Abstract
BackgroundThe health Millennium Development Goals (4, 5, 6) impose the same ambitious 2015 targets on every country. Few low-income countries are on track to reach them. Some authors have proposed country-specific targets as a more informative method by which countries can measure their progress against their potential.MethodsThis paper demonstrates a supplementary approach to assess individual country progress that complements the global goals by adjusting for socioeconomic resources and prior time trends. A minimum performance target adjusts for time and national GDP. Fast-track targets, based on best-performing countries’ progress within regional and income groups, adjust for health and non-health sector factors known to affect maternal and child health.ResultsMeasuring by the minimum performance target, 74% and 59% of low- and middle-income countries are on track for reducing child mortality and maternal mortality, respectively, compared with 69% and 22% using global MDGs. Only 20% and 7% of low- and middle-income countries are on track for the child and maternal mortality fast-track targets.ConclusionsSupplementary targets in maternal and child health, adjusted for each country's resources and policy performance can help countries know if they are truly underperforming relative to their potential. Adjusted targets can also flag countries that have surpassed their potential, and open opportunities for learning from success.FundingPartnership for Maternal, Newborn & Child Health and the Alliance for Health Policy and Systems Research, as part of the Success Factors Study on reducing maternal and child mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s12992-014-0067-7) contains supplementary material, which is available to authorized users.
Highlights
The Millennium Development Goals (MDGs) originate from the 2000 United Nation (UN) Millennium Declaration adopted by 189 UN member states during the Millennium Summit [1]
This paper explores methods to supplement a single global target to demonstrate what can be learned when accounting for country factors
In order to explore the implications of supplementing a single global target with country-specific targets, this study develops two versions for country-specific performance targets
Summary
The Millennium Development Goals (MDGs) originate from the 2000 United Nation (UN) Millennium Declaration adopted by 189 UN member states during the Millennium Summit [1]. Health MDGs 4 and 5a had respective targets to reduce the under-5 mortality rate (U5MR, the number of deaths of children under 5 per 1,000 live births) by two thirds and the maternal mortality ratio (MMR, the number of maternal deaths per 100,000 live births) by three quarters by 2015 and to achieve universal access to reproductive middle-income countries, especially in Africa, are “off track” for meeting the MDGs despite rapid progress in some places against considerable concurrent challenges. This has led some to suggest that applying a global standard to every country may be inappropriate [6]. Some authors have proposed country-specific targets as a more informative method by which countries can measure their progress against their potential
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