WORLD

HEALTH
STATISTICS

MONITORING
HEALTH FOR THE

SDGs

S U S T A I N A B L E
DEVELOPMENT GOALS

WORLD
HEALTH
STATISTICS

MONITORING
HEALTH FOR THE

SDGs
S U S T A I N A B L E
DEVELOPMENT GOALS

WHO Library Cataloguing-in-Publication Data

World health statistics 2016: monitoring health for the SDGs, sustainable development goals.
1.Health Status Indicators. 2.Global Health. 3.Health Priorities. 4.Mortality. 5.Universal Coverage. 6.Life Expectancy. 7.Statistics. I.World Health
ISBN 978 92 4 156526 4

(NLM classification: WA 900.1)

E-ISBN 978 92 4 069569 6 (PDF)

World Health Organization 2016
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CONTENTS
Executive summary. .
Abbreviations.
Introduction. .

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vi

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1. The 2030 Agenda a new impetus for health monitoring..

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2. Implications of the SDGs for health monitoring a challenge and an opportunity for all countries.
2.1
2.2
2.3
2.4
2.5
2.6
2.7

Scope an agenda for all countries.. . . . . . . . . . . . . . . . . . . . . . .

Contents all major health areas are included. . . . . . . . . . . . . . .
Equity the need for disaggregated data. . . . . . . . . . . . . . . . . . .
Multisectoral data health-related risk factors and determinants.
Country monitoring data gaps and capacity. . . . . . . . . . . . . . . .
Regional and global monitoring mechanisms and estimates. . . .
Review using data for improved implementation. . . . . . . . . . . .

3. Monitoring the health goal indicators of overall progress. .

3.1
3.2
3.3
3.4

5.1
5.2
5.3
5.4
5.5
5.6

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Sex major differences between men and women for many indicators. . . . . . . . . . . .
Age data should cover the full life course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Socioeconomic status major disadvantages for the poorest and the least educated. .
Place of residence focus on geographical differences within countries. . . . . . . . . . . .
Migrants and minorities requiring special efforts. . . . . . . . . . . . . . . . . . . . . . . . . . .
Data gaps disaggregation is a crucial data challenge.. . . . . . . . . . . . . . . . . . . . . . . .

6. SDG health and health-related targets.

6.1
6.2
6.3





6.4

3
4
4
4
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5
6

UHC coverage index of essential health services a new summary measure. .

Inequalities in coverage towards an integrated assessment.. . . . . . . . . . . . .
Financial protection measuring the impact of out-of-pocket payments. . . . .
Data gaps regular UHC monitoring is possible. . . . . . . . . . . . . . . . . . . . . . .

5. Equity leave no one behind. .

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Life expectancy major gains but still large differences. . . . . . . . . . . . . . . . . . .

Healthy life expectancy gaining healthy life years. . . . . . . . . . . . . . . . . . . . . .
Premature mortality focusing on deaths among those under 70 years of age. .
Data gaps most deaths not registered. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Universal health coverage at the centre of the health goal.

4.1
4.2
4.3
4.4

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29

Health targets 13 targets and 26 proposed indicators. . . . . . . . . . . .

Health-related targets in other goals many targets linked to health. .
Situation in 2016 a sketch based on global data. . . . . . . . . . . . . . . .
Reproductive, maternal, newborn and child health. . . . . . . . . . . . .
Infectious diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Noncommunicable diseases and mental health. . . . . . . . . . . . . . .
Injuries and violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health systems.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Data gaps need for strong country health information systems. . . . .

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MONITORING HEALTH FOR THE SDGs

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Annex A: Summaries of the SDG health and health-related targets. .

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Explanatory notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.1 Maternal mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.1 Births attended by skilled health personnel. . . . . . . . . . . . . . . . . . . .
Target 3.2 Child mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.3 HIV. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.3 Tuberculosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.3 Malaria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.3 Hepatitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.3 Neglected tropical diseases.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.4 Noncommunicable diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.4 Suicide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.5 Substance abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.6 Road traffic injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.7 Sexual and reproductive health. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.9 Mortality due to air pollution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.9 Mortality due to unsafe water, unsafe sanitation and lack of hygiene..
Target 3.9 Mortality due to unintentional poisoning. . . . . . . . . . . . . . . . . . . . . .
Target 3.a Tobacco use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.b Essential medicines and vaccines. . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.c Health workforce. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 3.d National and global health risks. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 2.2 Child stunting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 2.2 Child wasting and overweight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 6.1 Drinking-water. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 6.2 Sanitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 7.1 Clean household energy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 11.6 Ambient air pollution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 13.1 Natural disaster. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 16.1 Homicide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Target 16.1 Conflicts.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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103

Annex B: Tables of health statistics by country, WHO region and globally. .

Explanatory notes. .

Annex C: WHO regional groupings..

iv

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WORLD HEALTH STATISTICS: 2016

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EXECUTIVE SUMMARY

he 17 Sustainable Development Goals (SDGs) of the 2030 Agenda integrate all three dimensions of sustainable
development (economic, social and environmental) recognizing that eradicating poverty and inequality, creating
inclusive economic growth and preserving the planet are inextricably linked. Health is centrally positioned
within the 2030 Agenda, with one comprehensive goal (SDG 3) and its 13 targets covering all major health
priorities, and links to targets in many of the other goals.

The 2030 Agenda has major implications for health monitoring. Monitoring will need to reflect the fact that the SDGs
are relevant for all countries. In order to accommodate a much broader range of health and health-related issues, country,
regional and global monitoring systems will have to adapt. This will mean, at the very least, undertaking health data
collection, analysis and communication in an integrated manner. The SDG focus on leaving no one behind means that
much greater attention will have to be given to disaggregated data. Health monitoring will have to look beyond the health
sector and consider economic, social and environmental indicators, as well as intersectoral actions. The 2030 Agenda also
puts strong emphasis on country follow-up and review processes as the basis for accountability. Strengthening country
health information systems should therefore be a priority.
This report brings together the most recent data on the proposed health and selected health-related SDG indicators to
assess the current situation and describe crucial data gaps. In the current absence of official goal-level indicators, summary
measures of health such as (healthy) life expectancy are used to provide a general assessment of the situation. As universal
health coverage (UHC) is a central concern, statistics are presented on a service-coverage index and on measures of
financial protection using the WHO/World Bank UHC monitoring framework. In relation to equity, special attention is given
to describing the statistical situation disaggregated by key demographic, geographic and socioeconomic characteristics.
Because the 2030 Agenda emphasizes the interlinked nature of all the various goals, this report also includes indicators
of selected health determinants and risk factors in relation to other SDG targets. More work is required to fully integrate
monitoring the health dimension in other goals.
Available data show that in spite of the major progress during the Millennium Development Goal (MDG) era, major
challenges remain in terms of reducing maternal and child mortality, improving nutrition, and achieving further progress
in the battle against infectious diseases such as HIV/AIDS, tuberculosis, malaria, neglected tropical diseases and hepatitis.
The situation analysis also provides evidence of the importance of addressing noncommunicable diseases and their risk
factors such as tobacco use, mental health problems, road traffic injuries, and environmental health issues. Data on water
and sanitation and air quality show that much more needs to be done to reduce risks to health. Weak health systems are
a major obstacle in many countries, resulting in major deficiencies in UHC for even the most basic health services and
inadequate preparedness for health emergencies.
This report shows that for most SDG health and health-related targets it is possible to provide an overview of the global
situation and trends using a limited number of indicators. It, however, also shows that there are major data gaps for many
indicators. For instance, several health and health-related indicators require regular, quality data on mortality by age,
sex and cause of death, which are still lacking in most countries. The demand for comparable disaggregated statistics is
particularly challenging for almost all indicators. These deficiencies will require major investments in strengthening country
health information and statistical systems.

MONITORING HEALTH FOR THE SDGs

ABBREVIATIONS
ABR
AFR
AIDS
AMR
ART
CRD
CRVS
CVD
DHS
EML
EMR
EPPM
EUR
FCTC
GDP
GHO
GSHRH
HAT
HBV
HCV
HepBOT
HIV
HLE
HLPF
HRH
IAEG-SDGs
ICD
IGME
IHR
ITN
LMIC
MDG
MICS
MMEIG
MMR
NCD
NHA
NHWA
NTD
ODA

vi

adolescent birth rate

WHO African Region
acquired immunodeficiency syndrome
WHO Region of the Americas
antiretroviral therapy
chronic respiratory disease
civil registration and vital statistics
cardiovascular disease
Demographic and Health Survey
essential medicines list
WHO Eastern Mediterranean Region
ending preventable maternal mortality
WHO European Region
Framework Convention on Tobacco Control
gross domestic product
Global Health Observatory
Global strategy on human resources for health
human African trypanosomiasis
hepatitis B virus
hepatitis C virus
HBV vaccine birth dose administered in a timely way
human immunodeficiency virus
healthy life expectancy
High-Level Political Forum
human resources for health
Interagency and Expert Group on SDG Indicators
International Classification of Diseases
Inter-agency Group for Child Mortality Estimation (United Nations)
International Health Regulations
insecticide-treated net
low- and middle-income countries
Millennium Development Goal
Multiple Indicator Cluster Survey
Maternal Mortality Estimation Inter-agency Group (United Nations)
maternal mortality ratio
noncommunicable disease
national health account
national health workforce accounts
neglected tropical disease
official development assistance

WORLD HEALTH STATISTICS: 2016

OECD
OOP
PM
PPP
R&D
SDG
SEAR
STH
TB
THE
UHC
UN
UNAIDS
UNDESA
UNESCO
UNICEF
UNODS
WASH
WHA
WPR
YLD

Organisation for Economic Co-operation and Development

out-of-pocket
particulate matter
purchasing power parity
research and development
Sustainable Development Goal
WHO South-East Asia Region
soil-transmitted helminthiases
tuberculosis
total health expenditure
universal health coverage
United Nations
Joint United Nations Programme on HIV/AIDS
United Nations Department of Economic and Social Affairs
United Nations Educational, Scientific and Cultural Organization
United Nations Childrens Fund
United Nations Office on Drugs and Crime
water, sanitation and hygiene
World Health Assembly
WHO Western Pacific Region
years of healthy life lost due to disability

MONITORING HEALTH FOR THE SDGs

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INTRODUCTION

he World Health Statistics series is WHOs annual compilation of health statistics for its 194 Member States.
World Health Statistics 2016 focuses on the proposed health and health-related Sustainable Development Goals
(SDGs) and associated targets. It represents an initial effort to bring together available data on SDG health and
health-related indicators. In the current absence of official goal-level indicators, summary measures of health
such as (healthy) life expectancy are used to provide a general assessment of the situation.

The series is produced by the WHO Department of Information, Evidence and Research, of the Health Systems and
Innovation Cluster, in collaboration with all relevant technical departments of WHO. As in previous years, World Health
Statistics 2016 has been compiled primarily using publications and databases produced and maintained by WHO or United
Nations groups of which WHO is a member, such as the UN Inter-agency Group for Child Mortality Estimation (IGME).
A number of statistics have been derived from data produced and maintained by other international organizations, such
as the United Nations Department of Economic and Social Affairs (UNDESA) and its Population Division.
Unless otherwise stated, all estimates have been cleared following consultation with Member States and are published
here as official WHO figures. Where necessary the estimates provided have been derived from multiple sources, depending
on each indicator and on the availability and quality of data. In many countries, statistical and health information systems
are weak and the underlying empirical data may not be available or may be of poor quality. Every effort has been made
to ensure the best use of country-reported data adjusted where necessary to deal with missing values, to correct for
known biases, and to maximize the comparability of the statistics across countries and over time. In addition, statistical
modelling and other techniques have been used to fill data gaps. However, these best estimates have been derived using
standard categories and methods to enhance their cross-national comparability. As a result, they should not be regarded
as the nationally endorsed statistics of Member States which may have been derived using alternative methodologies.
Because of the weakness of the underlying empirical data in many countries, a number of the indicators presented here
are associated with significant uncertainty. It is WHO policy to ensure statistical transparency and to make available to
users the methods of estimation and the margins of uncertainty for relevant indicators. However, to ensure readability
while covering such a comprehensive range of health topics, printed versions of the World Health Statistics series do not
include the margins of uncertainty which are instead made available through online WHO databases such as the Global
Health Observatory (GHO).1
While every effort has been made to maximize the comparability of the statistics across countries and over time, users
are advised that country data may differ in terms of the definitions, data-collection methods, population coverage and
estimation methods used. More information on indicator metadata is available through the Global Health Observatory.

1 The Global Health Observatory (GHO) is WHOs portal providing access to data and analyses for monitoring the global health situation. See: http://www.who.int/gho/en/,
accessed 16 April 2016.

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WORLD HEALTH STATISTICS: 2016