunei Darussalam Bangladesh Turkmenistan Armenia Pakistan Fiji Russian Federation Sri Lanka Philippines China Kazakhstan Thailand India Mongolia Papua New Guinea Vanuatu Lao PDR Uzbekistan Malaysia Iran, Islamic Rep. Azerbaijan Bhutan Tajikistan Nepal Cambodia Australia Kyrgyzstan Viet Nam Solomon Islands Turkey Japan Tonga Maldives Georgia Samoa New Zealand Timor-Leste Micronesia, Fed. Sts.

-2

Public

Private

-4

-6

-8

-10

Source: Data from World Bank Development Indicators.

Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Box III-9 â&#x20AC;&#x201C; Marginal budgeting for bottlenecks in Pakistan

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6. Improve the governance of health systems

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

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CHAPTER III: Closing the health gaps

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Asia-Pacific Regional MDG Report 2011/12

CHAPTER III: Closing the health gaps

Chapter III Endnotes

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CHAPTER IV: Way Forward

CHAPTER IV Way Forward

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STATISTICAL APPENDIX

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Setting the target value :KHQ DQ LQGLFDWRU UHTXLUHV D WDUJHW YDOXH D YDOXH IRU WKH LQGLFDWRU IRU WKH \HDU LV UHTXLUHG WR FDOFXODWH LW :KHQ WKH YDOXH LV QRW DYDLODEOH ZLWK WKH H[FHSWLRQ RI WKH 1RUWK DQG &HQWUDO $VLDQ FRXQWULHV 82

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Using cut-off values 7KH FXW RII YDOXHV GHSHQG RQ WKH NLQG RI WDUJHW RI WKH LQGLFDWRU 6RPH RI WKH 0'* WDUJHWV UHTXLUH DQ LQGLFDWRU YDOXH WR LQFUHDVH RU GHFUHDVH E\ D FHUWDLQ SURSRUWLRQ RI WKHLU YDOXHV 7KH RQO\ LQGLFDWRU RI WKLV NLQG WKDW KDV FXW RII SRLQW LV D GD\ SRYHUW\ EHFDXVH SHU FHQW LV WKH ORZHVW OHYHO UHSRUWHG RQ WKLV LQGLFDWRU 0DQ\ RWKHU LQGLFDWRUV UHTXLUH DQ DEVROXWH OHYHO DV D WDUJHW VXFK DV WKH SULPDU\ VFKRRO HQUROPHQW 7KHVH WDUJHWV FDQQRW EH DFKLHYHG E\ WKH PRGHO GXH WR WKH WUDQVIRUPDWLRQ XVHG ,Q WKLV FDVH WKH LQGLFDWRU LV WUHDWHG DV DFKLHYHG LI WKH FRXQWU\ KDV UHDFKHG WKLV FXW RII YDOXH ,Q WKH FDVH RI SULPDU\ VFKRRO HQUROPHQW IRU H[DPSOH WKLV FXW RII YDOXH LV VHW DW SHU FHQW LQVWHDG RI 7KH WUDQVIRUPDWLRQ DQG FXW RII YDOXHV IRU LQGLFDWRUV DUH SUHVHQWHG LQ 7DEOH

Calculating regional and country group aggregates and the affected population Regional and country group aggregates 7KH DJJUHJDWHV DUH HVWLPDWHG E\ XVLQJ D ZHLJKWHG DYHUDJH RI WKH DFWXDO FRXQWU\ YDOXHV RU LPSXWHG FRXQWU\ YDOXHV ZKHUHYHU GDWD DUH PLVVLQJ IRU WKH \HDU UHTXLUHG 7KH UHIHUHQFH SRSXODWLRQV ZHUH REWDLQHG IURP :RUOG 3RSXODWLRQ 3URVSHFWV WKH 5HYLVLRQ 8QLWHG 1DWLRQV 7KH VDPH PRGHOV IRU HVWLPDWLQJ WUHQGV DUH XVHG WR LPSXWH PLVVLQJ YDOXHV IRU WKH \HDU IRU D FRXQWU\ SOHDVH VHH EHORZ KRZ WR FDOFXODWH WKH WUHQG 7KH DJJUHJDWH YDOXHV IRU D VSHFLILF LQGLFDWRU DUH FDOFXODWHG WKURXJK WKH IROORZLQJ SURFHVV Â&#x2021; (VWLPDWH WKH LQGLFDWRU YDOXHV IRU WKH FRXQWULHV VHH WKH SUHYLRXV VHFWLRQ HVWLPDWLQJ WKH WUHQG WKDW GR QRW KDYH GDWD LQ D \HDU Â&#x2021;

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STATISTICAL APPENDIX

Table 1. Cut-off values for selected MDG indicators

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Note: Protected area and Forest cover are marked “not applicable” as they tend to stay constant / show very little variation for most of the time and hence quadratic or other polynomial functional forms cannot be fitted.

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Asia-Pacific Regional MDG Report 2011/12

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STATISTICAL APPENDIX

Table 2. Data series names and responsible agency 6KRUW LQGLFDWRU QDPH

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Technical Note 2: Factors explaining disparities between countries Data and Methodology

Results

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Asia-Pacific Regional MDG Report 2011/12

Table 1. Cross country regressions of selected health outcomes and explanatory factors

STATISTICAL APPENDIX

Asia-Pacific Regional MDG Report 2011/12

Table 2. Relationship of health outcomes to basic infrastructure

STATISTICAL APPENDIX

Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Technical Note 3: Accounting for disparities between countries )URP :DQ * DQG < =KDQJ %HWZHHQ &RXQWU\ 'LVSDULWLHV LQ 0'*V WKH $VLD 3DFLILF 5HJLRQ 8QSXEOLVKHG EDFNJURXQG SDSHU IRU WKLV UHSRUW

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Technical Note 4: Analysis of disparities within countries Definitions i. Child nutrition status 7KH SUHYDOHQFH RI XQGHUZHLJKW FKLOGUHQ LV WKH SHUFHQWDJH RI FKLOGUHQ DJHG PRQWKV ZKRVH ZHLJKWV IRU DJH DUH OHVV WKDQ WZR VWDQGDUG GHYLDWLRQV EHORZ WKH PHGLDQ ZHLJKW IRU DJH RI WKH LQWHUQDWLRQDO UHIHUHQFH SRSXODWLRQ 8QGHUZHLJKW LV D JRRG PHDVXUH RI DFXWH DQG ORQJ WHUP PDOQXWULWLRQ DV LW WDNHV LQWR DFFRXQW ERWK ZHLJKW IRU KHLJKW DQG KHLJKW IRU DJH 7KH SUHYDOHQFH RI VWXQWHG FKLOGUHQ LV WKH SHUFHQWDJH RI FKLOGUHQ DJHG PRQWKV ZKRVH KHLJKWV IRU DJH DUH OHVV WKDQ WZR VWDQGDUG GHYLDWLRQV EHORZ WKH PHGLDQ KHLJKW IRU DJH RI WKH LQWHUQDWLRQDO UHIHUHQFH SRSXODWLRQ 6WXQWLQJ LV D PHDVXUH RI FKURQLF HIIHFW RI PDOQXWULWLRQ (VWLPDWHV XVLQJ WKH QHZ VWDQGDUGV ZHUH QRW DYDLODEOH LQ HDUOLHU VXUYH\V WKHUHIRUH WKH XQGHUZHLJKW DQG VWXQWLQJ VWDWXV RI WKH FKLOGUHQ ZHUH FDOFXODWHG XVLQJ WKH 1&+6 &'& :+2 VWDQGDUG DQG WKH LQWHUQDWLRQDO UHIHUHQFH SRSXODWLRQ RIWHQ UHIHUUHG WR DV WKH 1&+6 :+2 UHIHUHQFH SRSXODWLRQ ZKLFK ZDV IRUPXODWHG E\ WKH 1DWLRQDO &HQWHU IRU +HDOWK 6WDWLVWLFV 1&+6 DV D UHIHUHQFH IRU WKH 8QLWHG 6WDWHV DQG ODWHU DGRSWHG E\ WKH :RUOG +HDOWK 2UJDQL]DWLRQ :+2 7KH 1&+6 :+2 UHIHUHQFH VWDQGDUG UHSUHVHQWV WKH GLVWULEXWLRQ RI KHLJKW DQG ZHLJKW E\ DJH DQG VH[ LQ D ZHOO QRXULVKHG SRSXODWLRQ ,Q D ZHOO QRXULVKHG SRSXODWLRQ SHU FHQW RI FKLOGUHQ IDOO EHORZ PLQXV WZR VWDQGDUG GHYLDWLRQV ,Q WKH 1&+6 :+2 UHIHUHQFH SRSXODWLRQ GDWD IRU DJHV RI WR \HDUV LV EDVHG RQ D ORQJLWXGLQDO VWXG\ EDVHG RQ FKLOGUHQ IURP WR NQRZQ DV WKH 2KLR )HOV 5HVHDUFK ,QVWLWXWH /RQJLWXGLQDO 6WXG\ 7KH GDWD IRU FKLOGUHQ WR \HDUV LV FRPSURPLVHG RI FURVV VHFWLRQDO VWXGLHV IURP WR DOVR FRQGXFWHG LQ WKH 86 $ OLPLWDWLRQ RI LV WKDW WKLV UHIHUHQFH SRSXODWLRQ LV FRPSURPLVHG RI XQUHODWHG VDPSOHV +RZHYHU WKLV UHIHUHQFH VWLOO KDV IXQFWLRQDOLW\ IRU PRQLWRULQJ DQG FRPSDULQJ SRSXODWLRQV ii. Child mortality 7KH FKLOG PRUWDOLW\ UDWHV DUH FDOFXODWHG DV GHILQHG LQ WKH '+6 XVLQJ D GLUHFW PHWKRG EDVHG RQ D FRKRUW OLIH WDEOH 0RUWDOLW\ IRU VKRUWHU DJH VHJPHQWV DUH FRPELQHG LQWR WKH PRUH FRPPRQ DJH VHJPHQWV IRU H[DPSOH IRU

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STATISTICAL APPENDIX

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STATISTICAL APPENDIX

Table 1. Surveys used in the analysis

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Table 2. Sources of disparity assessed for selected MDG indicators

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Notes: *. Two education variables are used for modelling access to improved water and sanitation. The first is the attainment level of the besteducated household member. The second is the percentage of people in the village or neighbourhood with at least primary education.

Figure 1 – Conceptual framework on the causes of child malnutrition, death and disability

Source: UNICEF, The State of the world’s children 1998, accessed from http://www.unicef.org/publications/files/pub_sowc98_en.pdf Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Table 3. Criteria used to classify the attainment level of a country

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Technical Note 5: Selected MDG Indicators Goal 1: Eradicate extreme poverty and hunger

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STATISTICAL APPENDIX

Goal 2: Achieve universal primary education

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Goal 3: Promote gender equality and empower women

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STATISTICAL APPENDIX

Goal 4: Reduce child mortality

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Asia-Pacific Regional MDG Report 2011/12

STATISTICAL APPENDIX

Goal 5: Improve maternal health

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101

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Goal 6: Combat HIV and AIDS, malaria and other diseases

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Asia-Pacific Regional MDG Report 2011/12

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Goal 7: Ensure environmental sustainability

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103

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Goal 7: Ensure environmental sustainability

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Asia-Pacific Regional MDG Report 2011/12