PRESENTAT TATION Background of the National MICS Survey Putting - - PowerPoint PPT Presentation

PRESENTAT TATION

Background of the National MICS Survey Putting the National MICS results into the context of the HSMTDP Key Findings:

• Maternal Health
• Child Health
• Nutrition
• NHIS
• Water and Sanitation

Conclusions

BACKGROUND

The Ghana National MICS (with an enhanced Malaria module and biomarker) was conducted by the Ghana Statistical Service with financial and technical support from:

• National Malaria Control Programme/GHS
• Navrongo Research Centre
• USAID/CDC/ICF-MACRO
• UNICEF
• Government of Japan
• UNFPA
• A lot of technical support from other DPs, UN

Agencies and MDAs

BACKGROUND

 2010 Census Sampling Frame was used, and a total of 12,250 Households were sampled;  4 Regions (Upper East, Upper West, Northern and Central) were oversampled to provide more precise data  4 Questionnaires were used: HH, Women 15-49 yrs, Children 0-5 yrs, and Men 15-59 years;  Anthropometry, Malaria/Anaemia testing for children under-5 yrs, and salt was tested (Rapid test kits, and titration);  Survey methodology similar to that of Demographic and Health Survey (DHS), therefore, data is comparable;  Presentation only captures a few core indicators, and additional results will be available in the next one month.

OBJECTIVES OF THE MICS

 Provide more current information for assessing the situation of children and women, and reporting on country progress on achieving the GSGDA goals/targets, the MDGs and the reporting requirements of other local and international development declarations and agenda;  Provide much-needed data on practices used to treat malaria among children under-five and the use of specific anti-malarial medications, bednet coverage and use, coverage of IPTP for pregnant women, treatment practices for childhood fever, and prevalence of malaria and anaemia among children age 6-59 months;  Provide baseline data for the new United Nations Development Framework (UNDAF) (2012-2016).

National MICS in the context of HSMTDP

 MICS 2011 provides a mid-term snapshot on progress on key HSMTDP 2010-2013 strategic

• bjectives
• HO1: Bridge equity gaps in access to health care and

ensure sustainable financing arrangements that protect the poor

• HO3: Improve access to quality maternal, neonatal, child

and adolescent health and nutrition services

 MICS 2011 provides nationally representative data that can inform development of next health sector medium term plan.

MATERNAL HEALTH

In aggregate, positive trends in maternal care indicators, although disparities exist……..

82 40 86 58.9 44 89 62.3 44 92 69.4 47 95 78.2 59 96.7 84.7 68.4

20 40 60 80 100 120 ANC from health professional, at least one visit ANC from health professional, 4 or more visits Skilled assistance at delivery

Per Cent

Mater erna nal Care e In Indic icat ator

• rs

GDHS 1988 GDHS 1993 GDHS 1998 GDHS 2003 GDHS 2008 MICS 2011

Target is 60% for 2013 Target is 80% for 2013

Skilled deliveries still a challenges to many women in the northern region….

Northern 37% Volta 64% Ashanti 74% Brong Ahafo 64% Western 65% Eastern 78% Upper West 60% Central 63% Upper East 67% Greater Accra 90% Northern 27% Volta 54% Ashanti 73% Brong Ahafo 66% Western 62% Eastern 61% Upper West 46% Central 54% Upper East 47% Greater Accra 84%

Key

Below 50% 51-70% Above 70%

2008 2011

Ratio of highest to lowest is 1:2.43 Target: 1:1.8 (2011) Was: 1:3.1 (2008)

The richer, educated and urban residents benefiting more from skilled deliveries…

53.9 88.2 54.5 66.2 79.4 98.1 40.2 55.0 70.2 86.0 98.3 68.4 .0 20.0 40.0 60.0 80.0 100.0 120.0 Rural Urban RESIDENCE None Primary Middle/JSS Secondary + MOTHER EDUCATION Poorest Second Middle Fourth Richest WEALTH QUINTILE NATIONAL

Assistance by TBAs during delivery reducing, but still high in some regions…

11 44 2 2 30 8 3 13 54 1 1 16 12 3

10 20 30 40 50 60

Assis ista tance ce during g Deli liver ery

2008 DHS 2011 MICS

Northern 33% Volta 11% Ashanti 12% Brong Ahafo 11% Western 25% Eastern 12% Upper West 13% Central 30% Upper East 4% Greater Accra 5%

Key

Above 30% 20-30% Below20%

88 92 97 76 88 87 79 75 83 85 86 88 88 95 72 88 87 72 63 73 77 82

10 20 30 40 50 60 70 80 90 100

Western Central Greater Accra Volta Eastern Asante Brong Ahafo Northern Upper East Upper West Total

PNC for the newborn PNC for the mother

PNC for mother and child fairly high, although not uniform across regions…

The richer, educated and urban residents benefiting more from PNC…

10 20 30 40 50 60 70 80 90 100

Urban Rural RESIDENCE None Primary Middle/JSS Secondary + MOTHER'S EDUCATION Poorest Second Middle Fourth Richest WEALTH QUINTILE TOTAL

PNC for the mother PNC for the newborn

Progress seen over time in prevention

• f malaria in pregnant women…

31.0 16.1 37.3 25.0 18.1 21.9 34.2 27.7 40.3 43.7 27.5 45.5 45.7 29.4 59.8 40.8 50.8 63.7 27.9 26 52.5 43.7 63.0 67.8 62.5 40.5 74.1 76.1 63.8 74.1 70.2 70.2 67.1 .0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Western Central Greater Accra Volta Eastern Ashanti Brong Ahafo Northern Upper East Upper West National

% of pregnant gnant wo women en receiving iving at least st 2 d doses es of IPTp

MICS 2006 DHS 2008 MICS 2011

Use of modern contraceptives increasing….

13 17 22 21 17 16 22 6 14 21 17 24 29 27 16 26 23 27 13 19 22 23 5 10 15 20 25 30 35 40 45 50

Use of modern n met ethod

• ds

2008 2011

1 in 4 women in Ghana has unmet need for Contraception

25.1 22.6 19.7 37.9 22.4 29.8 27.3 30.4 26.3 28.0 35.3 26.4 .0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0

Unmet et need fo for Contr traception aception

CHILD HEALTH

Some gains made in immunization, but nearly 1 in 4 children missing out on vital immunization by age 1

94.2 80.1 81.4 77.7 64.4 93.0 75.5 79.9 76.5 59.9 97.8 90.7 92.1 88.5 77.3

20 40 60 80 100 120

BCG OPV 3 Penta3 Measles All vaccinations % of Chil ildre dren n full lly im immunized unized by age 1 MICS 2006 DHS 2008 MICS 2011 Target for Penta by age 1yr is 91% by 2013

Increased no. of children sleeping under ITNs, but well below the national target of 70% by 2013

Western Central Greater Accra Volta Eastern Ashanti Brong Ahafo Northern Upper East Upper West Total MICS 2006 11.5 19.8 16.3 21.5 24.9 21.8 25.7 21.9 39.3 37.1 21.8 DHS 2008 35.5 18.9 17.2 40.4 35.7 25.3 50 11.2 36.8 34 28.2 MICS 2011 32.7 27.7 22.1 70.7 60.2 31.2 41.3 41.8 45.0 46.9 39.0

10 20 30 40 50 60 70 80 90 100

% of Chil ildre dren n under er-5 5 yrs who sle lept t under er an IT ITN MICS 2006 DHS 2008 MICS 2011 LLIN Campaigns took place in these Regions

NUTRITION

Concerted efforts required to promote breastfeeding…..

52 35 46 46 10 20 30 40 50 60 70 80 90 100

2003 DHS 2006 MICS 2008 DHS 2011 MICS

Tim imely ely in init itia iation ion of breast astfeed eding ing (1hr) r)

7 31 53 54 63 46 10 20 30 40 50 60 70 80 90 100 1993 DHS 1998 DHS 2003 DHS 2006 MICS 2008 DHS 2011 MICS

Ex Exclu lusi sive e breast eastfeedin eeding

Exclusive Breastfeeding Target is 70% by 2012

Some reduction in malnutrition rates, but still more than 1 in 5 children in Ghana is stunted….

34 9 23 31 10 20 35 8 18 28 9 14 22.8 6.2 13.4

10 20 30 40 50 60

Stunting Wasting Underweight

Per Cent

Nutritiona ional l St Status us of Chil ildren ren under er-5 5 yrs

1988 1993 1998 2003 2008 2011

Target for U/W is 8% for 2013

Key

Above 30% 20-30% Below20%

Wide disparities in malnutrition across regions and poverty quintiles - Stunting

Northern 32% Volta 27% Ashanti 27% Brong Ahafo 25% Western 27% Eastern 38% Upper West 25% Central 34% Upper East 36% Greater Accra 14% Northern 37% Volta 22% Ashanti 22% Brong Ahafo 19% Western 23% Eastern 21% Upper West 23% Central 23% Upper East 32% Greater Accra 14%

2008 2011

UE and Northern well above national Target of 23%

NATIONAL HEALTH INSURANCE

At least 60% of children have NHIS in Ghana…

10 20 30 40 50 60 70 80 90 100

NHIS Membe mbership hip fo for Chil ildren ren under er-5 5 yrs

Yes, card seen Yes card not seen

NHIS for women 15-49 yrs…

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Yes, card seen Yes card not seen

NHIS for men 15-59 yrs…

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Yes, card seen Yes card not seen

WA WATER, SANITATION AND HYG YGIENE

71.5 80.5 85.6 61.8 76.5 90.5 80.4 68.4 78.3 88.6 90.7 68.6 56.4 69.8 86.0 92.0 92.1

.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Perc ercent entage age of f po popu pula latio ion n wi with Im h Impro proved ved Source ce of Dr f Drin inking king Wat ater er

National average is 80%, also the Target for 2013 4 regions fall below the National average

22 43 29 6 20 13 54 13 23 16 46 15 10 20 30 40 50 60 70 80 90 100 Open defecation Unimproved facilities Shared facilities Improved facilities

% of Populat ulatio ion with th acce cess s to impro proved d sani nitar tary y facilit cilities es

1990 2008 2011

Access to improved sanitation still a challenge, with wide disparities across regions…….

Sanitation Target is 21% by 2013

Northern 72% Volta 25% Ashanti 10% Brong Ahafo 16% Western 12% Eastern 6% Upper West 71% Central 15% Upper East 87% Greater Accra 9%

Key

Above 25% 10-25% Below 10%

Population with NO sanitation facilities quite high in the north…….

Majority of the unserved are the poorest, and those living in rural areas…….

69 91 56 70 86 92 92 79 9 21 5 8 9 15 38 15 10 20 30 40 50 60 70 80 90 100 Rural Urban Poorest Second Middle Fourth Richest Total Water Sanitation

Progress has been made overall, but worrying geographic and socio-economic disparities persist.  Current increased focus on deprived regions should continue while watching out for other regions that may also be vulnerable. MDG4

Coverage of key child survival interventions show improvement-immunization, malaria prevention, undernutrition However more efforts are needed to enable equitable attainment of MDG 4 for all children in Ghana

Conclusions

 MDG5

• Progress on coverage of key interventions- family planning and skilled

delivery

• However MDG target unlikely to be achieved at current pace and without

strategic focus on structural bottlenecks

• MAF-operational plan currently under development presents a huge
• pportunity to address these bottlenecks.

 NHIS

• Important tool for MDG attainment that needs further scale-up in

coverage for all but particularly for the poorest populations.

 ‘All hands on deck’ needed for the last lap to MDG 4 and 5 goals

CONCLUSIONS (CONTD.)