The health of the people What works African Regional Health Report 2014 he Health statistics © WHO Regional Office for Africa, 2014 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. Copies of this publication may be obtained from the Library, WHO Regional Office for Africa, P.O. Box 6, Brazzaville, Republic of Congo (Tel: +47 241 39100; +242 06 5081114; Fax: +47 241 39501; E-mail: afrobooks@afro.who.int). Requests for permission to reproduce or translate this publication – whether for sale or for non-commercial distribution – should be sent to the same address. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization or its Regional Office for Africa be liable for damages arising from its use. Printed in Luxembourg Contents Message from the Regional Director Health statistics 1. Demographic and socioeconomic statistics 2. Life expectancy and mortality 3. Cause-specific mortality and morbidity 4. Selected infectious diseases 5. Health service coverage 6. Risk factors 7. Health systems 8. Health expenditure 9. Health inequities Endnotes v 1 2 4 6 10 12 14 16 18 20 22 iii “ We have distilled what we have learned from examining what has worked in Africa … It is hoped that countries will take up the challenges of implementation or scale-up of proven efective interventions through strong health systems to move towards universal health coverage. ” Message from the Regional Director his report is a follow-up to the irst African regional health report in 2006, in which we provided a comprehensive situational analysis of the health status of people living in the World Health Organization African Region. In this second report, we have taken that baseline and examined what has happened since, seeking to answer the question: what has worked and why? Now, more than ever, we need to know – and do – the things that work. Not what might work, not what could work in 10 years’ time, but what does work, and should be done here and now, to improve the health of the people of the Region. In these pages you will ind a rich discussion of strategies that work, including a chapter devoted to the elements needed for stronger health systems: good information and surveillance systems; well-trained and motivated health-care workers; well-equipped health facilities with good laboratory services; and well-managed services, trusted by, and functioning in partnership with community involvement. Sadly, these were the elements sorely lacking in the countries whose systems were rapidly overwhelmed by the Ebola virus outbreak. As I write this, the Ebola virus is raging through western Africa, causing the most severe, complex and devastating outbreak seen in the four decades since this virus emerged. he destruction it has wreaked can be measured not only in the mounting toll of human lives lost, but in economies stalled and communities paralysed by fear and panic. he real cost of this outbreak is something that we will be measuring for years to come. In this report, we have done more than simply describe what works: we have distilled what we have learned from examining what has worked in Africa to 10 essential approaches. Our inal chapter describes those approaches and explains why they are crucial. Many of these are things that, had they been applied before Ebola virus disease arrived in western Africa, would have provided early warning and inbuilt resilience to even such a powerful shock. It is hoped that countries will take up the challenges of implementation or scale-up of proven efective interventions through strong health systems to move towards universal health coverage. We look forward to seeing what we have learned and described in these pages being applied towards reaching our ultimate goal: good health for all the people of the Region. Dr Luis Gomes Sambo Regional Director WHO – Regional Oice for Africa v African Region of the World Health Organization Algeria Mauritania Mali Cabo Verde Eritrea Niger Chad Senegal Gambia Guinea Bissau Nigeria Guinea South Sudan Central African Republic Sierra Leone Liberia Burkina Faso Côte d’Ivoire Ghana Togo Ethiopia Benin Uganda Democratic Republic of the Congo Gabon Sao Tome and Principe Cameroon Equatorial Guinea Kenya United Republic of Tanzania Congo Rwanda Burundi Seychelles Comoros Angola Zambia Zimbabwe Malawi Namibia Botswana Mauritius Mozambique Madagascar Swaziland South Africa Lesotho This report refers to the 47 Member States of the WHO African Region, as illustrated in this map. The WHO African Region does not include all the countries on the African continent and is not limited to sub-Saharan Africa. The “Region” is used when referring to the African Region as defined by WHO, while “Africa” is used when discussing the continent as a whole, including its islands. The WHO Regional Office for Africa is based in Brazzaville in the Congo. It should be noted that the World Bank divides the African continent into two regions: North Africa and sub-Saharan Africa, while UNICEF divides it into three regions: Eastern and South Africa; West and Central Africa; and North Africa. Health statistics Summary indicators he summary tables in this report include some of the most recent health statistics available from the 47 Member States of the Region. hey are based on evidence available in 2013 and represent the best estimates of WHO for a broad range of key public health indicators. he statistics cover the following categories: 1. 2. 3. 4. 5. 6. 7. 8. 9. Demographic and socioeconomic statistics Life expectancy and mortality Cause-speciic mortality and morbidity Selected infectious diseases Health service coverage Risk factors Health systems Health expenditure Health inequities hese estimates are computed by WHO using standardized categories and methods in order to enhance cross-national comparability. hey may not agree with estimates at country level and are not necessarily the oicial statistics of Member States. More detailed information is available from the African Health Observatory (https://www.aho.afro.who.int/en) and the Global Health Observatory (http:// www.who.int/gho/en). For a deinition of the health statistics' categories included in this annex, as well as the rationale for their inclusion and the estimation methods used in their productions, see section 7, Explanatory notes of the Atlas of African health statistics 2014. 1 1. Demographic and socioeconomic statistics The health of the people: what works Population a Member State Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe African Region Global Total (000s) Median age (years) Aged under 15 (%) Aged over 60 (%) 2012 2012 2012 2012 38 482 20 821 10 051 2 004 16 460 9 850 494 21 700 4 525 12 448 718 4 337 19 840 65 705 736 6 131 91 729 1 633 1 791 25 366 11 451 1 664 43 178 2 052 4 190 22 294 15 906 14 854 3 796 1 240 25 203 2 259 17 157 168 834 11 458 188 13 726 92 5 979 52 386 10 838 1 231 6 643 36 346 47 783 14 075 13 724 27 16 18 22 17 18 24 18 20 16 19 19 19 17 20 18 18 21 17 20 19 19 19 21 18 18 17 16 20 34 17 21 15 18 18 19 18 32 19 26 19 20 19 16 17 17 19 27 48 43 34 46 44 30 43 40 49 42 42 41 45 39 43 43 38 46 39 42 42 42 37 43 43 45 47 40 20 45 37 50 44 44 42 44 22 42 30 42 38 42 49 45 47 40 892 529 7 044 272 19 30 43 26 Endnotes appear after the summary tables. 2 Civil registration coverage (%) Living in Annual growth rate urban areas (%) (%) Births b Crude birth rate a (per 1000 population) Causes of death c 2002–2012 2012 2006–2012 2012 7 4 5 6 4 4 7 5 6 4 5 5 5 5 5 4 5 7 4 5 5 5 4 6 5 4 5 4 5 13 5 5 4 4 4 5 5 10 4 8 5 5 4 4 5 4 6 1.7 3.4 3 1 2.9 3.4 0.7 2.6 1.8 3.3 2.5 2.8 1.7 2.8 2.9 3.6 2.7 2.4 3.2 2.5 2.4 2.2 2.7 0.8 3.1 2.9 2.9 3.1 2.8 0.3 2.7 1.4 3.7 2.7 2.4 2.6 2.8 1.1 2.9 1.3 4.1 1.3 2.6 3.4 2.9 2.8 0.8 74 60 46 62 27 11 63 53 39 22 28 64 52 35 40 22 17 87 58 53 36 45 24 28 49 33 16 36 42 42 31 39 18 50 19 63 43 54 40 62 18 21 38 16 27 40 39 99 … 80 72 77 75 91 61 61 16 … 91 65 28 … … … 90 53 63 … 24 60 45 4j 80 … 81 59 … 48 78 j 32 42 63 75 75 … 78 95 j 35 50 78 30 16 14 49 … … … … … … … … … … … … … … … … … … … … … … … … … … … … … 100 … … … … … … … 100 … 92 … … … … … … … 24.6 44.8 36.9 23.8 41.4 45 20.4 37.7 34.5 46.4 35.9 38 36.7 43.2 35.8 37.4 33.5 32.2 43 31.3 37.3 37.9 35.5 27.6 36 34.9 40.1 47.4 34.5 11.5 39.4 26.4 49.8 41.5 35.8 34.7 38.1 17.1 37.1 21.1 36.5 30.2 36.8 43.7 39.7 43 31.6 5 11 2.6 1.2 39 53 … … … … 37.6 19.6 Statistical annex MDG 5 Crude death rate c (per 1000 population) Total fertility rate a (per woman) 2012 2012 MDG 2 MDG 1 Adolescent fertility rate d (per 1000 girls aged 15–19 years) Literacy rate among adults aged ≥15 years e (%) Net primary school enrolment rate e (%) 2006–2011 2006–2012 2006–2012 Male Female Gross national income per capita f (PPP int. $) 2012 MDG 8 Population Cellular phone living on <$1 subscribers h (PPP int. $) (per 100 a day g population) (%) 2006–2012 Member State 2012 5.7 14.4 9.7 8.1 9.8 11.5 5.2 11 14.4 14 8.3 10.4 12.7 14 11.9 6.5 7.5 9.2 8.4 8.3 10.3 12.2 8.6 14.1 8.2 7.1 9.5 11.5 7.9 7.3 12.4 6.3 10.5 12.3 6.8 6.6 7.2 6.7 17.1 11.6 11.6 11.7 9.8 9.7 8.4 10.4 10.1 2.8 6 4.9 2.7 5.7 6.1 2.3 4.9 4.5 6.4 4.8 5 4.9 6 4.9 4.8 4.6 4.1 5.8 3.9 5 5 4.5 3.1 4.9 4.5 5.5 6.9 4.7 1.5 5.3 3.1 7.6 6 4.6 4.1 5 2.2 4.8 2.4 5 3.4 4.7 6 5.3 5.7 3.6 4 … 94 51 130 65 … 127 229 203 … 147 128 135 … … 79 114 118 70 146 … 106 92 177 147 157 … … 31 167 … 206 113 41 110 96 78 122 54 … 89 88 146 128 … 115 73 70 29 l 85 29 87 85 71 57 35 76 … 57 61 94 69 39 89 51 71 25 55 72 l 76 l 43 l 64 l 61 l 33 59 89 51 76 l … 51 l 66 l 70 l 50 92 i 43 93 … 88 60 73 68 l 61 l 84 l 98 97 100 83 k 68 94 99 97 81 72 86 88 67 … 62 36 … … 71 84 k 81 73 82 k 80 42 … 90 78 68 98 89 87 69 61 k 97 98 77 92 … 90 k 48 k 84 98 90 98 95 k … 96 74 88 85 k 65 94 96 86 64 56 80 96 56 … 62 32 … … 76 81 k 70 69 83 k 84 40 … 97 68 73 98 84 90 58 56 k 100 100 82 95 … 91 k 34 k 86 87 92 98 96 k … 8 360 5 400 1 550 16 060 1 490 550 4 930 2 270 1 080 1 620 1 210 3 450 1 920 390 18 570 550 1 110 14 090 1 830 1 910 970 1 100 1 730 2 170 580 930 730 1 140 2 480 15 060 1 000 7 240 760 2 450 1 320 1 810 1 880 25 740 1 340 11 010 … 4 760 900 1 120 1 560 1 590 … … 43.4 … … 44.6 81.3 … 9.6 62.8 … … 54.1 23.8 87.7 … … 30.7 4.8 … 28.6 43.3 … 43.4 … 83.8 81.3 61.6 50.4 23.4 … 59.6 … 43.6 68 63.2 … 29.6 <2.0 51.7 13.8 … 40.6 28.2 38 67.9 74.5 … 98 47 84 154 61 23 86 60 25 35 40 99 91 31 68 5 22 179 85 101 42 63 71 75 57 39 29 98 106 120 36 95 31 67 50 65 84 148 37 131 21 65 50 45 57 75 92 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 10.4 7.9 5 2.5 114 49 60 84 81 92 77 90 2 594 12 018 51.5 21.5 61 89 African Region Global 3 The health of the people: what works Life expectancy at birth a (years) 2. Life expectancy and mortality Member State Both sexes Male Female Both sexes Male Female 1990 2012 1990 2012 1990 2012 1990 2012 1990 2012 1990 2012 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 68 43 53 65 50 49 66 54 48 45 56 56 51 49 48 48 45 61 52 57 47 49 60 61 42 51 45 46 58 70 43 63 43 46 48 61 57 69 38 62 42 61 55 47 51 43 62 72 51 59 62 58 56 74 56 51 51 62 59 53 52 55 63 64 63 61 62 58 54 61 50 62 64 59 57 63 74 53 67 59 54 65 67 64 74 46 59 55 54 58 57 61 57 58 66 41 51 65 48 48 63 53 46 43 54 55 50 48 46 46 42 60 50 55 46 47 58 59 39 50 43 46 57 66 41 62 43 45 46 59 56 64 38 59 41 62 54 44 49 40 60 70 50 57 61 57 54 71 55 50 50 60 57 52 50 54 61 62 62 59 61 57 53 59 49 60 62 58 57 61 70 52 64 59 53 63 65 63 69 45 56 54 52 57 56 59 55 56 69 45 56 66 51 51 68 56 50 47 58 58 54 51 49 50 48 63 53 58 48 52 62 62 46 53 46 46 60 74 45 64 43 47 50 63 59 75 38 66 44 61 57 49 52 47 64 73 52 60 63 59 57 78 57 52 52 63 60 54 53 57 66 65 64 63 64 59 56 62 52 63 65 60 57 65 78 54 69 59 55 66 69 66 78 46 62 56 55 59 58 63 58 60 17 14 15 17 15 15 17 16 15 14 15 16 16 15 15 12 15 17 16 16 15 14 17 17 14 15 15 14 16 17 14 16 15 15 15 17 16 17 11 15 14 16 16 15 16 15 18 18 16 16 18 15 16 20 16 16 15 16 17 16 15 16 15 18 18 17 17 16 15 18 16 16 17 16 15 16 20 16 18 15 16 18 18 16 20 13 16 16 17 17 16 18 17 18 16 13 14 18 14 14 16 15 14 13 14 16 15 14 14 11 14 17 15 16 15 14 16 16 13 15 14 14 15 15 14 16 14 14 14 17 15 14 11 13 13 16 16 14 15 14 17 17 15 15 18 15 15 17 16 15 14 15 17 15 15 16 13 17 18 16 17 16 14 17 15 15 16 16 15 16 18 16 18 15 15 17 17 15 17 12 14 16 17 16 16 17 16 17 18 14 16 17 15 16 18 16 15 15 16 17 17 16 15 13 15 18 16 17 16 15 18 17 15 16 15 14 16 19 15 16 15 15 15 18 16 21 11 17 14 15 17 16 16 16 18 19 16 16 18 15 17 22 17 16 15 17 18 16 16 17 17 19 19 17 18 17 15 18 17 17 17 17 16 17 22 17 19 16 16 19 19 17 23 13 18 17 17 17 17 18 18 19 African Region Global 50 64 58 70 48 62 56 68 52 67 59 73 15 18 17 20 14 17 16 18 16 20 17 21 Endnotes appear after the summary tables. 4 Life expectancy at age 60 a (years) Statistical annex MDG 4 Healthy life expectancy at birth a (years) Both sexes Neonatal mortality rate b (per 1000 live births) Infant mortality rate b (probability of dying by age 1 per 1000 live births) Both sexes Under-five mortality rate b (probability of dying by age 5 per 1000 live births) Both sexes Adult mortality rate a (probability of dying between 15 and 60 years of age per 1000 population) Both sexes Male Member State Female 2012 1990 2012 1990 2000 2012 1990 2000 2012 1990 2012 1990 2012 62 44 50 53 50 48 64 48 43 44 53 50 46 44 47 54 55 54 53 54 49 47 53 43 52 55 50 48 53 65 45 57 50 46 55 57 55 67 39 51 48 46 50 49 52 49 49 23 52 41 25 40 46 21 35 47 47 41 33 48 47 47 35 54 33 46 40 54 58 33 45 51 40 50 59 43 16 54 29 48 52 38 31 41 10 59 21 57 29 41 39 43 44 31 12 45 28 29 28 36 10 28 41 40 31 32 40 44 34 18 29 25 28 28 34 46 27 45 27 22 24 42 34 9 30 18 28 39 21 20 24 8 50 15 36 30 33 23 21 29 39 42 126 109 38 102 100 47 84 113 114 87 65 104 112 123 92 121 60 80 80 142 122 64 68 165 97 143 130 82 20 155 49 137 126 92 67 71 14 153 47 149 54 89 107 101 114 50 30 121 91 55 96 92 31 92 109 105 71 75 99 112 99 58 90 56 63 66 104 105 68 80 120 69 103 116 75 16 112 48 101 112 108 57 70 12 143 51 109 80 77 89 81 99 61 17 100 59 41 66 67 19 61 91 89 58 62 76 100 72 37 47 42 49 49 65 81 49 74 56 41 46 80 65 13 63 28 63 78 39 38 45 11 117 33 67 56 62 45 38 56 56 50 213 181 48 202 164 62 135 171 209 124 100 152 171 182 150 204 92 170 128 241 206 98 85 248 159 244 253 128 23 233 73 326 213 151 104 142 17 257 61 251 71 143 178 166 192 74 35 203 147 85 186 150 38 150 164 189 99 118 145 171 143 89 146 86 116 103 171 174 110 114 176 109 174 220 111 19 166 73 227 188 182 87 139 14 234 74 181 121 122 147 132 169 102 20 164 90 53 102 104 22 95 129 150 78 96 108 146 100 52 68 62 73 72 101 129 73 100 75 58 71 128 84 15 90 39 114 124 55 53 60 13 182 45 104 80 96 69 54 89 90 199 505 318 243 371 417 240 340 447 501 347 379 412 401 411 534 478 267 348 299 355 365 287 297 544 370 467 348 270 264 459 268 317 408 487 264 282 318 525 344 448 253 304 503 388 634 308 165 376 284 370 301 370 149 371 445 413 283 325 409 382 379 313 250 285 296 263 306 354 307 560 282 263 376 282 235 204 466 293 257 371 253 222 246 217 444 463 373 494 318 389 342 398 390 152 409 246 242 313 356 167 287 376 401 283 325 351 345 353 447 366 221 300 260 307 286 228 247 376 320 407 340 223 121 384 230 295 364 406 210 220 127 512 219 391 288 259 418 328 452 255 122 336 240 327 259 313 70 349 430 385 236 284 396 323 336 245 212 273 244 227 277 307 261 503 246 213 330 277 188 96 453 204 246 346 212 169 194 101 426 350 349 411 293 360 277 353 313 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 50 62 44 33 32 21 105 63 94 53 63 35 173 90 154 75 95 48 395 233 343 187 326 161 298 124 African Region Global 5 The health of the people: what works 2012 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe African Region Global 2012 HIV Diarrhoea Measles Malaria 2000 2012 2000 2012 2000 2012 2000 2012 2000 2012 20 149 31 3 66 43 0 74 19 82 2 15 75 391 3 12 205 3 5 56 42 8 108 6 11 44 43 82 11 0 84 2 90 827 24 0 30 0 39 49 40 3 22 103 98 50 39 0 1 1 46 2 4 6 4 6 3 0 6 6 1 3 2 4 7 1 3 1 2 13 34 1 1 13 1 1 0 5 29 0 2 3 2 0 … 0 36 2 35 4 7 10 14 45 1 1 1 5 1 1 4 3 3 2 1 3 2 1 7 1 2 2 1 1 2 3 4 19 1 1 12 1 0 0 6 9 0 3 1 1 1 … 0 17 3 15 1 7 6 6 9 7 19 12 5 13 16 11 14 10 14 12 10 10 12 11 12 16 8 11 8 11 11 13 8 11 15 13 14 13 2 12 8 16 11 19 14 11 … 13 9 18 10 10 12 12 12 6 4 15 10 7 11 13 5 12 9 13 9 8 10 12 8 10 10 7 7 7 8 10 10 7 8 10 8 12 10 1 9 6 12 10 10 9 7 … 14 7 11 9 9 9 8 9 9 6 1 7 8 5 5 2 5 10 5 0 5 4 11 5 24 5 3 4 10 15 8 1 1 17 8 0 3 5 0 4 1 5 15 1 0 5 … 12 1 3 0 6 8 2 5 0 1 1 1 1 1 0 0 1 1 0 0 0 0 4 4 6 2 1 0 1 2 1 0 1 1 1 1 1 1 0 0 3 0 1 1 1 1 … 6 1 2 0 1 0 0 1 1 0 15 26 1 29 8 0 19 23 24 15 22 22 19 24 0 5 19 23 21 24 23 5 0 23 5 20 25 9 0 25 3 27 23 6 9 24 … 25 0 7 0 24 18 19 19 2 0 13 21 0 23 5 0 12 25 19 15 25 16 16 15 0 3 19 20 19 27 18 4 0 21 7 15 14 10 0 18 0 19 20 4 8 17 … 14 0 6 0 18 13 10 16 1 3 070 6 554 5 2 3 2 13 13 10 9 8 5 1 2 18 8 15 7 710 768 761 612 784 729 482 675 551 713 695 632 794 724 729 672 476 505 630 670 681 765 515 672 657 649 655 866 555 577 594 580 649 674 585 … 558 … 964 711 623 702 679 664 570 587 599 54 19 635 4 810 12 406 138 102 199 75 280 17 031 98 53 328 35 559 12 712 88 39 743 26 187 9 111 119 62 658 42 924 13 422 147 74 914 51 897 14 209 54 15 736 5 127 8 695 106 66 447 45 696 14 488 108 86 460 69 308 10 575 114 94 968 75 598 12 700 132 47 196 29 959 11 603 89 62 710 45 395 11 739 124 78 319 54 054 16 884 137 94 624 70 873 14 227 134 71 724 48 783 15 054 119 36 628 22 640 9 469 94 42 966 29 697 8 571 77 44 352 30 028 10 127 96 53 070 35 805 11 970 76 45 576 28 629 12 863 96 64 439 45 952 12 912 112 75 954 56 025 13 835 101 51 435 37 031 9 133 142 76 738 57 102 11 697 83 47 041 32 485 10 525 89 39 785 24 877 10 233 98 54 730 41 453 9 228 120 76 206 55 170 14 432 83 45 160 31 786 9 373 44 21 106 2 399 16 472 175 73 589 53 997 11 531 76 29 801 18 018 8 027 98 70 633 54 270 10 726 146 81 624 59 843 13 237 106 40 122 24 964 9 517 … … … … 89 39 510 26 368 9 505 … … … … 150 113 198 82 802 21 114 104 50 128 30 989 14 121 143 70 179 50 404 12 108 119 66 341 48 011 11 412 93 61 629 43 673 12 507 167 60 022 41 005 10 918 129 48 220 32 565 9 699 156 66 252 49 853 9 379 82 57 699 42 568 9 782 2 418 20 9 887 133 5 057 43 4 444 4 6 312 96 8 809 42 1 914 0 6 263 97 6 577 24 6 670 73 5 634 2 5 576 14 7 382 87 9 524 352 7 887 3 4 519 15 4 697 412 4 197 3 5 295 6 4 084 65 5 574 68 6 094 9 5 271 128 7 939 7 4 030 23 4 675 71 4 049 81 6 603 102 4 001 11 2 235 0 8 061 122 3 755 4 5 637 121 8 544 1 035 5 642 79 … 0 3 637 53 … 0 9 282 43 5 017 74 7 667 49 6 918 4 5 449 22 8 098 167 5 956 177 7 020 76 5 349 39 683 178 652 539 116 73 6 480 3 654 63 153 44 628 12 045 28 311 11 315 13 343 Distribution of causes of death among children aged < 5 years a,b (%) Injuries Noncommunicable Communicable MDG 4 Number of deaths among children aged < 5 years a (000s) 98 873 577 555 648 705 142 769 1 212 1 071 495 667 861 921 757 506 559 589 590 476 680 870 657 1 110 609 430 778 588 619 62 998 357 740 866 402 … 588 … 1 327 612 827 884 682 697 584 764 711 Endnotes appear after the summary tables. 6 Years of life lost a (per 100 000 population) All causes Injuries Communicable Age-standardized mortality rates by cause a (per 100 000 population) Noncommunicable 3. Cause-specific mortality and morbidity Mortality Member State 4 014 9 848 Statistical annex Mortality Distribution of causes of death among children aged < 5 years a,b (%) Acute respiratory infections Prematurity Intrapartumrelated complications Neonatal sepsis Congenital anomalies Member State Other diseases Injuries 2000 2012 2000 2012 2000 2012 2000 2012 2000 2012 2000 2012 2000 2012 15 18 13 7 14 19 19 15 12 14 16 12 12 14 13 17 19 12 12 11 12 13 17 11 12 19 14 14 17 4 13 13 15 12 21 19 13 … 13 12 19 13 12 14 14 13 9 12 17 15 13 15 19 14 17 14 17 15 12 15 16 15 19 18 12 13 13 13 14 18 12 14 18 13 16 16 10 14 13 18 16 18 16 13 … 17 16 20 15 15 15 15 15 15 23 9 9 10 8 10 17 10 10 8 16 13 12 11 12 8 10 18 11 11 8 11 10 12 9 11 8 10 17 40 9 12 6 8 7 14 12 … 9 11 11 10 12 9 8 7 10 20 11 12 24 11 12 19 11 12 11 15 14 13 12 13 9 13 17 13 14 11 11 13 16 11 12 12 13 18 27 12 20 10 12 12 13 15 … 9 14 14 14 12 12 11 11 17 11 7 7 7 6 8 9 7 8 7 10 10 10 8 9 9 10 9 11 11 8 8 10 11 7 9 7 6 9 10 8 10 6 8 10 10 8 … 6 7 7 10 9 7 10 8 9 13 9 10 14 9 11 8 11 10 8 13 10 12 9 11 12 15 12 13 13 12 12 14 14 13 13 11 10 11 5 11 13 7 11 13 13 13 … 9 10 10 12 12 11 14 12 14 6 3 5 4 3 4 4 3 3 2 6 4 6 3 4 5 4 5 6 6 4 4 5 6 3 5 4 3 5 4 5 5 2 3 5 6 5 … 3 3 3 5 5 4 5 4 5 8 5 6 8 5 7 5 6 5 3 8 6 8 5 6 7 8 7 8 8 6 7 7 8 7 7 7 6 8 7 6 7 5 5 7 7 8 … 5 4 6 7 7 6 8 6 8 11 2 2 3 2 2 12 3 2 2 3 3 3 2 2 3 2 5 4 4 2 3 3 3 2 2 2 2 3 22 2 4 2 2 2 5 3 … 2 4 2 3 3 2 2 2 3 20 5 4 9 4 4 19 5 3 3 5 5 5 3 4 8 5 8 7 7 3 4 6 4 5 6 5 3 6 29 4 10 3 3 7 10 7 … 4 6 4 6 5 5 7 4 6 15 21 13 6 15 19 16 16 13 18 16 12 12 16 14 15 21 11 13 11 13 15 16 11 13 19 15 17 16 12 14 11 18 13 21 17 14 … 15 14 21 12 12 15 14 14 8 14 19 15 14 16 20 23 18 14 19 15 12 15 17 14 19 18 12 13 13 13 15 18 13 14 18 13 18 16 13 14 13 19 16 18 16 13 … 18 18 19 16 15 16 15 15 15 6 4 3 2 3 5 4 4 3 3 4 3 3 3 3 5 5 3 4 3 3 3 5 3 3 5 3 3 4 7 3 4 3 3 5 5 3 … 3 4 4 3 3 4 3 3 2 8 5 5 5 5 7 3 6 4 5 5 4 5 5 4 8 6 5 5 5 4 4 7 4 5 7 5 5 5 7 5 6 6 4 8 7 5 … 4 7 5 6 5 6 6 5 5 14 17 16 15 9 13 12 17 8 11 11 11 4 6 6 7 2 5 4 7 15 16 17 17 3 5 5 6 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe African Region Global 7 The health of the people: what works 3. Cause-specific mortality and morbidity (contd.) Member State Mortality MDG 5 Maternal mortality ratio c (per 100 000 live births) MDG 6 Cause-specific mortality rate (per 100 000 population) HIV/AIDS d Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe African Region Global Endnotes appear after the summary tables. 8 1990 2000 2013 2001 160 1 400 600 360 770 1 300 230 720 1 200 1 700 630 670 740 1 000 1 600 1 700 1 400 380 710 760 1 100 930 490 720 1 200 740 1 100 1 100 630 70 1 300 320 1 000 1 200 1 400 410 530 … 2 300 150 1 800 550 660 780 910 580 520 120 1 100 490 390 580 1 000 84 740 1 200 1 500 480 610 670 1 100 790 670 990 330 580 570 950 840 570 680 1 100 550 750 860 480 28 870 270 850 950 1 000 300 480 … 2 200 150 1 200 520 580 650 770 610 680 89 460 340 170 400 740 53 590 880 980 350 410 720 730 290 380 420 240 430 380 650 560 400 490 640 440 510 550 320 73 480 130 630 560 320 210 320 … 1 100 140 730 310 450 360 410 280 470 ... 59 57 1 171 163 191 <44 176 ... 160 0 280 283 65 <187 66 148 187 <39 100 37 <77 412 858 67 29 743 74 <18 1.3 a 210 483 28 120 267 <71 13 ... 25 438 100 713 158 424 339 745 1 252 960 380 820 330 500 210 221 32 Malaria e 2012 Tuberculosis among HIV-negative people f 2012 2000 2012 ... 60 31 282 33 48 <20 159 ... 116 6.7 119 157 48 194 19 51 143 <56 46 44 136 133 755 40 28 287 33 <26 5.5 a 305 219 20 142 49 <53 14 ... 55 449 119 443 108 174 167 215 288 0 99 79 0.1 101 33 … 56 116 136 68 104 71 105 69 3.2 17 67 82 69 103 95 28 … 69 27 64 87 50 … 70 0.1 110 108 33 43 59 … 108 0.1 56 0.2 83 55 44 78 9.1 14 42 14 50 13 40 34 51 143 24 6.9 36 56 61 0 7.7 41 81 36 27 44 28 19 16 54 69 28 12 57 0.7 75 24 46 38 49 13 26 2 59 44 … 34 12 35 17 31 17 15 42 9.4 21 8.5 18 23 29 50 18 6.3 42 22 54 0 4.6 18 44 51 6.9 23 29 22 17 46 46 9 9 93 1 53 14 16 16 10 16 20 1.8 143 59 30 63 8.7 13 13 28 33 377 56 63 11 38 22 26 13 Statistical annex Morbidity Member State MDG 6 Incidence rate (per 100 000 population) HIV/AIDS d 2001 Malaria e 2012 2012 Prevalence (per 100 000 population) Tuberculosis g 2000 HIV/AIDS d 2012 Tuberculosis g 2001 2012 2000 2012 ... 133 104 1 518 70 82 ... 381 ... 266 ... 277 356 107 ... 45 185 468 122 144 ... 320 426 1 759 142 ... 956 106 ... ... 870 1 213 69 320 198 <353 47 ... 141 1 399 ... 1 618 353 374 381 984 1 063 ... 134 41 616 35 46 ... 206 ... 125 ... 108 149 52 ... <8 22 62 <56 31 ... 219 228 1 284 <12 ... 414 28 ... ... 467 458 6.6 153 68 <53 14 ... 51 700 ... 966 73 380 174 396 501 0.2 18 241 29 282 30 33 759 8 492 22 16 877 34 675 26 152 22 419 33 824 20 730 25 999 24 767 1 282 4 563 24 892 29 095 27 337 38 333 28 120 8 200 … 27 793 6 020 27 462 20 399 17 591 … 27 947 23 27 726 28 710 5 714 12 375 27 925 … 19 027 33 29 891 43 23 543 24 597 17 318 26 087 7 844 87 250 86 918 71 288 160 310 1 071 151 39 353 369 327 101 157 421 527 225 152 234 192 286 553 242 293 467 77 277 24 513 1 407 191 172 325 114 155 37 264 576 … 803 72 427 236 713 726 89 316 70 408 54 130 144 238 367 151 34 381 172 327 139 93 247 428 284 72 178 242 272 630 304 234 163 60 350 21 552 655 104 108 86 93 137 30 674 1 003 146 1 349 73 179 165 427 562 ... 894 866 16 694 1 502 1 842 285 2 955 ... 2 213 0.1 2 856 3 845 909 2 276 738 1 912 3 348 569 1 385 716 1 584 5 024 14 822 1 110 337 9 206 1 021 327 615 4 508 8 853 500 2 044 2 761 <705 264 ... 618 9 512 1 777 13 614 2 635 4 094 4 340 9 082 14 679 ... 1 195 712 16 850 696 909 161 2 767 ... 1 712 1 098 1 717 2 268 733 4 259 290 827 2 490 798 930 1 031 2 480 3 812 17 482 521 264 7 103 675 276 850 6 169 9 742 270 2 030 1 806 731 312 ... 965 11 589 1 419 17 291 1 929 4 262 3 082 7 861 9 969 148 421 134 720 108 408 311 504 1 495 252 64 455 513 611 130 194 429 898 373 257 429 290 273 387 482 609 365 117 536 46 701 1 429 396 326 417 159 273 57 537 568 … 573 114 380 234 524 389 152 474 110 343 82 199 237 319 520 221 62 530 228 576 164 152 224 563 490 92 274 312 299 424 495 442 140 92 794 39 553 688 166 161 114 159 219 39 1 304 857 257 907 104 175 176 388 433 377 56 176 33 18 579 3 752 310 148 255 122 3 203 494 2 774 511 397 263 303 169 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe African Region Global 9 The health of the people: what works Diphtheria b Human African trypanosomiasis c Japanese encephalitis b Leishmaniasis c Leprosy d Malaria e Measles b Meningitis f Number of reported cases Cholera a 4. Selected infectious diseases Member State 2012 2012 2012 2012 2012 2012 2012 2012 2013 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe … 1 215 625 … 143 214 … 363 21 … … 1 181 424 33 661 … … … … … 9 548 7 350 3 068 … … 219 … 187 219 … … 647 … 5 284 597 9 … 1 … 23 124 … … … 61 6 326 286 198 23 0 15 0 0 0 … 0 … 0 … … 1 … … 0 8 … … 0 0 0 0 … 0 0 1 … … 0 0 … 2 0 … 0 0 … 0 … … … 0 0 … 0 0 0 … 70 0 … 0 … … 7 381 197 … 39 9 5 983 2 … … 9 … 0 70 … 2 … … … 18 0 … … … … … 2 … … … … … … 317 … 0 91 4 6 9 0 … … … … … 0 … … … … 0 … … … … … … 0 … … 0 0 0 0 … … … … 0 … … 0 … … … … 0 … … … 0 … … 0 0 0 9 127 … … … … … … … … … … … 0 … … … 2 500 … … … … … 457 … … … … … … … … … … 0 … … … … … … 5 012 … … 87 … … … … 431 243 1 313 … … 502 152 … … … 1 030 3 607 4 … 3 776 30 33 … 438 … … … … 1 474 … 228 … … 758 … 464 3 805 41 2 224 … 236 15 1 801 … … 264 2 528 … … 887 1 496 834 1 151 038 308 6 089 101 2 151 076 8 751 313 315 451 012 590 786 49 840 117 640 2 168 215 6 263 607 15 169 42 178 3 876 745 137 695 271 038 8 774 516 1 220 574 50 381 5 788 381 … 1 407 455 359 420 3 659 565 2 171 739 165 834 … 1 813 984 3 163 3 525 112 2 087 068 483 470 12 550 366 912 … 1 537 322 6 846 1 125 039 626 697 374 10 338 093 2 441 750 4 695 400 276 963 18 4 458 288 7 7 362 49 0 609 141 120 1 260 137 72 029 1 190 194 4 347 2 0 1 613 6 0 … 179 43 2 11 341 35 0 145 86 272 6 447 75 0 46 0 678 32 1 952 0 238 2 027 1 668 896 0 African Region Global 994 94 … … 490 4 899 6 … … … … 410 230 599 20 847 232 733 079 77 435 194 89 052 106 722 226 Endnotes appear after the summary tables. 10 … … 833 … 2 917 … … 1 010 210 j 371 … … 255 9 339 k … … … … 248 l 454 480 … … … … … … 358 14 … … … 311 871 … … 379 … … … 259 m … 266 … … … … … … Statistical annex Pertussis b Poliomyelitis g Congenital rubella syndrome b Rubella b Neonatal tetanus b Total tetanus b Tuberculosis h Yellow fever b Member State Mumps b Number of reported cases 2012 2012 2013 2012 2012 2012 2012 2012 2012 0 … … … … … 40 … … … … 0 … … … 2 350 … … 0 … … 0 0 0 0 … … … … 11 … 0 0 … … … … 0 … … … 0 … … … … 0 104 1 259 0 0 0 0 0 … 124 … … 12 … 3 407 0 208 … … 0 … … 0 … 0 0 33 … … 30 0 … 2 0 11 628 0 0 … 0 … … … 0 32 … 0 0 0 0 0 0 0 0 0 0 8i 0 4i 0 0 0 0 0 0 9 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 1i 56 i 0 0 0 0 0 0 0 0 0 0 0 0 0 0 … 0 … … … 0 … … … … 0 … … 0 … … … 0 0 … 0 0 0 0 … … … 0 1 … … 0 … 5 … … 0 … … … 0 0 … … 0 63 420 65 41 163 677 11 18 147 11 … 0 22 298 1 860 … 18 795 2 39 272 55 23 … 68 39 110 56 19 … 9 428 42 77 239 172 … 44 0 … 2 298 20 23 33 2 027 55 134 20 0 6 4 0 1 1 0 23 65 225 … 2 9 1 252 0 0 40 2 0 0 8 0 2 0 12 9 1 10 0 0 … 3 3 110 0 0 14 0 23 1 48 0 20 149 0 0 6 0 543 7 0 1 1 2 23 74 225 … 2 9 1 296 0 19 … 2 0 456 … 0 2 0 12 490 1 108 0 0 110 3 75 112 0 0 118 0 … 1 … 0 20 1 019 … 0 6 … 120 687 839 16 556 249 92 461 … … 830 10 030 94 001 2 650 4 737 4 392 10 21 880 51 819 3 966 6 161 5 210 6 921 420 24 802 8 084 10 585 120 11 303 23 762 108 984 … 3 143 145 323 4 929 2 333 14 753 11 407 1 939 92 987 10 776 8 093 25 782 20 335 5 446 2 616 128 47 741 10 003 10 989 92 818 6 091 115 12 265 20 13 074 323 664 8 403 7 165 2 843 44 663 62 178 40 726 35 760 0 0 0 … 0 … 0 31 0 48 … 1 4 1 0 0 0 0 1 3 0 0 0 0 17 … … 0 0 0 … … 0 0 0 0 1 0 94 … 0 0 12 32 0 0 0 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 122 344 1 838 776 5 245 … African Region Global 11 5. Health service coverage The health of the people: what works Member State MDG 5 Unmet need ContraAntenatal care ceptive prevafor family coverage b a (%) planning a lence (%) (%) Births Postnatal care Births by visit within attended by skilled health caesarean two days of personnel b section b childbirth b (%) (%) (%) Immunization coverage among 1-year-olds d (%) Neonates protected at birth against neonatal tetanus c (%) MDG 4 At least At least 1 visit 4 visits 2006–2012 2006–2012 2006–2013 Measles 2006–2013 2006–2012 2006–2012 2012 DTP3 HepB3 Hib3 1990 2000 2012 2012 2012 2012 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe … … 27 … 25 32 … 24 … 28 … … … 24 … … 26 … 22 36 … 6 26 23 36 19 26 28 … … … 21 16 19 21 38 30 … 27 … … 13 37 34 25 27 15 61 18 13 53 16 22 … 23 19 5 … 45 18 18 … … 29 31 13 24 6 14 46 47 11 40 46 8 9 … 12 55 14 14 52 38 13 … 11 … 4 65 15 30 34 41 59 89 68 k 86 94 95 99 91 l 85 k 55 43 92 90 89 89 91 … 34 95 k 86 96 85 k 93 92 92 96 86 95 74 72 … 60 95 83 61 98 98 95 … 91 … 40 97 51 95 88 94 90 … 47 61 73 34 33 … 62 38 23 … 79 44 44 67 … 19 78 72 87 50 68 47 70 66 49 46 35 … … 51 70 15 57 35 72 50 … 75 … 17 77 55 48 43 60 65 95 49 k 84 99 k 67 60 99 64 k 40 17 82 90 57 80 68 … 10 89 k 57 67 45 k 43 44 62 61 44 71 58 57 100 m 19 81 29 38 k 69 81 51 99 k 61 k … 17 82 44 58 49 47 66 … … 4 … 2 4 … 4 5 2 … 6 3 7 … … 2 10 3 11 2 2 6 7 4 2 5 2 … 44 q 4 13 1 5 7 5 6 23 5 … <1 12 9 5 5 3 5 … … 66 … 72 30 … 37 … … … 64 70 80 44 … 7 59 … 68 41 p … 42 48 60 46 43 22 n … … … 65 12 n 38 18 37 68 … 58 … … 22 … 33 31 39 27 90 72 93 92 88 85 92 85 66 43 85 83 82 70 75 94 68 75 92 88 80 80 73 83 91 78 89 89 80 95 83 83 84 60 85 … 91 … 87 77 0 86 81 85 88 81 66 83 38 79 87 79 74 79 56 82 32 87 75 56 38 88 … 38 76 86 61 35 53 78 80 0 47 81 43 38 76 59 … 25 54 83 71 51 86 0 79 … 85 73 52 80 90 87 80 41 70 91 48 72 86 49 36 28 70 34 68 46 51 76 33 55 89 90 42 71 78 74 63 57 73 49 46 84 71 69 37 33 74 69 48 97 37 72 … 92 58 57 78 85 75 95 97 72 94 87 93 96 82 49 64 85 80 85 73 51 99 66 71 95 88 58 69 93 85 80 69 90 59 75 99 82 76 73 42 97 92 84 98 80 79 62 88 72 82 97 83 90 95 91 85 96 90 96 90 85 47 45 86 85 94 72 33 99 61 82 98 92 59 80 83 83 77 86 96 74 80 98 76 84 74 41 98 96 92 98 84 68 59 95 84 78 92 78 89 95 91 85 96 90 96 90 85 47 45 86 85 94 72 … 99 61 82 98 92 59 76 83 83 77 86 96 74 80 98 76 84 74 41 98 96 92 99 84 73 … 95 84 78 92 78 89 95 91 85 96 90 96 90 85 47 45 86 85 94 72 … 99 61 82 98 92 59 76 83 83 77 86 96 74 80 98 76 84 74 10 98 96 92 98 84 68 … 95 84 78 92 78 89 African Region Global 25 12 27 63 75 81 47 56 48 72 4 16 41 48 75 81 58 73 53 73 73 84 72 83 72 79 65 45 Endnotes appear after the summary tables. 12 Statistical annex Children aged Children aged < 5 years (%) 6–59 months who received MDG 6 vitamin A With With Sleeping With fever supplemen- With ARI under who tation e symptoms suspected diarrhoea taken to pneumonia receiving insecticidereceived (%) a health receiving ORT treated treatment facility e antibiotics e (ORS and/or with any nets f RHF) e antimalarial g 2006–2013 2006–2013 2006–2012 Pregnant women with HIV receiving antiretrovirals to prevent MTCT h (%) MDG 6 Smear-positive Case-detection rate for Antiretroviral all forms of tuberculosis i tuberculosis treatmentsuccess rate j therapy (%) coverage (%) among people eligible for treatment h (%) 2012 2012 2000 2012 2000 2011 Member State … … 49 … 63 81 … … 78 98 … 65 61 82 30 50 53 54 73 74 41 79 30 34 43 72 86 72 56 … 75 52 60 65 93 48 78 … 91 … … 68 88 57 61 63 66 53 … 31 … 56 55 … 30 22 26 … 52 38 40 54 45 27 68 68 41 37 52 56 67 51 42 70 30 45 … 50 72 53 35 50 75 50 … 74 … … 58 32 79 31 68 48 59 … 29 … 47 43 … 45 31 31 … 59 29 42 27 … 7 50 70 56 38 35 50 … 49 … … … 24 … 12 … 11 45 … 60 … … 58 … … 61 41 47 … 47 31 27 … 54 … 24 41 … 22 38 48 … 37 22 53 o 44 58 31 37 65 59 37 81 72 71 62 29 69 40 31 … 62 69 47 38 35 57 27 … 84 … … 81 31 o,r 48 59 67 63 … 26 … … 47 44 … 11 … … … 31 37 6 42 … 33 39 … 38 … … 46 … 26 45 39 70 … … 7 10 … 5 56 56 29 … 25 … … 1 35 32 25 28 91 … 28 38 … 35 17 … 23 34 43 28 25 18 39 … 13 26 26 30 53 28 51 23 … 57 20 33 32 20 … 30 20 19 45 11 8 8 … 62 … 51 2 34 65 54 34 2 … 17 40 >95 66 54 … 64 … 14 … 19 68 13 … 46 41 70 … 95 44 33 53 58 87 … 60 … … … 86 94 … 17 87 … … … 93 83 13 83 86 72 77 >95 82 … 42 67 >95 62 58 >95 45 … 40 … 39 49 31 … 73 61 62 55 58 50 37 73 54 43 1 69 52 35 36 45 90 46 32 87 44 62 … 33 80 8 82 46 64 61 79 79 67 46 45 58 28 33 … 11 … … 58 84 25 40 … 110 33 … 56 38 27 52 72 95 21 … 45 53 41 55 23 40 22 12 22 61 56 69 34 59 … 69 40 29 68 69 56 64 79 57 75 58 54 59 48 49 56 49 68 69 51 … 55 64 71 46 81 56 48 79 83 64 49 78 61 20 49 34 68 62 51 62 66 65 73 32 62 53 43 59 69 79 68 46 87 68 78 77 60 80 64 77 58 … 93 69 57 78 … 76 80 … … 50 68 … 80 … 80 70 73 … … 93 75 56 65 79 61 78 52 82 77 63 … … … 63 78 67 69 92 55 90 81 78 92 77 80 68 68 25 71 78 87 … 87 90 51 88 86 82 73 88 74 86 83 85 68 73 90 … 84 80 85 89 72 85 67 88 79 73 73 85 77 88 88 81 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 65 46 49 59 … … 44 44 25 … … … 64 62 63 61 39 42 59 67 71 69 82 87 African Region Global 13 6. Risk factors The health of the people: what works Member State MDG 7 Population using Population using improved sanitation a improved a drinking-water sources (%) (%) Population using solid fuels b (%) Preterm birth rate c (per 100 live births) Children aged < 5 years e (%) Infants exclusively breastfed for the first 6 months of life d (%) Wasted Stunted 14 1990 –1995 2006 –2012 Overweight 2006 –2012 1990 2000 2012 1990 2000 2012 2012 2010 2006–2012 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 94 42 57 92 44 69 … 51 59 40 87 … 76 43 … 43 13 … 76 54 52 36 43 78 … 29 42 28 30 99 34 67 34 46 60 … 60 96 37 81 … 39 48 42 55 49 79 89 46 66 95 60 72 83 62 62 45 92 69 78 44 51 54 29 84 83 71 63 52 52 79 61 38 62 45 40 99 41 79 42 55 66 78 66 96 47 87 … 52 53 56 54 53 80 84 54 76 97 82 75 89 74 68 51 … 75 80 46 … … 52 92 90 87 75 74 62 81 75 50 85 67 50 100 49 92 52 64 71 97 74 96 60 95 57 74 61 75 53 63 80 89 29 5 39 8 42 … 40 15 8 18 … 15 17 … 9 2 … … 7 8 … 25 … … 8 10 15 16 89 8 24 5 37 30 … 35 97 11 58 … 49 13 26 7 41 41 92 42 9 52 12 44 44 42 17 10 28 13 18 23 89 11 8 39 61 10 13 12 27 24 14 11 10 18 21 89 14 28 7 32 47 21 43 97 12 65 … 52 12 30 9 41 40 95 60 14 64 19 47 65 45 22 12 … 15 22 31 … … 24 41 60 14 19 20 30 30 17 14 10 22 27 91 21 32 9 28 64 34 52 97 13 74 9 57 11 34 12 43 40 <5 56 94 37 95 >95 31 78 >95 93 71 76 79 93 78 63 >95 21 >95 84 >95 >95 84 62 >95 >95 >95 >95 56 <5 >95 55 94 75 >95 71 56 <5 >95 13 >95 62 >95 >95 >95 83 70 7 13 11 15 11 11 11 13 13 13 17 17 14 12 17 12 10 16 14 15 14 11 12 12 14 14 18 12 15 13 16 14 9 12 10 11 10 12 10 8 … 14 13 14 11 13 17 7 … 33 … 25 69 … 20 34 3 … 21 12 37 … … 52 6 36 46 21 38 32 54 29 51 71 38 19 … 43 24 23 15 85 51 38 … 32 … … 44 62 63 50 61 31 … 8.2 16 7.2 10.9 6.1 … 5.8 7.4 15.6 11.1 5.9 7.1 8.5 … … 10.1 3.4 9.5 6.2 5.6 5.8 7 3.9 2.8 … 4.1 8.9 11.6 … 6.1 7.5 18 10.2 3 11.2 8.7 … 9.2 4.7 22.7 0.8 4.8 4.8 6.6 5.6 3.1 … 29.2 44.6 31.4 32.9 57.5 … 32.6 40.7 38.8 30.1 24.4 28 43.5 … … 44.2 17.5 23.4 22.7 35.8 32.2 35.2 39 41.8 49.2 47.8 27.8 22 … 43.1 29.6 43.9 36 44.3 31.6 15.5 … 44.9 23.9 31.1 31 29.8 33.7 34.8 45.8 32.3 9.2 … … … 29.6 … 11.8 18 23.3 … 16.2 … 20.9 30.7 … 36.9 43.3 … … 25.1 21.2 … 20.1 13.8 … 35.5 24.4 … 43.3 13 23.9 21.5 41 35.1 24.3 … 19 … 25.4 8 … … … 21.5 25.1 21.2 11.7 … 15.6 21.3 11.2 24.4 29.1 … 15.1 23.5 30.3 15.3 11.6 14.1 24.2 … … 29.2 6.5 17.4 13.4 16.3 18.1 16.4 13.5 14.9 … 13.8 18.9 19.5 … 15.6 17.5 36.4 24.4 11.7 14.4 14.4 … 21.1 8.7 27.6 5.8 16.5 14.1 13.6 14.9 10.1 … … 17.9 11.2 2.8 2.9 … 6.5 1.8 2.8 9.3 3.3 2.8 4.9 … … 1.8 7.7 1.9 1.4 3.1 3.2 5 7.3 4.2 … 9.2 4.7 1.2 … 7.9 4.6 2.4 3 7.1 11.6 0.7 … 10.3 … 6 10.7 1.6 3.8 5.5 8.4 5.8 African Region Global 50 76 57 82 66 90 27 47 29 56 33 64 78 41 12 11 35 37 9.8 7.8 39.9 24.7 34.3 24.9 24.6 15.1 6.4 6.7 Endnotes appear after the summary tables. 2006–2012 MDG 1 Underweight Statistical annex Prevalence of raised fasting blood glucose f (≥ 25 years) (%) Male Female Prevalence of raised blood pressure g (≥ 25 years) (%) Male 2008 Female Adults aged ≥20 years who are obese h (%) Male 2008 MDG 6 Prevalence Alcohol Prevalence of Population aged Prevalence of consumption of smoking current tobacco use condom use 15–24 years with any tobacco among adolescents by adults aged comprehensive among adults aged product among aged 13–15 years k 15–49 years correct adults ≥15 years i during higher-risk knowledge of (%) aged ≥15 HIV/AIDS m sex l (litres of years j (%) (%) pure alcohol per person (%) per year) Female 2008 Male Female 2010 2011 Male Female Male 2006–2012 Female Male Member State Female 2006–2010 2006–2010 9 8.2 n 6.7 8n 8.9 n 6.2 n 15.6 9.5 7.3 n 8.8 n 7.9 n 7.8 n 9.2 n 6.6 n 8.7 n 7.8 n 7.3 n 9.1 n 9.9 9.9 8.8 n 8.6 n 7.6 n 9n 8.4 n 8.1 n 6.4 9n 7.5 11.6 8n 8.6 n 7.8 n 7.9 6.7 n 9.3 n 9.3 n 13.7 9.2 n 11.9 … 9n 8.7 n 6.8 n 8.3 7.2 8.7 n 9.3 8.7 n 6.5 10 n 8.7 n 5.9 n 14.7 10.4 8n 8.7 n 7.6 n 8.5 n 9.7 n 7.8 n 8.7 n 7.3 n 7n 9.9 n 11.3 10.3 8.6 n 9.1 n 7.8 n 12 n 9.3 n 7n 6.2 9.5 n 8.3 9.9 8.2 n 9.6 n 8.3 n 12 6.1 n 10.3 n 10.6 n 13.2 10 n 11.7 … 12.2 n 9.1 n 6.5 n 8.5 7.5 9.9 n 33.9 39.6 n 38.1 39.1 36.7 n 42.2 n 47.7 35.6 39.1 n 35.5 40.8 n 40.3 41.6 38.5 43.5 n 32.2 33 40 39.7 32.7 38.4 n 37.6 n 37.1 36.4 n 38.5 n 40.6 44.5 30.5 38.4 n 40.6 n 46.3 43.7 50.3 38.6 43.6 n 46.3 37.9 n 43.2 41.9 39.9 … 40.5 n 38.8 n 42.9 n 36.2 41 36.9 33.2 33.8 n 34.1 37.9 35.2 n 39.5 n 38.4 29.8 34.5 n 31.3 36.5 n 36.1 35.7 33.3 35.8 n 28.1 28.3 33 34.2 31.6 36.8 n 35.3 n 33 35.9 n 35.7 n 37.5 39.4 31.3 33.9 n 34.5 n 41.4 38.1 41 41.2 40.2 n 42.4 34.4 n 31.9 40.5 34.9 … 36.4 n 35.3 n 39.6 n 33.9 37.9 36.4 10.7 3.8 n 3.5 3 1.7 2.8 n 6.3 7 2 2.4 3.5 2.8 3.9 0.7 7.9 n 1.3 0.9 8.4 2.3 4.4 4.3 2.6 n 2.5 3.1 3.1 1.8 2.6 2.4 4.3 12.9 2.6 4.3 1.5 5.1 4.9 6.4 3.2 15.1 3.6 23.2 … 6.1 3 4.3 4 1.2 2.8 24.3 10.2 n 9.5 22.8 3 3.7 n 15.3 15.1 5.3 3.8 5.3 7.5 9.7 3 14.8 n 2.3 1.6 21.5 14.4 11.7 5.1 8.1 n 6.8 26.6 7.7 1.5 6.2 6.8 23.3 23 7.8 16.8 3.7 9 4 15.4 12.5 33.7 10.1 42.8 … 37.1 6.1 4.9 6.8 7 13.8 1 7.5 2.1 8.4 6.8 9.3 6.9 8.4 3.8 4.4 0.2 3.9 6 3.6 6.6 1.1 4.2 10.9 3.4 4.8 0.7 4 4.3 6.5 4.7 1.8 2.5 1.1 0.1 3.6 2.3 10.8 0.3 10.1 9.8 7.1 0.6 5.6 8.7 11 … 5.7 2.3 9.8 7.7 4 5.7 28 … 21 36 … … 14 … … 20 25 9 16 16 … 13 … 19 32 14 23 … 26 … 18 … 23 28 29 39 … 30 9 10 … 8 16 31 48 28 … 16 14 16 … 24 25 2 … 3 7 … … 3 … … 4 2 3 9 5 … <1 … 3 3 7 2 … <1 … 2 … 5 2 4 5 … 9 <1 2 … 3 <1 8 20 8 … 2 2 3 … 4 <1 … … … 27 … 21 15 … … 21 22 28 26 … 25 8 … … … 14 31 … 15 26 … 33 17 23 28 20 … 32 12 … 13 31 20 27 … 24 … 16 18 19 … 25 … … … … 21 … 17 12 … … 14 15 20 11 … 17 5 … … … 11 20 … 15 22 … 14 11 9 18 8 … 30 6 … 10 23 10 25 … 19 … 9 8 16 … 26 … … … 22 … 27 14 73 43 … … … 28 … 16 … 18 16 51 … 26 … … 37 52 22 7 25 12 … … 26 74 7 33 28 33 21 … 15 … … 56 … 13 24 28 33 … … 30 … 62 14 51 37 … … … 29 … 9 … 2 47 44 … 18 … … 32 39 14 8 27 8 … … 31 66 8 23 29 28 22 … 7 … … 55 … 16 27 33 48 … … 14 … 36 47 89 34 27 … … 22 … 21 … 34 34 36 … 34 … … 55 29 27 26 45 22 … … 52 53 16 33 46 43 31 … 28 … … 52 … 38 43 37 47 … … 8 … 31 45 90 29 17 … … 8 … 15 … 25 24 29 … 28 … … 47 39 21 23 42 18 … … 30 59 13 22 52 43 29 … 17 … … 52 … 32 48 34 52 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 8.3 9.8 9.2 9.2 38.1 29.2 35.5 24.8 5.3 10 11.1 14 6 6.2 22 36 7 8 … 20 … 10 … … … … 35 … 29 … African Region Global 15 7. Health systems The health of the people: what works Member State Density of health workforce (per 10 000 population) Physicians a Nursing and midwifery personnel a,b Dentistry personnel a,c Pharmaceutical personnel a,d 2006–2013 Infrastructures and technologies Psychiatrists e Hospitals f (per 100 000 population) Hospital beds g (per 10 000 population) Psychiatric beds e (per 10 000 population) 2006–2010 2013 2006–2012 2006–2010 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 12.1 1.7 0.6 3.4 0.5 … 3 0.8 0.5 0.4 … 1 1.4 … … … 0.3 … 1.1 1 … 0.7 1.8 … 0.1 1.6 0.2 0.8 1.3 … 0.4 3.7 0.2 4.1 0.6 … 0.6 … 0.2 7.8 … 1.7 0.5 … 0.1 0.7 0.6 19.5 16.6 7.7 28.4 5.7 … 4.5 4.4 2.6 1.9 … 8.2 4.8 … … … 2.5 … 8.7 9.3 … 5.9 7.9 … 2.7 … 3.4 4.3 6.7 … 4.1 27.8 1.4 16.1 6.9 … 4.2 … 1.7 49 … 16 2.7 … 2.4 7.8 12.5 3.3 … <0.05 j … <0.05 j … 0.1 j <0.05 j <0.05 … … … 0.1 j … … … … … 0.3 0.1 … 0.1 0.2 j … <0.05 j <0.05 j … 0.1 0.3 … … 0.4 j <0.05 j 0.2 j 0.1 … 0.1 j … <0.05 j 2 … 0.4 <0.05 … 0.1 0.2 j 0.1 j 2.4 … <0.05 j … 0.2 0.2 0.1 j <0.05 j <0.05 … … 0.2 0.2 j <0.05 j … … 0.3 … 0.5 0.7 … 0.1 1.6 … 0.8 … 0.2 j 0.1 j 0.4 … 0.6 j 1.8 <0.05 1.1 0.1 … 0.1 … 0.2 4.1 … 0.5 <0.05 j 0.3 <0.05 1.3 1.9 0.2 <0.05 <0.05 <0.05 <0.05 <0.05 0.1 <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 … <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 … <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 0.2 <0.05 <0.05 <0.05 <0.05 <0.05 0.1 <0.05 0.2 <0.05 <0.05 … <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 … … 0.4 k 1.3 k 0.3 0.5 k 1 0.8 0.5 0.7 0.7 k … 1.7 0.4 k … 0.4 0.2 3.5 0.7 k 1.4 0.4 56.4 1.5 … 0.4 k 0.5 0.4 k 0.5 k 1 1k … 1.9 0.5 … … … 0.2 k 1.1 k … 0.7 k … 0.8 0.6 k 0.4 … 0.5 0.5 African Region Global 2.6 14.1 12 29.2 0.5 2.7 0.9 4.3 <0.05 0.3 0.8 … Endnotes appear after the summary tables. 16 … … 5 18 4 19 21 13 10 … … … … … 21 7 63 63 11 9 3 … 14 … 8 2 13 1 … 34 7 … … … … 29 … 36 … … … 21 7 5 7 20 17 1.4 … 0.2 2.2 … … 0.9 0.1 0.1 0 0 … … … … … <0.05 0.8 0.6 0.7 0.1 … … 0.3 … 0.1 … 0.1 … 5.5 0.2 0.8 0.1 … 0.4 3.6 0.3 … 0.3 2.2 … 1.3 0.2 0.3 0.3 0.3 1 … 27 0.6 2.5 Statistical annex Infrastructures and technologies Computed tomography units f (per million population) 2013 Radiotherapy units f (per million population) 2013 … 0.4 0.3 1k 0.6 0.2 2 0.6 0 0.1n 1.4 … 0.7 0.1 … 0.3 0.4 3.6 1.1 0.2k 0k 0 0.2 … … 0.1 0.3 0.2k 1.5 6.4 … 4.8 0.2 … … … 0.4k 10.8k 0.3 1k … 2.4 0.7 0.5 0.1 0.2 0.4 0.4l <0.05k 0 0k 0 0 0 0.1 0 … 0 … 0 <0.05 … 0 <0.05 0.6 0n 0.1k 0k 0 <0.05 … … <0.05 0 0.1 0.3l 2.4 … 0.4 0 0.1l … … 0.1k … … 0.6k … 0 … 0.1 0.1k 0.1 0.4 0.4 … 0.1 1.8 Mammography units f (per million females aged 50 to 69 years) Essential medicines MDG 8 Median availability of selected Median consumer price ratio of selected generic medicines h (%) generic medicines i Public Private 2013 Public Member State Private 2001–2009 … 6.3 k 16.1 19.1 k 13.6 2.7 140.6 17.4 4.7 4.7 31.3 … 0 0.7 … 16.6 … 73.1 16.5 … 0k 0 6.8 k … … 6.2 0k 5.4 22.4 49.7 … 42.3 10.9 … … … 5.2 k 127.7 k … 7.8 k … 33.6 10.4 4.4 6.1 4.6 6.9 … … … … 87.1 … … 60 … 31.3 … 21.2 … 55.6 … … … … … 17.9 … … 37.7 … … … … 81 … 88.8 … … … 26.2 … 56.3 … … … … … … … 20 23.4 … … … … … … 72.1 … … 52.5 … 13.6 … 31.3 … 65.4 … … … … … 44.6 … … 72.4 … … … … 70 … 70 … … … 36.4 … 22.2 … … … 71.7 o … … … 80 47.9 … … … … … … 2.2 … … 2.2 … 3.9 … 6.5 … 2 … … … … … 2.4 … … 2 … … … … 1.8 … …m … … … 3.5 … 2.4 … … … … … … … …m 1.3 … … … … … … 2.9 … … 13.6 … 15.1 … 11.5 … 2.3 … … … … … 3.8 … … 3.3 … … … … 5.4 … 5.9 … … … 4.3 … 13.8 … … … 6.5 o … … … 2.6 2.7 … … Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 7.4 … … … … … … … … … African Region Global 17 The health of the people: what works Health expenditure ratios a 8. Health expenditure Member State Social security Total expenditure on General government Private expenditure General government External resources for expenditure on health as % of total on health expenditure on health as % of gross expenditure on health health as % of expenditure on health as % of total as % of total health as % of domestic product general government expenditure on health b expenditure on health b total government expenditure on health c expenditure 2000 2011 2000 2011 2000 2011 2000 2011 2000 2011 2000 2011 Algeria f Angola f Benin f Botswana f Burkina Faso Burundi f,g Cabo Verde h Cameroon f Central African Republic f Chad f,g Comoros f,g Congo Côte d'Ivoire f Democratic Republic of the Congo f Equatorial Guinea g,i Eritrea g,j Ethiopia f Gabon f Gambia f Ghana f Guinea f Guinea-Bissau f,g,k Kenya f Lesotho Liberia f,g Madagascar f Malawi f Mali f Mauritania Mauritius Mozambique f Namibia f Niger f Nigeria f Rwanda Sao Tome and Principe Senegal f Seychelles Sierra Leone f South Africa f South Sudan Swaziland Togo f Uganda f United Republic of Tanzania f Zambia f Zimbabwe 3.5 3.4 4.3 4.7 5.1 6.3 4.8 4.4 4.3 6.3 3.5 2.1 6.5 4.8 2.4 4.5 4.3 2.9 4.5 4.8 5.6 4.9 4.7 6.9 5.9 5 6.1 6.3 6 3.7 6.2 6.1 6.4 4.6 4.2 8.9 4.6 4.8 18.4 8.3 … 5.3 5.3 6.6 3.4 5.6 … 4.4 3.4 4.5 5.2 6.4 9 4 5.4 3.9 2.8 3.6 2.5 6.8 6.1 4.5 2.7 4.1 3.4 4.7 5.3 6 6.3 4.4 11.7 15.6 4.1 8.3 6.8 5.9 4.9 6.4 8.6 6.8 5.7 11 7.6 5 3.6 16.3 8.7 1.7 8.3 8 9.3 7.4 6.2 … 73.3 49.5 44.2 62.2 39.6 30.6 73.3 21 50.2 42.5 43.7 57.5 28.5 4.2 77.4 39.1 53.6 40.3 27.6 49.4 19.4 10.5 46.3 50.2 24.5 49.3 45.8 32.9 66.5 52 70 68.9 23.6 33.5 39.2 43.2 40.9 82.7 21.5 41.3 … 56.3 28.5 26.8 43.4 51.3 … 82 62.6 52.1 61.6 49.5 63.3 75.5 34.7 51.4 29.6 40.2 67.5 24.5 50.8 54.2 50.5 50 52.9 62.3 55.9 24.3 26.8 39.4 77.5 29.7 55.9 72.4 43.8 65.2 48.2 44 61.3 33.2 34 59.3 34.2 55.8 94.8 16.2 47.7 41.3 69.4 52.2 25 37.4 63.6 … 26.7 50.5 55.8 37.8 60.4 69.4 26.7 79 49.8 57.5 56.3 42.5 71.5 95.8 22.6 60.9 46.4 59.7 72.4 50.6 80.6 89.5 53.7 49.8 75.5 50.7 54.2 67.1 33.5 48 30 31.1 76.4 66.5 60.8 56.8 59.1 17.3 78.5 58.7 … 43.7 71.5 73.2 56.6 48.7 … 18 37.4 47.9 38.4 50.5 36.7 24.5 65.3 48.6 70.4 59.8 32.5 75.5 49.2 45.8 49.5 50 47.1 37.7 44.1 75.7 73.2 60.6 22.5 70.3 44.1 27.6 56.2 34.8 51.8 56 38.7 66.8 66 40.7 65.8 44.2 5.2 83.8 52.3 58.7 30.6 47.8 75 62.6 36.4 … 8.8 2.9 10 7.3 8.8 7.3 9.9 6.1 12.9 13.1 9.3 4.8 10 1.8 8.7 2.6 8.9 5.3 10 8 6.4 2.3 10.6 6.3 6.7 15.5 7.6 8.9 12.9 8.7 17 13.9 8.4 4.2 8.5 9 10.1 7.3 14.2 13.2 … 10.5 8.5 7.3 9.4 12.2 … 9 5.6 10.8 8 12.4 13.6 8.8 8.5 12.5 3.3 6.5 6.5 8.5 11.5 7 3.6 11.1 7.2 11.2 12.5 6.8 7.8 5.9 14.5 19.1 13.5 17.8 12.3 10.1 9.7 7.7 13.9 10.3 6.7 24 5.6 9.6 9.5 12.3 12.9 4 18.1 15.4 10.1 10.2 16.4 … 0.1 2.5 17 0.5 13.9 18.7 13 4.2 19.1 24.9 21.3 4.6 4.2 2.8 7.2 29.8 16.5 2.3 15.4 14.3 14 30 8 3 9.2 14.9 26.8 7.8 11.2 1.4 25.3 3.8 21.4 16.2 52 34.8 16.2 4.3 5.2 0.3 … 5.8 5.9 28.3 27.8 17.8 … 0 2.3 35.3 10 25.7 46.4 18 4.4 35.8 20.5 29.9 11.5 11.1 39.9 2.1 71.6 51.8 1 61.6 13.2 12.2 47.3 40 26.5 54 35.5 56.5 25.4 9.7 4.5 72.6 12 21.8 5.1 46.2 25 16.8 8.7 18.2 2.1 19.5 20 17.4 27.6 40.2 27.8 … 35.5 0 0.5 … 0.8 29.5 34.9 3.9 … … 0 0 2 … 0 0 0 14.2 0 0 1.1 5.4 10.9 0 0 … 0 1.5 8.7 … 0.3 1.8 3.3 0 6.4 0 7.4 5 0 3.3 … 0 11.7 0 0 0 … 31.6 0 0.4 … 0.2 12.4 25.2 2.6 … … 0 0 6.3 … 0 0 0 27.1 0 21.6 4.5 1.5 13.1 0 0 … 0 0.7 11.1 … 33.1 2.5 1.7 … 10.5 0 4 5.2 0 2.8 … 0 6.5 0 … 0 … African Region Global 5.6 8.2 6.2 9.1 43.5 56.3 48.3 58.8 56.5 43.7 51.7 41.1 8.7 13.6 9.7 15.2 6.5 0.3 11.8 0.4 8.2 58.8 8.0 60.6 Endnotes appear after the summary tables. 18 Statistical annex Health expenditure ratios a Per capita health expenditures a Member State Per capita total Private prepaid Per capita total Out-of-pocket Per capita government Per capita government plans as % of private expenditure on health expenditure on health e expenditure on health expenditure on health e expenditure as % of at average exchange private expenditure on expenditure on health at average exchange (PPP int. $) (PPP int. $) rate d (US$) rate d (US$) health 2000 2011 2000 2011 2000 2011 2000 2011 2000 2011 2000 2011 96.7 71.4 99.9 36.7 94.3 73 95.2 94.4 92.9 96.2 100 98.9 79.1 76.8 82.2 100 79.2 84.9 54.1 64.4 99.5 54.7 80.4 71.1 50.3 76.9 40.5 99.1 94.5 74.6 40.6 18.2 89.1 92.7 40.7 76.1 91.6 99.1 95.2 22.2 … 42.4 88.2 56.7 83.5 80.4 … 94.7 70.1 91.2 12.7 76.1 69.7 93.7 94.3 90.5 96.7 100 96 77 70 94.9 100 79.9 84.9 48.1 67.5 92.7 56.5 76.7 69 30 82 53.9 99.6 94.5 91.5 9 17.9 88.4 95.6 49.4 85.2 77.4 88.2 91.4 13.8 94.8 42.9 84.6 64.8 52.6 66.4 … 3.1 0 0.1 4.1 1 0.2 2.6 … 1.2 0.4 0 0.8 3.9 0 0 0 0.5 11.7 2.3 10.6 0 0 6.6 … … 5.3 8.1 0.1 0.6 8.3 … 77.3 3.4 5.1 0.9 0 7.1 … 0.6 72.4 … 18.9 4.7 0.1 4.5 0.9 … 5.1 0 7.2 79.9 2.2 1 3.1 … 1.8 0.2 0 3.6 3.5 2.4 0 0 1.5 11.7 3.1 6.3 0.7 0 9.3 … 0.7 8.9 16 0.4 0.6 1.7 … 61.2 2.3 3.1 … 0 21.1 5.4 0.2 81.1 3.7 19.2 4.2 0.2 1.5 3.6 … 60 22 15 152 12 7 59 26 11 10 13 22 42 14 57 7 5 118 29 13 19 16 19 29 11 12 9 16 24 146 15 126 10 17 9 46 22 371 28 246 … 75 14 16 10 18 … 233 178 34 404 39 21 153 64 19 25 31 85 84 15 1051 12 14 401 24 83 27 35 35 146 59 19 30 51 51 450 33 486 25 85 62 108 54 413 82 670 32 270 43 41 38 87 … 181 74 47 401 41 22 92 72 29 41 35 59 107 12 181 22 20 339 66 46 43 86 53 72 18 39 36 51 76 308 27 243 31 60 24 311 60 813 121 551 … 197 42 45 25 52 … 366 198 68 814 82 47 165 120 32 41 43 107 126 24 1327 15 43 516 87 99 62 72 73 219 92 39 74 85 107 767 61 612 42 143 138 143 94 877 192 930 35 436 75 123 108 99 … 44 11 7 95 5 2 43 5 5 4 6 13 12 <1 44 3 3 48 8 6 4 2 9 14 3 6 4 5 16 76 10 87 2 6 3 20 9 307 6 102 … 42 4 4 4 9 … 191 111 18 249 19 13 116 22 10 7 13 58 21 8 570 6 7 212 15 46 7 9 14 113 18 10 22 22 33 217 14 298 8 29 37 37 30 392 13 319 13 188 22 10 14 55 … 133 37 21 249 16 7 68 15 15 18 15 34 30 <1 140 8 11 136 18 23 8 9 25 36 4 19 16 17 51 160 19 168 7 20 9 134 25 672 26 228 … 111 12 12 11 27 … 300 124 36 502 41 30 125 42 16 12 17 72 31 12 719 8 21 273 54 55 15 19 29 169 27 22 53 37 70 370 27 375 14 49 82 49 53 832 31 443 14 303 39 31 40 63 … 56.2 49.5 56.6 49.7 34.6 38.6 31.7 38.2 35 485 99 1007 89 568 158 1053 15 280 49 613 39 320 76 619 Algeria f Angola f Benin f Botswana f Burkina Faso Burundi f,g Cabo Verde h Cameroon f Central African Republic f Chad f,g Comoros f,g Congo Côte d'Ivoire f Democratic Republic of the Congo f Equatorial Guinea g,i Eritrea g,j Ethiopia f Gabon f Gambia f Ghana f Guinea f Guinea-Bissau f,g,k Kenya f Lesotho Liberia f,g Madagascar f Malawi f Mali f Mauritania Mauritius Mozambique f Namibia f Niger f Nigeria f Rwanda Sao Tome and Principe Senegal f Seychelles Sierra Leone f South Africa f South Sudan Swaziland Togo f Uganda f United Republic of Tanzania f Zambia f Zimbabwe African Region Global 19 The health of the people: what works MICS 2010 MICS 2010 MICS 2006 DHS 2011 DHS 2010 DHS 2007 DHS 2010–2011 Endnotes appear after the summary tables. 20 4 … 11 14 … 3 2 … … … 6 2 … … 22 … … 11 … 3 12 28 7 18 37 5 4 … 6 32 3 3 37 15 8 … 7 … … 49 7 16 18 27 42 … … 88 … 47 37 … 86 … … … … … 62 … … 46 … … 94 … … 63 85 78 75 51 64 … … … 77 35 81 43 91 69 … 84 … … 85 … 59 59 62 73 … … 54 … 31 32 … 35 … … … … … 33 … … 12 … … 68 … … 35 68 62 37 44 31 … … … 51 12 22 33 53 45 … 72 … … 81 … 45 35 56 68 … … 85 … 57 46 … 82 … … … … … 56 … … 65 … … 88 … … 64 79 77 67 52 70 … … … 75 54 71 43 82 67 … 82 … … 80 … 56 65 63 68 … … 74 … 62 58 … 47 35 … … … 40 67 … … 5 … 43 43 … 27 37 54 32 39 69 12 39 … 46 73 8 28 67 75 49 … 59 … … 80 65 53 42 31 58 … … 86 … 94 88 … 87 83 … … … 84 94 … … 52 … 83 84 … 69 75 88 79 82 84 67 90 … 78 94 71 65 82 89 90 … 72 … … 89 94 89 83 83 86 … … 56 … 47 51 … 19 27 … … … 29 60 … … 2 … 28 24 … 19 20 35 26 22 63 9 21 … 37 60 5 8 61 74 30 … 44 … … 65 56 44 33 27 48 … … 97 … 93 81 … 97 89 … … … 95 96 … … 46 … 89 95 … 79 81 90 81 90 89 75 95 … 89 98 59 86 86 93 95 … 85 … … 94 96 88 90 91 91 … … 72 … 63 52 … 23 34 … … … 47 60 … … 5 … 51 36 … 28 19 40 36 23 62 22 45 … 41 50 13 12 57 73 58 … 57 … … 61 65 38 34 23 39 Secondary or higher … … 40 … 24 34 … 33 … … … … … 38 … … 8 … … 63 … … 36 58 55 35 41 23 … … … 64 9 16 34 58 32 … 68 … … 72 … 43 37 59 60 Educational level of woman None … … 71 … 45 39 … 77 … … … … … 57 … … 46 … … 88 … … 60 83 76 71 49 55 … … … 73 35 69 40 76 62 … 78 … … 80 … 57 55 59 66 Highest … … 55 … 31 33 … 50 … … … … … 39 … … 14 … … 72 … … 44 66 61 46 45 28 … … … 68 11 34 35 69 42 … 74 … … 76 … 46 39 61 64 Wealth quintile Lowest … … 16 … 44 34 … 25 29 … … … 22 10 … … 55 … … 19 … 26 52 55 18 34 49 23 19 … 33 63 29 19 52 32 26 … 23 … … 68 21 38 35 44 60 Rural Secondary or higher MICS 2008 DHS 2006–2007 DHS 2006 DHS 2008 DHS 2010 DHS 2008–2009 DHS 2010–2011 … None MICS 2006 DHS 2008–2009 DHS 2009 DHS 2007 DHS 2008–2009 DHS 2010 DHS 2006 MICS 2007 … Highest MICS 2005–2006 DHS 2008 … … 13 … 34 26 … 26 23 … … … 19 14 … … 48 … … 21 … 19 48 61 17 36 48 16 16 … 30 68 16 22 50 37 23 … 21 … … 68 16 39 38 48 64 Lowest DHS 2011 … … 2 … 7 15 … 2 1 … … … 4 1 … … 13 … … 12 … 1 17 29 3 18 35 3 1 … 5 30 2 3 39 31 4 … 5 … … 55 7 13 19 31 52 Educational level Place of of woman residence Urban MICS 2006 MICS 2010 … … 9 … 31 29 … 21 18 … … … 15 10 … … 50 … … 19 … 15 47 57 16 36 50 13 14 … 22 64 18 17 47 28 20 … 16 … … 69 14 39 34 42 60 Wealth quintile Rural DHS 2011 MICS 2006 … … 5 … 11 17 … 9 3 … … … 6 4 … … 23 … … 15 … 2 37 41 7 28 41 4 3 … 8 43 3 7 45 40 7 … 8 … … 61 9 23 25 28 56 Educational Place of level residence of woman Births attended by skilled health personnel a,c (%) Secondary or higher DHS 2010 DHS 2010 Highest DHS 2006 Lowest Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe Wealth quintile Urban Place of residence Antenatal care coverage: at least 4 visits a,b (%) Urban Contraceptive prevalence: modern methods a (%) None Source Rural 9. Health inequities MDG 5 Member State … … 98 … 97 91 … 93 88 … … … 87 88 … … 74 … 85 78 … 80 73 80 76 76 88 78 92 … 90 92 81 77 88 88 88 … 79 … … 88 92 81 86 73 75 Statistical annex MDG 4 … … 29 … 18 42 … 12 31 … … … 27 26 … … 29 … 15 14 … 37 25 28 25 43 35 22 20 … 26 12 40 24 26 19 15 … 33 … … 14 19 22 27 34 24 … … 47 … 37 62 … 46 47 … … … 43 50 … … 47 … 29 30 … 51 39 41 40 49 53 40 31 … 49 38 56 51 52 27 30 … 47 … … 40 34 40 45 45 38 g … … 27 … 11 31 … 19 36 … … … 31 35 … … 20 … 19 24 … 36 25 31 28 46 38 19 18 … 25 23 24 27 23 25 12 … 37 … … 25 22 25 22 37 30 … … 139 … 153 134 … 135 … … … … … … … … 121 … … 93 … … 90 123 147 85 137 222 … … … 80 220 175 104 86 90 … … … … … … 114 97 151 88 …… …… 132 145 …… 141 155 116 129 …… 121 153 …… …… …… …… …… …… …… …… 97 114 …… …… 75 90 …… …… 77 85 87 111 131 144 78 84 116 128 206 234 …… …… …… 58 75 213 229 166 190 96 103 55 67 82 101 …… …… …… …… …… …… 97 110 88 92 122 138 68 78 … … 115 … 104 79 … 93 … … … … … … … … 82 … … 75 … … 75 89 129 63 113 156 … … … 60 139 122 80 74 61 … … … … … … 76 95 131 77 … … 151 … 174 148 … 184 … … … … … … … … 136 … … 102 … … 97 107 137 106 131 233 … … … 90 204 217 115 86 118 … … … … … … 124 104 124 86 Secondary or higher … … 50 … 42 70 … 49 49 … … … 47 47 … … 49 … 37 33 … 49 44 45 43 48 56 44 34 … 51 38 57 52 54 37 35 … 47 … … 42 37 36 48 48 35 Educational level of mother Wealth quintile None … … 36 … 21 38 … 21 38 … … … 32 34 … … 31 … 19 20 … 41 27 29 29 43 40 27 24 … 35 24 35 31 28 30 20 … 41 … … 23 22 18 31 39 28 Member State Highest None … … 47 … 37 60 … 40 47 … … … 46 47 … … 46 … 32 32 … 51 37 40 42 51 48 42 32 … 47 31 58 45 46 28 31 … 46 … … 33 35 36 44 48 32 Urban Highest … … 40 … 32 53 … 29 40 … … … 37 40 … … 43 … 27 26 … 48 33 35 35 48 43 35 27 … 41 26 52 38 40 30 25 … 42 … … 28 27 29 38 42 27 Rural Lowest … … 46 … 37 63 … 35 46 … … … 44 47 … … 46 … 29 29 … 48 37 41 41 53 51 40 30 … 47 31 58 43 48 29 28 … 47 … … 34 32 37 45 48 35 Female Urban … … 91 … 92 93 … 84 63 … … … 87 73 … … 73 … 87 91 … 77 92 88 70 89 97 86 63 … 91 89 66 69 98 88 95 … 84 … … 90 79 79 96 90 78 Place of residence Male Rural … … 62 … 89 96 … 46 24 … … … 73 54 … … 32 … 86 85 … 61 82 …e 47 50 89 66 50 … 66 62 36 11 96 …e 81 … 74 … … 90 50 71 79 70 …e Sex Secondary or higher Female Highest … … 87 … 93 94 … 88 63 … … … 96 80 … … 64 … 89 93 … 78 90 88 72 93 94 78 60 … 88 94 63 77 99 91 88 … 80 … … 84 75 75 97 95 81 Male … … 50 … 83 94 … 45 22 … … … 60 48 … … 26 … 89 89 … 57 78 73 30 54 91 65 52 … 59 75 31 9 96 87 75 … 77 … … 90 58 75 84 78 67 Place of Wealth Educational level residence quintile of mother Sex Secondary or higher … … 77 … 92 91 … 80 55 … … … 89 77 … … 62 … 86 87 … 71 88 91 70 89 94 77 52 … 85 86 63 55 96 89 84 … 78 … … 89 70 76 97 90 76 Educational level of mother None … … 62 … 89 96 … 61 29 … … … 71 57 … … 33 … 86 91 … 62 86 82 41 71 93 65 58 … 69 82 35 27 97 86 82 … 75 … … 91 59 72 86 77 73 Wealth quintile Lowest Female … … 69 … 89 96 … 69 39 … … … 77 61 … … 39 … 88 89 … 64 90 84 52 73 94 65 56 … 73 83 41 36 97 87 81 … 75 … … 90 62 72 88 80 75 Urban Male … … 66 … 90 96 … 69 39 … … … 78 63 … … 35 … 84 89 … 65 83 84 49 73 93 71 56 … 73 84 39 36 97 88 84 … 77 … … 91 64 73 88 82 72 Rural Place of residence Sex Under-five mortality rate a,d (probability of dying by age 5 per 1000 live births) Lowest Children aged < 5 years who are stunted a (%) DTP3 immunization coverage among 1-year-olds a (%) … … 83 … 95 80 … 72 … … … … … … … … 84 … … 60 … … 69 81 115 48 105 123 … … … 30 154 88 75 28 54 … … … … … … 71 84 108 57 … … 143 … 155 138 … 175 … … … … … … … … 120 … … 102 … … 86 …f 149 97 136 223 … … … 78 221 209 123 …f 96 … … … … … … 133 97 146 …f … … 79 … 61 44 … 76 … … … … … … … … 36 … … 67 … … 58 89 116 54 94 102 … … … 55 91 107 63 46 37 … … … … … … 79 74 104 71 Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa South Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 21 The health of the people: what works Endnotes 1. Demographic and socioeconomic statistics a. World Population Prospects: the 2012 Revision. New York: Population Division, Department of Economic and Social Affairs, United Nations Secretariat; 2013. b. UNICEF Global Databases 2014. Based on DHS, MICS, other nationally representative surveys, censuses and vital registration systems, 2005–2012. First published in: Every Child’s Birth Right. Inequities and trends in birth registration. New York: UNICEF; 2013. The standard definition includes the percentage of children under 5 years of age who were registered at the moment of the survey. The numerator of this indicator includes children whose birth certificate was seen by the interviewer, or whose mother or carer said that the birth had been registered. c. Mortality data [online database]. Geneva: World Health Organization; 2014 (http://www.who.int/healthinfo/statistics/ mortality/en/). d. 2013 Update for the MDG Database: Adolescent Birth Rate. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2013 (http://www.un.org/en/development/ desa/population/publications/dataset/fertility/data/2013_Update_ MDG(5.4)_ABR.xls). WHO regional, income-group and global figures refer to 2010. If country-level data were not available for 2010, linear interpolation between the closest data points on both sides of the year was used. In other cases, the closest data point was used. e. Data centre. Montreal: UNESCO Institute for Statistics; February 2014 update (http://www.uis.unesco.org/Pages/DataCentre.aspx). WHO regional and income averages are estimated using different techniques based upon the type of data most recently available. For an explanation of methods see: http://www.uis.unesco.org/ Education/Pages/FAQ.aspx#theme3. f. PPP int. $ = Purchasing Power Parity at international dollar rate. World development indicators database [online database]. Washington, DC: World Bank; 2014 (http://data.worldbank.org/, accessed 10 January 2014). The income-group aggregates relate only to WHO Member States and therefore may differ from those reported in the World development indicators database. g. World development indicators database [online database]. Washington, DC: World Bank; 2014 (http://data.worldbank.org/, accessed 10 January 2014). These figures reflect the World Bank default poverty line. h. World telecommunication/ICT indicators database 2013 [online database]. Geneva: International Telecommunication Union; 18th Edition (http://www.itu.int/en/ITU-D/Statistics/Pages/stat/default. aspx, accessed 10 January 2014). i. Literacy rates are estimates for current decade based on survey or census data from previous decade. j. Data differ from the standard definition or refer to only part of a country. k. Figure estimated by UNESCO Institute for Statistics (UIS). 22 l. Data based on a reading test in a national household survey. A reading test typically yields lower literacy rates than the self- or household declaration used in most censuses and surveys. Care should be taken when analysing trends over time and in interpreting the results. 2. Life expectancy and mortality a. Mortality Data [online database]. Geneva: World Health Organization; 2014 (http://www.who.int/gho/mortality_burden_ disease/life_tables/en/index.html). b. Levels & Trends in Child Mortality. Report 2013. Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF; 2013 (http://www.childinfo.org/files/ Child_Mortality_Report_2013.pdf, accessed 14 March 2014). 3. Cause-specific mortality and morbidity a. Mortality Data [online database]. Geneva: World Health Organization; 2014 (http://www.who.int/gho/mortality_burden_ disease/life_tables/en/index.html). The column in Table 2 labelled “Communicable” shows the rates for communicable diseases, maternal causes, conditions arising during the neonatal period and nutritional deficiencies. Rates are age-standardized to WHO’s world standard population. Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, Inoue M. Age standardization of rates: a new WHO standard. Geneva: World Health Organization; 2001 (GPE Discussion Paper Series No. 31) (http://www.who.int/healthinfo/paper31. pdf, accessed 14 March 2014). WHO regional, income-group and global aggregates include country figures not shown. For regional groupings refer to WHO methods and data sources for global causes of death 2000-2012 (Global Health Estimates Technical Paper WHO/HIS/HSI/GHE/2014.7). b. Individual percentages may not add up to 100% due to rounding. c. WHO, UNICEF, UNFPA, United Nations Population Division and The World Bank. Trends in Maternal Mortality: 1990–2013. Geneva: World Health Organization; 2014. In preparation at the time of printing of this report. See report for the regional groupings used. d. Global Report. UNAIDS report on the global AIDS epidemic 2013. Geneva: UNAIDS; 2013 (http://www.unaids.org/en/media/ unaids/contentassets/documents/epidemiology/2013/gr2013/ UNAIDS_Global_Report_2013_en.pdf, accessed 14 March 2014). WHO regional, income-group and global aggregates may include country estimates not available for reporting. For uncertainty ranges see the report. e. World Malaria Report 2013. Geneva: World Health Organization; 2013 (http://www.who.int/malaria/publications/world_malaria_ report_2013/en/). f. These are classified as deaths from tuberculosis (A15–A19, B90) according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Geneva: World Health Organization; 2008 (http://apps.who.int/classifications/icd10/ browse/2010/en). Global Tuberculosis Report 2013. Geneva: World Health Organization; 2013 (http://www.who.int/tb/publications/ global_report/). WHO regional, income-group and global aggregates include territories. For uncertainty ranges see the full report. Statistical annex g. Data are for all forms of tuberculosis including tuberculosis in people with HIV infection. Global Tuberculosis Report 2013. Geneva: World Health Organization; 2013 (http://www.who.int/tb/ publications/global_report/). WHO regional, income-group and global aggregates include territories. For uncertainty ranges see the full report. b. 4. Selected infectious diseases a. Cholera, 2012. Weekly Epidemiological Record. 2013;88(31):321–36 (www.who.int/wer). b. Data provided by Member States through WHO/UNICEF Joint Reporting Form and WHO regional offices. Geneva: World Health Organization; 2013 (www.who.int/immunization_monitoring/ data/en/, October 2013 update). c. Neglected tropical diseases on the Global Health Observatory [online database]. Geneva: World Health Organization (http://apps. who.int/gho/data/node.main.A1629). d. Global leprosy: update on the 2012 situation. Weekly Epidemiological Record. 2013;88(35):365–80 (www.who.int/wer). e. World Malaria Report 2013. Annex 6A Reported malaria cases and deaths, 2012, . Geneva: World Health Organization; 2013 (http:// www.who.int/malaria/publications/world_malaria_report_2013/ en/). f. Suspected meningitis cases reported to WHO Global Alert and Response (GAR) in African countries under enhanced surveillance up to 29 December 2013. g. Data from World Health Organization, Polio Eradication Initiative, as of 15 January 2014. (Updated information can be found at: http:// www.who.int/immunization/monitoring_surveillance/data/en/). Confirmed polio cases refer to any circulating polioviruses from AFP (Wild poliovirus and circulating Vaccine Derived Poliovirus – cVDPV). Afghanistan, Nigeria and Pakistan are currently endemic countries. For non-endemic countries, cases are the result of importation. h. The number of new and relapsed tuberculosis cases diagnosed and treated in national tuberculosis control programmes and notified to WHO. Global Tuberculosis Report 2013. Geneva: World Health Organization; 2013 (www.who.int/tb/publications/global_ report/). WHO regional and global figures include territories. i. Figures include 4 cVDPV in Cameroon; 4 cVDPV in Chad; 1 cVDPV in Niger; 3 cVDPV in Nigeria. j. Number of cases reported up to 1 December 2013. k. Number of cases reported up to 24 November 2013. l. Number of cases reported up to 8 December 2013. m. Number of cases reported up to 13 October 2013. 5. Health service coverage a. 2013 Update for the MDG Database. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2013 (http://www.un.org/en/development/desa/population/ publications/dataset/fertility/). WHO regional and income-group aggregates are population-weighted averages of model-based country estimates for the reference year (2011) from Model-based Estimates and Projections of Family Planning Indicators: 2013 c. d. e. f. g. h. Revision (http://www.un.org/en/development/desa/population/ theme/family-planning/cp_model.shtml) WHO global database on maternal health indicators, 2014 update. Geneva: World Health Organization (http://www.who.int/gho). Antenatal care coverage only includes visits to a skilled provider (doctor, nurse and/or midwife). Contraceptive prevalence refers to any method. Births attended by skilled health personnel refer to doctor, nurse and/or midwife. Postnatal care was surveyed only for the mother. Proportion of neonates protected at birth against neonatal tetanus through maternal immunization with tetanus toxoid, based on a mathematical model taking into account the mother’s immunization in infancy, during pregnancy and in tetanus campaigns. WHO/UNICEF estimates of national immunization coverage. Geneva: World Health Organization; 2013 (http://www. who.int/immunization_monitoring/routine/immunization_ coverage/en/index4.html). Estimates based on data available up to July 2013. This indicator applies only to countries where tetanus is recommended for girls and women and therefore WHO regional, income-group and global aggregates relate only to these same Member States. Measles = measles-containing vaccine (MCV); DTP3 = 3 doses of diphtheria-tetanus pertussis vaccine; HepB3 = 3 doses of hepatitis B vaccine; Hib3 = 3 doses of Haemophilus influenzae type B vaccine. WHO/UNICEF estimates of national immunization coverage. Geneva: World Health Organization; 2013 (http://www. who.int/immunization_monitoring/routine/immunization_ coverage/en/index4.html). Estimates based on data available up to July 2013. For countries recommending the first dose of measles vaccine in children older than 12 months of age, the indicator is calculated as the proportion of children less than 24 months of age receiving one dose of measles-containing vaccine. Complete coverage estimates available online at the above website. Data compiled by WHO from Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), January 2014 (http://dhsprogram.com and http://www.unicef.org/statistics/ index_24302.html). ORT, oral rehydration therapy. Vitamin A supplementation data refer to the six months preceding the survey; data on children receiving oral rehydration salts (ORS) and/or recommended home fluids (RHF) refer to the two weeks preceding the survey; and data on children who were ill with a cough accompanied by rapid breathing (ARI symptoms) and who were taken to a health facility and/or received antibiotics refer to the two weeks preceding the survey. The WHO regional, incomegroup and global aggregates are population and prevalence weighted from available survey data and may differ from previously reported aggregates. World Malaria Report 2013. Annex 5: Household surveys, 2008– 2012. Geneva: World Health Organization; 2013 (http://www.who. int/malaria/publications/world_malaria_report_2013/en/). The State of the World’s Children. 2014 in Numbers: Every Child Counts. New York: UNICEF; 2014. See Table 3: Health (http://www. unicef.org/sowc2014/numbers/). MTCT, mother-to-child transmission. Global Aids response progress reporting 2013. Geneva: UNAIDS, 2013 (http://apps.who.int/ iris/bitstream/10665/78126/1/9789292530068_eng.pdf?ua=1, 23 The health of the people: what works i. j. k. l. m. n. o. p. q. r. accessed 14 March 2014). WHO regional and global aggregates include low- and middle-income countries only. Income groups were derived using the 2012 World Bank list of economies. For uncertainty ranges see the report or visit http://www.who.int/gho/ hiv/en/. The case-detection rate for all forms of tuberculosis is the estimated number of new and relapsed tuberculosis cases diagnosed and treated in national tuberculosis control programmes and notified to WHO, divided by WHO’s estimate of the number of incident tuberculosis cases for the same year, expressed as a percentage. Global Tuberculosis Report 2013. Geneva: World Health Organization; 2013 (http://www.who.int/tb/publications/global_ report/). For uncertainty ranges see the full report. WHO regional, income-group and global aggregates include territories. The treatment-success rate for new pulmonary smear-positive tuberculosis cases is the proportion of new smear-positive tuberculosis cases registered under a national tuberculosis control programme in a given year that successfully completed treatment – with or without bacteriological evidence of success (“cured” and “treatment completed” respectively). Global Tuberculosis Report 2013. Geneva: World Health Organization; 2013 (http://www.who. int/tb/publications/global_report/). WHO regional, income-group and global aggregates include territories. Definition of skilled personnel differs from standard definition. Skilled personnel not defined. Institutional births. Only women who gave birth outside of a health facility. ORT and/or RHF and/or increased fluids. No timing of postnatal visit was provided. The figure includes data from government and private hospitals. Continued feeding.) 6. Risk factors a. Progress on sanitation and drinking-water: 2014 Update. Joint Monitoring Programme for Water Supply and Sanitation. New York: UNICEF and Geneva: World Health Organization; 2014. In preparation. b. These estimates are modelled according to Bonjour S, Adair-Rohani H, Wolf J, Bruce NG, Mehta S, Prüss-Ustün A et al. Solid Fuel Use for Household Cooking: Country and Regional Estimates for 1980– 2010. Environ Health Perspect. 2013;121(7):784–90. doi:10.1289/ ehp.1205987 based on the WHO Household Energy database (available at: http://apps.who.int/ghodata/). This database contains compiled information on cooking-fuel use and cooking practices from about 716 nationally representative data sources, including all Demographic and Health Surveys (Macro International), Multiple Indicator Cluster Surveys (UNICEF), World Health Surveys (WHO) and Living Standards Measurement Studies (World Bank) as well as national censuses/surveys and national energy statistics. c. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 9 June 2012;379(9832):2162–72. doi:10.1016/S0140-6736(12)608204. See the paper for income groupings used. 24 d. WHO Global Data Bank on Infant and Young Child Feeding [online database]. Geneva: World Health Organization; 2014 (http://www. who.int/nutrition/databases/infantfeeding). e. WHO Global Database on Child Growth and Malnutrition [online database]. Geneva: World Health Organization; 2012 (http://www. who.int/nutgrowthdb/database/en, accessed 15 January 2014). 2012 Joint child malnutrition estimates – Levels and trends. New York: UNICEF, Geneva: WHO and Washington, DC: The World Bank (http://www.who.int/nutgrowthdb/estimates2012). For the reference period 1990–1995, figures refer to the first available survey year in the period. For the reference period 2006–2012, figures refer to the latest available survey year in the period. Wasted is calculated as the prevalence of low weight-for-height less than –2 standard deviations; underweight is the prevalence of weightfor-age less than –2 standard deviations; stunting is the prevalence of height-for-age less than –2 standard deviations; and overweight is the prevalence of weight-for-height above +2 standard deviations (using the WHO Child Growth Standards median). Global estimates refer to 2012 for wasted, stunting and overweight, and 1990 and 2012 for underweight. For more information, see the above databases. f. Percentage of population aged 25 years and over with fasting glucose ≥ 126 mg/dl (7.0 mmol/l) or on medication for raised blood glucose. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011 (http://www.who. int/nmh/publications/ncd_report2010). See Annex 4: Country estimates of NCD mortality and selected risk factors, 2008. Figures reported are age-standardized point estimates, and uncertainty ranges are available at the Global Health Observatory website (http://www.who.int/gho). Income-group aggregates are based on the 2008 World Bank list of economies. g. Percentage of population aged 25 years and over with raised blood pressure (systolic blood pressure ≥ 140 or diastolic blood pressure ≥ 90). Global Health Observatory. Geneva: World Health Organization; 2011. Figures reported are age-standardized point estimates, and uncertainty ranges are available at the Global Health Observatory website (http://www.who.int/gho). Incomegroup aggregates are based on the 2008 World Bank list of economies. h. Percentage of population aged 20 years and over with a body mass index ≥ 30.00 kg/m2. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011 (http:// www.who.int/nmh/publications/ncd_report2010). See Annex 4: Country estimates of NCD mortality and selected risk factors, 2008. Figures reported are age-standardized point estimates, and uncertainty ranges are available at the Global Health Observatory website (http://www.who.int/gho). Income-group aggregates are based on the 2008 World Bank list of economies. i. WHO Global Information System on Alcohol and Health [online database]. Geneva: World Health Organization; 2012 (http:// apps.who.int/gho/data/node.main.GISAH?showonly=GISAH). Definition of indicator: total (sum of three year average recorded and unrecorded) amount of alcohol consumed per adult (15+ years) over a calendar year, in litres of pure alcohol. Recorded alcohol consumption refers to official statistics (production, import, export, and sales or taxation data), while the unrecorded alcohol Statistical annex j. k. l. m. n. consumption refers to alcohol which is not taxed and is outside the usual system of governmental control. WHO Report on the Global Tobacco Epidemic, 2013. Geneva: World Health Organization; 2013 (http://www.who.int/tobacco/ global_report/2013/en/). See Technical Note II: Smoking prevalence in WHO Member States Definition of indicator: smoking at the time of the survey any form of tobacco, including cigarettes, cigars, pipes, bidis, etc. Note: these estimates cannot be used to form a time series with previously published estimates for past years because the quality and quantity of source data increase significantly each year. WHO report on the Global Tobacco Epidemic, 2013. Geneva: World Health Organization; 2013 (http://www.who.int/tobacco/ global_report/2013/en/). Global Youth Tobacco Survey data relate to most-recent survey for each country between 2006 and 2012 on tobacco use in any form in the past 30 days. Percentage of women and men aged 15–49 years who had more than one sexual partner in the past 12 months reporting the use of a condom during their last sexual intercourse. AIDSinfo [online database]. Geneva: UNAIDS (http://aidsinfoonline.org/devinfo/ libraries/aspx/Home.aspx, accessed 1 February 2014). Percentage of women and men aged 15–24 years who both correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission. AIDSinfo [online database]. Geneva: UNAIDS (http://aidsinfoonline.org/ devinfo/libraries/aspx/Home.aspx, accessed 1 February 2014). No country data available. Estimate modelled using data from other countries and specific country characteristics. 7. Health systems a. WHO Global Health Workforce Statistics (http://who.int/hrh/ statistics/hwfstats/en/). See this source for the latest updates, disaggregated health workforce statistics and metadata descriptors. Due to variability of data sources and national occupation titles, the figures provided may not always be comparable with regards to coverage and quality. In general, the denominator data for health workforce density (i.e. national population estimates) were obtained from the World Population Prospects database of the United Nations Population Division. In some cases the official report provided only workforce density indicators, from which estimates of the stock were calculated. b. Figures include nursing personnel and midwifery personnel, whenever available. In many countries, nurses trained with midwifery skills are counted and reported as nurses. This makes the distinction between nursing personnel and midwifery personnel difficult to draw. c. Figures include dentists, dental technicians/assistants and related occupations. Due to variability of data sources, the professionallevel and associate-level occupations may not always be distinguishable. d. Figures include pharmacists, pharmaceutical technicians/assistants and related occupations. Due to variability of data sources, the professional-level and associate-level occupations may not always be distinguishable. e. Mental health atlas 2011. Geneva: World Health Organization; 2011 (http://www.who.int/mental_health/publications/mental_health_ atlas_2011/). Income-group aggregates are based on the 2011 World Bank list of economies. f. Data are derived from the WHO Baseline country survey on medical devices 2013 conducted in 2013. Geneva: World Health Organization; 2013. Densities were computed by adding both public-sector and private-sector data unless otherwise noted. Hospitals include district, rural, provincial, specialized, teaching and research hospitals. Radiotherapy units include Linear Accelerators and Cobalt-60 units. g. PAHO/WHO Country Representative and National Authorities. Data provided by Member States on basic indicators via an online dataentry tool. Washington, DC; 2014. As of January 2014; European health for all database (HFA-DB). Copenhagen: WHO Regional Office for Europe; 2014 (http://data.euro.who.int/hfadb/); Western Pacific Country Health Information Profiles 2014 Revision. Manila: WHO Regional Office for the Western Pacific; 2014 (http://hiip. wpro.who.int/portal/default.aspx); Regional Health Observatory. Cairo: WHO Regional Office for the Eastern Mediterranean; 2014 (http://rho.emro.who.int/rhodata/); additional data compiled by the WHO Regional Office for Africa (as of January 2011) and the WHO Regional Office for South-East Asia (as of January 2014). Depending on the source and means of monitoring, data may not be exactly comparable across countries. See above sources for country-specific details. h. Surveys of medicine prices and availability using WHO/HAI standard methodology conducted between 2001 and 2012 (available at: http://www.haiweb.org/medicineprices/). In individual surveys, availability is reported as the percentage of medicine outlets in which a medicine was found on the day of data collection. As baskets of medicines differ by individual country, results are not exactly comparable across countries. Median availability is determined for the specific list of medicines in each survey, and does not account for alternate dosage forms or strengths of these products or for therapeutic alternatives. Public-sector data may be limited by the fact that the list of survey medicines may not correspond to national essential medicines lists (EMLs) where these exist, and some public-sector facilities may not be expected to stock all of the survey medicines. This has been addressed in the revised edition of the survey tool, which allows public-sector data to be analysed by EML status and level of care. i. Surveys of medicine prices and availability using WHO/HAI standard methodology conducted between 2001 and 2012 (available at: http://www.haiweb.org/medicineprices/). Consumer price ratio = ratio of median local unit price to the Management Sciences for Health (MSH) international reference price of selected generic medicines. Data are unadjusted for differences in the MSH reference price year used, exchange-rate fluctuations, national inflation rates, variations in purchasing power parities, levels of development or other factors. In each survey, median consumer price ratios are obtained for the basket of medicines surveyed and found in at least four medicine outlets. As baskets of medicines differ by individual country, results are not exactly comparable across countries. However, data on specific medicines are 25 The health of the people: what works j. k. l. m. n. o. publicly available at the above HAI website, and matched basket comparisons on a subset of medicines can be made. Separate figures were not reported for associate-level professionals and hence may not be comparable with previous publications. Refers to public sector only. Data derived from the Directory of Radiotherapy Centres (DIRAC) from the International Atomic Energy Agency (IAEA) – http:// www-naweb.iaea.org/nahu/dirac/query3.asp. This source does not specify if data are derived from the public or private sector, and was only taken into account if a country participating in the WHO Baseline country survey on medical devices did not provide such data. Medicines are provided free to patients in the public sector. Refers to the private sector only. Based on a survey of medicine prices and availability in Gauteng province, South Africa. 8. Health expenditure a. Health expenditure series. Geneva: World Health Organization (latest updates and more information on countries are available at: http://apps.who.int/nha/database/DataExplorerRegime.aspx). All the indicators refer to expenditures by financing agent except external resources which is a financing source. WHO regional, income-group and global aggregates are calculated using absolute amounts in national currency units converted to Purchasing Power Parity (PPP) equivalents unless otherwise noted. For health expenditure ratios, values smaller than 0.05% may appear as zero. For per capita indicators, when the value is less than 0.5 it is represented as < 1. In countries where the fiscal year begins in July, expenditure data have been allocated to the later calendar year (for example, 2011 data will cover the fiscal year 2010–11), unless otherwise stated for the country. Absolute values of expenditures are expressed in nominal terms (current prices). b. In some cases, the sum of general government and private expenditures on health may not add up to 100% because of rounding. c. Care needs to be taken in interpreting external resource figures. Most are taken from the OECD DAC/CRS database except where a reliable full NHA study has been done. These are disbursements to recipient countries as reported by donors, lagged one year to account for the delay between disbursement and expenditure. Disbursement data are not available prior to 2002 and commitments are used instead. d. National currency unit per US$ are calculated using the average exchange rates for the year. WHO regional, income-group and global aggregates are calculated using constant US$. 26 e. PPP series resulting from the 2005 International comparison project (ICP) estimated by the World Bank has been used. In countries where this is not available, PPPs are estimated by WHO. f. A new basis for these estimates was provided by new NHA reports, surveys, National Accounts series, accessed information and/or country consultations. g. Estimates should be viewed with caution as these are derived from scarce data. h. The national accounts data have been revised from 2002 onward. The new data are obtained through a new computation methodology that uses an updated input–output table (International Monetary Fund, World Economic Outlook). i. Increases in government expenditure on health are due to investment in capital expenditures. j. The change in the trend of out-of-pocket expenditure in 2008 was driven by a large decrease in total private consumption in 2008 and a large increase in 2009. k. Government expenditures show fluctuations due to variations in capital investment. 9. Health inequities a. Data are derived from the re-analysis of publicly available Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) micro-data, using the standard indicator definitions as published in DHS or UNICEF documentation. The analysis was carried out by the International Center for Analysis and Monitoring of Equity in Health and Nutrition based in the Federal University of Pelotas, Brazil, and updated in December 2013. In some cases there may be slight differences between these results and those reported in DHS or MICS country reports due to differences in the calculation of indicator numerators and/or denominators. b. Data derived from DHS relate to the most recent live births occurring in the five years preceding the survey. c. Data derived from DHS relate to births occurring in the five years preceding the survey. Data derived from MICS relate to births occurring in the two years preceding the survey. d. The under-five mortality rate relates to the decade preceding the survey. e. The figure is not reported as it is based on fewer than 25 cases. f. The figure is not reported as it is based on fewer than 250 unweighted person-years of exposure to the risk of death. g. The figure is based on a small number of cases (25–49 unweighted cases).