Kazakhstan Country Health Statistical Report

Publication date: 2010

USAID Country Health Statistical Report Kazakhstan January 2011 Table of Contents 1. About the Report 2. Country Profile I. Statistical Overview • Demographic Indicators • Socioeconomic Indicators • Family Planning Indicators • Maternal Health Indicators • Child Survival Indicators • HIV/AIDS Prevention Indicators • Infectious Diseases Control Indicators II. Trends in Health Indicators • Current and Projected Population by Age and Sex (Figure 1 and Table 1.1) • Population Estimates and Projections (Table 1.2) • Estimated Total Fertility Rate per Woman (Figure 2 and Table 2) • Infant Mortality Rates / Under-5 Mortality Rates (Figure 3 and Table 3) • Vaccination Coverage (DPT3) Trends (Figure 4 and Table 4) • Contraceptive Prevalence Rates - Married Women (Figure 5 and Table 5) 3. Data Notes 4. Sources About the Report Released January 2011 This report is one of a series of Country Health Statistical Reports produced on behalf of the United States Agency for International Development (USAID) by the Analysis, Information Management and Communication Activity (AIM) Project. Each profile contains statistical data on current health conditions, population dynamics, health and family planning behavior, and health and population trends in a given developing country. Information is compiled from AIM's health statistics database, which draws data from a diverse range of sources listed at the end of this profile. Hard copy editions of USAID's profiles are available from AIM'S publications department. Reports are available on the USAID Global Health Web site in Portable Document Format (pdf). Any feedback you have on the content or presentation of this report would be greatly appreciated. We would also appreciate receiving any more recent, more accurate, or more representative information. Contact us at the following: Analysis, Information Management & Communications Activity (AIM) 655 15th Street, NW, Suite 450 Washington, DC 20005 Phone: 202-661-8600 Fax: 202-661-8601 E-mail: dolphn@aimglobalhealth.org The Analysis, Information Management & Communications (AIM) Activity, a USAID contract managed by MasiMax Resources, Inc, with John Snow, Inc., ORC Macro, and Insight Systems Corporation prepared this document under task order number GPO-M-00-05- 00043-00, with the Bureau for Global Health, USAID. I. Statistical Overview *see data notes Demographic Indicators Indicator Value Data Unit Year Source Total Population 15,460,484 2010 BUCEN-IDB-2010 Population Growth Rate 0.4 % 2010 BUCEN-IDB-2010 Percent Urban 56 % 2004 World Bank/WDI-2006 Women, 15-19 678,324 2010 BUCEN-IDB-2010 Women, 15-49 4,327,536 2010 BUCEN-IDB-2010 Life Expectancy at Birth 68.2 2010 BUCEN-IDB-2010 Crude Birth Rate 16.7 per 1,000 2010 BUCEN-IDB-2010 Crude Death Rate 9.4 per 1,000 2010 BUCEN-IDB-2010 Number of Live Births 257,572 2010 BUCEN-IDB-2010 Healthy Life Expectancy: Female 59 2002 WHO Global Health Atlas-2008 Healthy Life Expectancy: Male 53 2002 WHO Global Health Atlas-2008 Population: Percent < Age 15 21.7 % 2010 BUCEN-IDB-2010 Socioeconomic Indicators Indicator Value Data Unit Year Source GNI per Capita (PPP) 7,730 $ 2005 World Bank/WDI-2006 Health Expenditure as Percentage of GDP 3.5 % 2003 World Bank/WDI-2006 Physicians per 1,000 People 3.6 per 1,000 2002 World Bank/WDI-2005 Adult Literacy Rate 99.5 % 2004 World Bank/WDI Database-2007 Adult Literacy Rate, Female 99.2 % 2002 World Bank/WDI-2005 Adult Literacy Rate, Male 99.7 % 2002 World Bank/WDI-2005 Gross Enrollment Ratio - Primary School 108.7 % 2007 UNESCO Global Monitoring Report-2010 Gender Parity Index - Net Enrollment Ratio 1 2007 UNESCO Global Monitoring Report-2010 Access to an Improved Water Source (Rural) 72 % 2002 World Bank/WDI-2005 Access to an Improved Water Source (Urban) 96 % 2002 World Bank/WDI-2005 Access to Improved Sanitation Facilities (Rural) 52 % 2002 World Bank/WDI-2005 Access to Improved Sanitation Facilities (Urban) 87 % 2002 World Bank/WDI-2005 Population Living Below $1 a Day 2 % 1990-2004 Human Development Report-2006 Human Development Index 0.79 2005 Human Development Report - 2007/2008- 2008 Population Below Poverty Line 12.1 % 2008 CIA World Factbook-2010 Real GDP (Growth) Rate 1 % 2009 CIA World Factbook-2010 Income Inequality (Gini index) 28.8 2008 CIA World Factbook-2010 Unemployment Rate 6.3 % 2009 CIA World Factbook-2010 Inflation Rate 7.3 % 2009 CIA World Factbook-2010 Airports 97 2010 CIA World Factbook-2010 Airports with paved runways 65 2010 CIA World Factbook-2010 Family Planning Indicators Indicator Value Data Unit Year Source Total Fertility Rate (BUCEN) 1.9 2010 BUCEN-IDB-2010 Total Fertility Rate (DHS) 2.1 1999 Kazakhstan DHS-1999 Contraceptive Prevalence Rate, Modern Methods, All Women 38.6 % 1999 Kazakhstan DHS-1999 Contraceptive Prevalence Rate, Modern Methods, Married Women 52.7 % 1999 Kazakhstan DHS-1999 Median Age of Sexual Debut Among Women, Ages 25-49 20.8 1999 Kazakhstan DHS-1999 Mean Ideal Family Size 2.8 1999 Kazakhstan DHS-1999 Women 20-24 Who Gave Birth Before Age 20 22.1 % 1999 Kazakhstan DHS-1999 Total Fertility Rate, Rural 2.7 1999 DHS STATcompiler as of September 2008-2008 Unmet Need for Family Planning: Rural 10 % 1999 DHS STATcompiler as of September 2008-2008 Unmet Need for Family Planning: Urban 7.6 % 1999 DHS STATcompiler as of September 2008-2008 Contraceptive Prevalence Rate, All Methods 50.7 % 2006 2006 Kazakhstan MICS-2006 Equity in use of modern contraception Data Not Available Percent of need satisfied by modern methods of family planning Data Not Available Maternal Health Indicators Indicator Value Data Unit Year Source Maternal Mortality Ratio (WHO/Hill) 140 Per 100,000 live births 2005 WHO/Hill-2005 Maternal Mortality Ratio (DHS) Data Not Available Antenatal Care (at least 1 visit) 80.9 1 % 1999 Kazakhstan DHS-1999 Antenatal Care (2+ visits) 78.1 2 % 1999 Kazakhstan DHS-1999 Antenatal Care (4+ visits) 70 3 % 1999 Kazakhstan DHS-1999 Assisted Delivery by a Health Professional 99.1 % 1999 Kazakhstan DHS-1999 Assisted Delivery by Doctor 76.8 % 1999 Kazakhstan DHS-1999 Assisted Delivery by Other Health Professional 22.3 % 1999 Kazakhstan DHS-1999 Anemia prevalence among women of reproductive age Data Not Available Equity in skilled attendance at delivery Data Not Available 1 The value for this country represents data from the five-year period preceding the survey. 2 The value for this country represents data from the five-year period preceding the survey. 3 The value for this country represents data from the five-year period preceding the survey. Child Survival Indicators Indicator Value Data Unit Year Source Acute Respiratory Infection (ARI) and Oral Rehydration Therapy (ORT) ARI Care Seeking - Children Under 5 48 % 1999 Kazakhstan DHS-1999 ORT Use Rate (ORS, RHS, or Increased Fluids) 63 % 1999 Kazakhstan DHS-1999 Mortality Indicators Infant Mortality Rate (BUCEN) 24.9 per 1,000 live births 2010 BUCEN-IDB-2010 Infant Mortality Rate (UNICEF) 27 2008 UNICEF-2010 Infant Mortality Rate (DHS) 61.9 per 1,000 live births 1999 Kazakhstan DHS-1999 Infant Mortality Rate, Females (BUCEN) 20.3 per 1,000 live births 2010 BUCEN-IDB-2010 Infant Mortality Rate, Males (BUCEN) 29.3 per 1,000 live births 2010 BUCEN-IDB-2010 Under-5 Mortality Rate (BUCEN) 29.6 per 1,000 live births 2010 BUCEN-IDB-2006 Neonatal Mortality Rate 34 per 1000 1999 DHS STATcompiler as of September 2008- 2008 Under-5 Mortality Rate (UNICEF) 30 per 1,000 live births 2008 UNICEF-2010 Under-5 Mortality Rate (DHS) 71.4 per 1,000 live births 1999 Kazakhstan DHS-1999 Nutrition Indicators Exclusive Breastfeeding (under 4 mos.) 46.6 % 1999 Kazakhstan DHS-1999 Exclusive Breastfeeding (under 6 mos.) 32.9 1 % 1999 Kazakhstan DHS-1999 Stunted (height-for-age) 9.7 % 1999 Kazakhstan DHS-1999 Underweight (weight-for-age) 4.2 % 1999 Kazakhstan DHS-1999 Wasted (weight-for-height) 1.8 % 1999 Kazakhstan DHS-1999 Vaccination Coverage DPT3 Vaccination Rate (DHS) 88.7 % 1999 Kazakhstan DHS-1999 DPT3 Vaccination Rate (WHO) 98 % 2009 WHO: Global Summary-2009 Measles Vaccination Rate (DHS) 78.5 % 1999 Kazakhstan DHS-1999 Measles Vaccination Rate (WHO) 99 % 2009 WHO: Global Summary-2009 Polio Vaccination Rate (DHS) 83.1 % 1999 Kazakhstan DHS-1999 Polio Vaccination Rate (WHO) 99 % 2009 WHO: Global Summary-2009 Tetanus Toxoid Vaccination Data Not Available Equity in DPT3 coverage (DHS) Data Not Available Improved sanitation/hygiene practices Data Not Available Vitamin A supplementation coverage among children 6-59 months Data Not Available 1 The value for this country represents data from children under seven months of age. HIV/AIDS Prevention Indicators Indicator Value Data Unit Year Source HIV Prevalence proportion: Adults (15–49 years) 0.1 % 2007 UNAIDS 2008-2008 Estimated number of people living with HIV: Adults and Children 12,000 2007 UNAIDS 2008-2008 Estimated number of people living with HIV: Women (15+ years) 3,300 2007 UNAIDS 2008-2008 Estimated number of people living with HIV: Children (0–14 years) Data Not Available Males Reporting Condom Use With Last Non-Regular Partner 58.3 % 1999 Kazakhstan DHS-1999 Females Reporting Condom Use With Last Non-Regular Partner 18.7 % 1999 Kazakhstan DHS-1999 Infectious Diseases Control Indicators Indicator Value Data Unit Year Source TB Estimated Number of Cases 19,894 2007 WHO: Global Atlas-2009 TB Case Detection Rate 108 % 2007 Global Atlas-2010 TB (DOTS) Treatment Success Rate 72 % 2006 WHO: Global Atlas-2009 Malaria Cases per 100,000 Data Not Available DOTS Coverage 100 % 2007 WHO: Global Atlas-2009 HIV-Infected with Active TB 2.8 % 2007 WHO: Global Atlas-2009 Avian Influenza: Cumulative Number of Confirmed Human Cases Data Not Available Avian Influenza: Cumulative Number of Confirmed Human Deaths Data Not Available Child Sleeps Under Insecticide-Treated Net Data Not Available Equity in Bednet (ITN) Ownership Data Not Available II. Trends in Health Indicators Figure 1: Current and Projected Population by Age and Sex (in thousands) Table 1.1: Current and Projected Population by Age and Sex Source: BUCEN-IDB Age Group Male - 2000 Male - 2020 Female - 2000 Female - 2020 0-4 562,647 596,039 538,567 568,495 5-9 731,820 625,568 702,556 598,058 10-14 859,193 595,289 837,778 570,065 15-19 767,709 529,417 744,057 504,302 20-24 664,664 508,565 616,893 484,321 25-29 548,394 660,198 523,050 639,988 30-34 490,227 765,679 497,042 767,235 35-39 584,869 663,730 628,851 675,908 40-44 541,347 560,310 587,340 558,418 45-49 435,188 449,503 484,853 470,283 50-54 284,717 385,079 329,311 441,341 55-59 200,957 436,637 245,120 552,277 60-64 284,150 365,443 365,615 493,295 65-69 138,345 251,023 196,184 377,114 70-74 124,280 134,597 236,926 228,937 75-79 41,663 64,478 119,938 134,040 80-84 14,908 63,597 52,901 159,811 85-89 6,162 13,201 34,065 48,693 90-94 693 3,554 7,273 27,514 95-99 138 211 1,562 4,472 99+ 16 6 171 354 TABLE 1.2: Population Estimates and Projections Source: BUCEN-IDB 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 9,982,014 13,106,377 14,966,718 16,398,131 15,032,140 15,460,484 15,977,045 15,979,334 15,672,663 15,099,700 Figure 2: Estimated Total Fertility Rate per Woman Table 2: Estimated Total Fertility Rate per Woman Source: BUCEN-IDB 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 2.8 2.3 1.9 1.9 1.9 1.9 1.8 1.8 1.8 1.8 1.7 1.7 1.7 Figure 3: Infant Mortality Rates / Under-5 Mortality Rates Table 3: Infant Mortality Rates / Under-5 Mortality Rates Source: BUCEN-IDB 2010 Indicator 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 Infant Mortality Rate (BUCEN) 45.5 48.2 35.4 29.2 24.9 21.3 18.2 15.7 13.5 11.7 10.2 9.0 8.0 Under-5 Mortality Rate (BUCEN) 52.9 57.3 42.7 34.9 29.6 25.2 21.4 18.3 15.7 13.6 11.8 10.4 9.2 Figure 4: Vaccination Coverage (DPT3) Trends Table 4: Vaccination Coverage (DPT3) Trends Source: WHO/Global Summary WHO: Global Summary 1990 1995 2000 2005 80.0 93.0 97.0 98.0 Figure 5: Contraceptive Prevalence Rates, Modern Methods, Married Women Table 5: Contraceptive Prevalence Rates, Modern Methods, Married Women Source: Kazakhstan DHS 1995 1999 46.1 52.7 Data Notes *Indicator definitions that differ from those in the data notes section are identified by footnotes accompanying the indicator tables. Demographic Indicators Total Population The number of people in a given area (i.e., country) in a particular time period (usually a midyear estimate). Population Growth Rate The average annual growth rate is the rate of natural increase in a population plus the net migration rate. The rate of natural increase is the difference between the birth rate and the death rate, but it is conventionally measured in percentage terms (per hundred rather than per thousand). Percent Urban The percentage of the midyear population living in areas defined as urban in each country and reported to the United Nations. Women, 15-19 The number of women between the ages of 15-19 in the midyear population. Women, 15-49 The number of women between the ages of 15-49 in the midyear population. Life Expectancy at Birth The average number of years that a person at age 0 will live if age-specific death rates remain constant. Life expectancy at birth is highly affected by rates of infant and child death. Crude Birth Rate The number of births per thousand of the population. The product of the number of live births, divided by the midpoint population, multiplied by 1,000. Crude Death Rate The number of deaths per thousand of the population. The product of the number of deaths divided by the midpoint population, multiplied by 1,000. Number of Live Births The number of live births, annually, within a country. Healthy Life Expectancy: Female The number of years of in full health that a female newborn can expect to live based on current rates of ill-health and mortality. HALE is based on life expectancy at birth but includes an adjustment for time spent in poor health. Healthy Life Expectancy: Male The number of years of in full health that a male newborn can expect to live based on current rates of ill- health and mortality. HALE is based on life expectancy at birth but includes an adjustment for time spent in poor health. Population: Percent < Age 15 Percent of population less than 15 years of age. Socioeconomic Indicators GNI per Capita (PPP) The gross national income (GNI) converted to international dollars using purchasing power parity (PPP) rates. An international dollar has the same purchasing power over GNI as a U.S. dollar has in the United States. Health Expenditure as Percentage of GDP Total health expenditures is the sum of public and private health expenditures figured as a percentage of a country's gross domestic product (GDP). It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation. Physicians per 1,000 People Physicians are defined as graduates of any faculty or school of medicine who are working in the country in any medical field (practice, teaching, research). Adult Literacy Rate The percentage of people ages 15 and over who can, with understanding, read and write a short, simple statement about their everyday life. Adult Literacy Rate, Female The percentage of women ages 15 and over who can, with understanding, read and write a short, simple statement about their everyday life. Adult Literacy Rate, Male The percentage of men ages 15 and over who can, with understanding, read and write a short, simple statement about their everyday life. Gross Enrollment Ratio - Primary School Total enrolment in primary level of education, regardless of age, expressed as a percentage of the population in the official age group corresponding to primary level of education. The GER can exceed 100% due to late entry or/and repetition. Gender Parity Index - Net Enrollment Ratio The ratio of the female-to-male values (or male to female, in certain cases) of net primary school enrollment rates (NER). NER measures the number of pupils in the official age group for a given level of ecudation, expressed as a percentage of the population in that age group. Access to an Improved Water Source (Rural) Access to an improved water source in rural areas. Refers to the percentage of the rural population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, or rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Access to an Improved Water Source (Urban) Access to an improved water source in urban areas. Refers to the percentage of the urban population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, or rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Access to Improved Sanitation Facilities (Rural) Access to improved sanitation facilities in rural areas. Refers to the percentage of the rural population with access to at least adequate excreta disposal facilities (private or shared, but not public) that can effectively prevent human, animal, and insect contact with excreta. Access to Improved Sanitation Facilities (Urban) Access to improved sanitation facilities in urban areas. Refers to the percentage of the urban population with access to at least adequate excreta disposal facilities (private or shared, but not public) that can effectively prevent human, animal, and insect contact with excreta. Population Living Below $1 a Day The percentage of the population living below the specified poverty line of $1 a day at 1985 international prices (equivalent to $1.08 at 1993 international prices), adjusted for purchasing power parity. Human Development Index The HDI is a composite index that measures the average achievements in a country in three basic dimensions of human development: a long and healthy life, as measured by life expectancy at birth; knowledge, as measured by the adult literacy rate and the combined gross enrollment ratio for primary, secondary, and tertiary schools; and a decent standard of living, as measured by gross domestic product (GDP) per capita in purchasing power parity (PPP) US dollars. Population Below Poverty Line National estimates of the percentage of the population falling below the poverty line are based on surveys of sub-groups, with the results weighted by the number of people in each group. Definitions of poverty vary considerably among nations. For example, rich nations generally employ more generous standards of poverty than poor nations. Real GDP (Growth) Rate This entry gives the gross domestic product (GDP) growth on an annual basis adjusted for inflation and expressed as a percent. Income Inequality (Gini index) This index measures the degree of inequality in the distribution of family income in a country. It is calculated from the Lorenz curve, in which cumulative family income is plotted against the number of families arranged from the poorest to the richest. The index is the ratio of (a) the area between a country's Lorenz curve and the 45 degree helping line to (b) the entire triangular area under the 45 degree line. The more nearly equal a country's income distribution, the closer its Lorenz curve to the 45 degree line and the lower its Gini index, e.g., a Scandinavian country with an index of 25. The more unequal a country's income distribution, the higher its Gini index, e.g., a Sub-Saharan country with an index of 50. If income were distributed with perfect equality, the index would be zero; if income were distributed with perfect inequality, the index would be 100. Unemployment Rate This entry contains the percent of the labor force that is without jobs. Substantial underemployment might be noted. Inflation Rate This entry furnishes the annual percent change in consumer prices compared with the previous year's consumer prices. Airports This entry gives the total number of airports or airfields recognizable from the air. The runway(s) may be paved (concrete or asphalt surfaces) or unpaved (grass, earth, sand, or gravel surfaces) but may include closed or abandoned installations. Airports or airfields that are no longer recognizable (overgrown, no facilities, etc.) are not included. Note that not all airports have accomodations for refueling, maintenance, or air traffic control. Airports with paved runways This entry gives the total number of airports with paved runways (concrete or asphalt surfaces) by length. For airports with more than one runway, only the longest runway is included according to the following five groups - (1) over 3,047 m, (2) 2,438 to 3,047 m, (3) 1,524 to 2,437 m, (4) 914 to 1,523 m, and (5) under 914 m. Only airports with usable runways are included in this listing. Not all airports have facilities for refueling, maintenance, or air traffic control. Family Planning Indicators Total Fertility Rate (BUCEN) The number of children a woman between ages 15-49 would have during her reproductive life, if, for all of her childbearing years she were to experience the age-specific birth rates for that given year. Total Fertility Rate (DHS) The number of children a woman between ages 15-49 would have during her lifetime if she were to bear children at the currently observed rates. Contraceptive Prevalence Rate, Modern Methods, All Women Percentage of all women ages 15-49 currently using a modern method of contraception. Modern methods include oral contraceptives, IUDs, injectables, female and male sterilization, all emergency contraception, and barrier methods (diaphragm, foam, jelly, male and female condom). Contraceptive Prevalence Rate, Modern Methods, Married Women Percent of currently married women ages 15-49 currently using a modern method of contraception. Modern methods include oral contraceptives, IUDs, injectables, female and male sterilization, all emergency contraception, and barrier methods (diaphragm, foam, jelly, male and female condom). Median Age of Sexual Debut Among Women, Ages 25-49 Median age of first sexual intercourse for women ages 25-49. Mean Ideal Family Size Mean ideal number of children for all women, according to number of living children. Women 20-24 Who Gave Birth Before Age 20 Percentage of women ages 20-24 who have given birth before age 20. Total Fertility Rate, Rural In rural areas only, the number of children a woman between ages 15-49 would have during her lifetime if she were to bear children at the currently observed rates. Unmet Need for Family Planning: Rural In rural areas, percentage of married women ages 15-49 with unmet need for family planning. Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women who are not using family planning and whose last birth was mistimed, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait 2 or more years for their next birth. Also included are fecund women who are not using any method of family planning and say they are unsure whether they want another child or who want another child but are unsure when to have the birth unless they say it would not be a problem if they discovered they were pregnant in the next few weeks. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and want no more children. Unmet Need for Family Planning: Urban In urban areas, percentage of married women ages 15-49 with unmet need for family planning. Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women who are not using family planning and whose last birth was mistimed, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait 2 or more years for their next birth. Also included are fecund women who are not using any method of family planning and say they are unsure whether they want another child or who want another child but are unsure when to have the birth unless they say it would not be a problem if they discovered they were pregnant in the next few weeks. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and want no more children. Contraceptive Prevalence Rate, All Methods Percentage of currently married women ages 15-49 currently using ANY method of contraception. Equity in use of modern contraception Contraceptive prevalence rate in the lowest wealth quintile/contraceptive prevalence rate in the highest wealth quintile. Percent of need satisfied by modern methods of family planning Number of women in union who are fecund and are currently using modern contraceptive methods to stop or postpone the next pregnancy/number of women in union who are fecund and who desire to either terminate childbearing or to postpone their next birth for 2 years or more. Maternal Health Indicators Maternal Mortality Ratio (WHO/Hill) The estimated number of women who die as a result of pregnancy or childbirth per 100,000 live births arrived through Hill et al., adjustment procedure depending on the nature of data used. The margins of uncertainty associated with the estimated maternal mortality ratios are very large and the estimates should not be used to monitor trends in the short term (including comparisons between 1995 and 2000 estimates). In addition, cross-country comparisons should be treated with considerable circumspection because different strategies are used to derive the estimates for different countries rendering comparisons fraught with difficulty. For further information please refer to the source. Maternal Mortality Ratio (DHS) The estimated number of women who die as a result of pregnancy or childbirth per 100,000 live births, arrived mostly through the "sisterhood method". The data are aggregated based on different time periods ranging from four to ten years preceding the survey. Thus, the data may not be suitable for trend analysis due to over-lapping year ranges of estimates. For further information on methodology please refer to: Stanton, Cynthia, Noureddine Abderrahim, and Kenneth Hill. 1997. DHS Maternal Mortality Indicators: An assessment of Data Quality and Implications for Data Use. Calverton: Macro International Inc., or individual country DHS reports. Antenatal Care (at least 1 visit) Percentage of women of reproductive age (15-49) who receive at least one antenatal care visit during pregnancy (in the three-year period preceding the survey). Antenatal Care (2+ visits) Percentage of women of reproductive age (15-49) who receive at least two antenatal care visits during pregnancy (in the three-year period preceding the survey). Antenatal Care (4+ visits) Percentage of women of reproductive age (15-49) who receive four or more antenatal care visits during pregnancy (in the three-year period preceding the survey). Assisted Delivery by a Health Professional The percentage of births/deliveries that occur with the assistance of any trained health professional during the five-year period preceding the survey. May include doctors, nurses, or midwives. Assisted Delivery by Doctor The percentage of live births/deliveries that occur with the assistance of a doctor during the five-year period preceding the survey. Assisted Delivery by Other Health Professional The percentage of live births/deliveries that occur with the assistance of a nurse or midwife during the five-year period preceding the survey. Anemia prevalence among women of reproductive age Number of women of reproductive age (15-49 years) with anemia/number of women of reproductive age (15-49 years). Equity in skilled attendance at delivery Percentage of births in the lowest wealth quintile attended by a doctor, nurse, or trained midwife/ percentage of births in the highest wealth quintile attended by a doctor, nurse, or trained midwife. Child Survival Indicators ARI Care Seeking - Children Under 5 Percentage of children under five years who were ill with an acute respiratory infection (ARI), which is associated with cough, rapid breathing and a high fever, during the two weeks preceding the survey, for whom care was sought from a health facility or provider. ORT Use Rate (ORS, RHS, or Increased Fluids) Oral Rehydration Therapy (ORT). Percentage of children under age 5 with diarrhea two weeks prior to survey who received increased fluids, oral rehydration solution (ORS) or recommended home solution (RHS). Infant Mortality Rate (BUCEN) The estimated annual number of deaths of infants under 12 months in a given year per 1,000 live births in that same year. Infant Mortality Rate (UNICEF) The under five mortality rate is the probability (as expressed as a rate per 1,000 live births)of a child born in a specified year dying before reaching the age of one if subject to current age-specific mortality rates. Infant Mortality Rate (DHS) The estimated annual number of deaths of infants under 12 months in a given year per 1,000 live births in that same year (five-year period preceding survey). Infant Mortality Rate, Females (BUCEN) The estimated annual number of deaths of female infants under 12 months in a given year per 1,000 live births in that same year. Infant Mortality Rate, Males (BUCEN) The estimated annual number of male infants under 12 months in a given year per 1,000 live births in that same year. Under-5 Mortality Rate (BUCEN) Annual number of deaths that occur in children 0-4 years old per 1,000 births. Neonatal Mortality Rate The estimated number of infant deaths in the first month of life per 1,000 live births in the five-year period preceding the survey. Under-5 Mortality Rate (UNICEF) Annual number of deaths that occur in children 0-4 years old per 1,000 births (five-year period preceding survey). Under-5 Mortality Rate (DHS) Annual number of deaths that occur in children 0-4 years old per 1,000 births (five-year period preceding survey). Exclusive Breastfeeding (under 4 mos.) Percentage of children under 4 months exclusively breastfed. Exclusive breastfeeding is defined as providing no food or liquid other than breast milk to the child during the 24-hour period before the survey. Exclusive Breastfeeding (under 6 mos.) Percentage of children under 6 months exclusively breastfed. Exclusive breastfeeding is defined as providing no food or liquid other than breast milk to the child during the 24-hour period before the survey. Stunted (height-for-age) Percentage of children under age five whose height-for-age is below minus-two standard deviations from the median of the reference population. Underweight (weight-for- age) Percentage of children under age five whose weight-for-age is below minus-two standard deviations from the median of the reference population. Wasted (weight-for- height) Percentage of children under age five whose weight-for-height is below minus-two standard deviations from the median of the reference population. DPT3 Vaccination Rate (DHS) Proportion of living children 12-23 months old who have received three complete doses of vaccines against diphtheria, pertussis, and tetanus. DPT3 Vaccination Rate (WHO) Proportion of living children 12-23 months old who have received three complete doses of vaccines aginst diphtheria, pertussis, and tetanus. Measles Vaccination Rate (DHS) Percentage of living children 12-23 months old who have received one dose of Measles Containing Vaccince. Measles Vaccination Rate (WHO) Percentage of living children 12-23 months old who have received one dose of Measles Containing Vaccince. Polio Vaccination Rate (DHS) Proportion of living children 12-23 months who have received three doses of polio vaccine. Polio Vaccination Rate (WHO) Proportion of living children 12-23 months who have received three doses of polio vaccine. Tetanus Toxoid Vaccination Percentage of pregnant women receiving two (or more) doses of tetanus toxoid (three-year period preceding survey). Equity in DPT3 coverage (DHS) DPT3 coverage in the lowest wealth quintile/DPT3 coverage in the highest wealth quintile. Improved sanitation/ hygiene practices Number of households with child under 5 years of age whose youngest child’s feces was safely disposed of the last time he/she passed stool/total number of households with a child under 5 years of age. Vitamin A supplementation coverage among children 6-59 months Number of children aged 6-59 months who received a vitamin A supplement in the last 6 months/total number of children aged 6-59 months surveyed. HIV/AIDS Prevention Indicators HIV Prevalence proportion: Adults (15–49 years) The adult HIV prevalence proportion is the estimated number of adults living with HIV divided by the adult population (aged 15–49). Estimated number of people living with HIV: Adults and Children Estimated number of adults and children living with HIV. Adults are 15 years and over. Children are defined as those aged 0–14 years. Estimated number of people living with HIV: Women (15+ years) Estimated number of women (aged 15 and over) living with HIV. Estimated number of people living with HIV: Children (0–14 years) Estimated number of children under age 15 living with HIV. Males Reporting Condom Use With Last Non- Regular Partner Among men who have had high risk sex in the last year, percentage who used condoms during their last sexual intercourse with a non-regular partner/non-cohabitating partner. Females Reporting Condom Use With Last Non-Regular Partner Among women who have had high risk sex in the last year, percentage who used condoms during their last sexual intercourse with a non-regular partner/non-cohabitating partner. Infectious Diseases Control Indicators TB Estimated Number of Cases The estimated number of cases (all forms). TB Case Detection Rate TB Case Detection Rate is defined as the percentage of the annual new smear-positive notifications of the estimated annual new smear-positive incidence. TB (DOTS) Treatment Success Rate The proportion of smear-positive patients who were cured plus the proportion who completed treatment. Malaria Cases per 100,000 Number of malaria cases per 100,000 of the population during the year for which data was reported. DOTS Coverage The percentage of the national population living in areas where health services have adopted DOTS. "Areas" are the lowest administrative or management units in the country (townships, districts, counties, etc). If an area is considered a DOTS area, then all cases registered and reported in that area are considered DOTS cases and the population living within the boundaries of that area counts toward national DOTS coverage. As a measure of patient access to diagnosis and treatment under DOTS, coverage is an approximation, and usually an overestimate. HIV-Infected with Active TB The TB incidence rate in HIV-infected people 15-49 divided by the incidence rate in HIV-uninfected people 15-49. Avian Influenza: Cumulative Number of Confirmed Human Cases The cumulative number of confirmed human cases of Avian Influenza A/(H5N1) reported to WHO. The total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases. Avian Influenza: Cumulative Number of Confirmed Human Deaths The cumulative number of confirmed human deaths from Avian Influenza A/(H5N1) reported to WHO. WHO reports only laboratory-confirmed cases and deaths. Child Sleeps Under Insecticide-Treated Net Percentage of children under five years of age who slept under an Insecticde Treated Net (ITN) the night before the survey. An ITN is (1) a permanent net that does not require any treatment, or (2) a pretreated net obtained within the last six months, or (3) a net that has been soaked with insecticide within the past six months. Equity in Bednet (ITN) Ownership Proportion of households in the lowest income quintile with an ITN / proportion of households in the highest income quintile with an ITN. Statistical Sources For Kazakhstan 2006 Kazakhstan MICS 2006 2006 Kazakhstan Multiple Indicator Survey, UNICEF BUCEN-IDB 2006 United States Census Bureau (BUCEN), International Programs Center. International Database. August 2006. BUCEN-IDB 2009 United States Census Bureau (BUCEN), International Programs Center. International Database. November 2009. BUCEN-IDB 2010 United States Census Bureau (BUCEN), International Programs Center. International Database. April 2010. CIA World Factbook 2010 CIA World Factbook 2010 https://www.cia.gov/library/publications/the-world-factbook/ index.html CIA World Factbook 2010 CIA World Factbook November 2010 https://www.cia.gov/library/publications/the-world- factbook/index.html DHS STATcompiler as of September 2008 2008 DHS STATcompiler as of September 2008 http://www.statcompiler.com Global Atlas 2010 WHO Global Health Atlas: http://apps.who.int/globalatlas/dataQuery/default.asp Human Development Report 2006 Human Development Report 2006. New York, United Nations Development Programme, 2006. Available at: http://hdr.undp.org/hdr2006/. Last accessed February, 2007. Human Development Report - 2007/2008 2008 Human Development Report 2007/2008. Fighting climate change: Human solidarity in a divided world. Published for the United Nations Development Programme (UNDP) Kazakhstan DHS 1995 National Institute of Nutrition [Kazakhstan] and Macro International Inc. 1996. "Kazakhstan Demographic and Health Survey, 1995." Calverton, Maryland: National Institute of Nutrition and Macro International Inc. Kazakhstan DHS 1999 Academy of Preventive Medicine (Kazakhstan) and Macro International Inc. 1999. Kazakhstan Demographic and Health Survey 1999. Calverton, Maryland: Academy of Preventive Medicine and Macro International Inc. UNAIDS 2008 2008 2008 Report on the Global AIDS Epidemic. Geneva: UNAIDS, 2008 UNESCO Global Monitoring Report 2010 EFA Global Monitoring Report April 2010 UNICEF 2010 UNICEF Global Database/Child Mortality WHO Global Health Atlas 2008 WHO Website: http://apps.who.int/globalatlas/dataQuery/default.asp WHO/Global Summary 2002 WHO Vaccine-Preventable Diseases Monitoring System. 2002 Global Summary. World Health Organization, Geneva. WHO/Global Summary 2008 Immunization surveillance, assessment and monitoring section of the WHO website: http://www.who.int/immunization_monitoring/en/globalsummary/timeseries/ tscoveragedtp3.htm WHO/Hill 2005 Maternal Mortality in 2005: Estimates developed by WHO, UNICEF, UNFPA and The World Bank WHO: Global Atlas 2009 WHO Global Health Atlas: http://apps.who.int/globalatlas/dataQuery/default.asp WHO: Global Summary 2009 WHO Global Summary Vaccine: http://www.who.int/immunization_monitoring/en/ globalsummary/timeseries/tscoveragemcv.htm World Bank/WDI 2005 World Bank Development Indicators 2005, CD-Rom. Washington, DC: The World Bank, 2005. World Bank/WDI 2006 World Bank Development Indicators 2006. Washington, DC: The World Bank, 2005. Available at: http://devdata.worldbank.org/wdi2006/contents/index2.htm. Last accessed April, 2007. World Bank/WDI Database 2007 World Bank Development Indicators Database 2007. Washington, DC: The World Bank, 2007. Available at: http://devdata.worldbank.org/data-query/. Last accessed April, 2007. aimglobalhealth.org DOLPHN - Report

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