According to the World Health Statistics 2009, please click here to access:

• The proportion of under-nourished children under five years of age declined from 27% in 1990 to 20% in 2005.

• Some 27% fewer children died before their fifth birthday in 2007 than in 1990.

• Maternal mortality has barely changed since 1990.

• One third of 9.7 million people in developing countries who need treatment for HIV/AIDS were receiving it in 2007.

• MDG target for reducing the incidence of tuberculosis was met globally in 2004.

• 27 countries reported a reduction of up to 50% in the number of malaria cases between 1990 and 2006.

• The number of people with access to safe drinking-water rose from 4.1 billion in 1990 to 5.7 billion in 2006. About 1.1 billion people in developing regions gained access to improved sanitation in the same period.

• Globally, the proportion of children under five years of age suffering from under-nutrition, according to WHO Child Growth Standards, declined from 27% in 1990 to 20% in 2005. But, the progress is uneven, and an estimated 112 million children are underweight.

• Globally, the number of children who die before their fifth birthday has been reduced by 27% from 12.5 million estimated in 1990 to 9 million in 2007. This reduction is due to a combination of interventions, including the use of insecticide-treated mosquito nets for malaria, oral rehydration therapy for diarrhoea, increased access to vaccines for a number of infectious diseases and improved water and sanitation. But pneumonia and diarrhoea continue to kill 3.8 million children aged under five each year, although both conditions are preventable and treatable.

• The global maternal mortality ratio of 400 maternal deaths per 100 000 live births in 2005 has barely changed since 1990. Every year an estimated 536 000 women die in pregnancy or childbirth. Most of these deaths occur in sub-Saharan Africa where the maternal mortality ratio is 900 per 100 000 births and where there has been no measurable improvement since 1990. A woman in Africa may face a 1-in-26 lifetime risk of death during pregnancy and childbirth, compared with only 1 in 7300 in the developed regions. 1 There are, however, signs of progress in some countries in Asia and Latin America and the Caribbean.

• The percentage of adults living with HIV worldwide has remained stable since 2000 but there were an estimated 2.7 million new infections during 2007. Moreover, deaths are increasing in parts of Africa, particularly eastern and southern Africa. The use of antiretroviral therapy has increased; in 2007, about 1 million more people living with HIV received the treatment. That means one third of the estimated 9.7 million people in developing countries who need the treatment were receiving it.

• The MDG target for reducing the incidence of tuberculosis was met globally in 2004. Since then, incidence has continued to fall slowly. Thanks to early detection of new cases and effective treatment using the WHO-recommended DOTS treatment strategy, treatment success rates have been consistently improving, with rates rising from 79% in 1990 to 85% in 2006. Multi-drug resistant tuberculosis is a challenge in countries, such as those of the former Soviet Union, while the lethal combination of HIV and tuberculosis is an issue particularly for sub-Saharan African countries.

• Efforts to control malaria are beginning to pay off with significant increases in the proportion of children sleeping under insecticide-treated mosquito nets. Although it is still too early to register the global impact, 27 countries – including five in Africa – have reported a reduction of up to 50% in malaria cases between 1990 and 2006. In 2006, the number of cases was estimated to be 250 million globally.

• Progress has been made in treating neglected tropical diseases that affect some 1.2 billion people. For example, only 9585 cases of dracunculiasis (guinea-worm disease) were reported in the five countries where the disease is endemic, compared with an estimated 3.5 million reported in 20 such countries in 1985.

• The number of people with access to safe drinking water rose from an estimated 4.1 billion in 1990 to 5.7 billion in 2006. But 900 million people still had to rely on water from what are known as unimproved sources, for example surface water or an unprotected dug well.

• Since 1990, an estimated 1.1 billion people in developing regions have gained access to improved sanitation. In 1990, just under 3 billion people had access to sanitation. Their number rose to more than 4 billion by 2006. Yet, in 2006 some 2.5 billion did not have access to improved sanitation and 1.2 billion had to practise open defecation.

• Although nearly all developing countries publish an essential medicines list, the availability of medicines at public health facilities is often poor. Surveys in about 30 developing countries show that availability of selected medicines at health facilities was only 35% in the public sector and 63% in the private sector. Lack of medicines in the public sector often means patients have no choice but to purchase them privately or do without treatment.

According to National Family Health Survey-III (2005-06), please click here to access:

NFHS III reports declining status of nutrition amidst women
 

• The NFHS III paints a mixed picture of India’s overall reproductive health status. Women are having fewer children and infant mortality has dropped in the seven-year period since the last NFHS survey in 1998-99.

• Anaemia and malnutrition are still widespread among children and adults. And, in an unusual juxtaposition, more adults, especially urban women, are overweight or obese than they were seven years ago.

Trend in Family Planning and Fertility
 

• Fertility has continued to decline since NFHS-2, dropping to an average of 2.7 children from 2.9 children. Ten states, mostly in Southern India, have reached replacement level or below replacement level fertility.

• While son preference remains a barrier to more rapid decline in fertility, an increasing number of women who have only daughters say that they want no more children. In NFHS-3, 62% of women with two daughters and no sons say they want no more children, compared with 47% in NFHS-2.

• Declining fertility could be attributed largely to women’s increased use of contraception. For the first time ever, more than half of currently married women in India are using contraception, and their use of modern contraceptive methods increased from 43% to 49% between NFHS-2 and NFHS-3.

• A rise in the average age at marriage is also contributing to the drop in fertility. Forty-five percent of women ages 20-24 were married before the legal age of marriage of 18 years, compared with 50% seven years earlier. This shift in age at marriage also influences the median age at first birth, which increased by six months to 19.8 years.

Half of Women Lack Proper Care during Pregnancy and Delivery
 

• More than three-quarters of pregnant women in India received at least some antenatal care (ANC), but only half of women had at least three ANC visits with a health provider during their pregnancy.

• The disparity between urban and rural women was especially pronounced, with 74% of urban women having ANC at least three times, compared with 43% of rural women. Births assisted by a health professional increased to 49% from 42%, with 75% of urban women but only 39% of rural women in NFHS-3 received assistance from a health professional.

• Institutional births increased from 34% to 41%, but most women still deliver their children at home. Only about one-third of women received postnatal care within two days of delivery.

Infant Mortality Drops, but Full Immunization Coverage Shows Little Progress

• Infant mortality continues to decline, dropping from 68 in 1998-99 to 57 in 2005-06 per thousand births.

• There were particularly notable drops in the infant mortality rate in Bihar, Goa, Haryana, Jammu and Kashmir, Meghalaya, Orissa, Punjab, Rajasthan, Tamil Nadu, and Uttar Pradesh.

• Overall, there was only a marginal improvement in full vaccination coverage, with 44% of children ages 12-23 months receiving all recommended vaccinations, up from 42% seven years earlier.

• Substantial improvements in coverage have been made in all vaccinations except DPT, which did not change at all between NFHS-2 and NFHS-3.

• Gains are particularly evident for polio vaccination coverage, but nearly one-quarter of children age 12-23 months did not receive three recommended doses.

• Progress in vaccination coverage varies markedly among the states. In 11 states, there has been a substantial deterioration in full immunization coverage in the last seven years, due to a decline in vaccination coverage for both DPT and polio.

• Large decline were seen in Maharashtra, Mizoram, Andhra Pradesh, and Punjab. On the other hand, there was major improvement in full immunization coverage in Bihar, Chhattisgarh, Jharkhand, Sikkim, and West Bengal. Other states with marked improvements in full immunization coverage were Assam, Haryana, Jammu and Kashmir, Madhya Pradesh, Meghalaya, and Uttaranchal.

• Diarrhoea continues to be a major health problem for many children.  Although knowledge about Oral Rehydration Salts (ORS) for the treatment of diarrhoea is widespread among mothers, only 58% of children with diarrhoea were taken to a health facility, down from 65% seven years earlier.

• There has been a rise in the number of dispensaries and hospitals, nursing personnel and doctors (including primary health care centers) in between 1991 and 2005/06, as could be deciphered from the table below.

Trends in health care infrastructure