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2015 THE 2014 REPO

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ealth Agenda for Wom

en and Children

Fulfilling the Health Agenda for Women and Children

The 2014 Report

ISBN: 978–92–806–4760–0

© Copyright UNICEF and World Health Organization, 2014.

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Photo credits: cover, © 2010, UNICEF/NIGB2010-00307/Giacomo Pirozzi; page iii, © UNICEF/NYHQ2011-1601/Roger LeMoyne; page iv, © UNICEF/NYHQ2006-2848/Julie Pudlowski; page 2, © UNICEF/SLRA2013-0821/Olivier Asselin; page 4, © UNICEF/BANA2014-00767/Jannatul Mawa; page 5, © UNICEF/MLIA2009-00162/Giacomo Pirozzi; page 13, © UNICEF/UKLA2013-04096/Adam Vardy; page 21, © Graham Crouch/World Bank; 2, © Dominic Chavez/World Bank; Page 24, © Arne Hoel/World Bank; Page 36, © UNICEF/UKLA2014-04749/Karin Schermbrucker; Page 40, © Chhor Sokunthea /World Bank; Page 42, © UNICEF/BANA2013-01079/Shafiqul Alam Kiron; Page 44, © UNICEF/SLRA2013-0148/Olivier Asselin; Page 222, © UNICEF/NYHQ2006-2477/Giacomo Pirozzi.

Editing and layout by Communications Development Incorporated, Washington, DC USA.

Contributors

Lead writers: Jennifer Requejo (PMNCH), Jennifer Bryce (Johns Hopkins University), Cesar Victora (Federal University of Pelotas)

Additional writing team: Adam Deixel (Family Care International), Aluisio Barros (Federal University of Pelotas), Zulfiqar Bhutta (Aga Khan University, SickKids Center for Global Child Health), Blerta Maliqi (WHO), Holly Newby (UNICEF), Joy Lawn (London School of Hygiene and Tropical Medicine, Save the Children)

Profile development team: Tessa Wardlaw (UNICEF), Holly Newby (UNICEF), Archana Dwivedi (UNICEF), Colleen Murray (UNICEF)

Countdown Coordinating Committee: Mickey Chopra (co-chair), Zulfiqar Bhutta (co-chair), Jennifer Bryce, Cesar Victora, Peter Berman, Joy Lawn, Elizabeth Mason, Ann Starrs, Carole Presern, Bernadette Daelmans, Tessa Wardlaw, Holly Newby, Ties Boerma, Andres de Francisco, Laura Laski, Jennifer Requejo, Archana Dwivedi, Nancy Terreri, Lori McDougall, Monica Fox

Production team: Christopher Trott and Elaine Wilson (Communications Development Incorporated), Jennifer Requejo (PMNCH)

Technical Working Groups

Coverage: Jennifer Bryce (co-chair), Holly Newby (co-chair), Archana Dwivedi, Jennifer Requejo, Allisyn Moran, Shams El Arifeen, Jocelyn DeJong, Monica Fox, Sennen Hounton, Doris Chou, Jamie Perin, James Tibanderana, Nancy Terreri, Lara Vaz

Equity: Cesar Victora (co-chair), Ties Boerma (co-chair), Aluisio Barros, Carine Ronsmans, Wendy Graham, Betty Kirkwood, Edilberto Loiaza, Zulfiqar Bhutta, Kate Kerber, Ahmad Hosseinpoor, Alexander Manu, Xing Lin Feng

Financing: Peter Berman (chair), Josephine Borghi, Lara Brearley, Rafael Cortes, Howard Friedman, Daniel Kraushaar, Gemini Mtei, Nebjosa Novcic, Ravi Rannan-Eliya, Nirmala Ravishankar

Health systems and policies: Bernadette Daelmans (co-chair), Joy Lawn (co-chair), Blerta Maliqi, Neha Singh, Lara Brearley, Eleonora Cavagnero, Tim Colbourne, Giorgio Cometto, Andres de Francisco, Kim Dickson, Sennen Hounton, Luis Huicho, Dan Kraushaar, Shyama Kuruvilla, Tiziana Leone, Zoe Matthews, Allisyn Moran, Susan Murray, Jennifer Requejo, Priyanka Saksena, Deb Sitrin, Amani Siyam, Nancy Terreri, Mark Young


The 2014 Report

Fulfilling the Health Agenda for Women and Children The 2014 Reportii

Acknowledgements

Countdown would like to thank the following:

UNICEF/Data and Analytics Section for use of the global databases, preparation of country profiles, and inputs to and review of report text. Particular recognition goes to Danzhen You for help with the child mortality and demographic estimates, Agbessi Amouzou for help with the child and maternal health indicators, Julia Krasevec for help with the nutrition indicators, David Brown for help with immunization estimates, Robert Bain for help with the water and sanitation indicators, Priscilla Idele for help with the HIV/AIDS indicators and Colleen Murray for help with the databases.

Siddha Development Research and Consultancy for its work in generating the profiles.

Johns Hopkins University colleagues Lois Park and Elizabeth Hazel for their inputs to the coverage analyses.

Federal University of Pelotas colleagues Maria Clara Restrepo, Giovanny Araújo França, Fernando Wehrmeister, Kerry Wong, Leonardo Ferreira and Luis Paulo Vidaletti for their inputs to the equity analyses.

Jo Borghi from the London School of Hygiene and Tropical Medicine for her analysis of the official development assistance data. Ravindra P Ranna-Eliya from the Institute for Health Policy, Sri Lanka, for his inputs to the catastrophic expenditure box. Priyanka Saksena from WHO for her inputs to the analysis of the financing data.

Thierry Lambrechts, Dilip Thandassery and Matthews Mathai from WHO for providing health systems and policy data based on the MCA survey. Annabel Lim and Rufus Ferrabee from WHO for their inputs to the analysis of the health systems and policies data.

The Partnership for Maternal, Newborn & Child Health for hosting the Countdown Secretariat

and for convening meetings and teleconferences for Countdown. Particular recognition goes to Nacer Tarif and Nick Green for providing administrative support.

American University of Beirut colleagues Hiam El Zein and Jocelyn DeJong for preparing a draft of the panel on conflict, including the material on Syria. Nadia Askeer and Zulfiqar Bhutta from the Centre for Global Child Health Hospital for Sick Children, Toronto, and the Aga Khan University and Taufiq Mashal from the Afghanistan Ministry of Public Health for their inputs to the Afghanistan text in the conflict panel.

Matthew Matthais, Elizabeth Mason, Dilip Thandas-sery, Thierry Lambrechts and Kathryn O’Neill from WHO for their inputs to the quality of care panel.

Shams El Arifeen and Peter Kim Streatfield from ICDDR, B for their contributions to the Bangladesh example in the family planning panel.

Robert Black and Li Liu at Johns Hopkins University for their inputs into the nutrition and cause of child death text.

Lale Say and Doris Chou for their inputs to the maternal mortality section.

Tiziana Leone from London School of Economics and Iqbal Shah for their inputs to the analysis of the legal status of abortion data.

Luc de Bernis from UNFPA and Petra ten Hoope-Bender from Integrare for inputs to the human resources box focused on midwifery care.

Family Care International for help with developing Countdown’s key advocacy messages.

The Bill & Melinda Gates Foundation, the World Bank, and the governments of Australia, Canada, Norway, Sweden, the United States and the United Kingdom for their support for Countdown to 2015.

Fulfilling the Health Agenda for Women and Children The 2014 Report iii

Countdown headlines for 2014 1

Introduction: unfinished business, achievable goals 3

Countdown: The 2014 Report 5

Progress towards Millennium Development Goals 4 and 5 6

Nutrition: a building block for progress 11

Coverage along the continuum of care 14

Equity: no women and children left behind 22

Determinants of coverage and equity—policies, systems and financing 26

Data revolution and evolution: the foundation for accountability and progress 37

The Countdown process—what we have learned so far 41

Countdown speaks: priorities for the next 500 days and beyond 43

Country profiles 45

The Countdown country profile: a tool for action 46

Annex A About Countdown to 2015 for Maternal, Newborn and Child Survival 198

Annex B Summary of Countdown data sources and analysis methods 200

Annex C Country profile indicators and data sources, organized by order of presentation in the profile 202

Annex D Definitions of Countdown coverage indicators 206

Annex E Definitions of health policies, systems and finance indicators 208

Annex F Technical annex for the Health Systems and Policies Technical Working Group and the Financing Technical Working Group 210

Annex G Countdown countries prioritized for malaria intervention coverage analysis 214

Annex H Details on estimates produced by interagency groups used in the Countdown report—mortality, immunization, and water and sanitation 215

Notes 217

References 218

Contents

Fulfilling the Health Agenda for Women and Children The 2014 Report 1

Countdown headlines for 2014

Real progress has been achieved.

• The median annual rate of reduction in under-5 mortality in the Countdown countries doubled over 2000–2012 compared with 1990–2000, and child deaths have been almost halved since 1990.

• Three-quarters of Countdown countries reduced maternal mortality faster in 2000–2013 than in the 1990s.

• Median national coverage is 75% or higher for several key interventions (at least one antenatal care visit with skilled health personnel, vitamin A supplementation, immunizations and improved source for drinking water).

• Rapid advances in coverage for malaria interventions show the impact of advocacy, investment and sustained effort and provide a model (and a challenge) for lagging interventions.

• High coverage has been reached among the wealthy populations in many Countdown countries. Similar levels can be achieved across the whole population. Countries that have closed the equity gap provide a model of success.

• Countdown countries continue to expand adoption of key policies that support improved coverage and quality of reproductive, maternal, newborn and child health interventions.

• Total per capita health expenditure in the Countdown countries grew more than 10% between 2010 and 2012.

• More than 75% of Countdown countries conducted a nationally representative household survey between 2008 and 2012. Before 2000 few countries had survey data available.

But substantial business remains unfinished.

• Fewer than half of Countdown countries will achieve Millennium Development Goal (MDG) 4, and very few will achieve MDG 5.

• Half of Countdown countries still have a high maternal mortality ratio (300–499 deaths per 100,000 live births), and 16 countries—all of them in Africa—have a very high maternal mortality ratio (500 or more deaths per 100,000 live births).

• Progress in reducing preventable newborn deaths is much slower than progress in reducing deaths among children under age 5 in many Countdown countries. Most newborn deaths occur on the day of birth from intrapartum events, infections or preterm birth complications.

• Preventable and treatable infectious diseases such as pneumonia and diarrhoea remain the leading causes of child deaths, and coverage of treatment interventions remains low in most Countdown countries.

• Nearly half of child deaths are attributable to undernutrition. In 42 of the 62 Countdown countries with available data, more than 30% of children are stunted. Poor nutrition also harms women’s health and increases women’s risk of experiencing a stillbirth or delivering a low-birthweight baby.

• Severe health workforce shortages limit countries’ ability to provide high-quality care to women and children. Only seven Countdown countries report having enough skilled health professionals to achieve high coverage of essential interventions.

• Not one Countdown country has adopted all 10 “tracer” policies that support delivery of proven

Fulfilling the Health Agenda for Women and Children The 2014 Report2

interventions across the reproductive, maternal, newborn and child health continuum of care.

• Official development assistance for maternal, newborn and child health in the Countdown countries decreased slightly between 2010 and 2011, driven by a 3% reduction in child health aid. Official development assistance for family planning grew substantially in 2011 but remains low. The amount of aid varies widely across countries and is not always proportional to need.

• Only eight Countdown countries reported recent data on all coverage indicators recommended by the Commission on Information and Accountability for Women’s and Children’s Health. Half of Countdown countries reported new data from 2011–2012 on only one recommended indicator.

Inequities—between and within countries—mean that too many women and children are being left behind.

• Even for interventions with high coverage in most Countdown countries, such as immunizations, some countries reach less than half of their population of women and children.

• Across Countdown countries coverage for key interventions along the continuum of care is much higher for the wealthy than for the poor. Stunting is, on average, 2.5 times higher among poor children than among children from wealthier families.

Concerted, emphatic action is needed now to save lives and accelerate progress.

• The next 18 months are critical for accelerating progress towards the MDG targets and for

ensuring that work to achieve the next set of goals begins right now.

• Sustainable development requires intensified support to countries that do not achieve the health MDGs and continued effort by and with countries that have.

• Action on improving nutrition and coverage of effective interventions for all population groups in order to end preventable maternal and child deaths must not wait for the post-2015 targets to be finalized. These goals are crucial to any global agenda, and delays in pursuing them are unacceptable and unconscionable.

• Increasing access to high-quality, skilled care around the time of birth will reduce maternal deaths, stillbirths and newborn deaths. Investment in water and sanitation programmes and strategies to increase coverage of treatment interventions for pneumonia and diarrhoea will help end the huge toll of deaths from these two leading killers of children.

• Greater efforts are needed to help countries facing rapid population growth develop innovative approaches, including plans to increase health workforce production, deployment and retention, in order to reach all women and children with essential services.

• We must all act to protect families, women and children from the destructive health impact of war and civil conflict and to help countries rebuild once conflict subsides.

• Countries and their partners must invest in collecting and reporting health data that are fit for purpose, reliable, representative, timely and able to be disaggregated for subnational equity analyses.


Introduction: unfinished business, achievable goals

At the dawn of this new century, the countries of the world agreed on a set of Millennium Development Goals (MDGs)—ambitious and inspired statements of our global commitment to end extreme poverty and meet the needs of the world’s poorest. Improving women’s and children’s health and well-being—and in particular dramatically reducing millions of their preventable and needless deaths—stood at the centre of the framework, as the fourth and fifth of the eight MDGs. The deadline for achieving the goals was set for the end of 2015—exactly 18 months from today.

When that deadline arrives, we will not have achieved the goals related to maternal and child health. Fewer than half of the 75 Countdown countries are likely to have succeeded in reducing child mortality by two-thirds from 1990 levels (MDG Target 4.A), only a small fraction will have cut maternal death by three-quarters (MDG Target 5.A), and we will still be far from ensuring universal access to reproductive health (MDG Target 5.B).

This report highlights important progress in many countries and on many pressing health challenges. At the global level, over the 25-year measurement span of the MDGs, maternal and child deaths will have been almost halved. Dramatic progress on HIV interventions, vaccinations and distribution of insecticide-treated nets will have demonstrated the compelling power of high-level commitment, plentiful and consistent funding, and a focus on evidence-based programming to effect dramatic, life-saving change.

The end of 2015 will inaugurate a new era in global health. We will enter that new era with unfinished business that can and must be addressed. As we move forward, setting new goals and establishing new accountability structures, we must renew and redouble our efforts in key areas where progress has been slowest:

• Meeting the vast unmet need for contraception, so that women and families can better control their fertility and their lives.

• Ensuring that there are enough adequately trained health care workers equipped with the supplies needed to provide high-quality care before, during and after pregnancy to make pregnancy and childbirth safer for both mother and baby.

• Improving maternal and newborn survival, including reducing preterm births and stillbirths, by investing in care on the day of birth when the risk of mortality is highest.

• Addressing the infectious diseases, especially pneumonia and diarrhoea, that needlessly kill millions of children because they do not have access to effective treatments, appropriate nutrition, safe water and adequate sanitation facilities.

• Confronting the huge burden of undernutrition that retards both the growth and the life opportunities of far too many children and adolescents in the majority of Countdown countries, where more than 30% of children are stunted.

Underlying each of these issues is the harsh reality of many millions of women and children who are being left behind. Overcoming the huge inequities in access to high-quality health care is fundamental to success or failure in meeting the health targets—both pre- and post-2015—that we set for ourselves. Succeeding “on average” too often means failing to reach millions of poor and other disadvantaged women, children and families. Focused, evidence-based health policies and programmes must be targeted to the unreached. The task in front of us is not just about easy wins or low-hanging fruit. It is about the hard work of fulfilling every woman’s and child’s fundamental right to the highest attainable standard of health.


Today, countries, their development partners and advocates are hard at work building consensus around a new set of objectives, with targets set a generation away. But we have not yet reached the end of 2015. Over the next 18 months we must use available data to drive emphatic, concerted action and sprint to the MDG finish line. A child dies every five seconds; a woman dies in pregnancy or childbirth every two minutes. Our efforts, right now, will save lives today and tomorrow, not just in 10 or 20 years. And a strong and determined run up to 2015 will put countries on a path to success in achieving the next set of goals and making life better for women and children everywhere.

Economic development is a central focus of emerging accountability frameworks. But economic growth will not, on its own, result in lifesaving health care for all. It must be coupled with a core focus on health. Addressing pressing health challenges—in countries that often face a complex mix of climate change, population growth, civil conflict, gender discrimination, high HIV prevalence and other issues—is one of the most effective ways of building human capital and enabling equitable, sustainable economic development.

We face a unique challenge, a compelling opportunity and a pressing obligation to end the heavy toll of millions of preventable women’s and children’s deaths. We can achieve this, but it will not happen on its own. We, as Countdown,

challenge ourselves and the global reproductive, maternal, newborn and child health community to make the remaining days in the MDG era and the years beyond 2015 count for women and children. There must be continued, even increased, accelerations in coverage for life-saving interventions and in improving nutrition and making family planning universally available. Coverage must be more equitable. And there must be greater commitment to data evolution that results in more and better data and data use for improving programmes.

These targets do not need to wait for validation through the language of the sustainable development goals—they are a necessary part of any global agenda, and delays are unconscionable. Without consistent commitment and collaborative efforts, built on a strong foundation of evidence, the next generation of women and children will be saddled with the same crippling burden of illness and loss that we face today. Every country can improve women’s and children’s health and reduce preventable deaths. Countdown will continue to track progress towards these immutable targets at the country level and will hold fast to the principle of accountability by all for the health and development of women and children. With this report, Countdown begins the next stage of its work, enabling that progress by spotlighting the successes, the gaps, the programmatic innovations, the inequities and the lessons learned along the way.


Countdown: The 2014 Report

Countdown to 2015 is a global movement to track, stimulate and support country progress towards the health-related Millennium Development Goals, particularly goals 4 (reduce child mortality) and 5 (improve maternal health). Established in 2003 by the Bellagio Study Group on Child Survival,1 Countdown is supra-institutional and includes academics, governments, international agencies, professional associations, donors, nongovernmental organizations and other members of civil society, with The Lancet as a key partner. Countdown focuses specifically on tracking coverage of a set of evidence-based interventions proven to reduce maternal, newborn and child mortality in the 75 countries where more than 95% of maternal and child deaths occur.

Countdown produces periodic publications, reports and other materials on key aspects of reproductive, maternal, newborn and child health, using data to hold stakeholders to account for global and national action. At the core of Countdown reporting are country profiles that present current evidence to assess country progress in improving reproductive, maternal, newborn and child health. The two-page profiles in this report are updated every two years and

include key demographic, nutritional status and mortality statistics; coverage levels and trends for proven reproductive, maternal, newborn and child health interventions; and policy, health system, financial and equity indicators. Countdown also prepares one-page versions of the profiles showcasing the priority indicators defined by the Commission on Information and Accountability for Women’s and Children’s Health and equity-specific profiles for each of the 75 priority countries. More information on Countdown data sources and methods are included in annexes B–H and at www.countdown2015mnch.org.

This report begins with a summary of Countdown results for 2014 based on the data presented in the country profiles. Progress has been impressive in some areas, but unfinished business remains that must be prioritized in the post-2015 framework. The report then assesses the state of the data to support evidence-based decisions in women’s and children’s health. From there it goes on to describe elements of the Countdown process that might inform ongoing efforts to hold the world to account for progress. And finally the report lists concrete action steps that can be taken now to ensure continued progress for women and children in the years ahead.


Improving maternal, newborn and child survival in the Countdown countries depends on our ability to work together effectively to reach women and children with essential interventions. Trends in maternal, newborn and child mortality and undernutrition are the bottom line for assessing the impact of global and country efforts to increase equitable coverage of interventions across the reproductive, maternal, newborn and child health continuum of care. This section reviews progress in the 75 countries towards the mortality targets for Millennium Development Goals (MDGs) 4 and 5 and in addressing undernutrition.

Progress in reducing mortality is accelerating—but not fast enough!

Child mortality in Countdown countries has declined substantially since 1990, paralleling a global drop from 12.6 million under-5 deaths in 1990 to 6.6 million in 2012.2 The median annual rate of reduction in under-5 mortality has increased in Countdown countries from 1.9% between 1990 and 1999 to 3.8% over 2000–2012 (table 1). But to achieve MDG 4, an annual rate of reduction of at least 4.4% over 1990–2015 was required, which few Countdown countries were able to reach and maintain. Only a minority of Countdown countries are on track to achieve MDG 4.3 However, 29 of the 75 Countdown countries achieved this high pace of progress over 2000–2012, an encouraging sign of what is possible.4 Approximately 18,000 children globally still die every day, the vast majority among disadvantaged population groups in Countdown countries.5 The leading causes of post-neonatal child deaths remain preventable infectious diseases—pneumonia, diarrhoea and malaria.6 Programmes that target these diseases need greater prioritization and sustained commitment.

Slower progress has been achieved in reducing newborn mortality, so the percentage of child deaths that occur in the first four weeks of life is rising. The median share of newborn deaths

among under-5 deaths in Countdown countries is 39%, with a low of 26% in Niger and a high of 64% in Brazil (see table 1). Countdown countries that have rapidly reduced child mortality, such as Brazil, tend to show a growing proportion of deaths in the newborn period. The three leading causes of newborn deaths are intrapartum events, complications of preterm birth and sepsis,7 all of which can be significantly reduced through increased investment in the quality of care around the time of birth. Such investments can also reduce the staggering number of stillbirths each year (around 2.6 million), more than 90% of which occur in the Countdown countries.8

Progress towards the maternal mortality target of MDG 5—reducing maternal mortality by three-quarters between 1990 and 2015—has been slower and is harder to measure than progress towards MDG 4. Very few Countdown countries will achieve MDG 5.9 The median annual rate of reduction in the 75 Countdown countries over 2000–2013 is 3.1%, with a low of –0.5% in Côte d’Ivoire (where the maternal mortality ratio actually increased) and a high of 8.6% in Rwanda (table 2). It is very good news that 56 Countdown countries saw maternal mortality decline faster over 2000–2013 than in the 1990s and that over 2000–2013, 11 countries saw an annual rate of reduction of 5.5% or higher—the rate needed over 1990–2015 to meet the MDG target.

However, the annual rate of reduction was less than 1% in four Countdown countries over the past decade, and 16 countries—all in Sub- Saharan Africa—still have a very high maternal mortality ratio (500 or more deaths per 100,000 live births). The median lifetime risk of a maternal death is 1 in 66 in the Countdown countries, with a low of 1 in 1,800 in Azerbaijan and China and a high of 1 in 15 in Chad. In comparison, the likelihood that an adult woman will die from maternal causes is 1 in 3,400 in high-income countries.10 The majority of maternal deaths occur during the intrapartum and immediate postpartum periods from preventable causes such

Progress towards Millennium Development Goals 4 and 5


(continued)

Country

Under-five mortality rate Share of under-5 deaths occurring in neonatal period (%)

Deaths per 1,000 live births

Average annual rate of reduction (%)

1990 2000 2012 1990–2012 1990–2000 2000–2012 2012

Rwanda 151 182 55 4.6 –1.9 10.0 39

Cambodia 116 111 40 4.9 0.5 8.5 47

China 54 37 14 6.1 3.8 8.1 61

Malawi 244 174 71 5.6 3.4 7.5 34

United Republic of Tanzania 166 132 54 5.1 2.3 7.4 40

Liberia 248 176 75 5.4 3.4 7.1 36

Senegal 142 139 60 3.9 0.2 7.1 42

Brazil 62 33 14 6.6 6.2 6.9 64

Peru 79 40 18 6.7 6.9 6.5 51

Egypt 86 45 21 6.4 6.4 6.4 56

Bangladesh 144 88 41 5.7 4.9 6.4 60

Ethiopia 204 146 68 5.0 3.4 6.3 43

Uganda 178 147 69 4.3 1.9 6.3 33

Democratic People’s Republic of Korea 44 60 29 1.9 –3.2 6.1 54

Azerbaijan 93 72 35 4.4 2.5 6.0 43

Niger 326 227 114 4.8 3.6 5.8 26

Nepal 142 82 42 5.6 5.5 5.7 57

Zambia 192 169 89 3.5 1.3 5.4 34

Bolivia (Plurinational State of) 123 78 41 5.0 4.6 5.3 46

Madagascar 159 109 58 4.6 3.8 5.2 38

Kyrgyzstan 71 50 27 4.4 3.5 5.2 54

Mozambique 233 166 90 4.3 3.4 5.1 34

Burkina Faso 202 186 102 3.1 0.8 5.0 27

South Sudan 251 181 104 4.0 3.3 4.6 35

Eritrea 150 89 52 4.8 5.2 4.5 36

Mali 253 220 128 3.1 1.4 4.5 33

Indonesia 84 52 31 4.5 4.7 4.4 48

Guinea 241 171 101 3.9 3.4 4.4 34

Lao People’s Democratic Republic 163 120 72 3.7 3.1 4.3 38

Benin 181 147 90 3.2 2.0 4.2 31

South Africa 61 74 45 1.4 –2.0 4.2 34

São Tomé and Príncipe 104 87 53 3.0 1.8 4.1 38

Morocco 80 50 31 4.3 4.6 4.0 59

India 126 92 56 3.6 3.2 4.0 55

Yemen 125 97 60 3.3 2.5 4.0 45

Gambia 170 116 73 3.8 3.8 3.9 40

Botswana 48 85 53 –0.5 –5.8 3.9 54

Guatemala 80 51 32 4.2 4.6 3.8 48

Cameroon 135 150 95 1.6 –1.1 3.8 30

Mexico 46 25 16 4.8 6.0 3.7 44

Uzbekistan 74 61 40 2.8 1.8 3.7 34

Tajikistan 105 91 58 2.7 1.4 3.7 40

Nigeria 213 188 124 2.5 1.2 3.5 32

Kenya 98 110 73 1.4 –1.2 3.5 37

Swaziland 71 121 80 –0.5 –5.4 3.5 37

Myanmar 106 79 52 3.2 3.0 3.4 51

Turkmenistan 90 79 53 2.4 1.4 3.3 41

Sudan 128 106 73 2.6 1.9 3.1 39

Ghana 128 103 72 2.6 2.1 3.0 40

Burundi 164 150 104 2.1 0.9 3.0 35

TABLE 1 Trends in child mortality in the 75 Countdown countries, by average annual rate of reduction, 2000–2012


Source: UN Inter-agency Group for Child Mortality Estimation 2013.

Country

Under-five mortality rate Share of under-5 deaths occurring in neonatal period (%)

Deaths per 1,000 live births

Average annual rate of reduction (%)

1990 2000 2012 1990–2012 1990–2000 2000–2012 2012

Equatorial Guinea 182 143 100 2.7 2.4 2.9 34

Haiti 144 105 76 2.9 3.2 2.7 34

Gabon 92 86 62 1.8 0.7 2.7 41

Viet Nam 51 32 23 3.6 4.7 2.6 53

Afghanistan 176 134 99 2.6 2.7 2.6 36

Philippines 59 40 30 3.1 3.7 2.5 47

Guinea-Bissau 206 174 129 2.1 1.7 2.5 36

Côte d’Ivoire 152 145 108 1.6 0.4 2.5 38

Djibouti 119 108 81 1.8 1.0 2.4 39

Mauritania 128 111 84 1.9 1.5 2.3 40

Pakistan 138 112 86 2.2 2.1 2.2 50

Iraq 53 45 34 2.0 1.7 2.2 56

Sierra Leone 257 234 182 1.6 0.9 2.1 27

Comoros 124 99 78 2.1 2.2 2.0 40

Togo 143 122 96 1.8 1.6 2.0 35

Central African Republic 171 164 129 1.3 0.4 2.0 32

Papua New Guinea 89 79 63 1.6 1.3 1.9 39

Chad 209 189 150 1.5 1.0 1.9 27

Angola 213 203 164 1.2 0.5 1.8 28

Congo 100 118 96 0.2 –1.7 1.7 34

Democratic Republic of the Congo 171 171 146 0.7 0.0 1.3 30

Somalia 177 171 147 0.8 0.4 1.2 31

Lesotho 85 114 100 –0.7 –3.0 1.1 46

Zimbabwe 74 102 90 – 0.9 –3.2 1.1 44

Solomon Islands 39 35 31 1.0 1.0 0.9 44

TABLE 1 (CONTINUED) Trends in child mortality in the 75 Countdown countries, by average annual rate of reduction, 2000–2012

as haemorrhage, pre-eclampsia or eclampsia, and infection.11 Unsafe abortion also exacts a high toll of avoidable maternal deaths in the Countdown countries (box 1). Most maternal deaths can be averted by implementing programmes and policies

that support women’s access to affordable and high-quality family planning, antenatal, delivery and postnatal care. Progress and gaps in intervention coverage across the Countdown countries are reviewed in the next section.


(continued)

Country

Maternal mortality ratioDeaths per 100,000

live birthsAverage annual

rate of reduction (%)1990 2000 2013 1990–2013 1990–2000 2000–2013

Rwanda 1,400 1,000 320 6.1 2.8 8.6

Cambodia 1,200 540 170 8.1 7.7 8.4

Lao People's Democratic Republic 1,100 600 220 6.8 6.1 7.4

Equatorial Guinea 1,600 790 290 7.0 6.6 7.4

Afghanistan 1,200 1,100 400 4.7 1.4 7.2

Ethiopia 1,400 990 420 5.0 3.1 6.4

Angola 1,400 1,100 460 4.9 2.9 6.4

Nepal 790 430 190 6.0 5.8 6.1

Azerbaijan 60 57 26 3.6 0.4 6.0

Botswana 360 390 170 3.1 –0.7 6.0

Zambia 580 610 280 3.1 –0.5 5.7

Bangladesh 550 340 170 5.0 4.6 5.4

Sierra Leone 2,300 2,200 1,100 3.3 0.7 5.3

Tajikistan 68 89 44 1.9 –2.6 5.3

China 97 63 32 4.7 4.2 5.1

United Republic of Tanzania 910 770 410 3.5 1.7 4.8

India 560 370 190 4.5 4.1 4.7

Mozambique 1,300 870 480 4.3 4.1 4.5

Myanmar 580 360 200 4.5 4.7 4.3

Uganda 780 650 360 3.2 1.9 4.3

Eritrea 1,700 670 380 6.2 8.7 4.2

Peru 250 160 89 4.4 4.6 4.2

Liberia 1,200 1,100 640 2.8 1.2 4.0

South Sudan 1,800 1,200 730 3.8 3.6 4.0

Nigeria 1,200 950 560 3.1 2.0 4.0

Viet Nam 140 82 49 4.4 4.9 3.9

Swaziland 550 520 310 2.5 0.6 3.9

Morocco 310 200 120 4.1 4.3 3.9

Egypt 120 75 45 4.1 4.4 3.8

Indonesia 430 310 190 3.5 3.2 3.8

Pakistan 400 280 170 3.6 3.3 3.7

Bolivia (Plurinational State of) 510 330 200 4.0 4.5 3.6

Solomon Islands 320 210 130 3.8 4.1 3.6

Djibouti 400 360 230 2.4 1.2 3.4

Mali 1,100 860 550 3.1 2.7 3.4

Papua New Guinea 470 340 220 3.3 3.2 3.4

Chad 1,700 1,500 980 2.3 1.0 3.2

Sudan 720 540 360 3.0 2.8 3.1

Guinea-Bissau 930 840 560 2.2 1.0 3.1

Mauritania 630 480 320 2.9 2.6 3.1

Senegal 530 480 320 2.2 1.1 3.0

Democratic Republic of the Congo 1,000 1,100 730 1.5 –0.5 3.0

Ghana 760 570 380 2.9 2.8 3.0

Congo 670 610 410 2.1 1.0 3.0

Guinea 1,100 950 650 2.2 1.2 2.9

Burkina Faso 770 580 400 2.9 2.8 2.9

Malawi 1,100 750 510 3.2 3.7 2.8

Zimbabwe 520 680 470 0.4 –2.7 2.8

Benin 600 490 340 2.4 2.0 2.7

TABLE 2 Trends in maternal mortality in the 75 Countdown countries, by average annual rate of reduction, 2000–2013


Source: Countdown estimates based United Nations Population Division database (http://esa.un.org/poppolicy/about_database.aspx, accessed January 2014).

About 22 million unsafe abortions occur each year, resulting in thousands of preventable maternal deaths and numerous women left with permanent disabilities.1 Three-quarters of these unsafe abortions, the vast majority of which occur in developing countries, could be averted through improved access to family planning services. Provision of safe abortion services (to the extent allowed by law) and post-abortion care in countries where safe abortion is legally restricted are also important measures for reducing unnecessary deaths and other complications. Of the 74 Countdown countries with data for 2013, 30 have legislation permitting abortion only to save a

woman’s life, 4 have legislation permitting abortion to preserve physical health, 26 have legislation permitting abortion to preserve mental or physical health, 2 have legislation permitting abortion for economic or social reasons as well as to preserve a woman’s health and survival and 12 have legislation permitting abortion on request. Four countries also have legislation allowing abortion in cases of rape or incest, 3 in cases of foetal impairment and 25 in cases of rape, incest or foetal impairment.

Notes1. WHO 2011.

BOX 1 Preventing unsafe abortion

Source: Maternal Mortality Estimation Inter-agency Group (World Health Organization, United Nations Children’s Fund, United Nations Population Fund,

United Nations Population Division and World Bank) 2014.

Country

Maternal mortality ratioDeaths per 100,000

live birthsAverage annual

rate of reduction (%)1990 2000 2013 1990–2013 1990–2000 2000–2013

Kenya 490 570 400 0.8 –1.6 2.7

São Tomé and Príncipe 410 300 210 2.8 3.1 2.6

Democratic People's Republic of Korea 85 120 87 –0.1 –3.8 2.6

Somalia 1,300 1,200 850 1.8 0.8 2.5

Lesotho 720 680 490 1.7 0.6 2.5

Comoros 630 480 350 2.6 2.6 2.5

Mexico 88 67 49 2.5 2.7 2.4

Gabon 380 330 240 2.0 1.4 2.4

Burundi 1,300 1,000 740 2.3 2.1 2.4

Yemen 460 370 270 2.3 2.2 2.3

Niger 1,000 850 630 2.0 1.6 2.3

Kyrgyzstan 85 100 75 0.5 –1.8 2.2

Uzbekistan 66 48 36 2.6 3.0 2.2

Central African Republic 1,200 1,200 880 1.3 0.2 2.2

Haiti 670 510 380 2.4 2.6 2.2

Gambia 710 580 430 2.1 2.1 2.2

Turkmenistan 66 81 61 0.3 –2.1 2.1

Togo 660 580 450 1.6 1.2 1.9

Cameroon 720 740 590 0.9 –0.4 1.8

Madagascar 740 550 440 2.3 3.0 1.7

Brazil 120 85 69 2.4 3.3 1.7

Guatemala 270 160 140 2.8 4.8 1.3

South Africa 150 150 140 0.4 –0.2 0.9

Iraq 110 71 67 2.0 4.1 0.4

Philippines 110 120 120 –0.6 –1.2 –0.2

Côte d’Ivoire 740 670 720 0.1 1.0 –0.5

TABLE 2 (CONTINUED) Trends in maternal mortality in the 75 Countdown countries, by average annual rate of reduction, 2000–2013


Nutrition: a building block for progress

Millennium Development Goal Target 1.C includes a focus on child undernutrition as an indicator for monitoring progress in eradicating poverty. The importance of ensuring good nutrition from adolescence through pregnancy and early childhood is being increasingly recognized as a priority for sustainable development.12 Poor nutrition status harms a woman’s own health and is a risk factor for intrauterine growth restriction and other poor obstetrical outcomes.13 Nearly half of all deaths among children under age 5—or about 3 million deaths a year—are attributable to undernutrition.14

Wasting (low weight for height) affects at least 52 million children globally.15 It indicates acute food shortage or disease, and it sharply increases a young child’s risk of death. The median prevalence of wasting in the 61 Countdown countries with available data is 7%, with a low of 1% in Peru and a high of 23% in South Sudan. Childhood wasting prevalence exceeds 5%—the threshold set by the World Health Assembly in 2013 for countries to achieve by 202516—in 41 of these countries.

Stunting (inadequate length and height for age) is the most sensitive indicator of the quality of a child’s life. Stunting reflects insufficient or low quality diets, poor child care or infection.17 In 42 of the 62 Countdown countries with available data, 30% or more of children are stunted (figure 1).

Stunting is highly concentrated among the poor. On average across the Countdown countries, stunting prevalence is 2.5 times higher among the poorest wealth quintile than among the richest (figure 2). Stunting also tends to be more common in rural areas, in disadvantaged population groups and among boys.18

Addressing high prevalence of wasting and stunting requires a comprehensive approach

that includes nutrition-specific interventions for women and children, multisectoral efforts to combat food insecurity and improve women’s low social status, and increased access to safe water and sanitation facilities.19 Efforts to improve maternal and child nutrition, especially among those who are not now being reached, must be massively intensified to achieve the global target of reducing stunting prevalence 40% by 2025, set by the World Health Assembly in 2013.20 Recognition of the crucial role nutrition plays in child health and development, long-term health outcomes, human capital development and economic productivity has seen a welcome expansion in recent years (box 2).

FIGURE 1 In 42 of the 62 Countdown countries with available data, 30% or more of children are stunted

Source: United Nations Children’s Fund global databases, April 2014,

based on Demographic and Health Surveys, Multiple Indicator Cluster

Surveys and other national surveys.

0

5

10

15

20

25

50%or more

40%–49%

30%–39%

20%–29%

9%–19%

Lessthan 9%

Number of Countdown countries

Minimum: 9% (China)Median: 33%Maximum: 58%(Burundi)

Prevalence of stunting among children under age 5, 2008–2012


FIGURE 2 On average across the Countdown countries, stunting prevalence is 2.5 times higher among the poorest wealth quintile than among the richest

Source: Demographic and Health Surveys and Multiple Indicator Cluster Surveys.

0 10 20 30 40 50 60 70 80

Madagascar (DHS 2008)

Egypt (DHS 2008)

Iraq (MICS 2011)

Zimbabwe (DHS 2010)

Niger (DHS 2012)

Uganda (DHS 2011)

Tajikistan (DHS 2012)

Sierra Leone (MICS 2010)

Central African Rep. (MICS 2010)

Ethiopia (DHS 2011)

Afghanistan (MICS 2010)

Congo, Dem. Rep. (MICS 2010)

Tanzania (DHS 2010)

Malawi (DHS 2010)

Burkina Faso (DHS 2010)

São Tomé and Príncipe (DHS 2008)

Lesotho (DHS 2009)

Kenya (DHS 2008)

Senegal (DHS 2010)

Ghana (MICS 2011)

Gabon (DHS 2012)

Haiti (DHS 2012)

Burundi (DHS 2010)

Mozambique (DHS 2011)

Côte d’Ivoire (DHS 2011)

Congo (DHS 2011)

Swaziland (MICS 2010)

Cambodia (DHS 2010)

Rwanda (DHS 2010)

Bangladesh (DHS 2011)

Togo (MICS 2010)

Nepal (DHS 2011)

Viet Nam (MICS 2010)

Cameroon (DHS 2011)

Pakistan (DHS 2012)

Peru (DHS 2012)

Bolivia (DHS 2008)

Lao PDR (MICS 2011)

Nigeria (MICS 2011)

Prevalence of stunting among children under age 5, wealthiest and poorest quintiles, various years (%)

Poorest quintile

Wealthiest quintile


Good nutrition during the “first 1,000 days”—from the beginning of pregnancy to a child’s second birthday—is essential for ensuring a healthy start in life and avoiding early morbidity and mortality.1 It has also been long recognized that insults and illnesses in early life can cause chronic conditions that last into adulthood. Examples include cerebral palsy as a result of birth hypoxia, paralysis as a consequence of polio, deformities from congenital syphilis and chronic obstructive pulmonary diseases caused by frequent lower respiratory infections in childhood. Recent evidence reveals that the long-term consequences of poor health and undernutrition in early life go well beyond the specific effects of particular conditions.

The first 1,000 days play an important role in the development of several noncommunicable diseases among adults, including diabetes, obesity, hypertension and other cardiovascular diagnoses.2 They also represent a critical window for the acquisition of human capital, which includes adult height and lean body mass, performance on intelligence tests and school achievement, economic productivity and reproductive performance.3 Children who are undernourished are more likely to experience poor cognitive development and lower academic achievement. When combined with the shorter stature of adults who were malnourished in early life, poor cognitive development reduces earning potential after entry into the workforce. Girls who are undernourished are also at elevated risk of later entering pregnancy with short stature and low body mass index, increasing the likelihood they will

deliver a low-birthweight baby, perpetuating an insidious cycle that entrenches families in poverty.4 Suboptimal breastfeeding practices are a major contributor to the risk of infectious diseases and may influence adult health, nutrition status and intelligence.5

With the emerging evidence of the importance of preconception care and adolescent nutrition for reproductive health and outcomes, other windows of opportunity for intervention along the life course have become evident,6 but the importance of the first 1,000 days remains unparalleled.

Countdown monitors intervention coverage during pregnancy, the perinatal period and the first years of the child’s life (see figure 3 in the main report). Access to these interventions is important not only for short-term survival, but also for reducing morbidity and ensuring optimal nutrition. The recognition of this crucial 1,000-day window of opportunity connects the short-term benefits of these interventions with their long-term effects on health and human capital, thus linking the child survival agenda with the broader agenda of economic and social development.

Notes1. Black and others 2013; UNICEF 2013a.

2. UNICEF 2013a.

3. Victora 2008.

4. Victora 2008.

5. Horta and Victora 2013.

6. Bhutta and others 2013a.

BOX 2 The first 1,000 days: How interventions in early life can improve adult health and human capital


This section presents levels and trends in the Countdown coverage indicators, including measures of equity in coverage. Coverage refers to the proportion of a population in need of an intervention that actually receives it. Intervention coverage is closely related to maternal, newborn and child survival and nutrition. Increases in coverage suggest that countries are successfully implementing effective reproductive, maternal, newborn and child health policies and programmes; failure to increase coverage is a cause for urgent concern.

Countries with high coverage of a basket of key interventions, as measured by the Composite Coverage Index,21 tend to have lower child mortality, and countries with low coverage tend to have higher child mortality (figure 3). There is a strong correlation between the Composite Coverage Index and child mortality that remains strong even after adjusting for country GDP. The correlation supports Countdown’s focus on tracking intervention coverage as central to accountability and counters suggestions that money can save lives directly.22 Financial well-being and maternal education are both of great importance to child health, but their impact is achieved primarily through more proximate interventions that address the causes of ill health and death.

Figure 4 shows median national coverage for 21 interventions, using the most recent available data since 2008. It provides a snapshot of how well the Countdown countries are doing in reaching women and children with a core set of effective interventions that should be available to all (table 3 shows the number of countries with available data, medians and ranges for each indicator). A grey dot indicates the national coverage for each reporting country; there is a wide range of variability across countries. Updated results for the remaining Countdown coverage indicators (Caesarean section, prevention of mother-to-child transmission of HIV and eligible HIV-positive pregnant women receiving antiretroviral treatment for their own health) are available at www.countdown2015mnch.org.

These interventions are presented along the continuum of care from pre-pregnancy to early childhood, and include improved drinking water sources and sanitation facilities as cross-cutting interventions relevant to women’s and children’s health. Only Countdown countries with a considerable proportion of the population at risk of Plasmodium falciparum (the most lethal form of malaria) transmission are included in the analysis of coverage for the malaria indicators.

These results clearly show the critical gaps that remain for care around the time of birth, when the risk of mortality is highest for mother and newborn, and for case management of childhood illnesses. By contrast, median coverage is at least 75% for antenatal care (at least one visit), vitamin A supplementation (two doses), immunization and improved drinking water sources. Yet, even for these high-performing interventions, some countries report coverage well below 50%. At the same time, for every intervention except intermittent preventive treatment of malaria for pregnant women (possibly due to this intervention’s relative newness or to changes in protocol and definition), there is at least one country with coverage that exceeds 75%.

The results also show that the enormous life-saving potential of appropriate infant and young child feeding is not being realized. Only a median of about 50% of mothers in Countdown countries reported early initiation of breastfeeding for their most recent child, and only 41% reported exclusive breastfeeding. Improvements in the coverage of exclusive breastfeeding remains one of the biggest missed opportunities to reduce child mortality.

These cross-sectional results should be interpreted in light of changes in coverage over time. For countries with representative survey data from both 2000–2007 and 2008–2012, table 4 shows the percentage point change in coverage from the first to the second time period for each intervention and the proportion of the gap between the first

Coverage along the continuum of care


FIGURE 3 Countries with high coverage of key interventions tend to have lower child mortality

Source: Demographic and Health Surveys; UN Inter-agency Group for Child Mortality Estimation 2013.

0

50

100

150

200

250

0 25 50 75 100

Under-5 mortality rate (per 1,000 live births)

Score on Composite Coverage Index (%)

FIGURE 4 Coverage of interventions varies across the continuum of care

a. Analysis is based on countries with 75% or more of the population at risk of p. falciparum transmission and 50% or more cases of malaria caused by

p. falciparum.

b. Data are for 2012.

Source: Immunization rates, WHO and UNICEF; postnatal visit for mother, Saving Newborn Lives analysis of Demographic and Health Surveys; improved

water and sanitation, WHO and UNICEF Joint Monitoring Programme; all other indicators, UNICEF global databases, April 2014, based on Demographic

and Health Surveys, Multiple Indicator Cluster Surveys and other national surveys.

0

25

50

75

100

Median national coverage of selected Countdown interventions, most recent survey, 2008 or later (%)

Pregnancy Birth Postnatal Infancy ChildhoodWater andsanitation

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measurement and 100% coverage that was closed by the time of the second measurement. The proportion of the gap closed metric is useful because it takes into account that coverage may have already been high during the first time period for some indicators (such as immunization and at least one antenatal care visit); looking only at percentage point change would mask any relative progress achieved by the second measurement.

The data in table 4 reveal three primary coverage patterns:

• For some interventions with high and sustained coverage at or over 80%, progress

has continued in closing the remaining gap to universal coverage. These interventions include antenatal care (at least one visit) and the three indicators of vaccination coverage.

• For a second group of interventions, measurable progress has been made in absolute terms, but coverage remains low, and a large gap remains between current coverage and 100% coverage. These interventions include intermittent preventive treatment of malaria for pregnant women, children sleeping under insecticide-treated nets and treatment with recommended antimalarials—each of which showed absolute increases of around 20 percentage points


p. falciparum.

b. Indicator is not included in figure 4.

Note: Bolded indicators are those recommended by the Commission on Information and Accountability for Women’s and Children’s Health.

Source: United Nations Children’s Fund global databases, April 2014, based on Demographic and Health Surveys, Multiple Indicator Cluster Surveys and

other national surveys.

IndicatorNumber of countries

with dataMedian coverage

(%)Range

(%)Pre-pregnancy

Demand for family planning satisfied 53 64 13–95

Pregnancy

Antenatal care (at least one visit) 58 90 40–100

Antenatal care (at least four visits) 48 53 15–94

Intermittent preventive treatment of malaria for pregnant womena 34 22 2–69

Neonatal tetanus protection 67 84 43–94

Birth

Skilled attendant at birth 60 63 10–100

Postnatal

Early initiation of breastfeeding 47 50 18–95

Postnatal visit for mother 32 45 7–93

Postnatal visit for baby 17 30 5–83

Infancy

Exclusive breastfeeding 51 41 3–85

Introduction of solid, semisolid or soft foods 47 66 20–92

Diphtheria-tetanus-pertussis (three doses) 75 85 33–99

Measles immunization 75 84 42–99

Haemophilus influenzae type b immunization (three doses) 66 86 10–99

Vitamin A supplementation (two doses) 55 78 0–99

Childhood

Children sleeping under insecticide-treated netsa 36 38 10–77

Careseeking for symptoms of pneumonia 53 52 26–80

Antibiotic treatment for symptoms of pneumonia 40 46 7–88

Malaria treatment (first-line antimalarial)a 35 32 3–97

Oral rehydration therapy with continued feedingb 45 47 12–76

Oral rehydration salts 55 37 11–78

Water and sanitation

Improved drinking water sources (total) 72 75 30–99

Improved sanitation facilities (total) 72 38 9–100

TABLE 3 National coverage of Countdown interventions, most recent survey, 2008 or later


between the two time periods. These examples show what can be accomplished with focused advocacy, sufficient resources and sustained effort.23

• The third group contains interventions for which coverage is inadequate and has not increased significantly since 2000. These interventions include demand for family planning satisfied, the presence of a skilled attendant at birth, exclusive breastfeeding among children under six months of age, use of improved sanitation facilities and appropriate careseeking and treatment for diarrhoea and pneumonia, the two most important infectious causes of death among children under age 5.

We—the global reproductive, maternal, newborn and child health community—are accountable for the gap between the current, insufficient coverage and the universal coverage that we can and must achieve. Box 3 illustrates this challenge by comparing progress for one intervention from the rapid acceleration group (children sleeping under

insecticide- treated nets) with one from the stagnant group (oral rehydration salts treatment). It shows that although coverage for insecticide-treated nets increased rapidly in Countdown countries from about 2006 to about 2011, coverage for the correct treatment of diarrhoea with oral rehydration salts has stagnated and even declined in some countries.

Countdown has done similar analyses, and drawn similar conclusions, from a comparison of prevention of mother-to-child transmission of HIV (rapid acceleration) and careseeking for symptoms of pneumonia (stagnation). Both HIV and malaria are specifically named in Millennium Development Goal 6 and thus attracted resources for scaling up interventions, whereas diarrhoea and pneumonia interventions are lagging behind, perhaps because they have failed to attract sufficient attention from donors, even though they claim many more child lives than HIV or malaria do. Ensuring that all essential interventions benefit from focused advocacy and adequate financing is our responsibility, and discrepancies in attention and coverage must be redressed.


p. falciparum.

b. Includes 2013 Demographic and Health Survey data for Gambia and Liberia.

c. Includes 2013 Demographic and Health Survey data for Gambia, Mali and Senegal.

d. Includes 2013 Demographic and Health Survey data for Pakistan and 2013 Performance Monitoring and Accountability Family Planning Survey data for

Ghana.

Note: Table includes only indicators for which trend data are available in the data sets shared by the United Nations Children’s Fund to date.

Source: UNICEF global databases, April 2014, based on Demographic and Health Surveys, Multiple Indicator Cluster Surveys and other national surveys.

Indicator

Number of countries with data

Median coverage (%) Change

(percentage points)

Proportion of gap closed

(%)2000−07 2008−12

Haemophilus influenzae type b immunization (three doses) 24 86 91 5 36

Malaria treatment (first-line antimalarial)a 19 5 37b 32 34

Antenatal care (at least one visit) 58 85 90 5 33

Children sleeping under insecticide-treated netsa 33 10 38 28 31

Antibiotic treatment for symptoms of pneumonia 21 26 47 21 28

Improved drinking water sources 71 66 75 9 26

Measles immunization 74 79 84 5 24

Skilled attendant at birth 60 54 63 9 20

Intermittent preventive treatment of malaria for pregnant womena 23 7 25c 18 19

Demand for family planning satisfied 39 56 64d 8 18

Diphtheria-tetanus-pertussis immunization (three doses) 74 82 85 3 17

Exclusive breastfeeding 47 34 41 7 11

Careseeking for symptoms of pneumonia 50 48 52 4 8

Oral rehydration salts treatment 52 29 35 6 8

Oral rehydration therapy with continued feeding 40 42 46 4 7

Improved sanitation facilities 71 36 40 4 6

TABLE 4 Changes in national coverage of Countdown interventions from 2000–2007 to 2008–2012, by proportion of the coverage gap closed between the two periods


Assessing country efforts to increase access to services and coverage of interventions requires understanding context. Simple statistics showing the proportion of a population that received an intervention do not always tell the full story.

Box 4 explores how population dynamics can affect progress in intervention coverage, and box 5 describes the destructive impact of conflict. Other key contextual variables that influence coverage patterns and health outcomes include

The figure below compares the annual percentage point change in coverage of insecticide-treated nets for the prevention of malaria with coverage of oral rehydration salt solution for the prevention of diarrhoea-related dehydration for Countdown countries with two data points since 2000. These two interventions, both targeted at leading killers of children, show divergent coverage trajectories, with considerable gains for insecticide-treated nets and small gains and even some reversals with oral rehydration salts solution.

Recent gains in insecticide-treated net coverage in many malaria-endemic countries were achieved through a combination of political commitment, public-private partnerships, strong advocacy and considerable financial investment to support the integration of net delivery with maternal and child health programmes such as immunization.1

Lessons from the insecticide-treated nets success story should be applied to efforts to scale up oral rehydration salts and other preventive and treatment measures to combat childhood diarrhoea, as well as other leading killers of women and children. One step in this direction was the launch of the Global Action Plan for Pneumonia and Diarrhoea in 2013, which set targets to end preventable child deaths from the two diseases by 2025.2 The plan calls for coordinating and integrating efforts to address the underlying environmental determinants of pneumonia and diarrhoea and to increase access to treatment.3

Notes1. Walker and others 2013.

2. WHO and UNICEF 2013.

3. Bhutta and others 2013b.

Rapid gains for insecticide-treated nets—why can’t we do the same for other interventions?

–10 –8 –6 –4 –2 0 2 4 6 8 10 12

Rwanda2005–2010

Mali2006–2010

Congo, Dem. Rep.2007–2010

Burkina Faso2006–2010

Benin2006–2012

Burundi2005–2010

Kenya2003–2009

Uganda2006–2011

Côte d’Ivoire2006–2012

Central African Rep.2006–2010

Sierra Leone2005–2010

Togo2006–2010

São Tomé & Príncipe2006–2009

Ghana2006–2011

Congo2005–2012

Comoros2000–2012

Niger2006–2012

Nigeria2003–2011

Cameroon2006–2011

Zimbabwe2006–2011

Lao PDR2006–2012

Swaziland2007–2010

Guinea-Bissau2006–2010

Gambia2006–2010

Average annual percentage point change in coverageover the specified period

Insecticide-treated nets

Oral rehydration salts




BOX 3 With adequate focus and financing, coverage can and should accelerate quickly for many proven interventions


women’s social status, education levels and access to health services; natural disasters and other humanitarian crises; economic development; and environmental factors such as pathogen

burden (for example, HIV and tuberculosis prevalence, malaria endemicity, other parasite loads).

Source: UNDESA 2013.

Expressed as proportions, coverage estimates can sometimes mask information on the number of people receiving care and thus must be interpreted in the context of population changes. A rising number of births translates into a parallel rise in the need for reproductive, maternal, newborn and child health services. In contrast, a falling number of births reduces service demand and makes it easier for countries to ensure health coverage for all. Projections show that in the absence of major changes, the highest levels of fertility will persist over the next generation in Countdown countries with the lowest per capita incomes and weakest health care infrastructures.2

Between 1990–1995 and 2005–2010 the absolute number of annual births increased around 36% in Sub- Saharan Africa but around 6% in South America. Brazil and the Democratic Republic of Congo are two Countdown countries from these regions that show how population change affects a country’s ability to improve health coverage.

In Brazil the absolute number of births increased slightly from 3.62 million in 1990 to 3.64 million in 2000 and then dropped steadily to 3.04 million in 2010 and is expected to further decrease to 2.96 million by 2015 (see figure). The proportion of births attended by skilled health personnel increased over a similar time period, from approximately 70% in 1991 to 97% in 2006, and is now near 100%. The decline in the number of births means that need for skilled birth attendants is less now than a decade ago, reducing the pressure on the health system to train, deploy and retain this cadre of health care workers and enabling a greater focus on improving the quality of care.

In contrast, the Democratic Republic of Congo has seen steady increases in the number of births, from approximately 1.71 million in 1990 to 2.26 million in 2000 to 2.74 million in 2010—an increase of more than a million births a year over two decades. Meanwhile, the proportion of births attended by a skilled provider increased from 61% in 2001 to 80% in 2010. Had the number of births remained at 2001 levels, coverage of skilled birth attendants in 2010 would likely have been much higher.

Since 1990 the number of births has decreased in Brazil but steadily increased in the Democratic Republic of Congo, yielding different pressures on the health system to ensure access to a skilled provider

0

1,000

2,000

3,000

4,000

201520102005200019951990

Annual births

Brazil

Congo, Dem. Rep.

Source: UNDESA 2013.

Although the absolute number of annual live births is converging in Brazil and the Democratic Republic of Congo, the population trends in the two countries reflect opposite patterns. Brazil is experiencing fertility declines, while the Democratic Republic of Congo has had sustained high fertility rates. These contrary trends have placed differing pressures on the health system. The Democratic Republic of Congo’s laudable 20 percentage point increase in coverage was achieved in a context of massive increases in the number of women and children needing care, showing that progress is possible even in the face of population growth. However, the sustainability of coverage gains as the population continues to grow remains an open question. Brazil’s almost universal coverage in skilled delivery care is equally impressive, and the country’s continued downward fertility trajectory suggests that the number of women of childbearing age will pose less of a programmatic challenge over time for increasing access to reproductive, maternal, newborn and child health services.

BOX 4 Demographic change affects coverage change


(continued)

Eight of the 10 Countdown countries with the highest under-5 mortality rates are currently affected by conflict (Afghanistan, Chad, Democratic Republic of Congo, Iraq, Somalia, Sudan, Pakistan and Yemen). Although the direct, short-term effects of armed violence usually receive considerable attention, the indirect and long-term impacts are often overlooked.1 For example, the collapse of health systems and poor access to health care by populations in conflict regions have significant harmful effects that are not directly related to battle injuries and death. Access to populations is challenging during humanitarian crises. Coverage rates of interventions are often unknown, particularly because the denominator of populations in need is difficult to determine or constantly changing. Children in countries affected by conflict are at increased risk of dying from preventable causes such as measles, malaria, diarrhoeal diseases, respiratory tract infections and malnutrition.2

Disruptions in the health care infrastructure and increased exposure to stress, food shortages and infectious diseases under conflict conditions also increase women’s risk of experiencing a maternal death.3 Adolescent pregnancy and violence against women are also common in conflict situations, with a negative impact on maternal and newborn health outcomes.4

The Syrian Arab Republic provides a troubling example of how conflict can turn back the clock on progress for women and children and strain health systems in neighbouring countries. Since the start of the crisis in 2011, nearly 7 million inhabitants have been displaced, almost half of them children.5 An estimated 2.5 million people, over two-thirds of them women and children, have taken refuge in neighbouring countries, and this number is expected to reach 4.1 million by the end of 2014 (see map). Population health indicators that were improving before the war6 are now spiralling downward. The health system has deteriorated, even totally collapsing in some areas. More than 35% of hospitals have been destroyed, and many doctors and other skilled providers have been killed, imprisoned or tortured. Access to safe water has decreased by around two-thirds, increasing the risk of exposure to many infectious diseases. For families that leave Syria, living conditions and availability of health care are highly variable and depend on arrangements in each host country. Refugee women who need services for themselves and their children often face major

challenges, including high costs, a scarcity of female providers and lack of transport.

The crisis in the Syrian Arab Republic shows how conflict can strain health systems in neighbouring countries

In Afghanistan decades of widespread conflict have ravaged the country. Although it is difficult to estimate with certainty, at least 400,000 people lost their lives due to the conflict. Many medical professionals fled in the 1980s and 1990s, and most medical training programmes ceased to operate. Smouldering and overt conflict, population displacement, the collapse of the health system and landmine injuries contributed to a desperate situation, with the brunt borne by women and children. But Afghanistan has made remarkable progress in women’s and children’s health since 2001. With increased donor support and national commitments, the country focused on innovations, task-shifting to outreach workers and engagement of civil society organizations for service delivery. The Basic Package of Health Services, introduced in 2003, expanded access to primary health care, and the community midwifery education programme, started in 2002, deployed large numbers of community midwives in target provinces. Coverage of skilled attendant at birth subsequently more than tripled to 47.4% in 2012, up from 14.0% in 2003 (see figure) and immunization coverage has exceeded 75%.

BOX 5 Conflict presents additional challenges for reproductive, maternal, newborn and child health


Despite challenges posed by conflict, coverage of skilled attendant at birth in Afghanistan more than tripled over 2003–2012

0

10

20

30

40

50

Skilled attendant at birth (%)

2003–2004

2005–2006

2007–2008

2009–2010

2011–2012

Source: Multiple Indicator Cluster Survey (2003–2004 and 2009–

2010), National Risk and Vulnerability Assessment (2005–2006,

2007–2008) and Afghanistan Health Survey (2005–2006, 2009–2010,

2011–2012).

Experience in both the Syrian Arab Republic and Afghanistan underscores the importance of resilience and targeted strategies in conflict-affected populations. Continued efforts are needed to strengthen the basic health care infrastructure, promote innovation and ensure independent monitoring and accountability. Data collection on health needs and intervention coverage rates must improve, and greater efforts must be made to ensure that internally and externally displaced refugees are included in country statistics. Country governments and the international community must mount—and intensify—a strong and sustained response focused on protective strategies for families, women and children in conflict zones, especially in regions in the grip of chronic conflict across generations.

Notes1. UNICEF 2013b.

2. CRED 2013.

3. Austin and others 2008.

4. WHO 2012.

5. UN Office for the Coordination of Humanitarian Affairs website

(http://syria.unocha.org, accessed 5 February 2014).

BOX 5 (CONTINUED) Conflict presents additional challenges for reproductive, maternal, newborn and child health


Equity: no women and children left behind

Focusing on coverage at the national level can mask large differences in access to services among different population groups within a country. A large part of the unfinished business in reproductive, maternal, newborn and child health is addressing pervasive inequity and ensuring that all women and children receive the services they need, regardless of differences in wealth, gender, ethnic group or geography. This section focuses on two summary metrics of socioeconomic inequity: the Composite Coverage Index and the co-coverage index. Details on how these indices are constructed are available at www.countdown2015mnch.org/reports-and-articles/equity.

Figure 5 shows the performance of Countdown countries with available data in achieving equitable coverage of eight preventive and curative interventions along the continuum of care, using the Composite Coverage Index. The message is clear: In virtually every country the coverage score among the richest—generally above 60%, and often above 80%—far exceeds coverage among the

poor. If such high coverage can be achieved among the wealthy, it should be possible to do the same across the whole population. And some countries have been able to do this. In Bolivia, Cambodia and Niger coverage has been increasing faster among the poor than among the rich (figure 6). In Nigeria, in contrast, inequality has remained unchanged over eight years. These examples indicate that rapid progress in reducing coverage inequality is possible in the Countdown countries, but that some countries are still lagging behind.

A second set of equity analyses uses the co-coverage index to assess the extent of inequity in the proportions of individual mothers and their children who receive eight well established interventions that have been available in most if not all countries—even the poorest—for at least a decade. Focusing on mothers and children in the poorest 20% of the population, it is striking that in countries such as Somalia, Chad, Yemen, Nigeria, Afghanistan and Ethiopia more than half have received two or fewer of the eight evidence-based interventions (figure 7).


FIGURE 5 In virtually every Countdown country with available data, coverage of eight preventive and curative interventions is higher among the richest than among the poor


0 25 50 75 100

Composite Coverage Index score for 31 Countdown countries with available data, by wealth quintile, 2008–2012

Richest quintile

Quintile 4

Quintile 3

Quintile 2

Poorest quintile

Burundi

Swaziland

Malawi

Peru

Rwanda

Egypt

Gabon

Indonesia

Sierra Leone

Iraq

Cambodia

Uganda

Congo, Dem. Rep.

Haiti

Congo, Rep.

Bangladesh

Kenya

Bolivia

Philippines

Tanzania

Niger

Côte d’Ivoire

Burkina Faso

Senegal

Nepal

Pakistan

Central African Rep.

Ethiopia

Madagascar

Cameroon

Nigeria


FIGURE 6 Some countries have been able to reduce inequality in coverage between rich and poor


Composite Coverage Index score, by wealth quintile, various years

Bolivia

Richest quintile

Quintile 4

Quintile 3

Quintile 2

Poorest quintile

2008

2003

1998

1994

0 25 50 75 100

Cambodia

2010

2005

2000

0 25 50 75 100

2012

2006

1998

Niger Nigeria

2011

2008

2007

2003

0 25 50 75 100 0 25 50 75 100


FIGURE 7 In some countries more than half the mothers and children in the poorest 20% of the population have received two or fewer essential interventions

Note: The length of the bar indicates the percentage of mothers and children who are receiving too few essential interventions. The ideal value is 0,

which would indicate that all mothers and children in the poorest 20% of the population are receiving at least three of the eight interventions.


0 10 20 30 40 50 60 70 80

Nigeria

Afghanistan

Ethiopia

Central African Rep.

Lao PDR

Pakistan

Cameroon

Madagascar

Iraq

Niger

Togo

Congo, Dem. Rep.

Côte d’Ivoire

Indonesia

Haiti

Mozambique

Philippines

Viet Nam

Kenya

Congo

Zimbabwe

Burkina Faso

Nepal

Sierra Leone

Lesotho

Gabon

Senegal

São Tomé and Príncipe

Bangladesh

Tanzania

Bolivia

Peru

Swaziland

Ghana

Uganda

Burundi

Malawi

Rwanda

Egypt

Share of mothers and children in the poorest 20% of the population who received none, one or two of eight essential preventive interventions, 2008–2012 (%)

Zero interventions

One intervention

Two interventions


Determinants of coverage and equity—policies, systems and financing

An understanding of intervention coverage is incomplete without attention to legislative frameworks and critical features of health systems, including health financing, human resources, supply chain and referral networks, the quality of service delivery, the acceptability of available services to the population and other factors driving service demand. Countdown works closely with those conducting research and programme evaluation in these areas. This section provides updates on country progress in improving determinants of coverage, including service quality (box 6). Countdown’s conceptual model (shown in annex A) illustrates how these key determinants of coverage can lead to improvements in health and nutrition outcomes.

Supportive policies and a strong health system

A well functioning health system and a set of enabling policies provide a foundation for reaching all women and children with the interventions they need. Box 7 describes country progress in family planning to show how these factors influence coverage change and ultimately fertility and mortality outcomes.

Countdown tracks adoption of 10 tracer policies that ensure access to family planning, provide protection for pregnant women from harmful environmental and labour conditions, authorize midwives to perform life-saving tasks, foster women’s ability to breastfeed immediately after birth and up to age 2, boost the delivery of key newborn interventions and stimulate increased uptake of treatment interventions for leading killers of children. Countdown also tracks a policy indicator on the legal status of abortion (see box 1). Some policies—such as low-osmolarity oral rehydration salts and zinc for management of diarrhoea, postnatal home visits in the first week of life and specific notification of maternal deaths—have high adoption rates (figure 8). But critical gaps remain, and fewer than half of Countdown countries report having policies that

allow adolescents access to contraception without parental or spousal consent, maternity protection in accordance with Convention 183 and regulation of the marketing of breastmilk substitutes.

These tracer policies are of relevance to virtually all Countdown countries, yet no country has endorsed all 10 tracer indicators, and 22 have adopted five or fewer (figure 9).

Understanding country progress in adopting key policy measures requires assessing changes in the number of countries that have endorsed policies over time. Over 2012–2014 the number of Countdown countries that have adopted five of the six key policies for which trend data are available has increased (figure 10). The number of Countdown countries that have adopted tracer policies related to maternal death notification and to postnatal home visits in the first week of life, for example, more than doubled between the two reporting years. These positive changes reflect important improvements in government prioritization of women’s and children’s health in recent years.24 The stagnation at a very low level in the number of countries that have adopted policies related to maternity protection is an alarm bell that should remind countries to focus more attention on this issue.

However, policy adoption is not sufficient per se in the absence of ample resources and political will for ensuring successful policy and programme implementation. For example, the high adoption of policies on low-osmolarity oral rehydration salts and zinc treatment for diarrhoea (see figure 8) are in sharp contrast to the lack of improvement in oral rehydration salts coverage rates (see box 3).

A major milestone on the pathway to sustainable programme and policy implementation is country development of costed plans for maternal, newborn and child health. Of the 57 Countdown countries with available data, 46 have costed plans for maternal health, 42 for newborn health and 36 for child health.


(continued)

Increases in intervention coverage will translate into reduced maternal, newborn and child mortality only if health care providers are able to deliver services at a high level of quality. Measuring and monitoring the quality of care is a complex process that ranges from time-consuming observations of the actual services provided during regular health care contacts to simpler, routine checks on the availability of equipment and supplies needed to deliver the standard of care.

For example, Countdown tracks coverage of the presence of a skilled attendant at birth, which is an important measure of how well countries are doing in reaching women with skilled delivery care. But this indicator does not capture information on the specific life-saving services actually provided during and immediately after delivery. Quality assessments of the care around the time of birth conducted in Egypt showed that although 65% of births occurred in facilities, only 8% of babies were born with the assistance of a midwife trained in resuscitation techniques and only 17% were born in facilities with equipment for newborn respiratory support.1 These findings show the importance of combining estimates of coverage with estimates of service quality (sometimes referred to as “effective coverage”) to best monitor health system performance.

An increasing number of Countdown countries are conducting assessments of quality and readiness for reproductive, maternal, newborn and child health services. Countries adapt standard tools to their own context, so cross-national interpretations must be made with care. The figures below show selected results collected since 2010 using one of these tools—the World Health Organization Service Availability Readiness Assessments—in eight Countdown countries in Sub- Saharan Africa with available data.

Share of facilities surveyed with tracer commodities available on the day of the assessment visit

Legend

Benin (2013)Burkina Faso (2012)Kenya (2013)

Mauritania (2013)Sierra Leone (2012)

Libya (2012) Togo (2012)Uganda (2012)

Commodities for basic obstetric care

Share of facilities surveyed (%)

0

20

40

60

80

100

Antibioticsinjectable

Magnesiumsulphate

Oxytocin

Commodities for child health services


0

20

40

60

80

100

AmoxcillinZincOralrehydration salts

BOX 6 Coverage + Service Quality/Readiness = Impact


An adequate and well trained health workforce and functioning referral and supply chain mechanisms are essential building blocks of a health system that can effectively and efficiently deliver services to all women and children. Many Countdown countries face severe health workforce shortages, including for midwives (box 8). These shortages negatively impact their ability to provide high-quality care. Only 7 of the 56 Countdown countries with available data (Botswana, Egypt, Gabon, India, the Philippines, the Solomon Islands and Viet Nam) meet or exceed the threshold of 23 skilled health professionals (doctors, nurses, midwives)

per 10,000 population needed to achieve high coverage of essential interventions. The good news is that most Countdown countries with available data are reporting increases in the absolute numbers of doctors, nurses and midwives. However, in some countries these net gains are not enough to keep pace with increased service demands resulting from population growth. Many countries are introducing various strategies to ameliorate their health workforce crises, such as delegating and sharing tasks across various categories of health care professionals and factoring in population dynamics when planning for human resource needs.25

Legend

Benin (2013)Burkina Faso (2012)Kenya (2013)

Mauritania (2013)Sierra Leone (2012)

Libya (2012) Togo (2012)Uganda (2012)

The low availability of many of the commodities in the highlighted countries should be a red flag to decisionmakers. Targeted efforts are needed to strengthen supply chain management systems, so that providers are equipped with the supplies needed to deliver lifesaving reproductive, maternal, newborn and child health services.

Tools enabling the regular collection of rigorous quality of care data need further development. In December 2013 the World Health Organization and the Partnership for Maternal, Newborn and Child Health convened a technical consultation to reach consensus on a core set of tracer indicators to monitor the quality of reproductive, maternal, newborn and child health services at the facility level. The next steps will focus on developing standardized definitions and data collection processes so that these indicators can be used to populate country and subnational scorecards that inform routine programme planning and monitoring.

Note1. Wall and others 2009.

Commodity for neonatal resuscitation


0

20

40

60

80

100

Availability of bag and mask for neonatal resuscitationin facilities providing basic obstetric care services

Commodities related to water and sanitation


0

20

40

60

80

100

Soap and wateror alcohol-based

hand rub available

Facility with improvedwater source

within 500 metres

Source: Service Availability and Readiness Assessment Surveys.

BOX 6 (CONTINUED) Coverage + Service Quality/Readiness = Impact


(continued)

Family planning is a cost-effective strategy for reducing maternal and newborn mortality by reducing the number of unintended and high-risk pregnancies and averting unsafe abortions (see box 1). Family planning services can also help delay women’s age at first pregnancy and lengthen the time interval between pregnancies, both of which improve maternal, newborn and child health and reduce the risk of low birth weight and stillbirth.1

Increasing access to and use of family planning services requires sustained political and financial support, accompanied by community-based approaches to improve awareness of and demand for modern contraceptive methods. Legislative frameworks are needed that support the availability of a full range of family planning services, including for adolescents, a rapidly expanding population group in many Countdown countries.

The median annual birth rate among adolescent women in Countdown countries with available data is 89 births per 1,000 women ages 15–19, with a low of 0.7 in the Democratic People’s Republic of Korea and a high of 229 in the Central African Republic. In the 45 Countdown countries with data for 2008–2012, the median proportion of women ages 20–24 that had given birth before the age of 18 was 23%, with a low of 3% in Viet Nam and a high of 47% in Chad.

It is important that laws and regulations to reduce adolescent pregnancy and prohibit child marriage are put into place and enforced to expand young women’s opportunities and improve their control over their own fertility. But only 15 of the 57 Countdown countries with policy data for 2013 have laws or regulations that allow adolescents to access contraception without parental or spousal consent.

Family planning in Bangladesh: Community outreach as a pathway to success!

Bangladesh identified family planning as a health priority more than five decades ago, even before the country’s independence from Pakistan. Early programmes in the 1970s–1990s involved recruiting thousands of married women as family welfare assistants to deliver basic family planning services—including oral pills, condoms, counselling and referrals for longer term methods on request—to the doorstep.

This intense community-based effort contributed to the steady increase in the country’s contraceptive prevalence rate, from 8% in the mid-1970s to around 50% by 1999, and to the drop in the total fertility rate, from around 7 children per woman to 3.3 over the same period.

The rising expense of maintaining an extensive family welfare assistants programme due to a tripling in the population of women of childbearing age led to a new approach, adopted at the end of the 1990s, to delivering family planning services through community clinics and the private sector. This helped the country maintain its positive trends in contraceptive prevalence rate and total fertility rate, which continued through 2011 (see figure).

The fertility decline in Bangladesh has also been attributed in part to the expansion of microcredit financing, girls’ improved access to education and growing employment opportunities in the textile sector, all of which increased legitimate alternatives to early motherhood.

Delivering family planning services through community clinics and the private sector has helped Bangladesh maintain its positive trends in contraceptive prevalence rate and total fertility rate

Contraceptive prevalence rate (modern and traditional) (%)

0

20

40

60

80

100

2011200720041999/2000

1996/1997

1993/1994

19911989

Source: Bangladesh Fertility Survey (1989), Contraceptive Prevalence

Survey (1991) and Demographic and Health Surveys (other years).

BOX 7 Family planning: addressing the unmet need


Total fertility rate (births per woman)

0

2

4

6

2011200720041999–2000

1997199419911989

Source: Bangladesh Fertility Survey (1989), Contraceptive Prevalence

Survey (1991) and Demographic and Health Surveys (other years).

However, early marriage and early childbearing are still very prevalent: The median age at marriage among women ages 20–24 is 16.6, and 40% of

women in this age group gave birth before age 18.2 Fertility has declined mostly among women older than age 30, which has been linked to increases in birth spacing intervals through the use of contraception.3 Geographic differences in fertility patterns that parallel economic development also persist, with higher fertility in the least developed eastern regions than in the west.

The current national family planning programme targets adolescents and regions of the country where higher than average total fertility rates persist and aims to make a greater diversity of contraceptive methods (including long-term methods) more widely available.

Notes1. Ahmed and others 2012; Cleland and others 2012; UNICEF, UNFPA

and UN Women 2012.

2. CPD 2003; Bangladesh Demographic and Health Survey 2011.

3. Arifeen and others forthcoming.

BOX 7 (CONTINUED) Family planning: addressing the unmet need

FIGURE 8 Some tracer policies have high adoption rates in Countdown countries, but critical gaps remain

a. Based on 33 countries.

Source: World Health Organization Global Maternal Newborn Child and Adolescent Health Policy Indicator Survey.

0

25

50

75

100

Share of 57 Countdown countries with tracer policy in place, 2013–2014 (%)

Pregnancy and birth Postnatal Infancy and childhoodPre-

pregnancy

Low

-osm

olar

ity o

ral

rehy

drat

ion

salts

and

zin

c fo

rm

anag

emen

t of d

iarr

hoea

Com

mun

ity tr

eatm

ent o

fpn

eum

onia

with

ant

ibio

tics

Inte

rnat

iona

l Cod

e of

Mar

ketin

g of

Bre

astm

ilk S

ubst

itute

s

Post

nata

l hom

e vi

sits

in fi

rst w

eek

of li

fe

Kang

aroo

mot

her c

are

for l

ow-b

irthw

eigh

t/pr

eter

m n

ewbo

rns

Ant

enat

al c

ortic

oste

roid

sas

par

t of m

anag

emen

t of

pret

erm

labo

ur

Mat

erni

ty p

rote

ctio

nin

acc

orda

nce

with

Con

vent

ion

183

Spec

ific

notifi

catio

nof

mat

erna

l dea

ths

Mid

wife

ry p

erso

nnel

auth

oriz

ed to

adm

inis

ter

core

set

of l

ife-s

avin

gin

terv

entio

nsa

Law

s or

regu

latio

ns a

llow

ing

adol

esce

nts

acce

ss to

fam

ily p

lann

ing

with

out

pare

ntal

or s

pous

al c

onse

nt


FIGURE 9 No Countdown country with available data has endorsed all 10 tracer indicators, and 22 have adopted five or fewer

Source: World Health Organization Global Maternal Newborn Child and

Adolescent Health Policy Indicator Survey.

0 2 4 6 8 10

GambiaBurkina Faso

BeninSenegalNigeria

NigerMozambique

MalawiGuatemala

EthiopiaEritrea

CambodiaViet Nam

TogoTanzania (U. Rep.)

MaliLao PDR

Equatorial GuineaZimbabwe

ZambiaUganda

Sierra LeoneRwandaPakistan

NepalMadagascar

LiberiaIndonesia

IndiaGuinea

Côte d'IvoireCongo

CameroonBotswana

BangladeshYemen

PhilippinesPapua New Guinea

EgyptDjibouti

Congo, Dem. Rep.Comoros

AfghanistanSudan

MoroccoLesotho

IraqGabon

BurundiAngola

MyanmarChad

Bolivia (Plur. St. of)Swaziland

South SudanSomalia

Solomon Islands

Number of policies in place (out of 10), Countdown countries with available data, 2014 (n = 57)

FIGURE 10 Over 2012–2014 the number of Countdown countries that have adopted five of the six key policies for which trend data are available has increased

Source: World Health Organization Global Maternal Newborn Child and

Adolescent Health Policy Indicator Survey.

0 10 20 30 40 50 60

Low-osmolarityoral rehydration salts

and zinc formanagement of

diarrhoea

Community treatmentof pneumonia

with antibiotics

International code ofmarketing of breastmilk

substitutes

Postnatal home visitsin first week of life

Maternity protectionin accordance with

Convention 183

Specific notificationof maternal deaths

Number of Countdown countries with available data that have adopted selected tracer reproductive, maternal, newborn and child health policies, 2012 and 2014 (n = 57)

20122014

Source: UNFPA 2014.

Almost all Countdown countries are facing major workforce challenges in delivering midwifery services, particularly in areas where the burden of maternal mortality and morbidity is highest. Although midwives can perform almost 90% of essential care for women and newborns if adequately trained on the latest evidence-based guidelines, countries have been slow to adopt policies enabling midwives to provide this care. There has been no increase among the 33 Countdown countries with available trend data since 2012 in adopting a policy authorizing midwives to administer a core set of life-saving interventions.

BOX 8 Midwives matter


Countdown tracks essential commodities across the continuum of care. The UN Commission on Life-Saving Commodities was established in 2012 to promote the availability and effective use of 13 life-saving commodities for women’s and children’s health.26 Including these commodities on the essential medicines list is a steppingstone to ensuring that these commodities are procured and widely distributed. Most Countdown countries with available data include the majority of these 13 commodities on their list, with the notable exception of the three prioritized reproductive health commodities, which are included on the list of fewer than half of countries with available data (figure 11).

Financing women’s and children’s health

Countdown tracks information on key indicators of domestic and external spending patterns for reproductive, maternal, newborn and child health. There is evidence of very modest

positive trends in these indicators. Across the Countdown countries, the per capita total expenditure on health (in current purchasing power parity terms) increased from $200 in 2010 to $222 in 2012. Over the same period there was also a very slight increase in government expenditure on health as a share of total government expenditure, from 9.9% to 10%. Similarly, countries made marginal improvements in reducing the reliance on out-of-pocket payments to finance health, from 43% of total expenditure on health in 2010 to 42% in 2012 (box 9). Increasing government expenditure on health is an important measure for improving access to health care and reducing poverty.

Tracking development partner disbursements to reproductive, maternal, newborn and child health is important for holding partners to account for commitments made and helps identify resource gaps or areas where further investment may be required.

FIGURE 11 Most Countdown countries with available data include the majority of the 13 essential commodities on their essential medicines list

a. Refers mainly to other uses (such as for response to allergic reaction). Antenatal corticosteroids in preterm labour are recommended for use in all

countries but were not added to the World Health Organization essential medicines list for preterm indication until 2013.

b. Chlorhexidine has been recommended only since 2013, and World Health Organization guidelines suggest use only in high-mortality countries (with a

neonatal mortality rate greater than 30 deaths per live births) and home births.

Source: Female condoms, World Health Organization EML database (www.who.int/medicines/publications/essentialmedicines, accessed March

2014); implants and emergency contraception, U.S. Agency for International Development Deliver Project (http://deliver.jsi.com/dhome/whatwedo/

commsecurity/csmeasuring/csindicators/csindicatordashboards, accessed March 2014); maternal and newborn lifesaving commodities, World Health

Organization Global Maternal Newborn Child and Adolescent Health Policy Indicator Survey 2013.

0

20

40

60

Number of Countdown countries with selected commodity, 2013 (n = 57)

Pregnancy and birth Postnatal Infancy and childhoodPre-pregnancy

Ora

l reh

ydra

tion

salts

Zinc

Paed

iatr

ict

form

ulat

ion

of a

mox

icill

in

Sel

f-in

flatin

gba

g an

d m

ask

7.1%

chl

orhe

xidi

nedi

gluc

onat

eb

Dex

amet

haso

nein

ject

iona

Gen

tam

ycin

inje

ctio

n

Mag

nesi

um s

ulph

ate

Mis

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stol

tab

lets

Em

erge

ncy

cont

race

ptio

n

Oxy

toci

n

Impl

ants

Fem

ale

cond

oms


Trend data on official development assistance (ODA) to the Countdown countries is available from 2003 for maternal, newborn and child health and from 2009 for reproductive health.27 This report presents ODA data up to 2011. Countdown expects to release ODA data for 2012 later in 2014.

ODA for health was an estimated $19 billion in 2011, an increase of only 1% in real terms over 2010. This amount represents 12.4% of total ODA. In the 75 Countdown countries an estimated $8.7 billion went to reproductive, maternal, newborn and child health in 2011, a 1% increase over 2010, and accounted for 44% of ODA to health and 5% of total ODA. Of this amount, $3.9 billion (45%) went to child health, $3.1 billion (36%) went to reproductive health (which includes funding for family planning, sexual health and

sexually transmitted infections including HIV) and $1.7 billion (19%) went to maternal and newborn health.28 ODA to maternal, newborn and child health in the 75 Countdown countries decreased by 1% in real terms from 2010, due to a 3% reduction in funding to child health.29 Funding to maternal and newborn health increased 4% over 2010, and funding to reproductive health increased 5%. The noted reduction in ODA to maternal, newborn and child health in Countdown countries in 2011 continues a slowdown detected between 2009 and 2010 relative to previous years.7

Assessing who benefits from ODA and whether resources are being allocated according to country need can improve resource allocation and efficiency (box 10).

In many Countdown countries the need to pay for health care out of pocket deters families from seeking care and depletes poor households of already scarce resources.1 Two types of indicators are commonly recommended to assess the effect of out-of-pocket spending on poverty2:• Impoverishment. The proportion of the population

impoverished as a result of out-of-pocket payments (for example, the share of the population falling below the purchasing power parity (PPP) $2 poverty line as a result of out-of-pocket expenditures on health in the last month).

• Catastrophic health expenditure. The proportion of the population incurring catastrophic health expenditures (for example, the share of the population spending more than a set proportion of nonfood expenditure, such as 25% or 40%, in a given month on direct healthcare payments).

Countdown reviewed the limited published data available on these indicators for the Countdown countries (see annex F for data sources and definitions of indicators). Only two Countdown countries have data from 2008 or later on the percentage of the

population falling below the PPP$2 poverty line as a result of out-of-pocket health expenditure (Bangladesh, 2.7%, and Lao PDR 1.4%), and only seven Countdown countries have data on the percentage of households with out-of-pocket expenditure greater than 40% of nonfood spending (ranging from 0.1% in South Africa to 3.7% in Lao PDR). Most information on the impact of out-of-pocket spending is outdated and lacks comparability owing to variations in definitions.

Greater investment is needed to gather reliable data on financial burdens to households resulting from out-of-pocket payments for health care and for reproductive, maternal, newborn and child health services specifically. Promising partnerships, including Equitap in Asia, LAnet-EHS in Latin America and SHIELD in Africa, need to be strengthened and coordinated to ensure comparability of data collected. Work is also under way by the World Bank and the World Health Organization on monitoring financial risk protection.

Notes1. Brearley and others 2012.

2. WHO and World Bank 2013.

BOX 9 Out-of-pocket financing—who pays for health care?


(continued)

From whom?

In 2011 ODA from bilateral agencies accounted for more than half of ODA for maternal, newborn and child health in the 75 Countdown countries, just under a quarter came from multilateral agencies and another quarter from global health initiatives and foundations (comparable to proportions in 2009 and 2010) (box figure 1). A higher proportion of ODA for reproductive health comes from bilateral donors (76% of all ODA; box figure 2).

Box figure 1. Official development assistance for maternal, newborn and child health in the 75 Countdown countries was $5.6 billion in 2011 (in 2012 dollars)

Bilateral aidagencies

55%

Global healthinitiatives

22%

Multilateralagencies

23%

Source: Organisation for Economic Co-operation and Development’s Development Assistance Committee’s Creditor Reporting System Aid Activities Database.

Box figure 2. Official development assistance for reproductive health in the 75 Countdown countries was $3.1 billion in 2011 (in 2012 dollars)

Bilateral aidagencies

76%

Global healthinitiatives

16%

Multilateralagencies

8%


The United States continues to be the largest source of funding to reproductive, maternal, newborn and child health in the Countdown countries, followed by the Global Fund to Fight AIDS, Tuberculosis and Malaria (box figure 3). U.S. contributions to reproductive health including HIV exceeded $1.8 billion, nearly four times more than the next largest donor and nearly twice as much as U.S. contributions to maternal, newborn and child health. Across all donors, on average, higher amounts were disbursed to child health ($76 million) than to reproductive health ($60 million) and to maternal and newborn health ($32 million). This pattern is similar to previous years.

Box figure 3. In 2011 the United States continued to be the largest source of funding to reproductive, maternal, newborn and child health in the Countdown countries

2012 $ billions

0

1

2

3

4

5

Childhealth

Maternal andnewborn health

Reproductivehealth

United StatesGlobal Fund to Fights AIDS, Tuberculosis and MalariaUnited KingdomInternational Development Association

United Nations Population FundEU institutionsGAVI AllianceCanadaOther

Source: Organisation for Economic Co-operation and Development’s

Development Assistance Committee’s Creditor Reporting System

and Activities Database.

To whom?

In 2011 approximately 79% of official development assistance for maternal, newborn and child health went to the 75 Countdown countries, with India and Ethiopia receiving the most (box figure 4). India also received the highest share of ODA for maternal, newborn and child health in 2009 and 2010. The

BOX 10 Official development assistance flows for reproductive, maternal, newborn and child health


(continued)

amount varies widely across countries and is not always in proportion to need.

Seven Countdown countries received more than half of ODA to reproductive health, with the highest shares going to South Africa and Kenya (box figure 5). Nigeria, Ethiopia, Tanzania and Kenya received high shares of both ODA to maternal, newborn and child health and to reproductive health.

Box figure 4. Ten Countdown countries received just under half of total official development assistance for maternal, newborn and child health in 2011

Other51.8%

Ethiopia6.1%

Afghanistan5.0%

Congo, Dem. Rep.5.4%

India6.6%

Nigeria5.6%

Kenya3.5%

Zambia2.7%

Pakistan5.4%

Tanzania4.6%

Bangladesh3.0%


Official development assistance to maternal, newborn and child health in the context of target population size

ODA for child and maternal and newborn health varies widely across Countdown countries, even after adjusting for the size of the target population. For example, in 2011 median ODA to child health per child ages 0–5 was $1.89 for the 10 countries receiving the least ODA and $47.58 for the 10 countries receiving the most (figure 6). Similarly, for maternal and newborn health, the median was $5.23 per live birth for the 10 countries receiving the least ODA and $115.92 per live birth for the 10 countries receiving the most (figure 7).

Box figure 5. Seven Countdown countries received just over half of official development assistance to reproductive health in 2011

Other48.6%

Ethiopia5.9%Mozaqmbique

4.8%

South Africa11.2%

Nigeria7.8%

Kenya9.3%

Tanzania6.2%

Uganda6.2%


Box figure 6. In 2011 median official development assistance to child health per child ages 0–5 was $1.89 for the 10 countries receiving the least official development assistance and $47.58 for the 10 countries receiving the most

PeruKorea, Dem. Rep.

IndonesiaPhilippines

TurkmenistanIndia

EgyptBrazilChina

MexicoPapua New Guinea

RwandaSierra Leone

ZambiaDjiboutiLesotho

HaitiLiberia

São Tomé & PríncipeSolomon Islands

Official development assistance to child health per child, 2012 ($)

0 30 60 90 120 150

Top 10 median: $47.58

Bottom 10 median: $1.89


BOX 10 (CONTINUED) Official development assistance flows for reproductive, maternal, newborn and child health


More-populous Countdown countries receive more ODA for maternal, newborn and child health than less-populous ones. But adjusting for the size of the target population shows a different picture of aid flows to women’s and children’s health in the Countdown countries. For example, in 2011 Nigeria received the most ODA per country for child health in absolute terms, but the amount received per child ages 0–5 was $8.59 (the 51st highest). In contrast, Solomon Islands received the highest amount per child, $143.45, but much lower total funds (the 54th highest). For maternal and newborn health India received the most ODA overall, but only $6.05 per live birth, compared with $32.58 in Ethiopia, which received the second highest total ODA for maternal and newborn health, and $90.89 in Afghanistan, which received the third highest total ODA.

Funding allocation by focus area

The slight reduction in funding to child health is driven by a reduction in funding to immunization, earmarked malaria funding and basket funding, 40% of which is assumed to go to child health.

The percentage of funding allocated to reproductive health remains driven by response to the HIV epidemic (78%). However, family planning accounts for a growing proportion (14%), a 42% increase over 2010 in real terms, compared with a 2% increase in funding related to HIV (which does not include prevention of mother-to-

child transmission or childhood AIDS, which are captured in maternal, newborn and child health totals).

Box figure 7. In 2011 median official development assistance to maternal and newborn health per live birth was $5.23 for the 10 countries receiving the least official development assistance and $115.92 for the 10 countries receiving the most

0 100 200 300 400

IndonesiaAngola

IndiaSouth Sudan

PhilippinesEgypt

TurkmenistanKorea, Dem. Rep.

BrazilChina

MexicoSierra Leone

LesothoAfghanistan

DjiboutiZambiaLiberia

SwazilandSão Tomé & Príncipe

HaitiSolomon Islands

Official development assistance to maternal and newborn health per live birth, 2012 ($)

Top 10 median: $115.92

Bottom 10 median: $5.23


BOX 10 (CONTINUED) Official development assistance flows for reproductive, maternal, newborn and child health


Data revolution and evolution: the foundation for accountability and progress

Without data there can be no accountability. Without accountability we risk making no progress for women and children. Countdown therefore puts a special focus on data availability, quality and use. Working closely with the independent Expert Review Group of the Commission on Information and Accountability for Women’s and Children’s Health,31 Countdown advocates for efforts to ensure that all countries have adequate data to make informed decisions about programme priorities for women and children and to monitor the implementation of those programmes. These data include but are not limited to high-quality household surveys. Continued efforts are needed to strengthen civil registration and vital statistics, health management information systems and institutional capacity at the country level to

conduct independent evaluations of reproductive, maternal, newborn and child health programmes.

Of the 75 Countdown countries, 28 (37%) conducted a nationally representative survey in 2011 or 2012, providing high-quality, recent data to support assessments of progress towards the Millennium Development Goals (map 1). Another 29 countries (39%) conducted such a survey between 2008 and 2010. This represents a major achievement, probably linked to the emphasis on global monitoring of the Millennium Development Goals. Prior to 2000 few of the 75 countries had nationally representative survey data on coverage of interventions for maternal, newborn and child health.

Accurate and consistent data are crucial for governments and their partners to manage health

MAP 1 Of the 75 Countdown countries, 28 (37%) conducted a nationally representative survey in 2011 or 2012, providing high-quality, recent data to support assessments of progress towards the Millennium Development Goals

Note: Based on country reporting on the antenatal care (at least one visit) indicator.

Source: United Nations Children’s Fund global databases, April 2014, based on Demographic and Health Surveys, Multiple Indicator Cluster Surveys and

other national surveys.

2011–2012 (n = 28)

2008–2010 (n = 29)

2000–2007 (n = 17)

Administrative record


systems effectively, allocate resources according to need, and make and deliver on commitments where the impact will likely be greatest. These data must be:

• Fit for purpose, designed to measure a set of standardized indicators that respond to accountability requirements. As new effective interventions are identified and consensus indicators agreed on, further work will be required to develop, validate and incorporate appropriate questions into the core surveys used by countries. The process through which indicators for postnatal care were defined and tested provides a good example of how this process can work (box 11).32 Similar efforts are needed to define standard coverage measures for other newborn-specific interventions and nutrition interventions that have been scaled up rapidly in the past decade but that lack standard methods for measurement.

• Reliable, at least, and ideally also valid, so that they can be used over time and across countries to assess progress. There is an important research agenda on improving coverage measurement for reproductive, maternal,

newborn and child health that has already shown that at least one of the core indicators recommended by the commission—antibiotic treatment for childhood pneumonia—cannot be measured accurately through household surveys.33 Countdown has therefore added an indicator on careseeking for symptoms of childhood pneumonia to its reporting on commission indicators. This work on improving coverage measurement is continuing and is closely coordinated with Countdown. A particular focus is on unpacking service contact indicators such as antenatal care visits and skilled attendant at delivery to determine how best to generate valid measures of coverage for individual interventions provided through these service delivery platforms.34

• Timely, providing information on coverage that reflects recent progress and can be used in the short term to improve the performance of reproductive, maternal, newborn and child health programmes.

• Able to be disaggregated, to assess inequity and to determine which women and children are not being reached, as a basis for action.35

Postnatal care visits for mothers and newborns offer an important opportunity to provide proven interventions that can save the lives of women and children. Despite the sparse and inconsistent data available at the time, Countdown began including postnatal care indicators for newborns in its reporting in 2005. This gap in data spurred efforts led by the Newborn Indicators Technical Working Group to refine the indicators and develop standard tools to measure coverage of key newborn interventions.1 These efforts informed the technical review process of Countdown, resulting in the addition over time of three newborn-related policy indicators on postnatal home visits in the first week of life on the Countdown 2012 country profiles and antenatal corticosteroids for preterm birth and kangaroo mother care on the Countdown 2014 country profiles. The visibility raised by including postnatal care indicators in Countdown reporting also sparked the two international household survey programmes that produce the majority of coverage data used in global monitoring, Demographic and Health Surveys and Multiple Indicator Cluster Surveys, to review their data

collection efforts on postnatal care. The United Nations Children’s Fund, for example, developed a new module on postnatal care visits that was incorporated into the current round of Multiple Indicator Cluster Surveys and has increased the availability of country data on coverage of this service contact. This process has resulted in the development of global consensus on the definition of postnatal care visits and a surge of new data—the number of Countdown countries with recent available data on postnatal visit for the baby increased from zero in the 2005 report to six in the 2010 report to 17 in the 2014 report.

Countdown currently tracks a systems indicator on emergency obstetric care and is actively working with partners on revising the list of signal functions that emergency obstetric care facilities must provide in order to include a comprehensive set of signal functions for newborn care.

Notes1. Moran and others 2013.

BOX 11 Keeping coverage measurement current: an example from postnatal care


The Demographic and Health Surveys and Multiple Indicator Cluster Survey programmes remain the primary source of coverage data for most low- and middle-income countries and have worked hard to coordinate their protocols and target their support to the 75 Countdown countries.36 An important development is that a small but growing number of countries are fielding their own surveys, often using adaptations of the standard protocols, and this increase in national capacity must be supported and expanded while ensuring that indicator definitions reflect international consensus to enable comparisons across countries and over time.

Success must be measured not only through the availability of high-quality, timely data, but also by the extent to which the process is implemented from start to finish by country-based research institutions, including special analyses to respond to questions from policymakers.

Well designed and well implemented household surveys must remain a central pillar of government systems for programme monitoring and evaluation. But they alone are not enough. Measures of coverage for interventions needed by subsets of women and children, including women with obstetric complications and newborns or children who are ill, are also likely to benefit from efforts to link household surveys to assessments of service providers. Surveys can tell us about coverage, or the proportion of those who need an intervention who have actually received it. Health facility–based data, whether from information systems or facility surveys, can tell us about the quality of care received by those who accessed services. Efforts are under way to meet these challenges and to ensure that standard, fit for purpose indicators are defined, subjected to validation assessments and measured with adequate technical and financial support and institutional capacity building at the country level. Good examples of interdisciplinary groups that engage independent technical experts to address these issues include the Roll Back Malaria Monitoring and Evaluation Reference Group, the Newborn Indicators Technical Working Group and the various interagency working groups tackling measurement issues related to women and children. Countdown collaborates closely with these groups.

Those who set global goals must be mindful of the technical demands of coverage measurement when defining indicators that will be used to track progress and assess accountability.37 Preliminary versions of the post-2015 sustainable development goals documentation included more than 20 targets for the health goal alone.38 Setting a

target implies measurement, and over the years Countdown has repeatedly pointed to the unfair demand that countries report on numerous indicators for which no measurement strategy is in place or supported. This message was echoed by the Commission on Information and Accountability for Women’s and Children’s Health, which defined 11 priority indicators—including 8 coverage measures—and recommended that countries report on them. However, uptake of this recommendation has been limited by the availability of data at the country level. Only 8 of the 75 Countdown countries had recent data on all of these coverage indicators in 2011–2012, and 37—half the Countdown countries—had data for only one of them (figure 12). The paltry number

FIGURE 12 Half of Countdown countries had data for only 1 of 9 recommended coverage measures in 2011–2012

Note: Indicators include demand for family planning satisfied (including

2013 data for Ghana and Pakistan), antenatal care (four or more visits),

skilled attendant at birth, postnatal care for mother, postnatal care for

baby, exclusive breastfeeding, DTP3 vaccine coverage, careseeking for

pneumonia and antibiotic treatment for pneumonia. This list does not

include two indicators related to HIV, counts postnatal care for mother

and baby separately and includes careseeking as well as treatment

for pneumonia, so it differs from the list of 11 priority indicators

(8 coverage and 3 impact) from the Commission on Information and

Accountability for Women’s and Children’s Health.




0 10 20 30 40 50 60 75

1 indicator

2 indicators

3 indicators

4 indicators

5 indicators

6 indicators

7 indicators

8 indicators

9 indicators

Number of 75 Countdown countries reporting updated data from2011 or 2012 for one or more of nine coverage indicatorsrecommended by the Commission on Information and Accountabilityfor Women’s and Children’s Health


of countries able to report recent data on the full set of recommended coverage indicators is a distressing testament to data gaps in the countries where the burden of preventable maternal, newborn and child deaths is highest. Responsibility for filling those gaps, and for defining indicators based on what it is feasible to measure well, is shared by countries and the global reproductive, maternal, newborn and child health community.

Gaps in data on the policy and health systems determinants of coverage also need to be addressed. Countdown reporting has drawn attention to some of these gaps and helped stimulate an effort led by the World Health Organization to work at the country level to obtain standardized reports on selected indicators in each area. Intensive efforts are also under way to generate evidence and develop guidance on policies and health systems factors that affect access to essential reproductive, maternal, newborn and child health interventions.39

There are critical gaps in resource tracking (see box 9). For the first time in 2014 Countdown country profiles include the Commission on

Information and Accountability for Women’s and Children’s Health–recommended resource indicator on reproductive, maternal, newborn and child health expenditures by source of funding, intended to track both domestic and external financial commitments to achieving the goals of the Global Strategy on Women’s and Children’s Health. More than two years have passed since the 2011 launch of the commission’s action agenda, and progress has been slow. According to the World Health Organization, only 4 of the 75 Countdown countries can report completely on the recommended financing indicator for recent years, and 2 countries can report partially. However, it is encouraging to note that 18 countries report that development of these indicators is in process and that 25 countries report being in the planning phase.40

Robust civil registration systems are still lacking in most Countdown countries, requiring the use of modelling to develop mortality and cause of death estimates (see annexes A and H). Most newborns and nearly all stillborn babies are born and die without ever being recorded, a situation that must be corrected in order to improve country capacity to plan for needed services and to monitor progress.


In 2014, as Countdown’s original time horizon approaches, we must look both backwards and forwards to draw lessons that may inform the future landscape for women’s and children’s health. Many of the same challenges remain. Some—including the broadening of the goals to encompass a more holistic agenda and the explosion of tools and initiatives for monitoring—will be new.

Countdown is fundamentally about accountability. It was conceived in a 2003 meeting at the Rockefeller Foundation’s Bellagio Center, resulting in the publication of a series on child survival in The Lancet in 2003.41 The original call was specific to child survival, but was later extended to include the full continuum of reproductive, maternal, newborn and child health:

… we commit ourselves to ensuring that there is an overall mechanism for improving accountability, re-energising commitment, and recognising accomplishments…

Participants will be those who support child survival, who monitor interventions and delivery strategies, and other concerned individuals and organisations.

… regular opportunities for the world to take stock of progress … and to hold countries and their partners accountable.

Countdown has grown in different dimensions since the first report in 2005. In addition to the shift from child survival to a broader reproductive, maternal, newborn and child health agenda, the number of countries has expanded from 60 to 75, and the number of interventions being monitored from 35 to 73. The 2005 report had 11 institutions’ logos on the back cover; the 2014 report has 43. Countdown now produces annual reports, with the full report (containing two-page country profiles) in even years and a shorter version (containing

one-page country profiles focused on the 11 commission indicators) in odd years. Countdown has become a key resource for the global health community.

What are the strengths of Countdown that merit special consideration as the accountability and oversight structures are framed for the post-2015 period? First on the list is Countdown’s reliance on recent, replicable, relevant data on coverage and its determinants at the country level as the driving force, providing an unfiltered lens on progress and results. Second is the essential focus on disaggregating data to reveal inequities. Third, Countdown has maintained its commitment to bringing to the table scientists, policymakers, program leaders and advocates from both country and international institutions to review and act on these data. Finally, Countdown continues to search for more user-friendly ways to present country-specific data to promote the translation of scientific findings into actions that will prolong and improve the lives of women and children.

Conversely, it is precisely these strengths that have produced some of Countdown’s biggest challenges. One challenge has been maintaining the plurality of Countdown and its supra-institutional governance, while remaining true to the evidence. Achieving evidence-based consensus across 43 institutions has transaction costs, particularly around issues related to selecting the subset of proven interventions to be tracked and upholding an appropriate balance across the reproductive, maternal, newborn and child health continuum of care. A related challenge is maintaining flexibility so that Countdown can change in response to new evidence and country needs while adhering to its core principles and processes of work. Another major challenge has been preserving the focus of Countdown. As Countdown has grown in visibility and influence, there has been continuous pressure to expand the areas of concern. For example, should Countdown also

The Countdown process—what we have learned so far


be reporting on child and maternal overweight or obesity? How much emphasis should be given to adolescent health, child development and human capital, maternal morbidity or stillbirths as elements of the continuum of care? How much collaboration is needed with other Millennium Development Goal and topic-specific monitoring initiatives so that each retains its added value yet is an integral part of the whole? Should Countdown retain its main focus on intervention coverage, or should it move more into social and environmental determinants of health or put a greater focus on health impact beyond mortality and nutrition? These debates are ongoing and are an important dialogue for ensuring that Countdown is responsive to the evidence and integrated into other accountability processes

while maintaining a manageable, well defined scope of work so that its messages are clear and actionable.

Protecting the strengths of the Countdown process while addressing these challenges is the work of the future. We believe that there is no one optimal structural arrangement to protect the scientific integrity, programme relevance and independence of Countdown and that instead it represents a process of dedication, commitment, compromise and trust. One absolute necessity is to generate and sustain interest and commitment among young epidemiologists, program evaluators, health economists, communications specialists and programme leaders at the global level—particularly those living and working in Countdown countries.


What do the 2014 findings mean for women and children, both immediately for the 500 days that remain until the end of the Millennium Development Goal era and for the process of defining the post-2015 framework? What actions must be taken? The 2014 Countdown results continue to point to the agenda-setting role of the Millennium Development Goals. This power must be harnessed for women and children in the next set of goals as well.

Looking forward to the post-2015 era, the Countdown experience and findings point to four absolute necessities related to accountability.

• First, this is the time to be building a foundation of baseline data that can be used to track progress. This was a critical omission in the Millennium Development Goal framework.

• Second, we must work to define an accountability mechanism that will serve women and children going forward. Countdown has tried to contribute to that conversation in this report.

• Third, we must back up our accountability rhetoric with real resources that can be used by countries to generate the data they need to participate meaningfully in the process. Too many Countdown countries still cannot report annually on key indicators, even after more than a decade of Millennium Development Goal monitoring and more recent efforts around the Commission on Information and Accountability for Women’s and Children’s Health initiative. Addressing this gap means increasing support for and strengthening country institutional capacity to conduct high-quality household surveys at regular intervals of no more than three years, while working to strengthen vital statistics, tracking of financial resources and assessments of service provision.

• Fourth, these data systems must be designed intentionally to permit disaggregation and

examination of equity trends, to identify the women and children who are being missed and to support effective programming to reach them.

Our mandate is to use the coming 18 months to maintain and move forward on achieving high, sustained and equitable coverage with proven interventions that can save women’s and children’s lives and to strengthen country data systems so that they are able to respond to the future accountability agenda and build better programmes. There are opportunities to save lives now that must not be missed in the process of final assessments related to the Millennium Development Goals and in the current scrambling for places in the sun in the next set of goals. Experience from the Millennium Development Goals reflected in our results show that it took a long while for international agencies and country leaders to translate their global commitments into concrete action and for countries to accelerate coverage gains and mortality reduction. This must not happen on our watch over the coming two to three years. The essential foundation and processes for achieving the next set of goals begins today, with reinvigorated efforts to address the unfinished business of maternal, newborn and child survival. This includes continued recognition of the deep links between women’s and children’s health and the importance of improving service integration across the reproductive, maternal, newborn and child health continuum of care to maximize the impact, quality and efficiency of care provided.

We, as Countdown, challenge ourselves and the global reproductive, maternal, newborn and child health community to make the remaining days in the Millennium Development Goal era and the years beyond 2015 count for women and children. There must be continued, and even increased, accelerations in coverage for life-saving interventions. There must be improvements in the equitable delivery of these interventions,

Countdown speaks: priorities for the next 500 days and beyond


providing essential services for all. There must be progress in ensuring that the necessary policy, health system and financial supports for these services are in place. And there must be greater commitment to data evolution that results in more and better data and data use for improving programmes. In addition, this transition period must see measureable progress in improving nutrition and in making family planning universally

available. These targets do not need to wait for validation through the language of the sustainable development goals—they are a necessary part of any global agenda, and delays are unconscionable. Countdown will continue to track progress towards these immutable targets at the country level, and we will hold fast to the principle of accountability by all for the health and development of women and children.


Country profiles

The information summarized in the profiles is intended to help policymakers and their partners assess progress, prioritize actions and ensure accountability for commitments to reduce maternal, newborn, and child mortality.

The following section contains profiles for the 75 Countdown countries:

AfghanistanAngolaAzerbaijanBangladeshBeninBoliviaBotswanaBrazilBurkina FasoBurundiCambodiaCameroonCentral African Republic ChadChinaComorosCongoCongo, Democratic Republic of theCôte d’IvoireDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambia, TheGhanaGuatemalaGuineaGuinea-BissauHaitiIndiaIndonesia

IraqKenyaKorea, Democratic People’s Republic ofKyrgyzstanLao People’s Democratic RepublicLesothoLiberiaMadagascarMalawiMaliMauritaniaMexicoMoroccoMozambiqueMyanmarNepalNigerNigeriaPakistanPapua New GuineaPeruPhilippinesRwandaSão Tomé and PríncipeSenegalSierra LeoneSolomon IslandsSomaliaSouth AfricaSouth SudanSudanSwazilandTajikistan Tanzania, United Republic ofTogoTurkmenistanUgandaUzbekistanViet NamYemenZambiaZimbabwe


The Countdown country profile: a tool for action

The Countdown country profiles present in one place the latest evidence to assess country progress in improving reproductive, maternal, newborn and child health. The two-page profiles in this report are updated every two years with new data and analyses. Countdown has also committed to annually updating the core indicators selected by the Commission on Information and Accountability for Women’s and Children’s Health.

Reviewing the information

The first step in using the country profiles is to explore the range of data presented: demographics, mortality, coverage of evidence-based interventions, nutritional status and socioeconomic equity in coverage, and information on policies, health systems and financing. Key questions in reviewing the data include:

• Are trends in mortality and nutritional status moving in the right direction? Is the country on track to achieve the health-related Millennium Development Goals?

• How high is coverage for each intervention? Are trends moving in the right direction towards universal coverage? Are there gaps in coverage for specific interventions?

• How equitable is coverage? Are certain interventions particularly inaccessible for the poorest segment of the population?

• Are key policies and systems measures and adequate funding in place to bring coverage of key interventions to scale?

Identifying areas to accelerate progress

The second step in using the country profiles is to identify opportunities to address coverage gaps and accelerate progress in improving coverage and health outcomes across the continuum of care. Questions to ask include:

• Are the coverage data consistent with the epidemiological situation? For example:

• If pneumonia deaths are high, are policies in place to support community case management of pneumonia? Are coverage levels low for careseeking and antibiotic treatment for pneumonia, and what can be done to reach universal coverage? Are the rates of deaths due to diarrhoea consistent with the coverage levels and trends of improved water sources and sanitation facilities?

• In priority countries for eliminating mother-to-child transmission of HIV, are sufficient resources being targeted to preventing mother-to-child transmission?

• Does lagging progress on reducing maternal mortality or high newborn mortality reflect low coverage of family planning, antenatal care, skilled attendance at birth and postnatal care?

• Do any patterns in the coverage data suggest clear action steps? For example, coverage for interventions involving treatment of an acute need (such as treatment of childhood diseases and childbirth services) is often lower than coverage for interventions delivered routinely through outreach or scheduled in advance (such as vaccinations). This gap suggests that health systems need to be strengthened, for example by training and deploying skilled health workers to increase access to care.

• Do the gaps and inequities in coverage along the continuum of care suggest prioritizing specific interventions and increasing funding for reproductive, maternal, newborn and child health? For example, is universal access to labour, delivery and immediate postnatal care being prioritized in countries with gaps in interventions delivered around the time of birth?


Sample country profile

101100

CHILD HEALTH

WATER AND SANITATION

DEMOGRAPHICS

MATERNAL AND NEWBORN HEALTH

7 14

29

59

42

8

22 19

1990 2012

1320

46

72

31

110 7

1990 20124 8

20

44

4715

29 33

1990 2012

11% 2% Preterm 12%

Asphyxia* 12%

Other 2%

Congenital 4%

Sepsis** 8%

0%7%

Measles 1%Injuries 4%

Malaria 19%

HIV/AIDS 1%

Other 17%

External sourcesGeneral government expenditureOut-of-pocket expenditureOther

Density of doctors, nurses and midwives (per 10,000 population)

POLICIES

Diarrhoeal disease treatmentPercent of children <5 years with diarrhoea:

receiving oral rehydration therapy/increased fluids with continued feeding

Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%

Shared facilitiesImproved facilitiesOpen defecation

Percent children receiving first line treatment among those receiving any antimalarial

35 (2011)

Percent children < 5 years sleeping under ITNs

422 28

39

020406080

100

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent

Midwives authorized for specific tasks (X of 7 tasks)

Per capita total expenditure onhealth (Int$)

106

82 88 92 92 90 96

0

20

40

60

80

100

1988DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent

Antenatal carePercent women aged 15-49 years attended at least once by askilled health provider during pregnancy

Causes of maternal deaths, 2013

4029

45 44

29 2939

2945

35

020406080

100

1993DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent

Improved drinking water coverage Improved sanitation coverage

Source: WHO/UNICEF JMP 2014

UnimprovedOther improvedPiped on premises

Percent of population by type of drinking water source, 1990-2012

Total Urban RuralSource: WHO/UNICEF JMP 2014

Percent of population by type of sanitation facility, 1990-2012

Unimproved facilities

Total Urban Rural

treated with ORS

34 (2013)

67 (2011)

11, 17, 7 (2011)

83 (2011)

83 (2011)

- -

88 (2012)

(2012)

Malaria prevention and treatment

Maternity protection (Convention 183)

Source: WHO/CHERG 2014

Women with low body mass index (<18.5 kg/m2, %)

Postnatal visit for mother (within 2 days for home births, %)

Postnatal visit for baby (within 2 days for home births, %)

Neonatal tetanus vaccine

C-section rate (total, urban, rural; %)(Minimum target is 5% and maximum target is 15%)

Malaria during pregnancy - intermittent preventive treatment (%)

Demand for family planning satisfied (%)

Surface water

87 (2011)Antenatal care (4 or more visits, %)

Globally nearly half of child deaths are attributable to undernutrition

Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Sub-Saharan Africa, 2013

General government expenditure on health as % of total government expenditure (%)

ODA to child health per child (US$)

ODA to maternal and neonatal health per live birth (US$)

10 (2012)

24 (2011)

56 (2011)

Reproductive, maternal, newborn and child health expenditure by source

Partially available

Legal status of abortion (X of 5 circumstances)

Costed national implementation plan(s) for: maternal, newborn and child health available

Life Saving Commodities in Essential Medicine List:

Maternal deaths notification

International Code of Marketing ofBreastmilk Substitutes

Postnatal home visits in the first week after birth

Low osmolarity ORS and zinc for management of diarrhoea

Community treatment of pneumonia with antibiotics

SYSTEMS

FINANCING

Kangaroo Mother Care in facilities for low birthweight/preterm newborns

3

7

Partial

Yes

Yes

-

Yes

Yes

Yes

Reproductive health (X of 3)

Maternal health (X of 3)

Newborn health (X of 4)

Child health (X of 3)

3

10.2

-2

National availability of Emergency Obstetric Care services (% of recommended minimum)

-

37

(2013)

-

-

(2013)

(2010)

(2011)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)

Antenatal corticosteroids as part of management of preterm labour

Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent

-

-

Note: See annexes for additional information on the indicators above

Out of pocket expenditure as % of total expenditure on health(%)

29 (2012)

* Intrapartum-related events ** Sepsis/ Tetanus/ Meningitis/ Encephalitis

Neonatal death: 40%

16 19

38

6810

836

5

1990 2012

40 34

44 59

8780

1990 20122 3

36

7810

952

10

1990 2012

NUTRITION(2011)

(2011)

(2012)

67517

DEMOGRAPHICS


46

* See Annex/website for indicator definition

CHILD HEALTH

(2011)

(2011)

EQUITY

11

4 7

31

53 6346

0

20

40

60

80

100

1988DHS

1993DHS

1998DHS

2003DHS

2008DHS

2011MICS

Perc

ent

ImmunizationPercent of children immunized:

against measles with 3 doses Hib with 3 doses pneumococcal conjugate vaccine

with 3 doses DTPwith rotavirus vaccine

Socioeconomic inequities in coverage

Total population (000)Total under-five population (000)Births (000)Birth registration (%)

Neonatal mortality rate (per 1000 live births)

Lifetime risk of maternal death (1 in N)Total fertility rate (per woman)Adolescent birth rate (per 1000 girls)

Stillbirth rate (per 1000 total births)

3.970

22

(2012)28

(2013)66

(2012)25,366(2012)3,640(2012)794(2011)63

(2013)3,100Total maternal deaths

128

72

43

0

40

80

120

160

1990 1995 2000 2005 2010 2015

Under-five mortality rate

MDG Target

Source: IGME 2013

760

380

190

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target

Maternal mortality ratio

Source: MMEIG 2014

88

46

83

68

87

34

0 20 40 60 80 100Percent


Source: DHS, MICS, Other NS

Skilled attendant

*Postnatal care

breastfeeding

Measles

40 4447 50 57

68

0

20

40

60

80

100

1988DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent

Skilled attendant at deliveryPercent live births attended by skilled health personnel

55

8095

020406080

100

2010 2011 2012

Perc

ent

4326

4434

51 41

24 1633 24

56

020406080

100

1993DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent

Pneumonia treatment

889292

4349

020406080

100

1990 1995 2000 2005 2010

Perc

ent

25 26 20 19 14 13

43 41 31 3628 23

0

20

40

60

80

100

1988DHS

1993DHS

1998DHS

2003DHS

2006MICS

2011MICS

Perc

ent

Underweight and stunting prevalencePercent of children <5 years who are moderately or severely:

underweight stunted

Exclusive breastfeeding

Source: UNICEF/UNAIDS/WHO 2013

Percent of children <5 years with symptoms of pneumonia:

receiving antibiotics

Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources.

Household wealth quintile: Poorest 20% Richest 20%

Demand for family planning satisfied

Antenatal care(4+ visits)

at delivery

Exclusive

Introduction of solid, semi-solid/soft foods (%)

Early initiation of breastfeeding (within 1 hr of birth, %)

Vitamin A two dose coverage (%)

Wasting prevalence (moderate and severe, %)

Low birthweight incidence (moderate and severe, %)

Source: WHO/UNICEF 2013

Neonatal deaths: % of all under-5 deaths (2012)40

Infant mortality rate (per 1000 live births) (2012)49

Deaths per 1000 live births Deaths per 100,000 live births

Note: MDG target calculated by Countdown to 2015.

Percent HIV+ pregnant women receiving ARVs for PMTCTUncertainty range around the estimate

Total under-five deaths (000) (2012)56

(2009)

(2012)

(2006)

Pre-pregnancyPregnancy

Birth

Neonatal periodInfancy

Eligible HIV+ pregnant women receiving ART for their own health (%, of total ARVs)

76 (2012)

Prevention of mother-to-childtransmission of HIV

2012

taken to appropriate health provider

Improved drinking water coverage

Percent of infants <6 months exclusively breastfed

Demand for familyplanning satisfied

Antenatal care (1+ visit)

Antenatal care (4+ visits)

Skilled attendantat delivery

Early initiation of breastfeeding

ITN use amongchildren <5 yrs

DTP3

Measles

Vitamin A (past 6 months)

ORT & continued feeding

Careseekingfor pneumonia

0 10 20 30 40 50 60 70 80 90 100PercentSource: MICS 2011

Fulfilling the Health Agenda for Women and Children The 2014 Report


GhanaGhana

Impact: under-5 mortality rateand maternal mortality ratioThese charts display trends overtime, reflecting progress towardsreaching the MillenniumDevelopment Goal 4 and 5 targets.

Cause of deathThese charts provide information useful for interpreting the coverage measures and identifying programmatic priorities.

Intervention coverageThese charts show most recent coveragelevels and trends for selected reproductive,maternal, newborn and child health interventions.

Continuum of careGaps in coverage along the continuum of care frompre-pregnancy and childbirth through childhood upto age 5 should serve as a call to action for a countryto prioritize these interventions.

Health systems and financingThese indicators provideinformation on health systemstrength and available financingfor scaling up interventions.

Water and sanitationWater and sanitation fromimproved sources are essentialfor reducing transmission ofinfectious disease.

NutritionUndernutrition contributes to at least athird of all deaths among children underage 5 globally.

Equity in coverageSocioeconomic inequitiesin coverage highlight theneed for concerted effortsto improve coverageamong the poorest.

Key population characteristicsThese demographic indicators include the proportion of newborn deaths among all deaths of children under age 5, a Commission on Information and Accountability for Women’s and Children’s Health indicator.

PoliciesThese indicators show whether needed policies are in place to support the introduction and scale-up of proven interventions.

48

-

EQUITY

-

54


CHILD HEALTH

(2004)

DEMOGRAPHICS


NUTRITION(2010-2011)

(2010-2011)

-

9

20

-

No Data





Total population (000)Total under-five population (000)

Births (000)

Birth registration (%)


Lifetime risk of maternal death (1 in N)

Total fertility rate (per woman)Adolescent birth rate (per 1000 girls)


5.190

29

(2012)36

(2013)49

(2012)29,825(2012)4,964(2012)1,053

(2010-2011)37


176

99

59

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1200

400300

0

400

800

1200

1600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

68

23

39

15

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles14

24

34 39

0

20

40

60

80

100

2003MICS

2008Other NS

2010DHS

2010-2011MICS

Perc

ent


0

5

10

15

20

2010 2011 2012Pe

rcen

t

61 64

0

20

40

60

80

100

2010-2011MICS

Perc

ent

Pneumonia treatment

687171

0

20

40

60

80

100

1990 1995 2000 2005 2010

Perc

ent

4533

53 59

0

20

40

60

80

100

1997MICS

2004Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth

Neonatal period

Infancy


-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100PercentSource: MICS 2010-2011


Afghanistan

49

DEMOGRAPHICS


CHILD HEALTH


18% 2% Preterm 11%

Asphyxia* 10%

Other 2%

Congenital 2%

Sepsis** 8%

1%13%


Malaria 0%

HIV/AIDS 0%

Other 23%

21 29

8 11

3845

3315

1995 2012

26

47

12

2146

32

160

1995 2012

2023

78

3649

3720

1995 2012



POLICIES



Embolism 2%

Haemorrhage 30%

Hypertension 10%Indirect 29%

Other direct 8%

Abortion 6%

Sepsis 14%



-


Very limited risk



47

16

36

6048

0

20

40

60

80

100

2003MICS

2008Other NS

2010DHS

2010-2011MICS

Perc

ent



48

30

53

020406080

100

2003MICS

2010-2011MICS

Perc

ent




Percent of population by type of drinking water source, 2012




treated with ORS

- -

- -

4, 9, 2 (2010-2011)

- -

23 (2010)

- -

60 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Southern Asia, 2013




7 (2012)

38 (2011)

91 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

No

Yes

Yes

Yes





1

7.3

33


2

-

(2013)

(2013)

(2013)

(2013)

(2011)

-

100

80

60

40

20

0

Perc

ent

Yes (2013)



-

No



74 (2012)


Neonatal death: 36%

1028

4

54

62

52

27

7

33

9 311

Total Urban Rural

100

80

60

40

20

0

Perc

ent


Afghanistan

50

55


CHILD HEALTH

(2007)

EQUITY

DEMOGRAPHICS


NUTRITION(2007)

(2001)

(2012)

87744

(2000)12

11

0

20

40

60

80

100

2001MICS

Perc

ent









6.0188

25

(2012)45

(2013)35

(2012)20,821(2012)3,966(2012)934(2001)36


213

164

71

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1400

460

350

0

300

600

900

1200

1500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

97

11

47

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

23

47

0

20

40

60

80

100

1996MICS

2006-2007Other NS

Perc

ent


2117 17

0

10

20

30

40

2010 2011 2012Pe

rcen

t

No Data

Pneumonia treatment

97

91

91

020406080

100

1990 1995 2000 2005 2010

Perc

ent

37

16

62

29

0

20

40

60

80

100

1996MICS

2007Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



<1 (2012)


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Angola

51

DEMOGRAPHICS


CHILD HEALTH


15%2% Preterm 8%

Asphyxia* 8%

Other 2%

Congenital 1%

Sepsis** 6%

0%14%


Malaria 13%

HIV/AIDS 1%

Other 24%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



77 (2011)


1826

020406080

100

2006-2007Other NS

2011Other NS

Perc

ent



212

80

0

20

40

60

80

100

2006-2007Other NS

Perc

ent



No Data




Percent of population by type of drinking water source, 1990-2012 Percent of population by type of sanitation facility, 1990-2012


Total Urban Rural

treated with ORS

- -

18 (2011)

- -

- -

- -

- -

72 (2012)

(2012)











Surface water

- -Antenatal care (4 or more visits, %)


Source: WHO 2014

Pneumonia

Diarrhoea





6 (2012)

6 (2011)

7 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

No

No

No

Yes





0

18.3

33


2

25

(2013)

(2013)

(2013)

(2013)

(2009)

(2006)

100

80

60

40

20

0

Perc

ent

Yes (2013)



No

Yes



27 (2012)


Neonatal death: 28%

621

36

33

3424

24 22

1990 2012

1634

27

34

44

3013

2

1990 20121 1

4133

28

15

30

51

1990 2012

No Data


Angola

52

(2006)

EQUITY

1032


CHILD HEALTH

(2006)

DEMOGRAPHICS


NUTRITION(2006)

(2006)

(2012)

78390

7 12

0

20

40

60

80

100

2000MICS

2006DHS

Perc

ent









1.947

12

(2012)15

(2013)1,800

(2012)9,309(2012)768(2012)168(2006)94

(2013)43Total maternal deaths

93

3531

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

60

26

15

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

66

12

66

99

45

77

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

97 10084 88 99

0

20

40

60

80

100

1990Other NS

1998Other NS

2000MICS

2006DHS

2010Other NS

Perc

ent


36

020406080

100

2000MICS

Perc

ent

Pneumonia treatment

667591

020406080

100

1990 1995 2000 2005 2010

Perc

ent

9 146 8

2824 18 27

0

20

40

60

80

100

1996Other NS

2000MICS

2001Other NS

2006DHS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100PercentSource: DHS 2006

020406080

100

2010 2011 2012Pe

rcen

tSource: UNICEF/UNAIDS/WHO 2013


Azerbaijan

53

DEMOGRAPHICS


CHILD HEALTH

WATER AND SANITATIONOut of pocket expenditure as % of total expenditure on health(%)

5782

5

73811

0 0

1995 2012

70

86

9

11213

0 0

1995 2012

43

782

355

18

0 1

1995 2012

16% 1% Preterm 17%

Asphyxia* 8%

Other 5%

Congenital 6%

Sepsis** 5%

0%8%

Measles 0%

Injuries 8%

Malaria 0%

HIV/AIDS 0%

Other 25%



POLICIES



Embolism 11%

Haemorrhage 23%


Other direct 17%

Abortion 5%

Sepsis 9%



-


10

20406080

100

2000MICS

Perc

ent



572

98

66 7077

0

20

40

60

80

100

1997MoH

2000MICS

1996-2001Other NS

2006DHS

Perc

ent



40 31

1021

020406080

100

2000MICS

2006DHS

Perc

ent








Total Urban Rural

treated with ORS

77 (2006)

- -

5, 5, 4 (2006)

- -

66 (2006)

- -

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Caucasus and Central Asia, 2013




4 (2012)

9 (2011)

18 (2011)


No Data









SYSTEMS

FINANCING


5

-

Yes

Yes

No

-

Yes

-

-





1

101.2

--


-

-

(2013)

-

-

-

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -

(R,F)



-

-


69 (2012)


Neonatal death: 43%

44 51

26

29

21 129 8

1990 2012

6778

21 1011 10

1 2

1990 2012

17 20

3251

3313

18 16

1990 2012


Azerbaijan

54

(2006)

EQUITY

2247


CHILD HEALTH

(2011)

DEMOGRAPHICS


NUTRITION(2011)

(2011)

(2012)

166299

46 4546 42 43

64

0

20

40

60

80

100

1993-94DHS

1996-97DHS

1999-00DHS

2004DHS

2007DHS

2011DHS

Perc

ent









2.2128

36

(2012)24

(2013)250

(2012)154,695(2012)15,074(2012)3,150(2011)31


144

41 48

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

550

170140

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

96

64

27

32

26

82

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles 10 1214 18

32

0

20

40

60

80

100

1993-94DHS

1999-00DHS

2003MICS

2007DHS

2011DHS

Perc

ent


28 33 27 20 3035

22

71

020406080

100

1993-94DHS

1996-97DHS

1999-00DHS

2004DHS

2006MICS

2011DHS

Perc

ent

Pneumonia treatment

96

9696

020406080

100

1990 1995 2000 2005 2010

Perc

ent

6253

42 43 41 37

6360 51 51

43 41

0

20

40

60

80

100

1989-90Other NS

1996-97DHS

1999-00DHS

2004DHS

2007DHS

2011DHS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles





0

10

20

30

40

2010 2011 2012Pe

rcen

tSource: UNICEF/UNAIDS/WHO 2013


Bangladesh

55

DEMOGRAPHICS


CHILD HEALTH

WATER AND SANITATIONOut of pocket expenditure as % of total expenditure on health(%)


3357

17

2816

1234

3

1990 2012

4655

2530

1915

10 0

1990 2012

30

58

15

28

15

1140

3

1990 2012

11% 2% Preterm 19%

Asphyxia* 13%

Other 7%

Congenital 7%

Sepsis** 11%0%6%

Measles 2%

Injuries 6%

Malaria 0%

HIV/AIDS 0%

Other 16%



POLICIES



Embolism 2%

Haemorrhage 30%

Hypertension 10%

Indirect 29%

Other direct 8%

Abortion 6%

Sepsis 14%

2011 Report



-


Very limited risk



68

2633

4052 55

0

20

40

60

80

100

1993-94DHS

1999-00DHS

2003MICS

2007DHS

2011DHS

Perc

ent



5268 76

5061 67

77 78

020406080

100

1993-94DHS

1999-00DHS

2004DHS

2007DHS

2011DHS

Perc

ent








Total Urban Rural

treated with ORS

82 (2011)

- -

17, 29, 14 (2011)

30 (2011)

27 (2011)

28 (2011)

94 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





8 (2012)

7 (2011)

17 (2011)

No Data









SYSTEMS

FINANCING


1

6

No

No

Yes

Yes

Partial

Yes

Yes





1

5.7

23


3

54

(2013)

(2013)

(2013)

(2013)

(2011)

(2007)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



-

Yes


63 (2012)


Neonatal death: 60%

5 10

63

75

2615

6 0

1990 2012

2332

58 54

17 142 0

1990 20120 1

6583

2816

7 0

1990 2012


Bangladesh

56

(2006)

EQUITY

1550


CHILD HEALTH

(2011-2012)

DEMOGRAPHICS



(2008)

(2012)

167699

10

3843

33

0

20

40

60

80

100

1996DHS

2001DHS

2006DHS

2011-2012DHS

Perc

ent









4.998

24

(2012)28

(2013)59

(2012)10,051(2012)1,631(2012)371

(2011-2012)80


181

90

60

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

600

340

150

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

72

33

84

61

28

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

6066

7484

0

20

40

60

80

100

1996DHS

2001DHS

2006DHS

2011-2012DHS

Perc

ent


2232

40

0

20

40

60

80

2010 2011 2012Pe

rcen

t

32 3536 31

020406080

100

1996DHS

2001DHS

2006DHS

2011-2012DHS

Perc

ent

Pneumonia treatment

7285

8585

020406080

100

1990 1995 2000 2005 2010

Perc

ent

26 22 20

39 3945

0

20

40

60

80

100

1996DHS

2001DHS

2006DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Benin

57

DEMOGRAPHICS


CHILD HEALTH


5 147

238

9

80

54

1990 2012

1425

20

3714

11

5227

1990 20120

51123

7

96

76

1990 2012

13% 2% Preterm 10%

Asphyxia* 9%

Other 1%

Congenital 3%

Sepsis** 6%

0%9%


Malaria 21%

HIV/AIDS 1%

Other 18%

52

22

20 6 External sources

General government expenditureOut-of-pocket expenditureOther


POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%

Countdown to 20152011 Report



32 (2011-2012)


720

71

020406080

100

2001DHS

2006DHS

2011-2012DHS

Perc

ent



70

80 81 84 86

0

20

40

60

80

100

1996DHS

2001DHS

2006DHS

2011-2012DHS

Perc

ent



42 42

26 23 23

50

020406080

100

1996DHS

2001DHS

2006DHS

2011-2012DHS

Perc

ent








Total Urban Rural

2011 Report

treated with ORS

28 (2012)

23 (2011-2012)

4, 6, 2 (2006)

- -

- -

- -

93 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

26 (2011)

43 (2011)


Available(2012)









SYSTEMS

FINANCING


3

7

Yes

Yes

Yes

Yes

Yes

Yes

Yes





-

8.3

33


2

34

-

(2013)

(2013)

(2013)

(2008)

(2011)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)

%



Partial

Yes



44 (2012)


Neonatal death: 32%

516

52

60

21

20224

1990 2012

1632

56

53

19 139 2

1990 20120 4

4965

22

25296

1990 2012


Benin

58

NUTRITION(2008)

(2008)

(2012)

18341

DEMOGRAPHICS


64


CHILD HEALTH

(2008)

(2008)

EQUITY

6

5143

5039

5460

0

20

40

60

80

100

1989DHS

1994DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent









3.389

17

(2012)19

(2013)140

(2012)10,496(2012)1,264(2012)273(2008)76


123

41 41

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

510

200

130

0

120

240

360

480

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

84

60

77

71

72

75

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

43 47

5969

61

71

0

20

40

60

80

100

1989DHS

1994DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent


0

25

50

75

100

2010 2011 2012Pe

rcen

t

40 4354 52 51

64

020406080

100

1994DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent

Pneumonia treatment

848080

76

020406080

100

1990 1995 2000 2005 2010

Perc

ent

8 11 6 6 5

4437 33 33 27

0

20

40

60

80

100

1989DHS

1994DHS

1998DHS

2003DHS

2008DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2005)


Birth



-


2012










DTP3

Measles






Bolivia

59

CHILD HEALTH


DEMOGRAPHICS


2846

12

2114

1446

19

1990 2012

41

57

20

2814

10255

1990 2012

12 243

513

22

7249

1990 2012

15%2% Preterm 13%

Asphyxia* 13%

Other 4%

Congenital 7%

Sepsis** 8%0%8%


Malaria 0%

HIV/AIDS 0%

Other 23%



POLICIES



Embolism 3%

Haemorrhage 23%


Other direct 15%

Abortion 10%

Sepsis 8%



-


Very limited risk



305

4653

6983 79

86

0

20

40

60

80

100

1989DHS

1994DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent



59 54

2933 30 25 29 35

020406080

100

1994DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent








Total Urban Rural

treated with ORS

75 (2008)

- -

19, 28, 8 (2008)

77 (2008)

77 (2008)

- -

76 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Causes of under-five deaths, 2012Regional estimates for Latin America, 2013




10 (2012)

18 (2011)

34 (2011)


No Data









SYSTEMS

FINANCING


3

-

Partial

Yes

No

No

Partial

No

Yes





3

14.8

33


3

48

(2013)

(2013)

(2013)

(2013)

(2011)

(2003)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R)



Partial

Yes



23 (2012)


Neonatal death: 46%

49

83

20

512

4198

1990 2012

7995

1218 4

1 0

1990 2012

12

5729

1519

540

23

1990 2012


Bolivia

60

NUTRITION(2007)

(2007)

-

746

-

DEMOGRAPHICS


40


CHILD HEALTH

(2007)

(2007)

EQUITY

13

3420

0

20

40

60

80

100

2000MICS

2007Other NS

Perc

ent









2.751

16

(2012)29

(2013)200

(2012)2,004(2012)232(2012)48(2007)72


48 53

16

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

360

170

90

0

100

200

300

400

500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

94

20

95

73

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

7887

94 95

0

20

40

60

80

100

1988DHS

1996Other NS

2000MICS

2007Other NS

Perc

ent


>95 >95 >95

020406080

100

2010 2011 2012Pe

rcen

t

140

20406080

100

2000MICS

Perc

ent

Pneumonia treatment

9496

96

52

020406080

100

1990 1995 2000 2005 2010

Perc

ent

15 11 11

3529

31

0

20

40

60

80

100

1996Other NS

2000MICS

2007Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



95 (2012)


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Botswana

61

CHILD HEALTH


DEMOGRAPHICS


3964

5

821

153513

1990 2012

61

78

5

62316

11 0

1990 2012

2242

6

1120

12

52

35

1990 2012

11% 2%Preterm 21%

Asphyxia* 13%

Other 3%

Congenital 6%

Sepsis** 9%0%7%

Measles 1%

Injuries 5%

Malaria 0%

HIV/AIDS 5%

Other 18%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



-


Sub-national risk



872

92 97 94

0

20

40

60

80

100

1988Other NS

2000MICS

2007Other NS

Perc

ent



7

49

020406080

100

2000Other NS

Perc

ent








Total Urban Rural

treated with ORS

- -

- -

- -

- -

- -

- -

92 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





8 (2012)

10 (2011)

26 (2011)


No Data









SYSTEMS

FINANCING


3

5

No

Yes

Yes

No

Yes

No

Yes





1

31.8

33


2

-

(2013)

(2013)

(2013)

(2013)

(2006)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



Yes

Yes



6 (2012)


Neonatal death: 54%

22

70

70

273 15 2

1990 2012

39

90

61

9

0 100

1990 2012

10

38

76

55

638 4

1990 2012


Botswana

62

NUTRITION(2008)

(2006)

-

270

-

DEMOGRAPHICS


68


CHILD HEALTH

(2006-2007)

(2010)

EQUITY

8

40 41

0

20

40

60

80

100

2006MoH

2008MoH

Perc

ent







Lifetime risk of maternal death (1 in N)

Total fertility rate (per woman)Adolescent birth rate (per 1000 girls)


1.865

10

(2012)9

(2013)780

(2012)198,656(2012)14,563(2012)3,009(2010)93


62

14 21

0

15

30

45

60

75

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

120

69

30

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

41

97

91

93

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

70

8897

0

20

40

60

80

100

1991DHS

1996DHS

2006MoH

Perc

ent


0

20

40

60

80

100

2010 2011 2012

Perc

ent

46 50

15

020406080

100

1996DHS

2006MoH

Perc

ent

Pneumonia treatment

999495

8986

020

406080

100

1990 1995 2000 2005 2010

Perc

ent

5 5 4 2

1914 7

0

20

40

60

80

100

1989Other NS

1996DHS

2002-2003Other NS

2006-2007DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100PercentSource: DHS 2006-2007


Brazil

63

CHILD HEALTH


DEMOGRAPHICS


6781

1115

15173

1990 2012

7987

1114 11

6 1

1990 2012

3149

1

120

3348

17

1990 2012

6% 1% Preterm 21%

Asphyxia* 10%

Other 10%

Congenital 12%Sepsis** 9%

0%2%

Measles 0%

Injuries 5%

Malaria 0%

HIV/AIDS 0%

Other 24%



POLICIES



Embolism 3%

Haemorrhage 23%


Other direct 15%

Abortion 10%

Sepsis 8%



-


Very limited risk



1,109

7486

97 98 98

0

20

40

60

80

100

1986DHS

1996DHS

2003MoH

2006MoH

2009MoH

Perc

ent



27

44

020406080

100

1991DHS

1996DHS

Perc

ent








Total Urban Rural

treated with ORS

93 (2006)

- -

50 , - , - (2009)

- -

- -

6 (1996)

93 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





8 (2012)

1 (2011)

1 (2011)


No Data









SYSTEMS

FINANCING


1

-

Partial

Yes

Yes

-

Yes

No

Yes





0

94.9

--


-

-

(2013)

-

-

-

(2013)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -

(R)



-

-



31 (2012)


Neonatal death: 64%

7892

106824 0

1990 2012

92 97

4 34 00 0

1990 2012

39

67

29

1818

12143

1990 2012


Brazil

64

(2010)

EQUITY

1442


CHILD HEALTH

(2012)

DEMOGRAPHICS


NUTRITION(2010)

(2012)

(2012)

115799

3 6

197

25

38

0

20

40

60

80

100

1993DHS

1998-1999DHS

2003DHS

2006MICS

2010DHS

2012Other NS

Perc

ent









5.7136

26

(2012)28

(2013)44

(2012)16,460(2012)2,932(2012)683(2010)77


202

102

67

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

770

400

190

0

200

400

600

800

1000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

87

38

72

66

34

40

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

4231

38

5466

0

20

40

60

80

100

1993DHS

1998-1999DHS

2003DHS

2006MICS

2010DHS

Perc

ent


50 5666

0

25

50

75

100

2010 2011 2012Pe

rcen

t

19 22

36 3956

12 15

47

020406080

100

1993DHS

1998-1999DHS

2003DHS

2006MICS

2010DHS

Perc

ent

Pneumonia treatment

87

9090

020406080

100

1990 1995 2000 2005 2010

Perc

ent

30 34 35 3826 24

41 46 43 4235 33

0

20

40

60

80

100

1993DHS

1998-1999DHS

2003DHS

2006MICS

2009Other NS

2012Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



-


2012










DTP3

Measles






Burkina Faso

65

DEMOGRAPHICS


CHILD HEALTH


8 197

177

7

7857

1990 2012

4450

3236

13 511 9

1990 20122 73

1068

8975

1990 2012

14% 2% Preterm 9%

Asphyxia* 8%

Other 1%

Congenital 2%

Sepsis** 6%

0%10%

Measles 1%

Injuries 5%Malaria 23%

HIV/AIDS 1%

Other 20%

40

28

30 2 External sources

General government expenditureOut-of-pocket expenditureOther


POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



25 (2010)


2 10

47

020406080

100

2003DHS

2006MICS

2010DHS

Perc

ent



90

59 6173

8594

0

20

40

60

80

100

1993DHS

1998-1999DHS

2003DHS

2006MICS

2010DHS

Perc

ent



47 4233

12 15 19 17 21

020406080

100

1993DHS

1998-1999DHS

2003DHS

2006MICS

2010DHS

Perc

ent








Total Urban Rural

treated with ORS

40 (2010)

11 (2010)

2, 6, 1 (2010)

26 (2010)

72 (2010)

14 (2010)

88 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





12 (2012)

14 (2011)

31 (2011)


Available(2012)









SYSTEMS

FINANCING


3

7

Yes

No

Yes

Yes

Yes

Yes

Yes





2

6.1

33


3

16

(2013)

(2013)

(2013)

(2013)

(2010)

(2011)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)

%



Yes

No



36 (2012)


Neonatal death: 27%

2 7

42

75

48

148 4

1990 2012

1127

64

70

243

1 0

1990 20120 0

39

76

51

1910 5

1990 2012


Burkina Faso

66

NUTRITION(2010)

(2010)

-

670

-

DEMOGRAPHICS


74


CHILD HEALTH

(2010)

(2010)

EQUITY

13

77

6245

69

0

20

40

60

80

100

1987DHS

2000MICS

2005Other NS

2010DHS

Perc

ent









6.165

28

(2012)36

(2013)22

(2012)9,850(2012)1,839(2012)443(2010)75


164

104

55

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1300

740

330

0

400

800

1200

1600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

93

69

30

60

33

40

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles19

2534

60

0

20

40

60

80

100

1987DHS

2000MICS

2005MICS

2010DHS

Perc

ent


49 51 54

0

20

40

60

80

2010 2011 2012Pe

rcen

t

40 38

55

2643

020406080

100

2000MICS

2005MICS

2010DHS

Perc

ent

Pneumonia treatment

93

96 9696

020406080

100

1990 1995 2000 2005 2010

Perc

ent

34 39 35 29

56 63 58 58

0

20

40

60

80

100

1987DHS

2000MICS

2005Other NS

2010DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



47 (2012)


2012










DTP3

Measles






Burundi

67

CHILD HEALTH


DEMOGRAPHICS


42 47

710

48 40

3 3

1990 2012

3143

27

37

4118

1 2

1990 2012

42 48

5 6

50 43

3 3

1990 2012

17% 2% Preterm 11%

Asphyxia* 10%

Other 2%

Congenital 2%

Sepsis** 7%

0%13%


Malaria 5%

HIV/AIDS 1%

Other 22%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



70 (2010)


1 8

45

020406080

100

2000MICS

2005MICS

2010DHS

Perc

ent



45

79 7892

99

0

20

40

60

80

100

1987DHS

2000MICS

2005MICS

2010DHS

Perc

ent



1623

43

11

35 38

020406080

100

2000MICS

2005MICS

2010DHS

Perc

ent








Total Urban Rural

treated with ORS

40 (2010)

- -

4, 12, 3 (2010)

8 (2010)

30 (2010)

12 (2010)

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





14 (2012)

21 (2011)

30 (2011)


No Data









SYSTEMS

FINANCING


3

-

No

No

Yes

No

Partial

Yes

Yes





3

2.2

33


3

27

(2013)

(2013)

(2013)

(2013)

(2004)

(2010)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



No

No



28 (2012)


Neonatal death: 35%

3 6

6669

21 13

10 12

1990 2012

3248

64 44

232 5

1990 20121 1

6672

23 14

10 13

1990 2012


Burundi

68

NUTRITION(2010)

(2010)

(2012)

118898

DEMOGRAPHICS


66


CHILD HEALTH

(2010)

(2010)

EQUITY

11

12

6066

74

0

20

40

60

80

100

2000DHS

2005DHS

2008Other NS

2010DHS

Perc

ent









2.930

18

(2012)18

(2013)180

(2012)14,865(2012)1,669(2012)386(2010)62


116

4039

0

35

70

105

140

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1200

170 300

0

300

600

900

1200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

93

74

70

72

59

75

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

34 32

44

71 72

0

20

40

60

80

100

1998MoH

2000DHS

2005DHS

2010DHS

2011Other NS

Perc

ent


0

20

40

60

80

100

2010 2011 2012Pe

rcen

t

3748

64

39

020406080

100

2000DHS

2005DHS

2010DHS

Perc

ent

Pneumonia treatment

93

9595

020406080

100

1990 1995 2000 2005 2010

Perc

ent

43 4028 29 29

5949 44

40 41

0

20

40

60

80

100

1996Other NS

2000DHS

2005DHS

2008Other NS

2010DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2012)


Birth



-


2012










DTP3

Measles






Cambodia

69

CHILD HEALTH


DEMOGRAPHICS


337

0

7

9

2

88

54

1990 2012

18

82

2

11

14

0

66

7

1990 20120

250

6

7

3

93

66

1990 2012

15% 2%Preterm 14%

Asphyxia* 12%

Other 4%

Congenital 7%

Sepsis** 8%

0%8%Measles 0%


HIV/AIDS 0%

Other 21%



POLICIES



Embolism 12%

Haemorrhage 30%

Hypertension 15%

Indirect 17%

Other direct 14%

Abortion 7%Sepsis 6%



-


40

20406080

100

2005DHS

Perc

ent



135

34 38

69

89

0

20

40

60

80

100

1998MoH

2000DHS

2005DHS

2010DHS

Perc

ent



50 48

1821

34

020406080

100

2000DHS

2005DHS

2010DHS

Perc

ent








Total Urban Rural

treated with ORS

75 (2010)

- -

3, - , - (2011)

- -

70 (2010)

- -

91 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for South-eastern Asia, 2013




7 (2012)

27 (2011)

64 (2011)


No Data









SYSTEMS

FINANCING


5

7

No

Yes

Yes

Yes

Yes

No

Yes





1

10.1

33


3

33

(2013)

(2013)

(2013)

(2013)

(2008)

(2008)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)



Yes

Yes



62 (2012)


Neonatal death: 48%

21820

5342

1536

14

1990 2012

15

6717

27

41

427

2

1990 20120 5

20

6143

1737

17

1990 2012


Cambodia

70

(2006)

EQUITY

1120


CHILD HEALTH

(2011)

DEMOGRAPHICS


NUTRITION(2006)

(2006)

(2012)

66388

7 12

24 21 20

0

20

40

60

80

100

1991DHS

1998DHS

2004DHS

2006MICS

2011DHS

Perc

ent









4.9128

26

(2012)28

(2013)34

(2012)21,700(2012)3,572(2012)820(2011)61


135

95

45

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

720

590

180

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

82

20

37

64

62

50

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

6458

60 62 63 64

0

20

40

60

80

100

1991DHS

1998DHS

2000MICS

2004DHS

2006MICS

2011DHS

Perc

ent


56 5564

0

20

40

60

80

2010 2011 2012Pe

rcen

t

4434 25

4035 3038 45

020406080

100

1991DHS

1998DHS

2000MICS

2004DHS

2006MICS

2011DHS

Perc

ent

Pneumonia treatment

82

858584

020406080

100

1990 1995 2000 2005 2010

Perc

ent

18 17 15 17 15

36 38 35 36 33

0

20

40

60

80

100

1991DHS

1998DHS

2004DHS

2006MICS

2011DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



44 (2012)


2012










DTP3

Measles






Cameroon

71

DEMOGRAPHICS


CHILD HEALTH


40 45

13 15

36 34

11 6

1990 2012

60 62

22 23

16 142 1

1990 2012

27 27

7 7

49 54

17 12

1990 2012

15% 2% Preterm 8%

Asphyxia* 10%

Other 1%

Congenital 2%

Sepsis** 6%

0%11%

Measles 1%Injuries 6%Malaria 12%

HIV/AIDS 3%

Other 22%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



26 (2011)


1 113 21

020406080

100

2000MICS

2004DHS

2006MICS

2011DHS

Perc

ent



120

79 79 7583 82 85

0

20

40

60

80

100

1991DHS

1998DHS

2000MICS

2004DHS

2006MICS

2011DHS

Perc

ent



3243

22

47

1822 14 17 13 17

020406080

100

1991DHS

1998DHS

2000MICS

2004DHS

2006MICS

2011DHS

Perc

ent








Total Urban Rural

treated with ORS

50 (2011)

26 (2011)

4, 7, 2 (2011)

- -

37 (2011)

8 (2011)

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





9 (2012)

1,819 (2011)

23 (2011)


No Data









SYSTEMS

FINANCING


3

7

Partial

Yes

No

No

Yes

Yes

Yes





1

5.2

33


3

60

(2013)

(2013)

(2013)

(2013)

(2009)

(2010)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R)



-

Yes



63 (2012)


Neonatal death: 30%

11 16

40

58

35

18

14 8

1990 2012

25 28

5366

2052 1

1990 20122 4

3248

4432

22 16

1990 2012


Cameroon

72

(2010)

EQUITY

1444


CHILD HEALTH

(2010)

DEMOGRAPHICS


NUTRITION(2010)

(2010)

(2012)

76083

317

2334

0

20

40

60

80

100

1994-1995DHS

2000MICS

2006MICS

2010MICS

Perc

ent









4.5229

24

(2012)41

(2013)27

(2012)4,525(2012)662(2012)156(2010)61


171

129

57

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1200

880

300

0

400

800

1200

1600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

49

34

54

38

36

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

46 4453

4454

0

20

40

60

80

100

1994-1995DHS

2000MICS

2006MICS

2009Other NS

2010MICS

Perc

ent


No Data

4132 32 30

3931

020406080

100

1994-1995DHS

2000MICS

2006MICS

2010MICS

Perc

ent

Pneumonia treatment

4947

4747

020406080

100

1990 1995 2000 2005 2010

Perc

ent

24 2228 24

42 45 4541

0

20

40

60

80

100

1994-1995DHS

2000MICS

2006MICS

2010MICS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Central African Republic

73

DEMOGRAPHICS


CHILD HEALTH


15 22

8 13

4542

32 23

1990 2012

20

4413

2859

24

8 4

1990 2012

12 75 3

37 56

4634

1990 2012

12% 2% Preterm 10%

Asphyxia* 10%

Other 1%Congenital 1%

Sepsis** 6%

0%9%


Malaria 25%

HIV/AIDS 3%

Other 15%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



9 (2010)


215

36

020406080

100

2000MICS

2006MICS

2010MICS

Perc

ent



32

67 6269 68

0

20

40

60

80

100

1994-1995DHS

2000MICS

2006MICS

2010MICS

Perc

ent



47 4738

28 17 13 16

020406080

100

1994-1995DHS

2000MICS

2006MICS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

36 (2010)

38 (2010)

5, 8, 2 (2010)

- -

- -

15 (1994-1995)

66 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





11 (2012)

22 (2011)

31 (2011)


No Data









SYSTEMS

FINANCING


1

7

Partial

No

No

-

No

No

-





2

3.1

--


-

-

(2013)

-

-

-

(2009)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -



-

-



46 (2012)


Neonatal death: 32%

3 2

5666

2829

133

1990 2012

8 4

72 86

18 102 0

1990 20120 0

46 54

35 41

195

1990 2012


Central African Republic

74

(2010)

EQUITY

2029


CHILD HEALTH

(2010)

DEMOGRAPHICS


NUTRITION(2010)

(2010)

(2012)

1646

0

2

10

2 3

0

5

10

15

20

25

1996-1997DHS

2000MICS

2004DHS

2010MICS

Perc

ent









6.4203

29

(2012)40

(2013)15

(2012)12,448(2012)2,406(2012)579(2010)16


209150

70

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1700

980

430

0

400

800

1200

1600

2000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

64

3

23

23

15

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles15 16 14

23

0

20

40

60

80

100

1996-1997DHS

2000MICS

2004DHS

2010MICS

Perc

ent


813

14

0

5

10

15

20

2010 2011 2012Pe

rcen

t

19 22 1226 31

020406080

100

1996-1997DHS

2000MICS

2004DHS

2010MICS

Perc

ent

Pneumonia treatment

644545

020406080

100

1990 1995 2000 2005 2010

Perc

ent

34 2934 30

4539

4539

0

20

40

60

80

100

1996-1997DHS

2000MICS

2004DHS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



32 (2012)


2012










DTP3

Measles






Chad

75

DEMOGRAPHICS


CHILD HEALTH


8 12

3 510

18

7965

1990 2012

2131

12

18

4237

25 14

1990 20124 61 12 14

9379

1990 2012

15% 2% Preterm 9%

Asphyxia* 7%


Sepsis** 5%

0%12%


Malaria 19%

HIV/AIDS 2%

Other 21%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



3 (2010)


110

020406080

100

2000MICS

2010MICS

Perc

ent



53

23

42 3953

0

20

40

60

80

100

1996-1997DHS

2000MICS

2004DHS

2010MICS

Perc

ent



4427 2323 16 15 13

020406080

100

1996-1997DHS

2000MICS

2004DHS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

15 (2010)

22 (2010)

2, 4, 1 (2010)

- -

- -

23 (2004)

43 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





6 (2012)

11 (2011)

16 (2011)


No Data









SYSTEMS

FINANCING


2

7

No

No

Yes

No

No

No

Yes





1

2.3

33


2

20

(2013)

(2013)

(2013)

(2013)

(2006)

(2011)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(F)



No

-



53 (2012)


Neonatal death: 27%

2 6

38

45

4646

143

1990 2012

725

42

47

4828

3 0

1990 20120 1

37 44

47 52

163

1990 2012


Chad

76

NUTRITION(2008)

(2008)

-

243

-

DEMOGRAPHICS


41


CHILD HEALTH

(2010)

(2008)

EQUITY

3

28

0

20

40

60

80

100

2008Other NS

Perc

ent









1.76

10

(2012)9

(2013)1,800

(2012)1,377,065(2012)88,934(2012)18,455

--


54

14 18

0

20

40

60

80

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

97

3224

0

30

60

90

120

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

28

100

97

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

94 8997 98 99 100

0

20

40

60

80

100

1990MoH

1995MoH

2000MoH

2005MoH

2008MoH

2011MoH

Perc

ent


No Data

No Data

Pneumonia treatment

9999

020406080

100

1990 1995 2000 2005 2010

Perc

ent

13 11 7 5 3

32 3118

12 9

0

20

40

60

80

100

1990Other NS

1995Other NS

2000Other NS

2005Other NS

2010Other NS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


China

77

CHILD HEALTH


DEMOGRAPHICS


24

657

1962

157 1

1990 2012

48

74

15

2434

23 0

1990 2012

15

564

1472

28

9 2

1990 2012

10% 4% Preterm 14%

Asphyxia* 15%

Other 15%

Congenital 9%Sepsis** 2%

1%3%

Measles 0%

Injuries 10%

Malaria 0%

HIV/AIDS 0%

Other 16%



POLICIES



Embolism 12%

Haemorrhage 36%

Hypertension 10%

Indirect 25%

Other direct 14%




-


Very limited risk



480

7079

89 90 9194

0

20

40

60

80

100

1992MoH

1995MoH

2000MoH

2005MoH

2008MoH

2011MoH

Perc

ent



No Data








Total Urban Rural

treated with ORS

97 (2001)

- -

36, 47, 33 (2011)

- -

- -

- -

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Eastern Asia, 2013




13 (2012)

0 (2011)

0 (2011)


No Data









SYSTEMS

FINANCING


5

-

No

Yes

Yes

-

Partial

-

Yes





0

29.7

--


-

-

(2013)

-

-

-

(2010)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -

(R,F)



-

-



34 (2012)


Neonatal death: 61%

33

71

34

2126

77 1

1990 2012

9295

5 32 21 0

1990 2012

12

45

44

40

34

1310 2

1990 2012


China

78

NUTRITION(1996)

(2000)

-

1134

-

DEMOGRAPHICS


25


CHILD HEALTH

(2012)

(2000)

EQUITY

25

321

0

20

40

60

80

100

1996DHS

2000MICS

Perc

ent









4.870

27

(2012)31

(2013)58

(2012)718(2012)115(2012)26(2000)88


124

78

41

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

630

350

160

0

150

300

450

600

750

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

85

21

82

37

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

5262

82

0

20

40

60

80

100

1996DHS

2000MICS

2012pDHS

Perc

ent


0

10

20

30

40

2010 2011 2012

Perc

ent

53 5638

020406080

100

1996DHS

2000MICS

2012pDHS

Perc

ent

Pneumonia treatment

8586 86

020406080

100

1990 1995 2000 2005 2010

Perc

ent

15 2125

15

39 4047

30

0

20

40

60

80

100

1991-1992Other NS

1996DHS

2000MICS

2012pDHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Comoros

79

CHILD HEALTH


DEMOGRAPHICS


13% 2% Preterm 13%

Asphyxia* 12%

Other 2%

Congenital 3%

Sepsis** 8%

0%9%


Malaria 15%

HIV/AIDS 1%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



16 (2012)


9

41

020406080

100

2000MICS

2012pDHS

Perc

ent



56

8574 75

92

0

20

40

60

80

100

1996DHS

2000MICS

2004Other NS

2012pDHS

Perc

ent



3129 1938

020406080

100

1996DHS

2000MICS

2012pDHS

Perc

ent





treated with ORS

37 (1996)

28 (2012)

5, 9, 4 (1996)

- -

- -

10 (1996)

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia





10 (2012)

21 (2011)

52 (2011)


No Data









SYSTEMS

FINANCING


3

7

-

Yes

Yes

Yes

-

No

Yes





-

8.9

22


3

33

-

(2013)

(2013)

(2013)

(2004)

(2005)

Yes (2013)



No

No



44 (2012)


Neonatal death: 40%

Diarrhoea

No Data No Data


Comoros

80

NUTRITION(2005)

(2005)

-

678

-

DEMOGRAPHICS


39


CHILD HEALTH

(2011-2012)

(2005)

EQUITY

13

19

0

20

40

60

80

100

2005DHS

Perc

ent









5.0147

26

(2012)32

(2013)48

(2012)4,337(2012)722(2012)165

(2011-2012)91


100 96

33

0

40

80

120

160

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

670

410

170

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

80

19

64

94

75

71

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

8394

0

20

40

60

80

100

2005DHS

2011-2012DHS

Perc

ent


19

7

19

0

10

20

30

40

2010 2011 2012Pe

rcen

t

48 52

020406080

100

2005DHS

2011-2012DHS

Perc

ent

Pneumonia treatment

808585

100

20406080

100

1990 1995 2000 2005 2010

Perc

ent

16 12 12

30 31 24

0

20

40

60

80

100

1987Other NS

2005DHS

2011-2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Congo

81

CHILD HEALTH


DEMOGRAPHICS


2538

2

50

58

37

16

4

36

90

25

Total Urban Rural

100

80

60

40

20

0

Perc

ent

10% 2% Preterm 12%

Asphyxia* 9%Other 1%

Congenital 3%

Sepsis** 6%

0%8%


Malaria 25%

HIV/AIDS 3%

Other 16%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



57 (2012)


626

020406080

100

2005DHS

2011-2012DHS

Perc

ent



140

8693

0

20

40

60

80

100

2005DHS

2011-2012DHS

Perc

ent



3918

35

020406080

100

2005DHS

2011-2012DHS

Perc

ent






Percent of population by type of sanitation facility, 2012


treated with ORS

71 (2011-2012)

22 (2011-2012)

3, 4, 2 (2005)

- -

64 (2011-2012)

13 (2005)

83 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





6 (2012)

15 (2011)

20 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

Yes

No

Yes

Yes





2

9.2

33


3

25

(2013)

(2013)

(2013)

(2013)

(2007)

(2010)

Yes (2013)



No

Yes



25 (2012)


Neonatal death: 33%

15 206

3041

9

47

37

65

8 220

Total Urban Rural

100

80

60

40

20

0

Perc

ent


Congo

82

NUTRITION(2010)

(2010)

(2012)

95284

DEMOGRAPHICS


43


CHILD HEALTH

(2010)

(2010)

EQUITY

10

24 24

36 37

0

20

40

60

80

100

1995MICS

2001MICS

2007DHS

2010MICS

Perc

ent









6.0135

29

(2012)44

(2013)23

(2012)65,705(2012)11,691(2012)2,839(2010)28


171 146

57

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1000

730

250

0

300

600

900

1200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

73

37

80

45

42

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

6174

80

0

20

40

60

80

100

2001MICS

2007DHS

2010MICS

Perc

ent


1

6

13

0

5

10

15

20

2010 2011 2012Pe

rcen

t

36 42 40 42

020406080

100

2001MICS

2007DHS

2010MICS

Perc

ent

Pneumonia treatment

737272

26

020406080

100

1990 1995 2000 2005 2010

Perc

ent

31 34 28 24

5144

4644

0

20

40

60

80

100

1995Other NS

2001MICS

2007DHS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



18 (2012)


2012










DTP3

Measles






Congo, Democratic Republic of the

83

CHILD HEALTH


DEMOGRAPHICS


1731

1117

5443

18 9

1990 2012

32 29

2725

3645

5 1

1990 2012

11335

13

61

41

23 13

1990 2012

14% 2% Preterm 10%

Asphyxia* 8%

Other 2%

Congenital 1%

Sepsis** 6%

0%12%


Malaria 16%

HIV/AIDS 1%

Other 19%

47 53



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



4 (2010)


1 6

38

020406080

100

2001MICS

2007DHS

2010MICS

Perc

ent



24

68

85 89

0

20

40

60

80

100

2001MICS

2007DHS

2010MICS

Perc

ent



17

42 39

1731 27

020406080

100

2001MICS

2007DHS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

42 (2010)

21 (2010)

7, 10, 6 (2010)

- -

- -

- -

70 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Sub Saharan Africa, 2013




13 (2012)

21 (2011)

23 (2011)


Available(2011)









SYSTEMS

FINANCING


1

-

No

No

Yes

Yes

Partial

Yes

Yes





3

6.4

43


2

-

(2013)

(2013)

(2013)

(2013)

(2004)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

%



No

No



32 (2012)


Neonatal death: 30%

14 8

29 38

3338

2416

1990 2012

49

20

39

59

1118

1 3

1990 20121 1

25 28

41 48

33 23

1990 2012


Congo, Democratic Republic of the

84


(2011-2012)

(2012)

76499

DEMOGRAPHICS


31


CHILD HEALTH

(2011-2012)

(2006)

EQUITY

17

3 410 5 4

12

0

20

40

60

80

100

1994DHS

1998-99DHS

2000MICS

2003-04Other NS

2006MICS

2011-12DHS

Perc

ent









4.9125

27

(2012)40

(2013)29

(2012)19,840(2012)3,088(2012)731

(2011-2012)65


152108

51

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

740720

190

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

85

12

70

59

44

45

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

45 47

63 55 57 59

0

20

40

60

80

100

1994DHS

1998-99DHS

2000MICS

2005Other NS

2006MICS

2011-12DHS

Perc

ent


55 5368

020406080

100

2010 2011 2012Pe

rcen

t

39 3538 35 38

19

020406080

100

1994DHS

1998-99DHS

2000MICS

2006MICS

2011-12DHS

Perc

ent

Pneumonia treatment

859494

020406080

100

1990 1995 2000 2005 2010

Perc

ent

2012

20 18 17 14

34 3240

28

0

20

40

60

80

100

1994DHS

1998-99DHS

2006MICS

2011-12DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



34 (2012)











DTP3

Measles






Côte d’Ivoire

85

CHILD HEALTH


DEMOGRAPHICS


15 22

2029

2921

36 28

1990 2012

2833

3643

30 18

6 6

1990 2012

7 1010 15

2724

56 51

1990 2012

12% 2% Preterm 12%

Asphyxia* 11%


Sepsis** 8%

0%10%


Malaria 16%

HIV/AIDS 2%

Other 18%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



17 (2011-2012)


14 3

37

020406080

100

2000MICS

2003-04Other NS

2006MICS

2011-12DHS

Perc

ent



144

83 84 88 87 85 91

0

20

40

60

80

100

1994DHS

1998-99DHS

2000MICS

2005Other NS

2006MICS

2011-12DHS

Perc

ent



3445

36

1124 16 10 17

020406080

100

1994DHS

1998-99DHS

2000MICS

2006MICS

2011-12DHS

Perc

ent








Total Urban Rural

treated with ORS

45 (2011-2012)

18 (2011-2012)

3, 5, 1 (2011-2012)

34 (2011-2012)

70 (2011-2012)

6 (2011-2012)

82 (2012)

(2012)











Surface water

44 (2011-2012)Antenatal care (4 or more visits, %)


Source: WHO 2014

Pneumonia

Diarrhoea





8 (2012)

15 (2011)

23 (2011)


No Data









SYSTEMS

FINANCING


1

7

Partial

Yes

Yes

Yes

No

No

Yes





1

6.3

33


2

7

(2013)

(2013)

(2013)

(2013)

(2008)

(2010)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Yes

No



56 (2012)


Neonatal death: 38%

2340

53

40

1417

103

1990 2012

5064

4028

10 70 1

1990 2012

5 14

6254

17 26

16 6

1990 2012


Côte d’Ivoire

86

(2006)

EQUITY

1055


CHILD HEALTH

(2012)

DEMOGRAPHICS


NUTRITION(2006)

(2006)

(2012)

223588

10

5

10

15

20

2006MICS

Perc

ent









3.521

34

(2012)31

(2013)130

(2012)860(2012)108(2012)24(2006)92


119

81

40

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

400

230

100

0

100

200

300

400

500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

83

1

93

7

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

61

93

0

20

40

60

80

100

2003MoH

2006MICS

Perc

ent


10 1320

0

10

20

30

40

2010 2011 2012Pe

rcen

t

62 6243

020406080

100

2002Other NS

2006MICS

Perc

ent

Pneumonia treatment

8381

81

020406080

100

1990 1995 2000 2005 2010

Perc

ent

20 1625

30 3028 32 27 33 34

0

20

40

60

80

100

1989Other NS

1996Other NS

2002Other NS

2006MICS

2012(p)Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Djibouti

87

DEMOGRAPHICS


CHILD HEALTH


6261

5 5

14 20

19 14

1990 2012

6973

5 616 1910 2

1990 2012

39

22

5

3

621

50 54

1990 2012

13% 2% Preterm 12%

Asphyxia* 9%

Other 2%

Congenital 3%

Sepsis** 6%

0%9%


Malaria 1%

HIV/AIDS 2%

Other 20%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



22 (2009)


120

020406080

100

2006MICS

2009Other NS

Perc

ent



231

67

92

0

20

40

60

80

100

2003MoH

2006MICS

Perc

ent



33

62

020406080

100

2006MICS

Perc

ent








Total Urban Rural

treated with ORS

- -

- -

12, - , - (2008)

- -

- -

- -

79 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





14 (2012)

42 (2011)

99 (2011)


No Data









SYSTEMS

FINANCING


1

7

No

Yes

Yes

No

Partial

No

Yes





1

10.3

32


3

50

(2013)

(2013)

(2013)

(2013)

(2008)

(2004)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Partial

Yes



40 (2012)


Neonatal death: 33%

5463

23

2921

82 0

1990 2012

6779

15

211800 0

1990 2012

13 9

47 56

34 34

6 1

1990 2012


Djibouti

88

(2008)

EQUITY

1343


CHILD HEALTH

(2008)

DEMOGRAPHICS


NUTRITION(2005)

(2008)

(2012)

87062

4656

57

30 38

53

0

20

40

60

80

100

1992DHS

1995DHS

2000DHS

2003DHS

2005DHS

2008DHS

Perc

ent









2.850

13

(2012)12

(2013)710

(2012)80,722(2012)9,237(2012)1,898(2005)99


86

21 29

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

120

4530

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

93

53

65

79

66

84

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

3541

4655 61

6974 79

0

20

40

60

80

100

1988DHS

1992DHS

1995DHS

1998DHS

2000DHS

2003DHS

2005DHS

2008DHS

Perc

ent


0

5

10

15

20

2010 2011 2012

Perc

ent


59 6266 70 73

25

7573

58

020406080

100

1992DHS

1995DHS

2000DHS

2003DHS

2008DHS

Perc

ent

Pneumonia treatment

9393

020406080

100

1990 1995 2000 2005 2010

Perc

ent

8 11 9 5 7

31 35 2520 24

31

0

20

40

60

80

100

1992DHS

1995DHS

2000DHS

2003DHS

2005DHS

2008DHS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2005)


Birth



-


2012










DTP3

Measles






Egypt

89

DEMOGRAPHICS


CHILD HEALTH


7296

4

414

0100

1990 2012

9198

325 01 0

1990 2012

57

94

4

6

22

017

0

1990 2012

8% 2%Preterm 23%

Asphyxia* 12%

Other 4%

Congenital 12%Sepsis** 4%0%5%Measles 0%

Injuries 3%

Malaria 0%

HIV/AIDS 0%

Other 27%



POLICIES



Embolism 3%

Haemorrhage 37%

Hypertension 17%

Indirect 18%

Other direct 17%




-


Very limited risk



323

53 5339

47 53

69 70 74

0

20

40

60

80

100

1988DHS

1992DHS

1995DHS

1998DHS

2000DHS

2003DHS

2005DHS

2008DHS

Perc

ent



29 26 271929

40 34 28 34 28

020406080

100

1992DHS

1995DHS

2000DHS

2003DHS

2005DHS

2008DHS

Perc

ent








Total Urban Rural

treated with ORS

84 (2008)

- -

28, 37, 22 (2008)

8 (2008)

65 (2008)

- -

86 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Northern Africa, 2013




6 (2012)

2 (2011)

5 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

No

Yes

No

Yes





0

63.5

23


2

-

(2013)

(2013)

(2013)

(2013)

(2009)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Partial

Yes



60 (2012)


Neonatal death: 56%

61

96

32

35 12 0

1990 2012

90 100

6 04 00 0

1990 2012

39

93

51

6713 0

1990 2012


Egypt

90

(2000)

EQUITY

13-


CHILD HEALTH

(2004)

DEMOGRAPHICS


NUTRITION-

-

-

3--

24

0

20

40

60

80

100

2000MICS

Perc

ent









4.9128

17

(2012)34

(2013)72

(2012)736(2012)113(2012)26(2000)37


182

100

61

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1600

290 400

0

400

800

1200

1600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

51

24

65

27

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles 5

65

0

20

40

60

80

100

1994Other NS

2000MICS

Perc

ent


No Data

No Data

Pneumonia treatment

5133

020406080

100

1990 1995 2000 2005 2010

Perc

ent

14 16 11

39 43 35

0

20

40

60

80

100

1997Other NS

2000MICS

2004Other NS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2001)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Equatorial Guinea

91

DEMOGRAPHICS


CHILD HEALTH


13% 2% Preterm 11%

Asphyxia* 10%

Other 2%

Congenital 2%

Sepsis** 6%

0%8%


Malaria 15%

HIV/AIDS 7%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



-


10

20406080

100

2000MICS

Perc

ent



1,432

37

86

0

20

40

60

80

100

1994Other NS

2000MICS

Perc

ent



36 29

020406080

100

2000MICS

Perc

ent





treated with ORS

27 (2011)

- -

- -

- -

- -

- -

75 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





7 (2012)

16 (2011)

48 (2011)


No Data









SYSTEMS

FINANCING


3

7

Partial

Yes

Yes

Yes

No

-

Yes





-

8.4

33


3

-

-

(2013)

(2013)

(2013)

(2004)

-

Yes (2013)



Yes

Yes



44 (2012)


Neonatal death: 33%

No Data No Data


Equatorial Guinea

92

NUTRITION(2002)

(2002)

(2012)

154338

DEMOGRAPHICS


78


CHILD HEALTH

(2002)

(2002)

EQUITY

14

5952

0

20

40

60

80

100

1995DHS

2002DHS

Perc

ent









4.885

21

(2012)18

(2013)52

(2012)6,131(2012)1,034(2012)230

--


150

5250

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1700

380 430

0

500

1000

1500

2000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

52

28

41

22

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

2128

0

20

40

60

80

100

1995DHS

2002DHS

Perc

ent


5 0

46

0

20

40

60

80

2010 2011 2012Pe

rcen

t

44

020406080

100

2002DHS

Perc

ent

Pneumonia treatment

999999

020406080

100

1990 1995 2000 2005 2010

Perc

ent

37 40 35

70

48 44

0

20

40

60

80

100

1993Other NS

1995DHS

2002DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(1999)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Eritrea

93

CHILD HEALTH


DEMOGRAPHICS


17% 2%Preterm 7%

Asphyxia* 11%

Other 2%

Congenital 5%

Sepsis** 7%

0%10%


Malaria 0%

HIV/AIDS 1%

Other 23%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



5 (2008)


4

49

020406080

100

2002DHS

2008Other NS

Perc

ent



17

49

70

0

20

40

60

80

100

1995DHS

2002DHS

Perc

ent



54

3345

020406080

100

1995DHS

2002DHS

Perc

ent





treated with ORS

22 (2002)

- -

3, 7, 1 (2002)

- -

- -

38 (2002)

94 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





4 (2012)

8 (2011)

21 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

No

Yes

Yes





2

6.3

33


3

-

(2013)

(2013)

(2013)

(2013)

(2004)

-

Yes (2013)

(R,F)



Yes

Yes



53 (2012)


Neonatal death: 34%

No Data No Data


Eritrea

94

NUTRITION(2011)

(2011)

(2012)

104931

DEMOGRAPHICS


52


CHILD HEALTH

(2011)

(2005)

EQUITY

20

5449

52

0

20

40

60

80

100

2000DHS

2005DHS

2011DHS

Perc

ent









4.687

26

(2012)29

(2013)52

(2012)91,729(2012)14,095(2012)3,084(2005)7


204

6868

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1400

420

350

0

300

600

900

1200

1500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

66

52

7

10

19

52

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles 6 610

0

20

40

60

80

100

2000DHS

2005DHS

2011DHS

Perc

ent


1624

41

0

20

40

60

80

2010 2011 2012Pe

rcen

t

16 1927

5 7

020406080

100

2000DHS

2005DHS

2011DHS

Perc

ent

Pneumonia treatment

6661

61

120

20406080

100

1990 1995 2000 2005 2010

Perc

ent

42 42 35 29

6757 51

44

0

20

40

60

80

100

1992Other NS

2000DHS

2005DHS

2011DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



38 (2012)


2012










DTP3

Measles






Ethiopia

95

CHILD HEALTH


DEMOGRAPHICS


2 244

13

2

2692

37

1990 2012

1927

29

4212

2340

8

1990 2012

0 230

7

0

27100

43

1990 2012

16% 2% Preterm 11%

Asphyxia* 14%

Other 2%

Congenital 4%

Sepsis** 9%

0%9%Measles 2%

Injuries 6%

Malaria 3%

HIV/AIDS 2%

Other 19%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



28 (2011)


2

33 30

020406080

100

2005DHS

2007Other NS

2011Other NS

Perc

ent



44

27 2843

0

20

40

60

80

100

2000DHS

2005DHS

2011DHS

Perc

ent



1525

1320 26

020406080

100

2000DHS

2005DHS

2011DHS

Perc

ent








Total Urban Rural

treated with ORS

52 (2011)

- -

2, 8, 1 (2011)

- -

7 (2011)

24 (2011)

68 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





11 (2012)

17 (2011)

33 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

Partial

Yes

Yes





3

2.8

33


3

11

(2013)

(2013)

(2013)

(2013)

(2009)

(2008)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



Yes

Yes



41 (2012)


Neonatal death: 43%

11012

4238

3149

17

1990 2012

10

51

71

4610

39 0

1990 20120 1

3

4142

38

55

20

1990 2012


Ethiopia

96

NUTRITION(2012)

(2000)

(2012)

362

2

DEMOGRAPHICS


32


CHILD HEALTH

(2012)

(2000)

EQUITY

14

6 60

20

40

60

80

100

2000DHS

2012DHS

Perc

ent









4.1115

17

(2012)25

(2013)94

(2012)1,633(2012)238(2012)53(2012)90


92

62

31

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

380

240

95

0

100

200

300

400

500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

71

6

59

89

78

54

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

86 89

0

20

40

60

80

100

2000DHS

2012DHS

Perc

ent


48 5070

0

25

50

75

100

2010 2011 2012Pe

rcen

t

4868

50

020406080

100

2000DHS

2012DHS

Perc

ent

Pneumonia treatment

718282

020406080

100

1990 1995 2000 2005 2010

Perc

ent

9 6

2617

0

20

40

60

80

100

2000-2001Other NS

2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Gabon

97

CHILD HEALTH


DEMOGRAPHICS


38 41

30 34

30 23

2 2

1995 2012

3943

33 36

26 192 2

1995 2012

35 32

2119

4145

3 4

1995 2012

10% 2% Preterm 15%

Asphyxia* 11%

Other 2%

Congenital 4%

Sepsis** 8%

0%7%


Malaria 19%

HIV/AIDS 2%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



34 (2012)


5539

020406080

100

2008Other NS

2012DHS

Perc

ent



558

94 95

0

20

40

60

80

100

2000DHS

2012DHS

Perc

ent



4452

25 26

020406080

100

2000DHS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

54 (2012)

3 (2012)

10, 11, 6 (2012)

25 (2012)

59 (2012)

5 (2012)

75 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





7 (2012)

6 (2011)

28 (2011)


No Data









SYSTEMS

FINANCING


1

4

Partial

Yes

Yes

No

Yes

No

Yes





-

53.1

33


3

123

-

(2013)

(2013)

(2013)

(2004)

(2001)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



No

No



41 (2012)


Neonatal death: 41%

35

61

45

317

3135

1995 2012

43

68

51

29

323

1

1995 2012

8 14

29

4919

7

4430

1995 2012


Gabon

98

(2010)

EQUITY

1052


CHILD HEALTH

(2010)

DEMOGRAPHICS


NUTRITION(2010)

(2010)

(2012)

103446

2641 34

0

20

40

60

80

100

2000MICS

2005-2006MICS

2010MICS

Perc

ent









5.888

26

(2012)28

(2013)39

(2012)1,791(2012)328(2012)77(2010)53


170

7357

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

710

430

180

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

95

34

57

72

38

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

4455

57 57

0

20

40

60

80

100

1990Other NS

2000MICS

2005-2006MICS

2010MICS

Perc

ent


0

25

50

75

100

2010 2011 2012Pe

rcen

t

75 69 696170

020406080

100

2000MICS

2005-2006MICS

2010MICS

Perc

ent

Pneumonia treatment

95 9898 98

020406080

100

1990 1995 2000 2005 2010

Perc

ent

2315 16 17

36

2428

23

0

20

40

60

80

100

1996MICS

2000MICS

2005-2006MICS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Gambia

99

DEMOGRAPHICS


CHILD HEALTH


61 60

2122

12 166 2

1995 2012

62 64

27 28

9 82 0

1995 2012

6155

1614

1327

10 4

1995 2012

11% 2% Preterm 11%

Asphyxia* 12%

Other 2%

Congenital 4%

Sepsis** 8%

0%7%


Malaria 20%

HIV/AIDS 1%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



37 (2013)


15

4933

020406080

100

2000MICS

2005-2006MICS

2010MICS

Perc

ent



98

9198 98

0

20

40

60

80

100

2000MICS

2005-2006MICS

2010MICS

Perc

ent



38 38

67

3339 39

020406080

100

2000MICS

2005-2006MICS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

38 (2010)

62 (2013)

3, 5, 1 (2010)

- -

- -

- -

92 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





11 (2012)

27 (2011)

31 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

Yes

Yes

Yes





1

9.7

33


3

50

(2013)

(2013)

(2013)

(2013)

(2008)

(2012)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Yes

Yes



16 (2012)


Neonatal death: 40%

1132

65

58

2410

0 0

1990 2012

27

52

59

42

14 60 0

1990 20121 5

6979

3016

0 0

1990 2012


Gambia

100

NUTRITION(2011)

(2011)

(2012)

67517

DEMOGRAPHICS


46


CHILD HEALTH

(2011)

(2011)

EQUITY

11

4 7

31

53 6346

0

20

40

60

80

100

1988DHS

1993DHS

1998DHS

2003DHS

2008DHS

2011MICS

Perc

ent









3.970

22

(2012)28

(2013)66

(2012)25,366(2012)3,640(2012)794(2011)63


128

72

43

0

40

80

120

160

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

760

380

190

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

88

46

83

68

87

34

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

40 4447 50 57

68

0

20

40

60

80

100

1988DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent


55

8095

020406080

100

2010 2011 2012Pe

rcen

t

4326

4434

51 41

24 1633 24

56

020406080

100

1993DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent

Pneumonia treatment

889292

4349

020406080

100

1990 1995 2000 2005 2010

Perc

ent

25 26 20 19 14 13

43 41 31 3628 23

0

20

40

60

80

100

1988DHS

1993DHS

1998DHS

2003DHS

2006MICS

2011MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



76 (2012)


2012










DTP3

Measles






Ghana

101

CHILD HEALTH


DEMOGRAPHICS


7 14

29

59

42

8

22 19

1990 2012

1320

46

72

31

110 7

1990 20124 8

20

44

4715

29 33

1990 2012

11% 2% Preterm 12%

Asphyxia* 12%

Other 2%

Congenital 4%

Sepsis** 8%

0%7%


Malaria 19%

HIV/AIDS 1%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



35 (2011)


422 28

39

020406080

100

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent



106

82 88 92 92 90 96

0

20

40

60

80

100

1988DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent



4029

45 44

29 2939

2945

35

020406080

100

1993DHS

1998DHS

2003DHS

2006MICS

2008DHS

2011MICS

Perc

ent








Total Urban Rural

treated with ORS

34 (2013)

67 (2011)

11, 17, 7 (2011)

83 (2011)

83 (2011)

- -

88 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

24 (2011)

56 (2011)


Partially available









SYSTEMS

FINANCING


3

7

Partial

Yes

Yes

-

Yes

Yes

Yes





3

10.2

-2


-

37

(2013)

-

-

(2013)

(2010)

(2011)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



-

-



29 (2012)


Neonatal death: 40%

16 19

38

6810

836

5

1990 2012

40 34

44 59

8780

1990 20122 3

36

7810

952

10

1990 2012


Ghana

102


(2008-2009)

(2012)

17114

DEMOGRAPHICS


56


CHILD HEALTH

(2008-2009)

(2008-2009)

EQUITY

11

46 51 50

0

20

40

60

80

100

1995DHS

2002Other NS

2008-2009Other NS

Perc

ent









3.892

10

(2012)15

(2013)170

(2012)15,083(2012)2,215(2012)474

(2008-2009)97


80

32

27

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

270

140

68

0

60

120

180

240

300

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

93

50

52

72

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

2935

41 4152

0

20

40

60

80

100

1987DHS

1995DHS

1998-1999DHS

2002Other NS

2008-2009Other NS

Perc

ent


0

10

20

30

40

2010 2011 2012

Perc

ent

41 37

64

020406080

100

1995DHS

1998-1999DHS

2002Other NS

Perc

ent

Pneumonia treatment

939696

81

020406080

100

1990 1995 2000 2005 2010

Perc

ent

2822 20 18 13

6655 53 54

48

0

20

40

60

80

100

1987DHS

1995DHS

1998-1999DHS

2002Other NS

2008-2009Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Guatemala

103

CHILD HEALTH


DEMOGRAPHICS


6280

6

810

6226

1990 2012

8188

9105 05 2

1990 2012

4972

4

613

123410

1990 2012

15% 2%Preterm 11%

Asphyxia* 14%

Other 3%

Congenital 10%

Sepsis** 9%

0%8%Measles 0%

Injuries 8%

Malaria 0%

HIV/AIDS 1%

Other 20%



POLICIES



Embolism 3%

Haemorrhage 23%


Other direct 15%

Abortion 10%

Sepsis 8%



-


10

20406080

100

1999Other NS

Perc

ent



368

35

5360

8493

0

20

40

60

80

100

1987DHS

1995DHS

1998-1999DHS

2002Other NS

2008-2009Other NS

Perc

ent



2230 34 37

020406080

100

1995DHS

1998-1999DHS

2002Other NS

2008-2009Other NS

Perc

ent








Total Urban Rural

treated with ORS

72 (2008-2009)

- -

16, 26, 11 (2008-2009)

- -

- -

- -

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





19 (2012)

6 (2011)

24 (2011)


No Data









SYSTEMS

FINANCING


1

-

Partial

Yes

Yes

Yes

Yes

Yes

Yes





2

18.3

33


3

-

(2013)

(2013)

(2013)

(2013)

(2009)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Yes

Yes



50 (2012)


Neonatal death: 48%

49

86

32

87312

3

1990 2012

68

98

2317 12 0

1990 2012

35

73

39

1685186

1990 2012


Guatemala

104

(2005)

EQUITY

1240


CHILD HEALTH

(2011-2012)

DEMOGRAPHICS


NUTRITION(2005)

(2008)

(2012)

63299

1123

27

48

0

20

40

60

80

100

1999DHS

2003MICS

2005DHS

2008Other NS

Perc

ent









5.0154

24

(2012)34

(2013)30

(2012)11,451(2012)1,856(2012)428(2005)43


241

101

80

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1100

650

280

0

250

500

750

1000

1250

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

58

48

45

50

29

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

31 35

56

3846 45

0

20

40

60

80

100

1992DHS

1999DHS

2003MICS

2005DHS

2007Other NS

2012DHS

Perc

ent


1731

44

0

20

40

60

80

2010 2011 2012Pe

rcen

t

39 3342 37

020406080

100

1999DHS

2003MICS

2005DHS

2012DHS

Perc

ent

Pneumonia treatment

585959

020406080

100

1990 1995 2000 2005 2010

Perc

ent

21 21 23 21 16

35 3439 40 36

0

20

40

60

80

100

1994-1995Other NS

1999DHS

2005DHS

2008Other NS

2011-2012Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Guinea

105

DEMOGRAPHICS


CHILD HEALTH


8 19

921

42

43

41

17

1990 2012

1833

23

43

54

23

5 1

1990 2012

5 113

8

37

55

55

26

1990 2012

11% 2% Preterm 10%

Asphyxia* 11%

Other 2%

Congenital 2%

Sepsis** 7%

0%8%


Malaria 27%

HIV/AIDS 2%

Other 14%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



5 (2012)


1 5

26

020406080

100

2005DHS

2007Other NS

2012DHS

Perc

ent



67

5871

84 82 88 85

0

20

40

60

80

100

1992DHS

1999DHS

2003MICS

2005DHS

2007Other NS

2012DHS

Perc

ent



44 3825

35 40 33 34

020406080

100

1992DHS

1999DHS

2003MICS

2005DHS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

29 (2005)

18 (2012)

2, 5, 2 (2007)

- -

- -

11 (2012)

80 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





7 (2012)

5 (2011)

17 (2011)


No Data









SYSTEMS

FINANCING


3

7

Partial

No

Yes

Yes

Partial

Yes

Yes





1

6.1

33


3

13

(2013)

(2013)

(2013)

(2013)

(2005)

(2013)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)



Partial

Yes



67 (2012)


Neonatal death: 34%

5 13

47

62

8

1840

7

1990 2012

1935

6757

78

7 0

1990 20120 0

3965

8

2453

11

1990 2012


Guinea

106

NUTRITION(2010)

(2010)

(2012)

64395

DEMOGRAPHICS


55


CHILD HEALTH

(2010)

(2010)

EQUITY

11

37

16

38

0

20

40

60

80

100

2000MICS

2006MICS

2010MICS

Perc

ent









5.0137

30

(2012)46

(2013)36

(2012)1,664(2012)265(2012)63(2010)24


206

129

69

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

930

560

230

0

200

400

600

800

1000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

69

38

43

68

70

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

2535

39 43

0

20

40

60

80

100

1990-1995Other NS

2000MICS

2006MICS

2010MICS

Perc

ent


1522

33

0

20

40

60

80

2010 2011 2012Pe

rcen

t

64 57 5242 35

020406080

100

2000MICS

2006MICS

2010MICS

Perc

ent

Pneumonia treatment

698076

020406080

100

1990 1995 2000 2005 2010

Perc

ent

22 17 17 18

3648

28 32

0

20

40

60

80

100

2000MICS

2006MICS

2008Other NS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Guinea-Bissau

107

CHILD HEALTH


DEMOGRAPHICS


12% 3% Preterm 9%

Asphyxia* 12%

Other 2%

Congenital 2%

Sepsis** 8%

0%10%


Malaria 18%

HIV/AIDS 3%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



-


7

39 36

020406080

100

2000MICS

2006MICS

2010MICS

Perc

ent



66

62

7893

0

20

40

60

80

100

2000MICS

2006MICS

2010MICS

Perc

ent



2325

5339

23 19

020406080

100

2000MICS

2006MICS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

70 (2010)

14 (2010)

2, 5, 1 (2010)

- -

- -

- -

80 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





8 (2012)

18 (2011)

47 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

-

-

Partial

No

-





-

6.6

--


-

127

-

-

-

-

(2009)

(2002)

100

80

60

40

20

0

Perc

ent

- -



-

-



43 (2012)


Neonatal death: 36%

4 5

32

69

60

24

4 2

1990 2012

14 11

31

85

55

30 1

1990 2012

2034

8

15

28

4

40

36

45

25

2

43

Total Urban Rural

100

80

60

40

20

0

Perc

ent

0 0

3256

6341

5 3

1990 2012


Guinea-Bissau

108

NUTRITION(2012)

(2012)

(2012)

58754

DEMOGRAPHICS


47


CHILD HEALTH

(2012)

(2012)

EQUITY

23

2441 40

0

20

40

60

80

100

2000DHS

2005-2006DHS

2012DHS

Perc

ent









3.265

15

(2012)25

(2013)80

(2012)10,174(2012)1,250(2012)265(2012)80


144

76

48

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

670

380

170

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

58

40

32

37

67

49

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

23 2124 26

37

0

20

40

60

80

100

1989Other NS

1994-1995DHS

2000DHS

2005-2006DHS

2012DHS

Perc

ent


40

71

>95

020406080

100

2010 2011 2012Pe

rcen

t

1726

31 38

3

46

020406080

100

1994-1995DHS

2000DHS

2005-2006DHS

2012DHS

Perc

ent

Pneumonia treatment

5860

020406080

100

1990 1995 2000 2005 2010

Perc

ent

24 2414

1911

4037 28 30

22

0

20

40

60

80

100

1990Other NS

1994-1995DHS

2000DHS

2005-2006DHS

2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Haiti

109

CHILD HEALTH


DEMOGRAPHICS


19 24

17 24

16

31

48

21

1990 2012

34 31

3935

1426

13 8

1990 2012

13 16

9 11

1635

62

38

1990 2012

20% 2% Preterm 11%

Asphyxia* 9%

Other 3%

Congenital 2%

Sepsis** 6%

0%11%


Malaria 1%

HIV/AIDS 1%

Other 27%



POLICIES



Embolism 3%

Haemorrhage 23%


Other direct 15%

Abortion 10%

Sepsis 8%



-


12

020406080

100

2012DHS

Perc

ent



84

71 6879 85 90

0

20

40

60

80

100

1984-1989Other NS

1994-1995DHS

2000DHS

2005-2006DHS

2012DHS

Perc

ent



41 4357

2635 40

53

020406080

100

1994-1995DHS

2000DHS

2005-2006DHS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

49 (2012)

- -

6, 10, 3 (2012)

19 (2012)

32 (2012)

9 (2012)

76 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Caribbean, 2013




5 (2012)

74 (2011)

283 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

No

-

-

Partial

No

Yes





3

3.6

--


-

12

(2013)

-

-

-

(1998)

(2008)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -



-

-



3 (2012)


Neonatal death: 34%

8 9

5353

2234

174

1990 2012

2612

61

63

8 245 1

1990 20122 4

48 43

28 45

228

1990 2012


Haiti

110


(2005-2006)

(2012)

205659

DEMOGRAPHICS


41


CHILD HEALTH

(2005-2006)

(2005-2006)

EQUITY

28

44 46 3746

0

20

40

60

80

100

1992-1993NFHS

1998-1999NFHS

2000MICS

2005-2006NFHS

Perc

ent









2.539

22

(2012)31

(2013)190

(2012)1,236,687(2012)120,581(2012)25,642

(2005-2006)41


126

56

42

0

40

80

120

160

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

560

190140

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

74

46

37

52

37

73

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

3442 43 47 52

0

20

40

60

80

100

1992-1993NFHS

1998-1999NFHS

2000MICS

2005-2006NFHS

2007-2008Other NS

Perc

ent


No Data

69 6769

3313

020406080

100

1992-1993NFHS

1998-1999NFHS

2005-2006NFHS

Perc

ent

Pneumonia treatment

7472

020406080

100

1990 1995 2000 2005 2010

Perc

ent

51 46 4458

54 48

0

20

40

60

80

100

1992-1993NFHS

1998-1999NFHS

2005-2006NFHS

Perc

ent


underweight stunted








at delivery

Exclusive












Total under-five deaths (000) (2012)1,414

(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100PercentSource: NFHS 2005-2006


India

111

CHILD HEALTH


DEMOGRAPHICS


1836

5

93

7

74

48

1990 2012

5060

172058

2812

1990 20127

251

52

5

90

65

1990 2012

12% 2%Preterm 25%

Asphyxia* 11%

Other 5%

Congenital 4%

Sepsis** 9%0%10%

Measles 2%

Injuries 3%

Malaria 0%

HIV/AIDS 0%

Other 16%



POLICIES



Embolism 2%

Haemorrhage 30%


Other direct 8%

Abortion 6%

Sepsis 14%



-


No Data



157

62 65 6274

0

20

40

60

80

100

1992-1993NFHS

1998-1999NFHS

2000MICS

2005-2006NFHS

Perc

ent



33

1827 26

020406080

100

1992-1993NFHS

1998-1999NFHS

2005-2006NFHS

Perc

ent








Total Urban Rural

treated with ORS

73 (2008)

- -

9, 17, 6 (2005-2006)

- -

37 (2005-2006)

- -

87 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





9 (2012)

2 (2011)

6 (2011)


No Data









SYSTEMS

FINANCING


4

-

No

Yes

Yes

Yes

Yes

Yes

Yes





2

24.1

33


3

-

(2013)

(2013)

(2013)

(2013)

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



No

No



58 (2012)


Neonatal death: 55%

1726

53

67

27

63 1

1990 2012

48 51

41 46

10 31 0

1990 2012

7 14

57

77

328

41

1990 2012


India

112

NUTRITION(2010)

(2007)

(2012)

128573

DEMOGRAPHICS


29


CHILD HEALTH

(2010)

(2007)

EQUITY

9

63

45 37 4240 32

42

0

20

40

60

80

100

1987DHS

1991DHS

1994DHS

1997DHS

2002-2003DHS

2007DHS

2012DHS

Perc

ent









2.447

15

(2012)15

(2013)220

(2012)246,864(2012)24,622(2012)4,736(2012)67


84

3128

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

430

190

110

0

100

200

300

400

500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

80

42

80

83

88

84

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

32 3743

6679

83

0

20

40

60

80

100

1991DHS

1994DHS

1997DHS

2002-2003DHS

2007DHS

2012DHS

Perc

ent


0

5

10

15

20

2010 2011 2012

Perc

ent

64 6369 61 66

75

39

020406080

100

1991DHS

1994DHS

1997DHS

2002-2003DHS

2007DHS

2012DHS

Perc

ent

Pneumonia treatment

8064

020406080

100

1990 1995 2000 2005 2010

Perc

ent

3023 20 19

4842 40 39

0

20

40

60

80

100

1995MICS

2001Other NS

2007Other NS

2010Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Indonesia

113

CHILD HEALTH


DEMOGRAPHICS


3559

7

1018

940

22

1990 2012

6171

8912 6

19 14

1990 2012

2446

6

1121

12

49

31

1990 2012

15% 1% Preterm 18%

Asphyxia* 10%

Other 5%

Congenital 7%

Sepsis** 6%

0%6%Measles 4%

Injuries 7%

Malaria 2%

HIV/AIDS 1%

Other 18%



POLICIES



Embolism 12%

Haemorrhage 30%

Hypertension 15%

Indirect 17%

Other direct 14%




-


30

20406080

100

2007DHS

Perc

ent



150

76 8289 92 93 96

0

20

40

60

80

100

1991DHS

1994DHS

1997DHS

2002-2003DHS

2007DHS

2012DHS

Perc

ent



61 56 54 61

43 43 36 35 39

020406080

100

1991DHS

2000MICS

2002-2003DHS

2007DHS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

84 (2012)

- -

12, 17, 8 (2012)

48 (2012)

80 (2012)

- -

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





7 (2012)

3 (2011)

7 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

No

Yes

Yes

Yes





1

15.9

33


2

-

(2013)

(2013)

(2013)

(2013)

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)



No

Yes



45 (2012)


Neonatal death: 48%

921

61

64

2413

6 2

1990 2012

25 32

65 61

9 71 0

1990 20122 8

5968

31 208 4

1990 2012


Indonesia

114

NUTRITION(2011)

(2011)

-

736

-

DEMOGRAPHICS


43


CHILD HEALTH

(2011)

(2011)

EQUITY

13

1225 20

0

20

40

60

80

100

2000MICS

2006MICS

2011MICS

Perc

ent









4.168

9

(2012)19

(2013)340

(2012)32,778(2012)4,824(2012)1,037(2011)99


53

34

18

0

15

30

45

60

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

110

67

28

0

30

60

90

120

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

69

20

91

50

87

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

54

72

8980

91

0

20

40

60

80

100

1989Other NS

2000MICS

2006MICS

2006-2007Other NS

2011MICS

Perc

ent


No Data

76 82 748267

020406080

100

2000MICS

2006MICS

2011MICS

Perc

ent

Pneumonia treatment

6969

4631

020406080

100

1990 1995 2000 2005 2010

Perc

ent

10 13 10 7 9

28 2834

28 23

0

20

40

60

80

100

1991Other NS

2000MICS

2003Other NS

2006MICS

2011MICS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles






Iraq

115

CHILD HEALTH


DEMOGRAPHICS


7285

9101356 0

1995 2012

8286

11 117 30 0

1995 2012

47

82

5

8

29

10190

1995 2012

13% 2% Preterm 18%

Asphyxia* 14%

Other 3%

Congenital 10%

Sepsis** 10%0%6%

Measles 0%

Injuries 6%

Malaria 0%

HIV/AIDS 0%

Other 18%



POLICIES



Embolism 9%

Haemorrhage 31%

Hypertension 13%

Indirect 23%

Other direct 16%




-


Very limited risk



149

78 7784 78

0

20

40

60

80

100

1996Other NS

2000MICS

2006MICS

2011MICS

Perc

ent



5464

262731 23

020406080

100

2000MICS

2006MICS

2011MICS

Perc

ent








Total Urban Rural

treated with ORS

87 (2011)

- -

22, 25, 16 (2011)

- -

- -

- -

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Western Asia, 2013




4 (2012)

6 (2011)

7 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

No

Partial

No

Yes





1

6.1

33


3

-

(2013)

(2013)

(2013)

(2013)

(2010)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Partial

Yes



46 (2012)


Neonatal death: 56%

75 74

3 117

1115 4

1990 2012

9584

0 103 5

2 1

1990 2012

29

56

10

1315

2246

9

1990 2012


Iraq

116

(2008-2009)

EQUITY

858


CHILD HEALTH

(2008-2009)

DEMOGRAPHICS



(2008-2009)

(2012)

78566

2312

12 1332

0

20

40

60

80

100

1989DHS

1993DHS

1998DHS

2003DHS

2008-2009DHS

Perc

ent









4.5106

22

(2012)27

(2013)53

(2012)43,178(2012)6,956(2012)1,535

(2008-2009)60


98

73

33

0

30

60

90

120

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

490400

120

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

93

32

42

44

47

64

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

50 45 44 42 44

0

20

40

60

80

100

1989DHS

1993DHS

1998DHS

2003DHS

2008-2009DHS

Perc

ent


42

6653

0

20

40

60

80

2010 2011 2012

Perc

ent

52 57 49 56

22

50

020406080

100

1993DHS

1998DHS

2003DHS

2008-2009DHS

Perc

ent

Pneumonia treatment

93838382

020406080

100

1990 1995 2000 2005 2010

Perc

ent

20 18 18 17 16

40 3741

36 35

0

20

40

60

80

100

1993DHS

1998DHS

2000MICS

2003DHS

2008-2009DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



58 (2012)


2012










DTP3

Measles






Kenya

117

DEMOGRAPHICS


CHILD HEALTH


25 30

20 26

36 31

19 13

1990 2012

2631

4048

31 18

3 3

1990 2012

24 29

16 19

38 35

22 17

1990 2012

15% 2% Preterm 10%

Asphyxia* 12%

Other 2%

Congenital 3%

Sepsis** 7%

0%10%


Malaria 4%

HIV/AIDS 4%

Other 22%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



34 (2008-2009)


35

47

020406080

100

2000MICS

2003DHS

2008-2009DHS

Perc

ent



84

77

95 9276

88 92

0

20

40

60

80

100

1989DHS

1993DHS

1998DHS

2000MICS

2003DHS

2008-2009DHS

Perc

ent



1533

4332

37 3929

39

020406080

100

1993DHS

1998DHS

2000MICS

2003DHS

2008-2009DHS

Perc

ent








Total Urban Rural

treated with ORS

64 (2008-2009)

15 (2008-2009)

6, 11, 5 (2008-2009)

- -

42 (2008-2009)

- -

73 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





6 (2012)

23 (2011)

27 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

-

Yes

No

Yes





3

9.7

1-


-

-

(2013)

-

(2013)

-

(2011)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -



-

-



48 (2012)


Neonatal death: 37%

18 20

25

4216

15

41

23

1990 2012

5644

36

38

413

4 5

1990 2012

10 13

2342

18

16

4929

1990 2012


Kenya

118

NUTRITION(2009)

(2004)

(2012)

43199

DEMOGRAPHICS


18


CHILD HEALTH

(2012)

(2009)

EQUITY

6

65

0

20

40

60

80

100

2004Other NS

Perc

ent









2.01

13

(2012)16

(2013)630

(2012)24,763(2012)1,690(2012)356(2009)100


4429

15

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

8587

21

0

25

50

75

100

125

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

65

100

94

83

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

97 97 100

0

20

40

60

80

100

2000MICS

2004Other NS

2009MICS

Perc

ent


No Data

93 8088

020406080

100

2004Other NS

2009MICS

Perc

ent

Pneumonia treatment

56

25 21 19 15

64

51 43

32 28

0

20

40

60

80

100

1998Other NS

2000MICS

2004Other NS

2009MICS

2012Other NS

Perc

ent


underweight stunted








at delivery

Exclusive












(2009)

(2012)

(2008)


Birth



-











DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data

9996

32

020406080

100

1990 1995 2000 2005 2010

Perc

ent

2012


Korea, Democratic People’s Republic of

119

CHILD HEALTH


DEMOGRAPHICS



100

80

60

40

20

0

15% 1%Preterm 20%

Asphyxia* 10%

Other 7%

Congenital 9%

Sepsis** 6%0%6%Measles 0%

Injuries 7%

Malaria 0%

HIV/AIDS 0%

Other 18%



POLICIES



Embolism 12%

Haemorrhage 36%

Hypertension 10%

Indirect 25%

Other direct 14%




-


Very limited risk



-

97 100

0

20

40

60

80

100

2000MICS

2009MICS

Perc

ent



6774

020406080

100

2009MICS

Perc

ent




Percent of population by type of drinking water source, 2012 Percent of population by type of sanitation facility, 1995-2012


treated with ORS

83 (2010)

- -

13, 15, 9 (2009)

- -

- -

- -

93 (2012)

-











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Eastern Asia, 2013




- -

3 (2011)

5 (2011)


No Data









SYSTEMS

FINANCING


5

-

No

-

Yes

-

No

Yes

Yes





-

74.1

--


-

-

-

-

-

-

(2003)

-

- -

(R,F)



-

-



- -


Neonatal death: 54%

89 9480

9 517

2 1 3

Total Urban Rural

100

80

60

40

20

0

Perc

ent

53

82

3

54413

0 0

1995 2012

57

88

4

639

60 0

1995 2012

4873

2

350

24

0 0

1995 2012


Korea, Democratic People’s Republic of

120

NUTRITION(2006)

(2006)

-

360

-

DEMOGRAPHICS


65


CHILD HEALTH

(2012)

(2006)

EQUITY

5

24 32

0

20

40

60

80

100

1997DHS

2006MICS

Perc

ent









3.141

10

(2012)14

(2013)390

(2012)5,474(2012)659(2012)148(2006)96


71

2724

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

85

75

21

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

98

32

99

67

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

98 98 99

0

20

40

60

80

100

1997DHS

2006MICS

2012DHS

Perc

ent


0

20

40

60

80

100

2010 2011 2012Pe

rcen

t

4862 45

020406080

100

1997DHS

2006MICS

Perc

ent

Pneumonia treatment

9896

96

020406080

100

1990 1995 2000 2005 2010

Perc

ent

103 5 3

36

1823

18

0

20

40

60

80

100

1997DHS

2006MICS

2009Other NS

2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Kyrgyzstan

121

CHILD HEALTH


DEMOGRAPHICS


92 92

7 71 10 0

1990 2012

91 92

3 35 51 0

1990 2012

12% 2%Preterm 16%

Asphyxia* 12%

Other 4%

Congenital 13%Sepsis** 8%0%6%

Measles 0%

Injuries 7%

Malaria 0%

HIV/AIDS 0%

Other 21%



POLICIES



Embolism 11%

Haemorrhage 23%

Hypertension 15%

Indirect 22%

Other direct 17%

Abortion 5%

Sepsis 9%



-


Very limited risk



175

97 97 97

0

20

40

60

80

100

1997DHS

2006MICS

2012DHS

Perc

ent



2240

2035

020406080

100

1997DHS

2006MICS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

67 (2012)

- -

6, 7, 6 (1997)

- -

- -

6 (2012)

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





12 (2012)

22 (2011)

38 (2011)


No Data









SYSTEMS

FINANCING


5

-

Partial

Yes

Yes

-

Partial

-

Yes





-

80.9

--


-

-

-

-

-

-

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -

(R,F)



-

-



35 (2012)


Neonatal death: 54%

4454

29

347

3209

1990 2012

79 87

1710

2 32 0

1990 2012

2336

36

4611

33015

1990 2012

91 92

5 54 30 0

1990 2012


Kyrgyzstan

122

NUTRITION(2006)

(2006)

(2012)

74147

DEMOGRAPHICS


30


CHILD HEALTH

(2006)

(2011-2012)

EQUITY

15

23 26

0

20

40

60

80

100

2000MICS

2006MICS

Perc

ent









3.194

14

(2012)27

(2013)130

(2012)6,646(2012)889(2012)181

(2011-2012)75


163

72

54

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1100

220 280

0

300

600

900

1200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

72

26

40

42

37

71

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

19 1520

42

0

20

40

60

80

100

2000MICS

2005Other NS

2006MICS

2011-2012MICS

Perc

ent


0

10

20

30

2010 2011 2012

Perc

ent

36 32

5452 57

020406080

100

2000MICS

2006MICS

2011-2012MICS

Perc

ent

Pneumonia treatment

72

7979

020406080

100

1990 1995 2000 2005 2010

Perc

ent

2012

40 36 36 32

54 53 48 48

0

20

40

60

80

100

1993Other NS

1994Other NS

2000Other NS

2006MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-











DTP3

Measles






Lao People’s Democratic Republic

123

CHILD HEALTH


DEMOGRAPHICS


20

651

2

10

469

29

1995 2012

62

90

3

4

9

226

4

1995 2012

12

500

1

10

778

42

1995 2012

18% 2%Preterm 10%

Asphyxia* 12%

Other 3%

Congenital 3%

Sepsis** 7%

0%12%

Measles 0%


HIV/AIDS 0%

Other 24%



POLICIES



Embolism 12%

Haemorrhage 30%

Hypertension 15%

Indirect 17%

Other direct 14%




11 (2011-2012)


18

41 43

020406080

100

2000MICS

2006MICS

2011-2012MICS

Perc

ent



84

27 2935

54

0

20

40

60

80

100

2000MICS

2005Other NS

2006MICS

2011-2012MICS

Perc

ent



3749

57

3246 42

020406080

100

2000MICS

2006MICS

2011-2012MICS

Perc

ent








treated with ORS

71 (2011-2012)

1 (2006)

4, 10, 2 (2011-2012)

41 (2011-2012)

40 (2011-2012)

- -

80 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





6 (2012)

21 (2011)

36 (2011)


No Data









SYSTEMS

FINANCING


2

7

No

Yes

Yes

Yes

Partial

Yes

Yes





-

10.6

33


3

46

-

(2013)

(2013)

(2013)

(2012)

(2011)

100

80

60

40

20

0

Perc

ent

Partial (2013)



Partial

Yes



38 (2012)


Neonatal death: 38%

25

60

6

47

24

59

2115

25

7 110

Total Urban Rural

100

80

60

40

20

0

Perc

ent


Lao People’s Democratic Republic

124

NUTRITION(2009)

(2009)

-

468

-

DEMOGRAPHICS


53


CHILD HEALTH

(2009)

(2009)

EQUITY

11

16 15

36

54

0

20

40

60

80

100

1996MICS

2000MICS

2004DHS

2009DHS

Perc

ent









3.192

25

(2012)45

(2013)64

(2012)2,052(2012)260(2012)57(2009)45


85100

28

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

720

490

180

0

150

300

450

600

750

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

85

54

48

62

70

67

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

61 60 55 62

0

20

40

60

80

100

1993MoH

2000MICS

2004DHS

2009DHS

Perc

ent


7764 58

020406080

100

2010 2011 2012Pe

rcen

t

4959

66

020406080

100

2000MICS

2004DHS

2009DHS

Perc

ent

Pneumonia treatment

858383

020406080

100

1990 1995 2000 2005 2010

Perc

ent

14 19 15 17 14

39 38

5345

39

0

20

40

60

80

100

1992Other NS

1993Other NS

2000MICS

2004DHS

2009DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2007)


Birth



50 (2012)


2012










DTP3

Measles






Lesotho

125

CHILD HEALTH


DEMOGRAPHICS


23 30

8 13

2023

4934

1995 2012

35 37

32 34

21 24

12 5

1995 2012

20 27

34

2124

5645

1995 2012

10% 3% Preterm 15%

Asphyxia* 14%

Other 2%

Congenital 3%

Sepsis** 9%0%7%


Malaria 0%

HIV/AIDS 19%

Other 14%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



-


Very limited risk



227

91 88 85 90 92

0

20

40

60

80

100

1993Other NS

1995Other NS

2000MICS

2004DHS

2009DHS

Perc

ent



29

53 4854 4251

020406080

100

2000MICS

2004DHS

2009DHS

Perc

ent








Total Urban Rural

treated with ORS

67 (2009)

- -

7, 11, 5 (2009)

- -

48 (2009)

4 (2009)

83 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





14 (2012)

52 (2011)

89 (2011)


No Data









SYSTEMS

FINANCING


1

4

No

Yes

Yes

Yes

No

No

Yes





1

6.7

33


2

29

(2013)

(2013)

(2013)

(2013)

(2003)

(2004)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Partial

-



15 (2012)


Neonatal death: 46%

622

72

59

20 182 1

1990 2012

26

66

67

27

7 70 0

1990 20122 4

73 73

23 22

2 1

1990 2012


Lesotho

126

NUTRITION(2007)

-

(2012)

3-

13

DEMOGRAPHICS


67


CHILD HEALTH

(2010)

(2007)

EQUITY

14

12

35 29 34

0

20

40

60

80

100

1986DHS

1999-2000Other NS

2007DHS

2010Other NS

Perc

ent









4.9149

27

(2012)27

(2013)31

(2012)4,190(2012)678(2012)150(2007)4


248

75 83

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1200

640

300

0

400

800

1200

1600

2000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

80

34

60

46

66

24

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

5851 46

0

20

40

60

80

100

1986DHS

1999-2000DHS

2007DHS

Perc

ent


No Data

62

020406080

100

2007DHS

Perc

ent

Pneumonia treatment

80

7777

020406080

100

1990 1995 2000 2005 2010

Perc

ent

23 20 15

4539

42

0

20

40

60

80

100

1999-2000Other NS

2007DHS

2010Other NS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Liberia

127

CHILD HEALTH


DEMOGRAPHICS


12% 2% Preterm 9%

Asphyxia* 12%

Other 2%

Congenital 3%

Sepsis** 7%

0%8%


Malaria 21%

HIV/AIDS 1%

Other 16%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



43 (2013)


26 37

020406080

100

2009Other NS

2011Other NS

Perc

ent



102

83 84 79

0

20

40

60

80

100

1986DHS

1999-2000DHS

2007DHS

Perc

ent



47

7

53

020406080

100

1986DHS

2007DHS

Perc

ent








treated with ORS

24 (2007)

48 (2013)

4, 5, 3 (2007)

- -

60 (2007)

- -

91 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





19 (2012)

98 (2011)

118 (2011)


Partially available









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

No

Yes

Yes





2

2.9

23


3

27

(2013)

(2013)

(2013)

(2013)

(2008)

(2011)

Yes (2013)

(R,F)



Partial

-



21 (2012)


Neonatal death: 35%

4 6 1

7181

62

12

12

13

131

24

Total Urban Rural

100

80

60

40

20

0

Perc

ent

1728

6

23

29

19

13

17

8

47

26

67

Total Urban Rural

100

80

60

40

20

0

Perc

ent


Liberia

128


(2008-2009)

(2012)

158688

DEMOGRAPHICS


72


CHILD HEALTH

(2003-2004)

(2008-2009)

EQUITY

16

3848 41

67

51

0

20

40

60

80

100

1992DHS

1997DHS

2000MICS

2003-2004DHS

2008-2009DHS

Perc

ent









4.5147

21

(2012)22

(2013)47

(2012)22,294(2012)3,529(2012)781

(2008-2009)80


159

5853

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

740

440

190

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

69

51

46

44

49

68

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

5747 46 51

44

0

20

40

60

80

100

1992DHS

1997DHS

2000MICS

2003-2004DHS

2008-2009DHS

Perc

ent


0

2

4

6

8

10

2010 2011 2012

Perc

ent

42 3747 48

42

20

020406080

100

1992DHS

1997DHS

2000MICS

2003-2004DHS

2008-2009DHS

Perc

ent

Pneumonia treatment

698686

020406080

100

1990 1995 2000 2005 2010

Perc

ent

36 3038 37

6155

5853 49

0

20

40

60

80

100

1992DHS

1995MICS

1997DHS

2003-2004DHS

2008-2009DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles






Madagascar

129

CHILD HEALTH


DEMOGRAPHICS


8 14

12 21

2626

5439

1990 2012

1419

2230

41 32

23 19

1990 2012

6 118

16

2325

63

48

1990 2012

16% 2%Preterm 10%

Asphyxia* 12%

Other 2%

Congenital 4%

Sepsis** 7%

0%10%

Measles 1%

Injuries 7%

Malaria 7%

HIV/AIDS 1%

Other 20%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



19 (2011)


0

46

77

020406080

100

2000MICS

2008-2009DHS

2011Other NS

Perc

ent



40

78 77 7180

86

0

20

40

60

80

100

1992DHS

1997DHS

2000MICS

2003-2004DHS

2008-2009DHS

Perc

ent



47 47 49

1423

10 12 17

020406080

100

1992DHS

1997DHS

2000MICS

2003-2004DHS

2008-2009DHS

Perc

ent








Total Urban Rural

treated with ORS

68 (2008-2009)

20 (2011)

2, 6, 1 (2008-2009)

- -

46 (2008-2009)

- -

78 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





13 (2012)

13 (2011)

19 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

No

Yes

Yes

Yes

Yes

Yes





2

4.8

33


2

11

(2013)

(2013)

(2013)

(2013)

(2007)

(2010)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



-

No



31 (2012)


Neonatal death: 38%

7 7

22

43

30

21

4129

1990 2012

2315

5063

15 1112 11

1990 2012

1 214

33

3527

5038

1990 2012


Madagascar

130

NUTRITION(2010)

(2010)

(2012)

48660

DEMOGRAPHICS


95


CHILD HEALTH

(2010)

(2010)

EQUITY

14

4453

5771

0

20

40

60

80

100

2000DHS

2004DHS

2006MICS

2010DHS

Perc

ent









5.5157

24

(2012)24

(2013)34

(2012)15,906(2012)2,859(2012)639

--


244

71 81

0

75

150

225

300

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1100

510

280

0

300

600

900

1200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

90

71

43

71

46

64

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

55 56 56 54

71

0

20

40

60

80

100

1992DHS

2000DHS

2004DHS

2006MICS

2010DHS

Perc

ent


26

4960

0

20

40

60

80

2010 2011 2012Pe

rcen

t

54

2737

5270

24 30

020406080

100

1992DHS

2000DHS

2004DHS

2006MICS

2010DHS

Perc

ent

Pneumonia treatment

90 9696

99

7020406080

100

1990 1995 2000 2005 2010

Perc

ent

24 26 22 18 16 14

56 64 5553 53 48

0

20

40

60

80

100

1992DHS

1997-1998Other NS

2000DHS

2004DHS

2006MICS

2010DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



86 (2012)


2012










DTP3

Measles






Malawi

131

CHILD HEALTH


DEMOGRAPHICS


10 10

6 6

5577

297

1990 2012

27 22

2218

4758

4 2

1990 2012

7 84 4

5680

33

8

1990 2012

11% 2% Preterm 10%

Asphyxia* 10%Other 2%

Congenital 3%

Sepsis** 7%

0%8%


Malaria 15%

HIV/AIDS 12%

Other 15%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



91 (2012)


315

2539

56

020406080

100

2000DHS

2004DHS

2006MICS

2010DHS

2012Other NS

Perc

ent



83

90 91 92 92 95

0

20

40

60

80

100

1992DHS

2000DHS

2004DHS

2006MICS

2010DHS

Perc

ent



51 54

27

48

32

4861 55

69

020406080

100

1992DHS

2000DHS

2004DHS

2006MICS

2010DHS

Perc

ent








Total Urban Rural

treated with ORS

64 (2010)

53 (2012)

5, 8, 4 (2010)

- -

43 (2010)

- -

89 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





18 (2012)

37 (2011)

52 (2011)


No Data









SYSTEMS

FINANCING


1

7

No

Yes

Yes

Yes

Yes

Yes

Yes





2

3.6

33


3

32

(2013)

(2013)

(2013)

(2013)

(2009)

(2010)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Partial

Yes



13 (2012)


Neonatal death: 34%

6 8

36

77

41

12173

1990 2012

37 33

55 62

5 53 0

1990 20121 3

35

80

45

14193

1990 2012


Malawi

132

NUTRITION(2010)

(2010)

(2012)

92793

DEMOGRAPHICS


57


CHILD HEALTH

(2010)

(2010)

EQUITY

18

9 8

2538

20

0

20

40

60

80

100

1987DHS

1995-1996DHS

2001DHS

2006DHS

2010MICS

Perc

ent









6.9172

23

(2012)42

(2013)26

(2012)14,854(2012)2,865(2012)705(2010)81


253

128

84

0

75

150

225

300

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1100

550

280

0

300

600

900

1200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

59

20

56

35

23

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

3240 41

49 56

0

20

40

60

80

100

1987DHS

1995-1996DHS

2001DHS

2006DHS

2010MICS

Perc

ent


0

10

20

30

40

2010 2011 2012

Perc

ent

2236

38 42 44

020406080

100

1995-1996DHS

2001DHS

2006DHS

2010MICS

Perc

ent

Pneumonia treatment

59

747474

020406080

100

1990 1995 2000 2005 2010

Perc

ent

2938 30 28

19

36 4043

3928

0

20

40

60

80

100

1987DHS

1995-1996DHS

2001DHS

2006DHS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Mali

133

CHILD HEALTH


DEMOGRAPHICS


15 22

13 19

4346

2913

1990 2012

33 35

36 38

26 23

5 4

1990 2012

10 156 9

4758

3718

1990 2012

14% 2% Preterm 11%

Asphyxia* 9%

Other 3%

Congenital 2%

Sepsis** 7%

0%11%


Malaria 14%

HIV/AIDS 1%

Other 20%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



19 (2012-2013)


27

70

020406080

100

2006DHS

2010Other NS

Perc

ent



74

3147

5770 75

0

20

40

60

80

100

1987DHS

1995-1996DHS

2001DHS

2006DHS

2010MICS

Perc

ent



45 38 32

16 12 14 11

020406080

100

1995-1996DHS

2001DHS

2006DHS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

23 (2006)

20 (2012-2013)

4, 8, 2 (2010)

- -

- -

- -

89 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





13 (2012)

29 (2011)

61 (2011)


No Data









SYSTEMS

FINANCING


1

7

Yes

No

Yes

Yes

Partial

Yes

Yes





3

5.1

33


3

-

(2013)

(2013)

(2013)

(2013)

(2010)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R)



Yes

No



61 (2012)


Neonatal death: 34%

414

24

53

63

32

91

1990 2012

1736

36

55

459

2 0

1990 2012

0 1

20

53

70

44

10 2

1990 2012


Mali

134

NUTRITION(2010)

(2010)

(2012)

126199

DEMOGRAPHICS


81


CHILD HEALTH

(2012)

(2011)

EQUITY

35

11 16

3546

0

20

40

60

80

100

2007MICS

2008Other NS

2009Other NS

2010Other NS

Perc

ent









4.788

27

(2012)34

(2013)66

(2012)3,796(2012)575(2012)131(2011)59


128

84

43

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

630

320

160

0

150

300

450

600

750

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

75

46

65

48

20

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

40

5761 65

0

20

40

60

80

100

1990-1991Other NS

2000-2001DHS

2007MICS

2011pMICS

Perc

ent


0

5

10

15

20

2010 2011 2012

Perc

ent

41 45 4324 30

020406080

100

2000-2001DHS

2007MICS

2011pMICS

Perc

ent

Pneumonia treatment

7580

80

020406080

100

1990 1995 2000 2005 2010

Perc

ent

43

2030 23 20

5550 40

2922

0

20

40

60

80

100

1990Other NS

1995-1996MICS

2000-2001DHS

2007MICS

2012Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2001)


Birth



-


2012










DTP3

Measles






Mauritania

135

CHILD HEALTH


DEMOGRAPHICS


16 27

610

2712

51 51

1990 2012

29

51

10

1838

16

23 15

1990 2012

8 93 4

20 11

69 76

1990 2012

14% 2%Preterm 15%

Asphyxia* 10%

Other 1%

Congenital 3%

Sepsis** 9%

0%9%


Malaria 10%

HIV/AIDS 0%

Other 21%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



7 (2011)


219

020406080

100

2003-2004Other NS

2011pMICS

Perc

ent



122

48

6475

84

0

20

40

60

80

100

1990-1991Other NS

2000-2001DHS

2007MICS

2011pMICS

Perc

ent



9

32 3423 20 19

020406080

100

2000-2001DHS

2007MICS

2011pMICS

Perc

ent








Total Urban Rural

treated with ORS

20 (2001)

19 (2011)

10, 18, 4 (2011)

- -

- -

9 (2000-2001)

80 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

12 (2011)

42 (2011)


No Data









SYSTEMS

FINANCING


1

-

Partial

-

-

-

No

Yes

-





1

8.0

--


-

31

(2013)

-

-

-

(2009)

(2004)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -



-

-



34 (2012)


Neonatal death: 41%

623

24

27

6447

6 3

1990 2012

1535

21

17

6348

1 0

1990 2012

0 1426

34

65

46

9 6

1990 2012


Mauritania

136

NUTRITION(2009)

(2009)

-

227

-

DEMOGRAPHICS


18


CHILD HEALTH

(2011-2012)

(2012)

EQUITY

9

38

20 19

0

20

40

60

80

100

1987DHS

1999Other NS

2009Other NS

Perc

ent









2.285

5

(2012)7

(2013)900

(2012)120,847(2012)11,405(2012)2,269(2009)93


46

1615

0

10

20

30

40

50

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

88

49

22

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

19

96

86

88

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

84 8693 95 96

0

20

40

60

80

100

1990Other NS

1997Other NS

2006Other NS

2004-2009Other NS

2012Other NS

Perc

ent


0

20

40

60

2010 2011 2012

Perc

ent

No Data

Pneumonia treatment

99999999 99

020406080

100

1990 1995 2000 2005 2010

Perc

ent

12 10 6 3 3

2926 22

16 14

0

20

40

60

80

100

1988Other NS

1996Other NS

1998-1999Other NS

2006Other NS

2011-2012Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2012)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Mexico

137

CHILD HEALTH


DEMOGRAPHICS


6685

8

114

3221

1990 2012

7887

10112210 0

1990 2012

35

795

10

9

851

3

1990 2012

9% 2% Preterm 16%

Asphyxia* 6%

Other 3%

Congenital 11%

Sepsis** 6%

0%3%


Malaria 0%

HIV/AIDS 0%

Other 36%



POLICIES



Embolism 3%

Haemorrhage 23%


Other direct 15%

Abortion 10%

Sepsis 8%



-


Very limited risk



1,062

7886

96 98

0

20

40

60

80

100

1987Other NS

1995Other NS

2004-2009Other NS

2006Other NS

Perc

ent



81

52

020406080

100

1996-1997Other NS

2012Other NS

Perc

ent








Total Urban Rural

treated with ORS

88 (2009)

- -

46, 49, 36 (2012)

- -

- -

- -

88 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





16 (2012)

0 (2011)

0 (2011)


No Data









SYSTEMS

FINANCING


5

-

Partial

Yes

No

-

Partial

Yes

-





-

46.2

--


-

-

-

-

-

-

(2011)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -

(R,F)



-

-



44 (2012)


Neonatal death: 44%

7591

7

45

5130

1990 2012

86 95

614 44 0

1990 2012

49

77

10

14

6

935

0

1990 2012


Mexico

138

(2003-2004)

EQUITY

1552


CHILD HEALTH

(2010-2011)

DEMOGRAPHICS



(2003-2004)

-

252

-

3750

25 31

0

20

40

60

80

100

1987DHS

1992DHS

1995DHS

2003-2004DHS

Perc

ent









2.732

20

(2012)18

(2013)300

(2012)32,521(2012)3,234(2012)739

(2010-2011)94


80

3127

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

310

120

78

0

70

140

210

280

350

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

31

74

31

86

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

26 3140

6374

0

20

40

60

80

100

1987DHS

1992DHS

1995DHS

2003-2004DHS

2010-2011Other NS

Perc

ent


0

20

40

60

2010 2011 2012

Perc

ent

1728

38

70

70

20406080

100

1992DHS

1997Other NS

2003-2004DHS

2010-2011Other NS

Perc

ent

Pneumonia treatment

999999

7288

020406080

100

1990 1995 2000 2005 2010

Perc

ent

13 8 8 103

3530 29

2315

0

20

40

60

80

100

1987DHS

1992DHS

1996-1997Other NS

2003-2004DHS

2010-2011Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



-


2012










DTP3

Measles






Morocco

139

DEMOGRAPHICS


CHILD HEALTH


5275

8

11

2

138

13

1990 2012

8185

14150 05 0

1990 2012

26

633

7

2

169

29

1990 2012

11% 2%Preterm 20%

Asphyxia* 12%

Other 5%

Congenital 9%

Sepsis** 9%0%6%

Measles 0%


HIV/AIDS 0%

Other 19%



POLICIES



Embolism 3%

Haemorrhage 37%

Hypertension 17%

Indirect 18%

Other direct 17%




-


Very limited risk



340

2532

45 42

6877

0

20

40

60

80

100

1987DHS

1992DHS

1995DHS

1997Other NS

2003-2004DHS

2010-2011Other NS

Perc

ent



46

1428 23

020406080

100

1992DHS

1995DHS

2003-2004DHS

Perc

ent








Total Urban Rural

treated with ORS

86 (2011)

- -

16, 19, 11 (2007-2010)

- -

- -

4 (2003-2004)

89 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Northern Africa, 2013




6 (2012)

4 (2011)

7 (2011)


No Data









SYSTEMS

FINANCING


3

-

Yes

Yes

Yes

-

No

No

Yes





0

15.1

31


3

69

(2013)

(2013)

(2013)

(2013)

(2009)

(2000)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



No

-



59 (2012)


Neonatal death: 58%

38

61

35

2324

143 2

1990 2012

7590

198

6 20 0

1990 2012

422

49

42

42 30

5 6

1990 2012


Morocco

140

NUTRITION(2011)

(2011)

(2012)

69020

DEMOGRAPHICS


77


CHILD HEALTH

(2011)

(2011)

EQUITY

17

30 3037 43

0

20

40

60

80

100

1997DHS

2003DHS

2008MICS

2011DHS

Perc

ent









5.3166

28

(2012)30

(2013)41

(2012)25,203(2012)4,332(2012)995(2011)48


233

9078

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1300

480

330

0

300

600

900

1200

1500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

82

43

54

51

29

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

44 4855 54

0

20

40

60

80

100

1997DHS

2003DHS

2008MICS

2011DHS

Perc

ent


54 53

86

020406080

100

2010 2011 2012Pe

rcen

t

3955

6550

2212

020406080

100

1997DHS

2003DHS

2008MICS

2011DHS

Perc

ent

Pneumonia treatment

827676

020406080

100

1990 1995 2000 2005 2010

Perc

ent

24 26 23 21 18 16

6049

5047 44 43

0

20

40

60

80

100

1995MICS

1997DHS

2000-2001Other NS

2003DHS

2008MICS

2011DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



40 (2012)


2012










DTP3

Measles






Mozambique

141

CHILD HEALTH


DEMOGRAPHICS


821

24

24

35

66

40

1990 2012

3444

68

2936

3112

1990 20122 110

222

35

76

52

1990 2012

12% 2% Preterm 11%

Asphyxia* 10%

Other 2%

Congenital 2%

Sepsis** 7%

0%9%


Malaria 18%

HIV/AIDS 6%

Other 16%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



60 (2011)


723

36

020406080

100

2007Other NS

2008MICS

2011DHS

Perc

ent



66

71 7685

92 91

0

20

40

60

80

100

1997DHS

2000Other NS

2003DHS

2008MICS

2011DHS

Perc

ent



47 4756

4249 46

55

020406080

100

1997DHS

2003DHS

2008MICS

2011DHS

Perc

ent








Total Urban Rural

treated with ORS

29 (2011)

19 (2011)

4, 9, 2 (2011)

- -

- -

7 (2011)

83 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





9 (2012)

24 (2011)

60 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

Yes

Yes

Yes





3

4.5

33


3

-

(2013)

(2013)

(2013)

(2013)

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



No

Yes



5 (2012)


Neonatal death: 34%

5 8

29

41

40

40

2611

1990 2012

20 25

52 55

24 164 4

1990 20121 1

22 34

4550

3215

1990 2012


Mozambique

142


(2009-2010)

(2012)

87686

DEMOGRAPHICS


76


CHILD HEALTH

(2009-2010)

(2009-2010)

EQUITY

9

1524

0

20

40

60

80

100

2003MICS

2009-2010MICS

Perc

ent









2.017

20

(2012)26

(2013)250

(2012)52,797(2012)4,434(2012)922

(2009-2010)72


106

52

35

0

30

60

90

120

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

580

200

150

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

84

24

71

73

66

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

4656 57

64 71

0

20

40

60

80

100

1991Other NS

1997Other NS

2001Other NS

2007Other NS

2009-2010MICS

Perc

ent


020406080

100

2010 2011 2012

Perc

ent

4866

69

34

020406080

100

2000MICS

2003MICS

2009-2010MICS

Perc

ent

Pneumonia treatment

8485

020406080

100

1990 1995 2000 2005 2010

Perc

ent

3728 30 30

23

54 5541 41 35

0

20

40

60

80

100

1991Other NS

1997Other NS

2000MICS

2003MICS

2009-2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Myanmar

143

CHILD HEALTH


DEMOGRAPHICS


5377

9

1323

515 5

1995 2012

7784

111310 22 1

1995 2012

45

74

8

1427

5207

1995 2012

15% 2% Preterm 18%

Asphyxia* 11%

Other 8%

Congenital 4%

Sepsis** 7%

0%7%

Measles 4%

Injuries 5%

Malaria 2%

HIV/AIDS 0%

Other 17%



POLICIES



Embolism 12%

Haemorrhage 30%

Hypertension 15%

Indirect 17%

Other direct 14%




-


11

020406080

100

2009-2010Other NS

Perc

ent



25

76 76 80 83

0

20

40

60

80

100

1997Other NS

2001Other NS

2007Other NS

2009-2010MICS

Perc

ent



48

6550

4553 61

020406080

100

2000MICS

2003MICS

2009-2010MICS

Perc

ent








Total Urban Rural

treated with ORS

66 (2001)

- -

- -

- -

- -

- -

93 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





2 (2012)

6 (2011)

13 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

-

-

No

Yes

Yes





2

16.2

23


3

-

(2013)

(2013)

(2013)

(2013)

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Partial

No



71 (2012)


Neonatal death: 50%

5 8

51

78

17

1127

3

1990 2012

17 19

6376

8

5120

1990 20121 3

47

78

20

1432

5

1990 2012


Myanmar

144

NUTRITION(2011)

(2011)

(2012)

116695

DEMOGRAPHICS


45


CHILD HEALTH

(2011)

(2011)

EQUITY

18

7468

5370

0

20

40

60

80

100

1996DHS

2001DHS

2006DHS

2011DHS

Perc

ent









2.487

23

(2012)24

(2013)200

(2012)27,474(2012)2,984(2012)593(2011)42


142

4247

0

40

80

120

160

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

790

190200

0

250

500

750

1000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

86

70

45

36

50

64

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles 7 911 16 19

36

0

20

40

60

80

100

1991Other NS

1996DHS

2001DHS

2003-04Other NS

2006DHS

2011DHS

Perc

ent


0

5

10

15

20

2010 2011 2012Pe

rcen

t

18 26

43 50

25

70

20406080

100

1996DHS

2001DHS

2006DHS

2011DHS

Perc

ent

Pneumonia treatment

86

9090

020406080

100

1990 1995 2000 2005 2010

Perc

ent

4738

43 3929

6661 57

4941

0

20

40

60

80

100

1996DHS

1997-1998Other NS

2001DHS

2006DHS

2011DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



-


2012










DTP3

Measles






Nepal

145

CHILD HEALTH


DEMOGRAPHICS


6

373

17

5

686

40

1990 2012

34

51

25

378

3339

1990 20123

341

13

5

6

91

47

1990 2012

12% 2%Preterm 16%

Asphyxia* 12%

Other 5%

Congenital 6%

Sepsis** 10%

0%6%

Measles 9%

Injuries 6%

Malaria 0%

HIV/AIDS 0%

Other 15%



POLICIES



Embolism 2%

Haemorrhage 30%


Other direct 8%

Abortion 6%

Sepsis 14%



-


Very limited risk



80

1524 28

4458

0

20

40

60

80

100

1991Other NS

1996DHS

2001DHS

2006DHS

2011DHS

Perc

ent



3747

2632 29

39

020406080

100

1996DHS

2001DHS

2006DHS

2011DHS

Perc

ent








Total Urban Rural

treated with ORS

64 (2011)

- -

5, 15, 4 (2011)

30 (2011)

45 (2011)

20 (2011)

82 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia





10 (2012)

13 (2011)

31 (2011)


No Data









SYSTEMS

FINANCING


5

-

No

No

Yes

Yes

Yes

Yes

Yes





2

6.7

43


3

46

(2013)

(2013)

(2013)

(2013)

(2004)

(2007)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)



Partial

Yes



49 (2012)


Neonatal death: 52%

621

60

67

27

97 3

1990 2012

46 49

5141

2 81 2

1990 20122

16

61

72

3097 3

1990 2012

Diarrhoea


Nepal

146

NUTRITION(2010)

(2010)

(2012)

186598

DEMOGRAPHICS


42


CHILD HEALTH

(2012)

(2006)

EQUITY

27

3 1

144

27 23

0

20

40

60

80

100

1992DHS

2000MICS

2006DHS

2008Other NS

2010Other NS

2012DHS

Perc

ent









7.6206

23

(2012)28

(2013)20

(2012)17,157(2012)3,557(2012)858(2006)32


326

114109

0

100

200

300

400

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1000

630

250

0

300

600

900

1200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

73

23

29

15

47

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles15 18 16 18

29

0

20

40

60

80

100

1992DHS

1998DHS

2000MICS

2006DHS

2012DHS

Perc

ent


0

20

40

60

80

2010 2011 2012Pe

rcen

t

1426

2747 58

90

20406080

100

1992DHS

1998DHS

2000MICS

2006DHS

2012DHS

Perc

ent

Pneumonia treatment

7374

74

020406080

100

1990 1995 2000 2005 2010

Perc

ent

41 47 44 40 3648 51

54 5544

0

20

40

60

80

100

1992DHS

1998DHS

2000MICS

2006DHS

2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles






Niger

147

CHILD HEALTH


DEMOGRAPHICS


5 93 57 10

85 76

1990 2012

2233

15

21

3629

27 17

1990 20122 41 22 5

95

89

1990 2012

16% 1% Preterm 9%

Asphyxia* 6%

Other 2%

Congenital 1%

Sepsis** 5%

0%12%


HIV/AIDS 0%

Other 20%

13

20 61

7 External sourcesGeneral government expenditureOut-of-pocket expenditureOther


POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



83 (2012)


1 7

43

64

20

020406080

100

2000MICS

2006DHS

2009Other NS

2010Other NS

2012DHS

Perc

ent



44

3039 41 46

83

0

20

40

60

80

100

1992DHS

1998DHS

2000MICS

2006DHS

2012DHS

Perc

ent



4334

1020 14 18

44

020406080

100

1992DHS

1998DHS

2000MICS

2006DHS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

47 (2012)

35 (2012)

1, 5, 0 (2006)

- -

- -

13 (2012)

84 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

14 (2011)

27 (2011)


Available(2011)









SYSTEMS

FINANCING


3

7

Partial

No

Yes

Yes

Yes

Yes

Yes





-

1.6

33


3

29

-

(2013)

(2013)

(2013)

(2008)

(2010)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(F)

%



Yes

Yes



53 (2012)


Neonatal death: 26%

4 8

30

44

6445

2 3

1990 2012

2239

39

60

3811 0

1990 20120 1

30 41

67 54

3 4

1990 2012


Niger

148

NUTRITION(2011)

(2011)

(2012)

103378

DEMOGRAPHICS


23


CHILD HEALTH

(2011)

(2011)

EQUITY

15

117

17 13 15

0

20

40

60

80

100

1990DHS

1999DHS

2003DHS

2008DHS

2011MICS

Perc

ent









6.0122

42

(2012)39

(2013)31

(2012)168,834(2012)29,697(2012)7,028(2011)42


213

124

71

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1200

560

300

0

300

600

900

1200

1500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

42

15

38

49

57

43

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

3142 35 39

49

0

20

40

60

80

100

1990DHS

1999DHS

2003DHS

2008DHS

2011MICS

Perc

ent


10

2017

0

10

20

30

40

2010 2011 2012Pe

rcen

t

37 3345 40

23 2345

020406080

100

1990DHS

2003DHS

2008DHS

2011MICS

Perc

ent

Pneumonia treatment

4241

100

20406080

100

1990 1995 2000 2005 2010

Perc

ent

35 35 27 27 24

5144 43

41 36

0

20

40

60

80

100

1990DHS

1993Other NS

2003DHS

2008DHS

2011MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



18 (2012)


2012










DTP3

Measles






Nigeria

149

CHILD HEALTH


DEMOGRAPHICS


3728

28

26

1123

24 23

1990 2012

36 31

4640

11

14

715

1990 2012

3725

18

12

12

32

33 31

1990 2012

14% 2% Preterm 10%

Asphyxia* 10%

Other 2%

Congenital 1%

Sepsis** 6%

0%9%


Malaria 20%

HIV/AIDS 3%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



12 (2010)


1 6

2916

020406080

100

2003DHS

2008DHS

2010Other NS

2011MICS

Perc

ent



161

79

5764 58 58

66

0

20

40

60

80

100

1986DHS

1990DHS

1999DHS

2003DHS

2008DHS

2011MICS

Perc

ent



28 25 28

12

3418 26 26

020406080

100

1990DHS

1999DHS

2003DHS

2008DHS

2011MICS

Perc

ent








Total Urban Rural

treated with ORS

43 (2011)

13 (2010)

5, 9, 3 (2011)

- -

38 (2008)

- -

60 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





7 (2012)

9 (2011)

10 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

Yes

Yes

Yes





2

4.1

33


3

-

(2013)

(2013)

(2013)

(2013)

(2009)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Partial

Yes



66 (2012)


Neonatal death: 32%

144

3260

20

2334

13

1990 2012

33

6

45

73

1617

6 4

1990 2012

3 1

2548

23

30

49

21

1990 2012


Nigeria

150

(2006-2007)

EQUITY

3229


CHILD HEALTH

(2011)

DEMOGRAPHICS



(2006-2007)

(2012)

153699

16

37

0

20

40

60

80

100

1995MICS

2006-07DHS

Perc

ent









3.348

47

(2012)42

(2013)170

(2012)179,160(2012)21,996(2012)4,604

(2006-2007)27


138

86

46

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

400

170

100

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

83

37

39

43

28

64

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles19 18

2331 39

43

0

20

40

60

80

100

1990-91DHS

1996-97Other NS

2001-02Other NS

2004-05Other NS

2006-07DHS

2010-11Other NS

Perc

ent


0

5

10

15

20

2010 2011 2012

Perc

ent

66 69

16

50

020406080

100

1990-91DHS

2006-07DHS

Perc

ent

Pneumonia treatment

8381

81

020406080

100

1990 1995 2000 2005 2010

Perc

ent

44 39 34 31 31

6355

42 43

0

20

40

60

80

100

1985-87Other NS

1990-91DHS

1995MICS

2001Other NS

2011Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles






Pakistan

151

DEMOGRAPHICS


CHILD HEALTH


2748

3

618

2352

23

1990 2012

72 72

6 6

14 18

8 4

1990 2012

7341

6

20

26

72

34

1990 2012

14% 3% Preterm 17%

Asphyxia* 12%

Other 3%

Congenital 3%

Sepsis** 11%

0%10%


Malaria 0%

HIV/AIDS 0%

Other 19%



POLICIES



Embolism 2%

Haemorrhage 30%


Other direct 8%

Abortion 6%

Sepsis 14%



-


Very limited risk



91

26 26

4336

61

0

20

40

60

80

100

1990-91DHS

1996-97Other NS

2001Other NS

2004-05Other NS

2006-07DHS

Perc

ent



3739 41

020406080

100

1990-91DHS

2006-07DHS

Perc

ent








Total Urban Rural

treated with ORS

64 (2013)

- -

7, 13, 5 (2006-2007)

- -

39 (2006-2007)

17 (2012-2013)

75 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





5 (2012)

12 (2011)

13 (2011)


No Data









SYSTEMS

FINANCING


3

-

No

Yes

No

Yes

Yes

Yes

Yes





3

14.0

23


3

-

(2013)

(2013)

(2013)

(2013)

(2010)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



No

Yes



62 (2012)


Neonatal death: 50%

2336

62

55

7 68 3

1990 2012

56 58

39 38

4 41 0

1990 2012

823

7366

8711 4

1990 2012


Pakistan

152

(2005)

EQUITY

11-


CHILD HEALTH

(2009-2011)

DEMOGRAPHICS


NUTRITION-

(2006)

(2012)

167615

59 56

0

20

40

60

80

100

1996DHS

2006DHS

Perc

ent









3.865

15

(2012)24

(2013)120

(2012)7,167(2012)982(2012)210

--


89

63

30

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

470

220

120

0

100

200

300

400

500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

67

56

53

55

54

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

53 53

0

20

40

60

80

100

1996DHS

2006DHS

Perc

ent


22 23

39

0

20

40

60

2010 2011 2012Pe

rcen

t

7563

020406080

100

1996DHS

2006DHS

Perc

ent

Pneumonia treatment

6763

63

020406080

100

1990 1995 2000 2005 2010

Perc

ent

23 1827

46 4448

0

20

40

60

80

100

1982-1983Other NS

2005Other NS

2009-2011Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2004)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Papua New Guinea

153

DEMOGRAPHICS


CHILD HEALTH


20 19

4 3

60 66

16 12

1990 2012

62 56

109

2531

3 4

1990 2012

13 133 3

66 71

18 13

1990 2012

15% 2%Preterm 11%

Asphyxia* 12%

Other 3%

Congenital 4%

Sepsis** 7%

0%9%


Malaria 11%

HIV/AIDS 1%

Other 19%



POLICIES



Embolism 15%

Haemorrhage 30%

Hypertension 14%

Indirect 17%

Other direct 12%




-


No Data



151

77 79

0

20

40

60

80

100

1996DHS

2006DHS

Perc

ent



No Data








Total Urban Rural

treated with ORS

54 (2006)

- -

- -

- -

- -

- -

70 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Oceania, 2013




14 (2012)

40 (2011)

62 (2011)


No Data









SYSTEMS

FINANCING


1

-

Partial

Yes

Yes

No

Partial

Yes

Yes





0

5.1

33


2

-

(2013)

(2013)

(2013)

(2013)

(2008)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Yes

-



9 (2012)


Neonatal death: 38%

12 9

2231

23 18

43 42

1990 2012

6155

26 33

7 96 3

1990 2012

4 3

20 30

27 19

49 48

1990 2012


Papua New Guinea

154

NUTRITION(2010)

(2004-2008)

-

182

-

DEMOGRAPHICS


51


CHILD HEALTH

(2012)

(2007)

EQUITY

8

28 33

5367

6166 71

0

20

40

60

80

100

1986DHS

1992DHS

1996DHS

2000DHS

2004DHS

2008DHS

2011DHS

Perc

ent









2.567

10

(2012)9

(2013)440

(2012)29,988(2012)2,925(2012)600(2012)96


79

18 26

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

250

89

63

0

60

120

180

240

300

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

94

71

93

87

94

90

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

53 5659

7183

87

0

20

40

60

80

100

1992DHS

1996DHS

2000DHS

2004DHS

2009DHS

2012DHS

Perc

ent


020406080

100

2010 2011 2012Pe

rcen

t

3346

5867 72 5955 48

020406080

100

1992DHS

1996DHS

2000DHS

2004-2006DHS

2009DHS

2012DHS

Perc

ent

Pneumonia treatment

949595

8991

020406080

100

1990 1995 2000 2005 2010

Perc

ent

9 6 5 5 4 3

3732 31 30

24 18

0

20

40

60

80

100

1992DHS

1996DHS

2000DHS

2005DHS

2009DHS

2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles






Peru

155

CHILD HEALTH


DEMOGRAPHICS


5473

6

87

1333

6

1990 2012

7181

896

9151

1990 2012

16

451

4

9

2874

23

1990 2012

8% 2%Preterm 19%

Asphyxia* 7%

Other 5%

Congenital 12%

Sepsis** 6%

0%4%Measles 0%

Injuries 6%

Malaria 0%

HIV/AIDS 1%

Other 30%



POLICIES



Embolism 3%

Haemorrhage 23%


Other direct 15%

Abortion 10%

Sepsis 8%



-


Very limited risk



555

64 67

8491 94 96

0

20

40

60

80

100

1992DHS

1996DHS

2000DHS

2004DHS

2009DHS

2012DHS

Perc

ent



60 64 64

2026 22 25 32 31

020406080

100

1992DHS

1996DHS

2000DHS

2004-2006DHS

2010DHS

2012DHS

Perc

ent








Total Urban Rural

treated with ORS

90 (2012)

- -

25, 33, 11 (2012)

- -

93 (2012)

1 (2007-2008)

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





18 (2012)

4 (2011)

13 (2011)


No Data









SYSTEMS

FINANCING


3

-

Partial

Yes

Yes

-

Yes

Yes

Yes





0

26.5

--


-

-

(2013)

-

-

-

(2012)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -



-

-



36 (2012)


Neonatal death: 51%

54

82

20

5179

9 4

1990 2012

7387

154

11 81 1

1990 2012

11

6333

929

1227

16

1990 2012


Peru

156

NUTRITION(2008)

(2008)

(2012)

79090

DEMOGRAPHICS


54


CHILD HEALTH

(2011)

(2008)

EQUITY

21

2637 34 34

0

20

40

60

80

100

1993DHS

1998DHS

2003DHS

2008DHS

Perc

ent



with 3 doses DTPwith Rotavirus vaccine






3.153

16

(2012)14

(2013)250

(2012)96,707(2012)11,165(2012)2,383(2010)90


59

30

20

0

20

40

60

80

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

110 120

28

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

85

34

77

62

78

72

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

53 5658 60 62

0

20

40

60

80

100

1993DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent


0

5

10

15

20

2010 2011 2012Pe

rcen

t

51 58 55 5044 36 42

020406080

100

1993DHS

1998DHS

2003DHS

2008DHS

Perc

ent

Pneumonia treatment

8586

2350

20406080

100

1990 1995 2000 2005 2010

Perc

ent

29 26 28 21 21 20

4539 38

34 32 34

0

20

40

60

80

100

1987Other NS

1993Other NS

1998Other NS

2003Other NS

2008Other NS

2011Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles






Philippines

157

CHILD HEALTH


DEMOGRAPHICS


5774

12

1615216 8

1990 2012

6979

15178 18 3

1990 2012

4569

10

1622

32312

1990 2012

17% 2% Preterm 15%

Asphyxia* 11%

Other 3%

Congenital 8%

Sepsis** 8%0%7%

Measles 0%

Injuries 8%

Malaria 0%

HIV/AIDS 0%

Other 21%



POLICIES



Embolism 12%

Haemorrhage 30%

Hypertension 15%

Indirect 17%

Other direct 14%




-


No Data



203

83 86 86 88 91

0

20

40

60

80

100

1993DHS

1998DHS

2000MICS

2003DHS

2008DHS

Perc

ent



7660

27

43 42 47

020406080

100

1993DHS

1998DHS

2003DHS

2008DHS

Perc

ent








Total Urban Rural

treated with ORS

72 (2011)

- -

10, 14, 5 (2008)

- -

77 (2008)

- -

76 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

2 (2011)

5 (2011)


No Data









SYSTEMS

FINANCING


1

3

No

Yes

Yes

No

Yes

Yes

Yes





0

71.5

33


2

-

(2013)

(2013)

(2013)

(2013)

(2004)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)



Partial

-



52 (2012)


Neonatal death: 47%

2443

60

49

14 72 1

1990 2012

4061

5231

7 81 0

1990 2012

926

66

65

22

83 1

1990 2012


Philippines

158

(2010)

EQUITY

771


CHILD HEALTH

(2010)

DEMOGRAPHICS


NUTRITION(2010)

(2010)

(2012)

379

3

83 8388 85

0

20

40

60

80

100

1992DHS

2000DHS

2005DHS

2010DHS

Perc

ent









4.641

23

(2012)21

(2013)66

(2012)11,458(2012)1,945(2012)410(2010)63


151

5550

0

70

140

210

280

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1400

320350

0

400

800

1200

1600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

97

85

18

69

35

71

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

26 3139

52

69

0

20

40

60

80

100

1992DHS

2000DHS

2005DHS

2007-2008DHS

2010DHS

Perc

ent


6756

87

020406080

100

2010 2011 2012Pe

rcen

t

3016

28 2850

4 13

020406080

100

1992DHS

2000DHS

2005DHS

2007-2008DHS

2010DHS

Perc

ent

Pneumonia treatment

9798

9898

50

020406080

100

1990 1995 2000 2005 2010

Perc

ent

24 23 20 1812

5745

48 5244

0

20

40

60

80

100

1992DHS

1996Other NS

2000DHS

2005DHS

2010DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



-


2012










DTP3

Measles






Rwanda

159

DEMOGRAPHICS


CHILD HEALTH


30

644

1059

23

7 3

1990 2012

64 61

2322

11 152 2

1990 2012

28

643

762

26

7 3

1990 2012

16% 2% Preterm 10%

Asphyxia* 12%

Other 2%

Congenital 5%

Sepsis** 8%

0%10%


Malaria 4%

HIV/AIDS 1%

Other 21%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



97 (2010)


5 13

5670

020406080

100

2000MICS

2005DHS

2007-2008DHS

2010DHS

Perc

ent



144

94 92 94 96 98

0

20

40

60

80

100

1992DHS

2000MICS

2005DHS

2007-2008DHS

2010DHS

Perc

ent



16 24 212810 12

21 29

020406080

100

1992DHS

2000MICS

2005DHS

2007-2008DHS

2010DHS

Perc

ent








Total Urban Rural

treated with ORS

71 (2010)

17 (2007-2008)

7, 16, 6 (2010)

5 (2010)

18 (2010)

5 (2010)

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





22 (2012)

39 (2011)

52 (2011)


No Data









SYSTEMS

FINANCING


3

-

No

Yes

Yes

Yes

No

Yes

Yes





3

7.5

33


3

-

(2013)

(2013)

(2013)

(2013)

(2010)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



No

Yes



21 (2012)


Neonatal death: 39%

1 4

5967

15

1825

11

1990 2012

2818

6263

3 127 7

1990 20120 1

5967

1519

2613

1990 2012


Rwanda

160

(2008-2009)

EQUITY

1035


CHILD HEALTH

(2008-2009)

DEMOGRAPHICS


NUTRITION(2006)

(2008-2009)

(2012)

117434

56 6051

0

20

40

60

80

100

2000MICS

2006MICS

2008-2009DHS

Perc

ent









4.1110

22

(2012)20

(2013)100

(2012)188(2012)31(2012)7

(2008-2009)75


104

53

35

0

30

60

90

120

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

410

210

100

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

92

51

37

82

72

51

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

79 81 82

0

20

40

60

80

100

2000MICS

2006MICS

2008-2009DHS

Perc

ent


0

20

40

60

80

2010 2011 2012

Perc

ent

47

75 60

020406080

100

2000MICS

2008-2009DHS

Perc

ent

Pneumonia treatment

9296

96

020406080

100

1990 1995 2000 2005 2010

Perc

ent

15 10 814

32 35 29 32

0

20

40

60

80

100

1986Other NS

2000MICS

2006MICS

2008-2009Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles







161

DEMOGRAPHICS


CHILD HEALTH


1834

36

5

6

7454

1995 2012

24

413

6

5

5

6848

1995 2012

13 234

734

8066

1995 2012

14% 2%

Preterm 10%

Asphyxia* 11%

Other 2%

Congenital 5%

Sepsis** 7%

0%9%


Malaria 8%

HIV/AIDS 1%

Other 23%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



43 (2008-2009)


2342

56

020406080

100

2000MICS

2006MICS

2008-2009DHS

Perc

ent



144

9197 98

0

20

40

60

80

100

2000MICS

2006MICS

2008-2009DHS

Perc

ent



5063

31 3149

020406080

100

2000MICS

2006MICS

2008-2009DHS

Perc

ent








Total Urban Rural

treated with ORS

51 (2008-2009)

60 (2008-2009)

5, 7, 4 (2008-2009)

- -

37 (2008-2009)

- -

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





6 (2012)

112 (2011)

234 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

-

-

-

Partial

-

-





-

23.6

--


-

-

-

-

-

-

(2004)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -



-

-



52 (2012)


Neonatal death: 38%

2033

54

647

119

2

1995 2012

29 39

5460

51120

1995 2012

13 22

52

72

9

226

4

1995 2012



162

(2010-2011)

EQUITY

1948


CHILD HEALTH

(2012)

DEMOGRAPHICS



(2010-2011)

-

967

-

5 612

34 39

0

20

40

60

80

100

1986DHS

1992-93DHS

1997DHS

2005DHS

2010-11DHS

Perc

ent









5.080

34

(2012)24

(2013)60

(2012)13,726(2012)2,313(2012)524

(2010-2011)75


142

6047

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

530

320

130

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

84

39

68

65

50

38

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

47 47

58 5852

65

0

20

40

60

80

100

1992-93DHS

1997DHS

2000MICS

2002Other NS

2005DHS

2010-11DHS

Perc

ent


0

20

40

60

2010 2011 2012Pe

rcen

t

31 27

47 50

18

020406080

100

1992-93DHS

2000MICS

2005DHS

2010-11DHS

Perc

ent

Pneumonia treatment

8492

92

020406080

100

1990 1995 2000 2005 2010

Perc

ent

22 20 20 15 14

3429

3020 16

0

20

40

60

80

100

1992-93DHS

1996MICS

2000MICS

2005DHS

2012Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2011)


Birth



-


2012










DTP3

Measles






Senegal

163

DEMOGRAPHICS


CHILD HEALTH


3552

11

1617

1537

17

1990 2012

5867

2024

1389 1

1990 2012

2140

5

1119

20

55

29

1990 2012

11% 2%Preterm 13%

Asphyxia* 12%

Other 2%

Congenital 5%

Sepsis** 9%

0%7%

Measles 1%

Injuries 5%

Malaria 17%

HIV/AIDS 1%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



21 (2012-2013)


2 716

29 35

020406080

100

2000MICS

2005DHS

2006Other NS

2008-09Other NS

2010-11DHS

Perc

ent



96

7482 79

87 93

0

20

40

60

80

100

1992-93DHS

1997DHS

2000MICS

2005DHS

2010-11DHS

Perc

ent



3443 42

715 13 15 22

020406080

100

1992-93DHS

1997DHS

2000MICS

2005DHS

2010-11DHS

Perc

ent








Total Urban Rural

treated with ORS

38 (2012-2013)

41 (2012-2013)

6, 11, 3 (2010-2011)

41 (2010-2011)

68 (2010-2011)

19 (2010-2011)

91 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

22 (2011)

44 (2011)


No Data









SYSTEMS

FINANCING


1

7

Partial

Yes

Yes

Yes

Partial

Yes

Yes





3

4.8

33


3

38

(2013)

(2013)

(2013)

(2013)

(2008)

(2000)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Yes

Yes



34 (2012)


Neonatal death: 42%

18

46

42

28

3925

1 1

1990 2012

46

77

43

1511 80 0

1990 20120

23

42

37

5639

2 1

1990 2012


Senegal

164

NUTRITION(2010)

(2010)

(2012)

92599

DEMOGRAPHICS


45


CHILD HEALTH

(2010)

(2010)

EQUITY

11

4 811

32

0

20

40

60

80

100

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent









4.8125

30

(2012)50

(2013)21

(2012)5,979(2012)928(2012)222(2010)78


257

182

86

0

100

200

300

400

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

2300

1100

580

0

700

1400

2100

2800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

80

32

58

63

75

29

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

42 43 42

63

0

20

40

60

80

100

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent


5169

93

020406080

100

2010 2011 2012Pe

rcen

t

50 48 46

74

21 27

58

020406080

100

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent

Pneumonia treatment

80

84 8483

020406080

100

1990 1995 2000 2005 2010

Perc

ent

25 25 28 21 21

41 3847

3745

0

20

40

60

80

100

1990Other NS

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2012)


Birth



-


2012










DTP3

Measles






Sierra Leone

165

CHILD HEALTH


DEMOGRAPHICS


11 13

23 28

4831

1828

1990 2012

23 22

43 42

34

26

010

1990 20125 7

14 19

5535

2639

1990 2012

14% 2%

Preterm 7%

Asphyxia* 8%

Other 1%

Congenital 2%

Sepsis** 6%

0%14%


Malaria 14%

HIV/AIDS 0%

Other 21%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



31 (2010)


2 5

26 30

020406080

100

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent



205

6881 87 93

0

20

40

60

80

100

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent



39 31

57 5542

5468 73

020406080

100

2000MICS

2005MICS

2008DHS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

29 (2010)

41 (2010)

5, 6, 4 (2010)

- -

58 (2008)

- -

87 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





12 (2012)

39 (2011)

64 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

No

Yes

Yes





1

1.9

33


2

24

(2013)

(2013)

(2013)

(2013)

(2010)

(2008)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



No

No



76 (2012)


Neonatal death: 27%

6 5

31

55

28

12

3528

1990 2012

16 11

5076

28 56 8

1990 20121 1

2141

2917

49 41

1990 2012


Sierra Leone

166

NUTRITION(2007)

(2007)

-

480

-

DEMOGRAPHICS


75


CHILD HEALTH

(2007)

(2007)

EQUITY

13

6574

0

20

40

60

80

100

2000Other NS

2007DHS

Perc

ent









4.162

15

(2012)14

(2013)180

(2012)550(2012)82(2012)17

--


3931

13

0

15

30

45

60

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

320

130

80

0

100

200

300

400

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

85

74

86

65

76

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

84 85 86

0

20

40

60

80

100

1994Other NS

1999Other NS

2007DHS

Perc

ent


No Data

73

23

020406080

100

2007DHS

Perc

ent

Pneumonia treatment

859090

020406080

100

1990 1995 2000 2005 2010

Perc

ent

16 12

34 33

0

20

40

60

80

100

1989Other NS

2007DHS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Solomon Islands

167

CHILD HEALTH


DEMOGRAPHICS


16% 2% Preterm 12%

Asphyxia* 12%

Other 3%

Congenital 9%

Sepsis** 8%

0%7%Measles 0%

Injuries 9%

Malaria 2%

HIV/AIDS 0%

Other 22%



POLICIES



Embolism 15%

Haemorrhage 30%

Hypertension 14%

Indirect 17%

Other direct 12%


Source: WHO 2014

Regional estimates for Oceania, 2013



-


40

020406080

100

2007DHS

Perc

ent



252

74

0

20

40

60

80

100

2007DHS

Perc

ent



76

38

020406080

100

2007DHS

Perc

ent




Percent of population by type of drinking water source, 2012 Percent of population by type of sanitation facility, 1990-2012


treated with ORS

76 (2007)

1 (2007)

6, 8, 6 (2007)

- -

- -

- -

85 (2012)

(2012)











Surface water



Pneumonia

Diarrhoea

Causes of under-five deaths, 2012




20 (2012)

142 (2011)

335 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

No

No

No

-

No

No





1

22.8

23


3

-

(2013)

(2013)

(2013)

(2013)

(2009)

-

Partial (2013)



No

No



2 (2012)


Neonatal death: 44%

26

61

16

55

32

61

126

14

71

9

Total Urban Rural

100

80

60

40

20

0

Perc

ent

No Data


Solomon Islands

168

NUTRITION(2006)

(2006)

-

1316

-

DEMOGRAPHICS


26


CHILD HEALTH

(2006)

-

EQUITY

-

9 90

20

40

60

80

100

1999MICS

2006MICS

Perc

ent









6.7123

30

(2012)46

(2013)18

(2012)10,195(2012)1,923(2012)452(2006)3


177147

59

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1300

850

330

0

350

700

1050

1400

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

46

9

33

6

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

3325

33

0

20

40

60

80

100

1999MICS

2002Other NS

2006MICS

Perc

ent


0

5

10

15

20

2010 2011 2012Pe

rcen

t

13

32

020406080

100

2006MICS

Perc

ent

Pneumonia treatment

4642

020406080

100

1990 1995 2000 2005 2010

Perc

ent

233329

42

0

20

40

60

80

100

1999MICS

2006MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2005)


Birth



-


2012










DTP3

Measles






Somalia

169

CHILD HEALTH


DEMOGRAPHICS


17% 2% Preterm 8%

Asphyxia* 10%

Other 2%

Congenital 1%

Sepsis** 6%

0%12%


Malaria 2%

HIV/AIDS 0%

Other 21%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



10 (2006)


11

020406080

100

2006MICS

Perc

ent



-

32 26

0

20

40

60

80

100

1999MICS

2006MICS

Perc

ent



730

13

020406080

100

1999MICS

2006MICS

Perc

ent





treated with ORS

- -

1 (2006)

- -

- -

- -

- -

64 (2012)

-











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





- -

11 (2011)

19 (2011)


No Data









SYSTEMS

FINANCING


1

5

No

No

No

No

No

Yes

-





0

1.5

33


3

56

(2013)

(2013)

(2013)

(2013)

(2006)

(2005)

Yes (2013)



No

No



- -


Neonatal death: 31%

No Data No Data


Somalia

170

(1998)

EQUITY

1561


CHILD HEALTH

(2008)

DEMOGRAPHICS


NUTRITION(2003)

(2003)

-

549

-

7 80

20

40

60

80

100

1998DHS

2003DHS

Perc

ent









2.454

20

(2012)15

(2013)300

(2012)52,386(2012)5,525(2012)1,102(2012)95


6145

20

0

25

50

75

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

150140

38

0

50

100

150

200

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

79

8

91

87

81

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

82 8491

0

20

40

60

80

100

1995Other NS

1998DHS

2003DHS

Perc

ent


86 91 83

020406080

100

2010 2011 2012Pe

rcen

t

7565

020406080

100

1998DHS

2003DHS

Perc

ent

Pneumonia treatment

796868

8178

020406080

100

1990 1995 2000 2005 2010

Perc

ent

8 10 12 9

29 3033

24

0

20

40

60

80

100

1994-1995Other NS

1999Other NS

2003DHS

2008Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2007)


Birth



81 (2012)


2012










DTP3

Measles






South Africa

171

DEMOGRAPHICS


CHILD HEALTH


5874

1013

18814 5

1990 2012

7582

1314

10 32 1

1990 2012

4062

7

1226

1627

10

1990 2012

14% 3% Preterm 12%

Asphyxia* 8%

Other 6%

Congenital 2%

Sepsis** 4%

0%7%


HIV/AIDS 17%

Other 21%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



-


Very limited risk



982

89 94 92 97

0

20

40

60

80

100

1994-1995Other NS

1998DHS

2003DHS

2008Other NS

Perc

ent



51 40

020406080

100

1998DHS

2003DHS

Perc

ent








Total Urban Rural

treated with ORS

81 (2004)

- -

21, 24, 15 (2003)

- -

- -

- -

77 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





13 (2012)

8 (2011)

17 (2011)


No Data









SYSTEMS

FINANCING


5

-

No

Yes

Yes

-

Yes

No

Yes





1

56.8

--


-

-

(2013)

-

-

-

(2013)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

- -

(R,F)



-

-



- -


Neonatal death: 34%

52

79

29

165

3142

1990 2012

85 93

1362 10 0

1990 2012

16

57

47

318

829

4

1990 2012


South Africa

172

NUTRITION-

(2010)

(2012)

232170

DEMOGRAPHICS


-


CHILD HEALTH

(2010)

-

EQUITY

-

45

0

20

40

60

80

100

2010MICS

Perc

ent









5.038

-

(2012)36

(2013)28

(2012)10,838(2012)1,726(2012)396(2010)35


251

10484

0

100

200

300

400

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

1800

730

450

0

500

1000

1500

2000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

62

45

19

17

13

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles10

19

0

20

40

60

80

100

2006MICS

2010MICS

Perc

ent


7

13

0

10

20

30

2010 2011 2012Pe

rcen

t

4833

020406080

100

2010MICS

Perc

ent

Pneumonia treatment

6259

020406080

100

1990 1995 2000 2005 2010

Perc

ent

33 2836

31

0

20

40

60

80

100

2006MICS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive












-

(2012)

(2008)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


South Sudan

173

CHILD HEALTH


DEMOGRAPHICS


18% 2% Preterm 12%

Asphyxia* 9%

Other 1%

Congenital 2%

Sepsis** 7%

0%11%


HIV/AIDS 3%

Other 22%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10% Regional estimates for Sub-Saharan Africa, 2013

Source: WHO 2014



8 (2010)


21 25

020406080

100

2006MICS

2009Other NS

Perc

ent



33

2640

0

20

40

60

80

100

2006MICS

2010MICS

Perc

ent



2339

020406080

100

2010MICS

Perc

ent







treated with ORS

13 (2010)

19 (2010)

1, 1, 0 (2010)

- -

- -

- -

- -

(2012)











Surface water



Pneumonia

Diarrhoea

Causes of under-five deaths, 2012




4 (2012)

- -

- -


No Data









SYSTEMS

FINANCING


-

-

-

No

No

No

-

Yes

No





2

-

12


2

-

(2013)

(2013)

(2013)

(2013)

-

-

Partial (2013)



No

No



57 (2012)


Neonatal death: 34%

9 167

36

211

20

10

7758

81

Total Urban Rural

100

80

60

40

20

0

Perc

ent

No Data


South Sudan

174

-

EQUITY

--


CHILD HEALTH

(2010)

DEMOGRAPHICS


NUTRITION-

(2010)

(2012)

165183

41

0

20

40

60

80

100

2010MICS

Perc

ent









4.5102

24

(2012)29

(2013)60

(2012)37,195(2012)5,671(2012)1,263(2010)59


128

73

43

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

720

360

180

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

85

41

23

47

24

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

29 23

0

20

40

60

80

100

2006MICS

2010MICS

Perc

ent


No Data

5666

020406080

100

2010MICS

Perc

ent

Pneumonia treatment

8592

92

75

020406080

100

1990 1995 2000 2005 2010

Perc

ent

27 3238

35

0

20

40

60

80

100

2006MICS

2010MICS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Sudan

175

DEMOGRAPHICS


CHILD HEALTH


27 24

7 6

28

24

3846

1990 2012

52 44

1210

28

26

820

1990 2012

18 13

54

29

24

48 59

1990 2012

16% 2% Preterm 11%

Asphyxia* 11%

Other 1%

Congenital 3%

Sepsis** 9%

0%11%


Malaria 2%

HIV/AIDS 1%

Other 23%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



33 (2010)


30

020406080

100

2006MICS

Perc

ent



159

74 74

0

20

40

60

80

100

2006MICS

2010MICS

Perc

ent



1227

3122

020406080

100

2000MICS

2006MICS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

24 (2010)

2 (2010)

7, 12, 5 (2010)

- -

- -

- -

74 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





11 (2012)

11 (2011)

35 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

Yes

Yes

No

Partial

No

Yes





0

11.2

33


3

35

(2013)

(2013)

(2013)

(2013)

(2008)

(2005)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



Partial

Yes



74 (2012)


Neonatal death: 38%

32 24

3531

2535

8 10

1990 2012

78

46

8

20

1231

2 3

1990 2012

16 13

4537

29

36

10 14

1990 2012


Sudan

176

NUTRITION(2010)

(2010)

(2012)

16633

DEMOGRAPHICS


55


CHILD HEALTH

(2010)

(2010)

EQUITY

9

24 3233

44

0

20

40

60

80

100

2000MICS

2006-2007DHS

2008Other NS

2010MICS

Perc

ent









3.489

18

(2012)30

(2013)94

(2012)1,231(2012)169(2012)37(2010)50


71 80

24

0

40

80

120

160

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

550

310

140

0

150

300

450

600

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

88

44

22

82

77

83

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

56

7074 69

82

0

20

40

60

80

100

1994Other NS

2000MICS

2002Other NS

2006-2007DHS

2010MICS

Perc

ent


7687 83

020406080

100

2010 2011 2012Pe

rcen

t

6073 58

24

61

020406080

100

2000MICS

2006-2007DHS

2010MICS

Perc

ent

Pneumonia treatment

889595

020406080

100

1990 1995 2000 2005 2010

Perc

ent

9 6 7 6

3730

4031

0

20

40

60

80

100

2000MICS

2006-2007DHS

2008Other NS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



79 (2012)


2012










DTP3

Measles






Swaziland

177

CHILD HEALTH


DEMOGRAPHICS


49 57

18 21

88

2514

1990 2012

63 63

29 29

6 72 1

1990 2012

44 56

1518

109

3117

1990 2012

13% 2% Preterm 12%

Asphyxia* 11%

Other 2%

Congenital 3%

Sepsis** 7%

0%9%


Malaria 0%

HIV/AIDS 15%

Other 20%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



18 (2010)


0 1 20

20406080

100

2000MICS

2006-2007DHS

2010MICS

Perc

ent



447

87 90 8597

0

20

40

60

80

100

2000MICS

2002Other NS

2006-2007DHS

2010MICS

Perc

ent



25 22

4866

86

57

020406080

100

2000MICS

2006-2007DHS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

83 (2010)

1 (2010)

12, 12, 13 (2010)

- -

22 (2006-2007)

- -

86 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





18 (2012)

32 (2011)

131 (2011)


No Data









SYSTEMS

FINANCING


3

-

No

Yes

No

No

Partial

No

Yes





-

17.7

33


3

-

-

(2013)

(2013)

(2013)

(2009)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(F)



Partial

No



11 (2012)


Neonatal death: 37%

1837

21

3716

1445

12

1990 2012

67 75

1919638 3

1990 2012

427

21

4218

1757

14

1990 2012


Swaziland

178

(2005)

EQUITY

1061


CHILD HEALTH

(2012)

DEMOGRAPHICS


NUTRITION(2005)

(2005)

(2012)

104197

1425

0

20

40

60

80

100

2000MICS

2005MICS

Perc

ent









3.847

12

(2012)23

(2013)530

(2012)8,009(2012)1,150(2012)265(2012)88


105

58

35

0

40

80

120

160

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

68

44

17

0

40

80

120

160

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

94

25

80

87

49

55

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

9079 71

83 88 87

0

20

40

60

80

100

1991Other NS

1996MoH

2000MICS

2005MICS

2010Other NS

2012DHS

Perc

ent


0

20

40

60

2010 2011 2012Pe

rcen

t

5164 63

41

020406080

100

2000MICS

2005MICS

2012DHS

Perc

ent

Pneumonia treatment

9494 94

020406080

100

1990 1995 2000 2005 2010

Perc

ent

15 15 12

42 42 33 3926

0

20

40

60

80

100

1999Other NS

2003Other NS

2005MICS

2007Other NS

2012DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles






Tajikistan

179

DEMOGRAPHICS


CHILD HEALTH


17% 2% Preterm 12%

Asphyxia* 11%

Other 2%

Congenital 5%

Sepsis** 8%

0%11%


Malaria 0%

HIV/AIDS 0%

Other 24%



POLICIES



Embolism 11%

Haemorrhage 23%

Hypertension 15%

Indirect 22%

Other direct 17%

Abortion 5%

Sepsis 9%

www.countdown2015mnch.orgCountdown to 2015

2011 Report



11 (2005)


10

20406080

100

2005MICS

Perc

ent



129

71 7789

79

0

20

40

60

80

100

2000MICS

2005MICS

2007Other NS

2012DHS

Perc

ent



29 2235

48

7360

020406080

100

2000MICS

2005MICS

2009Other

2012DHS

Perc

ent








Total Urban Rural


treated with ORS

55 (2012)

- -

- -

54 (2012)

80 (2012)

9 (2012)

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





7 (2012)

8 (2011)

11 (2011)


No Data









SYSTEMS

FINANCING


5

-

Partial

Yes

Yes

-

Partial

Yes

Yes





-

63.8

--


-

86

-

-

-

-

(2011)

(2005)

100

80

60

40

20

0

Perc

ent

- -

(R,F)



-

-



60 (2012)


Neonatal death: 40%

3343

25

29116

3122

1995 2012

7782

15 11

4245

1995 2012

1529

29

3514

7

4229

1995 2012

94 94 95

3 5 23 1 30 0 0

Total Urban Rural

100

80

60

40

20

0

Perc

ent


Tajikistan

180

NUTRITION(2010)

(2010)

(2012)

59295

DEMOGRAPHICS


49


CHILD HEALTH

(2010)

(2010)

EQUITY

8

United Republic of Tanzania

23 2932

41 50

0

20

40

60

80

100

1991-1992DHS

1996DHS

1999Other NS

2004-2005DHS

2010DHS

Perc

ent









5.3128

26

(2012)21

(2013)44

(2012)47,783(2012)8,487(2012)1,898(2010)16


166

5455

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

910

410

230

0

250

500

750

1000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

97

50

31

49

43

58

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

4438 36

43 49

0

20

40

60

80

100

1991-1992DHS

1996DHS

1999Other NS

2004-2005DHS

2010DHS

Perc

ent


5973 77

020406080

100

2010 2011 2012

Perc

ent

65 70 6859 71

22

020406080

100

1991-1992DHS

1996DHS

1999DHS

2004-2005DHS

2010DHS

Perc

ent

Pneumonia treatment

9792

92

020406080

100

1990 1995 2000 2005 2010

Perc

ent

25 27 2517 16

50 50 4844 43

0

20

40

60

80

100

1991-1992DHS

1996DHS

1999DHS

2004-2005DHS

2010DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2007)


Birth



56 (2012)


2012










DTP3

Measles






Tanzania, United Republic of

181

CHILD HEALTH


DEMOGRAPHICS


7 12

4 10

80 65

9 13

1990 2012

9258

24

8148

2 3

1990 2012

6 73 4

8173

10 16

1990 2012

13% 2% Preterm 10%

Asphyxia* 13%

Other 2%

Congenital 5%

Sepsis** 8%

0%8%


Malaria 10%

HIV/AIDS 6%

Other 17%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



62 (2010)


216

26

64 72

020406080

100

1999DHS

2004-2005DHS

2007-2008Other NS

2010DHS

2011-2012Other

Perc

ent



109

6250 49

78 7688

0

20

40

60

80

100

1991-1992DHS

1996DHS

1999DHS

2004-2005DHS

2007-2008Other NS

2010DHS

Perc

ent



53 5057 48 55 5444

020406080

100

1991-1992DHS

1996DHS

1999DHS

2004-2005DHS

2010DHS

Perc

ent








Total Urban Rural

treated with ORS

58 (2010)

26 (2010)

5, 10, 3 (2010)

- -

31 (2010)

- -

88 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

21 (2011)

45 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

Yes

No

Yes





3

2.5

33


3

21

(2013)

(2013)

(2013)

(2013)

(2006)

(2005)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Yes

No



32 (2012)


Neonatal death: 40%

7 9

48 44

25 30

20 17

1990 2012

3323

61

55

319

3 3

1990 20120 4

46 40

3033

24 23

1990 2012


Tanzania, United Republic of

182

(2010)

EQUITY

1146


CHILD HEALTH

(2010)

DEMOGRAPHICS


NUTRITION(2010)

(2010)

(2012)

54464

14 1018

2848

62

0

20

40

60

80

100

1988DHS

1998DHS

2000MICS

2006MICS

2008Other

2010MICS

Perc

ent









4.788

25

(2012)33

(2013)46

(2012)6,643(2012)1,069(2012)245(2010)78


143

96

48

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

660

450

170

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

72

62

59

55

29

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

51 4961 62 59

0

20

40

60

80

100

1998DHS

2000MICS

2003Other NS

2006MICS

2010MICS

Perc

ent


52

7586

020406080

100

2010 2011 2012Pe

rcen

t

26 30 233226 41

020406080

100

1998DHS

2000MICS

2006MICS

2010MICS

Perc

ent

Pneumonia treatment

728484

020406080

100

1990 1995 2000 2005 2010

Perc

ent

22 1724 22 21 17

41 40 3328 27

30

0

20

40

60

80

100

1988DHS

1996MICS

1998DHS

2006MICS

2008Other NS

2010MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



-


2012










DTP3

Measles






Togo

183

DEMOGRAPHICS


CHILD HEALTH


13 11

2420

3 16

60 53

1990 2012

26 25

44 43

5 12

25 20

1990 2012

12% 2% Preterm 10%

Asphyxia* 11%

Other 2%

Congenital 2%

Sepsis** 7%

0%9%


Malaria 18%

HIV/AIDS 1%

Other 19%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%




28 (2010)


2

3857

020406080

100

2000MICS

2006MICS

2010MICS

Perc

ent



75

43

8273

85 8472

0

20

40

60

80

100

1988DHS

1998DHS

2000MICS

2003Other NS

2006MICS

2010MICS

Perc

ent



25 22 2417 13 10 11

020406080

100

1998DHS

2000MICS

2006MICS

2010MICS

Perc

ent








Total Urban Rural

treated with ORS

29 (2010)

50 (2010)

9, 16, 5 (2010)

- -

- -

11 (1998)

81 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





15 (2012)

21 (2011)

48 (2011)


No Data









SYSTEMS

FINANCING


2

7

Partial

Yes

Yes

Yes

Partial

Yes

Yes





2

3.3

32


3

-

(2013)

(2013)

(2013)

(2013)

(2008)

(2020)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



Partial

Yes



41 (2012)


Neonatal death: 35%

4 5

4456

3220

20 19

1990 2012

14 12

65 80

20 71 1

1990 20120 1

36 40

37 29

27 30

1990 2012

8 2

155

319

74 74

1990 2012


Togo

184

(2006)

EQUITY

460


CHILD HEALTH

(2000)

DEMOGRAPHICS


NUTRITION(2006)

(2005)

-

754

-

13 11

0

20

40

60

80

100

2000DHS

2006MICS

Perc

ent









2.421

13

(2012)22

(2013)640

(2012)5,173(2012)503(2012)111(2006)96


90

53

30

0

25

50

75

100

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

6661

17

0

25

50

75

100

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

11

100

83

83

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

96 97 100

0

20

40

60

80

100

1996MoH

2000DHS

2006MICS

Perc

ent


No Data

51

83

50

020406080

100

2000DHS

2006MICS

Perc

ent

Pneumonia treatment

999797

020406080

100

1990 1995 2000 2005 2010

Perc

ent

11

28

0

20

40

60

80

100

2000DHS

Perc

ent


underweight stunted








at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles




0 10 20 30 40 50 60 70 80 90 100Percent

No Data


Turkmenistan

185

DEMOGRAPHICS


CHILD HEALTH


Source: WHO/UNICEF JMP 2014Total Urban Rural

100

80

60

40

20

0

15% 2% Preterm 15%

Asphyxia* 9%

Other 4%

Congenital 5%

Sepsis** 6%

0%9%


Malaria 0%

HIV/AIDS 0%

Other 27%



POLICIES



Embolism 11%

Haemorrhage 23%

Hypertension 15%

Indirect 22%

Other direct 17%

Abortion 5%

Sepsis 9%



-


Very limited risk



209

98 99

0

20

40

60

80

100

2000DHS

2006MICS

Perc

ent



25

47 40

020406080

100

2000DHS

2006MICS

Perc

ent





treated with ORS

83 (2000)

- -

3, 4, 2 (2000)

- -

- -

10 (2000)

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





9 (2012)

2 (2011)

5 (2011)


No Data









SYSTEMS

FINANCING


5

-

No

Yes

-

-

Yes

-

Yes





-

132.2

--


-

-

-

-

-

-

(2002)

-

- -

(R,F)



-

-



37 (2012)


Neonatal death: 41%

No Data

3

2931

26

55

45

110

1995 20121

101712

82 77

0 1

1995 20124

4643

3933

1520

0

1995 2012


Turkmenistan

186

NUTRITION(2011)

(2011)

(2012)

56770

DEMOGRAPHICS


53


CHILD HEALTH

(2011)

(2011)

EQUITY

12

6757

63 60 62

0

20

40

60

80

100

1988-1989DHS

1995DHS

2000-2001DHS

2006DHS

2011DHS

Perc

ent









6.0146

25

(2012)23

(2013)44

(2012)36,346(2012)6,939(2012)1,591(2011)30


178

6959

0

50

100

150

200

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

780

360

200

0

250

500

750

1000

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

82

62

33

57

48

47

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

38 3839 42

57

0

20

40

60

80

100

1988-1989DHS

1995DHS

2000-2001DHS

2006DHS

2011DHS

Perc

ent


42 49

72

020406080

100

2010 2011 2012Pe

rcen

t

61 67 73 79

47 47

020406080

100

1995DHS

2000-2001DHS

2006DHS

2011DHS

Perc

ent

Pneumonia treatment

82

7878

020406080

100

1990 1995 2000 2005 2010

Perc

ent

20 21 19 16 14

48 46 4539 34

0

20

40

60

80

100

1988-1989DHS

1995DHS

2000-2001DHS

2006DHS

2011DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2009)


Birth



47 (2012)


2012










DTP3

Measles






Uganda

187

CHILD HEALTH


DEMOGRAPHICS


26 34

17 23

3735

208

1990 2012

32 33

49 50

17 15

2 2

1990 2012

25 34

1317

4040

229

1990 2012

14% 2% Preterm 10%

Asphyxia* 10%

Other 2%

Congenital 3%

Sepsis** 6%

0%9%


Malaria 13%

HIV/AIDS 7%

Other 18%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



69 (2011)


010

3343

020406080

100

2000-2001DHS

2006DHS

2009Other NS

2011DHS

Perc

ent



108

87 91 92 94 93

0

20

40

60

80

100

1988-1989DHS

1995DHS

2000-2001DHS

2006DHS

2011DHS

Perc

ent



2939 3648

34 40 44

020406080

100

1995DHS

2000-2001DHS

2006DHS

2011DHS

Perc

ent








Total Urban Rural

treated with ORS

47 (2011)

25 (2011)

5, 14, 4 (2011)

11 (2011)

33 (2011)

10 (2011)

85 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

13 (2011)

21 (2011)


No Data









SYSTEMS

FINANCING


3

7

No

Yes

Yes

Yes

Yes

Yes

Yes





2

14.2

33


3

34

(2013)

(2013)

(2013)

(2013)

(2005)

(2003)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)



Partial

No



49 (2012)


Neonatal death: 33%

1 5

41

70

35

1523

10

1990 2012

623

71

72

19 44 1

1990 20120 1

37

70

37

1726

12

1990 2012


Uganda

188

NUTRITION(2006)

(2006)

(2012)

54799

DEMOGRAPHICS


67


CHILD HEALTH

(2006)

(2006)

EQUITY

5

316

1926

0

20

40

60

80

100

1996DHS

2000MICS

2002DHS

2006MICS

Perc

ent









2.326

6

(2012)14

(2013)1,100

(2012)28,541(2012)2,989(2012)623(2006)100


74

40

25

0

20

40

60

80

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

66

36

17

0

20

40

60

80

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

99

26

100

80

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

98 96 100

0

20

40

60

80

100

1996DHS

2000MICS

2006MICS

Perc

ent


020406080

100

2010 2011 2012Pe

rcen

t

8768

56

020406080

100

1996DHS

2006MICS

Perc

ent

Pneumonia treatment

9999 99

020406080

100

1990 1995 2000 2005 2010

Perc

ent

137 4

40

25 20

0

20

40

60

80

100

1996DHS

2002DHS

2006MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2006)


Birth



-


2012










DTP3

Measles






Uzbekistan

189

CHILD HEALTH


DEMOGRAPHICS


17% 1%Preterm 11%

Asphyxia* 7%

Other 3%

Congenital 6%

Sepsis** 5%

0%9%


HIV/AIDS 0%

Other 30%



POLICIES



Embolism 11%

Haemorrhage 23%

Hypertension 15%

Indirect 22%

Other direct 17%

Abortion 5%

Sepsis 9%



-


Very limited risk



221

95 97 99

0

20

40

60

80

100

1996DHS

2000MICS

2006MICS

Perc

ent



332831 32

28

020406080

100

1996DHS

2000MICS

2006MICS

Perc

ent






Total Urban Rural

treated with ORS

80 (1996)

- -

3, 5, 2 (1996)

- -

- -

10 (1996)

- -

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





10 (2012)

6 (2011)

9 (2011)


No Data









SYSTEMS

FINANCING


5

-

Partial

Yes

Yes

-

-

Yes

Yes





-

143.6

--


-

-

-

-

-

-

(2012)

-

100

80

60

40

20

0

Perc

ent

- -

(R,F)



-

-



44 (2012)


Neonatal death: 34%

5747

33 40

5 105 3

1990 2012

86 85

11 131 12 1

1990 2012

3726

4855

8 147 5

1990 2012

No Data


Uzbekistan

190

(2011)

EQUITY

540


CHILD HEALTH

(2011)

DEMOGRAPHICS


NUTRITION(2011)

(2011)

(2012)

45098

17 15 12 17 17

0

20

40

60

80

100

1997DHS

2002DHS

2005Other

2006MICS

2011MICS

Perc

ent









1.838

13

(2012)12

(2013)1,100

(2012)90,796(2012)7,184(2012)1,440(2011)95


51

2317

0

20

40

60

80

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

140

49

35

0

40

80

120

160

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

96

17

93

60

95

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

7770

85 88 93

0

20

40

60

80

100

1997DHS

2000MICS

2002DHS

2006MICS

2011MICS

Perc

ent


020406080

100

2010 2011 2012Pe

rcen

t

6960

7183

7355

68

020406080

100

1997DHS

2000MICS

2002DHS

2006MICS

2011MICS

Perc

ent

Pneumonia treatment

969797

020406080

100

1990 1995 2000 2005 2010

Perc

ent

41 4127 24 20

12

6153 43

34 31 23

0

20

40

60

80

100

1987-1989Other NS

1994Other NS

2000MICS

2004Other NS

2008Other NS

2011MICS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2010)


Birth



-


2012










DTP3

Measles






Viet Nam

191

DEMOGRAPHICS


CHILD HEALTH


37

752

4

22

1939

2

1990 2012

64

93

4

5

8

2240

1990 2012

31

672

4

24

2643

3

1990 2012

9% 4%

Preterm 20%

Asphyxia* 7%

Other 6%

Congenital 13%

Sepsis** 5%0%7%Measles 2%

Injuries 4%

Malaria 0%

HIV/AIDS 1%

Other 24%



POLICIES



Embolism 12%

Haemorrhage 30%

Hypertension 15%

Indirect 17%

Other direct 14%




42 (2011)


16 13 9

020406080

100

2000MICS

2005Other NS

2011MICS

Perc

ent



233

71 68

86 91 94

0

20

40

60

80

100

1997DHS

2000MICS

2002DHS

2006MICS

2011MICS

Perc

ent



24

65 57

40

11

4026

47

020406080

100

1997DHS

2000MICS

2002DHS

2006MICS

2011MICS

Perc

ent








Total Urban Rural

treated with ORS

95 (2011)

1 (2006)

20, 31, 16 (2011)

- -

- -

- -

91 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





9 (2012)

9 (2011)

33 (2011)


No Data









SYSTEMS

FINANCING


5

-

No

No

Yes

Yes

Yes

No

Yes





-

23.0

33


3

-

-

(2013)

(2013)

(2013)

(2011)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Partial (2013)

(R,F)



Yes

Yes



49 (2012)


Neonatal death: 54%

926

53

6922

4161

1990 2012

4361

4737

426 0

1990 20120 9

54

85

28

4182

1990 2012


Viet Nam

192

(1997)

EQUITY

3230


CHILD HEALTH

(2011)

DEMOGRAPHICS


NUTRITION(2006)

(2003)

(2012)

137611

13 18 12

0

20

40

60

80

100

1991-1992DHS

1997DHS

2003Other NS

Perc

ent









4.280

23

(2012)27

(2013)88

(2012)23,852(2012)3,397(2012)752(2012)17


125

60

42

0

30

60

90

120

150

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

460

270

120

0

100

200

300

400

500

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

71

12

36

14

54

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles16

2227

36

0

20

40

60

80

100

1991-1992DHS

1997DHS

2003Other NS

2006MICS

Perc

ent


0

5

10

15

20

2010 2011 2012Pe

rcen

t

28 3247 44

7

38

020406080

100

1991-1992DHS

1997DHS

2003Other NS

2006MICS

Perc

ent

Pneumonia treatment

71828282

23

020406080

100

1990 1995 2000 2005 2010

Perc

ent

30 34

48 4336

52 5059 58

47

0

20

40

60

80

100

1991-1992Other NS

1996MICS

1997DHS

2003Other NS

2011Other NS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2005)


Birth



-


2012










DTP3

Measles






Yemen

193

DEMOGRAPHICS


CHILD HEALTH


24

531

331

22

4422

1990 2012

70

93

1

22336 2

1990 2012

12341

333

32

5431

1990 2012

16% 2% Preterm 14%

Asphyxia* 13%

Other 3%

Congenital 4%

Sepsis** 9%

0%10%Measles 1%

Injuries 7%

Malaria 1%

HIV/AIDS 0%

Other 19%



POLICIES



Embolism 9%

Haemorrhage 31%

Hypertension 13%

Indirect 23%

Other direct 16%




-


Sub-national risk



118

2634 41 47

0

20

40

60

80

100

1991-1992DHS

1997DHS

2003Other

2006MICS

Perc

ent



48

26 32 33

020406080

100

1991-1992DHS

1997DHS

2006MICS

Perc

ent








Total Urban Rural

treated with ORS

54 (2006)

- -

9, -, - (2003)

- -

- -

25 (1997)

66 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea

Causes of under-five deaths, 2012Regional estimates for Western Asia, 2013




4 (2012)

8 (2011)

11 (2011)


No Data









SYSTEMS

FINANCING


1

-

No

No

Yes

No

Yes

Yes

Yes





0

8.7

33


2

14

(2013)

(2013)

(2013)

(2013)

(2010)

(2005)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)



Partial

Yes



72 (2012)


Neonatal death: 45%

2740

3915

2841

6 4

1990 2012

8471

12

1

327

1 1

1990 2012

1226

47 21

34

47

7 6

1990 2012


Yemen

194

(2007)

EQUITY

1157


CHILD HEALTH

(2007)

DEMOGRAPHICS


NUTRITION(2007)

(2007)

-

694

-

1019

2740

61

0

20

40

60

80

100

1992DHS

1996DHS

1999MICS

2001-2002DHS

2007DHS

Perc

ent









5.7151

26

(2012)29

(2013)59

(2012)14,075(2012)2,566(2012)608(2007)14


192

89

64

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

580

280

150

0

140

280

420

560

700

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

83

61

39

47

60

61

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

51 47 47 43 47

0

20

40

60

80

100

1992DHS

1996DHS

1999MICS

2001-2002DHS

2007DHS

Perc

ent


7490 >95

020406080

100

2010 2011 2012Pe

rcen

t

6271 69 68

14

47

020406080

100

1992DHS

1996DHS

2001-2002DHS

2007DHS

Perc

ent

Pneumonia treatment

8378

78

020406080

100

1990 1995 2000 2005 2010

Perc

ent

21 20 20 2315

46 4958

5346

0

20

40

60

80

100

1992DHS

1996DHS

1999MICS

2001-2002DHS

2007DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2005)


Birth



88 (2012)


2012










DTP3

Measles






Zambia

195

DEMOGRAPHICS


CHILD HEALTH


41 43

1414

19 27

26 16

1990 2012

61 56

2624

10 18

3 2

1990 2012

29 34

7 8

2233

4225

1990 2012

13% 2% Preterm 10%

Asphyxia* 11%

Other 2%

Congenital 2%

Sepsis** 7%

0%9%


Malaria 16%

HIV/AIDS 6%

Other 16%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



76 (2010)


1 723 29

4150

020406080

100

1999MICS

2001-2002DHS

2006Other NS

2007DHS

2008Other NS

2010Other NS

Perc

ent



112

92 9683

93 94

0

20

40

60

80

100

1992DHS

1996DHS

1999MICS

2001-2002DHS

2007DHS

Perc

ent



4856

53 54 53 60

020406080

100

1992DHS

1996DHS

2001-2002DHS

2007DHS

Perc

ent








Total Urban Rural

treated with ORS

61 (2007)

69 (2010)

3, 6, 2 (2007)

- -

39 (2007)

- -

81 (2012)

(2012)











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





16 (2012)

43 (2011)

114 (2011)


No Data









SYSTEMS

FINANCING


4

7

Partial

Yes

Yes

No

Yes

Yes

Yes





3

8.5

33


3

41

(2013)

(2013)

(2013)

(2013)

(2010)

(2005)

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



Partial

-



24 (2012)


Neonatal death: 34%

20 15

2948

3223

19 14

1990 2012

4836

41

49

10 131 2

1990 20121 2

2247

4629

31 22

1990 2012


Zambia

196


(2010-2011)

(2012)

38661

DEMOGRAPHICS


65


CHILD HEALTH

(2010-2011)

(2010-2011)

EQUITY

11

10 11

3222 31

0

20

40

60

80

100

1988DHS

1994DHS

1999DHS

2005-2006DHS

2010-2011DHS

Perc

ent









3.6112

20

(2012)39

(2013)53

(2012)13,724(2012)2,010(2012)439

(2010-2011)49


7490

25

0

30

60

90

120

1990 1995 2000 2005 2010 2015


MDG Target

Source: IGME 2013

520470

130

0

200

400

600

800

1990 1995 2000 2005 2010 2015

MDG Target


Source: MMEIG 2014

90

31

27

66

65

80

0 20 40 60 80 100Percent



Skilled attendant

*Postnatal care

breastfeeding

Measles

70 6973 69 66

0

20

40

60

80

100

1988DHS

1994DHS

1999DHS

2005-2006DHS

2010-2011DHS

Perc

ent


31

53

82

020406080

100

2010 2011 2012Pe

rcen

t

2543

48

816

31

020406080

100

2005-2006DHS

2009Other NS

2010-2011DHS

Perc

ent

Pneumonia treatment

908989

21

020406080

100

1990 1995 2000 2005 2010

Perc

ent

8 12 12 14 10

31 2934 36 32

0

20

40

60

80

100

1988DHS

1994DHS

1999DHS

2005-2006DHS

2010-2011DHS

Perc

ent


underweight stunted









at delivery

Exclusive













(2009)

(2012)

(2008)


Birth



70 (2012)


2012










DTP3

Measles






Zimbabwe

197

CHILD HEALTH


DEMOGRAPHICS


41 40

2627

0 8

33 25

1990 2012

54 52

4644

0 20 2

1990 2012

35 32

1816

0 12

47 40

1990 2012

12% 3%Preterm 14%

Asphyxia* 13%

Other 2%

Congenital 3%

Sepsis** 9%

0%9%Measles 1%

Injuries 5%

Malaria 1%

HIV/AIDS 9%

Other 18%



POLICIES



Embolism 2%

Haemorrhage 25%

Hypertension 16%

Indirect 29%

Other direct 9%

Abortion 10%

Sepsis 10%



48 (2010-2011)


317 10

020406080

100

2005-2006DHS

2009Other NS

2010-2011DHS

Perc

ent



-

91 93 93 94 90

0

20

40

60

80

100

1988DHS

1994DHS

1999DHS

2005-2006DHS

2010-2011DHS

Perc

ent



4735

46

79

6

3221

020406080

100

1994DHS

2005-2006DHS

2009Other NS

2010-2011DHS

Perc

ent








Total Urban Rural

treated with ORS

80 (2010-2011)

7 (2010-2011)

5, 8, 3 (2010-2011)

12 (2010-2011)

27 (2010-2011)

6 (2010-2011)

66 (2012)

-











Surface water



Source: WHO 2014

Pneumonia

Diarrhoea





- -

18 (2011)

46 (2011)


No Data









SYSTEMS

FINANCING


2

7

No

Yes

Yes

No

Yes

No

Yes





3

13.1

33


3

-

(2013)

(2013)

(2013)

(2013)

(2009)

-

100

80

60

40

20

0

100

80

60

40

20

0

Perc

ent

Perc

ent

Yes (2013)

(R,F)



No

Yes



- -


Neonatal death: 44%

33 34

4646

12 159 5

1990 2012

97

79

318

0 30 0

1990 2012

7 6

6463

17 22

12 9

1990 2012


Zimbabwe


Annex A About Countdown to 2015 for Maternal, Newborn and Child Survival

Countdown to 2015 for Maternal, Newborn and Child Survival is a global movement to track, stimulate and support country progress towards achieving the health-related Millennium Development Goals, particularly goals 4 (reduce child mortality) and 5 (improve maternal health). Established in 2003,42 Countdown includes academics, governments, international agencies, professional associations, donors, nongovernmental organizations and other members of civil society, with The Lancet as a key partner. Members of the Countdown community share a common goal of using data to increase accountability for women’s and children’s health. Countdown specifically focuses on tracking coverage of a core set of evidence-based interventions proven to reduce maternal, newborn and child mortality.

What Countdown does

Countdown produces periodic publications, reports and other materials on key aspects of reproductive, maternal, newborn and child health, using data to hold stakeholders to account for global and national action.43 At the core of Countdown reporting are two-page country profiles, updated approximately every two years, that present key demographic, nutritional status and mortality statistics; coverage levels and trends for proven reproductive, maternal, newborn and child health interventions; and policy, health system, financial and equity indicators to enable assessment of country progress in improving reproductive, maternal, newborn and child health. Countdown plays a central role in the follow-up to the UN Secretary-General’s Global Strategy for Women’s and Children’s Health by annually updating one-page profiles showcasing the 11 indicators selected by the Commission on Information and Accountability for Women’s and Children’s Health.44 Countdown also prepares equity profiles highlighting disparities in coverage in each of the 75 priority countries.

Countdown analyses are guided by a conceptual model (figure A1) consistent with the results-based evaluation framework for health systems strengthening that was developed by a working group of members from Countdown, the World Health Organization, the World Bank, the GAVI Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria.45 The model shows the range of indicators included in Countdown’s four linked datasets on coverage, equity, policies and systems, and financial flows and illustrates possible pathways through which policy, systems and financing measures in a given context impact levels and trends in coverage of proven reproductive, maternal, newborn and child health interventions.

Countdown recognizes the paramount role of social, political, economic, cultural and environmental determinants in shaping population health. Many of these broader determinants influence health outcomes by increasing access, utilization and coverage with available life-saving interventions. Intervention coverage is thus the specific niche occupied by Countdown in the array of initiatives aimed at monitoring the Millennium Development Goals.

Countdown harnesses the global learning potential of its datasets through cross-cutting research and country case studies that allow for an in-depth exploration of the “how” and “why” of progress in reproductive, maternal, newborn and child health. These have been completed to date in Niger for child survival46 and in Bangladesh for maternal survival,47 with additional work nearing completion in Afghanistan, Pakistan, Ethiopia, Tanzania, Malawi and Peru.


Supportive policies

For example, maternal protection,community health workers andmidwives authorized to provideessential services, vital registration,adoption of new interventions

Health systems and financing

For example, human resources, functioning emergency obstetric care, referral and supply chain systems, quality of health services, financial resources forreproductive, maternal, newborn andchild health, user fees

Increased survival and improved health and nutrition for women and children

Political, economic, social, technological and environmental factors

Increased and equitable intervention coverage

Pre-pregnancy Pregnancy Birth Postnatal Childhood

Family planningWomen’s nutrition

Antenatal careIntermittent preventive

treatment for malariaPrevention of mother-to-child

transmission of HIVTetanus vaccines

Skilled attendantat birth

Caesarean sectionand emergencyobstetric care

Postnatal care formother and baby

Infant and youngchild feeding

Case managementof childhood illness

VaccinesMalaria prevention

(insecticide-treatednets and indoorresidual spraying)

FIGURE A1 Summary impact model guiding Countdown work


Annex B Summary of Countdown data sources and analysis methods

Data sources

Most Countdown coverage, equity and nutrition data are from standardized, nationally representative household surveys, primarily Demographic and Health Surveys and Multiple Indicator Cluster Surveys. For national coverage estimates, Countdown reviews databases provided by stakeholder organizations, particularly the United Nations Children’s Fund but also the United Nations Population Division and Save the Children, and extracts the data for the 75 Countdown countries.

Cause of death profiles are abstracted from World Health Organization statistical databases based on work by the Child Health Epidemiology Reference Group. As in past Countdown reports, the child mortality estimates are based on the work of the UN Inter-agency Group for Child Mortality Estimation—led by the United Nations Children’s Fund and including the World Health Organization, the World Bank, the Population Division of the United Nations Department of Economic and Social Affairs and the United Nations Economic Commission for Latin America and the Caribbean Population Division—and are the official UN estimates for measuring progress towards Millennium Development Goal 4. The maternal mortality estimates are based on the work of an interagency group comprising the World Health Organization, the United Nations Children’s Fund, the United Nations Population Fund and the World Bank.

Data for the Countdown health systems and policies indicators are abstracted from global databases maintained by the World Health Organization and other groups such as the International Labour Organization, routine monitoring data from UN organizations, national service delivery surveys (for emergency obstetric care data) and surveys administered to government authorities by the World Health Organization with responses validated by UN agencies at the country level. Countdown financing data are abstracted from datasets maintained by the Development Assistance Committee of the Organisation for Economic Co-operation and Development.

Analysis methods

Countdown assesses progress at the country level, so it uses the country as the unit of analysis when summarizing results across databases. The summary measure used for the coverage indicators is the median, which gives each of the 75 Countdown countries equal weight, and the range, which illustrates the extent of variation across countries. Countdown coverage data are compiled and analysed by the Institute for International Programs at the Johns Hopkins University in collaboration with the Countdown Coverage Working Group and the United Nations Children’s Fund.

Summary estimates of coverage for 2014 include Countdown countries with available estimates for 2008–2012. A small number of data points for 2013 were available in time to be included in this report and are indicated in footnotes. To track coverage trends, subsets of countries with at least two data points for each indicator, one from 2000–2007 and one from 2008–2015, were used. The difference between the two summary point estimates were calculated for each indicator, as well as the proportion of the gap closed between the earlier estimate and 100% coverage.

Countdown tracks coverage (“the proportion of women and children in need of interventions who actually receive them”) in preference to measures of “effective coverage” that include estimates of intervention effectiveness, access, use and service quality. Effective coverage metrics are difficult to use in global monitoring because they typically require data that are rarely available in Countdown countries and sometimes rely on modelling procedures that must then be unpacked to guide decisionmaking.

Two summary metrics of coverage are used in presenting the results. The first, the Composite Coverage Index, is a weighted average of eight interventions and reflects the performance of each Countdown country in achieving coverage along the continuum of care.48 The second, the co-coverage index, reflects the extent to which individual women and their children are receiving eight well established preventive interventions. These interventions have been available in most if not all countries—even the poorest—for at least a decade.49


The equity analyses require that indicators be estimated for subgroups of the country population. Results are presented for selected individual coverage indicators as well as the two summary indices stratified by wealth quintiles.50 Equity analyses are conducted by the International Center for Equity in Health at the University of Pelotas, Brazil, in collaboration with the Countdown Equity Technical Working Group.

Information on country-specific policies and systems indicators related to maternal and newborn health is reviewed and confirmed by technical staff at World Health Organization headquarters and country offices and maintained by the World Health Organization with inputs from the Countdown Health Systems and Policies Technical Working Group. The data on financial flows are compiled and analysed by a team at the London School of Hygiene and Tropical Medicine in collaboration with the Countdown Financial Flows Technical Working Group.

Additional information

Further detail on Countdown’s data sources and methods are available in the published literature51 and on the Countdown website (www.countdown2015mnch.org). Countdown databases are publicly available for free through the Countdown website (http://countdown2015mnch.org/about-countdown/countdown-data).


Annex C Country profile indicators and data sources, organized by order of presentation in the profile

Indicator Data source Global database Demographics Demographics Total population United Nations Population Division United Nations Population Division

Total under-five population United Nations Population Division United Nations Population Division

Births United Nations Population Division United Nations Population Division

Birth registration Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national household surveys, censuses and vital registration systems

United Nations Children’s Fund

Total fertility rate United Nations Population Division United Nations Population Division

Adolescent birth rate Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Reproductive Health Surveys, other national surveys, civil registration systems and censuses

United Nations Population Division, United Nations Population Fund

Child mortality Total under-five deaths The UN Inter-agency Group for Child Mortality Estimation (United Nations Children’s Fund, World Health Organization, United Nations Population Division, World Bank)

The UN Inter-agency Group for Child Mortality Estimation (United Nations Children’s Fund, World Health Organization, United Nations Population Division, World Bank)

Neonatal deaths as a proportion of all under-five deaths*



Neonatal mortality rate The UN Inter-agency Group for Child Mortality Estimation (United Nations Children’s Fund, World Health Organization, United Nations Population Division, World Bank)


Infant mortality rate The UN Inter-agency Group for Child Mortality Estimation (United Nations Children’s Fund, World Health Organization, United Nations Population Division, World Bank)


Under-five mortality rate* The UN Inter-agency Group for Child Mortality Estimation (United Nations Children’s Fund, World Health Organization, United Nations Population Division, World Bank)


Causes of under-five deaths World Health Organization, Child Health Epidemiology Reference Group, United Nations Children’s Fund

World Health Organization, Child Health Epidemiology Reference Group, United Nations Children’s Fund

Stillbirth rate Cousens and others 2011 Cousens and others 2011

Maternal mortality Total maternal deaths Maternal Mortality Estimation Inter-agency Group (World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank)

Maternal Mortality Estimation Inter-agency Group (World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank)

Lifetime risk of maternal death Maternal Mortality Estimation Inter-agency Group (World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank)


Maternal mortality ratio (adjusted)*



Causes of maternal deaths (regional)

World Health Organization World Health Organization

Maternal and newborn healthDelivery care Skilled attendant at

delivery*Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Reproductive Health Surveys, other national surveys


AIDS Pregnant women living with HIV receiving antiretroviral therapy for their own health*

Country reporting through the Global AIDS Response Progress Report and Universal Access joint reporting process by the World Health Organization, the United Nations Children’s Fund and the Joint United Nations Programme on HIV/AIDS and UNAIDS Spectrum estimates

Joint United Nations Programme on HIV/AIDS, United Nations Children’s Fund, World Health Organization

Pregnant women living with HIV receiving antiretroviral drugs for prevention of mother-to-child transmission*

Country reporting through the Global AIDS Response Progress Report and Universal Access joint reporting process by the World Health Organization, the United Nations Children’s Fund and the Joint United Nations Programme on HIV/AIDS and UNAIDS Spectrum estimates


Antenatal care Antenatal care (at least one visit)

Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Reproductive Health Surveys, other national surveys


Antenatal care (four or more visits)*

Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Reproductive Health Surveys, other national surveys Demographic and Health Surveys, Reproductive Health Survey, other national surveys



Indicator Data source Global database Demand for family planning satisfied

Demand for family planning satisfied*

Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Reproductive Health Surveys, other national surveys

United Nations Population Fund

Intermittent preventive treatment of malaria during pregnancy

Intermittent preventive treatment of malaria during pregnancy

Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Malaria Indicator Surveys, other national surveys


Caesarean section Caesarian section rate Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Reproductive Health Survey, other national surveys


Neonatal tetanus protection

Neonatal tetanus vaccine Multiple Indicator Cluster Surveys, Demographic and Health Surveys

United Nations Children’s Fund, World Health Organization

Postnatal care Postnatal visit for baby* Demographic and Health Surveys Special data analysis by Saving Newborn Lives

Postnatal care Postnatal visit for mother* Demographic and Health Surveys Special data analysis by Saving Newborn Lives

Body mass index Women with low body mass index

Demographic and Health Surveys Demographic and Health Surveys, STATCompiler (accessed March 2014)

EquityDemand for family planning satisfied*

Multiple Indicator Cluster Surveys, Demographic and Health Surveys

Special data analysis by Federal University of Pelotas, Brazil

Antenatal care (at least one visit)



Antenatal care (four or more visits)*



Skilled attendant at delivery*



Early initiation of breastfeeding Multiple Indicator Cluster Surveys, Demographic and Health Surveys


ITN use among children < 5 years



Three doses of combined diphtheria/tetanus/pertussis vaccine immunization coverage*



Measles immunization coverage



Vitamin A (past 6 months) Multiple Indicator Cluster Surveys, Demographic and Health Surveys


Oral rehydration therapy and continued feeding



Careseeking for pneumonia Multiple Indicator Cluster Surveys, Demographic and Health Surveys


Child HealthImmunization Measles immunization

coverage World Health Organization and United Nations Children’s Fund estimates of national immunization coverage

World Health Organization and United Nations Children’s Fund estimates of national immunization coverage

Three doses of combined diphtheria/tetanus/pertussis vaccine immunization coverage*



Haemophilus influenzae type B immunization coverage



Rotavirus vaccine coverage World Health Organization and United Nations Children’s Fund estimates of national immunization coverage


Pneumococcal conjugate vaccine coverage



Pneumonia treatment Careseeking for symptoms of pneumonia

Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national surveys


Antibiotic treatment for symptoms of pneumonia*



Diarrhoeal disease treatment




Oral rehydration salts Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national surveys



Indicator Data source Global database Malaria prevention and treatment

Children receiving first-line treatment among those receiving any antimalarial

Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Malaria Indicator Surveys, other national surveys


Insecticide-treated net use Multiple Indicator Cluster Surveys, Demographic and Health Surveys, Malaria Indicator Surveys, other national surveys


NutritionAnthropometry Underweight prevalence Multiple Indicator Cluster Surveys, Demographic and

Health Surveys, other national surveys United Nations Children’s Fund, World Health Organization, World Bank

Stunting prevalence* Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national surveys

United Nations Children’s Fund, World Health Organization, World Bank

Wasting prevalence Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national surveys

United Nations Children’s Fund, World Health Organization, World Bank

Infant feeding Early initiation of breastfeeding Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national surveys


Exclusive breastfeeding rate (for first six months of life)*



Introduction of solid, semi-solid and soft foods (ages 6–8 months)



Low birthweight Low birthweight incidence Multiple Indicator Cluster Surveys, Demographic and Health Surveys, other national surveys, routine reporting


Micronutrient supplementation

Vitamin A two dose coverage United Nations Children’s Fund United Nations Children’s Fund

Water and sanitationWater Improved drinking water

coverageJoint Monitoring Programme for Water Supply and Sanitation (World Health Organization and United Nations Children’s Fund)

Joint Monitoring Programme for Water Supply and Sanitation (World Health Organization and United Nations Children’s Fund)

Sanitation Improved sanitation coverage Joint Monitoring Programme for Water Supply and Sanitation (World Health Organization and United Nations Children’s Fund)

Joint Monitoring Programme for Water Supply and Sanitation (World Health Organization and United Nations Children’s Fund)

Policies, systems and financingPolicies Laws or regulations that

allow adolescents to access contraceptives without parental or spousal consent

World Health Organization Global Maternal Newborn Child and Adolescent Health Policy Indicator Survey 2013 by the World Health Organization Department of Maternal Child and Adolescent Health

Legal status of abortion United Nations Population Division policy database United Nations Population Division policy database http://esa.un.org/poppolicy/about_database.aspx (Accessed January 2014)

Midwives authorized for specific tasks



International Labour Organization International Labour Organization, NORMLEX Information System on International Labour Standards, at: https://www.ilo.org/dyn/normlex/en (Accessed March 2014)

Maternal deaths notification World Health Organization Global Maternal Newborn Child and Adolescent Health Policy Indicator Survey 2013 by the World Health Organization Department of Maternal Child and Adolescent Health

Postnatal home visits in first week after birth


Kangaroo mother care in facilities for low-birthweight and preterm newborns




International Code of Marketing of Breastmilk Substitutes

World Health Organization World Health Organization and United Nations Children’s Fund special data compilation




Indicator Data source Global database

Low-osmolarity oral rehydration salts and zinc for management of diarrhoea


Systems Costed national implementation plans for maternal, newborn and child health available


Reproductive lifesaving commodities in essential medicines list: emergency contraceptives, implants and female condoms

U.S. Agency for International Development Deliver Project and World Health Organization

Emergency contraceptives and implants information: U.S. Agency for International Development Deliver Project, http://deliver.jsi.com/dhome/whatwedo/commsecurity/csmeasuring/csindicators/csindicatordashboards (Accessed March 2014) Female condoms information: World Health Organization EML database www.who.int/medicines/publications/essentialmedicines (Accessed March 2014)

Maternal lifesaving commodities in essential medicines list: oxytocin, misoprostol and magnesium sulfate


Newborn lifesaving commodities in essential medicines list: injectable antibiotics, antenatal corticosteroids, chlorhexidine and resuscitation equipment

World Health Organization and the Chlorhexidine Working Group

Global Maternal Newborn Child and Adolescent Health Policy Indicator Survey 2013 by the World Health Organization Department of Maternal Child and Adolescent Health and the Chlorhexidine Working Group

Child lifesaving commodities in essential medicines list: amoxicillin, oral rehydration salts and zinc


Density of doctors, nurses and midwives

World Health Organization Global Health Observatory 2013

National availability of emergency obstetric care services

Averting Maternal Death and Disability, United Nations Children’s Fund, United Nations Population Fund

Averting Maternal Death and Disability, United Nations Children’s Fund, United Nations Population Fund special data compilation

Financing Per capita total expenditure on health

World Health Organization Global Health Expenditure Database http://apps.who.int/gho/data/node.main.484?lang=en (Accessed February 2014)

General government expenditure on health as % of total government expenditure


Out-of-pocket expenditure as % of total expenditure on health



World Health Organization World Health Organization

Official development assistance to child health per child

Organisation for Economic Co-operation and Development’s Development Assistance Committee

London School of Health and Tropical Medicine

Official development assistance to maternal and neonatal health per live birth

Organisation for Economic Co-operation and Development’s Development Assistance Committee

London School of Health and Tropical Medicine

* Indicators in bold are those recommended by the Commission on Information and Accountability for Women’s and Children’s Health. The commission

indicator for under-five mortality includes the proportion of neonatal deaths, also tracked by Countdown.


Annex D Definitions of Countdown coverage indicators

Intervention Indicator definition Numerator Denominator Maternal and newborn healthSkilled attendant at delivery* Percentage of live births attended by

skilled health personnel Number of women ages 15–49 with a live birth in the X years prior to the survey who were attended during delivery by skilled health personnel (doctor, nurse, midwife or auxiliary midwife)

Total number of women ages 15–49 with a live birth in the X years preceding the survey

Treatment of pregnant women living with HIV*

Percentage of eligible pregnant women with HIV who received antiretroviral therapy

Number of pregnant women living with HIV who are receiving lifelong antiretroviral therapy

Estimated number of pregnant women living with HIVa

Prevention of mother-to-child transmission of HIV

Percentage of pregnant women living with HIV who received most efficacious regimens of antiretrovirals to prevent mother-to-child transmission of HIV

Number of pregnant women living with HIV who received most efficacious regimens of antiretrovirals to prevent mother-to-child transmission of HIV

Estimated number of pregnant women living with HIVa

Antenatal care (at least one visit) Percentage of women attended at least once during pregnancy by skilled health personnel

Number of women ages 15–49 who were attended at least once during pregnancy in the X years preceding the survey by skilled health personnel (doctor, nurse, midwife, or auxiliary midwife)


Antenatal care (four or more visits)* Percentage of women attended four or more times during pregnancy by any provider

Number of women ages 15–49 who were attended four or more times during pregnancy in the X years preceding the survey by any provider


Demand for family planning satisfied*

Percentage of women ages 15–49, either married or in union, who have their need for family planning satisfied

Women who are married or in union and currently using any method of contraception

Women who are married or in union and who are currently using any method of contraception or who are fecund, not using any method of contraception but report wanting to space their next birth or stop childbearing altogether

Intermittent preventive treatment for malaria during pregnancy

Percentage of women who received intermittent preventive treatment for malaria during their last pregnancy

Number of women ages 15–49 at risk for malaria who received two or more doses of a sulfadoxine-pyrimethamine (Fansidar™) to prevent malaria during their last pregnancy that led to a live birth


Caesarean section rate Percentage of live births delivered by Caesarean section

Number of women ages 15–49 with a live birth in the X years preceding the survey delivered by caesarean section


Neonatal tetanus protection Percentage of newborns protected against tetanus

Number of mothers with a live birth in the year prior to the survey who received two doses of tetanus toxoid vaccine within the appropriate interval prior to the infant’s birth

Total number of women ages 15–49 with a live birth in the year prior to the survey

Postnatal care for mothers*b Percentage of mothers who received postnatal care within two days of childbirth

Number of women ages 15–49 who received postnatal care within two days of childbirth (regardless of place of delivery)

Total number of women ages 15–49 with a last live birth in the x years prior to the survey (regardless of place of delivery)

Postnatal care for babies* Percentage of babies who received postnatal care within two days of childbirth

Number of babies who received postnatal care within two days of birth

Total number of last-born babies in the X years prior to the survey

Child healthMeasles immunization coverage Percentage of infants immunized with

measles-containing vaccine Number of children ages 12–23 months who are immunized against measles

Total number of children ages 12–23 months surveyed

Three doses of combined diphtheria/pertussis/tetanus vaccine immunization coverage*

Percentage of infants who received three doses of diphtheria/pertussis/tetanus vaccine

Number of children ages 12–23 months receiving three doses of diphtheria/ pertussis/tetanus vaccine


Three doses of Haemophilus influenzae type B immunization coverage

Percentage of infants who received three doses of Haemophilus influenzae type B vaccine

Number of children ages 12–23 months receiving three doses of Haemophilus influenzae type B vaccine


Careseeking for symptoms of pneumonia Percentage of children ages 0–59 months with symptoms of pneumonia taken to an appropriate health provider

Number of children ages 0–59 months with symptoms of pneumonia in the two weeks prior to the survey who were taken to an appropriate health provider

Total number of children ages 0–59 months with symptoms of pneumonia in the two weeks prior to the survey

Antibiotic treatment for symptoms of pneumonia*

Percentage of children ages 0–59 months with symptoms of pneumonia receiving antibiotics

Number of children ages 0–59 months with symptoms of pneumonia in the two weeks prior to the survey receiving antibiotics

Total number of children ages 0–59 months with symptoms of pneumonia in the two weeks prior to the survey


Percentage of children ages 0–59 months with diarrhoea receiving oral rehydration therapy and continued feeding

Number of children ages 0–59 months with diarrhoea in the two weeks prior to the survey receiving oral rehydration therapy (oral rehydration salts packet, pre-packaged oral rehydration salts fluid, recommended homemade fluid or increased fluids) and continued feeding

Total number of children ages 0–59 months with diarrhoea in the two weeks prior to the survey


Intervention Indicator definition Numerator Denominator

Oral rehydration salts treatment Percentage of children ages 0–59 months with diarrhoea receiving oral rehydration salts

Number of children ages 0–59 months with diarrhoea in the two weeks prior to the survey receiving oral rehydration salts

Total number of children ages 0–59 months with diarrhoea in the two weeks prior to the survey

First line antimalarial treatment Percentage of children ages 0–59 months receiving first-line antimalarial treatment

Number of children ages 0–59 months who had a fever in the two weeks prior to the survey who received first line treatment according to national policy

Total number of children ages 0–59 months who had a fever in the two weeks prior to the survey who received any antimalarial drugs

Insecticide-treated net use Percentage of children ages 0–59 months sleeping under an insecticide-treated mosquito net

Number of children ages 0–59 months sleeping under an insecticide-treated mosquito net the night before the survey


NutritionEarly initiation of breastfeeding Percentage of newborns put to the breast

within one hour of birthNumber of women with a live birth in the X years prior to the survey who put the newborn infant to the breast within 1 hour of birth

Total number of women with a live birth in the X years prior to the surveyed

Exclusive breastfeeding (for first 6 months of life)*

Percentage of infants ages 0–5 months who are exclusively breastfed

Number of infants ages 0–5 months who are exclusively breastfed

Total number of infants ages 0–5 months surveyed

Introduction of solid, semi-solid and soft foods (ages 6–8 months)

Percentage of infants ages 6–8 months who receive solid, semi-solid or soft foods

Number of infants ages 6–8 months who received solid, semi-solid or soft foods during the previous day

Total number of infants ages 6–8 months surveyed

Vitamin A supplementation Percentage of children ages 6–59 months who received two doses of vitamin A during the calendar year

Estimated number of children ages 6–59 months who received two doses of vitamin A during the calendar year

Total number of children ages 6–59 months

Water and sanitationUse of improved drinking water sources Percentage of the population using

improved drinking water sources (piped on premises or other improved drinking water sources)

Number of household members using improved drinking water sources (including piped on premises, public standpipe, borehole, protected dug well, protected spring, rainwater collection)

Total number of household members

Use of improved sanitation facilities Percentage of the population using improved sanitation facilities

Number of household members using improved sanitation facilities (including connection to a public sewer, connection to a septic system, pour-flush latrine, simple pit latrine, or a ventilated improved pit latrine)

Total number of household members

* Indicators in bold are those recommended by the Commission on Information and Accountability for Women’s and Children’s Health. The commission

indicator for under-five mortality includes the proportion of neonatal deaths, also tracked by Countdown.

a. More details on the HIV estimates methodology can be found at www.unaids.org.

b. As used for postnatal care in the graph on coverage along the continuum of care on the first page of each country profile.


Annex E Definitions of health policies, systems and finance indicators

Indicator Definition Criteria for rankingPolicy indicatorsFamily planning for adolescents Laws or regulations allow adolescents (married or

unmarried) to access contraception without parental or spousal consent.

Yes = legislation is available that allows adolescents to access contraception without parental or spousal consent.

Partial = legislation is available that allows either married adolescents to access contraception without spousal consent or allows unmarried adolescents to access contraception without parental consent.

No = no legislation is available that allows adolescents to access contraception without parental or spousal consent.

Legal status of abortion Legal grounds under which abortion is allowed. Abortion allowed on the following grounds:I = to save a woman’s life.II = to preserve physical health and above.III = to preserve mental health and above.IV = for economic and social reason and the above.V = on request and above.R = in case of rape or incest.F = in case of foetal impairment. — = data are not available.

Midwives authorized for specific tasks Midwifery personnel are authorized to deliver basic emergency obstetric and newborn care.

Number of the seven lifesaving interventions tasks authorized:• Parental antibiotics.• Parenteral oxytocin.• Parental anticonvulsants.• Manual removal of placenta.• Removal of retained products of conception.• Assisted vaginal delivery.• Newborn resuscitation.

Maternity protection (Convention 183) Country has ratified International Labour Organization Convention 183 or has passed national legislation that is in compliance with the three key provisions of the convention (14 weeks of maternity leave, paid at 66% of previous earnings by social security or general revenue)

Yes = International Labour Organization Convention 183 ratified (maternity leave of at least 14 weeks with cash benefits of previous earnings paid by social security or public funds).

Partial = International Labour Organization Convention 183 not ratified but previous maternity convention ratified (maternity leave of at least 12 weeks with cash benefits of previous earnings paid by social security or public funds).

No = no ratification of any maternal protection convention.

Maternal deaths notification National policy has been adopted requiring health professionals to notify any maternal death to a responsible national body.

Yes = national policy adopted and implemented.

Partial = national policy adopted but no systematic implementation.

No = no national policy adopted.


National policy recommending home visits to mother and newborn in the first week after childbirth by a trained provider have been adopted and implemented.

Yes = national policy or guidelines recommending postnatal home visits

adopted and implemented.

No = no national policy or guidelines on postnatal home visits adopted.

Kangaroo mother care for low birthweight newborns

National policy recommends kangaroo mother care for low-birthweight newborns.

Yes = national policy recommends kangaroo mother care for low-birthweight newborns.

No = national policy does not recommend kangaroo mother care for low-birthweight newborns.

Antenatal corticosteroids for preterm labour

National policy recommends antenatal corticosteroids for preterm labour.

Yes = national policy recommends use of antenatal corticosteroids for preterm labour.

No = national policy does not recommend use of antenatal corticosteroids for preterm labour.

International Code of Marketing of Breastmilk Substitutes

National policy has been adopted on all provisions stipulated in International Code of Marketing of Breastmilk Substitutes.

Yes = all provisions stipulated in International Code of Marketing of Breastmilk Substitutes adopted in legislation.

Partial = voluntary agreements or some provisions stipulated in International Code of Marketing of Breastmilk Substitutes adopted in legislation.

No = no legislation and no voluntary agreements adopted in relation to the International Code of Marketing of Breastmilk Substitutes.

Community treatment of pneumoniawith antibiotics

National policy or guidelines authorizing case management of pneumonia in the community by a trained provider has been adopted and implemented.

Yes = national policy or guidelines adopted on the identification and treatment of pneumonia by trained providers in the community.

No = no national policy or guidelines on the identification and treatment of pneumonia by trained providers.


Indicator Definition Criteria for ranking

Low-osmolarity oral rehydration salts and zinc for management of diarrhoea

National policy on management of diarrhoea with low osmolality oral rehydration salts and zinc has been adopted and implemented.

Yes = national policy or guidelines adopted on use of low osmolality oral rehydration salts and zinc for management of diarrhoea.

No = no national policy or guidelines adopted on use of low osmolality oral rehydration salts and zinc for management of diarrhoea

Systems indicatorsCosted national implementation plan for maternal, newborn and child health

National plan for scaling up maternal, newborn and child health interventions is available and costed.

Yes = costed plan or plans to scale up maternal, newborn and child health interventions available at the national level.

Partial = costed plan available for either maternal and newborn health or child health.

No = no costed implementation plan for maternal, newborn and child health available.

Reproductive lifesaving commodities in essential medicines list

Emergency contraceptives, implants and female condoms are in the essential medicines list.

Number of the three listed commodities that are included in the essential medicines list.

Maternal lifesaving commodities in essential medicines list

Oxytocin, misoprostol and magnesium sulfate are in the essential medicines list.


Newborn lifesaving commodities in essential medicines list

Injectable antibiotics, antenatal corticosteroids, chlorhexidine and resuscitation equipment are in the essential medicines list.

Number of the four listed commodities that are included in the essential medicines list.

Child lifesaving commodities in essential medicines list

Amoxicillin, oral rehydration salts and zinc are in the essential medicines list.


Density of health workers Proportion of physicians, nurses and midwives who are available per 10,000 population.

Percentage

National availability of emergency obstetric care services

At least five emergency obstetric care facilities per 500,000 people, including one comprehensive and four basic emergency obstetric care facilities. (The breakdown of comprehensive and basic by population and geographic area is available in country assessment reports but not included in the Countdown.)

Availability is expressed as a percentage of the minimum acceptable number of emergency obstetric care facilities.

The minimum acceptable number of emergency obstetric care facilities (comprehensive and basic) is calculated by dividing the population by 500,000 and multiplying by 5.

The percentage of recommended minimum number of emergency obstetric care facilities is calculated by dividing the number of functioning emergency obstetric care facilities by the recommended number and multiplying by 100. To qualify as a fully functioning basic or comprehensive emergency obstetric care facility, a facility must provide a standard set of signal functions

Finance indicatorsPer capita total expenditure on health Numerical

General government expenditure on health as a share of total government expenditure

Numerical

Out-of-pocket expenditure as a share of total expenditure on health

Numerical


Annex F Technical annex for the Health Systems and Policies Technical Working Group and the Financing Technical Working Group

Health systems and policies indicators

Most of the policy indicators compiled by the Countdown Health Systems and Policies Technical Working Group are the result of a biannual survey implemented by the World Health Organization’s Department of Maternal, Newborn, Child and Adolescent Health. Indicators are developed as a composite measure summarizing the presence and implementation of a given policy. If a policy is endorsed and implemented, the value of the indicator is marked as “Yes”. If the policy is not endorsed, the value of the indicator is marked as “No”. If the policy is endorsed but lacks implementation, the value of the indicator is marked as “Partial”. For policies such as midwifery personnel authorized to deliver basic emergency obstetric and newborn care or reproductive, maternal, newborn and child health lifesaving commodities in essential list of medicines, the value of the indicator is the number of policy components endorsed or present in the policy document. Respondents to the survey are ministry of health officials responsible for maternal, newborn, child and adolescent health in their country. The information reported is independently validated by the World Health Organization country office and at least one other UN organization that operates in the country. Data analysis and compilation are done by the World Health Organization. Data reported are collected from the 2013–2014 survey. The legal status of abortion indicator is a result of the analysis of legal grounds under which abortion is legally allowed, as per the information reported in the United Nations Population Division policy database.

The Health Systems and Policies Technical Working Group regularly reviews the evidence base for all the systems and policy measures that Countdown tracks. For example, a small working group has been formed to review the signal functions related to the indicator on emergency obstetric care, including on care for newborns.

Financing indicators

The Countdown Financing Working Group analysed 2011 official development assistance disbursements in the Organisation for Economic Co-operation and Development’s Development Assistance Committee’s Creditor Reporting System aid activities database using previously implemented methods.52 Data were downloaded on 3 April 2014 and included 242,382 records of aid disbursement.

All records were reviewed to correct for errors in the classification of health expenditures within the database. Records were manually coded against a framework defining reproductive, maternal, newborn and child health activities. Broadly, maternal and newborn health activities were defined as those that aim to restore, improve or maintain the health of women and their newborn during pregnancy, childbirth and the postnatal period, and child health activities were defined as those that aim to restore, improve or maintain the health of children ages 1 month to 5 years. Additional activities considered as reproductive health include family planning and those related to sexual health and sexually transmitted infections, including HIV. Based on these codes, each record was given an allocation factor between 0% and 100%, representing the proportion of expenditures spent on reproductive, maternal, newborn and child health. Allocation factors were established after reviewing the literature and current financial (for example, general government expenditure on health as a percentage of total government expenditure), epidemiological (for example, percentage of a population group with HIV) and population estimates (for example, percentage of population under age 5). Official development assistance from all 27 bilateral organizations, 22 multilateral organizations and 3 global health initiatives (including the Bill and Melinda Gates Foundation) to the Countdown’s priority countries was analysed and reported in two indictors: official development assistance to child health per child and official development assistance to maternal and neonatal health per live birth.

Comparison of results with those of the Institute for Health Metrics and Evaluation

Recent data from the Institute for Health Metrics and Evaluation report that development assistance to maternal, newborn and child health grew just under 18% in real terms between 2010 and 2011 among all recipient countries (not just the 75 Countdown countries), from $5.2 billion to $6.1 billion (in 2011 prices).


When considering official development assistance to all recipient countries (not just Countdown countries), Countdown estimates a 3% increase in real terms, from $6.9 billion to $7.1 billion (in 2012 prices).

These differences in estimates may reflect differences in methods used by the two resource tracking initiatives, which could explain the variation in findings (see table F1 for examples of differences). First, the Institute for Health Metrics and Evaluation estimates development assistance to health, which is defined more broadly than official development assistance to include all financial and in-kind contributions from global health channels that aim to improve health. Further, the Countdown analysis relies on the data reported in the Creditor Reporting System, which is restricted to donors that report to the system. The Institute for Health Metrics and Evaluation’s wider range of data sources account for 67% of the data analysed (Joe Dieleman, personal communication). For Countdown other, non-purpose-specific funding modalities and general health systems strengthening support that can be attributed to maternal, newborn and child health are picked up through the manual coding process. The Institute for Health Metrics and Evaluation conducts an automated keyword search. The Institute for Health Metrics and Evaluation

a. The Institute for Health Metrics and Evaluation tracks a wide range of health focus areas (such as maternal, newborn and child health; HIV; and malaria).

To avoid double counting, it divides projects across these areas, so a project addressing malaria in mothers and children would be divided between the

maternal, newborn and child health and the malaria health focus areas. Countdown would include such projects as maternal, newborn and child health.

Methods CountdownInstitute for Health Metrics and Evaluation Expected effect on estimates

What is being tracked? Official development assistance. Development assistance to health. Institute for Health Metrics and Evaluation > Countdown

Donors Donors reporting to the Creditor Reporting System.

Donors reporting to the Creditor Reporting System plus nongovernmental organizations, US private foundations, and the Pan American Health Organization.

Institute for Health Metrics and Evaluation > Countdown

Recipient countries 75 Countdown priority countries and all countries receiving official development assistance captured in the Creditor Reporting System.

Low- and middle-income countries as defined by the World Bank.


Data sources Organisation for Economic Co-operation and Development’s Creditor Reporting System.

Creditor Reporting System plus donor databases, annual reports, and audited financial statements; nongovernmental organization databases; and communication with donors.


Approach to coding Manual, line by line coding of the entire Creditor Reporting System database according to predefined methods. Includes in maternal, newborn and child health spending HIV and malaria spending that is related to maternal, newborn and child health.

Automated keyword search of the health and population sector codes. Allocates 100% of United Nations Children’s Fund and United Nations Population Fund spending to maternal, newborn and child health spending and 100% of Joint United Nations Programme on HIV/AIDS spending to reproductive health spending.

Health focus areas are mutually exclusive so that projects that are for maternal, newborn and child health and another health focus area get divided between the multiple health focus areas.a

Countdown > Institute for Health Metrics and Evaluation

Categorization of health focus areas Family planning included in reproductive health.

Family planning included in maternal, newborn and child health.

Institute for Health Metrics and Evaluation > Countdown for MNCH

Aid modality and health systems Allocates a share of pooled funding and health systems funding to maternal, newborn and child health.

Does not include pooled funding or health systems funding that is not explicitly earmarked for maternal, newborn and child health.

Countdown > Institute for Health Metrics and Evaluation

Data adjustments Disbursements as reported in the Creditor Reporting System. No adjustments made.

For projects where the Creditor Reporting System does not report disbursement data, commitment data are adjusted to reflect disbursements.


TABLE F1 Overview of key differences in methods to resource tracking between Countdown and the Institute for Health Metrics and Evaluation


allocates certain donors’ contributions, such as the United Nations Children’s Fund, in full to maternal, newborn and child health, whereas Countdown relies on manual coding to allocate only projects with direct relevance to maternal, newborn and child health.

Technical note on box 9

The evidence used for the Countdown countries in box 9 on out-of-pocket financing for health came from published, publicly available sources (table F2 and figures F1 and F2). Other estimates for the Countdown countries may be available in the grey literature, including UN reports. The aim of box 9 is to highlight the need for improvements in the collection, analysis and dissemination of data on financial risk protection.

Reference Indicator Year Countdown countries with data

van Doorslaer and others 2007 Share of population spending more than 40% of nonfood expenditure in a given month on direct health care payments

1994–2002 Bangladesh, China, India, Indonesia, Kyrgyzstan, Nepal, Philippines, Viet Nam

Xu and others 2007 Share of population spending more than 40% of nonsubsistence expenditure in a given month on direct health care payments

1990– 2003 32 Countdown countries

van Doorslaer and others 2006 Share of population falling below PPP$2.15 poverty line as a result of out-of-pocket expenditure on health in past month

1998–2001 Bangladesh, China, India, Indonesia, Kyrgyzstan, Nepal, Philippines, Viet Nam

Rannan-Eliya and others 2012 Share of population spending more than 40% of nonfood expenditure in a given month on direct health care payments

Share of population falling below PPP$2.15 poverty line as a result of out-of-pocket expenditure on health in past month

2005–2010 Bangladesh, Cambodia, Lao PDR, Pakistan, Papua New Guinea, Timor-Leste

Knaul, Wong and Arreola-Ornelas 2012 Share of population spending more than 40% of nonfood expenditure in a given month on direct health care payments

2003–2010 Brazil, Mexico, Peru

Mills and others 2012 Share of population spending more than 40% of nonfood expenditure in a given month on direct health care payments

2008 Ghana, South Africa, Tanzania

Ichoku and Fonta 2009 Share of population spending more than 40% of nonfood expenditure in a given month on direct health care payments

1999 Nigeria

Countdown and World Bank studies (unpublished)

Share of population spending more than 40% of nonfood expenditure in a given month on direct health care payments

Share of population falling below PPP$2.15 poverty line as a result of out-of-pocket expenditure on health in past month

2007–2010 Afghanistan, Solomon Islands

TABLE F2 Estimates and sources of available data on catastrophic expenditure, Countdown countries


FIGURE F1 Households with out-of-pocket health expenditure greater than 40% of nonfood spending

a. Estimate from Xu and others (2007) using similar but not strictly

comparable definition.

Source: See table F2.

0 2 4 6 8 10 12

Solomon Islands (2006)

South Africa (2008)

Morocco (1999)a

Timor-Leste (2007)

Djibouti (1996)a

Senegal (1995)a

Papua New Guinea (2010)

Brazil (2003)

Pakistan (2006)

Mexico (2010)

Tanzania (2008)

Philippines (1999)

Nigeria (1999)

Bangladesh (2010)

Yemen (1998)a

Indonesia (2001)

Ghana (2008)

Zambia (1996)a

Kyrgyzstan (2001)

Afghanistan (2007)

Uganda (2003)a

Egypt (1997)a

India (2003)

Botswana (1994)a

Peru (2006)

Lao PDR (2008)

Bolivia (2002)a

Kenya (2003)a

Tajikistan (1999)a

Nepal (1996)

China (2000)

Burkina Faso (1998)a

Viet Nam (1998)

Azerbaijan (1995)a

Côte d’Ivoire (1998)a

Malawi (2003)a

Cambodia (2007)

Share of households spending 40% or more of nonfood expenditures on health (%)

FIGURE F2 Households falling below international poverty line of PPP$2.15 a day as a result of out-of-pocket health expenditure

Source: See table F2.

0 1 2 3 4 5

Timor-Leste (2007)

Indonesia (2001)

Nepal (1996)

Lao PDR (2008)

Kyrgyzstan (2001)

India (2003)

Philippines (1999)

Cambodia (2007)

Bangladesh (2010)

Pakistan (2006)

China (2000)

Viet Nam (1998)

Share of people falling below poverty line of PPP$ 2.15 per day as a result of out-of-pocket payments for health care (%)


Annex G Countdown countries prioritized for malaria intervention coverage analysis

Table G1 organizes the Countdown countries according to a set of criteria related to malaria transmission risk:

• The left column includes 43 countries where at least 75% of the total population is at risk of malaria transmission and where a substantial proportion (50% or more) of malaria cases is due to Plasmodium falciparum. Only the countries meeting these criteria were included in the analyses for the malaria indicators in this report.

• The right column includes nine countries where 50–74% of the population is at risk of malaria transmission and where a substantial proportion (50% or more) of malaria cases is due to Plasmodium falciparum. When available, malaria intervention coverage data are included in the Countdown profiles.

TABLE G1 Countdown countries by malaria transmission risk

Source: Country profiles from WHO (2013).

Countries where at least 75% of the population is at risk of malaria and where a substantial proportion (50% or more) of

malaria cases is due to Plasmodium falciparum (N = 43)

Countries where 50–74% of the population is at risk of malaria and where a substantial proportion (50% or more) of

malaria cases is due to Plasmodium falciparum (N = 9)

AngolaBeninBurkina FasoBurundiCameroonCentral African RepublicChadComorosCongoCongo, Dem. Rep.Côte d’IvoireEquatorial GuineaEritreaGabonGambiaGhanaGuineaGuinea-BissauHaitiIndiaKenyaLiberia

MadagascarMalawiMaliMauritaniaMozambiqueNigerNigeriaPapua New GuineaPhilippinesRwandaSão Tomé and PríncipeSenegalSierra LeoneSolomon IslandsSomaliaSouth SudanSudanTanzania, United RepublicTogoUgandaZambia

BotswanaCambodiaDjiboutiEthiopiaIndonesiaLao People’s Democratic RepublicMyanmarYemenZimbabwe


Annex H Details on estimates produced by interagency groups used in the Countdown report—mortality, immunization, and water and sanitation

Mortality

Countdown to 2015 aims to stimulate progress towards Millennium Development Goals 4 and 5, so it relies on UN interagency estimates on child and maternal mortality that are produced for official Millennium Development Goal reporting. These estimates are used to monitor progress at the global level because they are made comparable across countries and over time by applying standard methods to generate country, regional and global estimates. The UN mortality estimates are generated based on national data but may not always correspond precisely to the results from the most recent available data source or to country official estimates due to differences in the methods applied.

Child mortality. The child mortality estimates in this report (neonatal mortality rate, infant mortality rate, under-5 mortality rate and under-5 deaths) are based on the work of the UN Inter-agency Group for Child Mortality Estimation (UN IGME), which includes the United Nations Children’s Fund, the World Health Organization, the United Nations Population Division and the World Bank. The UN IGME estimates are the official UN estimates for measuring progress towards Millennium Development Goal 4 (reduce child mortality). The UN IGME compiles available data from all possible nationally representative sources for a country, including household surveys, censuses and vital registration systems, and uses a model to fit a regression line to the data to produce the mortality estimates. Estimates are updated every year after a detailed review of all newly available data points. The review may result in adjustments to previously reported estimates as new data become available and provide more information on past trends.

The data inputs, methods and full time series of the UN IGME estimates for all countries are available at www.data.unicef.org and www.childmortality.org.

Maternal mortality. Maternal mortality estimates for 1990–2013 are based on the work of the Maternal Mortality Estimation Inter-agency Group, which comprises the World Health Organization, the United Nations Children’s Fund, the United Nations Population Fund and the World Bank. Maternal mortality data—more sparse than child mortality data—are from sources such as vital registration systems, surveys and censuses. Maternal mortality estimates from these sources are subject to serious misclassification and underreporting. These data are therefore adjusted to account for these errors, and multilevel regression models are fit to predict levels and trends in maternal mortality between 1990 and 2013. Covariates used in the models include gross domestic product per capita, general fertility rate and skilled birth attendance. For more information, see WHO and others (2014).

Immunization

The immunization data published in this report are based on the work of the World Health Organization and the United Nations Children’s Fund. The estimates should not be confused with other sources of information, such as Demographic and Health Surveys, Multiple Indicator Cluster Surveys or administratively reported data from ministries of health. The World Health Organization and United Nations Children’s Fund use data reported by national immunization programmes as well as surveys and other sources to obtain estimates of national immunization coverage each year. A draft report is sent to each country for review and comment. Final reports are published in July with coverage estimates for the preceding calendar year. All new evidence, such as final survey reports received after publication, are taken into consideration during production of the following year’s estimates. For each country’s final report for 2012 as well as methods, data sources and brief description of trends, see www.data.unicef.org.

Water and sanitation

The drinking water and sanitation coverage estimates are produced by the World Health Organization–United Nations Children’s Fund Joint Monitoring Programme for Water Supply and Sanitation. The estimates are the official UN estimates for measuring progress towards the Millennium Development Goal targets for drinking water and sanitation. They use a standard classification of what constitutes coverage.


The Joint Monitoring Programme does not report the findings of the latest nationally representative household survey or census. Instead, it estimates coverage using a linear regression line that is based on coverage data from all available household sample surveys and censuses. For specific country data, see www.childinfo.org and www.wssinfo.org.


1. The Bellagio Study Group on Child Survival 2003.2. UN Inter-agency Group for Child Mortality Estimation 2013.3. Wang and others forthcoming; UN IGME 2013.4. UN Inter-agency Group for Child Mortality Estimation 2013.5. UNICEF Division of Policy and Strategy 2013.6. WHO 2014.7. WHO 2014.8. Lawn and others 2010; Requejo, Newby and Bryce 2012.9. Kassebaum and others forthcoming; WHO and others 2014.10. WHO and others 2014.11. Kassebaum and others forthcoming; Say and others 2014.12. Lancet 2008, 2013.13. Black and others 2013; Bhutta and others 2013a.14. Lancet 2013.15. Lancet 2013.16. WHO Executive Board 2013.17. Lancet 2008; UNICEF 2013a.18. Bhutta and others 2013a.19. Ruel, Alderman and the Maternal and Child Nutrition Study

Group 2013; Gillespie and others 2013.20. Bhutta and others 2013a.21. The Composite Coverage Index is a weighted score

reflecting coverage of eight interventions along the continuum of care. For more details, see www.countdown2015mnch.org/reports-and-articles/equity.

22. Wang and others forthcoming.23. Walker and others 2013.24. Darmstadt and others forthcoming.25. Global Health Workforce Alliance and WHO 2013.26. UN Commission on Life-Saving Commodities for Women

and Children 2012.27. Hsu and others 2013.28. Differences with the data reported by the Institute for

Health Metrics and Evaluation are discussed in annex G.

29. Note that three additional donors now report to the Creditor Reporting System, accounting for an additional $3.9 million to maternal, newborn and child health and $760,000 to reproductive health.

30. Hsu and others 2012. [add to reference list]31. Independent Expert Review Group, Commission on

Information and Accountability for Women’s and Children’s Health 2013.

32. Moran and others 2013.33. Campbell and others 2013; Hazir and others 2013.34. Bryce and others 2013.35. Barros and Victora 2013.36. Hancioglu and Arnold 2013.37. Requejo, Newby and Bryce 2013.38. Sustainable Development Solutions Network 2014.39. Partnership for Maternal, Newborn & Child Health and

WHO 2014.40. Data prepared by World Health Organization.41. The Bellagio Study Group on Child Survival 2003.42. The Bellagio Study Group on Child Survival 2003.43. Bhutta and others 2010.44. Commission on Information and Accountability for

Women’s and Children’s Health 2011.45. Monitoring and Evaluation Working Group of the

International Health Partnership and Related Initiatives n.d.; Bryce and others 2011.

46. Amouzou, Habi and Bensaïd 2012.47. El Arifeen and others forthcoming.48. Barros and Victora 2013.49. Victora and others 2005.50. Filmer and Pritchett 2001.51. Requejo, Victora and Bryce 2014.52. Powell-Jackson and others 2006; Hsu, Berman and Mills

2013; Hsu and others 2012.

Notes


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