Daisy B.

Itchock
• is supporting countries in implementing
people-centered and integrated health
services by way of developing policy
options, reform strategies, evidence-
based guidelines and best practices that
can be tailored to various country settings.
• Integrated health services encompasses
the management and delivery of quality
and safe health services so that people
receive a continuum of health promotion,
disease prevention, diagnosis, treatment,
disease-management, rehabilitation and
palliative care services, through the
different levels and sites of care within
the health system, and according to their
needs throughout the life course.
 health care delivery system

• is defined by the World
Health Organization, which tracks
worldwide health outcomes data, as
a system that includes doing what it takes
to promote, restore, or maintain health.
 health care delivery system

• is the totality of ‘societal services and

activities designed to protect or restore the
health of individuals, families, groups and
communities.
 health care delivery system

• It includes both government and non-

government health facilities, programs,
services and activities (preventive,
promotive, curative and rehabilitative).
• Preventive health care is a major concern
of the government-owned
while curative care is provided by
hospitals, both government and private
• The Millennium Development Goals (MDGs)
are eight goals to be achieved by 2015 that
respond to the world's main development
challenges.
• The MDGs are drawn from the actions and
targets contained in the Millennium
Declaration that was adopted by 189 nations-
and signed by 147 heads of state and
governments during the UN Millennium
Summit in September 2000.
 WHAT ARE THE MDGS?
• The eight Millennium Development Goals
(MDGs) are a set of internationally agreed,
time-bound and measurable goals .
• Each of the eight goals has specific targets and
indicators to measure progress.
• The overall target date is 2015.
Ø Millennium Development Goal
1 has three targets:
• To halve the proportion of
people whose daily income is
less than $1.25
• To achieve full and productive
employment, as well as decent
work for all, including young
people and women
• To halve the proportion of
individuals suffering from
hunger in the period between
1990 and 2015.
• A considerable reduction in extreme poverty
over the last 25 years.
üIn 1990, nearly 50 percent of the population in
developing nations lived on less than $1.25 a
day.
üAs of 2015, that proportion has dropped to 14
percent.
• The number of people living in extreme
poverty worldwide has reduced by more than
50 percent.
üIn 1990, 1.9 billion people were said to be
living in extreme poverty, compared to 836
million in 2015.
üMost progress was seen in the new
millennium.
• The number of living on more than $4 a day –
those in the working middle class – has nearly
tripled between 1991 and 2015.
üIn 1991, this group made only 18 percent of
the population, and rose to 50 percent in 2015.
• The proportion of undernourished people in
the developing world has dropped by almost
50 percent since 1990; from 23.3 percent in
1990 – ’92 to 12.9 percent in 2014 – ’16.
• Recent gains in millennium
development goal 1 have
seen the number of
hungry people in the world
decrease to fewer than 1
billion, though the Food
and Agriculture
Organisation of the United
Nations believes that this
number is still
unacceptably high.
Ø To ensure that children
universally – including
both boys and girls –
will be able to complete
a full course of primary
education by 2015
Ø The Food and Agricultural
Organization of the UN claims
that nearly 57 million primary
school age children are not able
to attend school; of
whom live in rural areas.

Ø This has made the urban-rural

knowledge and education divide
today’s main obstacle to
achieving global primary
education by 2015.
Ø The fact that rural children are
highly affected by hunger and
malnutrition has also seriously
affected their learning ability.
Ø As such,
should be addressed at
the same time to give rural people
the capacity to feed themselves and
overcome

brings together all

efforts for education and food
security towards increased
effectiveness.
Ø There was only one
target under
millennium
development goal 3:

ü To eliminate gender
disparity in primary and
secondary education by
2005, and in all levels of
education by 2015.
ü It is important to promote the
total and equitable
participation of both men and
women in efforts aimed at
improving poverty reduction,
food security, and
sustainability of rural
development.
ü Without gender equality and
the economic and social
improvement for rural
women, food security cannot
be achieved.
ü Promote gender
equality in all levels of
education and
empower women.
Ø An increase in the number of girls
in school in 2015 compared to
2000.
ü The developing world as a whole
has achieved the goal of
eliminating gender disparity in all
levels of education, including
primary, secondary, and tertiary.
Ø In Southern Asia, the number of
girls enrolled in primary school
was 74 for every 100 boys in 1990.
ü By 2015, there were 103 girls
enrolled for every 100 boys.
Ø The proportion of women
in vulnerable employment
compared to total female
employment has reduced
by 13 percent in the
period between 1991 and
2015, compared to a 9
percent decrease for men.
Ø Significant gains in women’s
parliamentary representation
in nearly 90 percent of 174
countries for which data has
been available in the past two
decades.
Ø At the very least, the average
proportion of women in
parliament has increased by
nearly 100 percent during the
last 20 years, yet this still
translates to one woman for
every five men.
Ø To reduce the under-
five mortality rate by
two-thirds in the period
between 1990 and 2015
Ø Undernutrition is
estimated to contribute
to more than 33
percent of all deaths in
children under five.
Ø So, efforts to improve
household food security
and nutrition have
increased the chances
of children growing to
adulthood.
• In this regard, FAO programmes, in
combination with efforts by the Renewed
Efforts against Child Hunger and
Undernutrition (REACH) and WHO, WFP,
and UNICEF have helped communities and
households secure access to nutritionally
adequate diets to minimise child
undernutrition.

• Efforts include the provision of training

materials, community-centred initiatives,
training programmes for local and national
staff, nutrition education programmes, and
promotion of forums on community
nutrition and household food security.
Ø Improving
complementary feeding
for babies, or giving
foods in addition to
breast milk, has led to
significant reduction in
the child mortality
caused by
undernutrition.
• To reduce the maternal mortality
ratio by 75 percent
• To achieve universal access to
reproductive health
 Ø Improving maternal health is
critical to saving the lives of
hundreds of thousands of
women who die due to
complication from pregnancy
MDG 5: Reduce and childbirth each year.

maternal mortality Ø Over 90 percent of these

deaths could be prevented if
by 75 percent & women in developing regions
had access to sufficient diets,
achieve universal basic literacy and health
services, and safe water and
access to sanitation facilities during
pregnancy and childbirth.
reproductive health.
Ø A 45 percent reduction in the
maternity mortality ratio worldwide
since 1990, though most of the
reduction occurred since 2000

Ø A 64 percent reduction in maternal

mortality ratio in Southern Asia
between 1990 and 2013, and 49
percent in sub-Saharan Africa

Ø A 12 percent increase in the number

of births assisted by skilled health
personnel globally in 2014 compared
to 1990 – 59 percent to 71 percent.
Ø An increase in the
proportion of pregnant
women receiving four or
more antenatal visits in
North Africa from 50
percent in 1990 to 89
percent in 2014.
Ø Increase in contraceptive
prevalence among women
15 – 49 years old –
whether married or in
some other union – from
55 to 64 percent between
1990 and 2015.
Ø HIV, malaria, and other
diseases directly and
indirectly impact food
and nutrition security,
rural development, and
agricultural productivity.
Ø At the same time,
malnutrition and food
and nutrition insecurity
can increase
vulnerability to disease.
 Ø To halt by 2015 and have
started to reverse the
spread of HIV/AIDS
Ø To achieve global access to
treatment for HIV/AIDS for
those who need it by 2010
In this regard, Ø To have ceased and started
Millennium reversal of the incidence of
malaria and other major
Development Goal diseases by 2015
6 has three targets:
Ø 40 percent reduction in new
HIV infections from 3.5 million
cases in 2000 to 2.1 million
cases in 2013
Ø A massive increase in the
number of people living with
HIV receiving anti-retroviral
therapy (ART) globally, from
800,000 in 2003 to 13.6
million in 2014. ART have
helped avoid over 7.6 million
deaths from AIDS between
1995 and 2013.
Ø Averting over 6.2 million
deaths associated with
malaria between 2000 and
2015, mostly of children
under five years in sub-
Saharan Africa.
Ø The universal malaria
incidence rate has also
reduced by an estimated
37 percent, and the
mortality rate by 58
percent.
Ø The delivery of over 900 million
insecticide-treated mosquito nets
to malaria-endemic countries in
sub-Saharan Africa between 2004
and 2014.
Ø Tuberculosis prevention,
diagnosis, and treatment
interventions conducted between
2000 and 2013 saved an
estimated 37 million lives.
Ø The TB mortality rate reduced by
45 percent between 1990 and
2013, while prevalence rate fell
by 41 percent within the same
time period.
 Ø New HIV – human
immunodeficiency virus –
infections have declined
universally by nearly 40 percent
between 2000 and 2013,
indicating a drop from an
estimated 3.5 million to 2.1
million new infections.
Target #1: Halt Ø Among the countries with
sufficient data, 10 countries
and reversal of recorded a drop of more than 75
percent in new HIV infections
the spread of from 2000 to 2013, while another
HIV/AIDS 27 countries recorded a decline of
more than 50 percent.
Ø More than 75 percent of
new infections recorded in
2013 occurred in only 15
nations, though sub-
Saharan Africa is still the
most severely affected by
the epidemic with an
estimated 1.5 million new
infections in 2013.
Ø Of these, nearly 50 percent
have occurred in three
countries: South Africa,
Nigeria, and Uganda.
Ø That said, South Africa, which has
the largest number of people
living with HIV, recorded the
largest decline in the total
number of new infections, with
98,000 fewer infections in 2013
compared to 2010.
Ø Additionally, the number of new
infections among young people
(15 – 24) in the sub-Saharan
region has declined by 45 percent
between 2000 and 2013.
Ø In the Caribbean, new HIV
infections reduced by 56
percent, while Southern
Asia and Southern Africa
recorded a 49 percent
decrease.
ü There wasn’t much change
in Latin America and
South-Eastern Asia, while
new infections increased in
Western Asia, North Africa,
and Eastern Asia.
ü This represents a 35 percent
decline since the 2.4 million peak
recorded in 2005.
ü In the short period between 2010
and 2013, AIDS-related deaths
dropped by 19 percent, though
AIDS-related deaths have not
decreased among adolescents
aged 10 – 19, probably due to
lack of testing and treatment for
this age group.
ü As such, AIDS remains the
number one adolescent killer in
sub-Saharan Africa.
 • In 2013, an estimated 17.7 million
children across the globe (under
18) has lost at least one parent
due to AIDS-related causes.
ü Between 2000 and 2009, the
number rose from 10.5 to reach a
Target #2: Universal peak of 18.5 million.
ü Since then, this number has been
access to HIV/AIDS dropping gradually, through
investment in social protection
treatment and economic support will be
needed for years to come to
mitigate the impact of HIV on
these children.
 Ø Education is a critical
source of stability and
protection for vulnerable
children.
Target #2: Universal ü Fortunately, the rate of
access to HIV/AIDS school attendance for
orphaned and non-
treatment orphaned children has
increased from 0.80 to
0.96 between 2000 and
2014.
 • Access to ART has
increased at an amazing
pace, with an estimated
13.6 million people
living with HIV receiving
Target #2: Universal ART globally.
access to HIV/AIDS ü Of those, 12.1 million
treatment were in developing
regions, indicating a
huge increase from
375,000 in 2003.
Ø The world is still on track to get
15 million people to receive ART
by 2015, a goal set out in the UN
General Assembly Special Session
on HIV and AIDS in 2011.
Ø This accomplishment can be
attributed to the power of
community mobilisation, the
political resolve of leaders, the
commitment of health care
workers, and international
funding that continues to fuel the
universal scaling-up of ART.
• Global malaria incidence
rate has dropped by about
37 percent between 2000
and 2015, while mortality
rate has dropped by 58
percent in the same period.
Consequently, the global
MDG malaria target has
been achieved.
Ø Increased universal attention,
combined with considerable
expansion of anti-malaria efforts
have helped avert more than 6.2
million malaria deaths in the 15
year period, especially in children
under five in sub-Saharan Africa.
Ø The estimated 69 percent
reduction in malaria mortality for
children under five in this region
helped improve child survival
rates, directly contributing to
MDG4 – reduction of child
mortality by two-thirds.
Ø The massive gains since 2000
have been attributed to the
tenfold increase in international
funding for malaria, with stronger
political commitment and the
availability of new, more effective
tools.
Ø This has increased access to
malaria prevention and treatment
interventions, including indoor
residual spraying, long-lasting
insecticide-treated mosquito nets,
diagnostic testing, and
artemisinin-based combination
therapies.
Ø It is critical that the natural
resources base and
ecosystems are managed
sustainably to ensure that
people’s food requirements
and other social, economic,
and environmental needs are
sufficiently met.
Ø Climate change, conflicts over
access to resources, and
increased water scarcity all
pose a threat to not only
environmental sustainability
but also food security.
Ø To integrate the principles
of sustainable
development into every
nation’s policies and
programmes, and also
reverse the depletion of
environmental resources
Ø To reduce biodiversity loss
and achieve a substantial
reduction in the rate of
loss by 2010
Ø To halve the proportion of
the universal population
without sustainable access
to clean and safe drinking
water and basic sanitation
by 2015.
Ø To achieve substantial
improvement in the lives
of a minimum of 100
million slum dwellers by
2020.
• MDG 7: It is critical that
the natural resources
base and ecosystems
are managed
sustainably
• An estimated 30 percent of total
land area on the planet is forested.
• An estimated 1.6 billion people
depend on forests directly for their
livelihoods, plus they provide other
benefits enjoyed by all, including
clean air and water.
• Forests also provide a habitat for
millions of plants and animals, as
well as catchment for 75 percent of
the world’s fresh water.
• They help in the adaptation to and
mitigation of climate change, though
they are under threat from
deforestation.
• Hunger and poverty tend to
compel the disadvantaged to
over-exploit resources on
which their livelihoods depend.
• Policies, institutions, and
strategies for protecting,
conserving, and enhancing
natural resources should be
strengthened to deliver an
enabling environment, and be
based on the specific resource
challenged faced in a given
location.
Ø The virtual elimination of ozone-
depleting substances since 1990.
Consequently, the ozone layer is
expected to recover by around
the middle of the century
Ø Substantial increase in marine
and terrestrial protected areas in
many areas since 1990.
ü In Caribbean and Latin America,
coverage of terrestrial protected
areas increased from 8.8 percent
in 1990 to 23.4 percent in 2014.
• The number of people using
improved drinking water
sources has increased from 76
percent in 1990 to 91 percent
in 2015.
• 2.6 billion people have gained
access to better drinking water
since 1990. Of these, 1.9
billion have access to piped
drinking water on premises,
with 58 percent of the global
population enjoying this level
of service in 2015.
• 147 nations in the world have
fulfilled the drinking water
target; 95 nations have
achieved the sanitation target;
and 77 nations have met both.
• 2.1 billion people in the
universe have gained access to
improved sanitation.
ü At the same time, the
proportion of people
practising open defecation has
reduced by nearly 50 percent
since 1990.
• A reduction in the
proportion of urban
population in
developing nations
living in slums from 39.4
to 29.7 percent in the
period between 2000
and 2014.
• Millennium
development goal 8 has
6 targets that seek to
develop global
partnership for
development, namely:
• To further develop an open,
predictable, rule-based,
non-discriminatory trading
and economic system
• To address the special
needs of the least
developed countries
• To address the special
needs of small island
developing States and
landlocked developing
countries
• To deal exhaustively with the debt
problems of developing nations
• To provide access to affordable
essential drugs in the developing
world – in collaboration with
pharmaceutical companies
• To avail benefits of new
technologies, especially
information and communications,
in collaboration with the private
sector
• MDG 8: Develop a
global partnership for
development & avail
benefits of new
technologies
• Some of the
achievements of MDG 8
include:
• A 66 percent increase in
official development
assistance from developed
nations in real terms in the
period 2000 to 2014,
reaching $135.2 billion
• In 2014, the United
Kingdom, Sweden, Norway,
Denmark, and Luxembourg
continued to exceed the
UN official development
assistance target of 0.7
percent of gross national
income
• Imports from developing to
developed countries admitted
duty-free increased from 65
percent in 2000 to 79 percent in
2014
• The proportion of external debt
service to export revenue in the
developing world reduced from
12 to 3 percent between 2000
and 2013.
• 95 percent of the global
population is covered by a mobile
cellular signal as of 2015
• The number of mobile-cellular
subscription has grown by nearly
tenfold in the last 15 years, from
738 million to over 7 billion
between 2000 and 2015
• Internet penetration has
increased from about 6 percent
of the global population to 43
percent between 2000 and 2015.
Consequently, 3.2 billion people
are now linked to an international
network of content and
applications.