Achieving MDGs in Pakistan Faheem Jehangir Khan Research Economist Pakistan Institute of Development Economics Islamabad Saturday April 28th, 2007
Achieving MDGs in Pakistan For attainment of 8 Millennium Goals the UN Millennium Declaration had fixed 18 Targets and 48 Indicators Pakistan has adopted 16 Targets and 37 Indicators Even though for some of the MDGs Pakistan s progress may have been somewhat satisfactory, for most of the indicators performance is not quite adequate One of the reasons for slow progress could be low levels of public sector allocations for the social sectors (e.g. Health, Education, and Water & Sanitation)
MDGs Pakistan MDGs Targets Indicators 1 Eradicate Extreme Poverty and Hunger 2 3 2 Achieve Universal Primary Education 1 3 3 Promote Gender Equality & Women Empowerment 1 4 4 Reducing Child Mortality 1 6 5 Improving Maternal Health 1 5 6 Combating HIV/AIDS, Malaria and other Diseases 2 5 7 Ensuring Environmental Sustainability 3 8 8 Develop a Global Partnership for Development* 5 7 16 37
Achieving MDGs in Pakistan Education (Goal 2) Target 3 Target 4 Health (Goal 4, 5 and 6) Target 5 Target 6 Target 7 Target 8 Water & Sanitation (Goal 7) Target 9 Target 10 Target 11 {Primary Education} {Eliminate Gender Disparity} {Underfive Mortality, Health and Care} {Maternal Mortality} {HIV/ AIDS} {Malaria, TB and Other Major Diseases} {Environmental Resources} {Improved Water & Adequate Sanitation} {Katchi abadis (Slums)}
Financing MDGs (Pakistan) Public Sector Expenditure External Economic Assistance Out of Pocket Expenditure
Education
Financing Education Total Public Sector Education Expenditure (Federal plus Provincial) 140000 120000 Million Rs 100000 80000 60000 40000 20000 0 200001 200102 200203 200304 200405 200506 Development Current Total
Financing Education (Contd.) Share in Total Public Sector Education Expenditure 50 40 44 41 40 46 43 39 Percentage 30 20 10 12 24 22 22 22 19 20 17 18 19 19 18 16 15 13 12 12 13 7 6 6 5 5 4 0 200001 200102 200203 200304 200405 200506 Federal Punjab Sindh NWFP Balochistan
Financing Education (Contd.) Percentage 3.00 2.50 2.00 1.50 1.00 0.50 0.00 Public Sector Expenditure on Education as % GDP 2.39 2.73 1.86 2.15 1.45 1.65 0.34 0.41 0.45 0.05 0.14 0.18 200001 200102 200203 200304 200405 200506 Total Expenditure Development Expenditure
Financing Education (Contd.) External Economic Assistance in Education Sector 200405 (Million US$) USAID, 25.00 WFP, 2.89 UNFPA, 0.02 UK, 0.30 OPEC Fund, 1.35 ADB, 5.26 Norw ay, 1.47 Canada, 0.29 Japan, 1.13 IDA, 0.30 Germany, 0.37 EU, 8.18 Total External Economic Assistance in Education = 46.55 Million US$ (200405)
Out of Pocket Expenditure (Education) Out of Pocket Expenditure (Education) OPE Education 90 75 78 79 81 67 60 45 30 15 44 40 40 39 32 27 25 22 15 10 9 0 Average Urban Rural Average Urban Rural Average Urban Rural Average Urban Rural Average Urban Rural Pakistan Punjab Sindh NWFP Balochistan Monthly Rs/ HH
Health
Financing Health Total Public Sector Health Expenditure (Federal plus Provincial) 40000 32000 Million Rs 24000 16000 8000 0 200001 200102 200203 200304 200405 200506 Development Current Total
Financing Health (Contd.) Share in Total Public Sector Health Expenditure Percentage 45 40 35 30 25 20 15 10 5 0 39 39 42 43 40 37 29 22 23 24 25 26 19 19 19 17 16 16 12 11 10 11 10 8 8 9 7 8 7 5 200001 200102 200203 200304 200405 200506 Federal Punjab Sindh NWFP Balochistan
Financing Health (Contd.) Public Sector Expenditure on Health as % GDP Percentage 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.45 0.48 0.53 0.06 0.06 0.08 0.60 0.64 0.12 0.14 0.75 0.19 0.00 200001 200102 200203 200304 200405 200506 Total Expenditure Development Expenditure
Financing Health (Contd.) External Economic Assistance in Health Sector 200405 (Million US$) Japan, 9.00 UK, 17.89 UNDP, 0.01 IDA, 26.95 Germany, 0.54 USAID, 17.58 Canada, 1.22 ADB, 9.20 WFP, 0.87 Total External Economic Assistance in Health = 83.25 Million US$ (200405)
Out of Pocket Expenditure (Health) Out of Pocket Expenditure (Health) OPE Health 75 60 45 70 62 60 55 51 49 52 54 55 51 46 39 37 37 36 30 15 0 Average Urban Rural Average Urban Rural Average Urban Rural Average Urban Rural Average Urban Rural Pakistan Punjab Sindh NWFP Balochistan Monthly Rs/ HH
Water & Sanitation
Financing WatSan 12000 10000 Total Public Sector WatSan Expenditure (Federal plus Provincial) Million Rs. 8000 6000 4000 2000 0 200001 200102 200203 200304 200405 200506 Current Development Total
Financing WatSan (Contd.) Share in Public Sector WatSan Expenditure Percentage 70 60 50 40 30 20 10 0 65 52 38 38 39 39 28 25 21 20 20 22 20 17 15 16 17 13 12 13 10 8 11 7 9 7 6 7 3 2 200001 200102 200203 200304 200405 200506 Federal Punjab Sindh NWFP Balochistan
Financing WatSan (Contd.) Public Sector Expenditure on WatSan as % GDP Percentage 0.25 0.20 0.15 0.10 0.05 0.00 0.20 0.13 0.12 0.12 0.13 0.15 0.08 0.10 0.09 0.07 0.06 0.04 200001 200102 200203 200304 200405 200506 Total Expenditure Development Expenditure
Financing WatSan (Contd.) External Economic Assistance in WatSan 200405 (Million US$) UK, 1.79 ADB, 15.90 Japan, 14.35 IDB, 0.53 France, 3.76 Total External Economic Assistance in WatSan = 36.33 Million US$ (200405)
Out of Pocket Expenditure (WatSan ( WatSan) OPE WatSan 600 500 568 509 400 300 411 394 312 325 200 100 144 100 94 57 72 90 48 45 32 0 Average Urban Rural Average Urban Rural Average Urban Rural Average Urban Rural Average Urban Rural Pakistan Punjab Sindh NWFP Balochistan Monthly Rs/ HH
MDGs Status (Pakistan) Education Health WATSAN
MDG Status (Education) Primary Education Trend and Targets 100 100 Percentage 80 55 52 68 72 52 80 77 30 46 42 1990/91 2000/01 2004/05 MTDF Target 2009/10 MDGs Targets 2015 NER Primary (%) Primary Completion Rate
MDG Status (Child Care) Mortality Rate (under five Years) No. of deaths per thousand live births 150 125 100 75 50 25 140 105 100 1990/91 2000/01 2004/05 MTDF Target 2009/10 77 52 MDGs Targets 2015
MDG Status (Child Care) Infant Mortality Rate (under 1 Year) No. of deaths per thousand live births 110 90 70 50 30 102 77 1990/91 2000/01 2004/05 MTDF Target 2009/10 73 65 40 MDGs Targets 2015
MDG Status (Child Care) Fully Immunised Children (1223 months) 90 90 Proportion 75 75 77 60 45 53 1990/91 2000/01 2004/05 MTDF Target 2009/10 MDGs Targets 2015
MDG Status (Maternal Care) Maternal Mortality Ratio No. of Mothers dying due to complications of Pregnancy per 100,000 live births 600 500 400 300 200 100 550 350 400 300350 1990/91 2000/01 2004/05 MTDF Target 2009/10 140 MDGs Targets 2015
MDG Status (Maternal Care) Births attended by Skilled Birth Attendants 100 90 80 Proportion 60 40 40 48 60 20 18 0 1990/91 2000/01 2004/05 MTDF Target 2009/10 MDGs Targets 2015
MDG Status (Maternal Care) MDG Status (Maternal Care) Contraceptive Prevalence Rate 60 50 51 40 30 36 30 20 12 10 0 1990/91 2000/01 2004/05 MTDF Target 2009/10 55 MDGs Targets 2015 Proportion of eligible couples for family planning, using one of the contraceptive methods
MDG Status (Maternal Care) Total Fertility Rate Avg No. of children a woman delivered (age 1549) 6 5 4 3 2 1 0 5.48 4.18 3.59 2.79 1990/91 2000/01 2004/05 MTDF Target 2009/10 2.1 MDGs Targets 2015
MDG Status (Maternal Care) MDG Status (Maternal Care) Antenatal Care 90 70 50 30 10 15 35 1990/91 2000/01 2004/05 MTDF Target 2009/10 50 70 100 MDGs Targets 2015 Proportion of women (1549) who delivered during last 3 years and received at least one antenatal consultation
MDG Status (Water) Access to Improved Water Source 95 93 Percentage 80 65 69 66 76 50 53 1990/91 2000/01 2004/05 MTDF Target 2009/10 MDGs Targets 2015
MDG Status (Sanitation) Access to Sanitation 85 90 70 Percentage 65 45 45 54 30 25 1990/91 2000/01 2004/05 MTDF Target 2009/10 MDGs Targets 2015
Will MDG targets be reached? Probably Potentially Unlikely No Data 1 Achieve Universal Primary Education X 2 Mortality Rate (under 5 Years) X 3 Infant Mortality Rate (under 1 Year) X 4 Fully Immunized Children (1223 months) X 5 Maternal Mortality Ratio X 6 Birth attended by Skilled Birth Attendants X 7 Contraceptive Prevalence Rate X 8 Total Fertility Rate X 9 Antenatal Care X 10 Access to Improved Water Source X (1) X (2) 11 Access to Sanitation Facilities X (1) X (2)
State of Supportive Environment Strong Fair Weak but Improving Weak 1 Achieve Universal Primary Education X 2 Mortality Rate (under 5 Years) X 3 Infant Mortality Rate (under 1 Year) X 4 Fully Immunized Children (1223 m) X 5 Maternal Mortality Ratio X 6 Birth attended by Skilled Birth Attendants X 7 Contraceptive Prevalence Rate X 8 Total Fertility Rate X 9 Antenatal Care X 10 Access to Improved Water Source X (1) X (2) 11 Access to Sanitation Facilities X (1) X (2)
The problem of development must be defined as a selective attack on the worst forms of poverty. Development goals must be defined in terms of progressive reduction and eventually elimination of malnutrition, disease, illiteracy, unemployment and inequalities. We were taught to take care of our GNP because it would take care of poverty. Let us reverse this and take care of poverty because it will take care of the GNP. In other words, let us worry about the content of the GNP even more than its rate of increase. (Dr MahbubulHaq, former Commerce Minister and Deputy Chairman Planning Commission, writing in 1971 for Pakistan Economic and Social Review) Source: Time for trickle up by Hussain H. Zaidi (The News, April 22, 2007)
Thank You