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

To be achieve by 2015 Mid-term evaluation - 2007

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 diseases.7. Ensure environmental sustainability and8. Develop a global partnership for development

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

Indicator 1987-88

1993-94 1999-2000

Poverty headcount ratio OverallRuralUrban

38.939.138.2

36.037.332.4

26.127.123.6

Poverty gap ratio RuralUrban

8.58.1

5.35.2

Indicators related to poverty & hunger

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

6. National slum development programme

7. Swarna Jayanti Shahari Rozgar Yojana

8. Valmiki Ambedkar Yojana (VAMBAY)

9. Public distribution system

10. 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

11. National nutrition mission (2003)

12. National guideline on infant & young feeding 2004

13. 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 1992-93

2000-01

2004-05

Gross enrolment ratio in primary education

OverallMaleFemale

84.695.073.5

95.7104.985.9

108.56111.41105.48

Proportion of children starting Grade 1 who reach grade 5

overallMaleFemale

55.056.253.3

59.360.358.1

Adult literacy rate(7 years & above)

overallMalefemale

52.2*64.139.3

64.8475.2653.67

Source: Selected educational statistics,2002-03, GOI. *Census of India,1991 & 2001

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 1991 2001Primary education 71 78%Secondary 49 % 63 %Higher 50 % 58 %

1991 20010.560.58

0.60.620.640.660.68

0.70.72

0.610000000000001

0.710000000000001

Literacy ratio in women to men (Age 7 +)

Share of women’s in wage employment in non agricultural sector National level - 16%.Rural -15 %

Urban-16.6%.

1st 6th 13th 14th 15th0

2

4

6

8

10

12

4.4 3.8

9.28

10.61

Proportion of seats held by women in national parliament (Lok Sabha)

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

NFHS 1 NFHS 2 NFHS 3 Target(2015)

0

20

40

60

80

100

120119

103.7

8274

.6

63.1

51.7

10995

74

42RuralUrbanTotal

Infant Mortality Rate

19901993

19962000

20032005-

06 2008

01020304050607080 80

7472

68

6057

55

IMR

IMR

27

Immunization of child < 12 month against measles

NFHS 1 NFHS 2 NFHS 30

10

20

30

40

50

60

42.2

50.7 48.4

Immunization of child < 12 month against measles

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

1991 1998 SRS 2003 SRS 2004-06 20150

50

100

150

200

250

300

350

400

450

500

437407

301

254

109

Indicator 17: Proportion of births attended by skilled health personnel

NFHS 1 NFHS 2 NFHS 30

50

100

150

200

250

34.2 42.3 48.8

62.365.4

76.9

54

67

76

T.T. injections

Any ANC visit

Safe delivery

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

2001 2002 2003 20060

1

2

3

4

5

6

7

8

0.740000000000001

0.860000000000001

4.5

2.4

4.4

1.8

2.8

Condom usage among non-regular sex partnerHIV Prevelance among women 15-24yrs

•National AIDS Control Programme (1987)•NACP I(1992 - 1999) •NACP -II (1999 – 2006) •NACP-III (2006-2011) •ART Centers

Ministry of health & Family welfare,BSS 2001 & 2006

Target 8 Have halted by 2015 & begun to reverse the incidence of malaria & other major Diseases

Indicator 21: Prevalence & death rates associated with malaria

1990 1994 1998 2002 2004 20080

0.5

1

1.5

2

2.5

3

3.5

2.572.91

2.44

1.8 1.752.08

0.05 0.13 0.07 0.09 0.09 0.08

Annual Parsitic In-cidenceDeath per 100000

Ministry of health & Family welfare

(Per 1000)

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

1990 2002 2003 20060

10

20

30

40

50

60 57

3733

28

TB deaths /10000 population

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

1991 20010

20

40

60

80

100

56

8781 82

62

85

RuralUrban Total

1991 20010

20

40

60

80

9

3247

63

RuralUrban

Proportion of the population with access to an improved water sources

Proportion of the population with access to sanitation

Ministry of rural development,Urban development, Registrar general of India

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

Steps for urban water supply & sanitation

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 Plan2007

NPP 2010

XI FY Plan 2012

NRHM 2012

MDG2015

Current

Infant MR 45 <30 27Maternal MR 200 <100 100 301

(SRS 01-03)

Total fertility R 2.1 2.1 2.9Institutional deliveries

80% 80% 40.7 (NFHS III)

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Tracking the Millennium Development Goal. Copyright United Nations Development Programme, 2007.email: http://www.mdgmonitor.org/factsheets_00.cfm?c=IND&cd=356

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