MDG brochure 2013 with MDG insert
The MDGs are the most successful global anti-poverty initiative in history. They stand for a world of prosperity, equity, freedom, dignity and peace – as embodied in the Millennium Declaration. This publication presents an assessment of progress towards the MDG targets using a selection of child and maternal related MDG indicators. It highlights remaining challenges and lists key interventions that are indispensable to contribute to a post-2015 world fit for all children. The insert to this publication contains UNICEF’s guiding principles to contribute to the new development agenda and a list of key issues relevant to children for consideration by the international development community for inclusion under the post-2015 development agenda.
MDG Update: Accelerate Progress for Children Towards a Post-2015 development agenda for all children The MDGs are the most successful global anti-poverty initiative in history. They stand for a world of prosperity, equity, freedom, dignity and peace â€“ as embodied in the Millennium Declaration. This publication presents an assessment of progress towards the MDG targets using a selection of child and maternal related MDG indicators. It highlights remaining challenges and lists key interventions that are indispensable to contribute to a post-2015 world fit for all children. The insert to this publication contains UNICEFâ€™s guiding principles to contribute to the new development agenda and a list of key issues relevant to children for consideration by the international development community for inclusion under the post-2015 development agenda. 1 MDG Eradicate Extreme Poverty and Hunger Target 1C Indicator Progress Halve, between 1990 and 2015, the proportion of people who suffer from hunger Prevalence of underweight children under-five years of age Underweight prevalence has declined from 25% in 1990 to 15% in 2012 99 million children under-five years of age remain underweight, 162 million are stunted Stunting is associated with a weakened immune response and impaired cognitive development among young children - the effects of the latter are irreversible Chronic undernutrition is highest in sub-Saharan Africa and South Asia Percentage of children under age five who are moderately or severely stunted. 2008-20121 Less than 10% 10 – 19% 20 – 29% 30 – 39% 40% or more Data not available Sustainable development starts with safe, healthy and well-nourished children Chronic undernutrition is declining but still one in four children were stunted Stunting prevalence, by MDG region, 1990 & 2012 2 The continuing agenda for children 60 Southern Asia Southern Asia 35 41% decline Key interventions to prevent child under nutrition include: Improve women’s nutrition Practice early and exclusive breastfeeding Provide timely, safe, appropriate and highquality complementary food South-Eastern Asia South-Eastern Asia 47 28 41% decline 39 17 57% decline Caucasus & & Central CentralAsia Asia Caucasus Eastern Asia Eastern Asia 37 8 79% decline 38 29 19 37% decline 4% increase 37 Oceania Oceania Northern Africa Northern Africa Western Asia Western Asia Latin Latin America America & & Caribbean Caribbean Appropriate micronutrient interventions Reduce the incidence of infectious diseases, such as diarrhoea, pneumonia, and malaria 1990 29 18 38% decline 23 50% decline 11 1990 2012 Improve access to safe drinking water and sanitation, stop open defecation and improve overall household hygiene Global Global 40 38% decline 25 1 2 Source: UNICEF global databases 2013, based on DHS, MICS, and other national surveys. Source for stunting trend: UNICEF-WHO-WB Joint Child Malnutrition Estimates, 2012. 2 MDG Achieve Universal Primary Education Target 2A Indicator Progress Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling Net enrolment ratio in primary education Survival rate to the last grade of primary education Primary net enrolment ratio (adjusted) increased from 85% in 2000 to 91% in 2011 Only three out of four children who start primary school actually finish it Progress has slowed since 2004, making the goal of universal primary education difficult to achieve 120 100 80 60 40 20 23.5 million 0 2000 Rest of the world 14.9 million 2011 40.6 million Number of primary school age children out-of-school,by region,2000-20113 South and West Asia Total 102 million Sub-Saharan Africa Rest of world 37.8 million Total 57 million South & West Asia 12.4 million Sub-Saharan Africa Education is the single most powerful investment for development. Educate a girl, you educate a nation. Million 29.8 million Four out of ten children fail to reach minimum learning levels Estimates of minimum learning levels among primary school age children4 The continuing agenda for children How to ensure that all boys and girls go to school and receive a quality education? `` Expand early learning opportunities to increase children’s school readiness `` Address specific needs of the most disadvantaged children (e.g. poor, rural, and children with disabilities), especially girls `` Promote child-friendly education for quality enhancement and improved learning outcomes `` Provide alternative delivery mechanisms for those who dropped out or have never been to school `` Ensure safe and protective access to quality education in humanitarian emergencies attend school and achieve minimum level of learning 400 million attend school but fail to achieve a minimum level of learning 130 million 120 million will not reach grade 4 3 4 Source: UNESCO Institute for Statistics Fact Sheet, June 2013, No.25. Source: UNESCO EFA-GMR, 2012 3 MDG Promote Gender Equality Target 3A Indicator Progress Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 Ratios of girls to boys in primary, secondary and tertiary education The MDG target for primary education has been achieved In most regions fewer girls 13 are enrolled in secondary school than boys Urban Urban Rural 12 13 12 24 23 24 Rural 23 Gender parity in primary education has been achieved Primary, secondary and tertiary school gross enrolment rates by sex and region, 2011 (%)5 East Asia & the Paciﬁc East Asia & the Paciﬁc Latin America & Caribbean Latin America & Caribbean South & West Asia South & West Asia North America & Western North America & Western Europe Europe Central & Eastern Europe Central & Eastern Europe Central Asia Central Asia Sub-Saharan Africa Sub-Saharan Africa Arab States Arab States Poorest Poorest Second Second Middle Middle Fourth Fourth Richest Richest 10 8 10 8 25 23 25 20 23 19 20 16 19 14 16 14 32 30 32 30 Female Female Male Male Investing in children, especially girls, yields high and long-lasting returns for families, societies and future generations World World 0 0 25 25 50 75 50 75 Primary 100 100 0 0 25 50 75 100 25 50 75 100 Secondary 0 0 25 50 75 100 25 50 75 100 Tertiary More primary school age girls are out-of-school than boys Average rate of male and 13 female out-of-school children of primary Urban school age, by area of residence and wealth quintiles, 57 countries.6 12 13 Urban 12 24 13 Rural Urban 23 24 12 Rural 23 24 Rural 23 Poorest Poorest Second Poorest Second Middle Second Middle Fourth Middle Fourth Richest Fourth Richest Richest 10 25 23 25 20 2325 19 23 20 16 19 20 14 16 19 14 16 8 10 14 8 10 8 32 30 32 30 32 30 The continuing agenda for children Key interventions to reduce gender disparities in education include: `` Increase demand for education through community-based interventions `` Create inclusive gender-responsive learning environment through child-friendly education `` Tackle multiple drivers of out-of-school children (e.g. gender, poverty and geography) through innovative approaches `` Address gender disparity in access, progression and learning outcomes Female Female Male Female Male Male Note: Original source for wealth quintile and urban/rural data: DHS and MICS Surveys from 57 countries 5 6 Source: UNESCO Institute for Statistics (UIS), 2011 Source: UNESCO Institute for Statistics Fact Sheet, June 2013, No.25. 4 MDG Reduce Child Mortality Target 4A Indicator Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate Under-five mortality rate and infant mortality rate Proportion of 1-year old children immunized against measles Under-five deaths have declined from 12.6 million in 1990 to 6.6 million in 2012 About 44 percent of the under-five deaths occur within the first 28 days of life Global under-five mortality dropped from 90 deaths per 1,000 live births to 48 in 2012 Progress Under-five mortality declined but falls short of the two-thirds reduction required to achieve the MDG target Under-five mortality rate (per 1,000 live births), by region, 1990 and 20127 200 200 200 Deaths per 1,000 live births Deaths Deaths per per 1,000 1,000 live live births births 177 177 177 1990 1990 1990 2012 2012 2012 MDG4 MDG4 MDG4 target target target for for for 2015 2015 2015 1990 2012 MDG4 target for 2015 160 160 160 126 126 126 120 120 120 80 80 80 40 40 40 00 0 98 98 98 74 74 74 58 58 58 55 55 55 36 36 36 30 30 30 73 73 73 71 71 71 65 65 65 25 25 25 73 73 73 54 54 54 22 22 22 19 19 19 53 53 53 14 14 14 15 15 15 6 66 ns 99 99 99 90 90 90 48 48 48 53 53 53 The rate of decline in under-five mortality has accelerated significantly in the last decade ric a Ca rib be an Ea st er n As ia sia ns ia ia ia ia a ai a a s ai a a s ai a e ee s s ai a ai a ai a a ia a ia s s ia is ia is ia is ia is ldldld ia n n sia sis n nin ththth ric rifc rc dd oin on ricric rc ororor oin on gio ig As As A fA fA As As A As As A As As A A a a io ig d la laA l A rnrn g e e ea g g A AfAfAf W W W n n n n n n n n n n n n n a e e e c c c r r r e e e r r r r r r r rtr r rr a a a tetete r rr nrnrn tr tn ete etete OOO tets arn arn an n g hte hte he aa d dd ere e ica ra n n n sas s sts s tu en e nig ng e e a in ip ic a a eses e u th th re ric Ce CC p p pe op h h ha ro ro rth ere e e ea Ea p e-a e-a ea EEa o o ou W W W a a a o o o o o o b b b l l l S S S l l l d d d h h h S-S S m m b b b eve e tutut N NN Am eve e n n n i i i r r r v v v v A A u a a a bb b a aa ee ee ss in De DD De DD So So So tinta tin C CC ussu Su Su Su sa su a La La L c c ca u u u aa Ca CC As an As lA Af io ra er n he nt te O n re g rn W es Ce Ea rth ha pe ut So & lo Sa No hAm er ica & ve bus ut De uc as So La tin Ca De ve lo pi ng er ra st d re g Af ce rn n io Su Diseases of poverty like pneumonia, diarrhoea and malaria accounted for a third of under-five deaths in 20128 Pneumonia (neonatal) (5%) Pneumonia (13%) Pneumonia (13%) Pneumonia (neonatal) (5%) The continuing agenda for children Key interventions to reduce child mortality include: `` Focus on the poorest, most marginalized and most-vulnerable `` Ensure clean and safe delivery practices `` Improve ante-natal care Pneumonia (17%) PretermPreterm birth birth complications (15%) complications (15%) Other (19%) Other (19%) All Other (24%) Neonatal (44%) Intrapartum-related Intrapartum-related complications (10%) complications (10%) `` Reduce deaths from preventable diseases of poverty: pneumonia, diarrhoea, and malaria `` Encourage exclusive breastfeeding `` Immunize children against measles and other diseases `` Eliminate open defecation `` Promote washing hands with water and soap `` Let children sleep under insecticide treated bednets Measles Measles (1%) (1%) AIDS (2%) AIDS (2%) Meningitis (3%) Sepsis/meningitis (5%) Sepsis/meningitis (5%) Tetanus (1%) Meningitis (3%) Injury (5%) Injury (5%) Malaria (7%) Malaria (7%) Diarrhoea (9%) Diarrhoea (8%) Diarrhoea (8%) Tetanus (1%) Other neonatal (3%) Other neonatal (3%) Congenital abnormalities (4%) (4%) Diarrhoea (neonatal) (1%) Diarrhoea (neonatal) (1%) Congenital abnormalities Globally, almost half of the under-five deaths are attributable to malnutrition 7 8 Source: The UN Interagency Expert Group for Mortality Estimation, Levels and Trends in Child Mortality Report 2013, UNICEF 2013 Source: UNICEF, Committing to Child Survival: A Promise Renewed Progress Report 2013 W or ric As ld 5 MDG Improve Maternal Health Target 5A Indicator Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio Maternal mortality ratio Proportion of births attended by skilled health personnel Progress Since 1990, the maternal mortality ratio has declined by 47% from 400 to 210 per 100,000 live births in 2010 About two thirds of women delivered with the assistance of a skilled birth attendant Regions with the largest number of maternal deaths have highest levels of births NOT attended by skilled health personnel9 Maternal deaths, 2010 (in 1,000s) 162 83 17 8.8 6.4 3.5 2.8 0.8 Sub-Saharan Africa Southern Asia South-Eastern Asia Latin America and the Caribbean Eastern Asia Western Asia Northern Africa Caucasus and Central Asia % of births NOT attended by skilled health personnel, 2011 25 10 1 26 18 3 52 50 Making pregnancies wanted and childbirths safe prevents maternal deaths and saves children’s lives Target 5B Indicator Progress Achieve, by 2015, universal access to reproductive health Contraceptive prevalence rate Adolescent birth rate Antenatal care coverage In 2011, approximately half of all pregnant women in developing regions did not have the recommended minimum number of 4 antenatal care visits One in five women gave birth before age 18* Proportion of women age 20-24 who have given birth before age 18, 2000-20109 The continuing agenda for children Key maternal and reproductive health interventions include: `` Increase assistance from skilled health personnel at delivery with proper supplies and equipment `` Improve access to emergency obstetric care `` Ensure a minimum of four visits with quality antenatal care `` Expand access to information, counseling an supplies for a wide range of contraceptive methods `` Lower birth rates among adolescents Less than 10% 10 – 19% 20 – 29% 30 – 39% Greater than or equal to 40% Data not available * Excluding China 9 Source for both graphs: UNICEF Global databases, 2013 Based on MICS and DHS household surveys and other national sources 6 MDG Combat HIV/AIDS, Malaria and Other Diseases Target 6A Indicator Progress Have halted by 2015 and begun to reverse the spread of HIV/AIDS HIV prevalence among population aged 15-24 years Globally, new HIV infections dropped by 21% to 2.5 million between 2001 and 2011 Access to antiretrovirals for adults has increased to 59%, but only to 28% for children in 2011 Since 2005, AIDS-related mortality declined from 2.3 million to 1.7 million, but adolescent AIDS deaths increased In 2011, an estimated 4.6 million young people 15-24 were living with HIV; 64% were girls and 78% were in sub-Saharan Africa HIV prevalence among young people aged 15-24, 2011 (%)10 Less than 0.2% 0.2 – 0.9% 1.0 – 2.9% 3.0 – 4.9% 5.0 – 7.9% 8.0% or more Data not available We now have the knowledge and the means to make an AIDS-free generation a reality Target 6C Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases Indicator Incidence and death rates associated with malaria Proportion of children under-five sleeping under insecticide-treated bednets (ITN) Progress In 2012, more than a third of children sleep under an ITN, up from less than 5% in 2000 Over half of the households in sub-Saharan Africa own an ITN but only 37% of children under-five sleep under one Children under-five sleeping under insecticide treated nets (ITNs), Africa, 2012 (%)11 The continuing agenda for children Key interventions to reduce HIV/AIDS and malaria include: `` Increase antiretroviral coverage for treatment and the prevention of mother-to-child transmission of HIV `` Scale up high impact HIV prevention, treatment and care in adolescents including key populations `` Provide protection, care and support for children and families affected by HIV and AIDS 2012 2000 0 – 9% 10 – 25% 26 – 50% 51 – 75% Not malaria endemic Data not available `` Ensure that children and pregnant women sleep under a ITN `` Expand the use of artemisinin-based combination therapy `` Expand rapid diagnostic testing before commencing malaria treatment 10 11 Source: UNAIDS unpublished estimates, 2012 Source: UNICEF global databases 2013, based on MICS, DHS and MIS 7 MDG Ensure Environmental Sustainability Target 7C Halve by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation Proportion of the population using an improved drinking water source Proportion of the population using an improved sanitation facility The proportion of population without drinking water declined from 24% in 1990 to 11% in 2011 The proportion of population without sanitation declined from 51% in 1990 to 36% in 2011 Indicator Progress The drinking water target will be surpassed by >150 million people; the sanitation target will likely be missed by more than 600 million Population without an improved drinking water source and improved sanitation facility, current and MDG trends, 1990-201512 3,000 2,500 2,000 1,500 1,000 500 0 2015 Sanitatio Sanitation n Population (x 1,000) May be m Current trend issed by >600 mill ion May be m issed by >600 2.5 billion million MDG target 1.8 billion Drinking w Drinking water ater Cur Mrent trend et by >15 MDG target 0 million 871 million Met by >150 millio n 692 million MDG target 871 million 692 million Children are at the heart of sustainable development 1990 Open defecation rates declined in all regions, but still over 1 billion people continue the practice Open defecation rates, 1990 and 201112 Southern Asia Sub-Saharan Africa South-Eastern Asia Latin America & Caribbean Northern Africa Oceania Western Asia Eastern Asia Caucasus & Central Asia 39 39% decline 36 26 28% decline 31 31 14 55% decline 17 4 76% decline 16 4 75% decline 13 10 23% decline 8 63% decline 3 7 4 43% decline 1 0 24 24 15 36% decline 64 The continuing agenda for children A post-2015 vision for water and sanitation: `` No one practices open defecation `` Everyone has water, sanitation and hygiene at home 1990 2011 `` All schools and health centres have water, sanitation and hygiene `` Water, sanitation and hygiene are sustainable and inequalities in access have been progressively eliminated `` Water supply, sanitation and hygiene services are resilient to disasters World 12 Source: WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP), 2013 UNICEF is a global leader on statistics for children UNICEF as a global leader in statistics for children is proud to continue to provide the global development community with the latest statistics on children and women, many of which appear every year in the United National Secretary General’s Report on the MDGs. We reaffirm our commitment to work with governments in strengthening the collection and analysis of the evidence that allows for the monitoring of progress towards global development goals which has made such a measurable difference in children’s lives across the world. Prepared by: UNICEF Data & Analytics Division of Policy & Strategy, September 2013 Find the latest statistics on children at the UNICEF-Statistics website: www.childfinfo.org Front cover photo credit: © UNICEF/NYHQ2010-1548/Asselin Towards a Post-2015 agenda for all children Key Issues for Children in the Post-2015 Development Agenda Further reduction of under-five mortality Elimination of all preventable maternal and child deaths Reduction of child malnutrition Achievement of universal coverage of: basic health services safe drinking water and sanitation Completion by all children of quality basic education Protection of all children from all forms of violence, abuse and exploitation Protection and support of children and their families affected by conflict and humanitarian disasters Prioritize the worst-off and most deprived children, families and their communities Monitoring of progress and investment in supporting national statistics systems to collect disaggregated data to ensure that no child is left behind Guiding Principles to ensure a Post-2015 World Fit for All Children The Millennium Development Goals have been a success and achieved a lot for children and young people. However they have not fully been met. The unfinished and continuing business of investing in the rights and well-being of children – as well as emerging and neglected issues - must be boldly addressed in a vision of a world fit for children and future generations, with achievable goals for the post-2015 development agenda. Governments should reaffirm their existing commitments – specifically to the Millennium Declaration and to the Convention on the Rights of the Child – to underpin future efforts for inclusive and equitable human progress. Sustainable Development starts with safe, healthy and well-educated children. And safe and sustainable societies are, in turn, essential for children. The post-2015 development agenda must provide comprehensive solutions to advance peace, prosperity and a sustainable world – for both the present and future generations. The new development agenda needs to be universal – relevant for all societies and about all people regardless of where they live. Countries cannot achieve sustained growth and shared prosperity without investing effectively in their people, and above all, in their children. Photo credit: © UNICEF/NYHQ2006-1914/Pietrasik Different Faces of Disparities The poorest children are those more often stunted Percentage of children under age 5 who are moderately or severely stunted by selected regions, LDCs and the world1 Poorest 20% (%) 70 Poorer 20% Middle 20% Richer 20% Richest 20% More than one third of women in the world marry during childhood, with one in nine of them being married before their 15th birthday Percentage of women aged 20-24 years old who were first married or in union before age 18 and before age 15, in the 15 countries with the highest prevalence of child marriage among women and the world2 100 100 100 90 90 90 Married or in union at age 15 or after but before age 18 #REF! #REF! #REF! Married #REF! or in union before age 15 68 68 68 68 75 75 (%) 60 59 53 48 46 42 36 47 43 40 36 32 25 25 27 20 26 23 49 46 42 38 51 46 41 35 80 80 80 70 70 70 60 60 60 50 50 50 40 40 40 30 30 30 20 20 20 10 10 10 26 37 20 20 8 8 18 18 44 44 45 45 47 47 47 47 48 48 50 50 52 52 52 52 55 55 56 56 34 35 43 63 63 66 66 50 40 38 39 39 34 34 32 32 36 36 29 29 29 29 23 30 27 20 29 34 38 43 41 41 10 18 18 14 14 0 12 12 Si Si er er ra ra LeLe onon SoSo e e mm ali al a ia Er Er itr itr eaea In M M Ind adad iadia agag asas caca r r MM SoSo al al ut ut awaw h h i i BuB SuS ur du ada rk inkin n n aa Ethnic group with the highest FaFa soso prevalence MM MM Ethnic group with the lowest ozoz a a prevalence am am li li bi bi ququ ee CeC GG e ui ui nt nt B B ra ra a a nene l Al A ngng a a fri fri la la caca dede n n shsh ReR pe up bu bl lic ic ChC h adad Ni N geige r r * Excluding China Note: Analysis is based on a subset of countries with available data by subnational groupings and regional estimates are presented only where adequate coverage is met. Data from 2007 to 2011, except for Brazil and India * Excludes China The poorest 40 percent of the population in Southern Asia have barely benefited from improvements in sanitation Southern Asia: Sanitation coverage trends by wealth quintiles, based on population-weighted averages from three countries, 1995 and 20083 (%) 100 100 Levels of female genital mutilation/cutting (FGM/C) prevalence vary dramatically among ethnic groups Percentage of girls and women aged 15 to 49 years who have undergone FGM/C in the ethnic groups with the highest and lowest FGM/C prevalence4 Eritrea Poorest 2nd 3rd 4th 6 1 Richest 2 4 Ethiopia Guinea Mali Gambia Kenya Guinea-Bissau Chad Sierra Leone Burkina Faso 18 80 80 51 56 74 86 94 87 4 77 6 60 60 93 76 94 Senegal C么te d'Ivoire Benin Niger 40 40 8 20 20 7 0 0 4 2 1995 8 5 8 4 36 45 Nigeria Central African Republic Ghana Togo 18 19 7 2008 1995 2008 1995 2008 1995 2008 1995 2008 Cameroon Uganda Ethnic group with the higest prevalence Ethnic group with the lowest prevalence 0 0 10 10 20 20 30 30 40 40 50 50 60 60 70 70 80 80 90 90 100 (%) 100 Improved + shared Unimproved Open defecation Source: Adapted from Improving Child Malnutrition: The achievable imperative for global progress, based on UNICEF Global Databases, 2012. Sources: UNICEF global databases, 2012. Based on AIDS Indicator Surveys (AIS), DHS, MICS and other national surveys, 2002-2011. Sources: India: NFHS 1993, 1999, 2006; Bangladesh: DHS 1993, 1997, 2000, 2004, 2007; Nepal: DHS 1996, 2001, 2006 4 Sources: MICS and DHS 2002-1011 as presented in Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change, UNICEF, 2013. 1 2 3 WW or or ld ld * * Sub-Saharan Africa South Asia East Asia and the Pacific* Least developed countries World* 0 0 0 9 9 10 10 15 15 21 21 20 20 11 11