MDG: Progress in India
MDG: Progress in India Framework Introduction Monitoring at international level Monitoring at national level What is monitored? MDG: Progress in India Goal 1 Goal 2 Goal 3 Goal 4 Goal 5 Goal 6 Goal 7 Goal 8 Challenges References Introduction Sept 2000-Millennium Summit -New York Millennium Development Goals 1. 2. 3. 4. 5. 6. 7. 8. Eradicate extreme poverty and hunger Achieve universal primary education Promote gender equality and empower women Reduce child mortality Improve maternal health Combat HIV/ AIDS, malaria and other diseases. Ensure environmental sustainability and Develop a global partnership for development To be achieve by 2015 Mid-term evaluation - 2007 Who is monitoring? At International level United Nations, Inter-Agency & Expert Group on MDG Supporting Agencies *WHO *World Bank *International labour organization, *International monetary fund *Food & agricultural organization of UN *Economic commission of Africa, *UNICEF, *International telecommunication union *UNs environment programme * UNs development fund for women, *UNs development programmes, *WTO, *UNs population fund, *Joint UNs programme of HIV/AIDS …..etc. UN’s Statistics Division www. mdgs.un.org. Who is monitoring? At national level Ministry of Statistics & Programme Implementation Inter ministerial expert committee - Nov 2004 Source agencies Planning commission, Deptt of Education, Registrar general & census commissioner, National sample survey organization, Ministry of health & family welfare Ministries of finance, Agriculture, Coal, Petroleum & natural gas, Power, Urban development & Poverty Alleviation, Rural development, Water resources, Environment & forests, Health & family welfare, Human resource development, Communication & Information technology …….. etc What is monitored? 18 Targets & 48 Indicators 8 Targets & 18 Indicators directly related to health. Health related millennium development goal Goal 1: Eradicate extreme poverty and hunger Indicator 4. Prevalence of underweight children under five years of age Indicator 5. Proportion of population below minimum level of dietary energy consumption Goal 4: Reduce child mortality Indicator 13: Under-five mortality rate 14: Infant mortality rate 15: Proportion of one-year-old children immunized against measles Goal 5: Improve maternal health Indicator 16: Maternal mortality ratio 17: Proportion of births attended by skilled health personnel Goal 6: Combat HIV/AIDS, malaria and other diseases Indicator18: HIV prevalence among pregnant women aged 15-24 years 19: Condom use rate of the contraceptive prevalence rate 20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years 21: Prevalence and death rates associated with malaria 22: Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures 23. Prevalence and death rates associated with tuberculosis 24. Proportion of tuberculosis cases detected and cured under DOTS Goal 7: Ensure environmental sustainability Indicator 29: Proportion of population using solid fuels 30: Proportion of population with sustainable access to an improved water source, urban and rural 31: Proportion of population with access to improved sanitation, urban and rural Goal 8: Develop global partnership for development Indicator 46: Proportion of population with access to affordable essential drugs on sustainable basis. Goal 1: Eradicate extreme poverty and hunger Target 1 Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day Indicator 1: Proportion of population below $1 purchasing power parity (PPP) per day Indicator 2: Poverty gap ratio Indicators related to poverty & hunger Indicator Poverty headcount ratio Poverty gap ratio Overall Rural Urban Rural Urban 198788 38.9 39.1 38.2 1993-94 36.0 37.3 32.4 8.5 8.1 19992000 26.1 27.1 23.6 5.3 5.2 Source: planning commission & Ministry of health & family welfare,2005 Goal 1 Target 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger Indicator 4. Prevalence of underweight children under five years of age NFHS –II (1998-99)- 47% under 3 children underweight NFHS III (2005-06) - 43% under five children underweight. Steps for Goal 1 For rural area 1. Wage employment programme 2. Swarnajayanti Gram Swarozgar Yojana(1999) 3. Sampoorna Gramin Rozgar Yojana(2001) 4. Indira Awas Yojana 5. National Rural Employment Guarantee Act For Urban area 1. National slum development programme 2. Swarna Jayanti Shahari Rozgar Yojana 3. Valmiki Ambedkar Yojana (VAMBAY) 1. 2. 3. 4. 5. Public distribution system Targeted public distribution system: 1. Antyodaya Anna Yojana (2000) 2. ICDS (1975) 3. Mid-day meal scheme (1995) Revised 2004 4. Food for work programme 5. Annapurna scheme National nutrition mission (2003) National guideline on infant & young feeding 2004 NRHM (2005-2012) Goal 2: Achieve universal primary education Target 3 Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling Indicator 6: Net enrolment ration in primary education Indicator 7: Proportion of pupils starting grade 1 who reach grade 5 Indicator 8: Literacy rate of 15- 24 years old Indicator 199293 Gross enrolment ratio in Overall 84.6 primary education Male 95.0 Female 73.5 Proportion of children starting overall 55.0 Grade 1 who reach grade 5 Male 56.2 Female 53.3 Adult literacy rate(7 years & overall 52.2* above) Male 64.1 female 39.3 200001 95.7 104.9 85.9 59.3 60.3 58.1 64.84 75.26 53.67 Source: Selected educational statistics,2002-03, GOI. *Census of India,1991 & 2001 2004-05 108.56 111.41 105.48 Steps for achieving goal 2 Compulsory free primary education. Policies are been made Legislatation Intervention to support literacy Bridge gender disparity 1986 – National policy on education made –revised 1992 1992 – Programme of action –Universalizing elementary education. 1995-National programme of nutritional support (expanded 2002, 2004 revised) 1997-98 – Education guarantee scheme (EGS) 2000 – Sarva shiksha Abhiyan (SSA) 2002 – Canstitutional 86th amendment act 2004-Cess on taxes for funding basic education. Programmes of early childhood come & education Many experimental & innovative project 2004-Kasturba Gandhi Balika Vidyalaya (KGBV) Scheme Goal 3: Promote gender equality and empower women Target 4 Eliminate gender disparity in primary and secondary education, preferably by 2005, and at all levels of education no later than 2015 Indicator 9: Ratio of girls to boys in primary , secondary & tertiary education Indicator 10: Ratio of literate women to men 15-24 years old Indicator 11: Share of women in wage employment in the non-agricultural sector Indicator 12: Proportion of seats held by women in national parliament Proportion of girls(per100 boys) in primary, secondary & higher education Indicator Primary education Secondary Higher 1991 71 49 % 50 % 2001 78% 63 % 58 % Literacy ratio in women to men (Age 7 +) 0.72 0.7 0.68 0.66 0.64 0.62 0.6 0.58 0.56 0.71 0.61 1991 2001 Share of women’s in wage employment in non agricultural sector National level - 16%. Rural -15 % Urban-16.6%. Proportion of seats held by women in national parliament (Lok Sabha) 12 10.61 9.2 10 8 8 6 4.4 4 3.8 2 0 1st 6th 13th 14th 15th Ministry of human resource development Steps for achieving goal 3 Free & compulsory primary education for girls Schemes by UGC 1) Grants to women’s university for teaching courses 2)Construction of women’s hostels, 3)Setting up women study centers in 34 universities. World bank assisted programme for technical education 43% - women. No. of women in colleges, universities, professional college increasing 1996 - 97 - 2.14 million 2002 - 03 - 3.81 million 1988 – Total literacy campaign of the national literacy mission (NLM) 1989 – Mahila Samakhya Programme 1999 – NLM revised goal 75% literacy by 2007 in non literate 15-35 age group. Laws Factory act (1948) Plantation labour Act (1951) Contract labour (Regulation and abolition act) 1970) Inter state migrant workers (Regulation of employment and condition of services act 1979) Minimum wage act – 1948 1993 – Reservation for women 73rd and 74th constitution amendment - 33.3% reservation Karnataka 45%, Kerala – 36.4% , WB – 35.4% , Tamil Nadu Sarpanch – 36%, UP – 54 % of ZP President were women. Hindu succession act amendment – equal rights in property. 2004-2009-National common minimum programme Gender & Poverty Micro-credit initiatives SHG Rastriya Mahila Kosh Initiatives by Dept. of Women & Child development STEP programme: Support to Training & employment programme for women Swawlamban programme Swayamsiddha project Swashakti project Sampoorna Grameen Rojgar Yojana, Swarna Jayanti Gram Swarozger Yojana - 40% of benefit are for women Public sector banks 5% bank credit for lending Dec. 2004 – aggregate lending was 5.47%. Goal 4: Reduce child mortality Target 5: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate ◦ Indicator 13: Under-five mortality rate ◦ Indicator 14: Infant mortality rate ◦ Indicator 15: Proportion of one-year-old children immunized against measles Under five mortality 120 109 103.7 100 40 20 0 63.1 60 82 74.6 80 95 74 51.7 119 42 Rural Urban Total Infant Mortality Rate IMR 80 80 60 40 20 0 74 72 68 60 57 55 IMR 27 IMR Immunization of child < 12 month against measles Immunization of child < 12 month against measles 60 50 50.7 48.4 NFHS 2 NFHS 3 42.2 40 30 20 10 0 NFHS 1 Initiative for goal 4 CSSM (1992) RCH I( 1997) RCH II (2005) New Born care scheme National Neonatology Forum Prevention of macro nutrient deficiency Border district cluster stragety To reduce IMR and MMR by 50% by 2007 Initiative under immunization programme: Mobility support Vaccine delivery Increased annual expenditure Out reach session by AWW & PRI’s Auto disabled syringes IMNCI Community IMNCI Goal 5: Improve maternal health Target 6: Reduce by three-quarters, between 1990 and 2015, the MMR Indicator 16: Maternal mortality ratio Indicator 17: Proportion of births attended by skilled health personnel WHO estimates : 529,000 maternal deaths globally 25.7% in India. Maternal mortality ratio 500 450 437 407 400 350 301 300 254 250 200 150 109 100 50 0 1991 1998 SRS 2003 SRS 2004-06 2015 Indicator 17: Proportion of births attended by skilled health personnel 250 76 200 67 150 54 76.9 100 62.3 T.T. injections 65.4 Any ANC visit Safe delivery 50 34.2 42.3 48.8 0 NFHS 1 NFHS 2 NFHS 3 Initiative for goal 5 CSSM(1992) RCH (1997) National Population Policy (2000) RCH camps(2001) Traning of Dais RCH II (2005) Essential obstetrics care Emergency obstetrics care Janani Suraksha Yojana(2005) Vandemataram Scheme NRHM- ASHA, Streghthening Goal 6:Combat HIV/AIDS, malaria & other diseases Target 7: Have halted by 2015 & begun to reverse the spread of HIV/AIDS Indicator 18: HIV prevalence among pregnant women aged 15-24 years 19: Condom use rate of the contraceptive prevalence rate 20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years Target 8 Have halted by 2015 & begun to reverse the incidence of malaria & other major Diseases Indicator 21: Prevalence & death rates associated with malaria 22. Proportion of population in malaria-risk areas using effective malaria prevention & treatment measures 23. Prevalence & death rates associated with tuberculosis 24. Proportion of tuberculosis cases detected & cured under DOTS Indicator 18: HIV prevalence among pregnant women aged 15-24 years 8 2.8 7 6 4.4 5 4.5 4 3 2 1 0 1.8 2.4 0.74 0 2001 2002 Condom usage among non-regular sex partner HIV Prevelance among women 1524yrs 0.86 2003 2006 Ministry of health & Family welfare,BSS 2001 & 2006 •National AIDS Control Programme (1987) •NACP I(1992 - 1999) •NACP -II (1999 – 2006) •NACP-III (2006-2011) •ART Centers Target 8 Have halted by 2015 & begun to reverse the incidence of malaria & other major Diseases Indicator 21: Prevalence & death rates associated with malaria 3.5 3 2.5 2 1.5 2.91 2.57 2.44 2.08 1.8 1.75 1 Annual Parsitic Incidence (Per 1000) Death per 100000 0.5 0 0.13 0.09 0.09 0.08 0.07 0.05 1990 1994 1998 2002 2004 2008 Ministry of health & Family welfare 22:Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures Ministry of health & Family welfare 23. Prevalence and death rates associated with tuberculosis TB deaths /10000 population 60 57 50 37 40 33 28 30 20 10 0 1990 2002 2003 2006 24. Proportion of tuberculosis cases detected and cured under DOTS Case detection rate- 70% (2007, 2008) Cure rate 86% (2005 - 86%) (RNTCP status report,2009) 100% coverage by RNTCP March 2006 - 2nd Largest DOTS programme in world WHO Stop TB Strategy, (2006) Principal components Pursuing high quality DOTS expansion and enhancement Addressing TB/HIV, MDR-TB and other challenges Contributing to health system strengthening Engaging all care providers Empowering patients and communities Enabling and promoting research DOTS Plus – 2007 Gujarat & Maharashtra Goal 7: Ensure environmental sustainability Proportion of the population with access to an improved water sources 100 80 60 40 20 0 87 81 82 85 62 56 1991 Rural Urban Total 2001 Proportion of the population with access to sanitation 80 63 60 47 32 40 20 Rural Urban 9 0 1991 2001 Ministry of rural development,Urban development, Registrar general of India Steps for urban water supply & sanitation • Urban Infrastructure Development Scheme for Small and Medium Towns (UIDSSMT) VAMBAY National Slum Development Programme (NSDP) 1996-97 National Urban Renewal Mission 73rd Constitutional Amendment – Decentralized planning, implementation & management of water supply Community based Water Quality Monitoring and Surveillance Programme Sector Reform Project(1999)Scalled up as Swajaldhara programme Village Level Water and Sanitation Committee District water & Sanitation committee State Water & Sanitation Mission Communication & capacity Development (CCD) Units Rural Sanitation Total Sanitation Campaign(1999) NRHM Goal 8: Develop a global partnership for development In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries Proxy indicator “ percentage of population with access to essential drugs” Tenth five year plan NRHM Eleventh five year plan Table:1 National goals &MDG X FY NPP XI FY NRH Plan 2010 Plan M 2007 2012 2012 Infant MR 45 <30 Maternal MR 200 <100 Total fertility R Institutional deliveries 80% 2.1 80% MDG Current 2015 27 100 2.1 301 (SRS 01-03) 2.9 40.7 (NFHS III) References 1. Millenium development goal report-2008. United Nation, New York 2008. MDG Monitor: Tracking the Millennium Development Goal. Copyright United Nations Development Programme, 2007.email: http://www.mdgmonitor.org/factsheets_00.cfm?c=IND&cd=356 2. Progress- so far. [Online]. [cited 2009 May 8]. Available from: URL:http://mohfw.nic.in/NRHM/Documents/NRHM_The_Progress_so_far.pdf 3. Government of India. Ministry of statistics & progamme implementation, central statistical organization. Millenium development goal India country report 2005. Available from URL: www.mospi.nic.in 4. Ministry of Health and Family Welfare. Annual Report 2007. New Delhi: Ministry of Health and Family Welfare; [Online] 2008 [Cited Mar 08, 2009] Available from: [Online] 2008 [Cited Mar 08, 2009] Available from: http://www.nfhsindia.org/NFHS-3%20Data/VOL1/India_volume_I_corrected_17oct08.pdf 5. Wada na todo Abhiyaan. Measuring India’s progress on MDG-A citizens report. 2007 Dec. 6. 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