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Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi
Part 1
Six lines of action to promote health in the 2030 Agenda for Sustainable Development. . . . . . . . . . . . . . . . . . 1
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Monitoring the health-related SDGs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.2 Health system strengthening for universal health coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.3 Health equity leave no one behind. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
1.4 Sustainable health financing.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
1.5 Innovation, research and development. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1.6 Intersectoral action for health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Part 2
Status of the health-related SDGs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
2.1 Reproductive, maternal, newborn and child health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
2.2 Infectious diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
2.3 Noncommunicable diseases and mental health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
2.4 Injuries and violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
2.5 Universal health coverage and health systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
2.6 Environmental risks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
2.7 Health risks and disease outbreaks.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Part 3
Country success stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.1 Ending preventable maternal deaths in Kazakhstan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.2 Reducing the level of malaria in Papua New Guinea.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
3.3 Combating viral hepatitis in Cambodia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
3.4 Improving health by clearing the air in Ireland. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
3.5 Preventing suicide in the Republic of Korea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
3.6 Preventing early deaths due to alcohol in the Russian Federation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
3.7 Fighting the tobacco industry in Uruguay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
3.8 Strengthening health emergency preparedness in Ghana. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
3.9 Monitoring mortality and cause of death in the Islamic Republic of Iran. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Annex B: Tables of health-related SDG statistics by country, WHO region and globally. . . . . . . . . . . . . . . . . . . 85
Explanatory notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
T
he World Health Statistics series is WHOs annual compilation of health statistics for its 194 Member States. The
series is produced by the WHO Department of Information, Evidence and Research, of the Health Systems and
Innovation Cluster, in collaboration with all relevant WHO technical departments.
World Health Statistics 2017 focuses on the health and health-related Sustainable Development Goals (SDGs) and associated
targets by bringing together data on a wide range of relevant SDG indicators. In some cases, as indicator definitions are
being refined and baseline data are being collected, proxy indicators are presented. In addition, in the current absence of
official goal-level indicators, summary measures of health such as (healthy) life expectancy are used to provide a general
assessment of the situation.
World Health Statistics 2017 is organized into three parts. In Part 1, six lines of action are described which WHO is now
promoting to help build better systems for health and to achieve the health and health-related SDGs. In Part 2, the status
of selected health-related SDG indicators is summarized, at both global and regional level, based on data available as of
early 2017. Part 3 then presents a selection of stories that highlight recent successful efforts by countries to improve and
protect the health of their populations through one or more of the six lines of action. Annexes A and B present country-
level estimates for selected health-related SDG indicators.
As in previous years, World Health Statistics 2017 has been compiled primarily using publications and databases produced
and maintained by WHO or United Nations groups of which WHO is a member, such as the UN Inter-agency Group
for Child Mortality Estimation (IGME). Additionally, a number of statistics have been derived from data produced and
maintained by other international organizations, such as the United Nations Department of Economic and Social Affairs
(UNDESA) and its Population Division.
For indicators with a reference period expressed as a range, figures refer to the latest available year in the range unless
otherwise noted.
Unless otherwise stated, the WHO regional and global aggregates for rates and ratios are weighted averages when
relevant, while for absolute numbers they are the sums. Aggregates are shown only if data are available for at least 50%
of the population (or other denominator) within an indicated group. For indicators with a reference period expressed as
a range, aggregates are for the reference period shown in the heading unless otherwise noted. Some WHO regional and
global aggregates may include country estimates that are not available for reporting.
Unless otherwise stated, all estimates have been cleared following consultation with Member States and are published here
as official WHO figures. Where necessary, the estimates provided have been derived from multiple sources, depending
on each indicator and on the availability and quality of data. In many countries, statistical and health information systems
are weak and the underlying empirical data may not be available or may be of poor quality. Every effort has been made
to ensure the best use of country-reported data adjusted where necessary to deal with missing values, to correct for
known biases, and to maximize the comparability of the statistics across countries and over time. In addition, statistical
modelling and other techniques have been used to fill data gaps. However, these best estimates have been derived using
standard categories and methods to enhance their cross-national comparability. As a result, they should not be regarded
as the nationally endorsed statistics of Member States which may have been derived using alternative methodologies.
While every effort has been made to maximize the comparability of statistics across countries and over time, users
are advised that country data may differ in terms of the definitions, data-collection methods, population coverage and
estimation methods used. More detailed information on indicator metadata is available through the Global Health
Observatory.
1 The Global Health Observatory (GHO) is WHOs portal providing access to data and analyses for monitoring the global health situation. See: http://www.who.int/gho/en/, accessed 18
March 2017.
WHO/SEARO/Gary Hampton
FOR SUSTAINABLE
DEVELOPMENT
Overview the six main lines of action shown in Table 1.1. Recognizing
that the SDGs embrace all aspects of health, these actions
The 2030 Agenda for Sustainable Development (1) is are intended to encourage not only the realigning of
the worlds first comprehensive blueprint for sustainable present efforts in relation to the 2030 Agenda, but also
development. Launched at the end of 2015, this Agenda the investigating of new ways of accelerating gains already
frames health and well-being as both outcomes and made in improving health and well-being. For each of the six
foundations of social inclusion, poverty reduction and lines of action expanded upon in more detail in subsequent
environmental protection. From a health perspective, sections of this report (see sections 1.11.6) there are a
development can be said to be sustainable when resources number of opportunities and challenges.
natural and manufactured are managed by and for all
individuals in ways which support the health and well-being First, the monitoring and evaluation of progress made
of present and future generations (2).1 towards defined targets was a major strength of the
Millennium Development Goals (MDGs) both in terms
In addition to acting as a stimulus for action, the 2030 of measuring progress and fostering accountability. In the
Agenda provides an opportunity to build better systems for SDG framework, health both contributes to and benefits
health by strengthening health systems per se to achieve from all the other goals. As a result, the measurement of
universal health coverage (UHC), and by recognizing that progress must traverse the whole framework. In addition
health depends upon, and in turn supports, productivity to the 13 specific health targets of SDG 3, a wide range
in other key sectors such as agriculture, education, of health-related targets are incorporated into the other
employment, energy, the environment and the economy. goals. Examples include SDG 2 (End hunger, achieve food
security and improved nutrition and promote sustainable
To help build better systems for health and to achieve the agriculture); SDG 6 (Ensure availability and sustainable
Sustainable Development Goals (SDGs) WHO is promoting management of water and sanitation for all); SDG 7 (Ensure
access to affordable, reliable, sustainable and modern
1
This definition, oriented towards health, builds upon the general definition of energy for all); SDG 8 (Promote sustained, inclusive
sustainable development given in: Our common future. Report of the United Nations and sustainable economic growth, full and productive
World Commission on Environment and Development. Geneva: United Nations World
Commission on Environment and Development (www.un-documents.net/our-common- employment and decent work for all); SDG 11 (Make
future.pdf, accessed 13 March 2017).
Health research, and monitoring and evaluation activities The persistence of profound social and economic inequities
have been boosted in recent years by rapid technological not only compromises the freedoms and entitlements of
advances that allow for the collection and management of individuals but directly contravenes the principle, clearly set
increasingly large volumes of primary data disaggregated out in the WHO Constitution, that the right to the highest
to reveal the individuals and populations most in need. The attainable standard of health is a fundamental right of
advent of big data is a motivation to build links between every human being. As well as being an objective in its own
databases in different sectors, to provide greater access to right, health equity is a key enabling factor, for example in
data and to develop new analytical methods that will lead working towards UHC. In seeking health equity, there are
to a better understanding of disease and open up pathways mutual synergies to be harnessed between activities aimed
to new interventions. at achieving the SDG 3 targets and those that promote
gender equality (SDG 5), equality within countries more
Efforts to compile health statistics including for the WHO generally (SDG 10) and transparency, accountability and
World Health Statistics series have prompted reflection non-discriminatory laws (SDG 16). However, to make the
on how best to measure health as both an outcome and movement towards equity a real force for change, specific
determinant of sustainable development. In order to programmes of work are needed to identify objectively
monitor progress towards the overall SDG 3 goal (Ensure who is being left behind, and to develop and implement
healthy lives and promote well-being for all at all ages), effective solutions.
WHO has considered several overarching indicators. These
include life expectancy; healthy life expectancy; and Sustainable financing underpins any system that aims to
number of deaths before age 70 (3). Such indicators are improve health. One unintended consequence of the focus
affected not only by the progress made towards the SDG 3 on disease-control programmes during the MDG era was
targets but also towards the health-related targets in other the creation of parallel financial flows and the duplication
goals. They therefore reflect the multisectoral determinants of health system functions, such as those for information
of health. Current estimates of life expectancy and healthy gathering and procurement. It is intended that inclusion
life expectancy are included in this report as summary of the concept of UHC within SDG 3 will lead to a more
indicators of health throughout the life-course (see Annexes comprehensive approach to health financing.
A and B). The development and monitoring of comparable
indicators of health-state distributions, disability and well- New priorities for health financing have now been set out in
being in populations will require further research, along with the Addis Ababa Action Agenda (5). One point of agreement
the implementation of standardized survey instruments and is that each country has the primary responsibility for its
methodologies. own economic and social development. In that context, the
guiding principles of health financing include, for example,
During the period 20002015, the MDGs focused on enhancing domestic tax administration and reducing
programmes tailored to specific health conditions mainly tax avoidance to increase the overall capacity for public
in relation to maternal and child health, and communicable spending, including on health. In addition to the principles
diseases (notably HIV/AIDS, malaria and tuberculosis). outlined in the Addis Ababa Action Agenda, good practice
Far less attention was given to the performance of whole also involves reducing the fragmentation of financial flows
health systems, including health services, with the result and pooling health revenues so as to maximize redistributive
that the potential benefits of doing so were neglected. The capacity and better match funds to priority health services
SDGs remedy this situation by emphasizing the crucial and populations.
need for UHC, including full access to and coverage of
health services, with financial risk protection, delivered Research and innovation are further prerequisites for
via equitable and resilient health systems. UHC is not achieving the SDGs. Here, innovation refers not only to
an alternative to the disease-control programmes of the the invention and development of new technologies but
MDG era rather it embraces these programmes so that also to finding novel means of implementation that would
increased population coverage can be sustained within a include legal and financial instruments, health workforce
comprehensive package of health services. The SDGs also expansion outside the medical profession, and the use of
encompass the provision of services for noncommunicable common platforms for health delivery. Without continuous
Enabling factors Reinforcing research and innovation as foundations for sustainable development,
Scientific research and innovation (see section 1.5) including a balance of research on medical, social and environmental determinants
and solutions
Exploiting new technologies to manage large volumes of data, disaggregated to
Monitoring and evaluation (see section 1.1) ascertain the needs of all individuals; tracking progress towards SDG 3 and all other
health-related targets
investment in research and innovation in new technologies will provide the foundation for both regional and global-
and health service implementation many of the ambitious level reviews. Countries have affirmed their resolve to
SDG targets simply will not be achieved. implement robust monitoring strategies in order to ensure
accountability to their citizens. For many countries, this
It is clear that responsibility and accountability for health in would imply new and improved data-collection efforts.
the context of sustainable development extend well beyond Disaggregation by all relevant inequality dimensions is
the health sector. The 2030 Agenda now provides a real another key guiding principle that will have important
opportunity to place health in all domains of policy-making, implications for data gathering (see section 1.3).
to break down barriers and build new partnerships, and to
bring coherence to policies and actions. Among the many The SDGs also represent new directions in terms of the health
examples of key synergies that characterize the SDGs, and health-related indicators chosen. In addition to the 13
health stands on common ground with social inclusion explicit health targets of SDG 3 there are numerous health-
and poverty alleviation, and efforts to move towards UHC related targets in the other 16 goals (Table 1.2). In addition, in
contribute directly to public security. In addition, ending contrast to the MDG focus on maternal and child health and
hunger and achieving food security and improved food priority infectious diseases, the SDGs are broader and more
safety and nutrition are vital for health and development, comprehensive, and include indicators for NCDs, mental
while the provision of clean water and sanitation could health and injuries. The use of mortality indicators to monitor
substantially reduce the hundreds of thousands of deaths the health of populations has also increased. Around one
each year caused by diarrhoeal diseases. third of the selected health-related indicators shown in Table
1.2 require information on total or cause-specific mortality.
The six lines of action shown in Table 1.1 and individually Countries will face new challenges in building or improving
discussed in more detail in sections 1.11.6 below are systems for monitoring mortality by cause.
not intended to be comprehensive and exclusive. Rather,
their purpose is to highlight the core values that underpin Data for monitoring the health-related SDGs
sustainable development, and to identify some of the Currently, very few of the 42 selected health-related SDG
crucial factors that will need to be addressed in building indicators listed in Table 1.2 are adequately measured in
better systems for health and well-being, and in achieving most countries with the result that high-quality data
the ambitious goals and targets set by the international are not routinely collected with sufficient detail to allow
community. for regular computation of national levels and trends, or
for disaggregation across key dimensions of inequality.
In addition, whereas many countries have established
1.1 Monitoring the health-related SDGs monitoring systems for some indicators that can be
strengthened, other indicators are new and hard to measure,
One key element in fostering accountability around the and further investment and development will be required
MDGs was the increased emphasis placed on monitoring before sufficient country-level data are available. Countries
progress. In the SDG era this focus on monitoring progress will need strong health information systems that use
continues, with countries proposing a country-led follow-up multiple data sources to generate the statistics needed
and review framework (6). One of the frameworks guiding for decision-making and for tracking progress towards the
principles is that the monitoring process will be voluntary SDG targets.
and country-led, and that national official data sources
Indicator Indicator area CRVSb Surveyc Facility Other common data Key definitional or methodological challenges
recordsd sources
3.1.1 Maternal mortality Specialized study; Reporting of pregnancy-related deaths in surveys; under-reporting of
(census) maternal deaths in CRVS systems
3.1.2 Skilled birth attendance Need for consistent definition of skilled cadres across countries and
data sources
3.2.2 Neonatal mortality rate Under-reporting; age misstatement; misclassification with stillbirths
3.3.1 HIV incidence Models needed to infer incidence from observed prevalence and
antiretroviral therapy (ART) coverage data
3.3.2 Tuberculosis incidence Case notifications Determining rate of under-reporting of cases from facility data and/or
routine surveillance systems
3.3.3 Malaria incidence Case notifications Incompleteness of case notifications in high-burden areas; prediction
of incidence from parasite-prevalence surveys
3.3.4 Hepatitis B incidence Need to survey large number of five-year-olds once vaccination is at
scale
3.3.5 Need for neglected Case notifications Under-reporting of cases; aggregation across diseases
tropical disease
treatment/care
3.4.2 Suicide mortality rate Police/coronial data Determination of intent; under-reporting due to stigma, economic or
legal concerns
3.5.2 Alcohol use Industry/government Estimating tourist consumption and home production
sales records
3.6.1 Deaths from road traffic Police/coronial data Definitional differences across death registration data, surveillance
injuries systems and police data
3.8.1 UHC coverage index Asynchronous data collection across tracer indicators; lack of
disaggregation variables for some tracer indicators
3.9.1 Mortality due to air Air-quality monitors/ Uncertainty around assumptions used to attribute deaths to poor air
pollution satellite data quality
3.9.2 Mortality due to unsafe Hand-washing Uncertainty around assumptions used to attribute deaths to unsafe
WASH services observation studies WASH
3.9.3 Mortality due to Deaths from alcohol and illicit drug use are often assigned to
unintentional poisoning unintentional poisoning with an unspecified substance
3.b.1 Vaccine coverage Reconciliation of household survey and administrative data sources
3.b.3 Essential medicines Health-facility survey Establishing sampling frame of public and private facilities; confirming
quality of medicines in stock
3.d.1 IHR capacity Country self- Consistency and accuracy of reported assessments
and emergency assessment and/or
preparedness key informant survey
Indicator Indicator area CRVSb Surveyc Facility Other common data Key definitional or methodological challenges
recordsd sources
1.a.2 Proportion of Government budget Difficulty accessing expenditures that are not centrally available or are
government spending data off-budget
on essential services,
including health
2.2.2 Wasting and overweight Accuracy and precision of the scale used to weigh the child; age
among children misreporting
5.2.1 Intimate partner Definitional issues and comparability of self-reporting across countries
violence against women
6.1.1 Safely managed Supplementary data Obtaining data on water availability and quality in households
drinking-water services on quality of water
services
7.1.2 Clean household energy Survey modules must be revised to monitor clean energy
11.6.2 Air pollution Air-quality monitors; Placement of air-quality monitors; calibration of satellite data to match
satellite data ground measurements
13.1.2e Mortality due to Estimates by Defining end of disaster event and attributing deaths to the disaster
disasters governments, aid
agencies, NGOs,
academics and the
media
16.1.1 Homicide Police/coronial Under-reporting and misreporting in death registration data; under-
records reporting and inconsistent definitions in criminal justice data sources
16.1.2 Mortality due to Estimates by Civil registration and vital statistics (CRVS) systems are likely to break
conflicts governments, aid down during large-scale conflicts; definitional issues; under-reporting,
agencies, NGOs, double counting and biased reporting
academics and the
media
16.1.3 Population subject to Operational definition of psychological violence; data collection among
violence children
17.19.2 Birth and death Census Imprecise demographic methods used to determine completeness
registration
Note: Use of indicates preferred data source; or ( ) indicate a lower-quality, or non-preferred data source.
a
Indicators outside the health goal (SDG 3) were selected from indicators of health outcomes, proximal determinants of health, health-service provision or health information systems; in
cases where several indicators cover the same area, only a subset are shown above. Other health-related indicators within scope include: 2.1.1 (undernourishment); 4.2.1 (children
developmentally on track); 5.2.2 (non-intimate partner sexual violence against women); 5.3.1 (child marriage); 5.6.1 (women making informed decisions on reproductive health); 6.3.1
(wastewater treatment); 11.6.1 (urban waste management); 12.4.2 (hazardous waste management); 16.2.1 (children subject to physical punishment/caregiver aggression); 16.2.3 (youths
experiencing sexual violence); and 16.9.1 (birth registration).
b
Predominantly referring to death registration with medical certification of cause of death.
c
This category comprises a wide variety of population-based surveys, including demographic and health surveys, general health examination surveys, disease-specific biomarker surveys
and living-standard surveys.
d
Data based on facility contacts, at the primary, secondary or tertiary level.
e
Indicator 13.1.2 is the same as indicators 1.5.1 and 11.5.1 (all include deaths from natural disasters).
Figure 1.2
Proportion of deaths assigned to selected garbage codes by age and sex, 2005-2015a
Males Females
35
Deaths assigned to selected garbage codes (%)
30
25
20
15
10
0
All ages
04
59
1014
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
7579
8084
8589
9094
95
Unknown age
a
Data available by five-year age group up to age 85, average of all years with data 20052015.
Usability
Low (< 60%) Medium (6079%) High ( 80%)
SDG Target 3.8 on achieving universal health coverage
Completeness (%)
(UHC) lies at the centre of SDG 3 on health. Making progress
40% 50% 60% 70% 80% 90% 100%
0%
l l l l l l l towards UHC is an ongoing process for every country as they
Singapore Finland work to ensure that all people receive the health services they
10% need without experiencing financial hardship. The health-
related targets of the SDGs cannot be met without making
20% France
Garbage code (%)
SERVICE DELIVERY
HSS
(input/output) Medicines and other
Information
Workforce
health technologies
FINANCING
GOVERNANCE
Coverage (%)
50 Antenatal care
As shown in Figure 1.5 (17), global coverage of tracer 40
4 visits
Table 1.4
Tracer indicators of the coverage of essential health services
10
Figure 1.6
Out-of-pocket expenditures as a fraction of total health expenditures,a 2014 0
200 500 1000 2000 5000 10 000 20 000
100 G DP per capita (US $, log s cale)
80
70
OOP as a % of total health expenditures
60
50
40
30
20
10
0
200 500 1000 2000 5000 10 000 20 000 50 000 100 000 200 000
G DP per capita (US $, log s cale)
Circles
a
Inc omeare proportional to population size.
group
High-income countries Upper-middle-income countries Not applicable
Lower-middle-income countries Low-income countries
health expenditure demonstrate the interdependency Based on the latest available household expenditure survey
between different SDG targets specifically, eradicating data for 117 countries as of March 2017 (median year
extreme poverty (SDG Target 1.1) and achieving UHC (SDG 2008), around 9.3% of the population on average faced
Target3.8). OOP payments in excess of 10% of their budget (total
household expenditure or income), including on average
The primary source of data for estimating levels of both 1.8% of the population who spent 25% or more of their
catastrophic and impoverishing health expenditure is a budget on health care.1
household survey with information on both household
expenditure on health and total household expenditures, Across 106 countries with data (median year 2009) the
as routinely conducted by national statistics offices. Based average incidence of poverty was about 0.65 percentage
on information available to WHO in February 2017, the points higher than it would have been without OOP
extent of data availability is fair, with about half of all WHO payments for health care, based on a US$ 1.90 per capita
Member States having at least one data point since 2005, per day poverty line. This means an additional 4.6% of the
with the following WHO regional breakdown in terms of population ended up with less than US$ 1.90 per capita per
proportion of countries having such data: day after paying for health care. Looking at the extent to
which total expenditure or income fell short of the poverty
African Region 62% line, the severity of poverty as measured by the poverty gap2
Region of the Americas 37% was 7.5% higher than it would have been without any OOP
South-East Asia Region 82% payments for health care. As shown in Figure 1.7, OOP
European Region 59% health payments exacerbate the severity of poverty the
Eastern Mediterranean Region 43% most among the poorest and those living in rural areas.
Western Pacific Region 37%
All WHO Member States 52%
1
Average figures are unweighted.
2
The poverty gap is the average amount by which total household expenditure or income
falls short of the poverty line as a percentage of that line (counting the shortfall as 0 for
those above the poverty line).
0.6
reinforce and reform national health information systems
to ensure that they have the capacity to collect, analyse and
0.4 report equity-relevant data, and to support the systematic
0.2
integration and use of such data in decision-making and in
ongoing national and subnational planning, programming,
0
Poorest Second Middle Second Richest Rural Urban
monitoring, reviewing and evaluation.
20% poorest 20% richest 20%
20% 20%
(q1) (q2) (q3) (q4) (q5) Trends in health inequality
a
Analysis based on a US$ 1.90 per capita per day poverty line, from the latest available WHO World Health Statistics 2013 examined the health
survey for 106 countries with available estimates as of February 2017. The horizontal line gaps between countries and concluded that concerted
indicates the average change across the 106 countries.
efforts to achieve the MDGs and other health goals had
led to their reduction, at least in absolute terms, between
Progressive realization high-resourced and low-resourced countries (31). It is harder
Despite health system reforms, all countries struggle to to assess trends in within-country health inequality due
extend the coverage of quality services with financial to a lack of comparable and relevant data across health
protection, including high-income countries with long- indicators in a large number of countries. It is important here
established institutional arrangements for health systems to distinguish between the concepts of health inequality
that may, for example, be working to maintain their levels differences in health indicators among population subgroups
of coverage in the face of rising costs. Demographic and and income or wealth inequality. Although there has
epidemiological changes play an important role along with been an average increase in income inequality in both
technological advances and changes in patterns of service developing countries and many high-income countries in
utilization. Meeting the health-related SDG targets will recent decades (32), health inequalities have not necessarily
therefore require a progressive realization of UHC, through followed the same pattern.
significant efforts to strengthen health systems. This can
only be achieved through committed and coordinated Recent WHO global health inequality reports (29, 30) and
investments in health governance and financing; health a number of recent studies (33, 34) have indicated that
workforce, medicines and other health technologies; and overall, and in most countries with data available, health
health information systems. The key to delivering high- inequalities have been decreasing in terms of reproductive,
quality, people-centred and integrated health services is maternal and child health intervention coverage (Figure 1.8)
to: (a) establish efficient, decentralized and integrated (24), and child mortality. On the other hand, trends in child
health systems staffed by motivated and well-trained malnutrition inequalities are mixed, with no overall increase
professionals; and (b) provide and ensure appropriate use or reduction at the global level (29, 35).
of the full range of quality-guaranteed essential medical
products, financed in ways that guarantee predictable and There are currently no comparable cross-national studies of
adequate funding for the system while at the same time trends in adult mortality, life expectancy, NCDs or injuries.
offering financial protection to its users. There is, however, evidence of widening health inequalities
in some high-income countries. For example, several studies
found widening inequalities in life expectancy in the United
1.3 Health equity leave no one behind States of America with falling life expectancy among
non-Hispanic white Americans, particularly those of lower
The 2030 Agenda for Sustainable Development emphasizes socioeconomic status (3638). Suicide, drug poisoning and
the need for monitoring to go beyond the measurement of violence were major contributors to increased mortality.
aggregate performance to ensure that no one is left behind. Conversely, one study of health outcomes for 45 English
This means that data for health-related SDG targets should subregions grouped into quintiles of average deprivation
be disaggregated for key disadvantaged subgroups within (39) found that between 1990 and 2013, the range in life
countries and health inequality measures calculated. In expectancy remained 8.2 years for men and decreased from
keeping with the mutually reinforcing nature of the SDGs, 7.2 years in 1990 to 6.9 years in 2013 for women. Trends in
progress towards this end will not only contribute to the NCD risk factor inequalities are likely to vary depending on
achievement of the health-related targets themselves but the country and risk factor, with a lack of comparable data
also to SDG 5 on achieving gender inequality, SDG 10 on precluding any global understanding of these (40).
WHO region
AFR AMR SEAR EUR EMR WPR
A nnual abs olute exc es s c hange in the poores t c ompared with the ric hes t quintile
Malawi
1.5
Namibia
V iet Nam Niger
1.0
(perc entage points )
Haiti
K enya Madagas car R wanda
Median = 0.6 C had Mali Nepal
0.5 Uzbekis tan
Mozambique B enin
0.0
J ordan K azakhs tan
-0.5
E thiopia
Nigeria
-1.0
C ameroon Uganda
-1.5
Dec reas e in national average Inc reas e in national average
P ro-ric h c hange Median = 0.7 P ro-ric h c hange
(middle points). Blue and red text indicates desirable and undesirable scenarios, respectively. For each study country, annual absolute change in national average was calculated by
subtracting the national coverage in survey year 1 (conducted in 19952004) from the coverage in survey year 2 (conducted in 20052014) and dividing by the number of intervening
years. Annual absolute excess change was calculated by subtracting the annual absolute change in quintile 5 from the annual absolute change in quintile 1.
Health inequality monitoring educational level, sex, age, place of residence, ethnicity,
Monitoring health inequality helps to identify the health migrant status, disability status, and other characteristics
gap for disadvantaged population subgroups, and appropriate to the country context, such as caste.
to ensure that policies, programmes and practices are
successful in reaching the most vulnerable. Additional Table 1.5 lists potential ways of improving data sources for
information on the reasons behind the differences in health health inequality monitoring (41). Household surveys and
provides decision-makers with the information they need population censuses allow for the collection of a range of
to more effectively understand the barriers to health and inequality dimensions at individual and household level,
to design interventions and approaches to overcome them. including socioeconomic variables, minority population
status and disability status. Household survey programmes
Developing equity-oriented health information systems such as DHS and MICS currently offer comparable data
entails country capacity-building to support the collection, across a large number of developing countries (42, 43) and
analysis and reporting of data for the SDG health and health- are usually repeated over time. The main disadvantage
related indicators by population subgroups. Disadvantaged of household surveys for inequality monitoring is the
groups may be defined in terms of their economic status, requirement for relatively large sample sizes to allow
Table 1.5
Improving data sources for health inequality monitoring
Data source
Population census CRVS Household survey Institution-based records Surveillance system
Potential means of improvement
Include individual or small area Expand coverage Repeat surveys regularly Standardize electronic records Integrate surveillance
identifiers Include individual or small area Harmonize survey questions across institutions functionality into the national
identifiers over time Include individual or small- health information system
Include at least one Increase sample sizes area identifiers Include individual or small area
socioeconomic indicator (for Include individual or small area identifiers
example, educational level) identifiers
Include cause of death, birth Include a comprehensive list of
weight and gestational age (if relevant inequality dimensions
not included)
Total health
expenditure 60 70
40 50
100 Out-of-pocket 40
(right axis) 30
30
External 20
10 20
(right axis)
10
10
1 0 0
225
450
900
1800
3600
7200
14 400
28 800
57 600
l l l l l
1995 2000 2005 2010 2014
Figure 1.10 14
Percentage of total general government
5.0 8
6
4.0
4
Percentage of GDP
3.0 2
0
2.0 l l l l l
1995 2000 2005 2010 2014
1.0
0 Figure 1.14
l l l l l External sources as a percentage of total health expenditure, 19952014
1995 2000 2005 2010 2014
Global Low-income countries
Figure 1.11 40
Percentage of total health expenditure
20
50 15
10
40
5
30
0
l l l l l
20 1995 2000 2005 2010 2014
10
Another important challenge is to develop comprehensive Productive dialogue between the health sector and
approaches that go beyond framing sustainability as finance authorities tasked with allocating government
a revenue issue alone, and which also address system resources this should be done at the sectoral level
inefficiencies and expenditure management problems(58). (not at the level of a single programme or disease
Sustaining current and improved levels of health service intervention) and should focus on the overall level of
coverage will require efforts to address the ways in which funding for health. Such communication channels are
currently available resources are allocated and used. The important in aligning health-financing reform strategies
crucial importance of such a dual revenue-expenditure with public financial management rules, and enable
focus is underscored by recent evidence that shows wide health systems to take real steps towards results-
variations in key measures of health service coverage and oriented accountability rather than merely focusing on
financial protection at very low levels of public spending input control and budget implementation.
on health (< PPP$ 40 per capita). It has been noted that
some countries achieve coverage levels more than double Move away from silos this will require tackling the
those observed in other countries with similar levels issues of how resources for health are apportioned
of spending(59). Such results emphasize that ensuring and how the overall health system is designed and
sustainability is not about meeting a specific spending organized. At present, externally financed vertical health
target or advocating for funding streams for a particular programmes are often in place, and frequently operate
programme, because progress towards UHC will not depend independently of the rest of the health system so as to
simply on the level of health spending. In all countries, focus resources on a single disease or intervention. The
addressing existing system bottlenecks, constraints and rationale for such a narrow organizational approach
inefficiencies is essential for sustaining progress towards may no longer make sense when these programmes are
achieving UHC (59). domestically financed. Rather, in the context of overall
Figure 1.16
ODA for medical research and basic health sectors as a percentage of GNI and of total ODA, by donor country, 20102015a
Luxembourg
United Kingdom
Canada
Ireland
Norway
United Arab Emirates
Belgium
Iceland
Denmark
Sweden
Finland
Switzerland
Australia
United States of America
Germany
Netherlands
Republic of Korea
New Zealand
Japan
France
Spain
Austria
Portugal
Italy
Czechia
Malta
Romania
Lithuania
Estonia
Slovakia
Slovenia
Poland
Hungary
Kazakhstan
Greece
l l l l l l l l l l l l l l l
0.07% 0.06% 0.05% 0.04% 0.03% 0.02% 0.01% 0% 0% 2% 4% 6% 8% 10% 12%
As a % of GNI As a % of total ODA
Latest available data.
a
Table 1.6
Examples of opportunities for leveraging intersectoral action to improve health and achieve multiple other SDG targets
Box 1.4
Socioeconomic policies (8487)
conditions for vulnerable groups (such as workers in of consumables such as tobacco, alcohol, fat and sugars
the informal economy and children); and (d) affordable to address associated health risks such as smoking, poor
housing. Such policies address socioeconomic and health nutrition, interpersonal violence and obesity. Regulatory
inequalities, thus contributing to SDG 1 on poverty, SDG 2 levers are also effective in regulating products used in
on hunger, SDG 4 on education, SDG 5 on gender equality construction (for example, asbestos or lead paint). A
and SDG 10 on inequality, while also contributing to the 2014 World Health Assembly resolution on public health
sustainability of health care systems, with direct relevance impacts of exposure to mercury and mercury compounds
to SDG 3. For example, it has been estimated that each (88), aims to protect human health and the environment
additional month of paid maternity leave in LMIC is from the adverse effects of mercury, and encourages
associated with 7.9 fewer infant deaths per 1000 live births ministries of health to cooperate with related ministries
(78), while integrated social and medical services, tailored to including those for the environment, labour, industry and
disadvantaged families and delivered by nurses in homes, agriculture. In other areas, global health security can
result in significant developmental benefits(79). be improved through national intersectoral committees
constituted in accordance with the International Health
Leveraging world production, consumption and trade Regulations (2005), while the issue of global migration is
systems, and global phenomena such as migration and being given an increasing public health focus, broadening
climate change from codes of practice on international health worker
Economic and legal levers such as tax, regulation and recruitment to encompass refugee and economic migrant
laws have been used to change the production and trade populations (89).
1
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2017;389(10064):10318.
WHO/Hans Everts
Overview many countries, weak health systems remain an obstacle to
progress and result in deficiencies in coverage for even the
More than 50 SDG indicators, across more than 10 goals, most basic health services, as well as poor preparedness
have been selected to measure health outcomes, direct for health emergencies. Based on the latest available data,
determinants of health or health-service provision. These the global and regional situation in relation to the above
health-related indicators may be grouped into the following seven thematic areas is summarized below. Country-
seven thematic areas: specific findings by indicator, where available, are presented
graphically in Annex A and in tabular form in Annex B.
reproductive, maternal, newborn and child health
infectious diseases 2.1 Reproductive, maternal, newborn and
noncommunicable diseases and mental health child health
injuries and violence
universal health coverage and health systems Worldwide, approximately 830 women died every single
environmental risks day due to complications during pregnancy or childbirth
health risks and disease outbreaks. in 2015 (1). Reducing the global maternal mortality ratio
(MMR) from 216 per 100 000 live births in 2015 to less
Available data indicate that despite the progress made than 70 per 100 000 live births by 2030 (SDG Target
during the MDG era major challenges remain in terms 3.1) will require a global annual rate of reduction of at
of reducing maternal and child mortality, improving least 7.5% which is more than triple the annual rate of
nutrition, and making further progress in the battle against reduction that was achieved between 1990 and 2015 (2).
communicable diseases such as HIV/AIDS, tuberculosis Most maternal deaths are preventable as the necessary
(TB), malaria, neglected tropical diseases and hepatitis. medical interventions are well known. It is therefore crucially
Furthermore, the results of situation analyses provide important to increase womens access to quality care
clear evidence of the crucial importance of addressing before, during and after childbirth. In 2016, millions of births
NCDs and their risk factors such as tobacco use, mental globally were not assisted by a trained midwife, doctor or
health problems, road traffic injuries and environmental nurse, with only 78% of births were in the presence of a
conditions within the sustainable development agenda. In skilled birth attendant (3).
Coverage (%)
<50 (6 countries, or 3%)
5079 (30 countries, or 16%)
8089 (35 countries, or 18%) Data not available/HepB not introduced (9 countries, or 5%)
90 (114 countries, or 59%) Not applicable 0 750 1500 3000 Kilometres
health
Global trends in age-standardized mortality rate by NCD cause, by country income
groups, 20002015
3.9 million deaths (10%); and diabetes, 1.6 million deaths 200
(4%). The risk of dying from any one of the four main
150
NCDs between ages 30 and 70 decreased from 23% in
2000 to 19% in 2015. In high-income countries, age- 100
standardized cardiovascular mortality rates have declined 50
rapidly in recent years, while mortality rates from the other
0
main NCDs have fallen at a slower pace. Although age- l l l l
standardized cardiovascular mortality rates and chronic 2000 2005 2010 2015
300
The worldwide level of alcohol consumption in 2016 was
Age-standadized mortality rate
(per 100 000 population)
250
6.4 litres of pure alcohol per person aged 15 years or older,
with considerable variation between WHO regions (15). 200
Available data indicate that treatment coverage for alcohol 150
and drug-use disorders is inadequate, though further work
is needed to improve the measurement of such coverage. 100
50
In 2015, more than 1.1 billion people smoked tobacco,
0
with far more males than females currently engaging in l l l l
2000 2005 2010 2015
this behaviour (16). The WHO Framework Convention on
In 2015, there were an estimated 468000 murders, with In 2015, global coverage of three doses of diphtheria-
four fifths of all homicide victims being male. Men in the tetanus-pertussis (DTP3) vaccine, as a proxy for full
WHO Region of the Americas suffered the highest rate of immunization among children, was 86% (13). Data from
homicide deaths at 32.9 per 100000 population, 12 times 20072014 show that the median availability of selected
the rate among men in the WHO Western Pacific Region essential medicines in the public sector was only 60% in
(Figure 2.4). Globally, during the period 20002015 there selected low-income countries and 56% in selected lower-
was a marked decline (19%) in homicide rates (11). middle-income countries (21). Access to medicines for
chronic conditions and NCDs is even worse than that for
Figure 2.4 acute conditions. Despite improvements in recent decades,
Homicide rates by sex, by WHO region and globally, 2015
the development of innovative new products remains
Male Female focused away from the health needs of those living in
35
developing countries. As a result, the current landscape
of health research and development (see section 1.5) is
Mortality rate (per 100 000 population)
30
insufficiently aligned with global health demands and needs.
25 Health workforce densities are also distributed unevenly
20 across the globe. As shown in Figure 2.5, WHO regions
15
with the highest burden of disease expressed in disability-
10
1
SDG indicator 3.8.1 Coverage of essential health services is defined as the average
5 coverage of essential services based on tracer interventions that include reproductive,
maternal, newborn and child health, infectious diseases, noncommunicable diseases
0 and service capacity and access, among the general and the most disadvantaged
AFR AMR SEAR EUR EMR WPR Global populations.
AMR
80
in 2015 the coverage of safely managed drinking-water
60
services remains low, with preliminary estimates of 68%
coverage in urban areas and only 20% in rural areas(30,31).
40 WPR Around one third of the world population (32%) did not have
EMR
access to improved sanitation facilities in 2015, including
20 SEAR
AFR 946 million people who practised open defecation(30).
0
l l l l l l l l l
0 100 200 300 400 500 600 700 800 An estimated 108 000 deaths were caused by unintentional
Disability-adjusted life years (per 1000 population) poisonings in 2015. In LMIC, pesticides, kerosene,
household chemicals and carbon monoxide are all common
causes of such poisoning. In high-income countries, the
adjusted life years (22) also have the lowest densities of substances involved primarily include carbon monoxide,
health workforce required to deliver much-needed health drugs, and cleaning and personal-care products in the
services. Data from 20052015 show that around 40% of home. The number deaths attributed to this cause are
countries have less than one physician per 1000 population highest among children under 5 years of age and among
and around half of all countries have less than three nursing adults aged 60 years or older. Mortality rates are also
and midwifery personnel per 1000 population (23). Even in higher among men than among women across all age
countries with higher national health worker densities, the groups (Figure2.6)(11).
workforce is often inequitably distributed, with rural and
hard-to-reach areas tending to be understaffed compared Figure 2.6
Global mortality rate due to unintentional poisonings, by age and sex, 2015
to capital cities and other urban areas.
Male Female
3.5
States register at least 80% of deaths, with associated
3.0
information provided on cause of death (11, 24). In addition,
2.5
data-quality problems further limit the use of such
2.0
information.
1.5
1.0
0
04 514 1529 3059 60+
Around 3 billion people still heat their homes and cook
Age (years)
using solid fuels (that is, using wood, crop wastes, charcoal,
coal or dung) in open fires and leaky stoves. The use of
such inefficient fuels and technologies leads to high levels
of household air pollution. In 2012, such household air 2.7 Health risks and disease outbreaks
pollution caused 4.3 million deaths globally. Women and
children are at particularly high risk of disease caused by The International Health Regulations (IHR) monitoring
exposure to household air pollution, accounting for 60% of process involved the use of a self-assessment questionnaire
all deaths attributed to such pollution (25). sent to States Parties to assess the implementation status
of 13 core capacities. In 2016, 129 States Parties (66% of all
In 2014, 92% of the world population was living in places States Parties) responded to the monitoring questionnaire.
where WHO air quality guideline standards were not met. The average core capacity scores of all reporting countries
Outdoor air pollution in both cities and rural areas was in 2016 was 76% (32, 33).
estimated to have caused 3 million deaths worldwide in
2012. Some 87% of these deaths occurred in LMIC(26).
Jointly, indoor and outdoor air pollution caused an estimated 1
Includes deaths from diarrhoea, intestinal nematode infections and protein-energy
6.5 million deaths (11.6% of all global deaths) in 2012 (27). malnutrition attributable to lack of access to WASH services.
3. WHO global database on maternal health indicators, 2017 update 17. Global status report on road safety 2015. Geneva: World Health
[online database]. Geneva: World Health Organization (http:// Organization; 2015 (http://www.who.int/violence_injury_
www.who.int/gho/maternal_health/en/). prevention/road_safety_status/2015/en/, accessed 22 March
2017).
4. Estimates and projections of family planning indicators 2016.
New York (NY): United Nations, Department of Economic and 18. World Health Organization, United Nations Office on Drugs and
Social Affairs, Population Division; 2015 (see: http://www.un.org/ Crime and United Nations Development Programme. Global
en/development/desa/population/theme/family-planning/cp_ status report on violence prevention 2014. Geneva: World Health
model.shtml, accessed 23 March 2017). Special tabulations were Organization; 2014 (see: http://www.who.int/violence_injury_
prepared for estimates by WHO region. prevention/violence/status_report/2014/en/, accessed 23 March
2017).
5. World Population Prospects, the 2015 Revision (DVD edition).
New York (NY): United Nations, Department of Economic and 19. World Health Organization, London School of Hygiene & Tropical
Social Affairs, Population Division; 2015 (http://esa.un.org/unpd/ Medicine and South African Medical Research Council. Global
wpp/Download/Standard/Fertility/, accessed 13 April 2016). and regional estimates of violence against women: prevalence
and health effects of intimate partner violence and non-
6. Levels & Trends in Child Mortality. Report 2015. Estimates partner sexual violence. Geneva: World Health Organization;
developed by the UN Inter-agency Group for Child Mortality 2013 (http://www.who.int/reproductivehealth/publications/
Estimation. United Nations Childrens Fund, World Health violence/9789241564625/en/, accessed 23 March 2017).
Organization, World Bank and United Nations. New York (NY):
United Nations Childrens Fund; 2015 (http://www.unicef.org/ 20. Unweighted averages of country-specific data from WHO Global
publications/files/Child_Mortality_Report_2015_Web_9_ Health Expenditure Database [online database]. Geneva: World
Sept_15.pdf, accessed 22 March 2017). Health Organization (http://apps.who.int/nha/database/Select/
Indicators/en, accessed 22 March 2017).
7. Global database on child growth and malnutrition [online
database]. Geneva: World Health Organization; 2017 (http:// 21. Millennium Development Goal 8: taking stock of the global
www.who.int/nutgrowthdb/database/en). partnership for development. MDG Gap Task Force Report
2015. New York (NY): United Nations; 2015 (www.un.org/en/
8. AIDS by the numbers: AIDS is not over, but it can be. Geneva: development/desa/policy/mdg_gap/mdg_gap2015/2015GAP_
UNAIDS; 2015 (http://www.unaids.org/sites/default/files/ FULLREPORT_EN.pdf, accessed 23 March 2017).
media_asset/AIDS-by-the-numbers-2016_en.pdf , accessed 18
April 2016). Estimates by WHO region were calculated by WHO. 22. Global Health Estimates 2015: DALYs by cause, age, sex, by country
and by region, 20002015. Geneva: World Health Organization;
9. World Malaria Report 2016. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_disease/
2016 (http://www.who.int/malaria/publications/world-malaria- estimates/en/index2.html, accessed 23 March 2017).
report-2016/report/en/, accessed 22 March 2017).
23. WHO Global Health Workforce Statistics. 2014 update [online
10. Global tuberculosis report 2016. Geneva: World Health database]. Geneva: World Health Organization (http://who.int/
Organization; 2016 (http://apps.who.int /iris/bitstre hrh/statistics/hwfstats/en/).
am/10665/250441/1/9789241565394-eng.pdf?ua=1, accessed
22 March 2017). 24. Based on data reported to the WHO Mortality Database (http://
www.who.int/healthinfo/mortality_data/en/) as of 12 October
11. Global Health Estimates 2015: Deaths by cause, age, sex, by 2016.
country and by region, 20002015. Geneva: World Health
Organization; 2016 (http://www.who.int/healthinfo/global_ 25. Burning opportunity: clean household energy for health,
burden_disease/estimates/en/index1.html, accessed 22 March sustainable development, and wellbeing of women and children.
2017). Geneva: World Health Organization; 2016 (http://apps.who.
int/iris/bitstream/10665/204717/1/9789241565233_eng.pdf,
12. Global hepatitis report, 2017. Geneva: World Health Organization; accessed 23 March 2017).
2017 (http://www.who.int/hepatitis/publications/global-
hepatitis-report2017/en/, accessed 17 April 2017). 26. Ambient air pollution: a global assessment of exposure and burden
of disease. Geneva: World Health Organization; 2016 (see: http://
13. WHO/UNICEF estimates of national immunization coverage. July who.int/phe/publications/air-pollution-global-assessment/en/,
2016 revision (http://www.who.int/immunization/monitoring_ accessed 23 March 2017).
surveillance/routine/coverage/en/index4.html, accessed 22
March 2017).
29. Preventing diarrhoea through better water, sanitation and hygiene. 33. States Parties to the International Health Regulations (2005)
Exposures and impacts in low- and middle-income countries. [website]. Geneva: World Health Organization (http://www.who.
Geneva: World Health Organization; 2014 (http://apps.who. int/ihr/legal_issues/states_parties/en/, accessed 24 April 2017).
int/iris/bitstream/10665/150112/1/9789241564823_eng.
pdf?ua=1&ua=1, accessed 23 March 2017).
WHO/Sergey Volkov
STORIES
Despite global progress in reducing the maternal Kazakhstan initiated its confidential enquiry This example shows how the proactive reviewing
mortality ratio (MMR) (1) immediate action is system in 2011, when the Central Confidential and reclassification of maternal deaths can
needed to meet SDG Target 3.1 and ultimately Audit Commission (CCAC) audited the officially improve the classification of cases and quantify
eliminate preventable maternal mortality. Although reported maternal deaths for 20092010 to the accuracy of the data systems used to monitor
the rates of reduction that are needed to achieve determine why these deaths occurred (8). This the MMR. Such efforts are recognized by the
country-specific SDG targets may be ambitious audit resulted in recommendations to revise UN-MMEIG for countries conducting and
for most high-mortality countries, some countries clinical guidelines. In 2014, the CCAC audit describing this type of high-quality study, UN
have already made remarkable progress in was expanded to cover deaths in women of estimates of maternal mortality can be computed
reducing their MMR. Such countries can provide reproductive age that were not officially assigned directly from the country data without global
inspiration and guidance on how to accomplish to maternal causes. The CCAC then reviewed adjustment factors. As a result, in countries
the acceleration of efforts needed to reduce the pregnancy-related deaths1 that had occurred with primarily high-quality CRVS data, national
number of preventable maternal deaths. between 2011 and 2013. These included 166 level data and global estimates are harmonized.
deaths that had officially been registered as Furthermore, the results of confidential enquiries
Measuring maternal mortality is challenging maternal deaths2 and 18 deaths that had been can be used to revise and strengthen clinical
because of limited data availability, and even registered as accidents or deaths due to other guidelines, and to support activities aimed at
countries with well-functioning civil registration causes. Following CCAC review, 10 of the ending preventable maternal deaths.
and vital statistics (CRVS) systems have difficulties, original 166 deaths were found not to have been
due to misclassification, in ascertaining the due to maternal causes, while eight of the 18
causes of maternal deaths. The United Nations pregnancy-related deaths were re-categorized
Maternal Mortality Estimation Inter-Agency as maternal deaths (Table 3.1) (9).
Group (UN-MMEIG), of which WHO is a member,
has published a succession of MMR estimates Table 3.1
used for global reporting and comparison (27). Results of the 2014 CCAC confidential enquiry, Kazakhstan
Before each release of new MMR estimates, Number of deaths
WHO conducts a country consultation process Categorization 2011 2012 2013 Total
during which countries have the opportunity to
Officially registered as maternal deaths (a) 65 52 49 166
review and discuss the estimates made, and the
data and methodology used to generate them. Re-categorized as non-maternal deaths (b) 4 1 5 10
A particular focus is placed on the strengths Confirmed maternal deaths (a - b = c) 61 51 44 156
and limitations of data inputs and on problems Additional pregnancy-related deaths identified in the enquiry (d) 8 3 7 18
related to the misclassification of maternal deaths.
Re-categorized as maternal deaths (e) 4 2 2 8
In acknowledging the problem of misclassification, Total maternal deaths (c + e) 65 53 46 164
Kazakhstan is one of a number of countries
that have implemented specialized surveillance
systems and conducted confidential enquiries
into maternal deaths. This has allowed for the
strengthening of CRVS systems, and for the
reviewing and correction of mistakes in cause-
of-death assignment. Such confidential enquiries 1
Defined as: ...the death of a woman while pregnant or
are designed to improve maternal health and within 42 days of termination of pregnancy, irrespective
health care by collecting data, identifying any of the cause of death (International statistical
classification of diseases and related health problems,
shortfalls in the care provided and devising 10th revision. Volume 2: Instruction manual. Geneva:
recommendations to improve future care. The World Health Organization; 2011).
approach involves identifying and investigating 2
Defined as: ...the death of a woman while pregnant or
the cause of all deaths of women of reproductive within 42 days of termination of pregnancy, irrespective
of the duration and the site of the pregnancy, from any
age using multiple sources of data including cause related to or aggravated by the pregnancy or
interviews with family members and community its management, but not from accidental or incidental
health workers, and reviews of CRVS data, causes (International statistical classification of diseases
and related health problems, 10th revision. Volume 2:
household surveys, health-care facility records Instruction manual. Geneva: World Health Organization;
and burial records. 2011).
Papua New Guinea is largely mountainous but has The numbers of malaria cases, admissions and Figure 3.2
a diverse geography which also includes coastal Trend in prevalence of Plasmodium falciparum or
deaths at health facilities is tracked through the P. vivax malaria parasites in Papua New Guinea,
plains, swamps, plantations and offshore atolls. national health information system. In addition, 20092014
Malaria is highly endemic in coastal areas, where progress has been monitored through three
two thirds of the population live. People in these nationally representative household surveys 15
70
of malaria should be treated with at least two 61 for malaria programme expansion in Papua New
60 54
effective antimalarial medicines with different Guinea stems from the Global Fund, and more
48
mechanisms of action (combination therapy). 50 44 diverse sources of funding will be needed to
40 ensure programme stability. According to data
The reduction of malaria-related morbidity and 33 reported to WHO (10) governmental funding for
30
mortality is a key objective of Papua New Guineas the countrys malaria programme increased
National Health Plan, with the mass distribution 20 more than ten-fold between 2010 and 2015.
of ITNs viewed as an essential component of the 10 However, Papua New Guineas recent GDP
malaria-control strategy. In 2009, the country growth, which allowed for this investment, is
received US$ 102 million from the Global Fund 0 largely attributed to an expansion of natural
2009 2011 2014
and more than 7.5 million ITNs were distributed in resource projects and international demand for
three mass distribution rounds between 2009 and such resources can be volatile.
2015. In addition, RDTs for improving diagnosis Household surveys (11, 12) also revealed a drop in
and guiding the use of combination therapy parasite prevalence among the population living
(artemetherlumefantrine) were introduced below an altitude of 1600 metres (Figure 3.2). In
in 2011. Substantial investments, including total, WHO estimated that in 2015 the number of
investments in activities of nongovernmental malaria cases in Papua New Guinea had been
organizations, were made to reach some of the reduced to 900 000, with 1200 deaths (10).
most remote population groups in the world.
In 2015, infection with the hepatitis B virus (HBV) In 2011, a second biomarker survey was Despite the absence of nationally representative
contributed to an estimated 887 000 deaths conducted in three provinces among children data following the implementation of HBV
worldwide. Most of these deaths result from who had been born in 20062007 following vaccination, the intermediate biomarker-based
the chronic sequelae of HBV infection such as the national roll-out of HBV vaccination (17). In assessment conducted in 2011 had suggested
cirrhosis (52%) and liver cancer (38%) (15). These all three provinces, the prevalence of HBsAg that Cambodia was on course to meet the goal
chronic sequelae in adulthood are most often had decreased compared with the estimates set by the Regional Committee for the Western
the result of HBV infections acquired at birth or obtained for children born in similar settings in Pacific of reducing the seroprevalence of HBsAg
during childhood. The prevalence of hepatitis B 2000. In Phnom Penh, where third-dose coverage to < 2% among children 5 years of age by 2012
surface antigen (HBsAg) among children 5 years and timely birth-dose coverage were 91% and (18). The lessons learnt from this intermediate
of age may be used as a surrogate indicator of the 55% respectively, 0.33% of 1196 children were evaluation also led to successful national efforts
cumulated incidence of chronic HBV infections HBsAg positive. In Kratie (third-dose and timely to increase both third-dose coverage and timely
from birth to age five. Such early HBV infection birth-dose coverage 82% and 36% respectively) birth-dose coverage (Figure 3.4). Such increases,
can be prevented by timely vaccination. 1.41% of 569 children were HBsAg positive. In if maintained, would allow the country to meet
Ratanakiri (third-dose and timely birth-dose the new control goals of the global health sector
Several studies had indicated that the prevalence coverage 64% and 22% respectively) 3.45% strategy on viral hepatitis 20162021 of reducing
of chronic HBV infection as measured by the of 637 children were HBsAg positive. Children HBsAg seroprevalence in children 5 years of
prevalence of HBsAg was high in Cambodia, born at home without a skilled birth attendant age to 1% by 2020, and to 0.1% by 2030 (19).
with prevalence in specific adult populations were 1.94 times less likely to have received a In 2017, a new biomarker survey will further
such as blood donors and emigrants ranging timely birth-dose compared with those born in document the progress made towards these
from 8% to 14% (16). In 2001, Cambodia a health facilities with a skilled birth attendant. goals. The incorporation of robust monitoring
began to phase-in the universal immunization Children who had received a first dose of vaccine and evaluation activities as part of HBV vaccine
of infants against HBV, based upon a first dose after 7 days of life or who had never received roll-out in Cambodia will allow for the efficient
administered as soon as possible after birth and the vaccine were found to have the highest targeting of resources to ensure that all children
two subsequent doses. HBV vaccination was prevalence of HBsAg (Figure 3.3). are covered by the vaccination programme.
implemented nationwide in 2005. Biomarker
surveys conducted in 2006 and 2011 documented Figure 3.3 Figure 3.4
the improvement in immunization rates that had Prevalence of HBV infection (HBsAg) by first-dose WHO and UNICEF estimatesa of hepatitis B timely birth-
occurred since 2000. vaccination timing among four- and five-year olds in dose and hepatitis B third-dose vaccination coverage,
Phnom Penh, Kratie, and Ratanakiri, Cambodia, 2011 Cambodia, 20062015
The 2006 national biomarker survey was Phnom Penh Birth dose, within 24 hours of birth
conducted specifically to provide a formal Kratie Third dose
initial assessment prior to large-scale vaccine Ratanakiri
100
introduction (16). The prevalence of HBsAg 12 90
was measured among children 5 years of
Prevalence of HBV infection (%)
10 80
age all of whom had been born prior to the
introduction of routine hepatitis immunization 70
8
Coverage (%)
given
a
Based on national immunization coverage data reported
to WHO and UNICEF.
SDG Target 3.4 on reducing premature mortality exposure may occur indoors or outdoors. Policies of bituminous (smoky) coal abruptly improved air
from noncommunicable diseases (NCDs) will implemented in Ireland to reduce exposure to quality in Dublin and reduced chronic respiratory
require multifaceted action. Such action will dangerous particles have resulted in documented disease mortality (27). The ban was subsequently
include improving primary health care to treat reductions in mortality from chronic respiratory extended to other cities and large towns in the
heart disease, diabetes and hypertension; diseases. In September 1990, a ban on the sale following decades, contributing to declines in
promoting healthy diets and physical activity; measured black smoke concentrations and to
and building healthy environments. Between Figure 3.5 the reductions in NCD-associated mortality
2000 and 2015, the rate of mortality due to the Probability of dying from any of the four main NCDs observed from 2000 onwards.
four main NCDs1 declined globally by 17% (15). between age 30 and exact age 70, Ireland (by sex),
WHO European Region and the world
Such recent improvements are estimated to be Although the Dublin coal ban was implemented
mainly due to reductions in cardiovascular and Ireland (all) more than 25 years ago, bituminous coal is still
chronic respiratory disease mortality. Because Ireland (males) used for home energy needs in small towns and
Ireland (females)
of the myriad of ways in which deaths from World
rural areas in Ireland. Currently, smoke from
cardiovascular disease can be prevented, EUR solid fuel use continues to be the main source
modelling studies are typically used to estimate of particulate matter (PM) in rural areas where
25
which particular factors have led to the observed PM10 concentrations2 are similar to those seen
23
reductions in mortality. These studies have in cities and large towns (28). These exposures
shown that previous improvements in high- 21 are expected to reduce following the scheduled
Probability of dying (%)
income countries were the result of reductions 19 nationwide implementation of the coal ban by
in risk factors and improvements in medical 17 the end of 2018 (29).
care in approximately equal measure (20, 21). 15
In the case of chronic respiratory diseases, the 13 In 2004, Ireland became the first country in the
main risk factors are tobacco smoking, outdoor 11 world to ban smoking in all enclosed public places
air pollution and indoor use of solid fuels (22). 9 and workplaces. The ban is strictly enforced
7 and includes bars, restaurants, clubs, offices,
Ireland has achieved exemplary reductions in 5 public buildings, company cars, trucks, taxis
mortality from NCDs having achieved the l l l l and vans. A private residence is considered a
2000 2005 2010 2015
second largest reduction in mortality from the workplace when trades people, such as plumbers
four main NCDs between 2000 and 2015. During or electricians, are working there. Premises
this period, the probability of dying from any of Figure 3.6 must display a sign informing patrons of the
the four main NCDs between the ages of 30 Age-standardized mortality rate by cause, four main ban and providing the details of the person to
and 70 fell from 17.8% to 10.3% (Figure 3.5), NCDs, Ireland be contacted in the event of any complaints. A
corresponding to a reduction of 42%. Of the workplace can be given a fine of 3000 for each
Cancers
four main NCDs, the largest reductions were Cardiovascular diseases person found smoking (resulting, for example,
observed in the level of cardiovascular mortality Chronic respiratory diseases in a 15000 for five people in violation). In
(Figure 3.6). Among the factors contributing to Diabetes addition, a compliance line has been set up
these reductions were declining prevalence of 250 by the Office of Tobacco Control that people
both cigarette smoking (23, 24) and raised blood can call to report incidences of smoking in an
pressure (25), and improvements in medical enclosed public place. Studies have found that
Age-standardized mortality rate
200
(per 100 000 population)
treatment. A further contributing factor was the ban has resulted in significant reductions in
a reduction in exposure to harmful particles 150
hospital admissions for pulmonary disease and
in the air. acute coronary syndromes (30) and in mortality
from ischaemic heart disease, stroke and chronic
100
Breathing fine particles is known to cause obstructive pulmonary disease (31). These findings
cardiovascular disease, respiratory disease and are consistent with international reviews of the
50
cancers (26). These dangerous particles may health effects of smoking bans (32,33). Together
come from tobacco smoke, smoke from fires with other anti-tobacco initiatives, the ban on
for home energy needs, or from transportation 0 smoking may also have contributed to an observed
and industrial sources. Depending on the source, l l l l decline in the rate of cigarette smoking.
2000 2005 2010 2015
exact age 70 from any of cardiovascular disease, cancer, Concentrations of particulate matter with an
2
In 2015, there were almost 800 000 suicide Figure 3.7 half of the overall reduction in the suicide rate
deaths, making suicide the second leading Estimated suicide mortality rates in the Republic of between 2011 and 2013 could be attributed to
Korea,1 high-income countries, and the WHO Western
cause of injury death after road traffic injuries, Pacific Region, 20002015 the paraquat ban. Notably, this was achieved
and one of the leading causes of death overall without any impact on crop yield.
(15). Some suicides are linked to depression a Republic of Korea
High-income countries
mental health disorder estimated to affect 311 WHO Western Pacific Region
Given the magnitude of suicide by pesticide self-
million people worldwide (34). Because of this poisoning around the world, tens of thousands of
link, suicide mortality was selected as one of 40 Initiation of lives could be saved every year should effective
the two indicators for SDG Target 3.4. paraquat ban regulation of pesticides be enforced worldwide.
Suicide mortality rtae (per 100 000 population)
rich given the greater availability of pesticides the Republic of Korea prior to 2011 had not had 12 000 12
in rural areas (41). any meaningful impact as the pesticides that 10 000 10
accounted for the majority of deaths were not 8000 8
For many years, suicide mortality in the Republic adequately controlled. In 2011, the Republic of 6000 6
of Korea has been high compared to other high- Korea cancelled the re-registration of paraquat
4000 4
income countries and to the WHO Western Pacific and banned its sale in 2012. These actions
2000 2
Region in general (Figure 3.7) (15). According to resulted in an immediate and clear decline in
0 0
WHO estimates the suicide rate in the Republic pesticide-poisoning suicides, and contributed
to a decline in overall suicide rates (Fig 3.8)
2009
2010
2011
2012
2013
2014
2015
Korea for the years 2014 and 2015 have been updated
using data published in the WHO Mortality Database after
the closure date for the Global Health Estimates 2015
(15).
Following the dissolution of the Soviet Union in Many of the policies implemented in the period Box 3.1
Alcohol policy in the Russian Federation (20052016):
1991, the Russian Federation experienced a major 20052016 have been evidence based, in line timeline of selected key policy changes (52, 53, 57, 60)
demographic and health crisis characterized by with the WHO Global strategy to reduce the
premature mortality, ill health and disability among harmful use of alcohol (58) and the WHO Global 2005
young adults (47). Research on the underlying action plan for the prevention and control of Strengthening of the control system for
production, distribution, and sales (wholesale and
determinants of the increased mortality suggested noncommunicable diseases 20132020 (59) retail) of alcohol, and no sales at selected public
that it was caused by the collapse of the social, and were introduced in a step-wise manner. The spaces.
Mandatory excise stamp on all alcoholic
economic and health systems; a high prevalence of countrys experience clearly demonstrates that beverages for sale in the domestic market.
unhealthy behaviours; and lack of concerted efforts comprehensive government initiatives that utilize Ban on sales of alcoholic beverages containing
more than 15% ethanol alcohol by volume (ABV)
to prevent and control NCDs. The privatization evidence-based interventions and intersectoral in selected public places, by individuals, and other
and deregulation of the alcohol market in the approaches can produce notable results. places not properly licensed.
1990s may have contributed to the escalation 2008
Advertising ban for alcohol on all types of public
of alcohol-related problems (48, 49), with alcohol transportation infrastructure.
Figure 3.9
consumption contributing substantially to the Total alcohol consumption per capita (adults 15 years
Alcohol excise duties increase 10% per year as
part of an amendment to the tax code.
increased morbidity and mortality levels (4851). and over) in the Russian Federation, WHO European
Region and the European Union (EU), 20002016 2010
Adoption of a national programme of actions
The seriousness of the situation called for a major to reduce alcohol-related harm and prevent
Russian Federation
reframing of health policy to control the alcohol EUR
alcoholism among the Russian population for the
period 20102020.
market and reduce the harmful use of alcohol. EU Establishment of a minimum retail price for
In 2004, the government began a process of 18
beverages stronger than 28% ABV.
Zero tolerance for use of alcohol by drivers and
consumption (litres of pure alcohol)
strengthening alcohol-control policies (49, 51, 52). 16 0.0% blood alcohol concentration for driving.
In 2005, the President of the Russian Federation
Total alcohol per capita
14 2011
explicitly acknowledged the urgency of this 12 Strict enforcement and increased severity of
problem, linking the shorter life expectancy of administrative liability for the sale of alcohol
10 products to minors.
the population compared to western European 8 Prohibition of alcohol sales at gas stations.
countries to the prevalence of NCDs and to Implementation of an initiative to improve the
6 treatment system for alcohol and drug use
alcohol use (47). Later the same year a series 4 disorders.
of amendments to the law governing regulation 2 2012
of the production and trading volume of alcohol 0 Prohibition of sales of beer in selected places.
l l l l l Ban on alcohol advertising on the internet and in
products was passed. This was then followed electronic media.
2000 2004 2008 2012 2016
by amendments to other laws and regulations
2013
related to alcohol (Box 3.1). Ban on alcohol advertising in any printed media.
Further increase in minimum retail prices of
Figure 3.10 spirits.
Between 2007 and 2016, total (recorded and Death rate from alcohol use per 100 000 population in A limit of 0.16 mg/l (as a maximum measurement
unrecorded) alcohol consumption was reduced the Russian Federation,a WHO European Region, and error) for a breathalyzer test introduced while
upper middle-income countries (UMIC), 20002015 maintaining a zero tolerance policy; increased
by 3.5 litres of pure alcohol per capita (Figure 3.9) severity of punishment for drink-driving.
(53). During the period 20052015, the number UMIC, males UMIC, females 2014
of new cases of alcoholic psychoses decreased EUR, males EUR, females A Development of Health programme initiated to
Russian Federation, males Russian Federation, females prevent harmful use of alcohol.
from 52.3 to 20.5 per 100 000 population (54), Further increase in fines for alcohol sales to
with the death rate from alcohol use also declining, 70 minors, and criminal responsibility for repeated
violation.
especially in males (Figure 3.10) (15). Similar 60 Increase of alcohol excise duties by 33% and
(per 100000 population)
patterns were also observed among patients further increase of minimum prices for spirits.
50
Crude death rate
In September 2004, Uruguay became a Party able to stand up against the tobacco industry Based on the monitoring data collected by
to the WHO Framework Convention on Tobacco and actively defend its national laws. Support Uruguay, WHO has estimated that the proportion
Control (WHO FCTC). Since then, the country has for Uruguay was provided by WHO, the WHO of adults who smoke tobacco in Uruguay almost
become a global leader in this area through its FCTC Secretariat and the Pan American Health halved during 20002015, from 40% to 22%,
step-wise and comprehensive approach to the Organization, which filed amicus briefs, and by representing approximately twice the global rate
implementation of the Convention (Figure 3.10). international and national NGOs and Michael of reduction during the same period (Fig 3.11)
In March 2005, the Health Ministry established Bloomberg, who provided financial support. In (61). The approximate number of smokers aged15
a formal national tobacco control programme. July 2016, the tobacco industry finally lost the and over in Uruguay fell from one million in 2000
Within months, pictures were added to health- six-year landmark battle to block Uruguays strong to less than 600 000 in 2015. By progressively
warning labels and misleading terms such as tobacco packaging and labelling measures. strengthening its tobacco control measures and
light, ultra-light and mild were prohibited. This decision represented a major victory for winning the fight against the tobacco industry,
In 2006, Uruguay became the first country in the people of Uruguay and it showed countries Uruguay has led the way in accelerating the
Latin America to ban smoking in enclosed everywhere that they can stand up to tobacco implementation of the WHO FCTC.
public places. In 2009, Uruguay implemented companies and win. Uruguays experience sets
an ordinance permitting only one variant of a an important precedent for other countries
given tobacco brand to be on the market at considering implementing similar legislation,
any one time. This aim of this ordinance was and will strengthen the resolve of governments
to ensure that tobacco product packaging and to not be intimidated by tobacco industry threats
labelling did not promote a tobacco product of litigation.
through any means that were false or misleading,
including through packaging designs, colours,
or any other feature that could create the false Figure 3.11
Trends in prevalence of current smokers 15 years of age, globally and in Uruguay, and introduction of tobacco-
impression that one tobacco product was less control measures in Uruguay, 20002015
harmful than another. In the same year, the
size of warning labels was further increased Uruguay
Global
to 80% of the primary pack surface area the 2006
worlds largest at that time. In order to monitor Pictoral
the impact of these and other interventions, 45 warnings cover
50% of pack 2007
national surveys were conducted in 2003, 2006, 40 surface
Cost-covered 2010
Ban on smoking
2009 and 2013 to actively monitor the scale of cessation
Proportion of adult smokers (%)
The International Health Regulations (2005) A well-functioning surveillance system plays a To encourage cross-border communication and
(IHR)(62) a legal instrument that is binding on 196 crucial role in guaranteeing the public health cooperation, a cross-border coordination meeting
countries including all WHO Member States aim security of the community, and ensuring that was also held at the Tatale border point involving
to help countries prevent and respond to acute public health events are promptly detected over 30 representatives from Ghana and Togo.
public health risks that have the potential to cross and addressed through coordinated response
borders and threaten people worldwide. In order mechanisms. Surveillance-strengthening activities All of these activities contributed towards
to be able to notify the international community were conducted by the Ministry of Health of strengthening Ghanas core capacities under
of events and respond to public health risks and Ghana with the support of WHO. These activities the IHR as highlighted by an assessment of the
emergencies, countries must have the capacity included the orientation of 239 community countrys implementation of the EVD preparedness
to detect such events through a well-established health volunteers in five border districts on the checklist during 2015 (Figure 3.12). In late 2015,
national surveillance and response infrastructure. Integrated Disease Surveillance and Response as the threat of Ebola was decreasing in the
(IDSR) guidelines, and community outreach region, preparedness activities were broadened to
The IHR Monitoring and Evaluation Framework covering over 276communities with public health apply to all diseases. In 2016, Ghana carried out
outlines an approach for reviewing the messages. To enhance disease detection, WHO and a tabletop exercise in the form of a facilitated
implementation of the core public health capacities Ministry of Health teams trained over 40 clinicians discussion of a simulated emergency situation to
required in this area. The Framework consists on the principles of IDSR. As part of promoting test laboratory pre-diagnostic capacities (such as
of four components: (a) States Parties annual community engagement, Ghana rolled out the sample collection and transport) which helped to
reporting; (b) after-action review; (c) simulation unique strategy of training over 200 representatives identify major gaps and key areas that required
exercises; and (d) joint external evaluation of the Traditional Medicine Practitioners Association strengthening.
(JEE). This approach provides a comprehensive and community radio operators on their roles in
picture of a countrys ability to respond to risks public health emergencies. To complement the self-assessment undertaken
by identifying strengths, gaps and priorities. The as part of IHR annual reporting to the World
implementation status of 13 IHR core capacities The lack of diagnostics reagents, materials Health Assembly, and to determine its level of
has therefore been selected as the indicator to and equipment has also been a persistent gap. preparedness after several months of intense
monitor progress toward SDG Target 3.d. Consumables and reagents for sample collection, preparation, Ghana volunteered for a JEE, which
packaging, transportation and diagnosis were was carried out in February 2017. During the JEE
The Ebola outbreak of 2014 in West Africa therefore procured and distributed to national public process, an external team of experts conduct
highlighted the need for African countries to health laboratories and research organizations a series of multisectoral discussions based
strengthen their national capacities. During the as part of building diagnostic capacity. The upon 19 technical areas defined in the JEE
outbreak, Ghana served as a vital coordination procurement of such materials, along with the tool (64). In Ghana, this consisted of a formal
and operational base for response activities, and training of over 200 people on sample management presentation of Ghanas national capacities
was thus well positioned to participate in and and biosafety and biosecurity requirements, has with all national stakeholders in health security.
learn from the wide range of programme activities enhanced Ghanas capacity to accurately and During the conducting of the JEE process, best
launched. Ghana was among the first countries in rapidly detect emerging and dangerous pathogens practices in all technical areas were identified
Africa to roll out the activities outlined in the Ebola such as the Ebola virus. Some of these laboratory and recommendations provided for further
virus disease (EVD) consolidated preparedness materials were later used during cholera and improvement. Although the outcome scores of
checklist(63) developed by WHO and its partners meningitis outbreaks reported in 2016. the JEE process were lower than the results of
to guide preparedness activities in high-risk the self-assessment carried out in 2016 (Figure
countries. In accordance with IHR requirements, Another key aspect of disease surveillance is 3.13), the JEE report allows the country to take
these activities aimed to strengthen country monitoring points of entry. WHO trained 28 point- stock of its findings and turn the recommendations
capacities for early warning, risk reduction and the of-entry staff on ship inspection and ship sanitation, made into actionable activities. This will result
management of national and global health risks. following updated IHR certification procedures. in further strengthening of Ghanas national IHR
preparedness and response capacities.
Public awareness
Infection prevention and control 90
Case management 80
Safe burials 70
Epidemiological surveillance 60
Contact tracing 50
Laboratory 40
Points of entry 30
Budget 20
Logistics
10
l l l l l l
0 20 40 60 80 100 0
l l l l l l l l l l l l l
Proportion of activities implemented (%) 1 2 3 4 5 6 7 8 9 10 11 12 13
Indicator 17.19.2: Proportion of countries that: (a) have conducted at least one population and housing census in the last 10 years; and
(b) have achieved 100 per cent birth registration and 80 per cent death registration
Country: Islamic Republic of Iran
WHO region: Eastern Mediterranean Region
World Bank income category, 2015: Upper middle income
Life expectancy at birth, 2015: 75.5 years
Completeness of cause-of-death registration, 2015: 90%
A well-functioning civil registration and vital covering 65 million people and around 75% and coders) have resulted in data for the year
statistics (CRVS) system produces information of all deaths (Figure 3.14). Tehran, the most 2013 onwards being coded to the ICD-10 detailed
on vital events such as births, marriages, deaths populous province, was the only province not (four-digit) codes corresponding to over 1500
and causes of death. With 15 of the 17 SDGs covered. In 2015 a programme was launched cause categories. Such detailed data enable
requiring CRVS data to measure their indicators, to collect all death certificates sent to Tehran epidemiological research to be conducted to
investing in CRVS systems is a key step in SDG cemeteries thereby capturing cause-of-death support evidence-based policy decision-making
monitoring. It is only through the use of such information for all provinces nationwide. In in the country.
systems that continuous and routine data can be addition to geographic expansion, the capturing
generated on population, fertility and mortality by of death and cause-of-death data has also been As clearly demonstrated by the Islamic Republic
cause, disaggregated by socioeconomic status strengthened by the cross-checking of data of Iran, a long-term, step-wise strategy of CRVS
and geographic area. using multiple sources at the district level, such system development is crucial to the foundation
as NOCR, cemetery and facility data, to identify of a solid evidence base with which to monitor
In many countries, death registration lags behind omissions and duplication. the health of a nation. The use of multiple data
birth registration. However, death registration is sources by the MOH&ME to assess completeness
vitally important for a range of legal, administrative In addition to the substantial increase in the and improve the capture of mortality data
and statistical purposes, including monitoring proportion of deaths with cause recorded, the level has allowed the country to build a system for
the health of populations. In addition, more than of detail on cause of death has also increased. monitoring mortality by cause, and hence for
a dozen SDG indicators require information on During the period 20062012, cause-of-death monitoring many of the health-related SDGs
total or cause-specific mortality. Specific health- data were coded to a condensed list of 318 all in less than two decades. Future MOH&ME
related SDG indicators generated from death cause categories using the ICD-10 classification plans to further improve the capture of mortality
registration data include those for maternal and system. Since then, major investments in system data include linking death registration in the DH
infant mortality, and for cause-specific mortality strengthening (including the training of certifiers programme and NCOR systems.
such as deaths due to cancers, diabetes and
cardiovascular conditions, as well as those due
Figure 3.14
to external causes such as road traffic accidents, Coverage of NOCR death registration, coverage of DH programme total death registration, coverage of DH
suicide and violence. programme death registration with medical certification of cause of death, and number of provinces with the DH
programme, Islamic Republic of Iran, 20012015)a
In the Islamic Republic of Iran there are two NOCR
institutions that operate death registration DH (total)
systems: the National Organization for Civil DH (medically certified)
Registration (NOCR) and the Ministry of Health 100
and Medical Education (MOH&ME). The NOCR
90
is legally responsible for the registration of
Proportion of total estimated deaths (%)
31. Stallings-Smith S, Zeka A, Goodman P, Kabir Z, Clancy L. 44. Myung W, Lee GH, Won HH, Fava M, Mishoulon D, Nyer M et al.
Reductions in cardiovascular, cerebrovascular, and respiratory Paraquat prohibition and change in the suicide rate and methods
mortality following the national Irish smoking ban: Interrupted in South Korea. PLoS ONE. 2015;10(6):e0128980. doi:10.1371/
time-series analysis. PloS One. 2013;8(4)17 (http://journals.plos. journal.pone.0128980
org/plosone/article?id=10.1371/journal.pone.0062063, accessed
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community interventions. Geneva: World Health Organization;
32. Frazer K, Callinan JE, McHugh J, van Baarsel S, Clarke A, Doherty 2016 (http://apps.who.int/iris/bitstream/10665/246233/1/
K et al. Legislative smoking bans for reducing harms from WHO-MSD-MER-16.3-eng.pdf?ua=1, accessed 1 April 2017).
secondhand smoke exposure, smoking prevalence and tobacco
consumption (Review). Cochrane Database of Systematic Reviews 46. Clinical management of acute pesticide intoxication: Prevention
2016, Issue 2. Art. No.: CD005992 (abstract: http://onlinelibrary. of suicidal behaviours. Geneva: World Health Organization;
wiley.com/doi/10.1002/14651858.CD005992.pub3/epdf/ 2008 (http://www.who.int/mental_health/prevention/suicide/
abstract, accessed 1 April 2017). pesticides_intoxication.pdf, accessed 1 April 2017).
33. Tan CE, Glantz SA. Association between smoke-free legislation 47. Dying too young: Addressing premature mortality and ill health
and hospitalizations for cardiac, cerebrovascular, and respiratory due to non-communicable diseases and injuries in the Russian
diseases: a meta-analysis. Circulation. 2012;126(18):217783 Federation. Washington (DC): World Bank; 2005 (http://
(https://www.ncbi.nlm.nih.gov/pubmed/23109514, accessed 1 siteresources.worldbank.org/INTECA/Resources/DTY-Final.pdf,
April 2017). accessed 13 April 2017).
34. Global, regional, and national incidence, prevalence, and years 48. Nemtsov AV. Alcohol-related human losses in Russia in the 1980s
lived with disability for 310 diseases and injuries, 19902015: and 1990s. Addiction. 2002;97(11):141325.
a systematic analysis for the Global Burden of Disease Study
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thelancet.com/journals/lancet/article/PIIS0140-6736(16)31678- Europe; 2006 (http://www.euro.who.int/__data/assets/pdf_
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Federation: Implications of using price related policies to control
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Explanatory notes
The statistics shown below represent official WHO statistics for selected health-related SDG indicators based on evidence
available in early 2017. They have been compiled primarily using publications and databases produced and maintained
by WHO or United Nations groups of which WHO is a member. A number of statistics have been derived from data
produced and maintained by other international organizations. In some cases, as indicator definitions are being refined
and baseline data are being collected, proxy indicators are presented. All such proxy indicators appearing in this annex
are clearly indicated as such through the use of accompanying footnotes.
For indicators with a reference period expressed as a range, country values refer to the latest available year in the range
unless otherwise noted. Within each WHO region, countries are sorted in ascending order for mortality, incidence and
risk-factor indicators, and in descending order for coverage and capacity indicators. Countries for which data are not
available or applicable are sorted alphabetically at the bottom of each region, unless otherwise noted.
Wherever possible, estimates have been computed using standardized categories and methods in order to enhance
cross-national comparability. This approach may result in some cases in differences between the estimates presented
here and the official national statistics prepared and endorsed by individual WHO Member States. It is important to stress
that these estimates are also subject to considerable uncertainty, especially for countries with weak statistical and health
information systems where the quality of the underlying empirical data is limited.
More details on the indicators and estimates presented here are available at the WHO Global Health Observatory.1
The Global Health Observatory (GHO) is WHOs portal providing access to data and analyses for monitoring the global health situation. See: http://www.who.int/gho/en/, accessed
1
18March 2017.
129
Lithuania 10
Singapore 10
Mozambique 489 Honduras
Luxembourg 10
Eritrea 501 Paraguay 132 New Zealand 11
Portugal 10
Kenya 510 Nicaragua 150 Republic of Korea 11
Bosnia and Herzegovina 11
Guinea-Bissau 549 Suriname 155 Brunei Darussalam 23
Bulgaria 11
Niger 553 Bolivia (Plurinational State of) 206 China 27
Kazakhstan 12
Mali 587
Guyana 229 Turkey 16 Fiji 30
Cameroon 596
Haiti 359 Hungary 17 Malaysia 40
Mauritania 602 Serbia 17
Mongolia 44
SEAR
Malawi 634 Latvia 18
20
Samoa 51
Thailand
Cte d'Ivoire 645 Republic of Moldova 23
Sri Lanka 30 Viet Nam 54
Guinea 679 Ukraine 24
Vanuatu 78
Maldives 68 Armenia 25
Democratic Republic of the Congo 693
Democratic People's Republic of 82 Azerbaijan 25 Kiribati 90
Gambia 706 Korea
Indonesia 126 Russian Federation 25 Micronesia (Federated States of) 100
Burundi 712
148
Albania 29
Philippines 114
Bhutan
Liberia 725
Romania 31
India 174 Solomon Islands 114
South Sudan 789
Tajikistan 32
Bangladesh 176 Tonga 124
Nigeria 814
Georgia 36
Myanmar 178 Cambodia 161
Chad 856
Uzbekistan 36
Sierra Leone 1360 Nepal 258 Kyrgyzstan 76 Papua New Guinea 215
Trends in maternal mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2015
1
(http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/, accessed 23 March 2017). WHO Member States with a population of less than 100 000 in
2015 were not included in the analysis.
Mauritius 2
2 100 Argentina 100 Azerbaijan22 100 Jordan 100
78 SaintSaint
Vincent andand
Vincent thethe
Grenadines..
Grenadines 99 Serbia22 100
Zimbabwe Yemen22 45
Panama 94 Montenegro 99
Burundi 60 Niue22 100
90 Norway22 99
Sierra Leone 60 Peru Palau 100
Portugal22 99
Suriname 90 100
Cte d'Ivoire 59 Republic of Korea22
Romania22 99
Nicaragua22 88 100
Gambia 57 Singapore22
Slovakia 2
2
99
Guyana 86 Australia22 99
Uganda 57 Denmark 22
98
Bolivia (Plurinational State of) 85 Fiji 99
Mozambique22 54 France22 98
53
Honduras 83
Kyrgyzstan 98 Malaysia22 99
Senegal
Guatemala 66 Latvia22 98 Mongolia 99
Mali 49
Haiti 49 Cyprus22 97 Kiribati22 98
United Republic of Tanzania 49
Turkey22 97 Nauru22 97
Angola22 47 SEAR Tajikistan22 90
New Zealand22 97
Guinea 2
2 45 DemocraticPeoples
Democratic People's Republic
Republic of ..
of Korea 100
Andorra Tonga 96
Guinea-Bissau22 45 Thailand22 100
Belgium
Viet Nam 94
Togo 45 Sri Lanka 99 Greece
Tuvalu 93
Madagascar 44 Maldives 96 Iceland
Marshall Islands 90
Central African Republic 40 Indonesia 87 Israel
Cambodia22 89
Monaco
Niger 40 India 2
2 81
89
Vanuatu22
Netherlands
Nigeria 35 Bhutan22 75
Solomon Islands22 86
San Marino
Eritrea 34 Myanmar22 60
Samoa22 83
Spain
Ethiopia22 28 Nepal22 56 Philippines 73
Sweden
Chad 20 Bangladesh22 42
Switzerland Papua New Guinea 53
WHO/UNICEF joint Global Database 2017. (http://www.who.int/gho/maternal_health/en/ and https://data.unicef.org/topic/maternal-health/delivery-care). The data are extracted from
1
public available sources and have not undergone country consultation. Data shown are the latest available for 20052016. Data from 20052009 are shown in pale orange.
Non-standard definition. For more details see the WHO/UNICEF joint Global Database 2017.
2
Under-five
Under-five mortality
mortality and (orange
neonatal bar)and
mortality neonatal
rates (per mortality
1000 live (grey
births), 20151
line) rates per 1000 live births, 2015
AFR AMR EUR EMR
Mauritius 13.5 Canada 4.9 Luxembourg 1.9 Bahrain 6.2
Seychelles 13.6 Cuba 5.5 Iceland 2.0 United Arab Emirates 6.8
United States of America 6.5 Finland 2.3 Qatar 8.0
Cabo Verde 24.5
Norway 2.6 Lebanon 8.3
Algeria 25.5 Antigua and Barbuda 8.1
Slovenia 2.6
40.5 Chile 8.1 Kuwait 8.6
South Africa
Cyprus 2.7
Costa Rica 9.7 Oman 11.6
Rwanda 41.7
Andorra 2.8
Uruguay 10.1 Syrian Arab Republic 12.9
Botswana 43.6 Estonia 2.9
Saint Kitts and Nevis 10.5 Libya 13.4
Congo 45.0 San Marino 2.9
Grenada 11.8 Tunisia 14.0
Namibia 45.4 Sweden 3.0
Bahamas 12.1 Saudi Arabia 14.5
Eritrea 46.5 Czechia 3.4
Argentina 12.5 Iran (Islamic Republic of) 15.5
Austria 3.5
Senegal 47.2
Barbados 13.0 3.5 Jordan 17.9
Denmark
Sao Tome and Principe 47.3
Mexico 13.2 Italy 3.5 Egypt 24.0
United Republic of Tanzania 48.7 Morocco 27.6
Saint Lucia 14.3 Monaco 3.5
Kenya 49.4 3.6 Iraq 32.0
Venezuela (Bolivarian Republic of) 14.9 Ireland
Madagascar 49.6 Portugal 3.6 Yemen 41.9
Jamaica 15.7
Gabon 50.8 Germany 3.7 Djibouti 65.3
Colombia 15.9
Uganda 54.6 Netherlands 3.8 Sudan 70.1
Brazil 16.4
59.2 Switzerland 3.9 Pakistan 81.1
Ethiopia Belize 16.5
Israel 4.0 91.1
Swaziland 60.7 16.8 Afghanistan
El Salvador
Belgium 4.1
Ghana 61.6 Somalia 136.8
Peru 16.9
Spain 4.1
Malawi 64.0 Panama 17.0
United Kingdom 4.2 WPR
Zambia 64.0 Saint Vincent and the Grenadines 18.3 4.3 Japan 2.7
Croatia
Gambia 68.9 Honduras 20.4 France 4.3 Singapore 2.7
Liberia 69.9 Trinidad and Tobago 20.4 Belarus 4.6 Republic of Korea 3.4
Under five mortality rates are shown as bar and in numbers. Neonatal mortality rates are shown as vertical grey lines. Levels & Trends in Child Mortality. Report 2015. Estimates developed
1
by the UN Inter-agency Group for Child Mortality Estimation. United Nations Childrens Fund, World Health Organization, World Bank and United Nations. New York (NY): United Nations
Childrens Fund; 2015 (http://www.unicef.org/publications/files/Child_Mortality_Report_2015_Web_9_Sept_15.pdf, accessed 22 March 2017).
New HIVNew
infections among adults
HIV infections among1549
adultsyears
1549oldyears
(per old
1000 uninfected
(per population),
1000 uninfected 20151 2015
population),
AFR AMR EUR EMR
Algeria 0.02 Honduras 0.10 Uzbekistan 0.02 Egypt 0.03
0.55 Bahrain
0.50 Costa Rica 0.24 Republic of Moldova
Madagascar
Ukraine 0.68 Iraq
Liberia 0.56 Uruguay 0.27
Belarus 1.05 Jordan
Cabo Verde 0.60 Paraguay 0.30
Albania Kuwait
Benin 0.69 Venezuela (Bolivarian Republic of) 0.33
Andorra Libya
Sierra Leone 0.69 Dominican Republic 0.36
Austria Oman
Ghana 0.77 Brazil 0.39
Belgium Qatar
1.02 Colombia 0.39 Bosnia and Herzegovina
Chad Saudi Arabia
Mali 1.05 Guatemala 0.41 Bulgaria
Sudan
Cuba 0.48 Croatia
Guinea 1.18 Syrian Arab Republic
Cyprus
Togo 1.21 Panama 0.48 United Arab Emirates
Czechia
Gambia 1.24 Trinidad and Tobago 0.52
Denmark WPR
1.39 Suriname 0.62
Gabon Estonia Mongolia 0.03
Belize 0.82
Rwanda 1.41 Finland Cambodia 0.08
Guyana 0.88
Angola 1.86 France Australia 0.10
Jamaica 1.07 Germany
Cte d'Ivoire 1.88
Philippines 0.12
Barbados 1.19 Hungary
United Republic of Tanzania 2.11 Malaysia 0.27
7.07
Saint Lucia Montenegro Japan
Mozambique
Saint Vincent and the Grenadines Netherlands Kiribati
Zambia 8.55
308
Bolivia (Plurinational State of) 117
Bulgaria 24 China 67
Liberia
Peru 119 Bosnia and Herzegovina 37 Palau 76
Nigeria 322
Global tuberculosis report 2016. Geneva: World Health Organization; 2016 (http://apps.who.int/iris/bitstream/10665/250441/1/9789241565394-eng.pdf?ua=1, accessed 22 March 2017).
1
Cabo Verde 0.2 Costa Rica 0.0 Georgia 0.0 Saudi Arabia 0.1
289.5
Trinidad and Tobago Norway Brunei Darussalam
Central African Republic
United States of America Poland Cook Islands
Benin 293.7
World Malaria Report 2016. Geneva: World Health Organization; 2016 (http://www.who.int/malaria/publications/world-malaria-report-2016/report/en/, accessed 22 March 2017).
1
99 Monaco 99
Morocco 99
Swaziland 98 Saint Lucia
Turkmenistan 99
Oman 99
United Republic of Tanzania 98 Dominica 98
Uzbekistan 99
Qatar 99
Gambia 97 Nicaragua 98
Albania 98
98 Bahrain 98
Mauritius 97 Saint Vincent and the Grenadines
Austria 98
97
Iran (Islamic Republic of) 98
Sao Tome and Principe 96 Barbados Belgium 98
Saudi Arabia 98
Algeria 95 Chile 97 Kazakhstan 98
Tunisia 98
Botswana 95 Brazil 96 Portugal 98
Libya 94
Eritrea 95 Cuba 96 Cyprus 97
United Arab Emirates 94
Czechia 97
Burundi 94 Bahamas 95
Israel 97 Egypt 93
Cabo Verde 93 Guyana 95
Kyrgyzstan 97 Sudan 93
Lesotho 93 Uruguay 95
Russian Federation 97 Djibouti 84
92 Argentina 94
Namibia Spain 97 81
Lebanon
Belize 94
Burkina Faso 91 Azerbaijan 96 Afghanistan 78
89 Paraguay 93 Poland 96
Kenya Yemen 69
Ecuador 78
Guinea-Bissau 80 The former Yugoslav Viet Nam 97
The Former Yugoslav RepublicRepublic of ..
of Macedonia 92
Guatemala 74
Mozambique 80 Estonia 91 Singapore 96
79
Panama 73
Romania 90 Tuvalu 96
Benin
Haiti 60 Germany 88 93
Uganda 78 Australia
Canada 55 Republic of Moldova 88
New Zealand 92
Mauritania 73
France 83
Nauru 91
South Africa 71 SEAR Bosnia and Herzegovina 82
Madagascar 69 99
Palau 90
Bhutan Montenegro 82
Cambodia 89
Mali 68 Maldives 99
San Marino 75
Lao People's Democratic Republic 89
Niger 65 Sri Lanka 99 Sweden 53
Kiribati 87
Angola 64 Thailand 99 Ukraine 22
Marshall Islands 85
Nigeria 56 DemocraticPeoples
People's Republic of .. 96 Denmark
Democratic Republic of Korea
Finland Tonga 82
Chad 55 Bangladesh 94
Hungary Micronesia (Federated States of) 78
Liberia 52 Nepal 91
Iceland Vanuatu 64
Guinea 51 India 87
Norway Papua New Guinea 62
Central African Republic 47 Indonesia 81
Slovenia Philippines 60
South Sudan 31 Timor-Leste 76
Switzerland
Samoa 59
Equatorial Guinea 16 Myanmar 75 United Kingdom
Japan
1
This indicator is used here as a proxy for the SDG indicator. Data source: WHO/UNICEF estimates of national immunization coverage. July 2016 revision (http://www.who.int/immunization/
monitoring_surveillance/routine/coverage/en/index4.html, accessed 22 March 2017).
Seychelles 0 Saint Vincent and the Grenadines <0.1 Andorra 0 United Arab Emirates 0
Nigeria 140 542 140 542 India 497 396 497 396 Azerbaijan 1 700 Philippines 43 431 43 431
1
Scale of bars is logarithmic. The value shown is the number of people requiring interventions against NTDs in thousands. Neglected tropical diseases [online database]. Global Health
Observatory (GHO) data. Geneva: World Health Organization (http://www.who.int/gho/neglected_diseases/en/).
Probability of dying from any of cardiovascular disease, cancer, diabetes, chronic respiratory disease between age 30 and exact age 70 (%), 20151
Probability of dying from any of the four main NCDs between ages 30 and 70 (%), 2015
AFR AMR EUR EMR
Algeria 15.0 Canada 9.8 Iceland 8.3 Qatar 14.2
Sierra Leone 30.3 Indonesia 26.6 Turkmenistan 34.5 Papua New Guinea 36.1
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_
1
disease/estimates/en/index1.html, accessed 22 March 2017). WHO Member States with a population of less than 90 000 in 2015 were not included in this analysis.
Equatorial Guinea 22.6 Sri Lanka 35.3 Lithuania 32.7 Republic of Korea 2 28.4
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_
1
disease/estimates/en/index1.html, accessed 22 March 2017). WHO Member States with a population of less than 90 000 in 2015 were not included in this analysis.
The estimate of total suicide mortality for the Republic of Korea has been updated using data published in the WHO Mortality Database after the closure date for the Global Health
2
Estimates 2015.
Total alcohol per capita ( 15 years of age) consumption (litres of pure alcohol), projected estimates, 20161
Total alcohol per capita (>= 15 years of age) consumption, in litres of pure alcohol, predicted estimates, 2016
AFR AMR EUR EMR
Mauritania 0.1 Guatemala 3.1 Turkey 1.9 Libya 0.1
8.2
Argentina 9.1
Latvia 12.3 Fiji 3.3
Botswana
United States of America 9.3 Poland 12.3 Nauru 3.6
Cabo Verde 8.2
Canada 10.0 Slovakia 12.3 Cook Islands 5.1
Zimbabwe 8.5
United Kingdom 12.3 Cambodia 5.3
Sao Tome and Principe 8.8 SEAR Estonia 12.8
Philippines 5.6
Nigeria 9.1 Bangladesh 0.2 Ukraine 12.8
Niue 7.1
Cameroon 9.9 Bhutan 0.5 Belgium 13.2
Lao People's Democratic Republic 7.3
Angola 10.8 Indonesia 0.6 Bulgaria 13.6
China 7.8
Gabon 10.8 Timor-Leste 1.0 Croatia 13.6
Japan 7.8
Seychelles 10.8 Maldives 1.7 Czechia 13.7
Mongolia 7.8
Romania 13.7
South Africa 11.2 Myanmar 2.2
8.6
Viet Nam
Russian Federation 13.9
Rwanda 11.5 Nepal 2.5
New Zealand 10.1
Republic of Moldova 15.9
Equatorial Guinea 11.6 DemocraticPeoples
Democratic People's Republic
Republic of ..
of Korea 3.9
16.4 Australia 11.2
Belarus
Namibia 11.8 Sri Lanka 4.1
18.2 Republic of Korea 11.9
Lithuania
Uganda 11.8 India 5.0
Monaco Marshall Islands
South Sudan Thailand 7.2 San Marino Palau
1
WHO Global Information System on Alcohol and Health (GISAH) [online database]. Geneva: World Health Organization (http://www.who.int/gho/alcohol/en/).
Bahamas 13.8
Mauritania 24.5 France 5.1 Lebanon 22.6
Madagascar 28.4 Venezuela (Bolivarian Republic of) 45.1 Brunei Darussalam 8.1
Lithuania 10.6
Global status report on road safety 2015. Geneva: World Health Organization; 2015 (http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/, accessed 22 March
1
2017). WHO Member States with a population of less than 90 000 in 2015 who did not participate in the survey used to produce the report were not included in the analysis.
Estimate from Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/
2
Proportion of married or in-union women of reproductive age who have their need for family planning satisfied with modern methods (%), 200520151
Proportion of married or in-union women of reproductive age who have their need for family planning satisfied with modern methods (%), 2005-2015
AFR AMR EUR EMR
Zimbabwe 86.0 Brazil 89.3 France 95.5 Egypt 80.0
27.8
Saint Vincent and the Grenadines Luxembourg Papua New Guinea 40.6
Comoros
Uruguay Malta Samoa 39.4
Mali 27.3
World Contraceptive Use 2016 [online database]. New York (NY): United Nations, Department of Economic and Social Affairs, Population Division; 2016. Data shown are the latest available
1
Adolescent birth rate (per 1000 women aged 1519 years), 200520141
Adolescent birth rate (per 1000 women aged 1519 years), 20052014
AFR AMR EUR EMR
Algeria 12.4 Canada 12.6 San Marino22 1.3 Libya 6.0
Mauritius 29.4 United States of America 26.6 Switzerland 2.0 Tunisia22 6.7
143.0
Ecuador Slovakia 21.2 Fiji 27.5
Malawi
Grenada Belarus 21.6 Tonga 30.0
Zambia 145.0
Saint Kitts and Nevis Serbia 22.0 Micronesia (Federated States of) 32.6
Guinea 146.0
Armenia 22.7 Viet Nam 36.0
Congo 147.0 SEAR Russian Federation 26.6
Tuvalu 42.0
Liberia 147.0 Democratic People'sRepublic
Democratic Peoples Republic of .. 0.7
of Korea
Republic of Moldova 26.7
Samoa 44.0
Madagascar 148.0 Maldives 13.7
Ukraine 27.2
Kiribati 49.9
South Sudan 158.0 Sri Lanka 20.3 Turkey 29.0
Cook Islands 56.0
Mozambique 167.0 India 28.1 Uzbekistan 29.5
Cambodia 57.0
Mali 172.0 Bhutan 28.4 Kazakhstan 36.4
Philippines 57.0
Romania 38.9
Equatorial Guinea 176.0 Myanmar 30.3
62.0
Solomon Islands
Bulgaria 40.8
Angola 190.9 Indonesia 47.0
Vanuatu 78.0
Georgia 41.5
Chad 203.4 Timor-Leste 50.0
42.1 Marshall Islands 85.0
Kyrgyzstan
Niger 206.0 Thailand 60.0
47.2 Lao People's Democratic Republic 94.0
Azerbaijan
Central African Republic 229.0 Nepal 71.0
Tajikistan 54.0 Nauru 22 105.3
World Fertility Data 2015 [online database]. New York (NY): United Nations, Department of Economic and Social Affairs, Population Division; 2015 (http://www.un.org/en/development/
1
desa/population/publications/dataset/fertility/wfd2015.shtml). Data shown are the latest available for 20052014. Data from 20052009 are shown in pale orange.
Updated estimate.
2
Mortality rate attributed to household and ambient air pollution (per 100 000 population), 20121
Mortality rate (per 100000 population) attributed to household and ambient air pollution, 2012
AFR AMR EUR EMR
Mauritius 20.3 Canada 5.4 Sweden 0.4 United Arab Emirates 7.3
Public health and environment [online database]. Global Health Observatory (GHO) data. Geneva: World Health Organization (http://www.who.int/gho/phe/en/). WHO Member States with a
1
population of less than 250 000 population in 2012 were not included in the analysis.
Mortality rate attributed to exposure to unsafe WASH services (per 100 000 population), 20121
Mortality rate (per 100 000 population) attributed to exposure to unsafe WASH services, 2012
AFR AMR EUR EMR
Mauritius 0.9 Bahamas 0.1 Hungary 0.0 Kuwait <0.1
Argentina 0.7
Gambia 21.0 Malta <0.1 Iran (Islamic Republic of) 0.9
Madagascar 26.6
Pakistan 20.7
Mexico 1.1 The former
The Former Yugoslav
Yugoslav RepublicRepublic of ..
of Macedonia <0.1
Zimbabwe 27.1 Djibouti 26.4
Austria 0.1
Belize 1.2
United Republic of Tanzania 27.6
Italy 0.1 Afghanistan 34.6
Peru 1.3
Gabon 28.1 Luxembourg 0.1 Sudan 34.6
Preventing disease through healthy environments. A global assessment of the burden of disease from environmental risks. Geneva: World Health Organization; 2016 (http://apps.who.
1
int/iris/bitstream/10665/204585/1/9789241565196_eng.pdf?ua=1, accessed 23 March 2017); and: Preventing diarrhoea through better water, sanitation and hygiene. Exposures and
impacts in low- and middle-income countries. Geneva: World Health Organization; 2014 (http://apps.who.int/iris/bitstream/10665/150112/1/9789241564823_eng.pdf?ua=1&ua=1,
accessed 23 March 2017). WHO Member States with a population of less than 250 000 in 2012 were not included in the analysis.
Mortality rate attributed to unintentional poisoning (per 100 000 population), 20151
Mortality rate from unintentional poisoning (per 100 000 population), 2015
AFR AMR EUR EMR
Mauritius 0.1 Brazil 0.2 Germany 0.2 Kuwait 0.2
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_
1
disease/estimates/en/index1.html, accessed 22 March 2017). WHO Member States with a population of less than 90 000 in 2015 were not included in this analysis.
Age-standardized
Age-standardized prevalence
prevalence of tobacco
of tobacco smoking
smoking amongamong persons
persons 15 years
15 years andand older,
older, by by sex,
sex, 2015
2015 1
WHO global report on trends in prevalence of tobacco smoking 2015. Geneva: World Health Organization; 2015 (http://apps.who.int/iris/bitstream/10665/156262/1/9789241564922_eng.
1
pdf, accessed 22 March 2017). Darker orange bars represent the prevalence among males. Pale orange bars represent the prevalence among females.
Cigarette smoking only.
2
99 Czechia 99
Morocco 99
Gambia 97 Cuba
Greece 99
Oman 99
Mauritius 97 Saint Lucia 99
Hungary 99
Qatar 99
Seychelles 97 Dominica 98
Luxembourg 99
98 Bahrain 98
Sao Tome and Principe 96 Nicaragua
Monaco 99
98
Iran (Islamic Republic of) 98
Algeria 95 Saint Vincent and the Grenadines Turkmenistan 99
Saudi Arabia 98
Botswana 95 Barbados 97 Uzbekistan 99
Tunisia 98
Eritrea 95 Brazil 96 Albania 98
Libya 94
Burundi 94 Chile 96 Austria 98
United Arab Emirates 94
Finland 98
Cabo Verde 93 Trinidad and Tobago 96
France 98 Egypt 93
Lesotho 93 Bahamas 95
Kazakhstan 98 Sudan 93
Namibia 92 Guyana 95
Poland 98 Djibouti 84
91 United States of America 95
Burkina Faso Portugal 98 81
Lebanon
Uruguay 95
Swaziland 90 Sweden 98 Afghanistan 78
Zambia 90 Argentina 94
Andorra 97 Pakistan 72
89 Belize 94 Cyprus 97
Kenya Yemen 69
79
Guatemala 74
Armenia 94 Singapore 96
Benin
Panama 73 Croatia 94 Tuvalu 96
Uganda 78
Haiti 60 Georgia 94 Australia 93
Mauritania 73
Israel 94 New Zealand 92
Madagascar 69 SEAR Denmark 93
Nauru 91
South Africa 69 Bhutan 99
Estonia 93
Palau 90
Mali 68 Maldives 99
Italy 93
Cambodia 89
Niger 65 Sri Lanka 99 Lithuania 93
Lao People's Democratic Republic 89
Angola 64 Thailand 99 Iceland 92
Kiribati 87
Nigeria 56 DemocraticPeoples
Democratic People's Republic
Republic of ..
of Korea 96 Bulgaria 91
Marshall Islands 85
The former
The Former Yugoslav
Yugoslav RepublicRepublic of ..
of Macedonia 91
Chad 55 Bangladesh 94
82
Tonga
Montenegro 89
Liberia 52 Nepal 91
Micronesia (Federated States of) 72
Romania 89
Guinea 51 India 87
87 Samoa 66
Republic of Moldova
Central African Republic 47 Indonesia 81
82 Vanuatu 64
Bosnia and Herzegovina
South Sudan 31 Timor-Leste 76
San Marino 76 Papua New Guinea 62
This indicator is used here as a proxy for the SDG indicator. Data source: WHO/UNICEF estimates of national immunization coverage. July 2016 revision (see: http://www.who.int/
1
Total net official development assistance to medical research and basic health sector per capita (constant 2014 US$), by recipient country, 20141
Total net official development assistance to medical research and basic Income groups
High Lower middle Not applicable
health sector per capita (constant 2014 US$), by recipient country, 2014 Upper middle Low
Sao Tome and Principe 28.76 Nicaragua 3.79 Tajikistan 3.88 Afghanistan 8.26
17.70 3.66
Republic of Moldova 3.38
Somalia 6.70
Sierra Leone Honduras
Bosnia and Herzegovina 3.06
Djibouti 4.87
Gambia 11.44 Belize 3.30
Armenia 2.03
4.36
Rwanda 9.90 Saint Lucia 2.89 Yemen
Georgia 1.91
Jordan 3.72
Mozambique 9.56 Saint Vincent and the Grenadines 1.92
Uzbekistan 1.09
Sudan 2.47
South Sudan 8.70 Bolivia (Plurinational State of) 1.69
Azerbaijan 0.88
Pakistan 1.00
Central African Republic 8.43 Guatemala 1.65 Turkmenistan 0.88
Iraq 0.34
Guinea 8.35 Guyana 1.51 Albania 0.76
Morocco 0.31
Malawi 7.88 Suriname 1.41 Ukraine 0.75
Belarus 0.63 Syrian Arab Republic 0.29
Senegal 7.84 Dominican Republic 0.58
Tunisia 0.19
Kazakhstan 0.52
Guinea-Bissau 6.70 Paraguay 0.55
Montenegro 0.34 Egypt 0.08
Benin 6.23 El Salvador 0.45
The former Yugoslav 0.31 Iran (Islamic Republic of) 0.06
The Former Yugoslav RepublicRepublic of ..
of Macedonia
Democratic Republic of the Congo 6.18 Ecuador 0.44
Serbia 0.25 Libya 0.02
Cameroon 3.23 Saint Kitts and Nevis Lithuania Micronesia (Federated States of) 4.13
United Nations SDG indicators global database (https://unstats.un.org/sdgs/indicators/database/?indicator=3.b.2, accessed 6 April 2017) based on the Creditor Reporting System
1
database of the Organisation for Economic Co-operation and Development, 2016. See section 1.5 for more data. Income classification is based on the World Bank analytical income of
economies (July 2016).
Haiti 72.8
Chad 3.5 Israel 88.8 Palau
Saint Kitts and Nevis 88.6 69.5
Malawi 3.5 Bulgaria Cook Islands
3.4
Saint Vincent and the Grenadines Georgia 86.0 Mongolia 65.6
Sierra Leone
Suriname Latvia 82.5
Kiribati 48.2
Central African Republic 3.0
Figures shown for skilled health professionals refer to the latest available values (20052015) given in: WHO Global Health Workforce Statistics. 2016 update [online database].
1
Geneva: World Health Organization (http://who.int/hrh/statistics/hwfstats/en/) aggregated across physicians and nurses/midwives. Please refer to this source for the latest values, and
disaggregation and metadata descriptors. Data from 20052009 are shown in pale orange.
97 Ukraine 99
Bahrain 96
Seychelles 88 Brazil
Norway 98
Morocco 95
Namibia 81 Mexico 97
Armenia 96
Oman 95
Ethiopia 79 United States of America 96
Finland 96
94 Egypt 94
Cte d'Ivoire 78 El Salvador
Slovakia 95
94
Iraq 91
Niger 75 Venezuela (Bolivarian Republic of) Spain 95
United Arab Emirates 91
Ghana 74 Colombia 89 Netherlands 94
Iran (Islamic Republic of) 85
Lesotho 74 Nicaragua 88 Tajikistan 94
Kuwait 85
Togo 74 Costa Rica 86 Cyprus 93
Lebanon 76
Portugal 93
Algeria 73 Guyana 85
Sweden 93 Jordan 72
Uganda 73 Barbados 84
Switzerland 92 Sudan 71
Zimbabwe 73 Honduras 83
Czechia 91 Libya 64
71 Jamaica 83
Democratic Republic of the Congo Latvia 91 63
Syrian Arab Republic
Uruguay 82
Mauritius 70 Belarus 90 Tunisia 55
Panama 71 Georgia 82
Gabon 52 Viet Nam 99
70 Lithuania 82
Burkina Faso 50 Peru China 98
Republic of Moldova 81
Grenada 66 98
South Sudan 50 Fiji
Malta 79
Saint Vincent and the Grenadines 65 96
Eritrea 49 New Zealand
Monaco 79
Dominica 62 Brunei Darussalam 92
Guinea-Bissau 49 Ireland 78
Saint Kitts and Nevis 60 Palau 91
Sierra Leone 47 Kazakhstan 78
46
Haiti 56
Turkey 78 Tuvalu 89
Rwanda
Belize 55 Romania 77 Philippines 87
Congo 44
International Health Regulations (2005) Monitoring Framework [online database]. Global Health Observatory (GHO) data. Geneva: World Health Organization (http://www.who.int/gho/ihr/en/).
1
8.2
Brazil 6.8
Kazakhstan 10.9 Tonga 13.5
Nigeria
Haiti 6.1 Ukraine 10.8 Solomon Islands 12.5
Senegal 8.0
Venezuela (Bolivarian Republic of) 5.8 Poland 10.7 Republic of Korea 12.3
Guinea-Bissau 7.8
Uzbekistan 10.7 China 10.4
Togo 7.8 SEAR Turkey 10.5
Philippines 10.0
Gabon 7.4 Maldives 26.6
Hungary 10.1
Papua New Guinea 9.5
Cte d'Ivoire 7.3 Thailand 13.3
Greece 10.0
Fiji 9.2
Equatorial Guinea 7.0 Nepal 11.2 Latvia 9.8
Mongolia 6.7
Mali 7.0 Sri Lanka 11.2 Montenegro 9.8
Brunei Darussalam 6.5
Ghana 6.8 Bhutan 8.0 Russian Federation 9.5
Malaysia 6.4
Albania 9.4
Mauritania 6.0 Bangladesh 5.7
6.1
Cambodia
Turkmenistan 8.7
Niger 5.6 Indonesia 5.7
Cook Islands 6.1
Cyprus 7.6
Angola 5.0 India 5.0
7.0 Niue 5.9
Armenia
Cameroon 4.3 Myanmar 3.6
6.8 Kiribati 5.8
Tajikistan
South Sudan 4.0 Timor-Leste 2.4
Georgia 5.0 Nauru 5.2
The indicator here reflects the health-related portion of the SDG indicator. Data source: Global Health Expenditure Database [online database]. Geneva. World Health Organization. 2017
1
Algeria 11.7 United States of America 2.1 Belarus 4.5 Iran (Islamic Republic of) 6.8
37.9
Saint Kitts and Nevis Luxembourg Vanuatu 28.5
Sierra Leone
Saint Vincent and the Grenadines Malta Philippines 30.3
Ethiopia 38.4
United Nations Childrens Fund, World Health Organization, the World Bank Group. Levels and trends in child malnutrition. UNICEF/WHO/World Bank Group Joint Child Malnutrition
1
Estimates. UNICEF, New York; WHO, Geneva; the World Bank Group, Washington (DC); May 2017. Data shown are the latest available for 20052016. Data from 20052009 are shown in
pale orange.
Prevalence of wasting (green bar) and of overweight (orange bar) in children under 5, 2005-2016
Prevalence of wasting (green bar) and of overweight (orange bar) in children under 5 years of age (%), 200520161
AFR AMR EUR EMR
Senegal Haiti Germany Yemen
Chile
Czechia WPR
Guinea
Denmark Japan
Kenya Argentina
Estonia Cambodia
Namibia Paraguay Finland Lao People's Democratic Republic
Democratic Republic of the Congo Barbados France
Solomon Islands
Mali Panama Greece
Nauru
Antigua and Barbuda Hungary
Malawi Vanuatu
Bahamas Iceland
Uganda Philippines
Ireland
Congo Canada Viet Nam
Israel
South Sudan Cuba Tuvalu
Italy
Zambia Dominica China
Latvia
Grenada Malaysia
Cameroon Lithuania
Saint Kitts and Nevis Luxembourg Republic of Korea
Lesotho
Saint Vincent and the Grenadines Malta Australia
Gabon
Trinidad and Tobago Monaco Brunei Darussalam
Rwanda
Netherlands Mongolia
Mozambique
SEAR Norway Papua New Guinea
Sierra Leone DemocraticPeoples
Democratic People's Republic
Republic of ..
of Korea Poland Tonga
Swaziland Sri Lanka Portugal
Cook Islands
Equatorial Guinea Myanmar Romania
Fiji
Seychelles Bangladesh Russian Federation
Kiribati
Comoros Timor-Leste San Marino
Marshall Islands
Slovakia
South Africa India Micronesia (Federated States of)
Slovenia
Botswana Nepal New Zealand
Spain
Algeria Maldives Niue
Sweden
Madagascar Bhutan Palau
Switzerland
Cabo Verde Thailand Ukraine Samoa
Mauritius Indonesia United Kingdom Singapore
United Nations Childrens Fund, World Health Organization, the World Bank Group. Levels and trends in child malnutrition. UNICEF/WHO/World Bank Group Joint Child Malnutrition
1
Estimates. UNICEF, New York; WHO, Geneva; the World Bank Group, Washington (DC); May 2017. Data shown are the latest available for 20052016. Data from 20052009 are shown in
pale orange and green.
Sao Tome and Principe 97 Belize 100 Armenia 100 Qatar 100
Lesotho 82 Mexico 96
Iceland 100 Afghanistan 55
Nicaragua 87
Nigeria 69 United Kingdom 100 Tuvalu 98
Peru 87
Zambia 65 Bulgaria 99 Viet Nam 98
63
Dominican Republic 85
Latvia 99 Nauru 97
Kenya
Haiti 58 Serbia 99 96
Sierra Leone 63 China
Dominica The former
The Former Yugoslav
Yugoslav RepublicRepublic of ..
of Macedonia 99
Fiji 96
Togo 63
Ireland 98
Marshall Islands 95
South Sudan 59 SEAR Poland 98
Eritrea 58 Vanuatu 95
Bhutan 100
Lithuania 97
Philippines 92
Mauritania 58 Democratic People's Republic of 100 97
Russian Federation
Korea 89
58 Micronesia (Federated States of)
Niger Maldives 99 Ukraine 96
Solomon Islands 81
Ethiopia 57 Albania 95
Thailand 98
Cambodia 76
United Republic of Tanzania 56 Kazakhstan 93
Sri Lanka 96
Kyrgyzstan 90 Lao People's Democratic Republic 76
Democratic Republic of the Congo 52
India 94 67
Republic of Moldova 88 Kiribati
Madagascar 52
Nepal 92 Azerbaijan 87 Mongolia 64
Chad 51
Tajikistan 74 40
Bangladesh 87 Papua New Guinea
Mozambique 51
87
San Marino Brunei Darussalam
Indonesia
Angola 49
Turkmenistan
Myanmar 81 Palau
Equatorial Guinea 48 Uzbekistan
Timor-Leste 72
Republic of Korea
Timor-Leste
This indicator is used here as a proxy for the SDG indicator. Data source: Progress on sanitation and drinking water 2015 update and MDG assessment. New York (NY): UNICEF; and
1
Mauritius 93 United States of America 100 Austria 100 Saudi Arabia 100
99 Belgium 100
Bahrain 99
Algeria 88 Chile
Cyprus 100
Jordan 99
Equatorial Guinea 75 Grenada 98
Denmark 100
Qatar 98
Cabo Verde 72 Argentina 96
Israel 100
96 United Arab Emirates 98
South Africa 66 Barbados
Italy 100
96
Libya 97
Botswana 63 Uruguay Malta 100
Oman 97
Rwanda 62 Costa Rica 95 Monaco 100
Syrian Arab Republic 96
Gambia 59 Venezuela (Bolivarian Republic of) 94 Portugal 100
Egypt 95
Swaziland 58 Cuba 93 Spain 100
Tunisia 92
Switzerland 100
Angola 52 Bahamas 92
Uzbekistan 100 Iran (Islamic Republic of) 90
Burundi 48 Trinidad and Tobago 92
Czechia 99 Iraq 86
Senegal 48 Belize 91
France 99 Lebanon 81
46 Saint Lucia 91
Cameroon Germany 99 77
Morocco
Paraguay 89
Zambia 44 Greece 99 Pakistan 64
Gabon 42 Ecuador 85
Iceland 99 Djibouti 47
41 Mexico 85 Slovakia 99
Malawi Afghanistan 32
Panama 75 Estonia 97
Ethiopia 28 Singapore 100
68 Poland 97
Mali 25 Nicaragua Cook Islands 98
Montenegro 96
Guatemala 64 96
Cte d'Ivoire 23 Malaysia
Serbia 96
Bolivia (Plurinational State of) 50 92
Central African Republic 22 Samoa
Ukraine 96
Haiti 28 Fiji 91
Guinea-Bissau 21 Bosnia and Herzegovina 95
Antigua and Barbuda 95 Tonga 91
Mozambique 21 Tajikistan
20
Dominica Turkey 95 Viet Nam 78
Benin
Saint Kitts and Nevis Belarus 94 China 77
Burkina Faso 20
This indicator is used here as a proxy for the SDG indicator. Data source: Progress on sanitation and drinking water 2015 update and MDG assessment. New York (NY): UNICEF; and
1
Azerbaijan >95
Iraq >95
South Africa 82 Barbados >95
Belarus >95
Jordan >95
Gabon 73 Canada 22 >95
Belgium22 >95
>95 Kuwait22 >95
Cabo Verde 71 Chile
Cyprus22 >95
>95
Lebanon >95
Botswana 63 Costa Rica Czechia >95
Morocco >95
Angola 48 Ecuador >95 Denmark22 >95
Oman22 >95
Namibia 46 Grenada >95 Finland22 >95
Qatar >95
Mauritania 45 Saint Kitts and Nevis22 >95 France22 >95
Saudi Arabia >95
Germany22 >95
Senegal 36 Saint Lucia >95
Greece22 >95 Syrian Arab Republic >95
Swaziland 35 Saint Vincent and the Grenadines >95
Hungary 22
>95 Tunisia >95
Lesotho 32 Trinidad and Tobago >95
2
Iceland 2 >95 United Arab Emirates >95
31 United States of America22 >95
Zimbabwe Ireland22 >95 62
Yemen
Uruguay >95
Sao Tome and Principe 30 Israel22 >95 Pakistan 45
<5
Honduras 48
United Kingdom22 >95 Palau 58
Ethiopia
Guatemala 36 Croatia 94 China 57
Gambia <5
United Republic of Tanzania <5 Timor-Leste <5 Turkey Lao People's Democratic Republic <5
Burning opportunity: clean household energy for health, sustainable development, and wellbeing of women and children. Geneva: World Health Organization; 2016 (http://apps.who.int/iris/
1
Annual mean levels of fine particulate matter (PM2.5) in urban areas (g/m3), 20141
Annual mean concentrations of fine particulate matter (PM2.5) in urban areas (g/m3), 2014
AFR AMR EUR EMR
Liberia 6.0 Canada 7.2 Sweden 5.9 Somalia 16.9
Seychelles 13.0 United States of America 8.4 Finland 7.1 Morocco 18.9
42.4
Honduras 39.6
Czechia 20.7 Cambodia 25.0
Angola
Saint Kitts and Nevis Kazakhstan 21.1 Philippines 27.1
Gambia 43.0
Saint Vincent and the Grenadines Serbia 21.4 Viet Nam 27.6
Senegal 43.2
Hungary 22.7 Republic of Korea 27.8
Burundi 48.9 SEAR Georgia 23.0
Mongolia 32.1
Rwanda 50.6 Timor-Leste 15.0
Montenegro 24.3
Lao People's Democratic Republic 33.5
Niger 51.5 Indonesia 17.8
Armenia 25.0
China 59.5
Central African Republic 55.9 Thailand 27.3 Poland 25.4
Cook Islands
Congo 56.9 Sri Lanka 28.5 Turkmenistan 26.2
Kiribati
Democratic Republic of the Congo 60.7 DemocraticPeoples
Democratic People's Republic
Republic of ..
of Korea 31.4 Azerbaijan 26.3
Marshall Islands
Bulgaria 30.3
Chad 61.3 Bhutan 39.0
Nauru
Turkey 35.2
Cameroon 63.6 Myanmar 56.6
Niue
Uzbekistan 38.3
Uganda 79.6 India 65.7
TheThe 42.7 Palau
former
Former Yugoslav
Yugoslav RepublicRepublic of ..
of Macedonia
Mauritania 86.2 Nepal 74.3
50.7 Samoa
Tajikistan
Cabo Verde Bangladesh 88.8
Bosnia and Herzegovina 55.1 Tonga
Sao Tome and Principe Maldives San Marino Tuvalu
Ambient air pollution: a global assessment of exposure and burden of disease. Geneva: World Health Organization; 2016 (see: http://who.int/phe/publications/air-pollution-global-
1
Average death rate due to natural disasters (per 100 000 population), 201120151
Average death rate due to natural disasters (per 100 000 population), 20112015
AFR AMR EUR EMR
Cabo Verde 0.0 Antigua and Barbuda 0.0 Albania 0.0 Bahrain 0.0
Central African Republic 0.0 Bahamas 0.0 Armenia 0.0 Djibouti 0.0
Sierra Leone 0.1 Norway 0.1 Lao People's Democratic Republic 0.2
SEAR Portugal 0.1
Burundi 0.2 Papua New Guinea 0.2
Bhutan 0.0 Serbia 0.1
Ghana 0.2
Republic of Korea 0.3
Maldives 0.0 Spain 0.1
Lesotho 0.2 0.4
Fiji
0.0
Sweden 0.1
Madagascar 0.2 Timor-Leste
Cambodia 0.7
Tajikistan 0.1
Malawi 0.2 Bangladesh 0.1
United Kingdom 0.1 New Zealand 0.9
Mauritius 0.2 Indonesia 0.1
Uzbekistan 0.1 Vanuatu 0.9
Mozambique 0.2 Myanmar 0.1
Austria 0.2 1.3
Micronesia (Federated States of)
Niger 0.2 Democratic People's Republic of 0.2 Czechia 0.2
Korea Solomon Islands 2.0
Swaziland 0.2 France 0.2
India 0.2
Samoa 2.4
Zimbabwe 0.2 Georgia 0.2
Thailand 0.3
Philippines 2.5
South Sudan 0.3 Turkey 0.2
Sri Lanka 0.4
Namibia 0.9 Romania 0.6 Japan 4.2
Nepal 7.2
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_
1
disease/estimates/en/index1.html, accessed 22 March 2017). WHO Member States with a population of less than 90 000 in 2015 were not included in this analysis. The death rate is an
average over the five year period.
Saint Vincent and the Grenadines 21.7 United Kingdom 1.3 Pakistan 9.5
Gambia 9.1
TheThe former
Former Yugoslav
Yugoslav RepublicRepublic of ..
of Macedonia 1.4 12.7
Togo 9.1 Bahamas 23.7 Iraq
Bulgaria 1.5
Haiti 28.1
Guinea-Bissau 9.2
Romania 1.5
WPR
Angola 9.6 Dominican Republic 30.2
Japan 0.3
Finland 1.6
Zambia 9.7 Brazil 30.5
Armenia 1.7 Australia 0.9
Burkina Faso 9.8 Trinidad and Tobago 32.8
Serbia 1.7 China 0.9
Nigeria 9.8 Jamaica 35.2
Greece 2.0
1.2
New Zealand
Ghana 10.0 Guatemala 36.2
Israel 2.0
Brunei Darussalam 1.3
Niger 10.0 Belize 37.2 Azerbaijan 2.2
Republic of Korea 2.0
Congo 10.1 Colombia 48.8 Cyprus 2.2
Vanuatu 2.1
Mauritania 10.2 Venezuela (Bolivarian Republic of) 51.7 Turkey 2.4
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_
1
disease/estimates/en/index1.html, accessed 22 March 2017). WHO Member States with a population of less than 90 000 in 2015 were not included in this analysis.
Estimated deaths from major conflicts (per 100 000 population), 200120151
Iraq
Afghanistan
Somalia
South Sudan
Libya
Yemen
Sudan
Ukraine
Chad
Burundi
Nepal
Sri Lanka
Liberia
l l l l l l l l l l l
0 50 100 150 200 250 300 350 400 450 500
Crude death rate (per 100 000 population)
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_
1
disease/estimates/en/index1.html, accessed 22 March 2017). Conflict deaths include deaths due to collective violence and exclude deaths due to legal intervention,WHO Member States
with estimated conflict deaths exceeding 5 per 100 000 population in 20112015 or 10 per 100 000 population in earlier five-year periods. The death rate is an average over each five
year period.
Completeness
Completeness1
(%) and
(%) and quality2
of quality of cause-of-death
cause-of-death data , 2005-2015 Quality
data, 20052015 High Medium Low Very low
Malawi Palau 95
Peru 62 Lithuania 99
Philippines 82
Mali Dominican Republic 54 Bulgaria 98
98 Singapore 68
Mauritania Honduras 15 Greece
China 62
Mozambique Bolivia (Plurinational State of) TheThe former
Former Yugoslav
Yugoslav RepublicRepublic of ..
of Macedonia 98
1
Figures shown for completeness refer to the latest available value (20052015). Completeness was assessed relative to the de facto resident populations. Global Health Estimates 2015:
Deaths by cause, age, sex, by country and by region, 20002015. Geneva: World Health Organization; 2016 (http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.
html, accessed 22 March 2017).
2
See section 1.1. The colour represents the assessment of data quality for the period 20052015.
3
Completeness refers to year prior to 2010.
Explanatory notes
The statistics shown in Annex B represent official WHO statistics based on the evidence available in early 2017. They
have been compiled primarily using publications and databases produced and maintained by WHO or United Nations
groups of which WHO is a member. A number of statistics have been derived from data produced and maintained by
other international organizations. In some cases, as indicator definitions are being refined and baseline data are being
collected, proxy indicators are presented. All such proxy indicators appearing in this annex are clearly indicated as such
through the use of accompanying footnotes.
Wherever possible, estimates have been computed using standardized categories and methods in order to enhance
cross-national comparability. This approach may result in some cases in differences between the estimates presented
here and the official national statistics prepared and endorsed by individual WHO Member States. It is important to stress
that these estimates are also subject to considerable uncertainty, especially for countries with weak statistical and health
information systems where the quality of underlying empirical data is limited.
For indicators with a reference period expressed as a range, figures refer to the latest available year in the range unless
otherwise noted.
Unless otherwise stated, the WHO regional and global aggregates for rates and ratios are weighted averages when
relevant, while for absolute numbers they are the sums. Aggregates are shown only if data are available for at least 50%
of the population (or other denominator) within an indicated group. For indicators with a reference period expressed as
a range, aggregates are for the reference period shown in the heading unless otherwise noted. Some WHO regional and
global aggregates may include country estimates that are not available for reporting.
More details on the indicators and estimates presented here are available at the WHO Global Health Observatory.1
The Global Health Observatory (GHO) is WHOs portal providing access to data and analyses for monitoring the global health situation. See: http://www.who.int/gho/en/, accessed
1
18March 2017.
ANNEX B
Part 1 New HIV
infections
Maternal among adults
mortality Proportion of Under-five Neonatal 1549 years
Total Healthy life ratioc (per births attended mortality ratee mortality ratee oldf (per 1000
populationa expectancy at 100 000 live by skilled health (per 1000 live (per 1000 live uninfected
(000s) Male Female Both sexes birthb (years) births) personneld (%) births) births) population)
Member State 2015 2015 2015 2015 20052015 2015 2015 2015
Afghanistan 32 527 59.3 61.9 60.5 52.2 396 51 ac 91.1 35.5 0.06
Albania 2 897 75.1 80.7 77.8 68.8 29 99 14.0 6.2
Algeria 39 667 73.8 77.5 75.6 66.0 140 97 25.5 15.5 0.02
Andorra 70 2.8 1.4
Angola 25 022 50.9 54.0 52.4 45.8 477 47 ac 156.9 48.7 1.86
Antigua and Barbuda 92 74.1 78.6 76.4 67.5 100 ac 8.1 4.9
Argentina 43 417 72.7 79.9 76.3 67.6 52 100 12.5 6.3 0.23
Armenia 3 018 71.6 77.7 74.8 66.8 25 100 ac 14.1 7.4 0.26
Australia 23 969 80.9 84.8 82.8 71.9 6 99 ac 3.8 2.2 0.10
Austria 8 545 79.0 83.9 81.5 72.0 4 99 ac 3.5 2.1
Azerbaijan 9 754 69.6 75.8 72.7 64.7 25 100 ac 31.7 18.2 0.20
Bahamas 388 72.9 79.1 76.1 66.6 80 98 ac 12.1 6.9 2.26
Bahrain 1 377 76.2 77.9 76.9 67.0 15 100 ac 6.2 1.1
Bangladesh 160 996 70.6 73.1 71.8 62.3 176 42 ac 37.6 23.3 0.01
Barbados 284 73.1 77.9 75.5 66.6 27 99 ac 13.0 8.0 1.19
Belarus 9 496 66.5 78.0 72.3 65.1 4 100 4.6 1.9 1.05
Belgium 11 299 78.6 83.5 81.1 71.1 7 4.1 2.2
Belize 359 67.5 73.1 70.1 62.3 28 94 ac 16.5 8.3 0.82
Benin 10 880 58.8 61.1 60.0 52.5 405 77 ac 99.5 31.8 0.69
Bhutan 775 69.5 70.1 69.8 61.2 148 75 ac 32.9 18.3
Bolivia (Plurinational 10 725 68.2 73.3 70.7 62.2 206 85 38.4 19.6 0.24
State of)
Bosnia and Herzegovina 3 810 75.0 79.7 77.4 68.6 11 100 5.4 4.0
Botswana 2 262 63.3 68.1 65.7 56.9 129 100 ac 43.6 21.9 9.37
Brazil 207 848 71.4 78.7 75.0 65.5 44 99 ac 16.4 8.9 0.39
Brunei Darussalam 423 76.3 79.2 77.7 70.4 23 100 ac 10.2 4.3
Bulgaria 7 150 71.1 78.0 74.5 66.4 11 100 ac 10.4 5.6
Burkina Faso 18 106 59.1 60.5 59.9 52.6 371 66 88.6 26.7 0.45
Burundi 11 179 57.7 61.6 59.6 52.2 712 60 81.7 28.6 0.18
Cabo Verde 521 71.3 75.0 73.3 64.4 42 92 24.5 12.2 0.60
Cambodia 15 578 66.6 70.7 68.7 58.9 161 89 ac 28.7 14.8 0.08
Cameroon 23 344 55.9 58.6 57.3 50.3 596 65 ac 87.9 25.7 3.57
Canada 35 940 80.2 84.1 82.2 72.3 7 98 ac 4.9 3.2
Central African Republic 4 900 50.9 54.1 52.5 45.9 882 40 130.1 42.6 2.40
Chad 14 037 51.7 54.5 53.1 46.1 856 20 138.7 39.3 1.02
Chile 17 948 77.4 83.4 80.5 70.4 22 100 8.1 4.9 0.19
China 1 383 925 74.6 77.6 76.1 68.5 27 100 ac 10.7 5.5
Colombia 48 229 71.2 78.4 74.8 65.1 64 99 15.9 8.5 0.39
Comoros 788 61.9 65.2 63.5 55.9 335 82 73.5 34.0
Congo 4 620 63.2 66.3 64.7 56.6 442 94 ac 45.0 18.0
Cook Islands 21 100 ac 8.1 4.4
Costa Rica 4 808 77.1 82.2 79.6 69.7 25 99 9.7 6.2 0.24
Cte d'Ivoire 22 702 52.3 54.4 53.3 47.0 645 59 92.6 37.9 1.88
Croatia 4 240 74.7 81.2 78.0 69.4 8 100 4.3 2.6
Cuba 11 390 76.9 81.4 79.1 69.2 39 99 5.5 2.3 0.48
Cyprus 1 165 78.3 82.7 80.5 71.3 7 97 ac 2.7 1.5
Czechia 10 543 75.9 81.7 78.8 69.4 4 100 ac 3.4 1.8
Democratic People's 25 155 67.0 74.0 70.6 64.0 82 100 24.9 13.5
Republic of Korea
Democratic Republic of 77 267 58.3 61.5 59.8 51.7 693 80 98.3 30.1 0.34
the Congo
Denmark 5 669 78.6 82.5 80.6 71.2 6 98 ac 3.5 2.5
Djibouti 888 61.8 65.3 63.5 55.8 229 87 ac 65.3 33.4 1.09
Dominica 73 100 ac 21.2 15.6
Dominican Republic 10 528 70.9 77.1 73.9 65.1 92 98 ac 30.9 21.7 0.36
ANNEX B
Part 1 New HIV
infections
Maternal among adults
mortality Proportion of Under-five Neonatal 1549 years
Total Healthy life ratioc (per births attended mortality ratee mortality ratee oldf (per 1000
populationa expectancy at 100 000 live by skilled health (per 1000 live (per 1000 live uninfected
(000s) Male Female Both sexes birthb (years) births) personneld (%) births) births) population)
Member State 2015 2015 2015 2015 20052015 2015 2015 2015
Ecuador 16 144 73.5 79.0 76.2 67.0 64 96 21.6 10.8 0.15
Egypt 91 508 68.8 73.2 70.9 62.2 33 92 24.0 12.8 0.03
El Salvador 6 127 68.8 77.9 73.5 64.1 54 98 ac 16.8 8.3 0.15
Equatorial Guinea 845 56.6 60.0 58.2 51.2 342 68 ac 94.1 33.1 0.24
Eritrea 5 228 62.4 67.0 64.7 55.9 501 34 46.5 18.4 0.21
Estonia 1 313 72.7 82.0 77.6 68.9 9 99 ac 2.9 1.5
Ethiopia 99 391 62.8 66.8 64.8 56.1 353 28 ac 59.2 27.7
Fiji 892 67.0 73.1 69.9 62.9 30 99 22.4 9.6
Finland 5 503 78.3 83.8 81.1 71.0 3 100 ac 2.3 1.3
France 64 395 79.4 85.4 82.4 72.6 8 98 ac 4.3 2.2
Gabon 1 725 64.7 67.2 66.0 57.2 291 89 ac 50.8 23.2 1.39
Gambia 1 991 59.8 62.5 61.1 53.8 706 57 68.9 29.9 1.24
Georgia 4 000 70.3 78.3 74.4 66.5 36 100 11.9 7.2 0.50
Germany 80 689 78.7 83.4 81.0 71.3 6 99 ac 3.7 2.1
Ghana 27 410 61.0 63.9 62.4 55.3 319 71 61.6 28.3 0.77
Greece 10 955 78.3 83.6 81.0 71.9 3 4.6 2.9 0.19
Grenada 107 71.2 76.1 73.6 65.0 27 99 ac 11.8 6.0
Guatemala 16 343 68.5 75.2 71.9 62.1 88 66 29.1 13.4 0.41
Guinea 12 609 58.2 59.8 59.0 51.7 679 45 ac 93.7 31.3 1.18
Guinea-Bissau 1 844 57.2 60.5 58.9 51.5 549 45 ac 92.5 39.7
Guyana 767 63.9 68.5 66.2 58.9 229 86 39.4 22.8 0.88
Haiti 10 711 61.5 65.5 63.5 55.4 359 49 69.0 25.4 0.21
Honduras 8 075 72.3 77.0 74.6 64.9 129 83 20.4 11.0 0.10
Hungary 9 855 72.3 79.1 75.9 67.4 17 99 ac 5.9 3.5
Iceland 329 81.2 84.1 82.7 72.7 3 2.0 0.9
India 1 311 051 66.9 69.9 68.3 59.5 174 81 ac 47.7 27.7 0.11
Indonesia 257 564 67.1 71.2 69.1 62.2 126 87 27.2 13.5 0.50
Iran (Islamic Republic of) 79 109 74.5 76.6 75.5 66.6 25 96 15.5 9.5 0.14
Iraq 36 423 66.2 71.8 68.9 60.0 50 91 32.0 18.4
Ireland 4 688 79.4 83.4 81.4 71.5 8 100 ac 3.6 2.3
Israel 8 064 80.6 84.3 82.5 72.8 5 4.0 2.1
Italy 59 798 80.5 84.8 82.7 72.8 4 100 ac 3.5 2.1 0.16
Jamaica 2 793 73.9 78.6 76.2 66.9 89 99 ac 15.7 11.6 1.07
Japan 126 573 80.5 86.8 83.7 74.9 5 100 ac 2.7 0.9
Jordan 7 595 72.5 75.9 74.1 65.0 58 100 17.9 10.6
Kazakhstan 17 625 65.7 74.7 70.2 63.3 12 100 ac 14.1 7.0 0.36
Kenya 46 050 61.1 65.8 63.4 55.6 510 62 49.4 22.2 3.52
Kiribati 112 63.7 68.8 66.3 59.1 90 98 ac 55.9 23.7
Kuwait 3 892 73.7 76.0 74.7 65.8 4 99 ac 8.6 3.2
Kyrgyzstan 5 940 67.2 75.1 71.1 63.8 76 98 21.3 11.5 0.28
Lao People's Democratic 6 802 64.1 67.2 65.7 57.9 197 40 66.7 30.1
Republic
Latvia 1 971 69.6 79.2 74.6 67.1 18 98 ac 7.9 5.2 0.53
Lebanon 5 851 73.5 76.5 74.9 65.7 15 8.3 4.8 0.05
Lesotho 2 135 51.7 55.4 53.7 46.6 487 78 90.2 32.7 18.80
Liberia 4 503 59.8 62.9 61.4 52.7 725 61 69.9 24.1 0.56
Libya 6 278 70.1 75.6 72.7 63.8 9 100 ac 13.4 7.2
Lithuania 2 878 68.1 79.1 73.6 66.0 10 100 ac 5.2 2.5
Luxembourg 567 79.8 84.0 82.0 71.8 10 100 ac 1.9 0.9
Madagascar 24 235 63.9 67.0 65.5 56.9 353 44 49.6 19.7 0.50
Malawi 17 215 56.7 59.9 58.3 51.2 634 90 ac 64.0 21.8 3.82
Malaysia 30 331 72.7 77.3 75.0 66.5 40 99 ac 7.0 3.9 0.27
Maldives 364 76.9 80.2 78.5 69.6 68 96 8.6 4.9
Mali 17 600 58.2 58.3 58.2 51.1 587 49 114.7 37.8 1.05
Malta 419 79.7 83.7 81.7 71.7 9 100 ac 6.4 4.4
Marshall Islands 53 90 36.0 16.7
ANNEX B
Part 1 New HIV
infections
Maternal among adults
mortality Proportion of Under-five Neonatal 1549 years
Total Healthy life ratioc (per births attended mortality ratee mortality ratee oldf (per 1000
populationa expectancy at 100 000 live by skilled health (per 1000 live (per 1000 live uninfected
(000s) Male Female Both sexes birthb (years) births) personneld (%) births) births) population)
Member State 2015 2015 2015 2015 20052015 2015 2015 2015
Mauritania 4 068 61.6 64.6 63.1 55.1 602 65 84.7 35.7 0.28
Mauritius 1 273 71.4 77.8 74.6 66.8 53 100 ac 13.5 8.4 0.42
Mexico 127 017 73.9 79.5 76.7 67.4 38 96 13.2 7.0 0.16
Micronesia (Federated 104 68.1 70.6 69.4 62.5 100 100 ac 34.7 18.8
States of)
Monaco 38 3.5 1.9
Mongolia 2 959 64.7 73.2 68.8 62.0 44 99 22.4 11.1 0.03
Montenegro 626 74.1 78.1 76.1 67.9 7 99 4.7 3.1
Morocco 34 378 73.3 75.4 74.3 64.9 121 74 27.6 17.6 0.07
Mozambique 27 978 55.7 59.4 57.6 49.6 489 54 ac 78.5 27.1 7.07
Myanmar 53 897 64.6 68.5 66.6 59.2 178 60 ac 50.0 26.4 0.41
Namibia 2 459 63.1 68.3 65.8 57.5 265 88 45.4 15.9 6.79
Nauru 10 97 ac 35.4 22.7
Nepal 28 514 67.7 70.8 69.2 61.1 258 56 ac 35.8 22.2 0.08
Netherlands 16 925 80.0 83.6 81.9 72.2 7 3.8 2.4
New Zealand 4 529 80.0 83.3 81.6 71.6 11 97 ac 5.7 3.1
Nicaragua 6 082 71.5 77.9 74.8 63.7 150 88 ac 22.1 9.8 0.23
Niger 19 899 60.9 62.8 61.8 54.2 553 40 95.5 26.8 0.19
Nigeria 182 202 53.4 55.6 54.5 47.7 814 35 108.8 34.3
Niue 2 100 ac 23.0 12.5
Norway 5 211 79.8 83.7 81.8 72.0 5 99 ac 2.6 1.5
Oman 4 491 75.0 79.2 76.6 66.7 17 99 ac 11.6 5.2
Pakistan 188 925 65.5 67.5 66.4 57.8 178 52 ac 81.1 45.5 0.16
Palau 21 100 16.4 9.0
Panama 3 929 74.7 81.1 77.8 68.1 94 94 17.0 9.6 0.48
Papua New Guinea 7 619 60.6 65.4 62.9 56.4 215 53 57.3 24.5 0.54
Paraguay 6 639 72.2 76.0 74.0 65.2 132 96 ac 20.5 10.9 0.30
Peru 31 377 73.1 78.0 75.5 65.6 68 90 16.9 8.2 0.17
Philippines 100 699 65.3 72.0 68.5 61.1 114 73 28.0 12.6 0.12
Poland 38 612 73.6 81.3 77.5 68.7 3 100 ac 5.2 3.1
Portugal 10 350 78.2 83.9 81.1 71.4 10 99 ac 3.6 2.0
Qatar 2 235 77.4 80.0 78.2 67.7 13 100 8.0 3.8
Republic of Korea 50 293 78.8 85.5 82.3 73.2 11 100 ac 3.4 1.6
Republic of Moldova 4 069 67.9 76.2 72.1 64.8 23 100 ac 15.8 11.9 0.55
Romania 19 511 71.4 78.8 75.0 66.8 31 99 ac 11.1 6.3
Russian Federation 143 457 64.7 76.3 70.5 63.3 25 100 ac 9.6 5.0
Rwanda 11 610 61.9 67.4 64.8 55.5 290 91 ac 41.7 18.7 1.41
Saint Kitts and Nevis 56 100 ac 10.5 6.5
Saint Lucia 185 72.6 77.9 75.2 66.1 48 99 14.3 9.3
Saint Vincent and the 109 71.3 75.2 73.2 64.6 45 99 ac 18.3 11.5
Grenadines
Samoa 193 70.9 77.5 74.0 66.6 51 83 ac 17.5 9.5
San Marino 32 2.9 0.7
Sao Tome and Principe 190 65.6 69.4 67.5 59.1 156 93 ac 47.3 17.1
Saudi Arabia 31 540 73.2 76.0 74.5 64.5 12 98 ac 14.5 7.9
Senegal 15 129 64.6 68.6 66.7 58.3 315 53 47.2 20.8 0.14
Serbia 8 851 72.9 78.4 75.6 67.7 17 100 ac 6.7 4.2
Seychelles 96 69.1 78.0 73.2 65.5 99 ac 13.6 8.6
Sierra Leone 6 453 49.3 50.8 50.1 44.4 1 360 60 120.4 34.9 0.69
Singapore 5 604 80.0 86.1 83.1 73.9 10 100 ac 2.7 1.0
Slovakia 5 426 72.9 80.2 76.7 68.1 6 99 ac 7.3 4.2
Slovenia 2 068 77.9 83.7 80.8 71.1 9 100 ac 2.6 1.4
Solomon Islands 584 67.9 70.8 69.2 62.1 114 86 ac 28.1 12.2
Somalia 10 787 53.5 56.6 55.0 47.8 732 9 136.8 39.7 0.48
South Africa 54 490 59.3 66.2 62.9 54.5 138 94 40.5 11.0 14.40
South Sudan 12 340 56.1 58.6 57.3 49.9 789 19 ac 92.6 39.3
ANNEX B
Part 1 New HIV
infections
Maternal among adults
mortality Proportion of Under-five Neonatal 1549 years
Total Healthy life ratioc (per births attended mortality ratee mortality ratee oldf (per 1000
populationa expectancy at 100 000 live by skilled health (per 1000 live (per 1000 live uninfected
(000s) Male Female Both sexes birthb (years) births) personneld (%) births) births) population)
Member State 2015 2015 2015 2015 20052015 2015 2015 2015
Spain 46 122 80.1 85.5 82.8 72.4 5 4.1 2.8 0.14
Sri Lanka 20 715 71.6 78.3 74.9 67.0 30 99 9.8 5.4 0.05
Sudan 40 235 62.4 65.9 64.1 55.9 311 78 ac 70.1 29.8
Suriname 543 68.6 74.7 71.6 63.1 155 90 21.3 11.5 0.62
Swaziland 1 287 56.6 61.1 58.9 50.9 389 88 ac 60.7 14.2 23.60
Sweden 9 779 80.7 84.0 82.4 72.0 4 3.0 1.6
Switzerland 8 299 81.3 85.3 83.4 73.1 5 3.9 2.7
Syrian Arab Republic 18 502 59.9 69.9 64.5 56.1 68 96 ac 12.9 7.0
Tajikistan 8 482 66.6 73.6 69.7 62.1 32 90 ac 44.8 20.5 0.33
Thailand 67 959 71.9 78.0 74.9 66.8 20 100 ac 12.3 6.7 0.20
The former Yugoslav 2 078 73.5 77.8 75.7 67.5 8 100 ac
5.5 3.5
Republic of Macedonia
Timor-Leste 1 185 66.6 70.1 68.3 60.7 215 29 52.6 22.3
Togo 7 305 58.6 61.1 59.9 52.8 368 45 78.4 26.7 1.21
Tonga 106 70.6 76.4 73.5 66.0 124 96 16.7 6.9
Trinidad and Tobago 1 360 67.9 74.8 71.2 63.3 63 100 ac 20.4 13.2 0.52
Tunisia 11 254 73.0 77.8 75.3 66.7 62 74 14.0 8.2 0.04
Turkey 78 666 72.6 78.9 75.8 66.2 16 97 ac 13.5 7.1
Turkmenistan 5 374 62.2 70.5 66.3 59.8 42 100 51.4 22.6
Tuvalu 10 93 27.1 17.6
Uganda 39 032 60.3 64.3 62.3 54.0 343 57 54.6 18.7 5.12
Ukraine 44 824 66.3 76.1 71.3 64.1 24 100 ac 9.0 5.5 0.68
United Arab Emirates 9 157 76.4 78.6 77.1 67.9 6 6.8 3.5
United Kingdom 64 716 79.4 83.0 81.2 71.4 9 4.2 2.4
United Republic of 53 470 59.9 63.8 61.8 54.1 398 49 48.7 18.8 2.11
Tanzania
United States of America 321 774 76.9 81.6 79.3 69.1 14 99 6.5 3.6
Uruguay 3 432 73.3 80.4 77.0 67.9 15 100 10.1 5.1 0.27
Uzbekistan 29 893 66.1 72.7 69.4 62.4 36 100 ac 39.1 20.4 0.02
Vanuatu 265 70.1 74.0 72.0 64.6 78 89 ac 27.5 11.6
Venezuela (Bolivarian 31 108 70.0 78.5 74.1 65.2 95 100 ac
14.9 8.9 0.33
Republic of)
Viet Nam 93 448 71.3 80.7 76.0 66.6 54 94 21.7 11.4 0.28
Yemen 26 832 64.3 67.2 65.7 57.7 385 45 ac 41.9 22.1 0.07
Zambia 16 212 59.0 64.7 61.8 53.6 224 63 64.0 21.4 8.55
Zimbabwe 15 603 59.0 62.3 60.7 52.3 443 78 70.7 23.5 8.84
WHO region
African Region 989 173 58.2 61.7 60.0 52.3 542 53 81.3 28.0 2.72
Region of the Americas 986 705 74.0 79.9 77.0 67.3 52 96 14.7 7.7 0.30
South-East Asia Region 1 928 174 67.3 70.7 68.9 60.5 164 78 42.5 24.3 0.16
European Region 910 053 73.2 80.2 76.8 68.0 16 99 11.3 6.0 0.47
Eastern Mediterranean 643 784 67.4 70.4 68.8 60.1 166 71 52.0 26.6 0.13
Region
Western Pacific Region 1 855 126 74.5 78.7 76.6 68.7 41 96 13.5 6.7 0.09
Global 7 313 015 69.1 73.8 71.4 63.1 216 78 42.5 19.2 0.50
WHO region
275 244.9 76 632 923 079 20.9 8.8 6.0 26.6 49.6 100.3 African Region
27 10.0 89 52 468 604 14.7 9.6 8.2 15.9 82.5 51.7 Region of the Americas
246 17.9 87 726 474 894 23.2 12.9 4.0 17.0 73.5 33.9 South-East Asia Region
36 0.0 81 2 378 913 17.8 14.1 10.3 9.3 72.9 17.6 European Region
Eastern Mediterranean
116 19.0 80 86 152 675 21.8 3.8 0.7 19.9 61.1 46.1 Region
86 3.1 90 90 710 965 17.1 10.8 7.8 17.3 89.7 15.3 Western Pacific Region
142 94.0 84 1591 109 130 18.8 10.7 6.4 17.4 76.7 44.1 Global
Annual
mean
Proportion of concentrations
population Proportion of Proportion of of fine Average Estimated
using population population particulate death rate Mortality direct deaths
Prevalence Prevalence Prevalence of improved using with primary matter (PM2.5) due to natural rate due to from major Completeness
of stunting of wasting overweight drinking- improved reliance on in urban disastersk homicidek conflictsk,aa of cause-of-
in children in children in children water sanitationx clean fuelsy areasz (per 100 000 (per 100 000 (per 100 000 death dataab
under 5w (%) under 5w (%) under 5w (%) sourcesx (%) (%) (%) (g/m )3
population) population) population) (%)
20052016 20052016 20052016 2015 2015 2014 2014 20112015 2015 20112015 20052015 Member State
40.9 9.5 5.4 55 32 17 63.4 0.8 7.0 40.9 Afghanistan
23.1 9.4 23.4 95 93 67 17.1 0.0 4.1 <0.1 76 Albania
11.7 4.1 12.4 84 88 >95 25.1 <0.1 4.2 1.0 Algeria
100 100 >95 af 10.5 100 Andorra
37.6 4.9 3.3 49 52 48 42.4 0.1 9.6 0.0 Angola
98 >95 13.0 0.0 4.8 0.0 93 Antigua and Barbuda
8.2 1.2 9.9 99 96 >95 14.4 0.1 4.7 0.0 99 Argentina
9.4 4.2 13.6 100 90 >95 25.0 0.0 1.7 0.0 100 Armenia
2.0 0.0 7.7 100 100 >95 af 5.8 0.1 0.9 <0.1 100 Australia
100 100 >95 af 17.1 0.2 1.0 <0.1 100 Austria
18.0 3.1 13.0 87 89 >95 26.3 0.0 2.2 0.3 100 Azerbaijan
98 92 >95 af 12.6 0.0 23.7 0.0 89 Bahamas
100 99 >95 af 60.1 0.0 0.7 2.0 83 Bahrain
36.1 14.3 1.4 87 61 10 88.8 0.1 2.9 <0.1 Bangladesh
7.7 6.8 12.2 100 96 >95 14.0 0.0 10.1 0.0 75 Barbados
4.5 2.2 9.7 100 94 >95 18.0 0.0 6.2 <0.1 90 Belarus
100 100 >95 af 15.9 <0.1 1.1 <0.1 100 Belgium
15.0 1.8 7.3 100 91 87 20.7 0.0 37.2 0.0 76 Belize
34.0 4.5 1.7 78 20 7 27.9 <0.1 6.0 0.0 Benin
33.6 5.9 7.6 100 50 68 39.0 0.0 1.5 0.0 Bhutan
Bolivia (Plurinational
18.1 1.6 8.7 90 50 79 31.6 0.5 13.6 0.0 State of)
8.9 2.3 17.4 100 95 40 55.1 0.1 3.1 <0.1 95 Bosnia and Herzegovina
31.4 7.2 11.2 96 63 63 19.2 0.1 10.8 0.0 Botswana
7.1 1.6 7.3 98 83 93 11.3 0.2 30.5 0.2 99 Brazil
19.7 2.9 8.3 >95 af 5.4 0.0 1.3 0.0 100 Brunei Darussalam
99 86 79 30.3 0.1 1.5 <0.1 98 Bulgaria
27.3 7.6 1.2 82 20 7 36.8 <0.1 9.8 <0.1 Burkina Faso
57.5 6.1 2.9 76 48 <5 48.9 0.2 6.2 0.1 Burundi
92 72 71 0.0 5.9 0.0 95 Cabo Verde
32.4 9.6 2.0 76 42 13 25.0 0.7 2.2 <0.1 Cambodia
31.7 5.2 6.7 76 46 18 63.6 <0.1 11.5 1.2 Cameroon
100 100 >95 af 7.2 0.1 1.8 <0.1 100 Canada
40.7 7.1 1.8 69 22 <5 55.9 0.0 13.1 25.6 Central African Republic
39.9 13.0 2.5 51 12 <5 61.3 <0.1 9.0 0.1 Chad
1.8 0.3 9.3 99 99 >95 25.0 0.1 4.6 <0.1 99 Chile
9.4 2.3 6.6 96 77 57 59.5 0.1 0.9 <0.1 62 China
12.7 0.9 4.8 91 81 91 18.1 0.3 48.8 0.8 83 Colombia
32.1 11.1 10.9 90 36 7 16.0 0.1 7.6 0.0 Comoros
21.2 8.2 5.9 77 15 18 56.9 0.1 10.1 0.0 Congo
100 98 80 100 Cook Islands
5.6 1.0 8.1 98 95 >95 19.1 0.1 9.2 0.0 90 Costa Rica
29.6 7.6 3.2 82 23 18 19.2 <0.1 11.8 0.5 Cte d'Ivoire
100 97 94 20.3 0.1 1.0 0.0 100 Croatia
95 93 87 16.5 0.2 4.9 0.0 99 Cuba
100 100 >95 af 17.2 0.0 2.2 0.0 68 Cyprus
100 99 >95 20.7 0.2 0.9 <0.1 100 Czechia
Democratic People's
27.9 4.0 0.0 100 82 7 31.4 0.2 4.4 0.0 Republic of Korea
Democratic Republic of
42.6 8.1 4.4 52 29 6 60.7 <0.1 13.4 1.8 the Congo
100 100 >95 af 10.5 <0.1 1.1 <0.1 100 Denmark
33.5 21.5 8.1 90 47 10 46.0 0.0 6.8 0.1 Djibouti
92 13.0 100 Dominica
7.1 2.4 7.6 85 84 92 17.0 <0.1 30.2 0.0 54 Dominican Republic
Annual
mean
Proportion of concentrations
population Proportion of Proportion of of fine Average Estimated
using population population particulate death rate Mortality direct deaths
Prevalence Prevalence Prevalence of improved using with primary matter (PM2.5) due to natural rate due to from major Completeness
of stunting of wasting overweight drinking- improved reliance on in urban disastersk homicidek conflictsk,aa of cause-of-
in children in children in children water sanitationx clean fuelsy areasz (per 100 000 (per 100 000 (per 100 000 death dataab
under 5w (%) under 5w (%) under 5w (%) sourcesx (%) (%) (%) (g/m )3
population) population) population) (%)
20052016 20052016 20052016 2015 2015 2014 2014 20112015 2015 20112015 20052015 Member State
25.2 2.3 7.5 87 85 >95 13.3 0.2 10.2 <0.1 81 Ecuador
22.3 9.5 15.7 99 95 >95 100.6 0.0 5.0 0.4 95 Egypt
13.6 2.1 6.4 94 75 83 37.0 0.1 63.2 0.0 84 El Salvador
26.2 3.1 9.7 48 75 22 32.0 0.0 3.2 0.0 Equatorial Guinea
50.3 15.3 1.9 58 16 14 35.7 0.0 7.5 0.1 Eritrea
100 97 92 8.4 0.0 4.4 <0.1 100 Estonia
38.4 9.9 2.8 57 28 <5 36.2 0.0 7.6 0.2 Ethiopia
96 91 37 6.0 0.4 2.5 0.0 100 Fiji
100 98 >95 af 7.1 0.0 1.6 <0.1 100 Finland
100 99 >95 af 12.6 0.2 0.9 <0.1 100 France
17.5 3.4 7.7 93 42 73 35.8 0.0 9.0 0.0 Gabon
25.0 11.1 3.2 90 59 <5 43.0 <0.1 9.1 0.0 Gambia
11.3 1.6 19.9 100 86 55 23.0 0.2 4.2 <0.1 100 Georgia
1.3 1.0 3.5 100 99 >95 af 14.4 0.1 0.7 <0.1 100 Germany
18.8 4.7 2.6 89 15 21 22.1 0.2 10.0 0.0 Ghana
100 99 >95 af 12.6 <0.1 2.0 <0.1 98 Greece
97 98 >95 14.0 0.0 6.4 0.0 100 Grenada
46.5 0.7 4.7 93 64 36 33.4 0.2 36.2 0.2 92 Guatemala
31.3 9.9 3.8 77 20 6 19.4 0.0 8.5 0.2 Guinea
27.2 5.9 2.3 79 21 <5 28.9 0.0 9.2 <0.1 Guinea-Bissau
12.0 6.4 5.3 98 84 61 16.1 0.0 18.8 0.0 93 Guyana
21.9 5.2 3.6 58 28 9 24.6 0.4 28.1 0.0 Haiti
22.7 1.4 5.2 91 83 48 39.6 0.1 85.7 <0.1 15 Honduras
100 98 >95 af 22.7 0.0 1.2 0.0 100 Hungary
100 99 >95 af 7.7 0.0 1.3 0.0 100 Iceland
38.4 21.0 1.9 94 40 34 65.7 0.2 4.0 0.1 10 India
36.4 13.5 11.5 87 61 57 17.8 0.1 4.3 <0.1 Indonesia
6.8 4.0 0.0 96 90 >95 40.2 0.1 4.1 0.1 90 Iran (Islamic Republic of)
22.1 6.5 11.4 87 86 >95 51.3 <0.1 12.7 83.6 75 Iraq
98 91 >95 af 9.9 <0.1 0.9 <0.1 100 Ireland
100 100 >95 af 19.2 <0.1 2.0 0.3 100 Israel
100 100 >95 af 18.2 0.1 0.9 0.0 100 Italy
5.7 3.0 7.8 94 82 93 17.1 0.0 35.2 0.0 87 Jamaica
7.1 2.3 1.5 100 100 >95 af 12.9 4.2 0.3 <0.1 100 Japan
7.8 2.4 4.7 97 99 >95 37.7 0.0 3.0 <0.1 65 Jordan
8.0 3.1 9.3 93 98 92 21.1 <0.1 9.0 <0.1 86 Kazakhstan
26.0 4.0 4.1 63 30 6 16.8 0.1 8.2 0.6 Kenya
67 40 <5 0.0 9.1 0.0 56 Kiribati
4.9 3.1 6.0 99 100 >95 af 78.4 0.0 2.5 0.1 65 Kuwait
12.9 2.8 7.0 90 93 76 15.4 0.0 7.7 <0.1 95 Kyrgyzstan
Annual
mean
Proportion of concentrations
population Proportion of Proportion of of fine Average Estimated
using population population particulate death rate Mortality direct deaths
Prevalence Prevalence Prevalence of improved using with primary matter (PM2.5) due to natural rate due to from major Completeness
of stunting of wasting overweight drinking- improved reliance on in urban disastersk homicidek conflictsk,aa of cause-of-
in children in children in children water sanitationx clean fuelsy areasz (per 100 000 (per 100 000 (per 100 000 death dataab
under 5w (%) under 5w (%) under 5w (%) sourcesx (%) (%) (%) (g/m )3
population) population) population) (%)
20052016 20052016 20052016 2015 2015 2014 2014 20112015 2015 20112015 20052015 Member State
100 93 >95 14.3 0.2 2.7 0.0 97 Mauritius
12.4 1.0 5.2 96 85 86 20.1 0.2 19.0 1.1 100 Mexico
Micronesia (Federated
89 57 25 6.0 1.3 4.7 0.0 States of)
100 100 >95 af 9.2 100 Monaco
10.8 1.0 10.5 64 60 32 32.1 0.0 8.2 0.0 95 Mongolia
9.4 2.8 22.3 100 96 74 24.3 0.0 2.6 0.0 92 Montenegro
14.9 2.3 10.7 85 77 >95 18.9 <0.1 1.6 <0.1 22 Morocco
43.1 6.1 7.9 51 21 <5 22.3 0.2 3.0 0.1 Mozambique
29.2 7.0 1.3 81 80 9 56.6 0.1 3.9 1.6 Myanmar
23.1 7.1 4.1 91 34 46 18.4 0.9 14.6 0.0 Namibia
24.0 1.0 2.8 97 66 >95 Nauru
37.1 11.3 2.1 92 46 26 74.3 7.2 3.3 <0.1 Nepal
100 98 >95 af 14.9 <0.1 0.7 0.0 100 Netherlands
100 >95 af 5.3 0.9 1.2 0.0 100 New Zealand
23.0 1.5 6.2 87 68 49 26.0 0.2 15.0 <0.1 82 Nicaragua
43.0 18.7 3.0 58 11 <5 51.5 0.2 10.0 0.2 Niger
32.9 7.2 1.6 69 29 <5 37.6 0.1 9.8 3.1 Nigeria
99 100 91 Niue
100 98 >95 af 9.1 0.1 0.7 0.3 100 Norway
14.1 7.5 4.4 93 97 >95 af 47.4 0.1 5.0 0.0 81 Oman
45.0 10.5 4.8 91 64 45 67.7 0.4 9.5 4.2 Pakistan
100 58 95 Palau
19.1 1.2 0.0 95 75 86 12.8 0.3 18.7 0.0 94 Panama
49.5 14.3 13.8 40 19 31 12.0 0.2 12.2 0.2 Papua New Guinea
10.9 2.6 11.7 98 89 64 16.9 <0.1 7.5 0.1 81 Paraguay
14.6 0.6 7.2 87 76 68 35.7 0.1 14.6 <0.1 62 Peru
30.3 7.9 5.0 92 74 45 27.1 2.5 11.6 1.1 82 Philippines
98 97 >95 af 25.4 <0.1 0.9 0.0 100 Poland
100 100 >95 af 9.6 0.1 1.1 0.0 100 Portugal
100 98 >95 104.6 0.0 8.1 0.0 67 Qatar
2.5 1.2 7.3 100 >95 27.8 0.3 2.0 0.0 100 Republic of Korea
6.4 1.9 4.9 88 76 93 17.1 0.0 5.5 0.0 90 Republic of Moldova
100 79 82 20.2 0.6 1.5 0.0 100 Romania
97 72 >95 16.6 <0.1 10.3 0.5 89 Russian Federation
37.9 2.2 7.7 76 62 <5 50.6 <0.1 5.1 0.7 Rwanda
98 >95 af 88 Saint Kitts and Nevis
2.5 3.7 6.3 96 91 >95 15.0 0.7 13.5 0.0 88 Saint Lucia
WHO region
African Region 80.2 43.1 2.8 76 4.54 14.1 55 9.9
Region of the Americas 20.3 1.5 0.8 91 0.32 84.6 79 13.6
South-East Asia Region 119.9 20.1 1.5 87 0.47 24.6 80 9.3
European Region 64.2 0.6 1.0 93 106.4 81 13.2
Eastern Mediterranean 58.8 13.1 1.4 80 1.46 26.3 72 8.8
Region
Western Pacific Region 133.5 0.8 1.4 94 0.24 42.0 79 12.3
Annual
mean
Proportion of concentrations
population Proportion of Proportion of of fine Average Estimated
using population population particulate death rate Mortality direct deaths
Prevalence Prevalence Prevalence of improved using with primary matter (PM2.5) due to natural rate due to from major Completeness
of stunting of wasting overweight drinking- improved reliance on in urban disastersk homicidek conflictsk,aa of cause-of-
in children in children in children water sanitationx clean fuelsy areasz (per 100 000 (per 100 000 (per 100 000 death dataab
under 5w (%) under 5w (%) under 5w (%) sourcesx (%) (%) (%) (g/m )3
population) population) population) (%)
20052016 20052016 20052016 2015 2015 2014 2014 20112015 2015 20112015 20052015 Member State
38.2 16.3 3.0 23 52.7 0.1 6.5 7.0 Sudan
8.8 5.0 4.0 95 79 91 16.3 0.0 10.7 0.0 79 Suriname
25.5 2.0 9.0 74 58 35 19.8 0.2 20.0 0.0 Swaziland
100 99 >95 af 5.9 0.1 1.2 0.0 100 Sweden
100 100 >95 af 12.5 <0.1 0.6 0.0 100 Switzerland
27.5 11.5 17.9 90 96 >95 34.1 0.0 2.5 309.0 81 Syrian Arab Republic
26.8 9.9 6.6 74 95 72 50.7 0.1 1.3 0.1 82 Tajikistan
16.3 6.7 10.9 98 93 76 27.3 0.3 4.0 0.7 81 Thailand
United Republic of
34.4 4.5 3.6 56 16 <5 23.9 <0.1 7.6 <0.1 Tanzania
2.1 0.5 6.0 99 100 >95 af 8.4 0.4 5.3 <0.1 100 United States of America
10.7 1.3 7.2 100 96 >95 11.5 0.0 7.6 0.0 100 Uruguay
19.6 4.5 12.8 100 90 38.3 0.1 3.0 0.0 89 Uzbekistan
28.5 4.4 4.6 95 58 16 7.0 0.9 2.1 0.0 Vanuatu
90 Venezuela (Bolivarian
13.4 4.1 6.4 93 94 >95 24.0 <0.1 51.7 <0.1 Republic of)
24.6 6.4 5.3 98 78 51 27.6 0.1 3.9 0.0 Viet Nam
46.5 16.3 2.0 62 42.0 <0.1 6.1 14.3 Yemen
40.0 6.3 6.2 65 44 16 29.5 0.0 9.7 0.0 Zambia
27.6 3.3 3.6 77 37 31 23.9 0.2 28.5 <0.1 Zimbabwe
WHO region
33.5 7.4 4.1 68 32 16 37.4 0.1 10.3 1.4 5 African Region
6.6 0.9 7.1 96 89 91 14.7 0.2 18.6 0.2 94 Region of the Americas
33.8 15.3 5.3 92 49 35 58.8 0.3 4.0 0.1 11 South-East Asia Region
6.1 1.5 12.8 99 93 >95 19.1 0.1 3.3 0.5 95 European Region
32 Eastern Mediterranean
25.1 9.1 6.7 91 78 71 62.9 0.2 6.5 19.5 Region
7.0 2.4 5.2 95 79 61 49.8 0.5 1.7 0.1 64 Western Pacific Region
j
Neglected tropical diseases [online database]. Global Health Observatory (GHO) data. Geneva: World Health Organization (http://www.who.int/gho/neglected_diseases/en/).
k
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva, World Health Organization; 2016. (http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html,
accessed 22 March 2017). WHO Member States with a population of less than 90 000 in 2015 were not included in this analysis.
l
WHO Global Information System on Alcohol and Health [online database]. Geneva: World Health Organization; 2017 (http://apps.who.int/gho/data/node.main.GISAH?showonly=GISAH).
m
Global status report on road safety 2015. Geneva: World Health Organization; 2015 (http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/, accessed 22 March 2017). WHO Member States with a population
of less than 90 000 in 2015 who did not participate in the survey for the report were not included in the analysis.
n
World Contraceptive Use 2016 [online database]. New York (NY): United Nations, Department of Economic and Social Affairs, Population Division; 2016. Regional aggregates are estimates for the year 20165 from: United Nations,
Department of Economic and Social Affairs, Population Division (2016). Model-based Estimates and Projections of Family Planning Indicators 2016. New York: United Nations. (http://www.un.org/en/development/desa/population/
theme/family-planning/cp_model.shtml)
o
World Fertility Data 2015. New York (NY): United Nations, Department of Economic and Social Affairs, Population Division; 2015. (http://www.un.org/en/development/desa/population/publications/dataset/fertility/wfd2015.
shtml) Regional aggregates are the average of two five-year periods, 20102015 and 20152020, taken from: World Population Prospects: The 2015 Revision. DVD Edition. New York (NY): United Nations, Department of Economic
and Social Affairs, Population Division; 2015 (http://esa.un.org/unpd/wpp/Download/Standard/Fertility/, accessed 13 April 2016).
p
Public health and environment [online database]. Global Health Observatory (GHO) data. Geneva: World Health Organization (http://www.who.int/gho/phe/en/). WHO Member States with a population of less than 250 000
population in 2012 were not included in the analysis.
q
Preventing disease through healthy environments. A global assessment of the burden of disease from environmental risks. Geneva: World Health Organization; 2016 (http://apps.who.int/iris/bitstream/10665/204585/1/9789241565196_
eng.pdf?ua=1, accessed 23 March 2017); and: Preventing diarrhoea through better water, sanitation and hygiene. Exposures and impacts in low- and middle-income countries. Geneva: World Health Organization; 2014 (http://
apps.who.int/iris/bitstream/10665/150112/1/9789241564823_eng.pdf?ua=1&ua=1, accessed 23 March 2017). WHO Member States with a population of less than 250 000 in 2012 were not included in the analysis.
r
WHO global report on trends in prevalence of tobacco smoking 2015. Geneva: World Health Organization; 2015 (http://apps.who.int/iris/bitstream/10665/156262/1/9789241564922_eng.pdf, accessed 22 March 2017).
s
United Nations SDG indicators global database (https://unstats.un.org/sdgs/indicators/database/?indicator=3.b.2, accessed 6 April 2017). Based on the Creditor Reporting System database of the Organisation for Economic Co-
operation and Development, 2016.
t
Skilled health professionals refer to the latest available values (20052015) in the WHO Global Health Workforce Statistics database (http://who.int/hrh/statistics/hwfstats/en/) aggregated across physicians and nurses/midwives.
Refer to the source for the latest values, disaggregation and metadata descriptors.
u
International Health Regulations (2005) Monitoring Framework [online database]. Geneva: WHO (http://www.who.int/gho/ihr/en/).
v
Global Health Expenditure Database [online database]. Geneva. World Health Organization. 2017 (http://apps.who.int/nha/database/Select/Indicators/en, accessed March 23, 2017). WHO regional and global figures represent
unweighted averages. This indicator reflects the health-related portion of the SDG indicator.
w
United Nations Childrens Fund, World Health Organization, the World Bank Group. Levels and trends in child malnutrition. UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates. UNICEF, New York; WHO, Geneva; the
World Bank Group, Washington (DC); May 2017. WHO regional and global estimates are for the year 2016.
x
Progress on sanitation and drinking water 2015 update and MDG assessment. New York (NY): UNICEF; and Geneva: World Health Organization; 2015 (http://apps.who.int/iris/bitstream/10665/177752/1/9789241509145_eng.
pdf?ua=1, accessed 23 March 2017). This indicator is used here as a proxy for the SDG indicator.
y
Burning opportunity: clean household energy for health, sustainable development, and wellbeing of women and children. Geneva: World Health Organization; 2016 (http://apps.who.int/iris/bitstream/10665/204717/1/9789241565233_
eng.pdf, accessed 23 March 2017).
z
Ambient air pollution: a global assessment of exposure and burden of disease. Geneva: World Health Organization; 2016 (see: http://who.int/phe/publications/air-pollution-global-assessment/en/, accessed 23 March 2017).
aa
Conflict deaths include deaths due to collective violence and exclude deaths due to legal intervention.
ab
Global Health Estimates 2015: Deaths by cause, age, sex, by country and by region, 20002015. Geneva, World Health Organization; 2016. (http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html,
accessed 22 March 2017). Completeness was assessed relative to the de facto resident populations. WHO regional and global figures are for 2015.
ac
Non-standard definition. For more details see the WHO/UNICEF joint Global Database 2017. (http://www.who.int/gho/maternal_health/en/ and https://data.unicef.org/topic/maternal-health/delivery-care)
ad
Updated estimate.
ae
The estimate of total suicide mortality for the Republic of Korea has been updated using data published in the WHO Mortality Database after the closure date for the Global Health Estimates 2015.
af
For high-income countries with no information on clean fuel use, usage is assumed to be >95%.
ag
Cigarette smoking only.
WHO African Region: Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cabo Verde, Cameroon, Central African
Republic, Chad, Comoros, Congo, Cte dIvoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea*, Ethiopia,
Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius,
Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa,
South Sudan*, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia, Zimbabwe.
WHO Region of the Americas: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State
of), Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada,
Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint
Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, the United States of America, Uruguay, Venezuela
(Bolivarian Republic of).
WHO South-East Asia Region: Bangladesh, Bhutan, Democratic Peoples Republic of Korea, India, Indonesia, Maldives,
Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste*.
WHO European Region: Albania, Andorra*, Armenia*, Austria, Azerbaijan*, Belarus, Belgium, Bosnia and Herzegovina*,
Bulgaria, Croatia*, Cyprus, Czechia*, Denmark, Estonia*, Finland, France, Georgia*, Germany, Greece, Hungary, Iceland,
Ireland, Israel, Italy, Kazakhstan*, Kyrgyzstan*, Latvia*, Lithuania*, Luxembourg, Malta, Monaco, Montenegro*, Netherlands,
Norway, Poland, Portugal, Republic of Moldova*, Romania, Russian Federation, San Marino, Serbia*, Slovakia*, Slovenia*,
Spain, Sweden, Switzerland, Tajikistan*, The former Yugoslav Republic of Macedonia*, Turkey, Turkmenistan*, Ukraine,
the United Kingdom, Uzbekistan*.
WHO Eastern Mediterranean Region: Afghanistan, Bahrain, Djibouti, Egypt, Iran (Islamic Republic of), Iraq, Jordan,
Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia,
United Arab Emirates, Yemen.
WHO Western Pacific Region: Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Japan, Kiribati, Lao
Peoples Democratic Republic, Malaysia, Marshall Islands*, Micronesia (Federated States of)*, Mongolia, Nauru*, New
Zealand, Niue*, Palau*, Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga,
Tuvalu*, Vanuatu, Viet Nam.
Member States indicated with an * may have data for periods prior to their official membership of WHO.
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ISBN 978 92 4 156548 6