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VII. Performance Results

For each initiative/program that supports accomplishment of this strategic goal, the most critical FY 2006 performance indicators and targets are shown below.

ANNUAL 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.

I/P: HIV/AIDS

INDICATOR: Number of People Receiving HIV/AIDS Treatment in the 15 Focus Countries of the President’s Emergency Plan for AIDS Relief
Department of State seal PART Output
JUSTIFICATION: The Emergency Plan targets $10 billion in funding for HIV/AIDS prevention, care, and treatment in 15 of the most affected countries: Botswana, Cote d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia. One of the core goals of the Emergency Plan is to support treatment for 2 million people.
FY 2006 PERFORMANCE Target 665,000 individuals receiving HIV/AIDS treatment across the 15 focus countries.
Results As of March 31, 2006, the Emergency Plan supported anti-retroviral treatment for 561,000 men, women, and children. Of those treated, 61 percent were female. This mid-year result represents 84% of the goal of treating 665,000 individuals by October 2006. End-of-FY 2006 data will be available with the release of the Third Annual Report to Congress on the Emergency Plan, on or around January 31, 2007.
Rating On Target
Impact HIV/AIDS, with its implications for security, economic stability, and overall development, is one of the biggest threats facing nations today. Providing treatment to persons living with HIV/AIDS dramatically increasing their well-being and thereby helps address these threats. Lives are extended, families are held intact, productivity of working age persons continues, and nations move forward with development.
PERFORMANCE DATA Data Source
  • Annual and semi-annual progress reports from each of the focus countries reporting numbers of people receiving treatment in each country.
  • Annual reports by UNAIDS and the WHO identifying numbers of people receiving treatment.
Data Quality
(Verification)		 The Office of the Global AIDS Coordinator reviews and evaluates the accuracy and quality of results submitted through the progress reports.
PAST PERFORMANCE 2005 401,000 individuals received HIV/AIDS treatment across the 15 focus countries.
2004 155,000 individuals received HIV/AIDS treatment across the 15 focus countries.
2003 The President’s Emergency Plan for AIDS Relief was announced in January 2003; the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, consolidating all U.S. Government HIV/AIDS programs under the Office of the Global AIDS Coordinator, was signed into law in May.

 

INDICATOR: Estimated Number of HIV Infections Prevented in the 15 Focus Countries of the President’s Emergency Plan for AIDS Relief
Department of State seal PART Output
JUSTIFICATION: JUSTIFICATION: Slowing the rate of new HIV infections is the most difficult challenge in the fight against HIV/AIDS, but it is critical to winning the fight. One of the core goals of the Emergency Plan is to support prevention of 7 million new infections.
FY 2006 PERFORMANCE Target An estimated 1.9 million HIV infections prevented across the 15 focus countries.
Results The Census Bureau model that will allow estimation of cases averted (other than infant infections) is expected to be available in late 2006. With respect to prevention of mother-to-child transmission through March 31, 2006, the Emergency Plan supported services for women during more than 4.5 million pregnancies, antiretroviral prophylaxis for women during 342,200 pregnancies, and prevented an estimated 65,100 infant HIV infections.
Rating On Target
Impact Prevention is the only long-term, sustainable solution to turn the tide against HIV/AIDS. It decreases the burden of the disease on individuals, families, and nations.
PERFORMANCE DATA Data Source
  • Annual and semi-annual progress reports from each of the focus countries will report results for numbers of persons receiving prevention services and the number of infections prevented.
  • Country bi-annual reports from UNAIDS reporting prevalence rates.
  • Country demographic health surveys reporting HIV/AIDS prevalence rates.
Data Quality
(Verification)		 The Office of the Global AIDS Coordinator reviews and evaluates the accuracy and quality of results submitted through the progress reports.
PAST PERFORMANCE 2005 A total of 42,802,800 individuals were reached with prevention activities, including 24,862,000 individuals reached by community outreach promoting HIV/AIDS prevention through abstinence and/or being faithful and 17,941,100 individuals reached by community outreach programs that promote other prevention strategies.
2004 Funds obligated to provide HIV prevention services to 47.8 million people across the 15 focus countries, with an estimated 1.3 million infections prevented.
2003 The President’s Emergency Plan for AIDS Relief was announced January 2003; the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, consolidating all U.S. Government HIV/AIDS programs under the Office of the Global AIDS Coordinator, was signed into law in May.

 

INDICATOR: Number of People Receiving HIV/AIDS Care and Support Services in the 15 Focus Countries of the President’s Emergency Plan for AIDS Relief
Department of State seal PART Output
JUSTIFICATION: Care and support services for people infected and affected by HIV/AIDS, including orphans and vulnerable children, can mitigate the consequences of HIV/AIDS by restoring health and productivity and ensuring that orphans and vulnerable children have access to essential services such as health and education. One of the core goals of the Emergency Plan is to support care for 10 million people infected and affected by HIV/AIDS.
FY 2006 PERFORMANCE Target 4.3 million people infected and affected by HIV/AIDS receiving HIV/AIDS care and support services across the 15 focus countries.
Results As of March 2006, the Emergency Plan supported care for nearly 3 million individuals, including care for more than 1,323,000 orphans and vulnerable children. This mid-year result represents 89% of the goal of caring for 4,300,000 individuals by October 2006.
Rating On Target
Impact Care services, including for orphans and vulnerable children, mitigate the severe pain and debilitating symptoms caused by HIV/AIDS as well as its social and economic consequences.
PERFORMANCE DATA Data Source Annual and semi-annual progress reports from each of the focus countries reporting numbers of people receiving care and support in each country.
Data Quality
(Verification)		 The Office of the Global AIDS Coordinator reviews and evaluates the accuracy and quality of results submitted through progress reports.
PAST PERFORMANCE 2005 HIV/AIDS care and support services provided to 2,986,200 people infected and affected by HIV/AIDS across the 15 focus countries.
2004 HIV/AIDS care and support services provided to 1,727,100 people infected and affected by HIV/AIDS across the 15 focus countries.
2003 The President’s Emergency Plan for AIDS Relief was announced January 2003; the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, consolidating all U.S. Government HIV/AIDS programs under the Office of the Global AIDS Coordinator, was signed into law in May.

 

HIV/AIDS Treatment and Assistance in South Africa

Photo showing Nompumelelo and Elihle receiving antiretroviral treatment at Sinikithemba Clinic in Durban, South Africa.Nompumelelo,a 27-year-old resident of South Africa, initially kept her HIV-positive status a secret from her family and friends. “It was a very big shock when I discovered I was positive,” she said. She worried about the health of her three-year-old son, Elihle. “I went to get him tested. ... I was devastated when he was also positive.” Nompumelelo received medical aid that allowed Elihle to start taking antiretroviral drugs immediately. Unfortunately, there was not enough money to pay for her treatment as well. In January 2004, a test revealed that she desperately needed to start antiretroviral treatment. Nompumelelo did not believe she had any options, until a friend told her about McCord Hospital’s Sinikithemba Clinic in Durban. Sinikithemba is a Zulu word meaning “place of hope,” and the clinic has lived up to its name. With support from the U.S. President’s Emergency Plan for AIDS Relief, the Elizabeth Glaser Pediatric AIDS Foundation works with the clinic to provide antiretroviral treatment to adults and children living with HIV/AIDS, including Nompumelelo and Elihle.

With support from the President’s Emergency Plan for AIDS Relief, Nompumelelo and Elihle receive antiretroviral treatment at Sinikithemba Clinic in Durban, South Africa.
Photo: State Department

I/P: Infectious Diseases

INDICATOR: Tuberculosis Treatment Success Rate (18 Countries)
USAID Seal Output
JUSTIFICATION: Tuberculosis Treatment Success Rate is defined as the proportion of patients who complete their entire course of treatment. The above indicator reflects the Tuberculosis Treatment Success Rate by countries receiving assistance from USAID.
FY 2006 PERFORMANCE Target

Tuberculosis Treatment Success Rate (for 2006):

  • No countries with less than 50%
  • 13 countries with 50-84%
  • 5 countries with 85% or more.
Results

Tuberculosis Treatment Success Rate (for 2006):

  • No countries with less than 50%
  • 12 countries with 50-84%
  • 6 countries with 85% or more.
Rating On Target
Impact USAID assistance directly contributes to important advances in the control of tuberculosis through directly observed treatment short-course strategy.
PERFORMANCE DATA Data Source WHO Reports, Global Tuberculosis Control, Geneva.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005

Tuberculosis Treatment Success Rate (for 2005):

  • No countries with less than 50%
  • 14 countries with 50-84%
  • 4 countries with 85% or more.
2004

Tuberculosis Treatment Success Rate (for 2004):

  • No countries with less than 50%
  • 15 countries with 50-84%
  • 3 countries with 85% or more.
2003

Baseline: Tuberculosis Treatment Success Rate (for 2000):

  • No countries with less than 50%
  • 14 countries with 50-84%
  • 4 countries with 85% or more.

 

INDICATOR: Case Detection Rate for Tuberculosis (18 Countries)
USAID Seal Output
JUSTIFICATION: The proportion of annual new smear-positive notifications divided by the estimated annual new smear-positive cases (incidence). The above indicator reflects the Tuberculosis Case Detection Rate by countries receiving assistance from USAID.
FY 2006 PERFORMANCE Target

Case Detection Rate:

  • 8 countries with less than 40%
  • 9 countries with 40-69%
  • 1 country with 70% or more.
Results

Case Detection Rate:

  • 5 countries with less than 40%
  • 10 countries with 40-69%
  • 3 countries with 70% or more.
Rating Above Target
Impact USAID assistance directly contributes to important advances in the control of tuberculosis through the directly observed treatment short term strategy.
PERFORMANCE DATA Data Source WHO Reports, Global Tuberculosis Control, Geneva. This indicator only tracks 18 of USAID’s 19 Tier 1 countries for which progress can be monitored consistently over time (Ukraine does not have the validated data for this indicator).
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005

Case Detection Rate:

  • 8 countries with less than 40%
  • 9 countries with 40-69%
  • 1 country with 70% or more.
2004

Case Detection Rate:

  • 9 countries with less than 40%
  • 8 countries with 40-69%
  • 1 country with 70% or more.
2003

Case Detection Rate:

  • 9 countries with less than 40%
  • 8 countries with 40-69%
  • 0 countries with 70% or more.

 

INDICATOR: Percentage of Households in Malaria Endemic Areas with at
Least One Insecticide Treated Net
USAID Seal Output
JUSTIFICATION: This indicator measures the proportion of households with at least one insecticide-treated net in 17 USAID/malaria-supported countries. Insecticide-treated mosquito nets, if used properly, are one of the best ways to prevent mosquitoes from biting and infecting individuals with malaria.
FY 2006 PERFORMANCE Target Insecticide Treated Net Coverage Rate: 35%.
Results Insecticide Treated Net Coverage Rate: 29% of households in 18 USAID/malaria-supported countries had at least one insecticide-treated net. These results are for FY 2005. Please see “Reason for Shortfall” below.
Rating Below Target
Impact Insecticide Treated Nets are an important component of an overall strategy to control malaria, especially for children, which results in a 20 percent decrease in deaths.
Reason for Shortfall 2005 coverage data, much of which was collected in 2003 and 2004, are the only data available at this time. Therefore, these data do not completely reflect the FY 2006 investments that USAID has made with funding from the President’s Malaria Initiative as well as investments made in FY 2005 prior to the Presidential Initiative.
Steps to Improve USAID expects an increase in malaria monitoring and evaluation activities which will enable the Agency to report more up to date information on 2006 coverage data in the future.
PERFORMANCE DATA Data Source Preliminary result data from USAID’s Global Health Bureau.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Insecticide Treated Net Coverage Rate: 29%.
2004 Insecticide Treated Net Coverage Rate: 2%.
2003 N/A.

 

Better Nets Trap Malarial Mosquitoes

Photo showing a manufacturer in Kenya that now has access to technology to make Long-Lasting Insecticide Nets.USAID is assisting in the production of long-lasting insecticide-treated bed nets to provide better protection against malaria, an alternative to the commonly used nets that are designed to repel or kill mosquitoes for only six months. In Nairobi, Kenya, USAID brought together major African net manufacturers, owners of Long-Lasting Insecticide Nets (LLIN) technology, and groups supporting the technology’s expansion. The manufacturers were excited about the technology’s importance and potential, and are working with USAID to seek ways to incorporate it into production. Several manufacturers will invest in new equipment and staff training, and some have even joined the World Health Organization’s Roll Back Malaria Project. Making LLIN technology widely available will bring tremendous benefits to manufacturers, their employees, and, most importantly, to millions of Africans who will be spared the devastating effects of malaria.

This manufacturer in Kenya now has access to technology to make Long-Lasting Insecticide Nets. Photo: NetMark

 

INDICATOR: Capacity of WHO’s Global Infectious Disease Network to Respond
to Disease Outbreaks
Department of State seal Outcome
JUSTIFICATION: This indicator tracks the progress of the World Health Organization (WHO) International Health Regulations (IHRs), an important measure of WHO and global abilities to respond to public health emergencies of international concern.
FY 2006 PERFORMANCE Target States Parties submit any reservations to the International Health Regulations, seek to conform national legislative and administrative arrangements, and begin core capacity development in surveillance, preparedness, and response. Adoption at the May 2006 World Health Assembly of a resolution urging voluntary early implementation.
Results In May 2006, the World Health Assembly passed a resolution urging voluntary early implementation of the International Health Regulations. U.S. preparations are nearly complete for the submission of a reservation that clarifies that the U.S. will implement the International Health Regulations in a manner consistent with U.S. principles of federalism.
Rating On Target
Impact Upon entry-into-force in June 2007, States Parties will be obligated to report, and respond to public health emergencies of international concern, including mandatory reporting of smallpox, polio, Severe Acute Respiratory Syndrome, and human cases of the H5N1 strain of avian influenza or any other novel subtype of influenza. The regulations provide the legal framework for strengthening detection, sharing urgent public health and epidemiological information on an outbreak that could have global impact or cross international borders and for joint action to contain and mitigate its impact. WHO maintains an effective, proactive Global Outbreak Alert and Response Network, and can tap into a pool of human and technical resources for the rapid identification, confirmation of, and response to outbreaks.
PERFORMANCE DATA Data Source WHO, Department of Health and Human Services (Centers for Disease Control and Prevention), other governments, media or informal sources.
Data Quality
(Verification)		 International Health Regulations and other relevant documents are subject to public review on the WHO website (www.who.int/en).
PAST PERFORMANCE 2005 Negotiations were completed and the final text was approved at the 58th World Health Assembly in May 2005. Countries also committed to take action to voluntarily comply with the regulations prior to their entry-into-force in 2007.
2004 Completed technical review of the revised regulations at global, regional, and sub-regional levels. A revised draft was submitted to Member States for review and consideration at the Intergovernmental Working Group in November 2004.
2003 WHO strengthened its activities related to global and national-level disease surveillance and undertook major efforts with governments in limiting and controlling Severe Acute Respiratory Syndrome.

 

INDICATOR: Effectiveness of Surveillance and Response Capacities Worldwide
Department of State seal Output
JUSTIFICATION: Disease surveillance is a key part of improving global health by better identifying, tracking, and communicating about disease outbreaks.
FY 2006 PERFORMANCE Target
  • Support preparedness response plans for key diseases and bioterrorist events in two selected countries and begin work on building an international platform for information sharing.
  • Carry out regional meetings to encourage information sharing and collaborative planning among countries to ensure that information can be acted upon expeditiously.
  • African regional rapid response teams established to conduct epidemiological investigations on infectious diseases of public health importance.
Results
  • The U.S. has actively supported development of avian and pandemic influenza preparedness plans in 53 countries including in Turkey, Vietnam, Indonesia, Cambodia, Laos, and Nigeria.
  • The U.S. launched the International Partnership for Avian and Pandemic Influenza to share information, identify/discuss critical policy issues, and jointly develop a plan of action for coordinating national activities for pandemic preparedness.
  • The U.S., with Switzerland, co-sponsored a bioterrorism tabletop exercise for senior leaders from a broad range of international organizations emphasizing the importance of non-traditional partnerships across diverse sectors including law enforcement, health, military, humanitarian response, defense, transportation, and security.
  • The U.S. launched the Security and Prosperity Partnership with Canada and Mexico, in part to enhance critical infrastructure protection and implement a common approach to biosecurity and emergency response.
  • The U.S.-supported regional Global Disease Detection Response Center in Kenya is fully operational and provides comprehensive disease surveillance and response activities for Africa, including a Field Epidemiology and Training Program and International Emerging Infections Program. It continues to be critical to the ongoing investigation and response to the outbreak of avian influenza in Nigeria.
Rating On Target
Impact The U.S. has humanitarian, security, and economic interests in helping countries deal with infectious disease outbreaks. If there is insufficient capacity and resolve in key developing countries, infectious disease outbreaks could spread and directly affect the health and safety of Americans at home and abroad, could aggravate social and political instability nationally and/or regionally, and could have substantial national, regional, and/or global economic impact.
PERFORMANCE DATA Data Source
  • Reports from posts and countries on preparedness response plans.
  • Reports from regional meetings addressing information sharing about biosurveillance.
Data Quality
(Verification)		 Reports are sourced from technical staff at the Department of Health and Human Services directly responsible for global disease detection and response provided results information.
PAST PERFORMANCE 2005
  • Kenya, Thailand, Guatemala, Egypt, and China served as regional centers for disease surveillance, confirmation, and response.
  • A Memorandum of Understanding between the U.S. and China established a formal framework for an International Emerging Infections Program.
2004 Because preparedness response planning, information gathering and regional response capacity are very limited in much of the world, the Department has initiated assessment of USG capacity for international disease surveillance and compile list of resources and contacts and initiated an interagency process to discuss possibilities to improve surveillance and response. The Department also incorporated surveillance and response into planning for relevant diseases.
2003 N/A.

 

I/P: Maternal and Reproductive Health

INDICATOR: Percent of Live Births Attended by Skilled Birth Attendants
USAID Seal Output
JUSTIFICATION: In many countries most births occur at home. Prompt recognition of complications, initiation of treatment, and referral by a skilled birth attendant can be life saving.
FY 2006 PERFORMANCE Target Percent of Live Births Attended by Skilled Birth Attendants: 46.8%.
Results Percent of Live Births Attended by Skilled Birth Attendants: 47.6%.
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 DATA Data Source Demographic and Health Surveys data and Centers for Disease Control/Reproductive Health Surveys data as compiled by USAID’s Global Health Bureau.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Percent of Births Attended by Skilled Birth Attendants: 46.8%.
2004 Percent of Births Attended by Skilled Birth Attendants: 45.8%.
2003 Percent of Live Births Attended by Skilled Birth Attendants: 44.8%.

Photo showing Philippines Health Secretary Francisco Duque, left, Ambassador Kristie Kenney, center, and USAID acting Mission Director Francis Donovan at the signing of a bilateral agreement to improve public health service in the Philippines, September 2006.

 Philippines Health Secretary Francisco Duque, left, Ambassador Kristie Kenney, center, and USAID acting Mission Director Francis Donovan at the signing of a bilateral agreement to improve public health service in the Philippines, September 2006
Photo: AP/Wide World
INDICATOR: Modern Contraceptive Prevalence Rate (Global)
USAID Seal Output
JUSTIFICATION: Contraceptive Prevalence Rate: Percentage of in-union women of reproductive age (age 15-49) using, or whose partner is using, a modern method of contraception at the time of the survey. Expected progress is a one percentage point annual increase.
FY 2006 PERFORMANCE Target Modern Contraceptive Prevalence Rate: 37.9%.
Results Modern Contraceptive Prevalence Rate: 37.9%.
Rating On Target
Impact Use of modern contraception is a principal proximate determinant of fertility. As contraceptive use increases, fertility trends decrease as do abortion rates.
PERFORMANCE DATA Data Source Demographic and Health Surveys (DHS) data and Reproductive Health Surveys (RHS) data as compiled by USAID’s Global Health Bureau. Data based on 27 USAID assisted countries with DHS or RHS data.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Modern Contraceptive Prevalence Rate: 36.9%.
2004 Modern Contraceptive Prevalence Rate: 35.9%.
2003 Modern Contraceptive Prevalence Rate: 34.9%.

 

INDICATOR: Percent of Births Spaced Three or More Years Apart
USAID Seal Output
JUSTIFICATION: The proportion of all birth intervals (open and closed) that are 36 months or longer. Longer birth intervals are associated with better health outcomes for both mothers and infants.
FY 2006 PERFORMANCE Target Percent of Births Spaced Three or More Years Apart: 47.2%.
Results Percent of Births Spaced Three or More Years Apart: 47.6%.
Rating On Target
Impact Longer birth intervals are associated with better health outcomes for both mothers and infants.
PERFORMANCE DATA Data Source Demographic and Health Surveys (DHS) data and Reproductive Health Surveys (RHS) data as compiled by USAID’s Global Health Bureau. Data based on 27 USAID assisted countries with DHS or RHS data.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Percent of Births Spaced Three or More Years Apart: 46.8%.
2004 Percent of Births Spaced Three or More Years Apart: 45.8%.
2003 Percent of Births Spaced Three or More Years Apart: 45.1%.

 

INDICATOR: Percent of First Births to Mothers Under Age 18
USAID Seal Output
JUSTIFICATION: The proportion of women who had a first birth below age 18 among women aged 15-24 at the time of the survey. Young maternal age is associated with worse health outcomes for mothers and infants.
FY 2006 PERFORMANCE Target Percent of First Births to Mothers Under Age 18: 24.1%.
Results Percent of First Births to Mothers Under Age 18: 24.3%.
Rating On Target
Impact Young maternal age is associated with poorer health outcomes for mothers and infants.
PERFORMANCE DATA Data Source Demographic and Health Survey (DHS) and Reproductive Health Survey (RHS) data compiled by USAID’s Global Health Bureau. Data based on 26 USAID assisted countries with DHS or RHS data.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Percent of First Births to Mothers Under Age 18: 24.5%.
2004 Percent of First Births to Mothers Under Age 18: 24.6%.
2003 Percent of First Births to Mothers Under Age 18: 24.8%.

Photo showing a recent graduate of a USAID-sponsored health care training program showcasing a poster detailing patients' rights and obligations in the Dominican Republic.

 A recent graduate of a USAID-sponsored health care training program showcases a poster detailing patients’ rights and obligations in the Dominican Republic.
Photo: USAID/Stephanie Molina

I/P: Child Health

INDICATOR: Under Age Five Mortality Rate
USAID Seal Outcome
JUSTIFICATION: This is the basic indicator of child survival trends, and is the subject of the International (Millennium) Development Goals being tracked by most developing countries and international organizations.
FY 2006 PERFORMANCE Target Under Age Five Mortality Rate: 88/1,000.
Results Under Age Five Mortality Rate: 87/1,000.
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 progress in child survival, although slow, indicates the success of investment by USAID, host 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.
PERFORMANCE DATA Data Source UNICEF progress reports on child health.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Under Age Five Mortality Rate: 89/1,000.
2004 Under Age Five Mortality Rate: 91/1,000.
2003 Under Age Five Mortality Rate: 94/1,000.

Photo showing a boy in the village of Upper Mittikot in northwestern Pakistan carrying the 20-liter containers USAID provided to help families store drinking water safely.

 A boy in the village of Upper Mittikot in northwestern Pakistan carries the 20-liter containers USAID provided to help families store drinking water safely.
Photo: USAID/Kaukab Jhumra Smith
INDICATOR: Neonatal Mortality Rate
USAID Seal Outcome
JUSTIFICATION: Neonatal mortality is now the largest component of infant mortality in many countries, but requires program approaches beyond those that reduce mortality in older infants and children under the age five. Therefore, it needs to be measured separately and specifically.
FY 2006 PERFORMANCE Target Neonatal Mortality Rate: 32/1,000.
Results Neonatal Mortality Rate: 34/1,000.
Rating Below 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.
Reason for Shortfall Global neonatal mortality trends have stagnated because, until very recently, health programs did not focus specifically on providing care during the newborn period. Seventy-five percent of newborns die within the first week of life but, given scarce evidence on simple interventions that could reduce neonatal mortality, there persists a perception that newborn interventions are high-tech and costly.
Steps to Improve Neonatal interventions are now integrated in maternal and child health programs in almost all USAID programs in the Asia Near East region; in Africa, about seven countries plan to introduce newborn interventions this year; and in the Latin America and Caribbean region, USAID has developed a regional newborn strategy to strengthen ongoing efforts. The impact of newborn programs in reducing mortality can be seen in selected countries; but it is too early to see an impact in global averages.
PERFORMANCE DATA Data Source Demographic and Health Surveys data as compiled by USAID’s Global Health Bureau.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Neonatal Mortality Rate: 34/1,000.
2004 Neonatal Mortality Rate: 35/1,000.
2003 Neonatal Mortality Rate: 36/1,000.

 

INDICATOR: Underweight for Children Under Age Five
USAID Seal Outcome
JUSTIFICATION: This is a basic indicator of child nutritional status, which is the best reflection of the impact of health and other program investments in improving health and development among living children. As such, it fundamentally complements measurements of reduction of child deaths.
FY 2006 PERFORMANCE Target Underweight for Children Under Age Five: 33.0%.
Results Underweight for Children Under Age Five: 33.6%.
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.
PERFORMANCE DATA Data Source UNICEF progress reports on child health.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Underweight for Children Under Age Five: 34.3%.
2004 Underweight for Children Under Age Five: 35.0%.
2003 Underweight for Children Under Age Five: 35.7%.

Photo showing a volunteer weighing babies at the Maternal and Child Health clinic in the village of Bumari, The Gambia.

 A volunteer weighs babies at the Maternal and Child Health clinic in the village of Bumari, The Gambia.
Photo: Photoshare/Jade Juhl
INDICATOR: Percentage of Children with DPT3 Coverage
USAID Seal Output
JUSTIFICATION: This is the internationally accepted indicator for coverage of child immunization – one of the most fundamental child health interventions – through regular immunization programs (as opposed to special campaigns, which can affect coverage of other vaccines like polio without improving the overall immunization status of children).
FY 2006 PERFORMANCE Target Percentage of Children with DPT3 Coverage: 61.4%.
Results Percentage of Children with DPT3 Coverage: 61.1%.
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 DATA Data Source UNICEF & WHO reports.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 Percentage of Children with DPT3 Coverage: 60.4%.
2004 Percentage of Children with DPT3 Coverage: 59.7%.
2003 Percentage of Children with DPT3 Coverage: 58.9%.

Photo showing a child receiving a DPT injection during an immunization campaign for refugees at the Thai-Burma border.

 A child receives a DPT injection during an immunization campaign for refugees at the Thai-Burma border.
Photo: Photoshare/ FPLM /JSI/Paula Nersesian
INDICATOR: Percent of Children Aged 0-4 with Diarrhea Who Received
Oral Rehydration Therapy
USAID Seal Output
JUSTIFICATION: Oral Rehydration Therapy is one of the basic treatment interventions related to child survival in developing countries and was developed largely through U.S.-supported research.
FY 2006 PERFORMANCE Target 59%.
Results 57.1%.
Rating Below Target
Impact Since the development of Oral Rehydration Therapy 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.
Reason for Shortfall The target was simply too ambitious: from 2005 to 2006, the rate of increase of Oral Rehydration Therapy use continued at a steady, but slow, rate of about 0.5% per year. This rate is slower than in the late 1990s and early 2000s, in part because of competition for limited health program resources and resulting slower trends or even declines in some large countries. While USAID expected that remedial actions would begin to take effect in 2006, this has not yet happened.
Steps to Improve Remedial actions underway include revitalized promotion of Oral Rehydration Therapy through the introduction of new technologies, including an improved formulation of oral rehydration salts as well as zinc treatment to shorten illness. USAID is also beginning to work with several of the countries that experienced declining rates to identify strategies to improve those rates. With CDC, USAID is carrying out research to identify determinants of non-use of Oral Rehydration Therapy among mothers in urban and rural Kenya. These efforts, combined with influencing UNICEF, WHO, and other investors to refocus attention on the issue, should begin to accelerate progress. However, a more realistic target in the near term is a 1% per year increase.
PERFORMANCE DATA Data Source Demographic and Health Surveys data as compiled by USAID’s Global Health Bureau.
Data Quality
(Verification)		 The Agency’s performance data are verified using Data Quality Assessments (DQA), and must meet five data quality standards of validity, integrity, precision, reliability and timeliness. The methodology used for conducting the DQAs must be well documented by each operating unit. (For details, refer to USAID’s Automated Directive System [ADS] Chapter 203.3.5, http://www.usaid.gov/policy/ads/200/203.pdf).
PAST PERFORMANCE 2005 56.5%.
2004 56%.
2003 55.4%.

 

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Last Updated on: February 02, 2007