World Health Statistics 2012 : Part I - Health-related Millennium Development Goals

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World Health Statistics 2012 contains WHO’s annual compilation of health-related data for its 194 Member States, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. This year, it also includes highlight summaries on the topics of noncommunicable diseases, universal health coverage and civil registration coverage.
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In that time, substantial prog-ress has been made in reducing child and maternal mortality, improving nutrition, reducing morbidity and mortality due to HIV infection, tuberculosis and malar-ia, and increasing access to improved drinking-water sources. These current trends provide a firm basis for the intensified collective actions and expansion of suc-cessful approaches now needed to overcome the chal-lenges posed by multiple crises and large inequalities.  Although progress in settings with the highest rates of mortality has been accelerated in recent years, large variations in health status persist both between and within countries.Childhood malnutrition is the underlying cause of an estimated 35% of all deaths among children under five years of age. The proportion of such children in devel-oping countries who were underweight is estimated to have declined from 29% to 18% between 1990 and 2010. Although this rate of progress is close to the rate required to meet the relevant MDG target, 4  improve-ments have been unevenly distributed between and within different regions.Globally, significant progress has been made in reduc-ing mortality rates among children under five years old. Between 1990 and 2010, the under-five mortality rate declined by 35% – from an estimated 88 deaths per 1000 live births to 57. The global rate of decline has also accelerated in recent years – from 2.1% per an-num during 1990–2010 to 2.6% during 2005–2010 (Figure 1). The annual rate of decline in the WHO African Region – where almost half of all child deaths occur – increased from 1.8% during 1990–2010 to 2.8% during 2005–2010. Despite this improvement, most countries in the Region are unlikely to achieve the MDG target of a two-thirds reduction in 1990 mortality levels by the 4. MDG 1; Target 1.C: Halve, between 1990 and 2015, the pro-portion of people who suffer from hunger. 0.00.5  1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5(%)  AFR AMRSEAREUREMRWPRGlobal1990–20102005–2010MDG target Figure 1.  Average annual rate of decline (%) in under-five mortality levels, 1990–2010 and 2005–2010  13 year 2015. Globally, 37 out of 143 low- and middle-income countries will reach that target by 2015 if the pace of progress achieved during the period 2005–2010 is maintained.In 2010, global measles immunization coverage was 85% among children aged 12–23 months. More coun-tries are achieving high levels of measles immunization coverage, with 65% of all countries either reaching or maintaining at least 90% coverage in 2010. Between 2000 and 2010, the estimated number of measles deaths decreased by 74%, accounting for about one fifth of the overall reduction in child mortality. Almost 20% of deaths in children under the age of five – mostly those due to pneumonia and diarrhoeal dis-eases – are also preventable by vaccines. Efforts are therefore being made to expand interventions. For ex-ample, a rapidly increasing number of countries in the WHO African Region, the WHO Region of the Americas and the WHO Eastern Mediterranean Region have in-troduced pneumococcal conjugate vaccines in the past year with support from the GAVI Alliance.Despite a significant reduction in the number of ma-ternal deaths – from an estimated 543 000 in 1990 to 287 000 in 2010 – the rate of decline is just over half that needed to achieve the relevant MDG target. 5  Be-tween 1990 and 2010, the global rate of decline was 3.1% per annum, with lower rates in the WHO African Region, WHO Region of the Americas and WHO East-ern Mediterranean Region (Table 1). Approximately one quarter of the countries with the highest maternal mor-tality ratio in 1990 (≥100 maternal deaths per 100 000 live births) have made insufficient or no progress. 5. MDG 5; Target 5.A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. Table 1.  Average annual rate of decline (%) in maternal mortality, 1990–2010 WHO region1990–2010  AFR2.7 AMR2.5SEAR5.2EUR3.8EMR2.6WPR5.2 Global3.1  To reduce the number of maternal deaths, women need access to good-quality reproductive-health care and effective interventions. In 2008, 63% of women aged 15–49 years who were married or in a consen-sual union were using some form of contraception, while 11% wanted to stop or postpone childbearing but were not using contraception. The proportion of women receiving antenatal care at least once during pregnancy was about 81% for the period 2005–2011, but for the recommended minimum of four visits or more the corresponding figure drops to around 55%.  The proportion of births attended by skilled personnel – crucial for reducing perinatal, neonatal and maternal deaths – is above 90% in three of the six WHO re-gions. However, increased coverage is needed in cer-tain regions, such as Africa where the figure remains less than 50% (Figure 2).  About half the world’s population is at risk of malaria, and an estimated 216 million cases in 2010 led to ap-proximately 655 000 deaths – 86% of these in children under the age of five. In a total of eight countries and one territory in the WHO African Region there was a more than 50% reduction in either confirmed malaria cases or malaria admissions and deaths. In other WHO regions, the number of reported cases of confirmed malaria decreased by more than 50% in 35 of the 53 countries with ongoing transmission between 2000 and 010010110010111101010100101010100101100101111010101001010101000100110100110010011010011001001101001100100110100110010011010001010101001010101001010101001010101001010101001010101001010101101001100110100110011010011001101001100110100110011010011001100110001010110001010110001010110001010110001010110001010110001011010011001101001100110100110011010011001101001100110100110011010010101001010101100010011010010101001010101100010011010010101100010011010011010010110101001100010011010011010010110101001100101111010010101001010010111101001010100101001011110100101010110100110011010011001101001100110100110011010011001101001100110010100110100010100110100010100110100010100110100010100110100011010011001101001100110100110011010011001101001100110100110011011010010101001010111010010111101001010100101011101001011110100110100110011010011001101001100110100110011010011001101001100110001011110101010010110010111101010100101100101111010101001011001101001100110100110011010011001101001100110100110011010011001101001011010000100101101000010010110100001001011010000100101101110100110011010011001101001100110100110011010011001101001100110101011000100110100110100101101010101100010011010011010010110101101001100110100110011010011001101001100110100110011010011001100100101100101111010101001010101001011001011110101010010101010001001101001100100110100110010011010011001001101001100100110100010101010010101010010101010010101010010101010010101010010101011010011001101001100110100110011010011001101001100110100110011001100010101100010101100010101100010101100010101100010101100010110100110011010011001101001100110100110011010011001101001100110100101010010101011000100110100101010010101011000100110100101011000100110100110100101101010011000100110100110100101101010011001011110100101010010100101111010010101001010010111101001010101101001100110100110011010011001101001100110100110011010011001100101001101000101001101000101001101000101001101000101001101000110100110011010011001101001100110100110011010011001101001100110110100101010010101110100101111010010101001010111010010111101001101001100110100110011010011001101001100110100110011010011001100010111101010100101100101111010101001011001011110101010010110010010100110101010110010100101100101111010101001010100101010110  14    A   F   R   A   M   R    S   E   A   R   E   U   R   E   M   R   W   P   R    G   l   o   b   a   l     (    %    ) Figure 2.  Coverage of reproductive-health services2010, while downward trends of 25–50% were seen in four other countries. The estimated incidence of ma-laria fell globally by 1.8% per annum between 2000 and 2009 (Figure 3). The coverage of interventions such as the distribution of insecticide-treated nets and indoor residual spraying has greatly increased, and will need to be sustained in order to prevent the resurgence of disease and deaths caused by malaria.Globally, the annual number of new cases of tubercu-losis has been slowly falling since 2006. In 2010, there were an estimated 8.8 million new cases – approximate-ly 13% of which occurred in people living with HIV. In 2010, an estimated 1.1 million HIV-negative people died from tuberculosis, while an additional 0.35 million died from HIV-associated tuberculosis. Since 1990, mortality due to tuberculosis has fallen by just over one third – though regional variations persist (Figure 4). In 2009, the treatment-success rate reached 87% worldwide, repre-senting the third successive year that the target of 85% (first set by the World Health Assembly in 1991) was exceeded. Although all six WHO regions are on course to achieve the relevant MDG target, 6  multidrug-resistant tuberculosis continues to present significant problems.In 2010, an estimated total of 2.7 million people were newly infected with HIV – 15% less than the 3.1 million 6. MDG 6; Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases. 100806040200 AFR AMRSEAREUREMRWPR0 (%) –10–20–30–40–50 Figure 3.  Annual decline (%) in malaria incidence, 2000–2009 GlobalUnmet need for family planning, 2008Contraceptive prevalence (any method), 2008 Antenatal care coverage: at least one visit, 2005–2011Births attended by skilled health personnel, 2005–2011    A   F   R   A   M   R    S   E   A   R   E   U   R   E   M   R   W   P   R    G   l   o   b   a   l   A   F   R   A   M   R    S   E   A   R   E   U   R   E   M   R   W   P   R    G   l   o   b   a   l   A   F   R   A   M   R    S   E   A   R   E   U   R   E   M   R   W   P   R    G   l   o   b   a   l
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