MYANMAR 4. Prevalence of underweight children (under five years of age) Acronym Daw Cho New Oo. Feeding Practices in young children and infants. Department of Medical Research, Rangoon, Myanmar, 1986 DoMR Ministry of Health. Nutrition Situation of Myanmar Children. Preliminary report of the national nutrition survey 1990. Rangoon, Myanmar, 1991 NNS90 Ministry of Health. Nutrition situation of Myanmar children. Report of the National Nutrition Survey 1991. Rangoon, Myanmar, 1994 NNS91 Department of Health. National nutrition survey, 1994. National Nutrition Centre. Yangon, Myanmar, 1995 NNS94 Multiple Indicator Cluster Survey 1995 MICS95 Ministry of Health. National nutrition survey 1997. National Nutrition Centre. Yangon, Myanmar, 2000 NNS97 Multiple Indicator Cluster Survey 2000 MICS00 50 MYANMAR - PREVALENCE OF UNDERWEIGHT CHILDREN (UNDER FIVE YEARS OF AGE) % of children under 5 40 30 20 10 0 1980 1985 1990 1995 2000 DoMR NNS90 NNS91 NNS94 MICS95 NNS97 MICS00 Observed Line MDG Line
DoMR, NNS90, NNS91, NNS94, MICS95, NNS97: Children 0-2 years old. MICS95, MICS00: Children 0-4 years old. Percentage of children under five years who are classified as undernourished according to the anthropometric index of nutritional status: weight-for-age. The index is expressed in terms of the number of standard deviation (SD) units from the median of the NCHS/CDC/WHO international reference population. Children are classified as malnourished if their z-scores are below minus two standard deviations (-2 SD) from the median of the reference population. To achieve MDGs (to halve the prevalence of underweight children), 2.8% of annual reduction is needed between 1990-2015, shown as MDG line in the graph. Myanmar s progress, shown as observed line, is slower than MDG line, and it is about 0.6% of annual reduction. Additional indicators: Stunting, Breastfeeding, Vitamin A Prevalence of stunting (height for age <2 Z-scores) in children under 5 (%) % of infants under 6 months who are exclusively breastfed 0-3 months 4-6 months % of children 6-59 months who consumed vitamin A supplements 1983-85 49.7 1991 40.0 1994 44.6 1997 41.6 1999 42.4 2000 33.9 15.8 Note: Breastfeeding status refers to 24 hours preceding the survey. Stunting data refers children the same age as underweight. Source: For vitamin A, UNICEF/Nutrition Section survey 2000 For stunting and breastfeeding, the same as underweight
13. Under-five mortality rate Acronym 1983 census (indirect) Cen83 1991 Myanmar Population Change and Fertility Survey (direct) PFS91d 300 MYANMAR - UNDER-FIVE MORTALITY Under-five mortality rate (per 1000 births) 250 200 150 100 50 0 1960 1970 1980 1990 2000 Cen83 PFS91d KH line WDI04 MDG Line Direct estimates: Infant and under-five mortality rates are calculated from the data from a sample survey that collects birth histories, with a mother being asked for information on the date of birth and, if relevant, the age at death of every live-born child she has had. However, the collection of such information by surveys is complex and requires high levels of interviewer quality and training. The surveys are therefore quite expensive and can only cover small samples. Indirect estimates: Indirectly, under-five mortality and infant mortality can be calculated by asking each woman surveyed for very simple information: her age, the total number of children she has borne, and the number of those children that have died. Indirect estimates adjust the proportions dead by age group of mother for an estimated exposure distribution in order to arrive at pure measures of under-five mortality and of reference dates for these measures. The information from the younger women gives under-five mortality of more recent years whereas the information from the older women gives under-five mortality of more distant years. The adjustment process assumes certain patterns of fertility and under-five mortality by age (East, North, South, West model life tables), and results can be quite sensitive to the choices made.
KH line: The line was estimated by fitting a regression line to the relationship between infant or under 5 mortality rates and their reference dates using weighted least squares. The method of estimation is adopted from the papers: 1) K. Hill, R. Pande and G. Jones, Trends in child mortality in the developing world: 1990 to 1995, UNICEF staff working papers, Evaluation, Policy and Planning Series, UNICEF, New York, 1997. 2) K. Hill et al, Trends in child mortality in the developing world: 1990 to 1996, unpublished report, UNICEF, New York, January 1998. The weights are listed in the table in the last section of this document. WDI04: Estimates used for World Development Indicators 2004. To achieve MDGs (to reduce under five mortality by 2/3), 4.4% of annual reduction is needed between 1990-2025. Myanmar s progress, shown as WDI04 line, is slower than MDG line, and it is about 1.5% of annual reduction between 1990-2002. Additional indicators: Child (aged 1-4) mortality rate by gender Child (aged 1-4) mortality rate (per 1000 births) Survey year Male Female Note: Mortality rates are for the ten-year period preceding the survey Source:
14. Infant mortality rate Acronym 1983 census (indirect) Cen83 1991 Myanmar Population Change and Fertility Survey (direct) PFS91d 180 MYANMAR - INFANT MORTALITY Infant mortality rate (per 1000 births) 160 140 120 100 80 60 40 20 0 1960 1970 1980 1990 2000 Cen83 PFS91d KH line WDI04 MDG Line Direct estimates: Infant and under-five mortality rates are calculated from the data from a sample survey that collects birth histories, with a mother being asked for information on the date of birth and, if relevant, the age at death of every live-born child she has had. However, the collection of such information by surveys is complex and requires high levels of interviewer quality and training. The surveys are therefore quite expensive and can only cover small samples. Indirect estimates: Indirectly, under-five mortality and infant mortality can be calculated by asking each woman surveyed for very simple information: her age, the total number of children she has borne, and the number of those children that have died. Indirect estimates adjust the proportions dead by age group of mother for an estimated exposure distribution in order to arrive at pure measures of under-five mortality and of reference dates for these measures. The information from the younger women gives under-five mortality of more recent years whereas the information from the older women gives under-five mortality of more distant years. The adjustment process assumes certain patterns of fertility and under-five mortality by age (East, North, South, West model life tables), and results can be quite sensitive to the choices made.
KH line: The line was estimated by fitting a regression line to the relationship between infant or under 5 mortality rates and their reference dates using weighted least squares. The method of estimation is adopted from the papers: 1) K. Hill, R. Pande and G. Jones, Trends in child mortality in the developing world: 1990 to 1995, UNICEF staff working papers, Evaluation, Policy and Planning Series, UNICEF, New York, 1997. 2) K. Hill et al, Trends in child mortality in the developing world: 1990 to 1996, unpublished report, UNICEF, New York, January 1998. The weights are listed in the table in the last section of this document. WDI04: Estimates used for World Development Indicators 2004. To achieve MDGs (to reduce under five mortality by 2/3), 4.4% of annual reduction is needed between 1990-2025. Myanmar s progress, shown as WDI04 line, is slower than MDG line, and it is about 1.4% of annual reduction between 1990-2002. Additional indicators: Infant mortality rate by gender Infant mortality rate (per 1000 births) Survey year Male Female Note: Mortality rates are for the ten-year period preceding the survey Source:
15. Proportion of 1-year-old children immunized against measles Reported to WHO by country Reported to UNICEF by country Joint Government/Unicef/Who Review of the EPI in the Socialist Republic of the Union of Burma, 1987 1985 EPI Coverage Evaluation Survey for Myanmar, 1991 1985 EPI Coverage Evaluation Survey for Myanmar, 1991 1990 Multiple Indicator Cluster Survey 1995, 1996 1994 Monitoring Progress Towards the Goals of National Programme of Action for Myanmar's Children 1997, 1999 1996 Myanmar Multiple Indicator Cluster Survey 2000 1999 The graph is taken from WHO web site. http://www.who.int/vaccines-surveillance/whounicef_coverage_review/wucoveragecountrylist.htm Draft WHO/UNICEF estimate: WHO/UNICEF estimates of the most likely coverage for each year and antigen were made based on data from the WHO and UNICEF data bases and information from other sources. WHO and UNICEF consulted with Regional Offices and, where possible, national experts, to seek more in-depth knowledge regarding the functioning of the immunization system.
Additional indicators: WHO/UNICEF estimate of immunization coverage, BCG, DPT3, Pol3 Immunization coverage (%) WHO/UNICEF estimate BCG DPT3 Pol3 1985 45 16 3 1986 28 20 4 1987 54 23 10 1988 50 28 22 1989 66 50 45 1990 95 88 88 1991 69 84 84 1992 77 87 87 1993 80 90 90 1994 83 77 77 1995 90 84 84 1996 92 88 87 1997 94 90 90 1998 91 87 88 1999 88 83 87 2000 88 82 86 2001 70 72 71 2002 80 77 77 Source: WHO/UNICEF Review of National Immunization Coverage 1980-2002 http://www.who.int/vaccines-surveillance/whounicef_coverage_review/wucoveragecountrylist.htm
16. Maternal mortality ratio Estimate by WHO, UNICEF Estimate by WHO, UNICEF, UNFPA Estimate by WHO, UNICEF, UNFPA Acronym WHO90 WHO95 WHO00 1000 MYANMAR - MATERNAL MORTALITY Maternal Mortality Ratio (per 100,000 live births) 800 600 400 200 0 1985 1990 1995 2000 WHO90 WHO95 WHO00 WHO90: The WHO-UNICEF estimate, using a model. For countries without accurate information on numbers of deaths and without direct or indirect estimates of maternal mortality, the model is used to predict the proportion maternal of all deaths of women of reproductive age and this proportion is applied to the 1990 United Nations projections of adult female deaths to derive the maternal mortality ratio. Source: Revised 1990 estimates of maternal mortality: a new approach by WHO and UNICEF. WHO95:The estimate is developed using the model. The regression model was used to predict the proportion maternal among deaths of women of reproductive age (PMDF), and the prediction was then applied to an envelope of deaths of females of reproductive age in 1995 to estimate maternal deaths. The maternal mortality ratio was then obtained by dividing the number of maternal deaths by an estimate of the number of births in 1995. In almost all cases, the deaths envelope was obtained from the UN population projections (1998 Revision). Source: Maternal mortality in 1995: Estimates developed by WHO, UNICEF, UNFPA WHO00: The WHO, UNICEF and UNFPA estimate. The method is used for countries with no national data on maternal mortality. The estimates are developed using the model. For each country, the regression model is used to predict PMDF, and the prediction then applied to WHO estimates of non-hiv deaths of women of reproductive age in 2000 to calculate maternal deaths. The MMR is then obtained by dividing the number of maternal deaths by an estimate of the number of live births in 2000 derived from the United Nations projections (2000 Revision). Source: Maternal mortality in 2000: Estimates developed by WHO, UNICEF and UNFPA
17. Proportion of births attended by skilled health personnel Fertility and Reproductive Health Survey 1997. Department of Population, Ministry of Immigration and Population Acronym FRHS97 100 MYANMAR - % of Births Attended by Skilled Health Personnel % of Births Attended by Skilled Health Personnel 80 60 40 20 0 1985 1990 1995 2000 FRHS97 The year in the graph indicates the year of the survey. Additional reproductive health indicators: Fertility rate Adolescent fertility Total fertility rate (per woman) rate (per 1000 women aged 15-19) 1990 4.0 2000 3.1 2000-2005 29 Note: Total fertility rate is average lifetime total of live births per woman at the fertility rates of the year. Adolescent fertility rate is an annual number of live births to girls aged 15-19 per 1,000 girls aged 15-19. Source: UNICEF End-decade Databases
18. HIV prevalence among 15-to-24-year-old pregnant women HIV prevalence among 15-to-24-year-old pregnant women (No data)
HIV prevalence among pregnant women UNAIDS/WHO Epidemiological Fact Sheet 2002 Update The graphs are taken from WHO web site. Trends in HIV prevalence among antenatal clinic attendees. The data reported are mainly based on the HIV database maintained by the United States Bureau of the Census where data from different sources, including national reports, scientific publications and international conferences are compiled. Studies conducted in the same year are aggregated and the median prevalence rates are given for each of the categories. The maximum and minimum prevalence rates observed are also provided. The differentiation between the two geographical areas Urban and Rural is not based on strict criteria, such as the number of inhabitants. For most countries, urban areas were considered to be the capital city and where applicable other metropolitan areas with similar socio-economic patterns. The term rural considers that most sentinel sites are not located in strictly rural areas, even if they are located in somewhat rural districts.
HIV prevalence among young people 15 to 24 years UNAIDS Report on the global HIV/AIDS epidemic June 2000 1999 UNAIDS Report on the global HIV/AIDS epidemic July 2002 2001 5 MYANMAR - HIV PREVALENCE AMONG YOUNG PEOPLE AGED 15-24 Prevalence rate (%) 4 3 2 1 0 1999 2001 Low estimate, female High estimate, female Low estimate, male High estimate, male No data for 2001. Regarding the UNAIDS data, the estimated number of young people (15-24) living with HIV/AIDS at the end of the year divided by the population of young people (15-24) of the year. The estimates are expressed as a range generated by regional modeling.
19. Contraceptive prevalence rate Any method and modern method National Fertility/Family Planning/Health Survey 1992 National Fertility/Family Planning/Health Survey 1997 Acronym NFPHS92 NFPHS97 MYANMAR - CONTRACEPTIVE PREVALENCE 50 40 Contraceptive prevalence (%) 30 20 10 0 1985 1990 1995 2000 NFPHS92(any) NFPHS97(any) Percentage of women in union aged 15-49 who are using any contraception and modern contraception
Condom use rate of the contraceptive prevalence rate Acronym Percentage of women in union aged 15-49 who are using condoms for contraception among women in union aged 15-49 who are using any method. Simply calculated by: condom use divided by all methods.
20. Number of children orphaned by HIV/AIDS Number of orphans UNAIDS, Report on the global HIV/AIDS epidemic 2002 (No data) Number of children (aged 0-14) currently living whose mother, father or both parents have died due to AIDS (including those children who lost both parents and those who lost one parent to AIDS and the other parent due to another cause)
Ratio of proportion of orphans to non-orphans aged 10 to 14 years who are attending school (No data) The ratio of children (aged 10-14) who lost both parents and are attending school to non-orphaned children the same age who are attending school
21. Prevalence and death rates associated with malaria (No data)
22. Proportion of population in malaria risk areas using effective malaria prevention and treatment measures Bednet usage Acronym (No data)
Bednet treatment Acronym (No data)
Malaria treatment Acronym (No data) Percentage of children who received antimalarial medicine, among children who had fever in the last 2 weeks before the survey.
23. Prevalence and death rates associated with tuberculosis Prevalence rates Acronym Christopher Dye et al. Global Burden of Tuberculosis, JAMA, August 18, 1999; Vol 282 GBT WHO TB data submitted to the UN in May 2002 WHO 500 MYANMAR - TUBERCULOSIS PREVALENCE Prevalence rate per 100,000 400 300 200 100 0 1985 1990 1995 2000 GBT WHO Rates for tuberculosis prevalence excluding cases attributable to HIV/AIDS. Prevalence of smear-positive disease.
Death rates Acronym Christopher Dye et al. Global Burden of Tuberculosis, JAMA, August 18, 1999; Vol 282 GBT WHO TB data submitted to the UN in May 2002 WHO 100 MYANMAR - TUBERCULOSIS MORTALITY Death rate per 100,000 80 60 40 20 0 1985 1990 1995 2000 GBT WHO Rates for tuberculosis mortality excluding cases attributable to HIV/AIDS.
24. Proportion of tuberculosis cases detected and cured under directly observed treatment short course (DOTS) Proportion of tuberculosis cases detected WHO Report 2004 Global Tuberculosis Control 100 MYANMAR - PROPORTION OF ESTIMATED NEW SMEAR-POSITIVE TB CASES DETECTED UNDER DOTS DOTS detection rate (%) 80 60 40 20 0 1985 1990 1995 2000 Proportion of estimated new smear-positive tuberculosis cases detected under DOTS (Directly Observed Treatment Short Course)
Proportion of tuberculosis cases cured WHO Report 2004 Global Tuberculosis Control MYANMAR - PROPORTION OF REGISTERED NEW SMEAR-POSITIVE TB CASES SUCCESSFULLY TREATED UNDER DOTS 100 DOTS treatment success (%) 80 60 40 20 0 1985 1990 1995 2000 Proportion of registered new smear positive tuberculosis cases successfully treated under DOTS (Directly Observed Treatment Short Course)
Data: 1983 1984 Prevalence of underweight children (%) 38.0 WHO/UNICE F estim ate Reported by country to WHO Reported by country to UNICEF Government official estimate Reported doses administered Survey 12-23 months 1985 3 1986 5 5 3 1987 17 17 14 1988 32 32 25 1989 50 50 50 Survey <12 months 1990 32.4 90 68 73 63 580 1991 36.7 85 85 63 Proportaion of 1-year-old children immunized against measles (%) Maternal mortality Proportion of ratio (per births attended 100,000 live by skilled health births) personnel (%) Major urban areas, age 15-19 Major urban areas, age 20-24 Outside major urban areas, age 15-19 Outside major urban areas, age 20-24 Minimum Median Maximum Minimum Median Maximum 1992 84 84 71 0 0 0 0 0.5 5.5 1993 88 88 71 0 0 0 0.5 1 10 1994 31.2 77 77 77 75 0.3 0.4 0.5 0 0.8 8.4 1995 42.9 82 82 82 170 0.3 0.8 1.3 0 1 7.8 1996 86 86 86 81 0.8 0.8 0.8 0 1 8 1997 28.2 88 88 88 56.4 0 0.65 1.3 0.3 1.5 4.8 1998 85 85 85 1 1 1 0.8 2.3 3.8 1999 85 85 86 85 85 87 1.3 1.8 2.3 0 1.75 7.5 2000 35.3 84 84 84 84 84 360 2 2.75 3.5 0 1.76 5.29 2001 73 73 73 73 73 1 1.25 1.5 0 2.05 6 2002 75 75 75 75 75 HIV prevalence among 15-to-24-year-old pregnant women HIV prevalence among pregnant women (%) Urban Rural Ratio of proportion of Condom use Number of orphans to non- Proportion of Proportion of rate of the children orphans aged 10 Prevalence and tuberculosis tuberculosis contraceptive orphaned by to 14 years who death rates Treatment Tuberculosis Tuberculosis cases detected cases cured Contraceptive prevalence rate HIV/AIDS are attending associated with Bednet usage bednet usage Malaria prevalence rate death rate (per under DOTS under DOTS HIV prevalence among young people aged 15-24 (%) prevalence rate (%) (% ) currently living school (%) malaria (% ) (% ) treatment (%) (per 100,000) 100,000) (% ) (% ) Fem ale low Female high Male low Male high Modern estimate estim ate estim ate estimate All mdthods methods 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 16.8 1993 1994 1995 66 1996 25 79 1997 32.7 146 40 26 82 1998 29 82 1999 34 81 1.13 2.3 0.42 1.67 2000 51 82 133 38 2001 62 81 2002 73
Estimates of Under-five mortality and IMR, data and weights used for estimation: Under-five mortality rate (per 1000 births) Data used KH line Census83 Indirect PFS91 Direct Rate Reference year Rate W eight Reference year Rate W eight 1960 252 1982.3 137 0 1988 147 2 1965 213 1981.1 128 0.2 1983 127 1.8 1970 179 1979.4 136 1.2 1978 141 1.2 1975 151 1977.2 147 1.2 1980 134 1974.7 157 1.2 1985 140 1972.1 172 0.8 1990 146 1969.1 178 0.4 1995 153 2000 160 2001 161 2002 162 Infant mortality rate (per 1000 births) Data used KH line Census83 Indirect PFS91 Direct Rate Reference year Rate W eight Reference year Rate W eight 1960 169 1982.3 96 0 1988 103 2 1965 143 1981.1 90 0.2 1983 96 1.8 1970 122 1979.4 95 1.2 1978 102 1.2 1975 105 1977.2 102 1.2 1980 94 1974.7 108 1.2 1985 97 1972.1 118 0.8 1990 101 1969.1 121 0.4 1995 106 2000 110 2001 111 2002 112