Maternal & child health &
CHRONIC DISEASES: The neglected and unfinished agenda
Middle quintile Richest quintile 77 66 53
43
32
22
24
21
Ratio of measles immunisation coverage among 1-year-olds (%)
800
Laos
600
Indonesia
Cambodia
Philippines
Vietnam
Ratio: highest-lowest mother's education
Ratio: urban-rural
The rural-urban gap in skilled care during childbirth has narrowed but there is still some way to go
1995
2000
2005
2008
2015
88%
Fewer mothers are dying in childbirth since 1990, but some countries are unlikely to reach MDG 5 target of reducing maternal deaths by ¾ by 2015.
79% 63%
70%
68%
41%
39%
11%
Laos
Philippines
Indonesia
Ratio: highest-lowest wealth quintile
Indonesia
40%
1.2
1.1
Philippines
Children from the poorest families are more likely to die before age 5 than those from the richest families.
60%
Laos
1.1
Percentage of births attended by skilled health personnel, by location
Percentage of stunted children, below 5-years old, both sexes
Myanmar
Goal: 300
0
Child stunting rates remain high and are worsening in some countries
50%
Cambodia
Myanmar
200
1.0
1.5
1.3
580
Vietnam
Philippines
1.9
1.3
Cambodia
Indonesia
400
16
1.4
1.2
1990
Cambodia
2.8
Projection
1,000
Maternal deaths per 100,000 live births
Poorest quintile
56
Maternal Mortality Ratio per 100,000 live births
1.7
Deaths of children below 5-years old, per 1,000 children
114
It matters most whether mothers are educated in measles immunisation coverage
1,200
Serious inequities persist in child mortality rates
127
Slow progress in Millennium Development Goal 5:Improve maternal health
Cambodia
Philippines
Rural areas
Vietnam
Indonesia
Urban areas
30% 20%
China
Singapore
10%
“Investing in women's and children's health has a multiplier effect across the Millennium Development Goals. It is the best investment we can make.”
0 1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
– UN Secretary-General Ban Ki-moon
Chronic disease is not only the main cause of death in high-income countries...
Cardiovascular diseases and diabetes are responsible for most chronic disease deaths in all countries
...it kills more people in absolute numbers in low-income countries as well
90%
900
Brunei 85%
China
80%
Singapore
75%
Vietnam
Malaysia
70%
Philippines
65% 60%
Thailand
Laos Myanmar
Indonesia
55%
0
Cambodia Non-communicable diseases death rate per 100,000 people
Deaths caused by non-communicable diseases as a percentage of total deaths
Deaths caused by non-communicable diseases per 100,000 people
Laos
800
Myanmar 700
Indonesia China
Vietnam 600
Philippines
500
Singapore
300
400
500
128
Cambodia
117.5
Myanmar
119
369.5
74.5
Indonesia
122.5
350
77
Philippines
400
200
Laos
China
Thailand
Cambodia 50%
Malaysia
100
430.5
Malaysia
104.5
Singapore
116.5
94.5
286
87
103.5
345
57
277.5 140
700
113
409.5
143.5
600
58.5 15
300 500
5,000
50,000
500
Gross national income per capita, PPP (log scale)
5,000
50,000
Cancers
Cardiovascular diseases and diabetes
Chronic respiratory diseases
Gross national income per capita, PPP (log scale)
How will countries tackle the rising chronic disease burden?
ASIAN TRENDS MONITORING Myanmar Cambodia
Laos
Vietnam Philippines Indonesia Thailand
Malaysia Singapore
China
Healthy life expectancy at birth
50
53
54
64
62
60
62
64
73
66
Human Development Index rank
132
126
124
115
99
110
92
57
27
89
Prevalence of tuberculosis
597
693
131
333
520
285
189
109
43
138
Prevalence of smoking
57.4%
55.7%
79.3%
46.4%
65.4%
66.9%
45.1%
55.2%
42.5%
63.2%
Dietary energy consumption
2,940
2,070
2,370
2,630
2,490
2,890
2,400
2,880
1,929
2,930
Percentage of overweight adults
18.8%
12.7%
14.8%
10.1%
26.9%
20.7%
31.4%
44.6%
28.1%
25%
(In number of years)
(Out of 169, the lower the better)
(Per 100,000 population)
(As a percentage of the adult population)
(Calories consumed per person in a day)
(Body mass index higher than 25)