USAID - FY 2005 PAR: Strategic Goal 6 Performance Goal 1 Results

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V. Performance Results

Summary of Provisional or Preliminary Results — Strategic Goal 6

Total Goals and Indicators
Number of Performance Goals	3
Number of Program Goals	8
Number of Indicators	29

Performance Summary
Number of Targets Met	20
Number of Targets Not Met	8
Number with Data Lags	1

PERFORMANCE GOAL #1— Improved Global Health, Including Child, Maternal, and Reproductive Health, and the Reduction of Abortion and Disease, Especially HIV/AIDS, Malaria, and Tuberculosis

Program Goal: Infectious Diseases

Increased use of proven interventions to reduce the threat of infectious diseases of major public health importance.

Performance Indicator #1: Tuberculosis Treatment Success Rate (%) (37 Countries)
FY Results History	2002	Tuberculosis (TB) Treatment Success Rate: Less than 50%: 0; 50-84%: 27; 85% or more: 9.
	2003	Result data on the 2003 treatment success rate will be reported in the World Health Organization (WHO) Global TB report for 2006. As TB treatment takes six to eight months, there is a longer lag in the reporting of treatment success to WHO than there is in reporting case detection.
	2004	Result data on the 2003 treatment success rate will be reported in the WHO Global TB report for 2006. As TB treatment takes six to eight months, there is a longer lag in the reporting of treatment success to WHO than there is in reporting case detection.
FY 2005 Data	2005 Preliminary or Provisional Results	TB Treatment Success Rate: Less than 50%: 0; 50-84%: 25; 85% or more: 12.
	Target	TB Treatment Success Rate: Less than 50%: 0; 50-84%: 25; 85% or more: 12.
	Rating	On Target
	Impact	USAID assistance has directly contributed to important advances in the control of TB through the directly observed treatment short-course strategy.

Performance Indicator #2: Case Detection Rate for Tuberculosis
FY Results History	2002	Case Detection Rate for TB: Less than 40%: 16; 40-69%: 14; 70% or more: 7.
	2003	Case Detection Rate for TB: Less than 40%: 13; 40-69%: 15; 70% or more: 7.
	2004	N/A
FY 2005 Data	2005 Preliminary or Provisional Results	Case Detection Rate for TB: Less than 40%: 15; 40-69%: 15; 70% or more: 7.
	Target	Case Detection Rate for TB: Less than 40%: 11; 40-69%: 18; 70% or more: 8.
	Rating	On Target
	Impact	Case detection rate: Of the 18 highest priority USAID countries, 14 have increased case detection. The average case detection rate is 45 percent in these USAID-assisted countries, slightly higher than the global average of 43 percent. In two of the most populated high-burden countries, USAID has contributed to significant increases in case detection. In two provinces of Indonesia, where USAID is the primary funder, case detection increased from 17 percent in 2002 to nearly 30 percent in 2003, a nearly 80 percent increase. In 2002 to 2003, in Nigeria, case detection increased from 15 percent to 20 percent, a 53 percent increase.

Performance Indicator #3: Percentage of Households in Malaria Endemic Areas
with at Least One Insecticide-Treated Net (ITN Coverage Rate)
FY Results History	2002	ITN Coverage Rate: N/A (new indicator in FY 2004)
	2003	ITN Coverage Rate: N/A (new indicator in FY 2004)
	2004	ITN Coverage Rate: 7 percent.
FY 2005 Data	2005 Preliminary or Provisional Results	ITN Coverage Rate: 23.57 percent.
	Target	ITN Coverage Rate: 45 percent.
	Rating	Below Target
	Impact	ITNs are an important component of an overall strategy to control malaria, especially for children, which results in a 20 percent decrease in deaths.

Performance Indicator #4: Number of People Receiving HIV/AIDS Treatment in the
15 Emergency Plan Focus Countries
FY Results History	2002	N/A (new indicator in FY 2004)
	2003	N/A (new indicator in FY 2004)
	2004	155,000 adults and children.
FY 2005 Data	2005 Preliminary or Provisional Results	235,000 men, women, and children (as of 3/21/2005).
	Target	470,000 men, women, and children.
	Rating	Below Target
	Impact	With its severe social, economic, and political consequences, HIV/AIDS presents a security threat and violates a basic principle of development—that each generation do better than the one before. HIV/AIDS treatment mitigates the consequences of HIV/AIDS by dramatically improving health and therefore productivity. With every person receiving treatment, life is extended, families are held intact, and nations move forward with development.

Photo showing Crimea Medical College students reviewing brochures before watching a theatrical musical show on HIV/AIDS stigma and discrimination, sponsored by USAID. Crimea Medical College students review brochures before watching a theatrical musical show on HIV/AIDS stigma and discrimination, sponsored by USAID.
Photo: Arvidas Shemetas, USAID/kyiv

Performance Indicator #5: Estimated Number of HIV Infections Prevented in the
15 Emergency Plan Focus Countries
FY Results History	2002	N/A (new indicator in FY 2004)
	2003	N/A (new indicator in FY 2004)
	2004	120,000,000 people reached using targeted abstinence and "Be Faithful" campaigns and teaching correct condom use.
FY 2005 Data	2005 Preliminary or Provisional Results	Prevalence data released by UNAIDS in 2003 indicates that prevalence ranges from a low of 0.4 percent in Vietnam to a high 37.7 percent in Bostswana. The 2003-2004 baseline prevalence information will be available at the end of CY 2005. By the end of CY 2006 results will be collected for the CY 2005-CY 2006 timeframe. This data will be compared to the baseline data to measure infections averted and will be available at the end of CY 2007.
	Target	Final target will be presented in the FY 2005 PAR Addendum in April 2006.
	Rating	Final results will be presented in the FY 2005 PAR Addendum available April 2006.
	Impact	With its severe social, economic, and political consequences, HIV/AIDS presents a security threat and violates a basic principle of development—that each generation do better than the one before. Preventing HIV infections will dramatically decrease burdens of disease on individuals, families, and nations.

Performance Indicator #6: Number of People Receiving HIV/AIDS Care in the
15 Focus Countries
FY Results History	2002	N/A (new indicator in FY 2004)
	2003	N/A (new indicator in FY 2004)
	2004	1,727,000 adults and children.
FY 2005 Data	2005 Preliminary or Provisional Results	2,009,259 adults and children (June 2005).
	Target	2,600,000 adults and children.
	Rating	On Target
	Impact	With its severe social, economic, and political consequences, HIV/AIDS presents a security threat and violates a basic principle of development—that each generation do better than the one before. Care for people infected and affected by HIV/AIDS, including orphans, mitigates the severe pain and debilitating symptoms caused by HIV/AIDS as well as its social and economic consequences.

Performance Indicator #7: Number of Clients Provided Services at Sexually
Transmitted Infection (STI) Clinics
FY Results History	2002	120,207 total clients.
	2003	1,299,334 total clients.
	2004	1,234,533 total clients.
FY 2005 Data	2005 Preliminary or Provisional Results	873,938 total clients.
	Target	791,773 total clients.
	Rating	Exceeded Target
	Impact	With its severe social, economic, and political consequences, HIV/AIDS presents a security threat and violates a basic principle of development—that each generation do better than the one before. Care for people infected and affected by HIV/AIDS, including orphans, mitigates the severe pain and debilitating symptoms caused by HIV/AIDS as well as its social and economic consequences.

Performance Indicator #8: Number of Orphans and Other Vulnerable Children Receiving
Care/Support Services Through USAID-Assisted Programs
FY Results History	2002	327,636 orphans and vulnerable children.
	2003	490,490 orphans and vulnerable children.
	2004	393,154 orphans and vulnerable childrenl.
FY 2005 Data	2005 Preliminary or Provisional Results	390,000 orphans and vulnerable children.
	Target	389,382 orphans and vulnerable children.
	Rating	On Target
	Impact	With its severe social, economic, and political consequences, HIV/AIDS presents a security threat and violates a basic principle of development—that each generation do better than the one before. Care for people infected and affected by HIV/AIDS, including orphans, mitigates the severe pain and debilitating symptoms caused by HIV/AIDS as well as its social and economic consequences.

Performance Indicator #9: Number of HIV-infected Pregnant Women Receiving a Complete Course of Anti-Retroviral (ARV) Prophylaxis to Reduce the Risk of Mother-to-Child Transmission (MTCT) in USAID-Assisted Sites
FY Results History	2002	6,618 pregnant women.
	2003	10,841 pregnant women.
	2004	2,727 pregnant women.
FY 2005 Data	2005 Preliminary or Provisional Results	4,366 pregnant women.
	Target	4,366 pregnant women.
	Rating	On Target
	Impact	With its severe social, economic, and political consequences, HIV/AIDS presents a security threat and violates a basic principle of development—that each generation do better than the one before. Care for people infected and affected by HIV/AIDS, including orphans, mitigates the severe pain and debilitating symptoms caused by HIV/AIDS as well as its social and economic consequences.

Program Goal: Maternal and Reproductive Health

Reduce unintended pregnancy; promote healthy reproductive behavior; and enhance maternal survival, health, and nutrition.

Performance Indicator #1: Total Fertility Rate (TFR)
FY Results History	2002	TFR: 4.3
	2003	TFR: 4.3
	2004	TFR: 4.2 preliminary
FY 2005 Data	2005 Preliminary or Provisional Results	TFR: 4
	Target	TFR declines in aggregate across recipient countries with trend data.
	Rating	On Target
	Impact	TFR illustrates overall trends in family size. USAID programs reduce unintended pregnancy; promote healthy reproductive behavior; and enhance maternal survival, health, and nutrition.

Performance Indicator #2: Percent of Live Births Attended by Skilled Birth Attendants
FY Results History	2002	47.1 percent
	2003	48.0 percent
	2004	48.8 percent
FY 2005 Data	2005 Preliminary or Provisional Results	49.6 percent (extrapolated)
	Target	49.2 percent
	Rating	On Target
	Impact	Attendance at labor and delivery by a trained person with the skills to recognize the first signs of complications, initiate treatment, and facilitate referral is a key component of safe motherhood programs. Given that measuring maternal mortality trends is not possible on an annual basis, attendance by a skilled birth attendant is the best proxy indicator for determining maternal mortality trends.

Performance Indicator #3: Modern Contraceptive Prevalence Rate (Global)
FY Results History	2002	33.6 percent
	2003	34.7 percent
	2004	36.0 percent
FY 2005 Data	2005 Preliminary or Provisional Results	37.0 percent
	Target	39.4 percent
	Rating	Below Target
	Impact	Use of modern contraception is a principal proximate determinant of fertility. As contraceptive use increases, fertility tends to decrease as do abortion rates.

Performance Indicator #4: Percent of Births Spaced More Than Three Years Apart
FY Results History	2002	46.0 percent
	2003	46.8 percent
	2004	47.7 percent
FY 2005 Data	2005 Preliminary or Provisional Results	48.5 percent
	Target	45.9 percent
	Rating	Exceeded Target
	Impact	Longer birth intervals are associated with better health outcomes for both mothers and infants.

Performance Indicator #5: Percent of First Births to Mothers Under 18
FY Results History	2002	24.2 percent
	2003	23.9 percent
	2004	23.6 percent
FY 2005 Data	2005 Preliminary or Provisional Results	23.3 percent
	Target	24.1 percent
	Rating	Below Target
	Impact	Young maternal age is associated with poorer health outcomes for mothers and infants.

Performance Indicator #6: Percent Need Satisfied with Modern Contraceptive Methods
FY Results History	2002	48.1 percent
	2003	49.5 percent
	2004	52.4 percent
FY 2005 Data	2005 Preliminary or Provisional Results	51.0 percent
	Target	67.8 percent
	Rating	Below Target
	Impact	Increases in the percentage of need satisfied indicate that women are increasingly able to achieve the number and spacing of children that they desire.

Performance Indicator #7: Percent of Births Parity 5 or Higher
FY Results History	2002	26.1 percent
	2003	25.6 percent
	2004	25.2 percent
FY 2005 Data	2005 Preliminary or Provisional Results	24.7 percent
	Target	24.1 percent
	Rating	On Target
	Impact	High parity births are associated with poorer health outcomes for infants.

Program Goal: Child Health

Infant and child survival, health, and nutrition improved.

Performance Indicator #1: Under-Five Mortality Rate
FY Results History	2002	Under-Five Mortality Rate (2000): 91/1,000
	2003	Under-Five Mortality Rate (2002): 89/1,000
	2004	87/1,000
FY 2005 Data	2005 Preliminary or Provisional Results	85/1,000
	Target	86/1,000
	Rating	On Target
	Impact	Survival of children under age five is one of the most important indicators of a population’s overall well being. Continued, although slow, progress in child survival indicates the success of investment by USAID, countries, and other partners in direct interventions in child health, such as immunization and improved nutrition, combined with the effects of poverty alleviation, education (especially for women and girls), increased food security, and other development interventions. For every additional child who survives through these program investments, hundreds more leave their childhood healthier, better nourished, and more able to reach their own potential and contribute to their country’s progress.

Performance Indicator #2: Neonatal Mortality Rate
FY Results History	2002	Neonatal Mortality Rate (1997-2002): 34/1,000
	2003	Neonatal Mortality Rate (1997-2002): 34/1,000
	2004	Neonatal Mortality Rate (1997-2002): 34/1,000
FY 2005 Data	2005 Preliminary or Provisional Results	Neonatal Mortality Rate (1997-2002): 35/1,000 (extrapolated)
	Target	33/1,000
	Rating	Exceeded Target
	Impact	Neonatal mortality contributes to more than one-third of child deaths. Yet, little has been done to improve newborn care and neonatal mortality trends have stagnated. With the USAID-supported publications of the Lancet neonatal series and the World Health Report in 2005, there is now a global momentum to strengthen newborn care interventions which, when scaled up, can reduce neonatal mortality even where health systems are weak. This new global awareness has recently stimulated many government and USAID Missions to develop new neonatal programs. However, the impact of these new programs on newborn mortality is not yet able to be seen in global averages.

Performance Indicator #3: Underweight for Age Among Children Under Five
FY Results History	2002	No Data Available.
	2003	28 percent
	2004	27 percent
FY 2005 Data	2005 Preliminary or Provisional Results	27 percent
	Target	27 percent
	Rating	On Target
	Impact	The proportion of young children beneath the normal range of weight for their age is a basic indicator of child nutritional status. USAID combines promotion of breastfeeding—a vital source of nutrition and protection against diseases—with improved young child feeding and prevention of the malnourishing effects of child illness. The slow but positive global trend in child nutrition is a strong reflection of the impact of health and other program investments in improving the well being of children, and also contributes to lower risk of severe illness and death from infectious diseases. As part of its work to control the HIV/AIDS epidemic, USAID has worked closely with UNICEF, the World Health Organization (WHO), and other partners to promote safe infant feeding, including exclusive breastfeeding, in populations where HIV infection is highly prevalent.

Performance Indicator #4: Percentage of Children with Diphtheria, Pertussis, and
Tetanus (DPT3) Coverage
FY Results History	2002	59 percent
	2003	59 percent
	2004	60 percent
FY 2005 Data	2005 Preliminary or Provisional Results	60 percent
	Target	60 percent
	Rating	On Target
	Impact	Immunization is one of the most fundamental and cost-effective child health interventions. In developing countries, immunization saves millions of children from the health-impairing and often life-threatening effects of diseases like measles, whooping cough, tetanus, and polio.

Performance Indicator #5: Percent of Children Aged 0-4 with Diarrhea Who Received
Oral Rehydration Therapy (ORT)
FY Results History	2002	60 percent
	2003	60 percent
	2004	60 percent
FY 2005 Data	2005 Preliminary or Provisional Results	59 percent
	Target	61 percent
	Rating	Below Target
	Impact	Since the development of ORT through USAID-supported research in the 1970s, this simple treatment has saved millions of child deaths from the dehydrating effects of the diarrheal illnesses that are common in poor countries. However, with focus shifting to HIV/AIDS and other health problems, ORT is receiving less attention from partners and countries. As a result, in 2005 several large countries, including Nigeria, Kenya, Philippines, and Indonesia, had declines in ORT use, bringing the global average down. USAID has engaged UNICEF and WHO agents to address this decline.

Photo showing a baby receiving shot in Thailand.
Baby receiving shot in Thailand. Photo: USAID/ANE

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Last Updated on: December 29, 2005