Achieving MDGs for Global Health

MDG case reportSocial determinants of health

Ketmany Chathakoummane (Laos)Yang Liu (China)

Si Li (China)Agnes Lai (China)

Content

• Background of the countries• Millennium Development Goals (MDGs)• Social determinants of health • The situation• The Policies• Existing Problems• Recommendation• Conclusion

Background of the country (China)Location Population Special chararteristics

China East Asia

1.35 billion

(Male, 51%, Female, 49%)

A sovereign state located in East Asia.A single-party state governed by the Communist Party, with its seat of government in the capital city of Beijing.

Life expectancy:Male: 72.4 years oldFemale: 77.4 years old

Hong Kong

South coast of China

7 million people (95 % ethnic Chinese )(male, 46.5%, Female, 53.5%)

Hong Kong’s status as a British colony since the mid-1800’s . Hong Kong was returned to China on 30 June 1997. Area : ‘East meets West’

Life expectancy:Male: 80.5 years oldFemale: 86 years old

Background of the country (Laos)Location Population Special characteristics

Lao PDR South East Asia

Around 6.385.057 million people with 49 ethnic minorities)Percentage for male and female is not different.

Lao PDR ‘s a small landlocked country in South East Asia , the borders with 5 countries China, Myanmar, Thailand, Vietnam and Cambodia. Lao’s France colony and Independent to Lao PDR on 2 Dec 1975. 80% of population living in rural area.

Millennium Development Goals

1. Eradicate extreme poverty and hunger2. Achieve universal primary education3. Promote gender equality and empower women4. Reduce child mortality5. Improve maternal health6. Combat HIV/AIDS, malaria and other disease7. Ensure environmental sustainability8. Develop a global partnership for development

What is social determinants of health?

• Social determinants of health are the circumstances, in which people are born, grow up, live and work. They are affected by the social and health systems implementing to deal with illness. These circumstances are shaped by the allocation of resources at global, national and local levels.

• According to MDGs, the first three goals related to social determinants of health including:

(i) eradicating extreme poverty and hunger; (ii) achieving universal primary education; and (ii) promoting gender equality and empowering women.

Social Health Determinants

Goal 1. Eradicate extreme poverty and hunger

Goal 2. Achieve universal primary education

Goal 3. Promote gender equality and empower women

Target 1A: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day.Target 1B: Achieve full and productive employment and decent work all including women and young peopleTarget 1C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger.

Target 2.A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling

Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015

Current situations

The indicators for Goal 1 Eradicate extreme poverty and hunger

• 1.1 Proportion of population below $1 (PPP) per day• 1.2 Poverty gap ratio• 1.3 share of poorest quintile in national consumption• 1.4 Growth rate of GDP per person employed• 1.5 Employment-to-population ratio • 1.6 Proportion of employed people living below $1 (PPP) per

day• 1.7 Proportion of own-account and contributing family workers

in total employment• 1.8 Prevalence of underweight children under-five years of age• 1.9 Proportion of population below min level of dietary energy

consumption

PovertyChina HK, China Laos

2 decades ago Present 2 decades ago Present 2 decades ago Present

1.1 Proportion of population below $1 (PPP) per day

60.2% 11.8%(2009)

No information on absolute poverty

Relative poverty(Gini Coefficient)

0.48 (1991)0.54 (2011)

55.7%(1992)

33.9%(2008)

1.2 Poverty gap ratio

20.7% 2.8%(2009)

11.2%(1992)

27.2 %(2007)

1.3 Share of poorest quintile in national consumption

8.0% 4.7%(2009)

9.3%(1992)

7.6%(2008)

EmploymentChina HK, China Laos

2 decades ago Present 2 decades ago Present 2 decades ago Present

1.4 Growth rate of GDP per person employed

7.7%(1991)

4.6%(2011)

3.5%(1991)

4.8%(2011)

5% 8.5%

1.5 Employment-to-population ratio

76%M,81%; F, 70%(1991)

71%M,76%; F, 65%(2011)

64%M,70%; F, 68%(1991)

59%M,68%; F, 51%(2011)

47% 49%

1.6 Proportion of employed people living below $1 (PPP) per day

NA NA NA NA 55.7%(1992)

33.9%(2008)

1.7 Proportion of own-account and contributing family workers in total employment

NA NA NA NA 33.5%(1995)

46%(2005)

HungerChina HK, China Laos

2 Decades ago

Present 2 Decades ago

Present 2 Decades ago

Present

1.8 Prevalence of underweight children under-five years of age

12.6% 3.6% (2010)

NA NA 44%(1993)

26.6%(2012)

1.9 Proportion of population below min level of dietary energy consumption

21.4% 11.5%(2011)

NA NA 31%(1990)

16%(Target 2015)

The indicator for Goal 2 Achieve Universal primary education

• 2.1 Net enrolment ratio in primary education• 2.2 Proportion of pupils starting grade 1 who

reach last grade of primary • 2.3 Literacy rate of 15-24 years old , women

and men

EducationChina HK, China Laos

2 decades ago

Present 2 decades ago

Present 2 decades ago

Present

2.1 Net enrolment ratio in primary education

97.0% 99.5%(2007)

97.5% M,99.5%F,95.5%

98.3%M,97%F,99.8%

66.2%M,62.6%F, 55.1%

97.4%M,98.2%F, 96.4%

2.2 Proportion of pupils starting grade 1 who reach last grade of primary

87.3% 99%(2006)

98.7%M,98.7%F,100%

99.6%M,99.6%F,99.3%

32.7% 68%

2.3 Literacy rate of 15-24 years old , women and men

94.3% 99.6%(2010)

Almost 100% Almost 100%

71.1% 83.9%

The indicator for Goal 3 Achieve Universal primary education

• 3.1 Ratios of girls to boys in primary, secondary and tertiary education

• 3.2 Share of women in wage employment in the non-agricultural sector

• 3.3 Proportion of seats held by women in national parliament

Gender EqualityChina HK, China Laos

1990 2 decades ago

Present 2 decades ago

Present 2 decades ago

Present

3.1 Ratios of girls to boys in primary, secondary and tertiary education

1o,0.902o, 0.733o, 0.53

1o,1.042o,1.053o,1.13

1o,0.992o,1.023o, 0.70

1o, 1.042o, 1.023o, 1.02

1o,0.762o,0.663o,0.46

1o, 0.912o, 0.853o, 0.74

3.2 Share of women in wage employment in the non-agricultural sector

37.8% 39.1% 41% 50% 20.3% 31.1%

3.3 Proportion of seats held by women in national parliament

21.3% 21.3% Legistlative Council 12% 18%

Directorate officers 4% 36%

The Policies

The Policies for poverty and hunger

China HK, China Laos

• Sustainable Environment

• Economic development• Poverty alleviation• Focus on the vulnerable

population (elderly, women, children etc.)

• Social motivation

• Social security scheme• Comprehensive social

security assistance scheme,

• Traffic accident Victims assistance scheme and

• Emergency relief.

• Minimum wage

• Mandatory Provident Fund Schemes

• Reduce extreme poverty by half

• Reduce hunger by half• Achieve full and

productive employment and decent work for all

• Around 80% of workers are still engaged in subsistence-oriented agriculture.

The Policies for educationChina HK, China Laos

• Compulsory Education Law

• Rural compulsory education finance reform

• modern distance education project of primary and middle schools in rural area

• Compulsory Education System

• All children above 6 years old must receive education in school. Once students finish junior secondary or are 15-years-old, school attendance is no longer mandatory.

Education is better- performing sectors.• Net enrolment in

primary school education. All number of children of official school age who are enrolled in primary school.

• Population age 15-24 who can both read and understand a short , simple statement on every life.

The Policies for gender equalityChina HK, China Laos

• Program of China's Women Development (2001-2010);

• Population and Family Planning Law;

• Law on the Protection of Women's Rights and Interests;

• Marriage Law;

• Bill of Right Ordinance

• Sex Discrimination Ordinance

• Family Status Discrimination Ordinance

• Convention on the elimination of all forms of Discrimination against women.

Five programs: • Improve women’s

participation in implementation of NGPES

• promote opportunities for women and girls to be equal with men and boy in education and other field.

• Improve health care services.• Increase number of women

in leading position at all level• Strengthen the capacity the

national organizations concerned with protection and promotion of their advancement.

Exiting Problems

Existing Problem on poverty and hunger

China HK, China Laos

• The scale of poverty is still large;

• The degree of poverty is still deep;

• The problem of urban poor is neglected.

• No poverty line was defined.

• Evaluation of anti-poverty measures on the number of applicants.

• The minimum wage alone is found to be not sufficient to cover the family expenses of many low-income workers.

• Meanwhile, it is inadequate to lift their families out of poverty.

• The problem of poverty is still large in Rural area, the most important is driver in reducing rural poverty.

• Needs higher employment and higher unskilled wage-rates for poor family.

Existing Problem on educationChina HK, China Laos

• The quality of education in rural area is low;

• Migrant and disabled children have not been educated well;

• The educational budget is not enough;

• Education statistics system is imperfect.

• Hong Kong education system is exam-oriented.

• Ignorance of moral quality and conduct

• Primary enrolment and children mortality reduction.

• Improving nutrient dietary intake.

• Improving opportunities

• Improving livelihoods between people living in urban and rural area.

Existing Problem on gender equalityChina HK, China Laos

• Gender discrimination still exists in the labor market;

• Proportion of female leaders is small;

• Domestic violence to women still exists.

• Gender discrimination is still a part of the culture and a practice of many indigenous villages.

• Many villages still refuse to allow women to vote in village elections.

• Women and girls enjoy a set of basis human capabilities such as education, health and nutrition.

• Improving Teachers and pupil have the same language

• still have violence and abuse to women and girls in family.

Recommendations

Recommendations on poverty and hunger

China HK, China Laos

• Enhance investment of poverty alleviation;

• Monitor the condition and situation of the poverty in the urban area

• Set a poverty line

• Assess the number of people be lifted out of poverty through its poverty-alleviation policies

• Set up food bank for the people in crisis,

• Needs in education, infrastructure including roads, electricity and piped water. And also need support by agriculture sector to reduce poverty.

Recommendations on educationChina HK, China Laos

• Enhance the quality of education in rural area

• Focus on the migrant and disabled children

• Increas the educational budget

• Improve the education statistics system.

• Modify the way of conducting education

• Reduce the amount of teaching materials

• Enforce the administration of the compulsory education.

• Access to school for all girls or boys and ethnic groups on remote area .

Recommendations on gender equality

China HK, China Laos

• Promote females participating in political and public fairs.

• Solve the problem of domestic violence to women.

• Take the initiative both to educate the people in the public and private sectors about gender equality and sexual harassment and the consequences of harassing.

• Implement more women protection policies

• Ensure all girls and women have opportunities to access to education

Conclusion (China)There are good progress to meet the MDGs in China.• Indicators for poverty : 1.1 (60.2% to 11.8%); 1.3 (8% to 4.7%) for education: 2.2 Finish primary education(87.3% to 99%); 2.3 literacy rate(94.3% to 99.6%) for gender equality: 3.1 Secondary education: female to male ratio (0.73 to 1.05) 3.2 Employment : 37.8% to 39.1%)• Education means more than acquiring knowledge. It empowers

people to develop personally and become politically active.

There are good progress to meet the MDGs in LaosIndicators for poverty : 1.1 (55.7% to 33.9%); 1.3 (9.3% to 7.6%) for education: 2.2 Finish primary education (87.3% to 99%); 2.3 literacy rate (94.3% to 99.6%) for gender equality: 3.1 Secondary education: female to male ratio (0.66 to 0.85) 3.2 Employment : 20.3% to 31.1%)• Set up a better education system and health facilities to rural

area to improve they poverty life and to reduce under 5 mortality rate and child mortality rate

Conclusion (Laos)

- Set up a better education system and health facilities to rural area to improve they poverty life and to reduce under 5 mortality rate and child mortality rate.

Reference • World health organisation web site: http//www.who.int/social

determinants/ the commission• Census and statistics Department, special Report on Gross

Domestic Product 2012, http:// www. Censtatd.gov.hk/sub/sp250• Half-yearly Economic Report, Hong Kong 2012• http://www.stats.gov.cn/tjsj/ndsj/• http://unstats.un.org/unsd/mdg/Data.aspx?cr=156• http://data.un.org/Explorer.aspx• World data bank: http://

data.worldbank.org/indicator/SL.EMP.TOTL.SP.ZS?page=3• UN database: http://data.un.org/Data.aspx?

d=MDG&f=seriesRowID%3A773