achieving the health-related millennium development goals

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

20121 4 5 6 7 8

“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

1

The Millennium Development Goals

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

z 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.

z 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.

2

World Africa Americas Eastern Mediterranean Europe South-East

AsiaWestern Pacific

4Under-5 mortality per 1000 live births (2010)

57 119 18 68 14 57 19

Measles immunization% coverage (2010) 85 76 93 85 95 79 97

5

Maternal mortalityper 100 000 live births (2010) 210 480 63 250 20 200 49

Skilled birth attendant% births (2005–2011) 69 48 93 59 98 59 91

Contraceptive use% married women aged 15–49 (2005–2010)

63 24 75 42 71 58 80

6

HIV/AIDS prevalence2

% adults aged 15–49 (2010) 0.8 4.7 0.5 0.2 0.4 0.3 0.1

Malaria mortalityper 100 000 population (2008) 12 94 0.1 2.5 0 2.9 0.2

TB treatment% success rate (2009) 87 80 76 88 68 89 93

7

Water% using improved sources (2010) 89 63 96 85 98 90 92

Sanitation% using improved facilities (2010) 63 34 87 66 92 43 69

Health MDGs scorecard for WHO regions

On track Insufficient progress Off trackSource: World Health Statistics 2012

Refer to page 16 for health MDGs scorecard colour code criteria

3

The scorecards reveal clear priorities

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

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

z 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.

z 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.

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

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

4

Cambodia China Fiji Lao PDR Malaysia Mongolia Papua New Guinea Philippines Solomon

Islands Viet Nam

4Under-5 mortality3

per 1000 live births (2010) 51 18 17 54 6 32 61 29 27 23

Measles immunization4

% coverage (2011) 93 99 82 69 95 98 60 79 73 96

5

Maternal mortality5

per 100 000 live births (2010) 250 37 26 470 29 63 230 99 93 59

Skilled birth attendant6% births (2006–2010) 71 96 100 37 99 99 40 62 70 84

Contraceptive use6

% married women aged 15–49 (2005–2008)

51** 85 – 38 – 66 36 51 35 80

6

HIV/AIDS prevalence2, 7

% adults aged 15–49 (2009) 0.5 0.1 0.1 0.2 0.5 <0.1 0.9 <0.1 – 0.4

Malaria mortality8

per 100 000 population (2010) 0.9 <0.1 – 0.4 0.1 – 9.2 <0.1 2.5 <0.1

TB treatment9% success rate (2009) 95 95 94 93 78 88 72 89 88 92

7Water10

% using improved sources (2010) 64 91 98 67 100 82 40 92 – 95

Sanitation10

% using improved facilities (2010) 31 64 83 63 96 51 45 74 – 76

On track Insufficient progress Off track* LMICs – Low- and middle-income countries

** Cambodia Demographic Health Survey 2010

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

Refer to page 16 for health MDGs scorecard colour code criteria

5

Cook Islands Kiribati Marshall

Islands, the

Micronesia, the Fed. States of

Nauru Niue Palau Samoa Tonga Tuvalu Vanuatu

4Under-5 mortality3 per 1000 live births (2010)

9 49 26 42 40 22 19 20 16 33 14

Measles immunization4

% coverage (2011) 89 90 89 92 100 100 80 67 99 98 92

5

Maternal mortality5

per 100 000 live births (2010) – – – 100 – – – 100 110 – 110

Skilled birth attendant6% births (2006–2010) 100 98 86 100 97 100 100 81 98 93 74

Contraceptive use6

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

– 36 45 – 36 – 33 29 – 31 38

6

HIV/AIDS prevalence2, 7

% adults aged 15–49 (2009) – – – – – – – – – – –

Malaria mortality8

per 100 000 population (2010) – – – – – – – – – – 0

TB treatment9% success rate (2009) – 97 84 88 – – 75 90 83 88 96

7Water10

% using improved sources (2010) – – 94 – 88 100 85 96 100 98 90

Sanitation10

% using improved facilities (2010) 100 – 75 – 65 100 100 98 96 85 57

* LMICs – Low- and middle-income countries

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

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.

6

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

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

Cambodia

China

Lao PDR

Malaysia

Mongolia

Papua New Guinea

Philippines

Solomon Islands

Viet Nam

Vanuatu

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

1989

1996

1990

1993

1990

1992

1983

1990

1993

1996

2011

2010

2006

2006

2005

2005

2008

2007

2008

2007

Earliest data available Latest data available Target

MDG 1 Eradicate extreme poverty and hungerMDG target: Halve, between 1990 and 2015, the proportion of people who suffer from hunger

1

Breast feeding

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

Low birth weight (LBW)

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

Anaemia in women and children

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.

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

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

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

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

6

The nutritional status of children under 5 years has improved.

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

Overweight*

Stunted*

Viet NamVanuatu

TuvaluSolomon Islands

SingaporeSamoa

PhilippinesPapua New Guinea

NauruMongoliaMalaysiaLao PDRKiribati

JapanFiji

ChinaCambodiaAustralia

0 10 20 30 40 50

8.20

40.91.9

9.46.6

4.3

8.32.2

2.934.4

15.947.6

1.317.2

27.55.5

14.224.0

2.843.9

3.432.3

3.3

6.24.4

2.6

6.4

32.82.5

10.0

25.94.7

6.3

30.53.0

�� 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.

7

Viet Nam

Solomon Islands

Philippines

Papua New Guinea

Mongolia

Malaysia

Lao PDR

Fiji

China

Cambodia

2015 Target

1990 baseline

2010

12151

40

48

3017

10

1816

14554

4818

66

10732

36

6190

3059

2920

45

1551

2317

27

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

4

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

≥ 90% coverage

< 90% coverage

Measles immunization reaching:

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

Prematurity 17% Neonatal sepsis 3%

Pneumonia 16% Measles 1%

Birth asphyxia 14% Malaria 0%

Congenital anomalies 12% HIV/AIDS 0%

Injuries 9% Others 22%

Diarrhoea 4%

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

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.

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

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

7

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.

� 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.

� 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.

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.

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.

8

Viet Nam

Solomon Islands

Philippines

Papua New Guinea

Mongolia

Lao PDR

China

Cambodia

0 20 40 60 80 100Contraceptive prevalence rate (%)

35

36

51a

38

51

66

80

85

0

200

400

600

800

1000

1200

1400

1600

1800

Viet NamSolomonIslands

PhilippinesPapuaNew Guinea

MongoliaMalaysiaLao PDRFijiChinaCambodia

2010

20001990

Mat

ern

al m

ort

alit

y ra

tio

830

1600

870

470390

310230

170120 99

15093

240

100 59120

510

250

12061 37 32 31 26 53 39 29

120 96 63

5

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.

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

Figure 7. Contraceptive prevalence rate in LMICs with ≥ 250 000 population in the Western Pacific Region, 2005-2010

≥ 85%60%–85%<60%

Proportion of births attended by skilled health personnel (%)

� 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.

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

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

Source: World Health Statistics 2012

Source: World Health Statistics 2012 a Cambodia Demographic Health Survey 2010

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.

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

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

8

9

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

Malaria mortality and morbidity have been steeply declining since 1990 in

10 endemic countries in the Region.

6

HIV / AIDS

Malaria

Tuberculosis

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

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

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.

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.

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.

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

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

�� Condom use and coverage of preventive interventions for most-at-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.

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

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

201020092005200019951990

Viet Nam

Philippines

Papua New Guinea

Mongolia

Malaysia

Lao PDR

FijiChina

Cambodia

HIV

pre

vale

nce

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

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

10

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

MDG 7 Ensure environmental sustainabilityMDG target: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation

7

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

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

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

8

� 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

0 20 40 60 80 100

Viet Nam

Vanuatu

Tuvalu

Tonga

Samoa

Philippines

Papua New Guinea

Palau

Niue

Nauru

Mongolia

Marshall Islands

Malaysia

Lao PDR

Fiji

Cook Islands

China

Cambodia

RuralUrban

0 20 40 60 80 100

Viet Nam

Vanuatu

Tuvalu

Tonga

Samoa

Philippines

Papua New Guinea

Palau

Niue

Nauru

Mongolia

Marshall Islands

Malaysia

Lao PDR

Fiji

ChinaCook Islands

Cambodia

RuralUrban

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

� 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.

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

10

11

z 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.

z 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.

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

z 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.

z 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.

Improving equity on MDGs

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

Source: UNESCAP, UNDP, ADB. Achieving the Millennium Development Goals in an era of global uncertainty: Asia-Pacific 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].

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

12

Universal health coverage and the Millennium Development Goals

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

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

z Universal coverage requires access to a continuum of integrated people-centred health services at every stage of each individual’s life.

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

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

13

Lack of progress in improving CRVS is “the single most critical development failure over the past 30 years.” —Richard Horton, The Lancet 2007

z 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.

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

z 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.

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

Civil registration and vital statistics (CRVS) underpin MDGs

14

TablesMDG 1 MDG 4 MDG 5

Prevalence of underweight children (%)

Infant mortality rateper 1000 live births

Under-5 mortality rate per 1000 live births

Measles immunization% coverage

Maternal mortality ratio per 100 000 live births

Proportion of births attended by skilled health personnel (%)

Contraceptive prevalence rate (%)

WHO Regions 1983–1999

2005–2011

2015 Target 1990 2010

2015 Target 1990 2010

2015 Target 1990 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

Countries with ≥ 250 000 population 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

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

Countries with < 250 000 population 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 92 220 120 110 … … 74 … 38

15

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 (%)

Proportion of population using improved sanitation facility (%)

National Urban Rural National Urban Rural

WHO Regions1990 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

Countries with ≥ 250 000 population1990 1995 2000 2009 2005 2010 1995 2009 1990 2010

2015 Target 1990 2010 1990 2010 1990 2010

2015 Target 1990 2010 1990 2010

Cambodia 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

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

Solomon Islands … … … … 7.5 2.5 65 88 … … … … … … … … … … 98 98 … …

Viet Nam <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

Countries with < 250 000 population1990 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

Tables

*Data applies to 2000

16

Health MDGs scorecard colour code for the Western Pacific Region

On Track Insufficient Progress Off Track

4Under-5 mortality per 1000 live births

Achieved at least 75% of MDG target


Achieved less than 50% of MDG target

Measles immunization% coverage ≥ 90% < 90% N/A

5

Maternal mortalityper 100 000 live births




Skilled birth attendant% births ≥ 85% 60% – 84% < 60%

Contraceptive use% married women aged 15–49 ≥ 60% 30% – 59% < 30%

6

HIV/AIDS prevalence% adults aged 15–49

WHO Regions:

Decreased or no change between 2000 and 2010



LMICs in WPR:




Malaria mortalityper 100 000 population Significantly decreased High with little change

or decreaseHigh with no change

or increaseTB treatmentsuccess rate % ≥ 85% 70% – 84% < 70%

7Water% using improved sources




Sanitation% using improved facilities




17

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 1993–2005 : WHO global database on anaemia. Geneva, WHO, 2008.

Data sources

achieving the health-related millennium development goals

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