National Department of Health

Presentation to the Portfolio Committee on Health

Progress towards attaining the Millennium Development Goals (MDS)

30 October 20131

MDG REPORT TO THE UN

• The MDGs were adopted by the UN in 2000• Goals are to be met by 31 December 2015• Countries report to the UN through Heads of

State• STATSSA co-ordinates the writing of the

national report using verifiable data

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The 8 MDGs• To eradicate extreme poverty and hunger• To promote universal primary education• To promote gender equality and empower

women• To reduce child mortality• To improve maternal health• To combat HIV/AIDS, malaria and other diseases• To ensure environmental sustainability• To develop a global partnership for the

development.

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Government Outcome MDGs

Outcome 1: Improved quality of basic education Goal 2: Achieve universal primary education

Outcome 2: A long and healthy life for all South Africans

Goal 4: Reduce child moralityGoal 5: Reduce maternal mortalityGoal 6: Combat HIV/AIDS, malaria & other diseases

Outcome 3: All people in South Africa are, and feel safe

 

Outcome 4: Decent employment through inclusive economic growth

Goal 1 (Target 1B): Achieve full and productive employment and decent work for all including women and young people

Outcome 5: A skilled & capable workforce Goal 2: Achieve universal primary education Goal 3: Promote gender equality and empower women

Outcome 6: An efficient, competitive, and responsive economic infrastructure network

 

Outcome 7: Vibrant, equitable, and sustainable rural communities with food security for all

Goal 7 (Target 7A): Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resourcesGoal 1 (Target 1C): Halve, between 1990 and 2015, the proportion of people who suffer from hunger

Outcome 8: Sustainable human settlements, and improved quality of life for households

Goal 7 (Target 7C): Halve by 2015, the proportion of people without sustainable access to safe drinking water & basic sanitationGoal 7 (Target 7D): Achieve significant improvement in the lives of slum dwellers

Outcome 9: A responsive, accountable, effective, and efficient local government system.

 

Outcome 10: Environmental assets and natural resources that are well protected and continuously enhanced

Goal 7 (Target 7B): Reduce biodiversity loss, achieving by 2010, a reduction in the rate of loss.

Outcome 11: Create a better South Africa and contribute to a better and safer Africa and world

Goal 8: To develop a global partnership for development. Develop an open, rule-based, predictable, non-discriminatory trading and financial system

Outcome 12: An efficient, effective, and development oriented public service and an empowered, fair, and inclusive citizenship

 

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Indicators 1994 baseline (or nearest year)

2010 Status (or nearest year)

Current status (2013 or nearest year)

2015 Target Target achievability

Target 1A: Halve between 1990 and 2015 the proportion of people whose income is less than one dollar a dayProportion of population below $1.00 (PPP) per day

11.3 (2000) 5.0 (2006) 4.0 (2011) 5.7 Achieved

Proportion of population below $1.25 (PPP) per day

17.0 (2000) 9.7 (2006) 7.4 (2011) 8.5 Likely

Proportion of population below $2.00 (PPP) per day

33.5 (2000) 25.3 (2006) 20.8 (2011) 16.8 Likely

Poverty gap ratio ($1.00 (PPP) per day)

3.2 (2000) 1.1 (2006) 1.0 (2011) 1.6 Achieved

Poverty gap ratio ($1.25 (PPP) per day)

5.4 (2000) 2.3 (2006) 1.9 (2011) 2.7 Likely

Poverty gap ratio ($2.00 (PPP) per day)

13.0 (2000) 8.1 (2006) 6.5 (2011) 6.5 Likely

Poverty gap ratio ($2.50 (PPP) per day)

18.0 (2000) 12.5 (2006) 10.3 (2011) 9.0 Likely

Share of the poorest quintile in national consumption

2.9 (2000) 2.8 (2006) 2.7 (2011) 5.8 Unlikely

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Target 1B: Achieve full and productive employment and decent work for all, including women and young people

Percentage growth rate of GDP per person employed

4.7 (2002) 1.9 (2009) 1.5 (2011) 6.0 Unlikely

Employment-to-population ratio 44.1 (2001) 42.5 (2009) 40.8 (2011) 50-70 Unlikely

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

5.2 (2000) No data 3.9 (2009) 0 Likely

% of own-account and contributing family workers in total employment

11 .0 (2000) 9.9 (2010) 10.0 (2011) 5 Unlikely

Target 1C: Halve between 1990 and 2015, the proportion of people who suffer from hunger

Prevalence of underweight children under five years of age (%)

13.2 (1993) 10.2 (2005) 8.3 (2008) 4.7 Likely

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Target 3: 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

Data deficiency Data deficiency Data deficiency NA NA

96.8 (2002) 99.0 (2009) 99.2 (2011) 100

Proportion of learners starting grade 1 who reach last grade of primaryMale Female

89.2 (2002) 91.8 (2009) 93.4 (2012) 100 Likely

90.1 (2002) 93.4 (2009) 96.1 (2012) 100

Literacy rate of 15-24 year-oldsMale Female

83.3 (2002) 88.9 (2009) 90.7 (2011) 100 Likely

88.4 (2002) 93.1 (2009) 94.6 (2011) 100

15 (2001) 19 (2009) 22 (2011) 20 Achieved

NA NA 43 (2011) No target

59.5 (2009) 66.5 (2010) 72.4 (2012) 84.4 Likely

12.0 (2002) No data 26.7 (2011) No target NA

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Goal 3: Promote Gender Equality and Empower WomenIndicator 1994 baseline

(or nearest year)2010 Status (or nearest year)

Current status (2013 or nearest year)

2015 Target

Target achievability

Target 4: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2013

GPI primary 0.97:1 (1996) 0.98:1 (2009)

0.96:1 (2011) 1:1 Likely

GPI secondary 1.13:1 (1996) 1.01:1 (2009)

1.07:1 (2011) 1:1 Achieved

GPI tertiary 0.86:1 (1996) 1.32:1 (2009)

1.38:1 (2011) 1:1 Achieved

Ratio of literate females to literate males 15-24 years

1.1:1 (1996) 1:1 (2009)

1.0:1 (2011) 1:1 Achieved

Female share of non-agricultural wage employment

43 (1996) 45 (2010)

45 (2012) 50 Unlikely

Proportion of seats held by women in national parliament (%)

25 (1996) 44 (2009) 44 (2009) 50 Likely

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Goal 4: Reduce child mortality

Indicator

1994 baseline (or nearest year)

2010 status (or nearest year)

Current status (2013 or nearest

year)

2015 Target

Target achievability

Target 4: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

Under 5 mortality rate (per 1 000 live births)

59(1998)

104(2007)

* - (2011)20 Likely***

**67(2007)

**53(2010)

Infant mortality rate (per 1 000 live births)

54 (1998)

53 (2007)

* - (2011)

18 Likely***

**48(2007)

**38(2010)

Proportion of one year old children immunised against measles (%)

68.5(2001)

97.1(2009)

99.1(2011)

100 Likely

Life expectancy at birth (years):Males Females

50.0

(2002)

51.7

(2007)

56.8

(2012)70 Unlikely

So what will it take the meet the MDG targets?

• Focus on the major causes of mortality• Newborns

– Prematurity– Infections– Asphyxia

• Under 5– HIV– Diarrhoea– Pneumonia– Severe malnutrition– TB

• Maternal mortality– HIV– Hypertension– Haemorrhage

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Goal 5: Improve Maternal Health

Indicators 1994 baseline (or nearest year)

2010 status (or nearest year)

Current status (2013 or nearest year)

2015 Target

Target achievability

Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio

Maternal mortality ratio (per 100 000 live births)

150(1998)

625 (2007)

269**(2010)

38 Unlikely

299**(2007)

Proportion of births attended by skilled health personnel (%)

76.6(2001)

94.3(2009)

No update available

100 Likely

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Target 5B: Achieve by 2015, universal access to reproductive health

Contraceptive prevalence rate (for all women using all methods) (%)

50.1(1998)

50.2(2003)

No update available 100 NA

Adolescent birth rate (%)

12.5(1996)

No data

13.7(2011)

No target NA

Antenatal care coverage (at least one visit and at least four visits) (%)

76.6(2001)

102.8(2009)

100.6(2011)

100 Achieved

Unmet need for family planning (married women or those in union) (%)

15.0(1998)

13.8(2003)

No update available No target NA

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Maternal mortality ratios by year of death: 2002-2010 and the 2015 MDG target

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Province 2008 2009 2010 2011 2012Eastern Cape 180.4 215.2 197.0 158.26 146.44

Free State 267.0 350.9 263.5 240.08 124.54

Gauteng 136.0 160.2 159.2 121.45 142.52

KwaZulu-Natal 183.8 194.2 208.7 186.74 160.33

Limpopo 176.6 160.4 166.7 195.51 185.80

Mpumalanga 179.8 159.4 218.6 190.13 173.76

North West 161.7 279.5 256.1 153.75 127.76

Northern Cape 274.4 251.8 267.4 191.10 149.33

Western Cape 61.8 113.1 88.0 64.81 78.64

South Africa 164.8 188.9 186.2 159.14 146.71

Table: Comparison of Institutional MMR per province from 2008-2012 (NCCEMD)

Key achievements attained in reducing MMR

• Improved access to lifelong ART for pregnant women taking antiretrovirals for their own health.

• Considerable decline in the Free State within 12 to 18 months by:– Re-organizing their emergency medical services;

improving inter facility transfer times.– Realignment of services for caesarean section

times.

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Goal 6: Combat HIV/AIDS, Malaria and Other DiseasesIndicators 1994 baseline

(or nearest year)

2010 status (or nearest year)

Current status (2013 or nearest year)

2015 Target

Target achievability

Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS

HIV prevalence among population aged 15-24 years (%)

9.3(2002)

8.7(2008)

7.3(2012)

4.2 Likely

Condom use at last high risk sex (%)

27.3(2002)

62.4(2008)

59.9(2012)

100 Unlikely

Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS (%)

66.4(2005)

42.1(2008)

48.5(2012)

95 Likely

Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years

1:1(2002)

1:1(2008)

1:1.01(2011)

1:1 Achieved

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Target 6B: Achieve by 2010, universal access to treatment for HIV/AIDS for all those who need it

Proportion of population with advanced HIV infection with access to antiretroviral drugs (%)

13.9(2005)

41.6(2009)

75.2(2011)

80 Likely

Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

Incidence of tuberculosis per 100 000 population

253 (2004)

283 (2009)

< 253 NA

993(2011)

449 NA

Prevalence of tuberculosis per 100 000 population

768(2011)

392 NA

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Death rates associated with tuberculosis per 100 000 population

147(2002)

50(2010)

49(2011)

<147 Achieved

Incidence of malaria per 100 000 population

64 622(2000)

8 066(2010)

6 846(2012)

32 311 Achieved

Death rates associated with malaria per 100 000 population

459(2000)

87(2010)

72(2012)

229 Achieved

Non Health MDGs.

Integral to improved health outcomes

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Target 7C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation

Proportion of population using an improved drinking water source (%)

76.6(1996)

84.4(2001)

90.8(2011)

88.3 (2015)

Achieved

Proportion of population using an improved sanitation facility (%)

49.3(1996)

53.6( 2001)

66.5(2011)

74.65 Likely

In Conclusion

• Need to consider the impact of the social determinants of health on health outcomes

• Many gains have been made – especially since 2009

• However, more work in specific areas are needed to meet the MDGs by 31 December 2015

• Many of these issues should be taken forward past 2015, including a focus on universal health coverage and non-communicable diseases

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Thank You

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