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Review
. 2017;10(1):1267961.
doi: 10.1080/16549716.2017.1267961.

The impact of the worldwide Millennium Development Goals campaign on maternal and under-five child mortality reduction: 'Where did the worldwide campaign work most effectively?'

Seungman Cha  1   2   3
Affiliations
Review

The impact of the worldwide Millennium Development Goals campaign on maternal and under-five child mortality reduction: 'Where did the worldwide campaign work most effectively?'

Seungman Cha. Glob Health Action. 2017.

Abstract

Background: As the Millennium Development Goals campaign (MDGs) came to a close, clear evidence was needed on the contribution of the worldwide MDG campaign.

Objective: We seek to determine the degree of difference in the reduction rate between the pre-MDG and MDG campaign periods and its statistical significance by region.

Design: Unlike the prevailing studies that measured progress in 1990-2010, this study explores by percentage how much MDG progress has been achieved during the MDG campaign period and quantifies the impact of the MDG campaign on the maternal and under-five child mortality reduction during the MDG era by comparing observed values with counterfactual values estimated on the basis of the historical trend.

Results: The low accomplishment of sub-Saharan Africa toward the MDG target mainly resulted from the debilitated progress of mortality reduction during 1990-2000, which was not related to the worldwide MDG campaign. In contrast, the other regions had already achieved substantial progress before the Millennium Declaration was proclaimed. Sub-Saharan African countries have seen the most remarkable impact of the worldwide MDG campaign on maternal and child mortality reduction across all different measurements. In sub-Saharan Africa, the MDG campaign has advanced the progress of the declining maternal mortality ratio and under-five mortality rate, respectively, by 4.29 and 4.37 years.

Conclusions: Sub-Saharan African countries were frequently labeled as 'off-track', 'insufficient progress', or 'no progress' even though the greatest progress was achieved here during the worldwide MDG campaign period and the impact of the worldwide MDG campaign was most pronounced in this region in all respects. It is time to learn from the success stories of the sub-Saharan African countries. Erroneous and biased measurement should be avoided for the sustainable development goals to progress.

Keywords: MDGs; Maternal mortality ratio; child mortality rate; progress; sub-Saharan Africa.

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Figures

Figure 1.
Figure 1.
Under-five mortality rate of the MDG model, intervention group and control group in Egypt and Senegal (x-axis: year; y-axis: under-five mortality rate; MDG model (blue line) indicates the target value which each country has to achieve in each year; intervention (red rectangle in the graph) indicates the real under-five mortality rate actually observed (source: WHO World Health Statistics); control (green line) means the counterfactual of the under-five mortality rate, which we estimated based on historical trends. The actual under-five mortality rate of Egypt in 2000 was 44, already much better than the target which the MDGs wanted to achieve in the same year, and in fact it corresponded to the goal of the year 2006. The mortality rate of the counterfactual was 20.76, which was almost identical with the actual value, suggesting little change occurred from the historical trend. In sharp contrast, the actual under-five mortality rate of Senegal in 2000, 130, was exceedingly worse than the target value, 88. In 2011, the observed mortality rate was far below the counterfactual, indicating a substantial change from the historical trend. This graph shows that the methods of the MDGs progress assessment must be completely redefined. Data source: the World Health Statistics published by the World Health Organization.
Figure 2.
Figure 2.
Impact of MDG campaign on the reduction rate of maternal mortality ratio (> 10%). Data source: the World Health Statistics published by the World Health Organization.
Figure 3.
Figure 3.
Impact of MDG campaign on the reduction rate of under-five mortality rate (> 10%). Data source: the World Health Statistics published by the World Health Organization.
Figure 4.
Figure 4.
Maternal mortality ratio of MDG model, intervention and control groups. Data source: the World Health Statistics published by the World Health Organization.
See this image and copyright information in PMC

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