ANE/E&E SOTA October 2002 Trend Analysis and Sector Profiles ANE and E&E Regions.

ANE/E&E SOTA October 2002

Trend Analysis and Sector ProfilesANE and E&E Regions


Total Fertility, 1990-2000

0

1

2

3

4

5

6

7

8

Tota

l Fert

ility R

ate

Yemen

Wes

t Ban

k/Gaz

a

Nepal

Cambo

dia

Jord

an

Philipp

ines

Egyp

t

Mor

occo

Bang

lade

sh

India

Indo

nesia

Viet

nam

Kyrg

zsta

n

Uzbe

kistan

Turk

men

istan

Kaza

ksta

n

Azer

baija

n

Moldo

va

Geor

gia

Armen

ia

Ukra

ine

Russ

ia

Roman

ia

USAID Countries

Replacement Level Fertility

2.1

Source: DHS/RHS1990-2001 and PRB 2001 Data Sheet.


Maternal Mortality Ratios and Attended Births in ANE Region

0

10

20

30

40

50

60

70

80

90

100

Afgh

anist

anLa

os*

Nepal

Bang

lades

h

Pakis

tan

Yemen

Cambo

diaIn

dia

Moroc

co

Indo

nesia

Philip

pines

Egyp

t

China

*

Thail

and*

Vietnam

Mongo

lia*

Sri L

anka

*

Jord

an

Per

cen

t b

irth

s at

ten

ded

by

trai

ned

per

son

nel

0

100

200

300

400

500

600

700

800

900 Matern

al death

s per 100,000 live b

irths

Births Attended 1995-2000 Maternal Mortality Ratio 1985-1999

Source: UNICEF State of the World’s Children, 2002. DHS and WHO/Hill data used when UNICEF data not available.

*No current USAID PHN funding


Abortion and Non-Abortion Maternal Mortality Rate (MM) in Romania 1965, 1980-1999

Source: 1999 National Commission for Statistics/Romania; UNFPA

0

20

40

60

80

100

120

140

160

180

200

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Year

Abortion MM Non-Abortion MM MM

‘65 ‘80 ‘81 ‘82 ‘83 ‘84 ‘85 ‘86 ‘87 ‘88 ‘89 ‘90 ‘91 ‘92 ‘93 ‘94 ‘95 ‘96 ‘97 ‘98 ‘99

Num

ber

of

death

s per

100

,000 w

om

en


0

50

100

150

200

250

1990 2000

Death

s per

1,0

00 liv

e b

irth

s

Neonatal Mortality(>28 days) Infant Mortality (>12 months) Under 5 Mortality

Stagnating Decline in Neonatal Mortality in ANE Region

Note: Countries include those that have received USAID support for over 10 yearsSource: The State of the World’s Children 2002, UNICEF

28% decline

32% decline

18% decline


AlbaniaArmenia

AzerbaijanBelarus

Bosnia***

Georgia

KazakstanKyrgyzstan

LatviaLithuania

MoldovaPoland

Romania***

TajikistanTurkey

TurkmenistanUkraine

Uzbekistan

Hungary

Croatia***Cyprus

Slovenia***

RussiaSlovak Rep.***

020406080100120140

Estimated 2007 plan average** 35

APP 99 baseline average 51

BUCEN average* 1997 44

APP 99 plan average 1999 47Source: US BUCEN International Database* Country (unweighted average)** 2007 Plan from APP 2000*** When 1990 data were unavailable, the closest available year was used.Albania, Armenia, Azerbaijan, Belarus, Bosnia, Georgia, Kazakstan, Kyrgystan, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan all experienced increases in their under-5 mortality rates.

= reduction in rate1990

1997

1997 1990

= increase in rate

KEY

Under-5 mortality rateUSAID-assisted countries-progress towards benchmarksEurope/NISBars reflect change in under-5 mortality rate, 1990-1997


Malaria Deaths in ANE = 1.1 million

ANERegion

10%

AFRRegion

Malaria in ANE Region

0

20

40

60

80

100

120

1975 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994

Year

Cure Rate %

Quinine

Mefloquine

Chloroquine

Sulphadoxine-

PyrimethamineCu

re R

ate

(%)

Falling Cure Rates for Falciparum Malaria in Southeast Asia

Source: SE Asia J Trop Med Public Health 1999; 30: 68

Example from Thailand


Trends in TB Case Notification Rates in E&E DOTS Countries

0

20

40

60

80

100

120

140

160

1980 1985 1990 1995 2000

Case

Noti

fica

tion p

er

100,0

00 P

opula

tion

Azerbaijan

Georgia

Kazakhstan

Kyrgyzstan

Romania

Russia

Source: WHO Global Tuberculosis Report, 2002


Low Prevalence Low Risk in Bangladesh

Source: Bangladesh BSS

FSW(9% married)

IDU(40% married) 33%

VisitFSW

34%VisitFSW

Rickshawpullers

MSM(46% married)

(76% married)

Visit FSW

9% are IDU

2% are IDU

1% are IDU

69%


0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

1,000,000

1993 1995 1996 1997 1998 1999 2000 2001

New Cases E. Europe/ CAR New Cases W. Europe

Eastern Europe & Central Asia Western Europe

HIV Trends in Eastern Europe & Central Asia and Western Europe, 1993 - 2001

Source: Report on the Global HIV/AIDS Epidemic, UNAIDS July 2002


563

608

844

814

952

891

904

636

802

805

676

563

665

606

508

367

261

664

775

893

814

747

684

582

614

575

462

335

199

310

160

39

55

144

1200 1000 800 600 400 200 0 200 400 600 800 1000 1200

0-4

'5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80+ MaleFemale

899

870

799

746

531

407

421

359

325

256

212

155

128

98

76

45

29

31

19

931

893

814

782

516

375

365

297

256

172

160

115

93

72

52

1200 1000 800 600 400 200 0 200 400 600 800 1000 1200

0-4

'5-9

'10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80+

Source: US Bureau of the Census, International Data Base

Cambodia Romania

Population Pyramids, 2000

Population in Thousands Population in Thousands


Causes of Death in ANE Region, 2000

Infectious and parasitic diseases

23%

Chronic diseases

excluding CVD31%

Cardiovascular diseases (CVD)

29%

Maternal, perinatal, and

nutritional conditions

7%

Intentional and unintentional

injuries10%

Source: WHO World Health Report, 2001


Causes of Death in E&E Region, 2000

Cardiovascular diseases (CVD)

57%

Maternal, perinatal and

nutritional conditions

1%

Chronic diseases excluding CVD

26%

Intentional and unintentional

injuries11%

Infectious and parasitic diseases

5%



Population Sector


Population and Economic Growth Rates in ANE Region

-8

-6

-4

-2

0

2

4

6

8

Per

cen

t

% Annual Population Growth 2000 % GDP Growth 1999-2000

* No current USAID PHN funding

Source: (GDP) World Bank, World Development Indicators 2002, and (Pop) Bureau of Census, International Database 2002. No economic growth data available for Afghanistan.


Percentage of Population Living on Less Than $2 a Day in E&E Region

Source: 2001 World Development Report/ The World Bank


Total Fertility and Modern Contraceptive Prevalence in ANE Region

0

10

20

30

40

50

60

70

80

90

Yemen

Afgh

anist

an

Pakis

tan

Cambo

diaLa

os*

Nepal

Philip

pines

Wes

t Ban

k/Gaz

a

Jord

an

Mongo

lia*

India

Bang

lades

h

Sri L

anka

*

Moroc

coEg

ypt

Indo

nesia

Vietnam

Thail

and*

China

*

Co

ntr

acep

tive

Pre

vale

nce

Rat

e

0

1

2

3

4

5

6

7

8

Live b

irths p

er wo

man

CPR

TFR


Source: PRB 2001 Population Data Sheet


Contraceptive Prevalence Modern Methods in E&E Region

1220 22

3038 45 49 50 51 53 54 53

0

10

20

30

40

50

60

70

80

90

100

AZ GE AM RO UA CZ KG MD UZ TM RU KZ

Tota

l co

ntr

ace

ptive P

revale

nce

Rate

Traditional MethodsModern Methods

Source: DHS or RHS, most recent surveys, 1993-2001, or PRB 2001 Population Data Sheet if DHS/RHS data not available.


Total Fertility Rate and Total Induced Abortion Rate in E&E Region

1.8 1.92.1 2.1

2.9

3.3 3.4

2.22.5

1.6

2.6

3.7

3.2

1.71.71.41.31.3

1.5

0.60.9

1.41.6

1.3

0

1

2

3

4

5

RO RU UA AM GE MD CZ AZ KZ TM UZ KGTota

l Fe

rtilty

Rate

and T

ota

l In

duce

d A

bort

ion R

ate Total Fertility Rate

Total Induced AbortionRate

Source: DHS or RHS, data from most recent survey, 1993-2001, or PRB 2001 Population Data Sheet if DHS/RHS data not available.


Outcome of Pregnancy in E&E Region

37

53

30

45

5

11

9

8

60

37

61

47

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Georgia Moldova Russia Ukraine

Perc

ent

of Pre

gnanci

es

Induced abortionMiscarriageLive birth

Source: CDC RHS Surveys and Relationships between Abortion and Contraception in Republics of the former Soviet Union by H.I. Goldberg and F. Serbanescu (August 2001).

Data ending five years before survey.


Unmet Need for Family Planning Services (Modern Methods) in E&E Region

23

27 28 2931 31

37

0

10

20

30

40

50

MD GE RU RO CZ AZ UA

Perc

ent

Unm

et

Need

Source: DHS or RHS, data from most recent survey, 1993-2000, or PRB 2001 Population Data Sheet if DHS/RHS data not available.


Maternal and Child Health Sector


Infant Mortality in ANE Region, 1990-2002

0

20

40

60

80

100

120

140

160

Infa

nt

dea

ths

per

1,0

00 l

ive

bir

ths 1990

2002

Source: US Bureau of the Census, International Database, 2002. Uttar Pradesh data from DHS 1992-93 and 1998-99.


World Summit Goal (2000)=50


Infant Mortality in E&E Region, 1990-2000

5

17 18

2732

3641

49

61 62

74 74

0

20

40

60

80

100

CZ UA RU MD RO AM GE UZ KG KZ TM AZ

Death

s per

1,0

00 liv

e b

irth

s

Source: DHS or RHS, data from most recent survey, 1990-2001. UNICEF, State of the World’s Children 2002, 2000 data for CZ, MD, RU, and UA.


Estimated 2007 plan** 74

APP 99 baseline average 60

BUCEN average* 1997 73

APP 99 plan average 1999 56

Source: US BUCEN International Database* Country (unweighted average)** 2007 Plan from APP 2000*** When 1990 data were unavailable, the closest available year was used.

Bangladesh***

Cambodia

Egypt

Gaza Strip

India***

Indonesia

Israel

Jordan

Lebanon

Mongolia

Morocco

Nepal

Philippines

Sri Lanka

West Bank

050100150200

= reduction in rate1990 1997

1997 1990

= increase in rate

KEY

Under-5 mortality rateUSAID-assisted countries-progress towards benchmarksAsia/Near EastBars reflect change under-5 mortality rates, 1990-1997


Under-5 Mortality Rates and Immunization Coverage in ANE Region, 2000

0

10

20

30

40

50

60

70

80

90

100

Sri L

anka

*

Thail

and*

Jord

an

Vietna

m

China

*

Philip

pines

Indo

nesia

Egyp

t

Moroc

co

Mongo

lia*

Bang

lades

hIn

diaNep

al

Laos

*

Pakis

tan

Yemen

Cambo

dia

Afgh

anist

an

% o

f ch

ildre

n r

ecei

vin

g D

PT

3

0

2040

6080

100120

140160

180200

220240

260

Death

s of ch

ildren

less than

5 years old

per 1,000

live birth

s

DPT3

U5MR

*No current USAID PHN funding

Source: UNICEF, State of the World’s Children, 2002


Immunization Coverage in Selected E&E Countries

63.5%94%Tajikistan

98.2%98.2%Kyrgyzstan

61.4%97.7%Georgia

63.4%87.5%Armenia

72%94.7%Azerbaijan

DPT3 Coverage-Surveys by 12 Months of Age

DPT3 Coverage – Official Figures by

Child*

Country

Source: Azzam, H. “GAVI and the Europe and Eurasia Region.” USAID, October 2000. Data for Azerbaijan, Armenia, Georgia and Kyrgyzstan from UNICEF/WHO Joint Report Form on Vaccine-Preventable Diseases.*Official national immunization rates are per child and not by 12 months of age as is the international standard of reporting.In Azerbaijan, the government just adopted the 72% figure of the EPI survey, the only one to do so.Georgia data collected for immunization between the age of 0-27 months. UNICEF’s data for the same period of time indicate 80.5% coverage.Tajikistan’s official data is for 1998.


IRELAND

UNITEDKINGDOM

NORWAY

SWEDEN

U.K.Dublin

BELGIUM

NETHERLANDSDENMARK

GERMANY

FINLAND

POLANDCZECHREPUBLIC

SLOVAKREPUBLIC

HUNGARY

RUSSIA

YUGO

AUSTRIA

LATVIALITHUANIA

BELARUS

MOLDOVAROMANIA

BULGARIA UKRAINE

BlackSea

GEORGIAARMENIA

CaspianSea

TURKEY

SYRIA

AZERBAIJAN

Jordan

IRAQ

IRAN

KUWAIT

PersianGulf

SAUDIARABIA

AFGHANISTAN

TURKMENISTAN

UZBEKISTAN

KYRGYZSTAN

TAJIKISTAN

AralSea

KAZAKHSTAN

RUSSIA

ESTONIA

Maternal deaths per 100,000 live births

Less than 30

Between 30 and 60

Between 60 and 90

More than 90

Source: Hill, Abou Zahr, and Wardlaw, 2001

Maternal Mortality Ratios in E&E Region, 1995


HIV/AIDS Sector


Adult HIV Prevalence in ANE Region, 2001

Source: UNAIDS, July 2002 and the National AIDS Control Organization

India0.8%

Maharashtra>2%

Andhra Pradesh>2%

Tamil Nadu1-2%

Karnataka1-2%

Manipur1-2%

Myanmar1.99%

Cambodia2.7%

Thailand 1.8%


OshYange Yul

Temirtau

Almaty

Country Boundary

Major Road

Narcotics Traffic

Capital City

Other Major City

Source: Synergy, 2001.

HIV/AIDS and Drug Trafficking Routes in Central Asia


Cumulative reported HIV infections per million population in Eastern European countries: 1993-2001

Estonia*

Kazakhstan

Latvia

Lithuania

Moldova, Republic of

Russian Federation

Ukraine

0

300

600

900

1,200

1,500

1,800

1993 1994 1995 1996 1997 1998 1999 2000 2001Projected

Cases p

er

million

pop

ula

tion

* actual 2001 year-end data

Source: National AIDS Programmes (2001) HIV/AIDS surveillance in Europe. Mid-year report. Data compiled by the European Centre for the Epidemiological Monitoring of AIDS

ANE/E&E SOTA October 2002Source: Synergy, 2001.

ANE/E&E SOTA October 2002Source: Synergy, 2001.

DRAFT


HIV Prevalence Rate and Adults Living with HIV/AIDS in E&E Region, 2001

Ukraine25%

Belarus1%

Poland1%

Other EE&CA Countries

4%

Russia69%

Source: UNAIDS, July 2002.

Country HIV Prevalence Rate

Estonia 1.0

Ukraine 1.0

Russia 0.9

Latvia 0.4

Belarus 0.3

Armenia 0.2

Moldova 0.2

Hungary 0.1

Kazakhstan 0.1

Lithuania 0.1

Poland 0.1

Eastern Europe & Central Asia

0.5

Percent Adults Living with HIV/AIDS in Eastern and Central

Asia

Total Adults Living with HIV/AIDS : 1,000,000


Infectious Diseases Sector


Causes of Death in ANE Region, 2000

0

2

4

6

8

10

12

14

Eastern Mediterranean Southeast Asia Western Pacific

To

tal d

eath

s (m

illio

ns)

Infectious/parasiticdiseases

Chronic diseases

Other

WHO regions



Infectious Disease Deaths in ANE Region, 2000

Malaria1%

Diarrheal disease16%

Acute respiratory infection

32%

Vaccine-preventable

childhood diseases7%

HIV/ AIDS6%

All others22%

Tuberculosis16%



Estimated New Tuberculosis Cases in ANE Region, 2000

Rest of World: 42%

China: 16%

Other High-burden ANE

Countries: 21%

India: 21%



Tuberculosis Incidence in ANE Region, 2000

140175184189

242

572

330 321280

0

100

200

300

400

500

600

700

Cambodia

Philippin

es

Afghanis

tan

Indones

ia

Bangla

desh

Vietn

amIn

dia

Pakis

tan

Thailand*

TB

cas

es p

er 1

00,0

00 p

op

ula

tio

n




Malaria Cases in ANE Region, 1999/2000

Source: WHO, Roll Back Malaria Web site, Country Profiles

Country Number of Malaria Cases 1999/2000

Afghanistan 395,581

Bangladesh 60,396

Cambodia 62,439

China 18,620

India 1,910,000

Laos 40,006

Myanmar 124,630

Nepal 7,616

Pakistan 82,526

Philippines 36,596

Sri Lanka 210,039

Thailand 91,703

Vietnam 74,316


Emerging Issues


Life Expectancy in E&E Region, 1990-2000

60

62

64

66

68

70

72

74

76

78

1990 1995 2000

Life e

xpect

ancy

at

bir

th (

years

)

2.5% Increase

2.5% Decrease

Source: WHO Regional Office for Europe, European Health for All Database Note: CEE Countries include Albania, Bulgaria, Hungary, Poland, Romania, Czech Republic, Slovakia, Bosnia and Herzegovina, Croatia, Slovenia, Macedonia, and Yugoslavia. NIS Countries include Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan.

Men

Women CEE

NIS

CEE

NIS

2.2% Increase

1.1% Decrease


Distribution of Chronic Disease Deaths in E&E Region, 2000

Ischaemic heart disease35%

Other diseases3%

Respiratory disease4%

Cerebrovascular disease22%

Other cardiovascular disease13%

Digestive and genitourinary

disease5%

Cancers18%



Trends in Cigarette Consumption in E&E Region, 1990s

0

500

1000

1500

2000

2500

3000

1990 1997

An

nu

al p

er c

apit

a ci

gar

ette

co

nsu

mp

tio

n

(N

o. c

igar

ette

sti

cks)

Belarus

Bulgaria

Kazakhstan

Romania

Russia

Turkey

Note: Turkey data is for 1998.

Source: The American Cancer Society, Inc. Tobacco Control Country Profiles, 2000.

ANE/E&E SOTA October 2002 Trend Analysis and Sector Profiles ANE and E&E Regions.

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Transcript of ANE/E&E SOTA October 2002 Trend Analysis and Sector Profiles ANE and E&E Regions.