Bolivia's Mdg Targets: Success Or Failure?

The Millennium Development Goals (MDGs) were eight international development goals for the year 2015, created following the Millennium Summit and the adoption of the United Nations Millennium Declaration. All 191 United Nations member states committed to achieving these goals by 2015. The goals were:

- 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

- To develop a global partnership for development

Bolivia's progress towards the Millennium Development Goals is unclear. However, one source mentions that the country has made some impressive gains in achieving health-related targets.

Eradicate extreme poverty and hunger

Millennium Development Goal 1 (MDG1) is to "Eradicate extreme poverty and hunger". It is associated with three targets:

• Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day (or $1.25 a day according to other sources).
• Achieve full and productive employment and decent work for all, including women and young people.
• Halve, between 1990 and 2015, the proportion of people who suffer from hunger.

The latest estimates show that the proportion of people living on less than $1.25 a day fell from 43.6% in 1990 to 17% in 2011. Forecasts based on country-specific growth rates in the past 10 years indicate that the extreme poverty rate will fall to 13.4% by 2015, a drop of more than two-thirds from the 1990 baseline. The number of people living on less than $1.25 a day worldwide is also forecast to be halved by 2015 from its 1990 level.

The number of people living in extreme poverty worldwide has reduced by more than 50%. In 1990, 1.9 billion people were said to be living in extreme poverty, compared to 836 million in 2015. Most progress was seen in the new millennium. The poverty rate in the developing world has plummeted from 47% to 14% in the period between 1990 and 2015 – a 70% drop. The MDG target of reducing global poverty by half was achieved by 2010 – 5 years before the 2015 deadline.

By 2011, all developing regions, with the exception of sub-Saharan Africa, had achieved the target of halving the number of people living in extreme poverty. The most populous countries in the world – China and India – played a major role in the worldwide reduction of poverty. The remarkable progress in China led to a reduction in extreme poverty in Eastern Asia from 61% to 4% between 1990 and 2015. Southern Asia’s progress has also been impressive, with a decline from 52% to 17% within the same time period, but with accelerated reduction since 2008.

In contrast, the rate of poverty in sub-Saharan Africa did not change between 1990 and 2002. Although the rate of poverty decline has accelerated since, more than 40% of the sub-Saharan population continued to live in extreme poverty in 2015. Worse still, extreme poverty in Western Asia was expected to increase between 2011 and 2015.

The global economy is in a new era characterised by slower growth, greater inequalities, and turbulence, and employment opportunities are not growing as fast as the increasing labour force. The employment-to-population ratio in the world has dropped from 62% to 60% between 1991 and 2015, with a considerable downturn during the 2008/09 global crisis. In fact, the International Labour Organisation claims that there were more than 204 million unemployed people in 2015, which is 34 million more than before the start of the 2008 economic crisis and 53 million more than in 1991. Employment opportunities have diminished in both developed and developing regions.

The number of people undernourished in the developing world has dropped by almost 50% since 1990; from 23.3% in 1990-92 to 12.9% in 2014-16. This means that nearly 780 million people living in developing regions are undernourished, or one in nine people do not have enough to eat.

Despite the MDG targets having been met, it will be extremely difficult to eliminate the remaining extreme poverty and hunger.

Achieve universal primary education

The second Millennium Development Goal (MDG 2) is to "Achieve Universal Primary Education". This goal aims to guarantee all children, regardless of gender or economic status, the right to basic schooling in both developed and developing nations.

MDG 2 has one target: to ensure that, by 2015, children everywhere can complete a full course of primary education. This includes increasing the net enrolment ratio in primary education, ensuring pupils reach at least grade 5, and improving the literacy rate of 15-24-year-olds.

There has been notable progress towards MDG 2 since 1990, especially after the adoption of the MDGs in 2000. The primary school net enrolment rate in developing regions increased from 83% in 2000 to 91% in 2015. Globally, the number of out-of-school children of primary school age decreased by nearly 50% from 100 million in 2000 to around 57 million in 2015.

However, there are still several developing countries where primary-aged children do not attend school, and those who do start often do not complete their education. In 2015, one in every 10 primary-school-age children remained out of school. Sub-Saharan Africa faces significant challenges in achieving universal primary education, including poverty, rapid growth of the school-age population, armed conflicts, and other emergencies. While the region has made impressive strides in primary school enrolment, with a rate increase from 52% to 78% between 1990 and 2012, 33 million of the 57 million out-of-school children globally are in sub-Saharan Africa, with girls comprising 55% of this number.

Barriers to enrolment and completion of primary education include conflict, household wealth, and disability. In nations affected by conflict, the number of out-of-school children increased from 30% to 36% between 1999 and 2012. Children from the poorest households are four times more likely to be out of school than those from the wealthiest households. Disability is another impediment, particularly in India, where more than 33% of children aged 6-13 years with disabilities are not in school despite efforts to improve inclusive education.

The quality of education is also a concern. While most countries in Africa have achieved universal primary enrolment, with rates above 90%, low completion rates and high grade repetition are issues. One in three pupils enrolled in primary school will drop out due to late entry, poverty, poor-quality education, or a lack of awareness of the importance of schooling.

To achieve universal primary education, addressing issues of access, completion, and quality of education is essential. This may include improving food security and social protection, as well as improving educational infrastructure and raising the priority of education at a national level.

Promote gender equality and empower women

The Millennium Development Goals (MDGs) are eight international development goals established by the UN member states in 2000, with a deadline of 2015. The third of these goals was to "Promote Gender Equality and Empower Women".

The MDGs recognised target areas that could support this goal, including primary and secondary education, job security, and strength of influence. The aim was to eliminate gender disparity in primary and secondary education by 2005, and in all levels of education by 2015.

There has been an increase in the number of girls in school in 2015 compared to 2000, with the developing world achieving the goal of eliminating gender disparity in all levels of education. In Southern Asia, the number of girls enrolled in primary school rose from 74 for every 100 boys in 1990, to 103 girls enrolled for every 100 boys in 2015. However, it is important to note that gender parity in education is only one aspect of promoting gender equality and empowering women.

In terms of employment, the proportion of women in vulnerable employment compared to total female employment has reduced by 13% between 1991 and 2015. The share of women in paid employment outside agriculture has also increased, from 35% in 1990 to 41% in 2015. However, women still face discrimination in access to work, with fewer social benefits and less secure jobs. There are also substantial gaps in the labour market, with women less likely to be part of the labour force compared to men.

Political representation of women has also increased, with significant gains in women's parliamentary representation in nearly 90% of 174 countries for which data has been available in the past two decades. However, there is still a long way to go to achieve equal representation, and women continue to be denied opportunities to make decisions that affect their lives.

While progress has been made in some areas, there are still gaps in addressing gender inequality. Violence against women, unequal opportunities in the labour market, gender-based discrimination, and unequal division of unpaid care work are all issues that need to be addressed to achieve true gender equality and empower women.

Reduce child mortality

Millennium Development Goal 4: Reduce Child Mortality

The fourth Millennium Development Goal (MDG 4) has only one target: to reduce the under-five mortality rate by two-thirds between 1990 and 2015. This target was not met by 2015, and it was projected that it would take until 2028 to achieve it globally. However, substantial progress has been made in reducing child mortality. Between 1990 and 2012, the child mortality rate almost halved, resulting in 6 million fewer children dying in 2012 compared to 1990.

The leading causes of death for children under five are preterm birth complications, pneumonia, diarrhoea, and birth asphyxia. Undernutrition also contributes to more than 33% of all deaths in this age group. Efforts to address undernutrition and improve access to adequate nutrition have increased the chances of children surviving to adulthood. For example, improving complementary feeding for babies, or giving foods in addition to breast milk, has led to a significant reduction in child mortality caused by undernutrition.

In 2009, the United Nations Economic and Social Council (ECOSOC) held its Annual Ministerial Review on global public health, including child health. Bolivia was one of seven countries that presented their recent efforts to improve public health. However, specific details on Bolivia's progress towards MDG 4 were not readily available.

While there has been progress in reducing child mortality, more needs to be done to improve child survival rates. This includes implementing sound strategies, providing adequate resources, and demonstrating political will to reduce child mortality worldwide.

Improve maternal health

Millennium Development Goal 5: Improve Maternal Health

Millennium Development Goal (MDG) 5, which aims to improve maternal health, is supported by two targets:

• Target 5a: Reduce the maternal mortality ratio by 75% between 1990 and 2015
• Target 5b: Achieve universal access to reproductive health by 2015

Maternal mortality has dropped significantly since the adoption of the MDGs. Between 1990 and 2013, the maternal mortality ratio reduced by 45% worldwide, from 380 to 210 maternal deaths per 100,000 live births. This equates to a reduction from 543,000 to 287,000 maternal deaths per year between 2000 and 2015. Despite this progress, around 800 women still die every day during pregnancy or from childbirth complications.

Bolivia's millennium target for 2015 was 200 maternal deaths per 100,000 live births. Between 1990 and 2003, Bolivia's maternal mortality rate dropped from 390 to 230 per 100,000 live births. This improvement has been attributed to Bolivia's health policies and programs, which have prioritised reducing maternal deaths. To achieve its 2015 target, Bolivia needed to maintain its focus on maternal health and strengthen basic obstetric and gynecological care, including contraceptive information and services.

The proportion of births in Bolivia where mothers received a doctor's care during pregnancy rose from 49.5% in 1994 to 70.2% in 2003. The proportion of doctor-attended deliveries rose from 42.7% to 55.9% during the same period, while institutional deliveries rose from 42.3% to 57.1%. However, there are wide discrepancies between rates among the rural poor and higher-income groups in major cities.

To reduce maternal deaths, women need access to good-quality reproductive health care and effective interventions. Antenatal care is critical, with the WHO recommending four or more antenatal care visits during pregnancy to ensure the wellbeing of mothers and newborns. In Bolivia, the proportion of women receiving antenatal care at least once during pregnancy was about 83% for the period 2007–2014, but only around 64% for the recommended minimum of four or more visits.

Contraceptive use is another important factor in reducing maternal deaths. In 2012, 64% of women aged 15–49 years who were married or in a consensual union in Bolivia were using some form of contraception, while 12% wanted to stop or postpone childbearing but were not using contraception.

Bolivia has made promising progress towards improving maternal health, but continued efforts and a focus on addressing disparities between rural and urban areas are needed to achieve MDG 5.

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