18 surprises from new global health data: Where rivals Ethiopia, Eritrea win and Mauritius, Botswana come last

Here "hopeless" Burundi gets to be a star; Rwanda doesn't win them all; and South Africa and Kenya, drop the ball.

EVERY year the World Health Organisation releases a trove of rich statistical health information, and with the a new set of goals being crafted to replace the Millennium Development Goals, this year’s data is significant in sizing up progress towards the outgoing goals.

Four of the eight MDG goals unveiled in 2000 are health-related. Mail and Guardian Africa dug through the data and found some unlikely African stars, and laggards.

1: Malawi is the country that has most reduced its under five mortality rate, a 72% reduction rate between 1990 and 2015, ahead of the global target of 67%. It is closely followed by battle-weary Liberia, which has just triumphed over Ebola, with a 71% reduction.

2: When not feuding, Ethiopia and Eritrea were the next top performers in this category, with reductions of under-five mortality of 69% and 67% respectively, besting other stars such as Cape Verde (59%). Niger reduced deaths by 68%, pipping Rwanda with 66%.

3: Zimbabwe however saw a precipitous rise in under-five deaths, with a -15% change over the period, essentially a reversal. Lesotho (-14%) and Swaziland at -8% also suffered significantly. An unexpected poor performer was Botswana, with only a 6% reduction over 25 years.

4: Burundi has not had the most favourable coverage this past week, but is a top performer in immunising one-year-olds against measles, at 98% it is second only to Mauritius and Tanzania which have inoculated 99% of the target group. Eritrea also makes strong progress, with a 96% rate, which is matched by The Gambia.

5: The Central African Republic lags regionally, with a 25% immunisation rate against measles. Together with Equatorial Guinea (42%) they are the only countries in Africa that have not achieved a least 50%, against a global target of 90%.

6: Equatorial Guinea compensates by being the African country that has most reduced maternal mortality, with an 82% ratio against the global target of 75%. Eritrea with a 78% reduction continues to be a star, edging out Cape Verde and Rwanda, which have reduced their ratio by 77%.

7: On the other end of the maternal mortality scale is, surprisingly, Mauritius with a reduction of -4%, which means more mothers are dying instead. Other unexpected poor performers are Ivory Coast, with a 3% reduction, and South Africa (7%). Cameroon and Kenya, both 18%, are additional stragglers.

8: Mauritius recovers well—100% of its births are attended by skilled health personnel, against the global target of 90%/. Botswana, Seychelles and Cape Verde record 99%, with Algeria at 97% also strong in this sub-category.

9: Only 10% of births in Ethiopia, and 14% in Chad, are attended to by skilled personnel.  South Sudan (17%), Niger (29%), Eritrea (32%) and Nigeria (35%) also struggle on this indicator.

10: Burundi bests the African field in ensuring mothers make at least one antenatal care visit, with a 99% coverage rate. The global target is 100%. Rwanda and Sao Tome have a 98% rate. Three countries are on 97%—Namibia, South Africa, Swaziland and surprise package Sierra Leone.

11: Only three in every 10 Ethiopian mothers (34%) experience an antenatal visit, with CAR (55%) and Angola at 68% trailing the rest of the field.

12: Sao Tome and Principe has the highest unmet need for contraception, at 38%, with Togo and Ghana also high, at 37%. Liberia records 36%. 

While there are data gaps, Guinea-Bissau has most met this need, with only a 6% unmet need.

13: Niger has most reduced HIV incidence between 2001 and 2013, with a 95% cut. Burundi reduced incidence by 90%, while Ethiopia and Eritrea have also made significant progress in this area, with 87% and 86% reductions.

14: The slowest pace in reducing HIV incidence over that period is in Algeria, at -30%. Angola (-8%) and Uganda at -4% are also poor performers.  

15: The best progress in reducing the mortality rate of tuberculosis in HIV-negative people over the 23-year period from 1990 has been in Ghana at 90%, while Uganda and Niger are next, tying at 87%. The wooden spoon goes to Cameroon, Swaziland and Togo, all at over -50%, and Rwanda at -35%.

16: Mauritius (100%) and Sao Tome and Principe (88%) have done most at increasing access to improved drinking water sources. Algeria  (over -50%) and Tanzania (-4%) have most struggled.

17: With over one billion people globally defecating in the open, Algeria interestingly has increased access to sanitation, at 55% between 1990 and 2012, against the global target of 50%. Angola and Cape Verde also rank among the biggest movers.

18: Nigeria has made the least improvement with progress/reversal of -14%, with Togo and Zimbabwe (both -3%) for company. The Seychelles (0%) has made no progress over that period in increasing access to improved sanitation.

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