Listed below are the major advances and challenges that we still need to overcome regarding the 3 MDGs that are closely related to Espolea’s agenda:
Goal 3: Promote gender equality and empower women
Girls still face barriers when it comes to schooling, especially in Northern-Africa, sub-Saharan Africa, and Western Africa. Although there are substantially more girls in school in these areas in 2011 than in 1990, the attendance of girls compared to the attendance of boys is still low. At secondary education level the disparity between girls and boys is even more marked, girls are still in disadvantage compared to boys, however, since 1990, some progress has been made on girls’ attendance. When it comes to higher education the differences are even greater than the two other levels. However, in Latin America and the Caribbean, the Caucasus and Central Asia, Eastern Asia, Northern Africa and South-Eastern Asia there are more women enrolled than men. In Western Asia and Southern Asia the case is the opposite: women are less likely to enrol in higher education. Even though the number of women in higher education is increasing, there is still a lack of women in managerial positions. Within the household there is also a tendency for women's decision-making power to be significantly lower than that of men.
When it comes to non-agricultural employment, the number of women has increased from 35 percent to 40 per cent worldwide. In Western Asia, Northern Africa, and Southern Asia there is a significant difference from the world statistics, in these regions only 20 per cent of women are working in non-agricultural employment. Women are generally more likely to work as a contributing family member and have little or non-financial security and social benefits. This is probably because of the common lack of opportunities for childcare, women's responsibilities in unpaid family life, and a lack of social rights.
In 2012 there was an increase of one per cent in female representatives in parliament globally. Quotas are the main reason to the above average increase in female representatives in parliament. Where quotas are enforced, women take 24 percent of the parliamentary seats while in countries where quotas are not used women took only 12 percent of the seats. Today there are only six parliaments with no female members.
Goal 5: Improve maternal health
The MDG target for reducing maternal mortality is to reduce deaths by three quarters. All developing regions have made progress, but there is still a strong need for more skilled health professionals and medication, especially antiretroviral drugs. There is still a long way to go in order to provide maternal care to all women, especially the differences between rural and urban areas still remains significantly large. Around 53 per cent in rural areas received maternal care in 2011, while 83 percent received maternal care in urban areas – in sub-Saharan Africa and Southern Asia the numbers were even lower. There has been a positive development concerning young girl pregnancies, where girls between 15 and 19 having children have decreased in all regions. However, there are large differences between the regions: Eastern Asia has 6 births per 1,000 girls, and sub-Saharan Africa has 118 per 1,000 girls.
Coverage of antenatal care has improved in the developing regions – from a 63 per cent in 1990 to a 81 per cent in 2011. However, only half of all pregnant women do in reality receive the recommended amount of antenatal care visits– which the World Health Organisation set to be a minimum of four, conducted by qualified medical professionals. The importance for intervention in reproductive health is shown clearly in Africa where there are great differences between the countries that does not and countries that does provide skilled attendance at birth and have a high level of contraceptive use.
Goal 6: Combat HIV/AIDS, malaria, and other diseases
Worldwide new HIV infections have dropped by 21 per cent from 2001 to 2011. Even though most regions have a decline in new HIV infections, in 2011 there has been an increase of new infections in the Caucasus and Central Asia. The majority of HIV infected persons between 15 and 24 are women, this corresponds with the interplay between physical factors and gender inequalities. Girls are generally in disadvantage when it comes to accessing information about reproductive health and when it comes to negotiating condom usage.
The UN aims that 95 per cento of women and men have a comprehensive knowledge of HIV, however, it falls short: in countries with a generalized epidemic, less than 50 per cent of young men and women have sufficient knowledge of HIV. In the worst affected region, sub-Saharan Africa, as few as 36 per cent of boys and 28 per cent of girls have sufficient and comprehensive knowledge about HIV.
The amount of people receiving antiretroviral drugs increases every year and, if it continues with the current rate, the UN goal will be reached by 2015 and close to 15 million people will receive the drugs. However, the MDG target of providing universal access to antiretroviral drugs by 2010 was not reached; there is still only 55 per cent of people living in developing countries that receives the drug. Medical coverage was in 2011 higher among women than men. When it comes to children only among 28 per cent on world basis receives the medication.
Deaths caused by malaria decreased by 25 per cent between 2000 and 2010. Malaria diagnosis was provided free of charge in 84 countries across all regions in 2011 and rapid diagnostic tests have increased from 200 000 in 2005 to 74 million in 2011. A major concern however is the possibility of resistance towards malaria medicine. It needs to be continuously checked in order not loose the last 10 years' progress.
Globally, cases of tuberculosis have decreased with 2 per cent per 100 000 people. People living with HIV represent 13 percent of all people living with tuberculosis. Tuberculosis infections decrease slowly but keeping this progress the spreading will come to a halt in the world as a whole. More than 51 million patients with tuberculosis were treated successfully with the Directly Observed Treatment, Short-course (DOTS) between 1995 and 2011. Much work is still to be done, yet, only one third are treated with this strategy, and many of tuberculosis infected are HIV-positive without knowing and without antiretroviral treatment – something that slows their progress.
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