Goal 4: Reduce child mortality

1
MDGs Expanding The Agenda
2
Goal 4 Reduce child mortality
3
Existing Target 5Reduce by two thirds between
1990 and 2015 the Under Five Mortality Rate

• Proposed Target 5
• Reduce by two thirds between 1990 and 2015, the
  Under Five Mortality Rate for Girls Boys

4
Existing indicators approved by GOP
Proposed additional Indicators

• Under-five mortality rate
• Infant mortality rate
• Proportion of fully immunised children 12-23
  months
• Proportion of under 1 year children immunised
  against measles
• Prevalence of under weight children (under 5
  years of age)
• Proportion of children under five who suffered
  from diarrhoea in the last 30 days and received
  ORT
• Lady Health Worker coverage of target population

• Under five mortality rate for boys and girls
  divided by income quintile
• Infant mortality rate for girls and boys divided
  by income quintile
• Proportion of 1-year-old children (girls and
  boys) immunized against all preventable diseases
  including measles.
• Proportion of women in the reproductive age
  (15-45) with access to quality, affordable and
  comprehensive SRHR services, including
  contraceptive, safe delivery, safe abortion, and
  safe motherhood services at the primary health
  care level divided by income quintile.

5
Rationale for inclusion of Indicators

• Gender and income quintile disaggregated data
  help in understanding health seeking behaviours
  at the household and community levels.
• The already existing system of government
  measures gender disaggregated data these systems
  should be further strengthened and maintained.

6
Early And Late Childhood Mortality Rates
Source Pakistan Population Assessment Report
2003 and NIPS 2000-01

• Neonatal Mortality probability of dying within
  the first month of life
• Infant Mortality probability of dying before the
  first birthday
• Under Five Mortality probability of dying before
  the fifth birthday
• Child Mortality probability of dying between the
  first and the fifth birthday, having survived the
  first year

7
Regarding Immunization

• Since measles is not the only preventable disease
  that threatens Pakistans population and TB,
  hepatitis, diphtheria, pertusis (whooping cough),
  tetanus etc have a higher incidence in our
  population it is recommended that the indicator
  measuring proportion of children immunised
  against measles must be modified to measure
  proportion of children immunised against all
  preventable diseases, including measles.
• Other diseases such as diarrhoea and Acute
  Respiratory infections (ARI), which account for
  two-thirds of child and infant mortality rates,
  must also be considered and measured. This is
  already part of the Pakistan Governments plans
  and should be included as part of the MDG
  framework.

8
Source of data UNICEF State of the World
Children - 2005
9
Access to Quality Health Services

• One of the pressing challenges towards achieving
  the child health goal has been mentioned in the
  MDG progress report as
• Access to high quality essential health
  services, especially reproductive and emergency
  obstetric care
• Since access to quality SRHR services is directly
  linked to child health, it is proposed that the
  MDG framework include an indicator that measures
  the proportion of quality, affordable and
  comprehensive SRHR services, including
  contraceptive, safe delivery, safe abortion, and
  safe motherhood services at the primary health
  care level.