1. MDG: Progress in India

2. Framework Introduction Monitoring at international level
Monitoring at national level
What is monitored?
MDG: Progress in India
Goal 1
Goal 2
Goal 3
Goal 4
Goal 5
Goal 6
Goal 7
Goal 8
Challenges
References
Millennium Summit -New York (Sept 2000) 189 countries
Millennium Development Goals
To be achieve by 2015
Mid-term evaluation

3. Introduction Sept 2000-Millennium Summit -New York
Millennium Development Goals
To be achieve by 2015
Mid-term evaluation
Eradicate extreme poverty and hunger
Achieve universal primary education
Promote gender equality and empower women
Reduce child mortality
Improve maternal health
Combat HIV/ AIDS, malaria and other diseases.
Ensure environmental sustainability and
Develop a global partnership for development
Millennium Summit -New York (Sept 2000) 189 countries
Millennium Development Goals
To be achieve by 2015
Mid-term evaluation

4. Who is monitoring? At International level
United Nations, Inter-Agency & Expert Group on MDG
Supporting Agencies
*WHO *World Bank *International labour organization, *International monetary fund *Food & agricultural organization of UN *Economic commission of Africa, *UNICEF, *International telecommunication union *UNs environment programme * UNs development fund for women, *UNs development programmes, *WTO, *UNs population fund, *Joint UNs programme of HIV/AIDS …..etc.
UN’s Statistics Division
www. mdgs.un.org.
At International level
United Nations, Inter-Agency & Expert Group on MDG Indicators led by deptt of economics & Social affair
Supporting Agencies
*WHO *World Bank *International labour organization, *International monetary fund *Food & agricultural organization of UN *Economic commission of Africa, *UNICEF, *International telecommunication union *UNs environment programme * UNs development fund for women, *UNs development programmes, *WTO, *UNs population fund, *Joint UNs programme of HIV/AIDS …..etc.
United Nations Statistics Division
www. mdgs.un.org.

5. Who is monitoring? At national level
Ministry of Statistics & Programme Implementation
Inter ministerial expert committee - Nov 2004
Source agencies
Planning commission, Deptt of Education,
Registrar general & census commissioner,
National sample survey organization,
Ministry of health & family welfare
Ministries of finance, Agriculture, Coal, Petroleum & natural gas, Power, Urban development & Poverty Alleviation, Rural development, Water resources, Environment & forests, Health & family welfare, Human resource development, Communication & Information technology …….. etc
Ministry of Statistics & Programme Implementation
Inter ministerial expert committee set up in November 2004

6. What is monitored? 18 Targets & 48 Indicators
8 Targets & 18 Indicators directly related to health.

7. Health related millennium development goal
Goal 1: Eradicate extreme poverty and hunger
Indicator 4. Prevalence of underweight children under five years of age
Indicator 5. Proportion of population below minimum level of dietary energy consumption
Goal 4: Reduce child mortality
Indicator 13: Under-five mortality rate
14: Infant mortality rate
15: Proportion of one-year-old children immunized against measles
Goal 5: Improve maternal health
Indicator 16: Maternal mortality ratio
17: Proportion of births attended by skilled health personnel
Goal 6: Combat HIV/AIDS, malaria and other diseases
Indicator18: HIV prevalence among pregnant women aged years
19: Condom use rate of the contraceptive prevalence rate
20. Ratio of school attendance of orphans to school attendance of non-orphans aged
10-14 years
21: Prevalence and death rates associated with malaria
22: Proportion of population in malaria-risk areas using effective malaria prevention
and treatment measures
23. Prevalence and death rates associated with tuberculosis
24. Proportion of tuberculosis cases detected and cured under DOTS
Goal 7: Ensure environmental sustainability
Indicator 29: Proportion of population using solid fuels
30: Proportion of population with sustainable access to an improved water source,
urban and rural
31: Proportion of population with access to improved sanitation, urban and rural
Goal 8: Develop global partnership for development
Indicator 46: Proportion of population with access to affordable essential drugs on sustainable basis.

8. Goal 1: Eradicate extreme poverty and hunger
Target 1 Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day
Indicator 1: Proportion of population below $1 purchasing power parity (PPP) per day
Indicator 2: Poverty gap ratio
Indicators related to poverty & hunger
Indicator
Poverty headcount ratio
Overall
Rural
Urban
38.9
39.1
38.2
36.0
37.3
32.4
26.1
27.1
23.6
Poverty gap ratio
8.5
8.1
5.3
5.2
Source: planning commission & Ministry of health & family welfare,2005

9. Goal 1
Target 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Indicator 4. Prevalence of underweight children under five years of age
NFHS –II ( )- 47% under 3 children underweight
NFHS III ( ) - 43% under five children underweight.

10. Steps for Goal 1 For rural area Wage employment programme
Swarnajayanti Gram Swarozgar Yojana(1999)
Sampoorna Gramin Rozgar Yojana(2001)
Indira Awas Yojana
National Rural Employment Guarantee Act
For Urban area
National slum development programme
Swarna Jayanti Shahari Rozgar Yojana
Valmiki Ambedkar Yojana (VAMBAY)
Public distribution system
Targeted public distribution system:
Antyodaya Anna Yojana (2000)
ICDS (1975)
Mid-day meal scheme (1995) Revised 2004
Food for work programme
Annapurna scheme
National nutrition mission (2003)
National guideline on infant & young feeding 2004
NRHM ( )
India has taken some positive steps to reduce poverty & hunger
Recent initiatives such as the National Rural Employment Guarantee Act are being seen as important measures to help India meet its goal of eradicating extreme poverty through targeted interventions to ensure employment, along with the creation of long term social and economic assets for the socially excluded
Public distribution system to make minimum quality of food available to every household even in remotest part of the country at an affordable price
Targeted public distribution system: Provides heavily subsidized cereals to the entire BPL Class.
Antyodaya Anna Yojana (2000) – Target absolute destitute (Kangala, Niradhar)
ICDS – Covers young children & mothers.
Mid-day meal scheme1995 – supports the school going children ( Mid-day meal programme 1961)
Food for work programme- provide food grains to the working poor.
Annapurna scheme supports the aged.
National nutrition mission has been setup under the chairmanship of the prime minister in 2003 with basic objective of addressing the problem of malnutrition in a holistic manner.
National guideline on infant & young feeding were released in Aug

11. Goal 2: Achieve universal primary education
Target 3 Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Indicator 6: Net enrolment ration in primary education
Indicator 7: Proportion of pupils starting grade 1 who reach grade 5
Indicator 8: Literacy rate of years old
Indicator
Gross enrolment ratio in primary education
Overall
Male
Female
84.6
95.0
73.5
95.7
104.9
85.9
108.56
111.41
105.48
Proportion of children starting Grade 1 who reach grade 5
overall
55.0
56.2
53.3
59.3
60.3
58.1
Adult literacy rate(7 years & above)
female
52.2*
64.1
39.3
64.84
75.26
53.67
Source: Selected educational statistics, , GOI. *Census of India,1991 & 2001

12. Steps for achieving goal 2
Compulsory free primary education.
Policies are been made
Legislatation
Intervention to support literacy
Bridge gender disparity
1986 – National policy on education made –revised 1992
1992 – Programme of action –Universalizing elementary education.
1995-National programme of nutritional support (expanded 2002, 2004 revised)
– Education guarantee scheme (EGS)
2000 – Sarva shiksha Abhiyan (SSA)
2002 – Canstitutional 86th amendment act
2004-Cess on taxes for funding basic education.
Programmes of early childhood come & education
Many experimental & innovative project
2004-Kasturba Gandhi Balika Vidyalaya (KGBV) Scheme
Legislatation
Policies are been made
To make primary education compulsory, Govt. of India with constitution made mandate compulsory to have free primary education. There are other initiative like
Bridge gender disparity
Intervention to support literacy
1992 – Programme of action – given impetus to universalizing elementary education.
1986 – National policy on education made –later revised in 1992
2002 – Canstitutional 86th amendment act was passed.
In national umbrella programme for the universalization of elementary education for all children & to give elementary education for all by 2010
2000 – Sarva shiksha Abhiyan (SSA) (Campaign on education for all)
Free & compulsory education of children ---- a fundamental right.
It is one of most significant development toward MDG goal. It made free & compulsory education a fundament right for all children in the age group of 6-14 yrs.
Group of children
National programme for education of girls at elementary level provides region specific strategies to enable girls to come to school, includes remedial teaching through bridge courses & residential camps. It target, the most educationally backward blocks in the country where female literacy rate is below nations average & gender gap is above national average.
Intervention for enhancing girls education like “Model cluster school” with facility like teaching – learning equipment, library sports.
Gender sensitization of teacher.
Cess on taxes for funding basic education(2004).
An education 2% has been levied on all central taxes (2004) to finance quality basic education prasambhik shiksha kosh- a non-lapsable fund for funding SSA & the mid-day meal is being established to receive the proceeds of education cess.
Programmes of early childhood come & education
ICDS
Creches
Balwadis
ECE center
Pre-primary school rum by the state & private
Many experimental & innovative project
Child to child programme
Child media lab.
Vikas kendras
Mobile creches
National programme of nutritional support to primary education called as mid –day meal scheme
It was started 1995 & expanded in 2002
Objective –
In addition to improve nutritional status of primary school children, it is to give boost to universalization of primary education by increasing enrolment, retention & attendance.
Covered entire progamme ,
– Education guarantee scheme (EGS)
Alternative & innovative education
Sept – revised Mid-day meal programme and added new compound of central assistance, including assistance for meeting cooking cost, mid-day meal during summer vacation in drought affected area. It central govt. provides food grain (Wheat & rice) free of cost at the rate of 100 grams per child per school day & also coking cost & transport subsidy. 25 states & all union territory fully covered. Till 2005, 120 million child covered under Mid-day meal scheme.
Kasturba Gandhi Balika Vidyalaya (KGBV) Scheme launched in 2004.
The Kasturba Gandhi Balika Vidyalaya (KGBV) scheme was launched by the Government of India in August, 2004 for setting up residential schools at upper primary level for girls belonging predominantly to the SC, ST, OBC and minorities in difficult areas. Till 2005, 750 such residencial schools were established. The scheme of the KGBV ran as a separate scheme but in harmony with the Sarva Shiksha Abhiyan (SSA), National Programme for Education of Girls at Elementary Level (NPEGEL) and Mahila Samakhya (MS) for the first two years,but has since 1st April, 2007 merged with the SSA programme as a separate component of that programme.

13. Goal 3: Promote gender equality and empower women
Target 4 Eliminate gender disparity in primary and secondary education, preferably by 2005, and at all levels of education no later than 2015
Indicator 9: Ratio of girls to boys in primary , secondary & tertiary
education
Indicator 10: Ratio of literate women to men years old
Indicator 11: Share of women in wage employment in the
non-agricultural sector
Indicator 12: Proportion of seats held by women in national parliament

14. Proportion of girls(per100 boys) in primary, secondary & higher education
Indicator
1991
2001
Primary education 71
78%
Secondary
49 %
63 %
Higher
50 %
58 %
Literacy ratio in women to men (Age 7 +)

15. Share of women’s in wage employment in non agricultural sector
National level - 16%.
Rural -15 %
Urban-16.6%.
Ministry of human resource development

16. Steps for achieving goal 3
Free & compulsory primary education for girls
Schemes by UGC
1) Grants to women’s university for teaching courses
2)Construction of women’s hostels,
3)Setting up women study centers in 34 universities.
World bank assisted programme for technical education
43% - women.
No. of women in colleges, universities, professional college increasing
million
million 
1988 – Total literacy campaign of the national literacy mission (NLM)
1989 – Mahila Samakhya Programme
1999 – NLM revised  goal 75% literacy by 2007 in non literate
15-35 age group.
To achieve target set under MDG - primary education made free & compulsory for girls
In higher education university grant commission (UGC) has been implementing schemes for promoting women education – like 1) Scheme of grants to women’s university for teaching courses 2)Scheme for construction of women’s hostels, 3)Setting up women study centers in 34 universities.
World bank assisted programme for technical education to women of rural minorities, schedule castes (ST) (OBC) & other disadvantage section of the society. Under this programme currently 43% of total beneficial are women.
The number women in colleges, universities, professional college like Medical, engineering etc. increasing from
Year
number women in colleges, universities, professional college
1996 – 97
2.14 million
2002 – 03
3.81 million
1988 – Total literacy campaign of the national literacy mission (NLM)
1999 – NLM was revamped  goal 75% literacy by 2007 in non literate age group.
1989 – Mahila Samakhya Programme(Program for women empowerment )
Focus – society & economic disadvantage & marginalized
Education for them
It is now operational in 15,000

17. Laws Factory act (1948) Plantation labour Act (1951)
Contract labour (Regulation and abolition act) 1970)
Inter state migrant workers (Regulation of employment and condition
of services act 1979)
Minimum wage act – 1948
1993 – Reservation for women
73rd and 74th constitution amendment % reservation
Karnataka 45%, Kerala – 36.4% , WB – 35.4% , Tamil Nadu Sarpanch – 36%, UP – 54 % of ZP President were women.
Hindu succession act amendment – equal rights in property.
National common minimum programme
Services -crèche facilities for working mother, time of for Feeding,
provision of maternity leave, separate toilets and washing facility.
1993 – Reservation for women
73rd and 74th constitution amendment provide for 33.3% reservation of seats for women in rural and local urban bodies. Karnataka was first state to guarantee participate of women in local governance through reservation was gone up 45%, Kerala – 36.4% West Bengal – 35.4% In UP – 54 % of Zila parishad President are women. Tamil Nadu Sarpanch – 36%.
Recent amendment to the Hindu succession act provides that daughter would get equal rights n ancestral property.
Commitment for women empowerment by National common minimum program

18. Gender & Poverty Micro-credit initiatives SHG Rastriya Mahila Kosh
Initiatives by Dept. of Women & Child development
STEP programme: Support to Training & employment programme for women
Swawlamban programme
Swayamsiddha project
Swashakti project 
 Sampoorna Grameen Rojgar Yojana, Swarna Jayanti Gram Swarozger Yojana - 40% of benefit are for women
 Public sector banks 5% bank credit for lending
Dec – aggregate lending was 5.47%.
Micro-credit initiatives SHGS  To address poverty & unemployment in women & providing access to saving and credit mechanism and institutions
Rastriya Mahila Kosh (National credit fund for women) – Provides credit for livelihood & related activities to poor women.
Initiatives by Dept. of Women & Child development
STEP programme: STEP (Support to Training & employment programme for women) programme
Swawlamban programme
Swayamsiddha project
Swashakti project 
 In Sampoorna Grameen Rojgar Yojana, Swarna Jayanti Gram Swarozger Yojana - 40% of benefit under this programme are for women
 14 point action plant – For strengthen credit delivery to women particularly in tiny & small scale industries.
 Public sector banks ear marked 5% of their net bank credit for lending to women.
Dec – aggregate lending was 5.47%.

19. Goal 4: Reduce child mortality
Target 5: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Indicator 13: Under-five mortality rate
Indicator 14: Infant mortality rate
Indicator 15: Proportion of one-year-old children immunized against measles

20. Table: showing Under 5 Mortality
Male Female Total
Rural
Urban
Total
Table: showing Under 5 Mortality

21. Under five mortality

22. Under five mortality

23. Infant Mortality Rate 27

24. Immunization of child < 12 month against measles

25. Initiative for goal 4 CSSM (1992) RCH I( 1997) RCH II (2005)
New Born care scheme
National Neonatology Forum
Prevention of macro nutrient deficiency
Border district cluster stragety
To reduce IMR and MMR by 50% by 2007
Initiative under immunization programme:
Mobility support
Vaccine delivery
Increased annual expenditure
Out reach session by AWW & PRI’s
Auto disabled syringes
IMNCI
Community IMNCI
Emphasis – On EBF
Complementary feeding
New Born care scheme
Phase I – 80 district
Phase II – 60 district Empowered action group state.
National Neonatology Forum (NNF) imparting training to 2544 MOs, Pediatrician, Obstetrician). Iron deficiency anaemia widely prevented.
Border district cluster stragety
To reduce IMR and MMR by 50% by 2007
New initiative under immunization programme:
Introduction of auto disabled syringes for increase injection safely & easy handling by ANM. There is also mobility support to state and district immunization officer for better monitoring, supportive supervision & mobilizing children to the immunization site by ASHA, AWW, SHG given. Vaccine delivery to the immunization site from PHC to village ANM. Annual expenditure is increased on immunization. Out reach session organism by AWW & PRI’s
IMNCI – is Indian adaptation of IMCI.

26. Goal 5: Improve maternal health
Target 6: Reduce by three-quarters, between 1990 and 2015, the MMR
Indicator 16: Maternal mortality ratio
Indicator 17: Proportion of births attended by skilled health personnel
WHO estimates : 529,000 maternal deaths globally
25.7% in India.
WHO estimates : 529,000 maternal deaths globally
25.7% in India.

27. Maternal mortality ratio
India should reduce maternal mortality (MMR) from 437 deaths per 100,000 live births in 1991 to 109 by 2015.

28. Indicator 17: Proportion of births attended by skilled health personnel
T.T. injections
Any ANC visit
Safe delivery

29. Initiative for goal 5 CSSM(1992) RCH (1997)
National Population Policy (2000)
RCH camps(2001)
Traning of Dais
RCH II (2005)
Essential obstetrics care
Emergency obstetrics care
Janani Suraksha Yojana(2005)
Vandemataram Scheme
NRHM- ASHA, Streghthening

30. Goal 6:Combat HIV/AIDS, malaria & other diseases
Target 7: Have halted by 2015 & begun to reverse the spread of HIV/AIDS
Indicator 18: HIV prevalence among pregnant women aged years
19: Condom use rate of the contraceptive prevalence rate
20. Ratio of school attendance of orphans to school attendance of non-orphans aged years
Target 8 Have halted by 2015 & begun to reverse the incidence of malaria & other major Diseases
Indicator 21: Prevalence & death rates associated with malaria
22. Proportion of population in malaria-risk areas using effective malaria prevention & treatment measures
23. Prevalence & death rates associated with tuberculosis
24. Proportion of tuberculosis cases detected & cured under DOTS

31. Indicator 18: HIV prevalence among pregnant women aged 15-24 years
The first AIDS case in India was detected in Realizing the gravity of epidemiological situation of HIV infection prevailing in the country, the Government of India launched a National AIDS Control Programme in A comprehensive five- year project was launched in Learning with the experience of Phase-1, there was a paradigm shift in present Phase-II of the project addressing AIDS in the country. The second Phase of the National AIDS Control Programme (NACO-II) was formulated by Government of India with the two key objectives: (I) to reduce the spread of HIV infection in India; and (II) strengthen India s capacity to respond to HIV/AIDS on a long term basis. The total outlay for Second Phase of the National AIDS Control Programme (NACP-II) is Rs crore.
GOI (1985) Constituted task force for looking in AIDS Matter
1987 –NATIONAL AIDS CONTROL PROGRAMME LAUNCHED
Phase-I ( ) was implemented across the country with objective to slow the spread of HIV to reduce future morbidity, mortality, and the impact of AIDS by initiating a major effort in the prevention of HIV transmission.
Phase-II ( ) was aimed at reducing spread of HIV infection in India and strengthen India's capacity to respond to HIV epidemic on long term basis.
Phase-III ( )is based on the experiences and lessons drawn from NACP-I and II, and is built upon their strengths. Its priorities and thrust areas are drawn up accordingly and include the following:
Ministry of health & Family welfare,BSS 2001 & 2006
National AIDS Control Programme (1987)
NACP I( )
NACP -II (1999 – 2006)
NACP-III ( )
ART Centers

32. Indicator 21: Prevalence & death rates associated with malaria
Target 8 Have halted by 2015 & begun to reverse the incidence of malaria & other major Diseases
Indicator 21: Prevalence & death rates associated with malaria
(Per 1000)
Ministry of health & Family welfare

33. 22:Proportion of population in malaria-risk areas using
22:Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures
Ministry of health & Family welfare

34. 23. Prevalence and death rates associated with tuberculosis
TB deaths /10000 population

35. 24. Proportion of tuberculosis cases detected and cured under DOTS
Case detection rate- 70% (2007, 2008)
Cure rate % ( %) (RNTCP status report,2009)
100% coverage by RNTCP March nd Largest DOTS programme in world
WHO Stop TB Strategy, (2006)
Principal components
Pursuing high quality DOTS expansion and enhancement
Addressing TB/HIV, MDR-TB and other challenges
Contributing to health system strengthening
Engaging all care providers
Empowering patients and communities
Enabling and promoting research
The twin objectives of RNTCP are the curing of at least 85% of the new sputum positive TB patients and detecting at least 70% of
The new WHO Stop TB Strategy, (2006) has identified six principal
components to realise the global Tbrelated MDGs by They are:
Pursuing high quality DOTS expansion and enhancement
Addressing TB/HIV, MDR-TB and other challenges
Contributing to health system strengthening
Engaging all care providers
Empowering patients and communities
Enabling and promoting research
DOTS Plus – 2007 Gujarat & Maharashtra

36. Goal 7: Ensure environmental sustainability
Proportion of the population with access to an improved water sources
Proportion of the population with access to sanitation
Ministry of rural development,Urban development, Registrar general of India

37. Steps for urban water supply & sanitation
Urban Infrastructure Development Scheme for Small and Medium Towns (UIDSSMT)
VAMBAY
National Slum Development Programme (NSDP)
National Urban Renewal Mission
73rd Constitutional Amendment – Decentralized planning, implementation & management of water supply
Community based Water Quality Monitoring and Surveillance Programme
Sector Reform Project(1999)Scalled up as Swajaldhara programme Village Level Water and Sanitation Committee
District water & Sanitation committee
State Water & Sanitation Mission
Communication & capacity Development (CCD) Units

38. Rural Sanitation Total Sanitation Campaign(1999) NRHM
It follows a principle of “low to no subsidy” where a nominal subsidy in the form of incentive is given to rural poor households for construction of toilets. TSC gives strong emphasis on Information, Education and Communication (IEC), Capacity Building and Hygiene Education for effective behaviour change with involvement of PRIs, CBOs, and NGOs etc. The key intervention areas are Individual household latrines (IHHL), School Sanitation and Hygiene Education (SSHE), Community Sanitary Complex, Anganwadi toilets supported by Rural Sanitary Marts (RSMs) and Production Centers (PCs). The main goal of the GOI is to eradicate the practice of open defecation by 2010.
Total Sanitation Campaign(1999)
NRHM

39. Goal 8: Develop a global partnership for development
In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
Proxy indicator “ percentage of population with access to essential drugs”

40. Tenth five year plan NRHM Eleventh five year plan

41. Challenges Ahead Low expenditure on public health Poor infrastructure
Recession
Inflation
Tobacco & Non communicable Ds
Adverse climate & Global warming

42. Table:1 National goals &MDG
X FY Plan
2007
NPP
2010
XI FY Plan 2012
NRHM 2012
MDG
2015
Current
Infant MR 45
<30 27
Maternal MR
200
<100
100
(SRS 01-03)
Total fertility R
2.1
2.9
Institutional deliveries
80%
(NFHS III)

43. References
Millenium development goal report United Nation, New York MDG Monitor: Tracking the Millennium Development Goal. Copyright United Nations Development Programme,
Progress- so far. [Online]. [cited 2009 May 8]. Available from: URL:
Government of India. Ministry of statistics & progamme implementation, central statistical organization. Millenium development goal India country report Available from URL:
Ministry of Health and Family Welfare. Annual Report New Delhi: Ministry of Health and Family Welfare; [Online] 2008 [Cited Mar 08, 2009] Available from: [Online] 2008 [Cited Mar 08, 2009] Available from: 1/India_volume_I_corrected_17oct08.pdf
Wada na todo Abhiyaan. Measuring India’s progress on MDG-A citizens report Dec.
National Health Policy ‘Box-1 : Achievements Through The Years ’.[Online].[cited 2009 June 12]. Available from: URL:
Global progress on the Millennium Development Goals: Are we on track to meet the MDGs by 2015? [Online].[cited 2009 June 22]. Available from: URL:
MDG Monitor: Quick Facts, India’s Current Progress Status. [Online]. [cited 2009 May 30]. Available from: URL:
India to meet Millennium Goals Early. [Online].[cited 2009 May 8]. Available from: URL:
International Institute of Population Sciences and Macro International National Family Health Survey (NFHS – 3), : India: Volume 1. Mumbai: IIPS [Online] 2008 [Cited June 08, 2009] Available from: