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Maternal & child health &

CHRONIC DISEASES: The neglected and unfinished agenda

Middle quintile Richest quintile 77 66 53

43

32

22

24

21

Ratio of measles immunisation coverage among 1-year-olds (%)

800

Laos

600

Indonesia

Cambodia

Philippines

Vietnam

Ratio: highest-lowest mother's education

Ratio: urban-rural

The rural-urban gap in skilled care during childbirth has narrowed but there is still some way to go

1995

2000

2005

2008

2015

88%

Fewer mothers are dying in childbirth since 1990, but some countries are unlikely to reach MDG 5 target of reducing maternal deaths by ¾ by 2015.

79% 63%

70%

68%

41%

39%

11%

Laos

Philippines

Indonesia

Ratio: highest-lowest wealth quintile

Indonesia

40%

1.2

1.1

Philippines

Children from the poorest families are more likely to die before age 5 than those from the richest families.

60%

Laos

1.1

Percentage of births attended by skilled health personnel, by location

Percentage of stunted children, below 5-years old, both sexes

Myanmar

Goal: 300

0

Child stunting rates remain high and are worsening in some countries

50%

Cambodia

Myanmar

200

1.0

1.5

1.3

580

Vietnam

Philippines

1.9

1.3

Cambodia

Indonesia

400

16

1.4

1.2

1990

Cambodia

2.8

Projection

1,000

Maternal deaths per 100,000 live births

Poorest quintile

56

Maternal Mortality Ratio per 100,000 live births

1.7

Deaths of children below 5-years old, per 1,000 children

114

It matters most whether mothers are educated in measles immunisation coverage

1,200

Serious inequities persist in child mortality rates

127

Slow progress in Millennium Development Goal 5:Improve maternal health

Cambodia

Philippines

Rural areas

Vietnam

Indonesia

Urban areas

30% 20%

China

Singapore

10%

“Investing in women's and children's health has a multiplier effect across the Millennium Development Goals. It is the best investment we can make.”

0 1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

– UN Secretary-General Ban Ki-moon

Chronic disease is not only the main cause of death in high-income countries...

Cardiovascular diseases and diabetes are responsible for most chronic disease deaths in all countries

...it kills more people in absolute numbers in low-income countries as well

90%

900

Brunei 85%

China

80%

Singapore

75%

Vietnam

Malaysia

70%

Philippines

65% 60%

Thailand

Laos Myanmar

Indonesia

55%

0

Cambodia Non-communicable diseases death rate per 100,000 people

Deaths caused by non-communicable diseases as a percentage of total deaths

Deaths caused by non-communicable diseases per 100,000 people

Laos

800

Myanmar 700

Indonesia China

Vietnam 600

Philippines

500

Singapore

300

400

500

128

Cambodia

117.5

Myanmar

119

369.5

74.5

Indonesia

122.5

350

77

Philippines

400

200

Laos

China

Thailand

Cambodia 50%

Malaysia

100

430.5

Malaysia

104.5

Singapore

116.5

94.5

286

87

103.5

345

57

277.5 140

700

113

409.5

143.5

600

58.5 15

300 500

5,000

50,000

500

Gross national income per capita, PPP (log scale)

5,000

50,000

Cancers

Cardiovascular diseases and diabetes

Chronic respiratory diseases

Gross national income per capita, PPP (log scale)

How will countries tackle the rising chronic disease burden?

ASIAN TRENDS MONITORING Myanmar Cambodia

Laos

Vietnam Philippines Indonesia Thailand

Malaysia Singapore

China

Healthy life expectancy at birth

50

53

54

64

62

60

62

64

73

66

Human Development Index rank

132

126

124

115

99

110

92

57

27

89

Prevalence of tuberculosis

597

693

131

333

520

285

189

109

43

138

Prevalence of smoking

57.4%

55.7%

79.3%

46.4%

65.4%

66.9%

45.1%

55.2%

42.5%

63.2%

Dietary energy consumption

2,940

2,070

2,370

2,630

2,490

2,890

2,400

2,880

1,929

2,930

Percentage of overweight adults

18.8%

12.7%

14.8%

10.1%

26.9%

20.7%

31.4%

44.6%

28.1%

25%

(In number of years)

(Out of 169, the lower the better)

(Per 100,000 population)

(As a percentage of the adult population)

(Calories consumed per person in a day)

(Body mass index higher than 25)


Rising Asia, Growing Inequalities (health)