Expanding the Agenda:
Millennium Development Goals
© Aahung 2004
MDG Goals
• Goal 1 - Eradicate Extreme Poverty And Hunger
• Goal 2 - Achieve Universal Primary Education
• Goal 3 - Promote Gender Equality And Empower Women
• Goal 4 - Reduce Child Mortality
• Goal 5 - Improve Maternal Health
• Goal 6 - Combat HIV/AIDS , Malaria And Other Diseases
• Goal 7- Ensure Environmental Sustainability
• Goal 8 - Develop A Global Partnership Of Development
© Aahung 2004
Goal 6: Combat HIV/AIDS , Malaria And Other Diseases
Target 1
Have halted by 2015, and begun to reverse, the spread
of HIV/AIDS (promote and protect)
Target 2
Have halted by 2015, and begun to reverse the incidence
of malaria and other major diseases
© Aahung 2004
Targets and Existing Indicators
Have halted by
2015, and begun to
reverse, the spread
of HIV/AIDS
(promote and
protect)
• Existing
Indicators
•HIV prevalence among 15-24 pregnant
women
• HIV prevalence among vulnerable groups
(e.g. active sexual workers)
© Aahung 2004
Rationale for expanding indicators
Rationale
• Pakistan is not a high prevalence
country (adult prevalence rate 0.1
%) but is regarded as a “high risk
country
• GOP recognizes this and has
initiated a number of interventions
to prevent the spread of HIV/AIDS in
Pakistan
• In order to strengthen GOP
commitment it is imperative to
expand MDG indicators in order to
ensure effective prevention of
HIV/AIDS and other diseases
© Aahung 2004
Rationale for expanding indicators
•
•
•
Data
•
•
•
Total number of HIV cases documented 2431NACP statistics (2004)
Total number of AIDS cases documented 310 NACP statistics (2004)
Estimated number of HIV cases in 2003 – 74000
-UNAIDS statistics (low estimate)
Estimated number of women (15-49) with HIV
8,900 in 2003– UNAIDS statistics
Estimated number of deaths 4,900 in 2003 –
UNAIDS statistics
Reasons for vulnerability to HIV/AIDS: increase
in poverty, gender inequality, un sterilized
equipment and unscreened blood transfusions,
high risk unprotected behavior (sex work), lack
of knowledge about STIs and lack of access to
formal health care, injecting drug users,
homosexuality, increase mobility and migration
for job opportunities
© Aahung 2004
Proposed indicators 1
Condom Prevalence rate
•STIs/HIV/AIDS, Hepatitis B are all transmitted through the exchange of
bodily fluids
• Research has shown that the most common mode of transmission is through
heterosexual intercourse (37%) followed by blood products (18 %), homosexual
and bisexual sex (6 %), drug use (4 %), mother and child transmission (1.3%)
and unknown means (35%)
• The most important measure to prevent transmission is the use of a
condom. Therefore, condom prevalence rate must be measured in order to
determine protection/prevention efforts and adoption of safe behaviors
© Aahung 2004
Proposed indicators 2
HIV/AIDS prevalence rate in the general population disaggregated by
gender and age
•
•
•
•
•
•
•
There is currently no means of tracking prevalence
There is significant under reporting due to the social stigma attached to
STIs
Research has shown that 70 % of HIV carriers are between the ages of 2049 year (30.87% - 30-39 years, 22.47 % - 20-29 years, 17.63% - 40-49 years)
The male – female ratio is 6:1 per 100,000.
It is imperative to monitor prevalence amongst the general population
disaggregated by gender and age as opposed to only between the ages of
15-24 as recommended in the MDG framework
The significance of heterosexual transmission increases the female
vulnerability to STIs/RTIs and HIV/AIDS, especially among those of
reproductive age
It is imperative to have the appropriate data in order to design and
implement strategic programmes
© Aahung 2004
Proposed indicators 3
Percentage of primary health care facilities providing free, voluntary
screening, counseling and treatment services for Hepatitis B /STI/HIV
AIDS for men, women and young people, regardless of marital and HIV
status
•Primary Health care facilities should provide free voluntary screening, counseling and
testing facilities for Hepatitis B, STIs/HIV/AIDS for men, women and adolescents,
regardless of marital and HIV status
• Government of Pakistan needs to integrate provision of free VCT services into their
existing primary health care system in order to effectively utilize already scarce
resources and to reach maximum population
• Data shows that 60 % of the population has access to primary health care facilities
•Provision of this service needs to be integrated as an indicator for monitoring the
progress on achievement of Goal 6 within formal government machinery
© Aahung 2004
Proposed indicators 4
Percentage of schools and non-formal education centers providing Life Skills
education and safe behavior practices
• Life Skill Education equips young people with adequate and appropriate sexual
and reproductive health knowledge and encourages them to adopt safe/preventive
behaviors (30 million young people 10-19 years)
• Life Skill Education includes topics such as: negotiation skills, body protection,
confidence building, puberty, actual information on HIV/AIDS and other STIs,
etc
• Ignorance of basic sexual and reproductive health information increases
vulnerability to disease and infection
• Ignorance enhances unsafe behavior especially amongst young people both male
and female and encourages isolation
© Aahung 2004
Proposed indicators 5
Percentage of government service providers who have undergone
training/sensitization on gender, HIV/AIDS, SRHR and quality care.
• It is imperative to measure the numbers trained in SHR issues amongst
government service providers in order to ensure effective service delivery
• Without skilled service providers there can be no effective implementation of
SRHR programmes aimed towards preventing the spread of HIV/AIDS in Pakistan
• It is recommended that SRHR concerns be integrated into the curriculum of Lady
health workers, male motivators, family planning based community workers, etc.
© Aahung 2004
Thank you
© Aahung 2004