Health Inequities, Environmental Insecurity and the Attainment of the Millennium Development Goals in Sub-Saharan Africa: The Case Study of Zambia
Abstract
:Introduction
Materials and Methods
Results
Attainment of MDGs in the Different Regions of the World
Attainment of MDGs in Zambia: Progress Report
Goal 1: Eradicate extreme poverty and hunger
Target 1: Reduce by half, between 1990 and 2015, the proportion of people living in extreme poverty
Target 2 – Reduce by half, between 1990 and 2015, the proportion of people who suffer from hunger
Goal 4: Reduce child mortality
Target 5: Reduce by two-thirds between 1990 and 2015, the under-five mortality rate
Goal 5: Improve maternal health
Target 6: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio
Goal 6: Combat HIV/AIDS, malaria and other diseases
Target 7: Have halted by 2015, and began to reverse the spread of HIV/AIDS
Target 8: To halt and begin to reverse the incidence of malaria and other major diseases by 2015
Goal 7: Ensure environmental sustainability
Target 9: Integrate the principles of sustainable development into country policies and programmers and reverse the loss of environmental resources
Target 10: Reduce by half by 2015 the proportion without sustainable access to safe drinking water and basic sanitation
Discussion
- Allocate more funds to health, education and agriculture to ensure scaling up of all that works well to eradicate poverty.
- Eliminate school and uniforms fees to enable all children, especially girls, attend and complete school.
- Provide children with free school meals and take home rations, to prevent malnutrition and anaemia.
- De-worm school children annually for improved health and educational outcomes.
- Design community nutrition programmes that support breastfeeding and use of local indigenous foods as supplements.
- In malaria-endemic areas, carry out combined activities such as distribution of free, insecticide-treated bed nets to children and pregnant women, intermittent preventive treatment of pregnant women, and indoor residual spraying.
- Eliminate user fees (and all hidden costs) for basic health care.
- Scale up treatment for AIDS, sexually transmitted infections, TB and malaria.
- Scale up activities and messages for prevention of STIs and HIV.
- Provide clean water, electricity, sanitation for all communities.
- Provide farmers with affordable soil nutrients and technical skills for diversified farming and increased food production.
- Train community leaders and members in health promotion, health, farming and infrastructure management so as to rapidly increase pool of skilled persons in rural communities.
Africa 840 million | Asia 3,738 million | Oceania | Latin America and the Caribbean | Commonwealth of Independent states 281 million | ||||||
---|---|---|---|---|---|---|---|---|---|---|
North | Sub Saharan | East | South East | Southern | Western | Europe | Asia | |||
Goal 1: Eradicate Extreme Hunger | ||||||||||
Reduce poverty by half | On track | High no change | Met | On track | On track | Increase | ····· | Low minimal improvement | Increase | Increase |
Reduce hunger by half | On track | Very high no change | On track | On track | Progress but lagging | Increase | Moderate no change | On track | Low, no change | Increase |
Goal 2: Achieve Universal Primary Education | ||||||||||
Universal primary schooling | On track | Progress but lagging | Met | Lagging | Progress but lagging | High but no change | Progress but lagging | On track | Decline | On track |
Goal 3: Promote Gender Equality and Empower Women | ||||||||||
Equal girls enrollment in primary schools | On track | Progress but lagging | Met | On track | Progress but lagging | Progress but lagging | On track | On track | Met | On track |
Equal girls enrollment in secondary school | Met | No significant change | ····· | Met | No significant change | No significant change | Progress but lagging | On track | Met | Met |
Literacy parity between young women and men | Lagging | Lagging | Met | Met | Lagging | Lagging | Lagging | Met | Met | Met |
Women’s equal representation in national parliaments | Progress but lagging | Progress but lagging | Decline | Progress but lagging | Very low, small progress | Very low, no change | Progress but lagging | Progress but lagging | Recent progress | Decline |
Goal 4: Reduce Child Mortality | ||||||||||
Reduce mortality of under five years olds by two thirds | On track | Very high, no change | Progress but lagging | On track | Progress but lagging | Moderate, no change | Moderate no change | On track | Low no change | Increased mortality |
Measles immunization | Met | Low no change | Progress but lagging | On track | Progress but lagging | On track | Decline | Met | Met | Met |
Goal 5: Improve Maternal Health | ||||||||||
Reduce maternal mortality by three quarters | Moderate level | Very high level | Low level | High level | Very high level | Moderate level | High level | Moderate level | Low | Low |
Goal 6: Combat HIV/AIDS, malaria and other Diseases | ||||||||||
Halt and reverse the spread of HIV/AIDS | ····· | Stable | Increase | Stable | Increase | ····· | Increase | Stable | Increase | Increase |
Halt and reverse the spread of malaria | Low risk | High risk | moderate risk | moderate risk | moderate risk | Low risk | Low risk | Moderate risk | Low risk | Low risk |
Hal and reverse the spread of TB | Low risk | High increasing | Moderate declining | High declining | High declining | Low declining | High increasing | Low declining | Moderate increasing | Moderate increasing |
Goal 8: Global Partnership For Development | ||||||||||
Youth unemployment | High no change | High no change | Low increasing | Rapidly increasing | Low increasing | High increasing | Low increasing | Increasing | Low, rapidly increasing | Low, rapidly increasing |
Goal 7: Ensure Environmental Sustainability | ||||||||||
Reverse loss of forests | Less than 1% of forests | Decline | Met | Decline | Small decline | Less than 1% forest | Decline | Decline except Caribbean | Met | Met |
Half the proportion without improved drinking water in urban areas | High access but little change | Progress but lagging | Progress but lagging | Progress but lagging | On track | Progress but lagging | Low access no change | Progress but lagging | High access but limited change | High access but limited change |
Half the proportion without sanitation in urban areas | On track | Low access no change | Progress but lagging | On track | On track | Met | High access but no change | High access but no change | High access but no change | High access but no change |
Half proportion without sanitation in rural areas | Progress but lagging | No significant change | Progress but lagging | Progress but lagging | Progress but lagging | No significant change | No significant change | Progress but lagging | No significant change | No significant change |
Improve the lives of slum dwellers | On track | Rising number and proportion of slum dwellers | Progress but lagging | On track | Some progress | Rising number and proportion of slum dwellers | ····· | Progress but lagging | Low but no change | Low but no change |
Indicator | Value | Year | Latest Value |
---|---|---|---|
Population size (million) | 9.9 | 2000 | 11.4m (2005)* |
Annual population growth rate (%) | 2.5 | 2000 | |
Life expectancy at birth (years) | 50 | 2000 | 37.5 (2005) |
Real GDP per capita (US$) | 354 | 2002 | 877 (2005) |
Domestic debt as % of GDP | 26 | 2002 | |
External debt as % of GDP | 190 | 2002 | |
Debt service as % of exports of goods and services | 13.7 | 2002 | |
Human development Index (value) | 0.38 | 2003 | |
Human Development Index (rank out of 175) | 163 | 2003 | 166 (2005) |
Population below national poverty line (%) | 73 | 1998 | 63.7 (2005) |
Prevalence of HIV/AIDS (15–49 years) | 16 | 2002 | |
Percentage of underweight children under 5 years (%) | 28 | 2002 | |
Infant mortality (per 1,000 live births) | 95 | 2002 | |
Under five mortality (1,000 live births) | 168 | 2002 | |
Maternal mortality (per 100,000 live births) | 729 | 2002 | |
Adult literacy (%) | 67 | 2000 | |
Net enrolment in primary education (%) | 72 | 2002 | |
Population without access to safe drinking water supply (%) | 51 | 2002 | |
Population relying on traditional fuels for energy use (%) | 83 | 2000 |
Zambia’s Progress towards the Millennium Development Goals | ||||
---|---|---|---|---|
Goals/Targets | Will target be met? | State of national support | ||
2005 | 2003 | 2005 | 2003 | |
Extreme Poverty Halve between 1990 and 2015, the proportion of people living in extreme poverty. | Potentially | Unlikely | Good | weak but improving |
Hunger Halve, between 1990 and 2015, the proportion of people who suffer from hunger | Unlikely | Unlikely | Weak | weak but improving |
Universal Primary Education Ensure that by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling | Likely | Potentially | Strong | Strong |
Gender Equality and Women Empowerment Eliminate gender disparity in Primary and Secondary Education preferably by 2005 and to all levels of education no later than 2015 | Likely | Probably | Good | Fair |
Child Mortality Reduce by two thirds, between 1990 and 2015, the under five mortality rate | Potentially | Potentially | Strong | Fair |
Maternal Mortality Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio | Unlikely | Unlikely | Weak | weak but improving |
HIV/AIDS Have halted by 2015, and began to reverse the spread of HIV/AIDS | Likely | Potentially | Good | Fair |
Malaria and other major diseases Have halted by 2015, and began reversing the incidence of malaria and other major diseases | Potentially | Potentially | Good | Fair |
Environmental Sustainability Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources | Unlikely | Unlikely | Weak | weak but improving |
Water and Sanitation Halve by 2015 the proportion without sustainable access to safe drinking water and sanitation. | Potentially | Potentially | Weak | weak but improving |
Indicator | 1990 | 2003 | 2015 MDG target |
---|---|---|---|
% Total population living in extreme poverty | 58 | 46 | 29 |
% Urban population living in extreme poverty | 32 | 74 | 16 |
% Rural population living in extreme poverty | 81 | 52 | 40 |
Indicator | 1990 | 2001/2 | 2015 MDG target |
---|---|---|---|
Underweight children <5 years of age (%) | 25 | 28 | 12.5 |
Stunted children <5years of age (%) | 40 | 47 | 20.0 |
Wasted children <5 years of age (%) | 5 | 5 | 2.5 |
Indicator | 1990 | 2001/2 | 2015 MDG target |
---|---|---|---|
Under-five mortality rate/1000 live births | 191 | 168 | 63* |
Infant mortality rate/1000 live births | 107 | 95 | 35* |
Proportion of 1 year-old children immunized against measles | No data | 99% | 99%** |
Indicator | 1990 | 2001/2 | 2015 MDG target |
---|---|---|---|
Maternal mortality ratio/100,000 live births | 649 | 729 | 162 |
Proportion of births attended by skilled health personnel | 51% | 43% | 80% |
Province | Dr:Pop | CO:Pop | RM:Pop | RN:Pop | ZEM:Pop | ZEN:Pop | Pharm. Staff:Pop | Lab. Staff:Pop | EHT:Pop |
---|---|---|---|---|---|---|---|---|---|
Lusaka | 6,247 | 7, 544 | 12, 397 | 3,799 | 5, 243 | 1,577 | 319,847 | 15,527 | 27,573 |
Copperbelt | 8,998 | 9, 719 | 14, 425 | 5, 091 | 3, 599 | 1,567 | 55,076 | 16,523 | 23,006 |
Average Rural | 43,313 | 10,970 | 74, 713 | 17, 324 | 11, 541 | 2,863 | 169,160 | 49,582 | 13,099 |
Provinces National | 17,589 | 9, 787 | 27, 714 | 8, 822 | 6, 099 | 2,293 | 123,509 | 27,249 | 15,150 |
Disease | Incidence (Cases/1000 pop) | In-Patient CFR*(deaths/100 Admissions) | ||||
---|---|---|---|---|---|---|
1999 | 2002 | 2004 | 1999 | 2002 | 2004 | |
Malaria | 311.9 | 387.8 | 383.2 | 36.3 | 26.5 | 33.0 |
Respiratory Infections: Non Pneumonia | 125.8 | 148.0 | 152.9 | 28.6 | 17.4 | 48.1 |
Diarrhoea Non Bloody | 59.8 | 80.0 | 74.7 | 69.6 | 53.9 | 62.5 |
Eye Infections | 38.8 | 42.7 | 39.7 | 17.8 | 0.9 | 2.0 |
Respiratory Infections: Pneumonia | 33.5 | 45.0 | 43.7 | 120.1 | 58.0 | 68.7 |
Indicator | 1990 | 2002 | 2015 MDG target |
---|---|---|---|
New malaria cases per 1000 | 255 | 377 | Less than 121 |
Malaria fatality rates per 1000 | 11 | 48 | |
Households with ITN* (%) | - | 14 |
Indicator | 1990 | 1996 | 2001 | 2003 |
---|---|---|---|---|
Percentage of land covered by forest | 59.8 (1992) | 59.1 | 59.6 | 45 |
Percentage of households with access to an improved water source* | ||||
---|---|---|---|---|
Indicator | 1991 | 1996 | 2000 | 2003 |
All Zambia | 50 | 47 | 49.1..... | 53 |
Rural | 20 | 28 | 31.2 (2001) | 37 |
Urban | 90 | 85.3 | 89.8 (2001) | 86 |
Percentage of households with access to improved sanitation** | ||||
Indicator | 1991 | 1996 | 2000 | 2003 |
All Zambia | 24 | 18 | 14.9 | 65 |
Rural | 6 | 2 | 2.9 (2001) | 57 |
Urban | 47 | 45.9 | 44.8 (2001) | 80 |
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Anyangwe, S.C.E.; Mtonga, C.; Chirwa, B. Health Inequities, Environmental Insecurity and the Attainment of the Millennium Development Goals in Sub-Saharan Africa: The Case Study of Zambia. Int. J. Environ. Res. Public Health 2006, 3, 217-227. https://doi.org/10.3390/ijerph2006030026
Anyangwe SCE, Mtonga C, Chirwa B. Health Inequities, Environmental Insecurity and the Attainment of the Millennium Development Goals in Sub-Saharan Africa: The Case Study of Zambia. International Journal of Environmental Research and Public Health. 2006; 3(3):217-227. https://doi.org/10.3390/ijerph2006030026
Chicago/Turabian StyleAnyangwe, Stella C. E., Chipayeni Mtonga, and Ben Chirwa. 2006. "Health Inequities, Environmental Insecurity and the Attainment of the Millennium Development Goals in Sub-Saharan Africa: The Case Study of Zambia" International Journal of Environmental Research and Public Health 3, no. 3: 217-227. https://doi.org/10.3390/ijerph2006030026