The Eight Millennium Development Goals are: to eradicate extreme poverty and hunger; to achieve universal primary education; to promote gender equality and empower women; to reduce child mortality; to improve maternal health; to combat HIV/AIDS, malaria, and other diseases; to ensure environmental sustainability; and.

1. • By. Kailash Nagar
• Assistant Professor
• Dept. Of Community Health Nursing

2. INTRODUCTION

3. TERMINOLOGIES
• Health: a state of complete physical, mental, and social well
being, Not being mere absence of disease or infirmity.
• Mortality: death rate, the quality of being mortal.
• Morbidity: the condition of being diseased.
• Disability: disqualification, want of power.
• Indicators: a singal for attracting attention.
• EPI: Expanded Programme on Immunization.
• ILO: International Labour Organization.

4. Cont…..
• MDGs: millennium development goals
• NHP: national health policy
• MMR: maternal mortality rate
• IMR: infant mortality rate
• CDR: crude death rate
• CMR: child mortality rate
• PREVENTIVE: something used to prevent
diseases
• ACHIEVEMENT: a thing done successfully with
effort
• FOCUS: a centre of interest or activity.

5. Cont……
• TARGET: something that are trying to do or
achieve.
• PLAN: a detailed proposal for doing something
• ERADICATE: destroy completely or put an end
to.
• SSA: sarva shiksha abhiyan
• MDM: mid-day meal scheme
• KGBV: kasturba gandhi balika vidyalaya.
• U5MR: under five mortality rate.

10. Cont….
• A question that is often raised is how healthy
is a given community?. Indicators are required
not only to measure the health status of a
community, but also to compare the health
status of one country with that of another; for
assessment of health care needs; for
allocation of health services, activities, and
programmes. Indicators help to measure the
extent to which the objectives and targets of a
programme are being attained.

13. Characteristics of indicators
• Should be valid, i.e. they should actually
measure what they are supposed to measure;
• Should be reliable and objectives, i.e. the
answers should be the same if measured by
different people in similar circumstances;
• Should be sensitive, they should be sensitive
to changes in situation concerned.
• Should be specific- they should reflect
changes only in the situation concerned
• Should be feasible, i.e. they should have the
ability to obtain data needed

38. The following morbidity rates are used for
assessing ill health in the community.
• Incidence and prevalence
• Notification rates
• Attendance rates at out- patient departments,
health centres, etc.
• Admission, readmission and discharge rates
• Duration of stay in hospital and
• Spells of sickness or absence from work or
school.

39. 3. Disability Rates
• It indicator the indicate the incidence and
prevalance of case who are not able to
perform full range of activities because of
some illness or injury.
• Such as blindness, deafness, dumbness,
paralytic poliomyelities,limited
mobility,mental retardation.

40. Conti….
• Limitation of activity: for example, limitation
to perform the basic activities of daily living
(ADL) e.g., eating, washing, dressing, going to
toilet, moving about, etc, limitation in major
activity, e.g., ability to work at a job, ability to
housework, etc.

41. 4. Nutritional Status Indicators
• Nutritional status is a positive health indicator.
Three nutritional status indicators are considered
important as indicators of health status. They are;
• Anthropometric measurements of preschool
children, e.g., weight and height, mid arm
circumference;
• Heights (and sometimes weights) of children at
school entry; and
• Prevalence of low birth weight (less than 2.5kg)

42. 5. Health care delivery indicators
• The frequently used indicators of health care
delivery are:
• Doctor population ratio
• Doctor nurse ratio
• Population bed ratio
• Population per health/sub centre
• population per traditional birth attendant These
indicators reflect the equity of distribution of
health resources in different parts of the
country, and of the provision of health care.

43. 6. Utilization rates:
• Indicators of the utilization of health services such as:-
• Proportion of infants who are fully immunized against the
6 EPI diseases.
• Proportion of pregnant women who receive antenatal care
or have their deliveries supervised by a trained birth
attendant.
• Percentage of the population using the various methods of
family planning.
• Bed occupancy rate (i.e., average daily in patient
census/average number of beds).
• Average length of stay (i.e., days of care
rendered/discharges).
• Bed turn over ratio( discharges/average beds)

44. 7. Indicators for social and mental
health
• As long as valid positive indicators of social and
mental health are scarce, it is necessary to use
indirect measures, viz. Indicators of social and
mental pathology.
• These include suicide, homicide, other acts of
violence and other crime; road traffic
accidents, juvenile delinquency; alcohol and
drug abuse; smoking; etc.
• These social indicators provide a guide to social
action for improving the health of the people.

45. 8. Environmental Indicators
• Environmental indicators reflect the quality of
physical and biological environmental in which
diseases occur
• and in which the people live. They include
indicators relation to pollution of air and water,
radiation, solid wastes, noise, exposure to toxic
substances in food or drink. Among these, the
most useful indicators are those measuring the
proportion of population having access to safe
water and sanitation facilities,

46. Cont…
• as for example, percentage of households with
safe water in the home or within 15 minutes
walking distance from a water standpoint or
protected well; adequate sanitary facilities in
the home or immediate vicinity.

47. 9. Socio Economic Indicators:
• These indicators do not directly measure health.
Nevertheless, they are of great importance in the
interpretation of the indicators of health care.
These include;
• Rate of population increase
• Per capita GNP
• Level of unemployment
• Dependency ratio
• Literacy rates, especially female literacy rates
• Family size
• Housing; the number of persons per room
• Per capita “calorie” availability.

48. 10. Indicators of Quality Of Life;
• Increasingly, mortality and morbidity data have
been questioned as to whether they fully reflect
the health status of a population. The previous
emphasis on using increased life expectancy as an
indicator of health is no longer considered
adequate, especially in developed countries, and
attention has shifted more toward concern about
the quality of life is enjoyed by individuals and
communities. Quality of life is difficult to define
and even more difficult to measure. Various
attempts have been made to reach one composite
index from a number of health indicators. The
physical quality

49. 11.Other Indicators Series
• A) Social indicators: social indicators, as defined by
the United Nations statistical office, have been
divided into 12 categories; population; family
formation, families and households; learning and
educational services; earning activities.
Distribution of income, consumption, and
accumulation; social security and welfare services;
health services and nutrition; housing and its
environment; public order and safety; time use;
leisure and culture; social stratification and
mobility.

50. Conti….
• B) Basic needs indicators: basic needs indicators are
used by ILO. Those mentioned in “basic needs
performance” include calorie consumption; access
to water; life expectancy; deaths due to disease;
illiteracy, doctors and nurses per population; rooms
per person; GNP per capita.
• Health for all indicators: for monitoring progress
towards the goal of health for all by 2000 AD.

51. Millennium development
goals(MDGs)
• The Millennium Declaration, made during the
UN Millennium Summit on 8 September 2000,
was signed by 189 countries, including 147
Heads of State and Government, and
included eight (8) Goals called the Millennium
Development Goals (MDGs).
• Provides an apportunity for cencerted action
to improve global health. (millennium
development goals-MGD) by 2015.

52. Conti…
• India committed in September 2000 to this
vision MGDs that has human development at
its core to sustain social and economic
progress. Eight goals, and eighteen targets and
forty eight indicators have been accepted as
framework for measuring development
progress.

54. Towards Achieving Millennium Development Goals
India 2013

60. Halve, between 1990 and 2015, the proportion of people whose income is less than one
dollar a day1

61. As per the poverty estimates of 2011-12, the Poverty Head Count Ratio
(PHCR) is 21.9% thus India has already achieved the target against the
target of 23.9%.
Country is likely to achieve Poverty level of 20.74% by 2015.
Malnutrition continues to be a major hurdle….
All-India trend of the proportion of underweight (severe and
moderate) children below 3 years of age shows India is going slow in
eliminating the effect of malnourishment. the proportion of
underweight children has declined by 3 percentage points during
1998-99 to 2005-06, from about 43% to about 40%. At the
historical rate of decline, it is expected to come down to about 33%
only by 2015 vis –a vis the target value of 26%.

63. Universal primary education has already been achieved….
A trend based on DISE (District Information System on education) data shows
that the country is now well set to achieve cent percent primary education
for children in the primary schooling age of 6-10 years ahead of 2015. DISE
2010-11 reports Net Enrolment Ratio (NER) at Primary level as 99.89.
Apparent Survival Rate: Grade V (Ratio of enrolment in grade V to grade 1) is
the proportion of pupils starting Grade I who reach the last grade of
primary. The DISE shows apparent survival rate at Primary level of 82 for 2010-
11.
According to the trend exhibited during 1991 -2001 (1991: 61.9% and 2001:
76.4 %), India is
likely to attain 100% Youth literacy (Literacy rate of 15-24 year olds) by 2015.

65. Gender parity has already achieved in primary education and the
disparity in secondary education is set to disappear shortly….

66. The percentage share of females in wage employment in the
non- agricultural sector, stood at 18.6% in 2009-10 and 19.6%
and 17.6% were the respective figures in Rural and Urban areas
respectively. It is projected that with the historical rate of
progression, the share of women in wage employment can at
best reach a level of about 23.1% by 2015 which is much below
target of 50%.
The Proportion of seats held by women in National Parliament
(%) is 11.21% in 2013 vis –a- vis the target of 50% in 2015.
Conti…

68. : Reduce by two-thirds, between 1990 and 2015, the
Under-five Mortality Rate

69. Cont…
Given to reduce U5MR to 42 per thousand live births by 2015,
India tends to reach 50 by 2015 as per the historical trend,
missing the target by 8 percentage points. However, considering
the sharper decline in the recent years, the target is likely to be met.
As per the historical trend IMR is likely to miss the 2015 target, however, the
faster decline in recent years indicates to narrowing the gap between the
target and the likely achievement in 2015.
The proportion of one-year old (12-23 months) children immunised against
measles is at 74.1% in 2009 (UNICEF & GOI , Coverage Evaluation Survey
2009) and as per the historical trend, India is expected cover about 89%
children in the age group 12-23 months for immunisation against measles
by 2015

72. At the historical pace of decrease, India tends to reach MMR of
139 per 100,000 live births by 2015, against the target of 109.
However, the bright line in the trend is the sharper decline ie.
17% during 2006-09 and 16% during 2003-06 compared to 8%
decline during 2001-2003.
: Reduce by three quarters, between 1990 and 2015, the Maternal
Mortality Ratio

73. With the existing rate of increase in deliveries by skilled personnel, the
achievement for 2015 is likely to be 62% only, which is far short of the targeted
universal coverage.

75. Conti…

77. Conti…
Source: Directorate of National Vector Borne Disease Control Programme
(NVBDCP)

78. Conti…

79. Conti…

82. : Integrate the Principles of Sustainable Development into Country Policies
and Programmes and Reverse the loss of Environmental Resources
There is an increase in forest cover by about 1128 sq. km between 2007
and 2011. The network of protected areas in India, presently covers
about 5.02 percent of the country’s total land area.
Conti…
As per Census 2011, 67.4% households are using solid fuels for
cooking.
The target of halving the proportion of households without access to safe
drinking water sources from its 1990 level of about 34% to the order of 17%,
to be reached by 2015, has already been attained by 2007-08, much before the
target timeline. The prevailing trend over time suggests attainability of almost
cent percent coverage of safe drinking water by 2015, including both rural and
urban sectors.

84. As per Census 2011, at all India level, for 43.5% households, Tap
water is the source of drinking water. In urban areas, 62% households
have tap water from treated source as the source of drinking water,
whereas in rural areas, majority of the households (43.6%) depend on
hand pumps for drinking water

87. In co-operation with the Private Sector, make available the benefits of new
technologies, especially Information and Communication

89. Conti…

90. CONCLUSION

91. Journal Abstract

92. BIBLIOGRAPHY:
• K. PARK “PREVENTIVE AND SOCIAL MEDICINE”. 20th edition. Jasalpur,
Banarsidas bhanot publication: 2009
•
• BT Basavantappa “COMMUNITY HEALTH NURSING” 1st edition. New Delhi,
jaypee publication: 2003.
•
• AH suryakantha “COMMUNITY MEDICINE” 1st edition. New Delhi. Jaypee
publication. 2009
•
• J S Mathur” COMMUNITY MEDICINE” 1ST EDITION. New Delhi :CBS
Publication, 2008
• K.K.Gulani.Community health nursing.First edition,Delhi:kumar publisher
house:2005

93. Website
• Kuldeep singh.Millennium developmnet
golas.Available from
http://www.slideshare.com/kuldeep-
singh/millennium/development/goals