BANGLADESH: Goal 5: A MAJOR TURNAROUND IN MATERNAL MORTALITY RATIO

The Bangladesh MDGs reflect a set of targets and actions contained in the Millennium Declaration that was adopted by 193 nations including Bangladesh, in 2002 based on the Millennium Declaration agreed in September 2000. Bangladesh has been observed and recorded to achieve impressive feats in pulling people out of poverty; ensuring that more  and more children-both girls and boys, attend school, and have access to clean water. Bangladesh is among the 16 countries who have received UN recognition for being on track to achieve many of its MDGs, for instance, noteworthy progress has been made in the child survival rate. There have been some improvements to address the country’s massive environmental challenges over the past decade as well.

But we will look into the improvement made in the maternal mortality ratio of Bangladesh; which at 194 has shown a major turnaround. Performance on this goal is a major achievement as it was lagging behind in this sector. MDG 5 of Bangladesh is to improve maternal health; which has one target and two indicators, namely, maternal mortality ratio and births attended by skilled health personnel.

•  Maternal Mortality Ratio:

Ever since the government of Bangladesh decided to emphasize the importance of the need to rapidly improve maternal health, it has been successful in progressing atleast some of the indicators. This was achieved by increasing the use of modern health care technologies/facilities among all segments of the population. According to goal 5 of MDGs, the maternal mortality ratio should be reduced by three-quarters between 1990 and 2015. Impressively, the Maternal Mortality Ratio in Bangladesh has reduced from 574 per 100,000 live births in 1991 to 320 per 100,000 live births in 2001 (Figure 4).
In 2006 the estimated maternal mortality ratio was 290 per 100,000 live births (as per UNFPA). However, this rate does not include the abortion related deaths. Yet the current trend/pattern in the maternal mortality ratio shows Bangladesh is on more or less on the right track of meeting its target, that is 143 per 1,00,000 live births, by the year 2015. The decrease in maternal mortality ratio between 1990 and 2006 might be due to increase in the rate of receiving antenatal care and tetanus toxoid vaccine by the pregnant mothers from 1990 to 2006, as it reduces the risks involved during pregnancies and at delivery-for both- the mother and child(Figure 4). The proportion of pregnant mothers who received at least one Antenatal care vaccine and who received it from doctors/nurses or medically trained people almost doubled; from 28% in 1989-92 to 49% in 2002-06. The mothers, who received two or more tetanus toxoid vaccines during pregnancy increased from 49% in 1990-93 to 64% in 2002-06.

 

Recently in 2010, according to the Bangladesh Maternity Mortality Survey 2010 (NIPORT, 2011), maternal mortality declined from 322 in 2001 to only 194 in 2010, which is a 40% decline in 9 years implying an average rate of decline of about 3.3 percent per year. The overall proportion of births attended by skilled health personnel has increased by more than fivefold in the last two decades, i.e. from 5% in 1991 to 26.5% in 2010.

 

• Births attended by skilled health personnel

Even at this age and day, 85 percent of deliveries take place at home in Bangladesh. The proportion of birth delivered at health facility increased from 4 percent in 1989-93 to 15 percent in 2002-2006. The institutional deliveries in Bangladesh increased significantly in the last three years compared to the progress in earlier years. However, there are high rural-urban variations and regional disparities in institutional deliveries. According to BDHS 2007, the number of birth deliveries at medical facilities was three times higher in the urban areas than that in rural areas of the country (Figure 5).

 

Also, the proportion of birth deliveries attended by medically trained and skilled health personnel was only 5 percent in 1990 and it increased to 18 percent in the period 2002-2006, at an annual average rate of 16.25 percent; which is considerably lower than the country’s MDG target, which should be 50 percent by 2015 (Figure 5). If this trend goes on like this rate, then the country will not be able to achieve its MDG target for improving maternal mortality ratio.

Moreover, Bangladesh needs to take measures to significantly increase Institutional deliveries in order to improve maternal health to a satisfactory level because these medically trained personnel, apart from qualified doctors also include trained nurses, midwife, paramedic, family welfare visitor (FWV); who are not trained well enough to prevent many of the obstetric complications. The statistics show that the proportion of delivery assisted by skilled health personnel is considerably higher in urban areas than that in rural areas. Thirty five percent of the deliveries were attended by medically trained providers in urban area and only 7 percent in rural area during 1991 to 1993. In the period of 2002-2006 the corresponding figures were 37 percent and 13 percent respectively. This trend illustrates that the rate of improvement in terms of increase in number of deliveries attended by skilled health personnel is higher in rural area compared to urban area (Table 10).

• Challenges:

Though Bangladesh has considerably succeeded in achieving most of the MDG targets, there is still room for improvement in some of the indicators in Goal 5 of the MDGs. These are:-

1. More medical facilities and attention should be provided to pregnant women as a significant proportion of them are iodine deficient as well and develop night blindness during pregnancy. This needs to be taken into consideration and should b e prevented.
2. Improvement in births attended by skilled health personnel is not satisfactory. Only on average 480 CSBA are produced annually by the Obstetrical and Gynecological Society of Bangladesh (OGSB) and a total of 3000 have been trained so far, which should have been nothing less than the target of 13,000 trainees. Rapid training of skilled health personnel, increase in infrastructure and cautious monitoring is needed, for Bangladesh to reach its set target by the year 2015.
3. One important intervention of the Maternal Health Strategy 2001 was to train medical officers in obstetrics or anaesthesia (1 year diploma level) and place them in functional teams at District facilities. So far only 206 obstetrics and 118 officials in anaesthesia have been trained. Moreover, only 57 percent of the obstetrics and 69 percent of the medical officers in anaesthesia are appointed in designated positions with frequent failure to retain both the obstetric and the anaesthesia to perform caesarian sections in a facility due to variety of reasons (MTR 2008). The Government should take steps to overcome this problem, with special emphasis on reducing absenteeism in rural areas.

Actually, the problem lies at the grassroots level. In Bangladesh, majority of the population still has very little knowledge about the MDGs and its necessity in the country. Until and unless the concept is well understood by the mass people, the benefits of the MDGs may not be achieved to its full potential.

WEBLIOGRAPHY

http://www.undp.org.bd/projects/prodocs/PRS_MDG/Situation%20analysis_health.pdf

http://www.undp.org.bd/mdgs.php

 

 

–SAKSHI RAINA

TYBMM

 

 

 

UNITED NATIONS: EFFORTS AND SUCCESS IN PEACE KEEPING

The United Nations founded in 1945 just after the Second World War; was formed to maintain peace and harmony across continents. The five permanent members of the United Nations are the United States of America, France, China, the United Kingdom and the Soviet Union. They exercise the right to participate in the democratic methods of decision making as carried out by the United Nations.

All one hears about is how miserably the United Nations has failed to ensure world peace and security is maintained and how there have been more and more violence and bloodshed; be it millions of Iraqis being killed by America’s agenda of ‘war on terror’ or be it the Israel-Palestine conflict. Criticism is always at the forefront but here, we are going to look at the success achieved by the UN in bringing peace and security to the countries.
UN has built up an impressive record of peacekeeping achievements over more than 60 years of its existence, and also won the prestigious Nobel Peace Prize for the same.

Since 1948, the UN has helped end conflicts whose consequences could have been catastrophic and also in fostering reconciliation by conducting successful peacekeeping operations in dozens of countries such as Cambodia, El Salvador, Guatemala, Mozambique, Namibia, Tajikistan, and Timor-Leste. It has also made a significant difference in places like Sierra Leone, Timor-Leste, Liberia, Haiti and Kosovo by providing the basic security guarantees and responding to them in situation of crisis. Through these, UN operations have supported political transitions and helped establish fragile new state institutions and have helped countries to overcome the state of conflict and have a real chance at normal development of the nation at a whole; even if major peace-building challenges within the country remain.

By May 2010, UN Peacekeeping operations had more than 124,000 military, police and civilian staff and there are currently 14 peacekeeping operations and one special political mission the United Nations Assistance Mission in Afghanistan (UNAMA) led by the Department of Peacekeeping Operations.

In other instances, however, it can be debated that peacekeeping strategies and help from the UN peacekeeping and by the international community as a whole have yet not reached places such as Somalia, Rwanda and the former Yugoslavia in the early 1990s. But these setbacks provided important lessons for the international community for deciding how and when to deploy and support UN peacekeeping as a tool to restore and maintain international peace and security.

Recognizing the need to better prepare and respond to the challenges of peace building, the 2005 World Summit approved by the United Nations encourages the creation of a new Peace-building Commission in which the resolutions such as resolution 60/180 and resolution 1645 (2005)can come into play. The measures decided upon by the United Nations General Assembly and the Security Council included the mandatory as well as collective effort on the part of all participatory nations to advise on the proposed integrated strategies for post conflict peace-building and recovery; to marshal resources and help ensure predictable financing for these activities; and to develop best practices in collaboration with political, security, humanitarian and development in such countries.

There are certain guidelines/factors that the UN came up with, in order to ensure a fair and successful peacekeeping operation across countries worldwide. It must ensure the following:

• Every step or measure of the UN should be guided by the principles of consent, impartiality and the non-use of force except in self-defense and defense of the mandate;
• To be perceived as legitimate and credible, particularly in the eyes of the local population;
• To promote national and local ownership of the peace process in the host country.

Unique global partnership

The first UN peacekeeping mission was established in 1948, when the Security Council authorized the deployment of the United Nations Truce Supervision Organization (UNTSO) to the Middle East to monitor the Armistice Agreement between Israel and its Arab neighbours. Since then, there have been a total of 64 UN peacekeeping operations around the world.

UN peacekeeping is a unique global partnership which brings together the General Assembly, the Security Council, the Secretariat, troop and police contributors and the host governments in a combined effort to maintain international peace and security. Its strength lies in the legitimacy of the UN Charter and in the wide range of contributing countries that participate and provide precious resources.

Other achievements of the United Nations:

• The First and foremost achievement of the United Nations is that it has prevented the occurrence of any further world wars and has been instrumental in the maintenance of international balance of power till date.
• It has managed to more or less eradicate Apartheid and colonialism and imperialism.
• It played a Significant role in disarming the world and making it nuclear free. Various treaty negotiations like ‘Partial Test Ban Treaty’ and ‘Nuclear non-proliferation treaty’ have been signed under UN.
• The UN Acted as vanguard for the protection of human rights of the people of the world, through the establishment of the Universal Declaration of Human Rights, 1948.
• Despite being crippled by the Bretton Woods Institutions, UN played limited but effective role on economic matters and also supported the North-South dialogue, aspiring for emergence of new international economic order.
• Agencies of United Nations like WHO, UNICFF, UNESCO have keenly participated in the transformation of the international social sector.
• Peace keeping operations, peaceful resolution of disputes and refugee concerns had always been on the list of core issues.
• Since 1945, the UN has been credited with negotiating 172 peaceful settlements that have ended regional conflicts.
• The UN world body is also instrumental in institutionalizing international laws and world legal frame work.

WOMEN, PEACE AND SECURITY

Women may not be the main combatants and perpetrators of war, but they are the ones who have and continue to increasingly suffer the greatest harm in the process.  In contemporary conflicts, it is alleged that among the 80-90 percent of the civil casualties of war, most lives lost are those of women and children. Women in war-torn societies have faced horrific forms of sexual abuse and violence, which have sometimes been carried out for achieving military or political objectives. Moreover, even in today’s age and world, women continue to be poorly represented in formal peace processes and decisions, even when they play a very integral role (direct or indirect) towards contributing and resolving conflicts.

However, the UN Security Council has come to recognise the importance of including women and gender perspectives in decision-making, which can further strengthen prospects for sustainable peace worldwide. This recognition was formalized in October 2000 with the landmark unanimous adoption of Resolution 1325 on women, peace and security, which specifically addresses the situation of women in armed conflict and majorly focuses on two key goals, i.e. to strengthen women’s participation in decision-making on conflict resolution and ending sexual violence and impunity.

–SAKSHI RAINA
TYBMM
WEBLIOGRAPHY:

http://www.un.org/en/globalissues/peacesecurity/

http://www.un.org/en/peacekeeping/operations/present.shtml

THE ISRAELI-PALESTINE CONFLICT: “The Intifada”

The Israeli–Palestinian conflict, which began in the early 20^th century, is the ongoing struggle between Israelis and Palestinians, which was in the earlier years, referred to the conflict between the Zionists and the Arab population living in Palestine under Ottoman and then British rule. The key issues of the conflict include mutual recognition, borders, security, water rights and control of Jerusalem, Israeli settlements,  and the Palestinian freedom movement. The violence resulting from the conflict has raised security and human rights concerns between both sides as well as internationally.

The form of the Israeli-Arab/Palestinian conflict has seen many mutations and changes over the years- from its early stages since the Zionists first settled in Palestine in 1882, to the creation of the State of Israel in 1948; Arab Jewish tensions could be broadly defined as a dispute between two ethno-religious nationalisms competing for the same small stretch of land. This was, however, only until the first Intifada of 1987 and the Oslo peace agreement of 1993, which started a process that would lead to the establishment of a Palestinian state, thus promising to turn the conflict from an existential struggle to a border conflict[1].

The “Intifada”

After living under much hardship and humiliation, the Palestinian population in the year 2000, began an uprising against Israeli rule called the “Intifada.” This term – rarely translated in the American media – is simply the Arabic word for ‘uprising or rebellion’.
This is the second such uprising. The first one began in 1986 and ended in 1993 when the peace negotiations offered hopes of justice but sadly, in the following years, these hopes were crushed after Israel, rather than withdrawing from the West Bank and Gaza, as promised, actually doubled its expansion in these areas.
It is said that during this uprising, which consisted largely of Palestinians throwing stones at Israeli troops (as very few Palestinians had weapons), the people of Palestine were killed at a rate approximately 7-10 times that of Israelis.

Partial casualty figures for the Israeli–Palestinian conflict from the OCHAoPt (numbers in parentheses represent casualties under age 18)
Year	Deaths		Injuries
	Palestinians	Israelis	Palestinians	Israelis
2008–26.12.08	464 (87)	31 (4)	–	–
2007	396 (43)	13 (0)	1843 (265)	322 (3)
2006	678 (127)	25 (2)	3194 (470)	377 (7)
2005	216 (52)	48 (6)	1260 (129)	484 (4)
Total	1754 (309)	117 (12)	6297 (864)	1183 (14)

 

One of the many brutal ways Israeli forces attempted to put down this rebellion was through the “break the bones” policy, implemented by Yitzhak Rabin, where Palestinian people who had been throwing stones (majority of whom were youths), were held down and their arms broken. On the first day of this policy alone, on an average, one hospital in Gaza treated 200 People for fractures.[2]

Recent uprising which has been termed as the “Second Intifada” – was sparked when an Israeli general, Ariel Sharon, known for his infamous slaughter of Palestinian civilians throughout his career, visited a Jerusalem holy site, accompanied by over a thousand armed Israeli soldiers. When some Palestinian youths threw stones, Israeli soldiers responded with live gunfire, killing 5 the first day, and 10 the second.
This uprising has been going on ever since then, as Israel periodically mounts massive invasions into Palestinian communities, using tanks, helicopter gunships, and F-16 fighter jets; killing thousands. Palestinian fighters resisting these forces possess rifles and homemade mortars and rockets; had no choice but to strap explosives onto their own bodies and attempt to deliver their bombs in person; often killing only themselves. While the large majority of Palestinians oppose suicide bombings, many feel that armed resistance has become necessary. Nevertheless, only a small portion takes an active part in the resistance, despite the fact that virtually everyone supports its aim, which is to create a nation that is free from foreign oppression.

It has started becoming difficult for them to even live an approximation of a normal life, with Israel attempting to prevent them from doing so at every step of their lives; for instance, preventing them at checkpoints from traveling from town to town, preventing their children from travelling to schools, to work, to celebrate festivals, destroying their crops, and even not letting the sick and injured from getting to the hospitals!

Most Palestinians feel that the Israeli government’s intention is to drive them off the land, and there is a great deal of evidence that this is the goal of many Israeli leaders. However, at the same time, there is a small but determined and supportive minority of Israelis, joined by citizens from throughout the world, who are increasingly coming to the Palestinian Territories in order to show their support against Israeli occupation. These “internationals,” as they are often called, take part in peaceful marches, attempt to help Palestinian farmers harvest their crops despite Israeli military closures, live in refugee camps in the hope that their presence will prevent Israeli invasions and shelling, and walk children to school. The result? They are sometimes beaten, shot, and even killed.

Meanwhile, the semblance of Palestinian autonomy continues. There have been attempts to improve the situation such as the Elections that were held in January 2005, resulting in new Palestinian leadership that was hoped to be governed under occupation and that will eventually attempt to negotiate Palestinian liberation. Yet even this election demonstrated Israel’s power, as various Palestinian candidates were arrested, detained, and sometimes beaten by Israeli forces. This aspect, however, like so much else, was rarely reported by the American media.

Regardless of whether one considers the Israeli-Palestinian conflict a border dispute, an ethnic conflict, a religious war, an anti-colonial struggle, or a combination of the above, what emerges from various studies is that without a fair and satisfactory- a mutually agreed upon settlement to the dispute, there can be no end to the conflict. And maybe the United Nations needs to step in and take control of the situation. A negotiated two-state solution with an administrative arrangement for a common capital of both states seems to be a reasonable possibility. It’s time that the Policy makers take responsibility and control of the situation and put this conflict to a rest.
–SAKSHI RAINA
TYBMM

WEBLIOGRAPHY:

Menachem Klein. The Shift: Israel-Palestine from Border Struggle to Ethnic Conflict. New York: Columbia University Press. 2010.

“Under orders from Defence Minister Yitzhak Rabin, ‘Soldiers armed with cudgels beat up those they could lay their hands on regardless of whether they were demonstrators, or not, breaking into homes by day and night, dragging men and women, young and old, from their beds to beat them. At Gaza’s Shifa Hospital 200 people were treated during the first five days of the new policy, most of them suffering from broken elbows and knees. Three had fractured skulls.’” (PALESTINE AND ISRAEL: THE UPRISING AND BEYOND, David McDowall, University of California Press, 1989, p. 7.)

 

 

---

[1] … argues senior lecturer in political science at Ben Gurion University, Menachem Klein, in his fittingly entitled The Shift: Israel-Palestine From Border Struggle to Ethnic Conflict (New York: Columbia University Press, 2010)

[2] “Under orders from Defence Minister Yitzhak Rabin, ‘Soldiers armed with cudgels beat up those they could lay their hands on regardless of whether they were demonstrators, or not, breaking into homes by day and night, dragging men and women, young and old, from their beds to beat them. At Gaza’s Shifa Hospital 200 people were treated during the first five days of the new policy, most of them suffering from broken elbows and knees. Three had fractured skulls.’” (PALESTINE AND ISRAEL: THE UPRISING AND BEYOND, David McDowall, University of California Press, 1989, p. 7.)

 

Pakistan: the Need for Global Partnership for Development

 

Pakistan like many other nations, adopted the millennium Declaration in the year 2000, and pledged to leave no stone unturned in their efforts to free its men, women and children from extreme poverty conditions.
The 18 global targets and 48 indicators adopted in 2000 have been translated into 16 national targets and 37 indicators keeping in view Pakistan’s specific conditions, priorities, data availability and institutional capacity. Since 2006, numerous successful developments have taken place in Pakistan which has changed its social, political and economic state.

Targets for achieving Global Partnership For Development in Pakistan are:

• To comprehensively deal with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term.
• To develop and implement strategies for decent and productive work for youth, in cooperation with developing countries.
• To make available the benefits of new technologies, especially information and communications, in cooperation with the private sector.

The consequences of a world that is interconnected or a globalised world have been recognised by all participant countries that make up the global economy; be it environmental disasters or natural occurrences — such as the 2008 global financial crisis, or the war on terror in and around Pakistan and Afghanistan, the consequences of numerous local and supposedly isolated events, have negative global outcomes, some of which can be disastrous and catastrophic.

Pakistan has become a focal point, both in terms of geography and of development, requiring help and assistance to achieve all seven of its MDGs by means of the Eighth Goal, which includes greater market access, development assistance, and greater connectivity.
With Pakistan being an aid dependent country for decades now, the manner of aid distribution and its conditionality, variability and uncertainty has caused various problems which have undermined its benefits of providing assistance for achieving many of Pakistan’s MDGs and overall development. But with trade replacing aid as a means to achieve this stage of development, Pakistan’s desire for greater market access is largely supply- constrained, where Pakistan’s narrow export base has limited exportable services and commodities.
Therefore, it has been observed that for Pakistan to be able to take due advantage of the wide spread global economy, rather than being victims of it; bilateral and multilateral overseas development assistance can play a key role in doing so.

Conclusion

However, unless there is an urgency to create a renewed and collective effort to mobilize resources, both at the domestic and international front; and also to refocus the priorities of the country in favour of these development Goals, there is a high risk of considerable shortfalls in the MDGs set for 2015. Though time is needed in order to bridge the gigantic gap between performance and expectations that exist presently, future trends and dramatic results can happen when nations are faced with overwhelming challenges.

The adoption of the Seventh National Finance Commission Award in 2011 will free up some resources from the federal government to the provinces and allow the less developed provinces to access further funds. And since provinces are responsible for achieving many of the Goals of the MDGs, this transformation in resource allocation may be fortuitous for achieving some of the MDG Goals, as long as these Goals receive their priority.

An elected democratic government is the call of the hour that will take extraordinary measures, wherever necessary, to achieve the targets set up for each of the country’s Eight MDGs. These targets can be easily met as long as there is a clear commitment and collective effort as a country to achieving these Goals.
–SAKSHI RAINA
TYBMM (Journalism)

 

WEBLIOGRAPHY:

http://www.qismat.org.pk/component/content/article/38/82-millenium-development-goals-in-pakistan

 http://www.pc.gov.pk/mdgs-pak2010.html

GEM for MDG 2

By Shruti Parmar

While most countries are on-track to achieve the MDGs by 2015 galvanised despite all differences to help the world’s poor, it is essential to remember that poor people do not need poor solutions. Numbers need to be substantiated with quality when meeting the targets of the MDGs. MDG 2 Achieve Universal Primary Education has a single sub target-

Target 2A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling

• Enrolment in primary education
• Completion of primary education
• Literacy Rate

Learning outcomes i.e. the basic quality of education ensued, youth skills and the impact on secondary and post secondary education, that may have negative long-term economic consequences according to a study by Eric A. Hanushek and Ludger Woessmann, are not being discussed in MDG 2. Further, the EFA global monitoring report has said that by current trends we would miss this MDG by a large margin. Add to this, aid to education is on a decline.

However, a Government of Uganda project launched in association with the UNICEF, the Ministry of Education and Sports (MoES) and Forum of African Women Educationists (FAWE) by the in 2001 offers some hope. The Girls Education Movement (GEM) is a project that takes a more sensitive look at the crisis of education and offers a holistic approach to achieving MDG 2. The underlying principle at GEM is to involve girls in achieving their Right to Education through the institution of GEM Clubs in primary schools, thus making it a child-centric and child-led grassroots movement.

The project addresses the hygiene and sanitation coverage in schools to make them girl-friendly and encourage girls’ school enrolment and reduced dropout rates. It also takes into account the bias of parent and teachers against girls’ education (especially in science and maths) and trains teachers in gender responsiveness i.e. to treat girls and boys equally. By an open discussion of girls’ safety and security due to violence, sexual harassment and discriminatory cultural practices, girls are empowered with knowledge, skills and confidence to protect themselves and their peers. Music, dance, drama and debates are also conducted as gender sensitization tools. The GEM club helps keep boys in school as well through peer-to-peer counselling and leadership workshops are also part of the Project.

Community Mapping is another technique that the girls undertake to carry out Go to Stay in school, Back to school, Stay in school campaigns. Gulu district in Uganda for example brought back 199 girls (36 child mothers) and 69 boys in the first quarter 2006 through Community Mapping.

Today, the GEM project is not an organisation but groups of children across Africa who are working, not just talking or discussing, to bring a positive change in the lives of African girls and boys. Through their networking, lobbying, encouragement and facilitation they are creating a critical mass of support for the cause of an MDG that’s struggling to be achieved. There’s a lesson there.

http://ugandaradionetwork.com/a/story.php?s=20889

http://faweu.efoundation-it.net/index.php/girls-education-movement

http://www.unicef.org/infobycountry/uganda_33942.html

CHILD MORTALITY AND NEPAL

Millennium Development Goal

GOAL 4:
REDUCE CHILD MORTALITY

Improving child health is taken as the important criteria for the health development in general and is seen not only as the goal in itself. There have been remarkable and visible improvements in some of the indicators of child health globally. Service provisions like immunization, oral re-hydration and other, essential for the child survival, are substantially increased. Some concrete results have been achieved for this MDG. Between 1990 and 2000 under-five mortality declined by 11 percent worldwide. There was the decline in the global child deaths from diarrhoea by half during the decade of 1990-2000, which saved about one million lives. Underweight among the children in developing countries fell from 32 to 28 percent.

TARGET: To Reduce the under -five Child Morality by two thirds

Status:

There has been a considerable decline in the case of child morality within last three decades.

Reason for the reduction was the control over some of the deadly diseases like chicken pox, malaria, cholera and other highly deadly diseases. The rate of under-five child morality differs from different region from rural to urban. As per report the morality rate is higher in rural areas as compared to urban areas.

Nepal has made significant progress in reducing the infant mortality rate (IMR) and under-five mortality rate (U5MR) in recent years. By 2006, the national IMR had decreased to 48 deaths per 1,000 live births and the U5MR had decreased to 61 deaths per 1,000 live births (Ministry of Health and Population, MOHP et al. 2007). Trend analysis of data from 1995 to 2005 suggests that the IMR declined by 39 per cent and the U5MR by 48 per cent over the period. A recent survey in rural locations of 40 districts shows that in these areas IMR has fallen to 41 deaths per 1,000 live births and U5MR to 50 deaths per 1,000 live births.

Analysis of the IMR and U5MR for Nepal shows that there are important disparities by gender, caste, ethnicity, and geographic location. Data from 2006 show little difference in the national IMR and U5MR between girls and boys (MOHP et al. 2007); however, the Nepal Family Health Programme survey shows that in rural areas gender disparity is still quite significant, with infant mortality 1.18 times higher for females than for males and under-five mortality 1.19 times higher.

Although immunization against measles for children aged 12–23 months reached 85 percent in 2006 (Ministry of Health and Population, MOHP et al. 2007), it declined to 83 per cent in 2007-08 (Department of Health Service, DOHS 2008) and recorded a slight improvement in 2009 to 85.6 per cent (Nepal Family Health Programme, NFHP 2010). There are also disparities in access to anti-measles vaccination in terms of boys and girls, rural–urban residence, ecological zone, and development region (MOHP et al. 2007).

Supportive Environment for Controlling Child-5 morality:

To control morbidity and mortality among children, the government has initiated several child-survival programmes including the Community-Based Integrated Management of Childhood Illness (CB-IMCI), the Community-Based Newborn Care Package (CB-NCP), and the National Immunization Programme (NIP). The CB-IMCI package has recently been expanded to all 75 districts. Based on the National Neonatal Strategy 2004, the government is piloting the CB-NCP in 11 districts. This programme promotes the use of skilled birth attendants during delivery, and provides community-based counselling, treatment and referral of sick neonatal.

The NIP, including vaccination against measles, is a high-priority government programme, and covers the entire country free of cost. Nepal has made landmark progress in relation to child survival. In recognition of this, it received an award at the International Partners’ Forum held in Hanoi in November 2009. The Ministry of Health and Population (MOHP) has also been awarded by the Global Alliance for Vaccine and Immunization(GAVI).

Challenges:

Neonatal mortality is a serious concern in Nepal, accounting for 69 per cent of IMR and 54 per cent of U5MR in 2006 (DOHS 2008). The present pace of reduction in the IMR and U5MR cannot be sustained unless reduction in the neonatal mortality rate is accelerated. The most common causes of neonatal deaths are infection, birth injury and birth asphyxia.

The challenges faced during the process of overcome the serious concern were:-

• Ensuring adequate nutrition to children and developing locally sensitive nutrition program.
• Investing a higher level of public expenditure on health and investing on areas having above rate of child morality.
• Raising the quality of health services.
• Reducing the cost of medicines.
• Developing authority responsible for health programs and awareness.
• Increasing people awareness by providing campaigns regarding child morality.
• Developing appropriate strategies to address the high prevalence of neonatal morality.

Although the budget for child health has risen in recent years, little effort has been made to mobilize local resources such as block grants provided by the government through the Ministry of Local Development and resources generated by the local bodies for child health. In fact, spending by local bodies on basic health has been minimal and not guided by health indicators.

GENDER EQUALITY AND PAKISTAN

Millennium Development Goal

Goal 3:

GENDER EQUALITY AND WOMEN EMPOWERMENT

Target 3: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015

• For girls in some regions, education remains elusive
• Poverty is a major barrier to education, especially among older girls
• In every developing region except the CIS, men outnumber women in paid employment
  Women are largely relegated to more vulnerable forms of employment
• Women are over-represented in informal employment, with its lack of benefits and security
• Top-level jobs still go to men — to an overwhelming degree
• Women are slowly rising to political power, but mainly when boosted by quotas and other special measures

Pakistan will be missing most of the Millennium Development Goals (MDGs) with slow economic growth and increasing income inequality in the country.

According to UN annual MDG report for 2012, besides Pakistan’s slow economic growth of around 3% for the last 3-4 years, the income inequality in the country has been on rise, whereby share of lowest quintile in consumption is only 9.6% against 40.3% for the highest quintile – a startling disparity. At the domestic front, security issues, war on terror and IDPs have put further pressure on our economy.

Also, Pakistan has faced serious challenges in the last six years, stemming from a sudden meltdown in the global economy in 2008, along with a sharp rise in oil and food prices earlier that year. The report covers the period since 2006 in which numerous and far reaching developments have taken place, which have transformed the social, political and economic landscape of Pakistan, all having an impact on the outcomes, achievements and targets of Pakistan’s Millennium Development Goals.

The status of Pakistan is as follows:

• Pakistan has made steady though slow progress with regard to the Gender Parity Index (GPI) for primary and secondary education. Despite the fact that Pakistan has missed the MDG target of gender parity in primary and secondary education in 2005, with the current pace, the MDG target of gender parity is likely to be unachievable by 2015.

• Youth literacy GPI improved during 2004-09. With the existing pace, the MDG target of 1.00 by 2015 is likely to be unachievable.
• Women’s share in wage employment in the non-agricultural sector has increased but Pakistan is making slow progress in achieving the target. Keeping in view the slow progress, proper steps need to be taken to achieve the MDG target of 14 percent.
• With regard to number of women seats in the national parliament, Pakistan has shown substantial improvement over the years. The proportion of seats in the present National Assembly is substantial, and is amongst the highest in the world.

Pakistan had adopted 18 targets and 41 indicators against which progress was measured. However, the UN annual report said data against only 33 indicators was available. Of the total 33 indicators, progress on 20 indicators is lagging behind, slow on four, on track for three, off track for one, while targets against five indicators have been met.

POVERTY AND BANGLADESH

Millennium Development Goal

Goal 1:

ERADICATE EXTREME POVERTY AND HUNGER

Bangladesh has made reasonably good progress in its effort at reducing poverty. The decline in poverty was more rapid in the 1990s than during earlier decades. Poverty reduction in the first half of the current decade was also somewhat faster than in the 1990s. During the 9 years between 1991-92 and 2000, the poverty head-count ratio in Bangladesh fell by 9 percent – an annual rate of decline of one percentage point. Between 1999 and 2004, the poverty head-count ratio fell by 5.3 percent (from 46.2% to 40.9%), depicting an annual rate of decline of 1.06 percent (BBS, 2004).

The reduction of poverty in the most recent times has been possible mainly because of a steady rate of economic growth. During the last decade, the economy grew consistently at around 5 percent a year. The growth rate reached a peak of 6.3% in 2002-03. For a sustained reduction of poverty, there is in fact no alternative to growth, which, therefore, is currently the government’s top priority.

Target 1: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar per day

Bangladesh has successfully achieved significant reduction in poverty since 1990. According to source of United Nation; national poverty headcounts declined from 56.6 percent in 1991-92 to 31.5 percent in 2010. The percentage of population under the lower poverty line, the threshold for extreme poverty, fell by 26.9 percent from 25 percent of the population in 2005 to 17.6 percent in 2010. The fall in poverty headcount rates was significantly more than the population growth during 2005-2010 leading to the decline in number of poor people. Real per capita consumption expenditure during 2005-2010 increased at an average annual rate of 16.9 percent with a higher increase in rural areas with compared to urban areas.

The sustained growth has been accompanied by corresponding improvement in several social indices in country such as increased life expectancy and lower fertile rate despite having the world’s highest population growth.

Poverty Gap Ratio:

Poverty gap ratio is the mean distance separating the population from the poverty line, expressed as a percentage of the poverty line. The poverty gap ratio is an indicator that measures the depth of poverty.

As per studies, poverty gap ratio in declination in Bangladesh is dramatic. Trends in the poverty gap show a drop from 17.20 in 1991-92 to 12.9 in 2000 and 9.00 in 2005 and finally 6.5 in 2010. Thus, the target of making the poverty gap half has already achieved which was due in 2015.

It is also worth noticing that poverty gap declined relatively more rapidly than the poverty headcount.

Target 2: Achieving full and productive employment and decent work for all

As per data from World Bank the GDP per person employed in Bangladesh was $3,722 in 2008 with a growth rate of 3.76 percent.

Employment to Population Ratio:

In Bangladesh the share of manufacturing sector in GDP has increased, while that of agriculture was declined. However, the service sector maintains the same level of contribution to GDP.

The reported unemployment in Bangladesh is low. The inclusion of the informal sector in the formal sector and subsequent slow employment generation in related sector remains challenge in Bangladesh. Overseas migration and remittances from 7 million expatriate Bangladeshis contribute directly to improvements in the Financial and development status of migrants’ families and communities.

Target 3: To reduce the proportion of people by half who suffer from hunger between 1990 and 2015

Nearly two-third of Bangladeshis Children were underweight in 1990 and less than half were underweight in 2009. Underweight prevalence rate fell sharply between 1992 and 2000. There were many reasons behind this declination which includes increased literacy of women, reduction of fertility rate, enhanced vaccination coverage, smaller family size, spread of vitamin A etc. Despite the above mentioned progress, Bangladesh in all likelihood may not meet its targets of halving the proportion of the population below the minimum level of dietary energy consumption by 2015.

Regional disparities exist in the proportion of the population with less than 2122kcals/day. More recently the Bangladesh household Food Security Nutrition Assessment 2008-2009 reported that population living in Barisal and Rajshahi division had worse food consumption scores in comparison with other divisions. The survey also found that female headed household and household in rural areas are food insecure compared to their respective counterpart.

Challenges:

• Despite the linkage between poverty, hunger and employment. The progress towards hunger and employment related MDG targets have not been as encouraging as poverty.
• The lack of diversity in Bangladesh food crop sector also poses a challenge and more emphasis on the production of non cereal crops.
• Extreme poverty that exists in small pockets poses specific challenges, which need to be addressed.
• Ensuring food security to different group of poor such as extreme poor people and potential poor refugees.
• A major concern in the country is the persuasive underemployment which has prevented meeting MGD-1. The challenge is to ensure economic growth that is “Pro-Poor” and that can lead to more job, better employment and household income.