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   
     
   

   
Progress towards
Achieving the MDGs in Egypt:
2014
The Social Contract Center
Mahmoud El Kholy
Director, SCC
Noha Abed
Deputy Director, SCC
Equitable Development
Observatory
Dr. Mai Gadallah
Unit Head
Enas Aly
Bassant Yousef
Hend Ibrahim
Nouran Shakra
Eman Refaat
Quality Control Unit
Nadia Abd El Azim
Unit Head
Communication Unit
Wesam Ghazi
Unit Head
Aya Noureldeen
Progress towards
Achieving the MDGs in Egypt:
 
  
  
     
By:
Bassant Yousef
Eman Refaat
1
Where poorest villages in Egypt stands from the MDGs?
Progress towards Achieving the MDGs in Egypt:
The Poorest Villages Compared to the National Level
By: Basant Yousif and Eman Refaat (Draft)
Set by the United Nations Development Program (UNDP) as human development goals to be achieved by 2015
and adopted by world leaders in 2000, the Millennium Development Goals (MDGs) provide a framework for
the entire international community to work together towards a common end, thereby making sure that human
development reaches everyone, everywhere. The MDGs also provide concrete, numerical benchmarks for
different dimensions of human development that, if achieved, would cut world poverty by half, save tens of
millions of lives, and billions more people will have the opportunity to benefit from global economy. The eight
MDGs are:
Goal 1: Eradicate extreme poverty and hunger
Goal 2: Achieve universal primary education
Goal 3: Promote gender equality and empower women
Goal 4: Reduce child mortality rates
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria, and other diseases
Goal 7: Ensure environmental sustainability
Goal 8: Develop a global partnership for development
These eight MDGs break down into 21 quantifiable targets that are measured by 60 indicators. Thus a
framework is provided for the entire UN system to work coherently towards a common end. The MDGs can be
achieved through sound national development policies, effective investment in key human development sectors
and international support. This is true even in the poorest countries and those recovering from conflict and
natural disasters.
Less than Two Years to the Deadline!!
April 5th, 2013 marked the 1000-day milestone until the 2015 target date to achieve the MDGs. All countries
will have to report on their progress towards achieving the MDGs. In Egypt it is important to measure the
progress on regular intervals to get a sense of what would be achieved by the target date and to take corrective
2
measures to improve the achievement rate. However, measuring the progress towards the MDGs provides a
picture of the achievement of human development indicators at the national level; i.e. using averages of data
representing the national level. This does not provide enough representation of the conditions of the most
vulnerable groups, who mostly exist in the countryside, hence does not sufficiently inform social development
policies at a time when Egypt is keen on progressing on the path of social justice.
This paper attempts to compare the situation of human development at the national level to the level of the
poorest 151 villages in Egypt, where 84% of citizens are poor, using the MDGs benchmarks with a view to
testing and highlighting evident inequalities between the two levels. The results of the paper, hence, points out
the legitimate need of the Egyptian government to continue its strategy of spatial targeting of poverty through
the continuation of the 1000 villages program.
This paper analyzes data from two surveys; these two surveys are conducted as part of the monitoring
and evaluation system with regard to the poorest 1000 village government initiative in Egypt1
. The first survey
includes 151 poor villages in the 1000 poorest villages in Egypt, it was conducted in the period between
November-December 2009, and the second survey is Maternal Child Health (MCH), it covered 109 villages of
the 151 villages of the first survey, it was conducted in January 2011. For national level, the data is from The
official United Nation Site for MDGs indicators2
.
1
The first phase of the initiative consists of choosing the poorest 151 village according to the poverty map definition (designed by the World Bank and the Egyptian
ministry of planning).
2
http://mdgs.un.org/unsd/mdg/Data.aspx.
3
Goal One: Eradicate Extreme Poverty and Hunger
This goal aims to reduce poverty by half according to three integrated targets. Further geographical targeting as
well as support for most vulnerable families are essential for achieving this goal. Target 1.A measures income
inequality, the proportion of poor people, and the amount of resources they need to move above the poverty
line. Target 1.B measures employment rates of population and the proportion of vulnerable families. Target 1.C
measures rates of population suffering from hunger and the nutritional status of children.
Target 1.A: Halve, between 1990 and 2015, the proportion of people whose income is less than $1.25 a day
1.1 Proportion of population below $1 (PPP) per day
1.2 Poverty gap ratio
1.3 Share of poorest quintile in national consumption
Target 1.B: Achieve full and productive employment and decent work for all, including women and young
people
1.4 Growth rate of GDP per person employed
1.5 Employment-to-population ratio
1.6 Proportion of employed people living below $1 (PPP) per day
1.7 Proportion of own-account and contributing family workers in total employment
Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
1.8 Prevalence of underweight children under-five years of age
1.9 Proportion of population below minimum level of dietary energy consumption
Target 1.A: Halve, between 1990 and 2015, the proportion of people whose income is less than
one dollar a day.
1.1 Proportion of population below $1 (PPP) per day
At the national level, according to the latest update which indicated the proportion of population below $1
(PPP) per day, there was a decrease from 4.5 % in 1991 to 1.7% in 20083
(under the thin red line which
indicates the target proportion). In the 151 poor villages4
, the proportion was 55%.
3Based on nominal per capita consumption averages and distributions estimated from household survey data.
4Household survey in the 151 poor villages “The 1000 poorest village initiative.”
4
0.6% 0.3% 0.3% 0.4% 0.4%
0%
1%
2%
3%
4%
5%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.2 Poverty gap ratio
1.2 Poverty gap ratio
At national level, the poverty gap ratio indicated the per capita amount of resources needed to eliminate
poverty through proper targeted cash transfers by different types of subsidies. Although the poverty gap
ratio decreased from 0.6% in 1991 to 0.3% in 1996, it increased to 0.4% in 2005 and it remained constant
until 20085
. On other hand, the poverty gap in the 151 poor villages in Egypt was 35% in 2009.
5
Based on nominal per capita consumption averages and distributions estimated from household survey data.
4.50%
2.50%
1.80%
2%
1.70%
0%
1%
2%
3%
4%
5%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.1 Proportion of population below $1 (PPP) per day
5
8.70% 9.50% 9.00% 9.00%
9.20%
Poorest villages
12%
0%
5%
10%
15%
20%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.3 Share of poorest quintile in national consumption
Inequality in the distribution of income is reflected in the percentage shares of national consumption of the
population ranked according to the consumption levels.
The share of poorest quintile in national consumption was 8.7% in 1991 and then it went up to 9.5% in
1996. Afterwards, it slightly went down to 9.2% in 2008. In the 151 poor villages, it was 12%.
Because of the high level of economic growth and the adoption of pro-poor policies, target one, which is
only limited to extreme poverty, has been achieved.
Target 1.B: Achieve full and productive employment and decent work for all, including women
and young people
1.4 Growth rate of GDP per person employed
In 1992 the growth rate of GDP per person employed was negative which led to a high inflation rate6
of about
19.7. But it became positive in 1995 and reached about 2.21, which did not last long; it went down to -1.19 in
2002 and remained negative7
.
6
http://data.worldbank.org/indicator/NY.GDP.DEFL.KD.ZG
7
Household or labor force survey
-1.50% -0.94%
-0.36%
2.21%
1.46%
0.74%
-1.19%
-0.74%
-1.02%
-5%
-3%
-1%
1%
3%
5%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
1.4 Growth rate of GDP per person employed
6
3.10%
1.70%
1.20% 1.30%
0%
1%
2%
3%
4%
5%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.6 Proportion of employed people living below $1 (PPP) per dayconsumption
42% 39% 46% 45%
46%
45% 42% 44% 45% 44% 41%
47% 44% 46%
64% 62% 70%
71% 72% 71% 72% 70% 72% 71% 68%
74% 70%
71%
20% 16% 21% 19% 19% 18% 12%
16% 17% 16%
15%
18%
17%
20%
Poorest villages
56%
0%
20%
40%
60%
80%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.5 Employment-to-population ratio
Total Men Women
1.5 Employment-to-population ratio
Employment-to-population ratio slightly fluctuated between 39% and 45.8% from 1990 to 2007. This ratio is
higher among men than women and it is even higher in the 151 poor villages in Egypt; 56%: 76% among men
and 36% among women.
1.6 Proportion of employed people living below $1 (PPP) per day
Globally, 456 million workers lived below the poverty line in 2011, each worker earning less than $1.25 a day.
At the national level, the proportion of employed people living below $1 per day was 3.1% in 1991 and then
went down to 1.3% in 2005.
7
14% 14%
13% 13% 12%
11% 12%
9%
10%
12%
14%
13% 13%
14%
10%
9% 9% 9%
10%
9%
8% 8%
8% 9% 9% 9% 9% 9%
33%
34%
30% 30% 23% 22%
26%
17%
20%
26%
32%
32%
33%
34%
0%
10%
20%
30%
40%
50%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.7 Proportion of own-account and contributing family workers in total employment
Total Men Women
10.5% 8.2% 10.8%10.2%
9.4%
8.7% 5.4%
6.8%
Poorest villages
14.10%
0%
10%
20%
30%
40%
50%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.8 Prevalence of underweight children under-five years of age
1.7 Proportion of own-account and contributing family workers in total employment
Globally, vulnerable employment —insecure, poorly paid jobs, more likely to be held by women and youth—
was estimated by49.1 per cent of the total employment in 2011, with a decrease from 54.4 per cent in 1991. At
the national level, it fluctuated from 9.3% to 14.2% during the period of 1993 – 2007; the proportion was very
high among women. These proportions are typical of a large section of the agricultural sector, which is
characterized by a low growth in the formal economy and a large rural economy. When there is a large number
of contributing family workers, there is likely to be poor development: little job growth and widespread poverty.
This target is not likely to be achieved by 2015 because of the challenges that face youth and
women in the Egyptian society. If this target is achieved, poverty will decrease.
Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
1.8 Prevalence of underweight children under-five years of age
About 850 million people, or nearly 15 percent of the global population, are estimated to be undernourished.
8
Despite some progress, nearly one in five children under the age of five in the developing world is underweight.
Children in rural areas are nearly twice as likely to be underweight as those in urban areas. At the national level,
it was 10.5% in 1991 and decreased over 17 years and became 6.8 % in 2008. But the prevalence in the 151
poor villages was higher by about 14.1%8
than the national percentage in 1990 because of poverty and
malnutrition.
1.9 Proportion of population below minimum level of dietary energy consumption
Globally, the proportion of population below minimum level of dietary consumption was 13 % in 2006/08.
This is due to the fact that more than 42 million people have been uprooted by conflict or persecution. At
the national level, it was 5 %; this proportion remained constant during 1990-2011 without any
improvement9
.
This target is possible to be achieved by 2015 if positive changes take place.
Summary of Goal 1:
According to the above figure, the percentage of employment to population ratio in the 151 poor villages is
higher than that at the national level because agricultural labor is highly demanded in villages. Yet, given
the very low payment of such labor and its irregular pattern, the poverty rate in the 151 villages is still
higher than the national level. Reducing the proportion of population below $1 (ppp) per day to half was
achieved at the national level, while in the 151 poor villages the same proportion is in deterioration, it was
55% in 2009. Therefore, there is a need for geographical targeting and for supporting poor families in order
to reduce the proportion. Also, transferring a higher degree of consumption to raise the poor above the
poverty line is needed in order to reduce the poverty gap in the 151 poor villages and achieve an acceptable
poverty gap.
8
Maternal Child Health survey.
9
Source: SOFI 2011.
5%
0%
10%
20%
30%
40%
50%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1.9 Proportion of population below minimum level of dietary energy consumption
9
10
92%
93%
94%
95%
96%
97% 97%
95%
98%
98%
96%
95% 96%
96%
97%
98%
99% 100%
97%
100% 100%
88%
90%
91%
93%
94%
96%
95%
93%
95%
96%
85%85%
90%
95%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
2.1 Net enrolment ratio in primary education
Total Boys Girls
Goal Two: Achieve Universal Primary Education
Education is a fundamental human right and essential for the practice of all other human rights. It promotes
individual freedom and empowerment and yields important development benefits. Reducing dropout and
gender gap in primary education are the main tasks which were adopted by the different and consecutive
governments since 1990.
Target 2.A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to
complete a full course of primary schooling
2.1 Net enrolment ratio in primary education
2.2 Proportion of pupils starting grade 1 who reach last grade of primary
2.3 Literacy rate of 15-24 year-old, women and men
2.1 Net enrolment ratio in primary education
Globally, enrolment in primary education in developing regions reached 90 per cent in 2010, which went up
from 82 per cent in 1999.This means that more kids than ever are attending primary school.
In 2010, 61 million children of primary school age were out of school. More than half of them (33 million) were
in sub-Saharan Africa. At the national level in Egypt, the situation improved as the net enrolment ratio in
The poorest villages'
level
11
96%
94%
93%
92%
93%
95%
97%
93%
96%
99%
101%
100%
98%
96%
93%
95%
97%
101%
94%
98%
100%
91%
91% 90%
91% 91%
93%
92% 90%
93%
97%
85%
90%
95%
100%
105%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
2.2 Proportion of pupils starting grade 1 who reach last grade of primary
Total Boys Girls
85% 85%
88%
90% 88% 91%
79% 82%
84%
Poorest villages
80%
50%
60%
70%
80%
90%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
2.3 Literacy rate of 15-24 year-old, women and men
Total Men Women
primary education increased during 2000-2010 and the gender gap narrowed down. Net enrolment ratio in
primary education is expected to increase by 2015. This ratio in the 151 poor villages was lower than that in
total Egypt in 1990, which means that more targeting is needed to increase the percentage.
2.2 Proportion of pupils starting grade 1 who reach last grade of primary
Globally, the proportion of pupils starting grade 1 who reach final grade of primary education was 90.2% in
2012 which means that more effort is necessary to enroll about 61 million who remain out of school. At the
national level, the cohort of pupils enrolled in grade 1 of the primary level of education in a given school
year who are expected to reach grade 5 fluctuated from 92.1% to 101% in the period of 1999-2010. But, this
percentage increased during the period 2009-2010. There is a narrow gender gap and the female proportion
could reach 100% by 2015.
2.3 Literacy rate of 15-24 year-old, women and men
12
Gender gaps in youth literacy rates are also narrowing. Globally, there were 95 literate young women for
every 100 young men in 2010, compared with 90 women in 1990. At the national level, the number of adult
people (15-24 years old) who can read and write is higher among males and was reflected in the literacy rate
of both sexes. In the 151 poor villages the literacy rate was 80.3% and is higher among males than females
by 13%.
Summary of Goal 2:
According to the above figure, the net enrolment ration in primary education in the poorest 151 villages is a
bit lower than the national average (85% compared to 98%). This shows that previous government efforts to
ensure access to primary had an equitable coverage. Also, literacy rate of (15-24) years-old in the poor
villages is close to the national rate; it is 80.3% and 87.5% respectively. Moreover, the gender gap in 151
poor villages is little higher than national gender gap. Thus, there is no huge difference between the national
level and poor villages' level.
This goal is likely to be achieved by 2015 if Egypt succeeds in reducing dropout rates and eliminating
class density especially in poor villages.
13
14
83%
91%
92%
93%
94%
95% 96%
94% 94%
95%
96%
96%
Poorest villages
91.83%
50%
60%
70%
80%
90%
100%
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
3.1 Ratios of girls to boys in primary education
Goal Three: Promote Gender Equality and Empower Women
The Egyptian governments during 1990-2012 were achieving a great progress in the
elimination of gender gap. At the educational level, gender gaps are very likely to be realized
before 2015. But the share of women in wage employment in non-agricultural sector is very low
and needs more targeting to reduce the gap. Finally, the proportion of seats held by women in
parliament is still less than 50% and is not expected to be achieved by 2015.
Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005,
and in all levels of education no later than 2015
3.1 Ratios of girls to boys in primary, secondary and tertiary education
3.2 Share of women in wage employment in the non-agricultural sector
3.3 Proportion of seats held by women in national parliament
Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005,
and in all levels of education no later than 2015
3.1 Ratios of girls to boys in primary, secondary and tertiary education
Globally, the ratio of girls to boys in primary education was 97% in 2010, in secondary education was 97%
and in tertiary education was 108%. At the national level, gender gap in primary education is narrow and
can be eliminated by 2015. But in the 151 poor villages, the gender gap is somewhat wide although basic
education is mandatory by law for both sexes.
15
59%
77%
91%
Poorest villages
61.24%
50%
60%
70%
80%
90%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
3.1 Ratios of girls to boys in tertiary education
79%
91%
92%
93%
93%
94%
96% 96%
Poorest villages
74.25%
50%
60%
70%
80%
90%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
3.1 Ratios of girls to boys in secondary education
In secondary education, all over Egypt, the gender gap is almost eliminated. But in the 151 poor villages, the
gap still exists and is about 25.75 %, meaning that the trend is that more boys go to secondary education
than girls. This can point out to important social phenomena such as early marriage for girls.
Tertiary education increased during 1991-2010 and the gender gap was significantly decreased around 10%.
But in the 151 poor villages, the gender gap in this type of education is much wide than the national
average, about 38.76%.
16
21%
19%
18%
19%
19%
19%
19%
20%
21%
19%
21%
22%
20%
19%
18%
18%
19% 18%18%
Poorest villages
13.70%0%
20%
40%
60%
80%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
3.2 Share of women in wage employment in the non-agricultural sector
3.2 Share of women in wage employment in the non-agricultural sector
Globally, the share of women in wage employment in the non-agricultural sector was 39.6 in 2010. At the
national level, the share of women in wage employment in the non-agricultural sector expressed as a percentage
of total employment in the sector slightly fluctuated during 1991-2009 but was still low. The non-agricultural
sector includes industry and services. In the 151 poor villages, the situation was not different from the rest of
Egypt, which was so low, about 13.7%. This percentage is not expected to be achieved by 2015.
3.3 Proportion of seats held by women in national parliament
Globally, the proportion of seats occupied by women was 19.7%. At the national level, during 1990-2012
women representation in the national parliament didn't exceed more than 12 female members. In 2010, the
3.9%
2.0%
2.0%
2.0%
2.0% 2.4%
2.4%
2.4%
2.9%
2.0%
2.0% 1.8%1.8%
1.8%
12.7%
2.0%
0%
5%
10%
15%
20%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
3.3 Proportion of seats held by women in national parliament
17
female ratio increased to 12.7%, but this ratio lasted for not more than a month when the January 25th
Revolution broke out. This proportion is not expected to increase by 2015.
Summary of Goal 3:
According to figure 3 there is a considerable gap between the national level and the 151 poor villages with
respect to secondary and tertiary education as a result of the high dropout rates in these levels of education
and early marriage in rural areas, particularly poorest villages. This means that the development programs
targeting the 151 poorest villages should only continue, but also include gender promotion programs.
Furthermore, the share of women in wage employment and in parliamentary elections is low across Egypt
and the poorest villages are no exception. However, the activation of the economic and political role of
women still needs special attention in the poorest villages as the geographic scope of programs in such
fields usually target urban areas.
18
80.8
76.0
71.2
66.8
62.4
58.5
54.6
51.0
47.6
44.4
41.5
38.7
36.3
33.9
31.6
29.5
27.6
25.8
24.1
22.5
21.1
Poorest villages
36.6
0
20
40
60
80
100
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
4.1 Under-five mortality rate (per 1000 live births)
Goal Four: Reduce Child Mortality
Since 1990, Egypt adopted social protection of children in its policy agenda. More geographical and
socioeconomic targeting is needed to continue progress at all levels. The under-five mortality rate was achieved
in 2008 when it was reduced by two- thirds. There is a remarkable increase in measles coverage.
Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
4.1 Under-five mortality rate
4.2 Infant mortality rate
4.3 Proportion of 1 year-old children immunized against measles
Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
4.1 Under-five mortality rate
Globally there is about 57 deaths per 1000 live births. At the national level, over the past 20 years, Egypt has
made significant progress concerning the under-five-year child mortality rate, reduced by 70% between 1990
and 2008. The rate at the poorest villages was higher than the Egyptian national rate which was about 36.6 per
1000 live births; this rate is acceptable comparable to the global average.
4.2 Infant mortality rate
19
59.7
56.7
53.6
50.8
47.9
45.3
42.7
40.2
37.8 35.6
33.5
31.5
29.7
28.0
26.2
24.6
23.2
21.8 20.4
19.1
18.0
Poorest villages
28.1
0
20
40
60
80
100
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
4.2 Infant mortality rate (per 1000 live births)
89%
89%
89%
89%
89%
92%
92%
98%
96% 98%
97%
97%
98%
97%
98%
98% 97%
92%
95%
96%
Poorest villages
50.30%
0%
20%
40%
60%
80%
100%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
4.3 Proportion of 1 year-old children immunized against measles
Globally, there are about 44 deaths of children under 12 months per 1000 live births. At the national level,
currently 9 out of 10 deaths of children under the age of 5 take place before the child's first birthday, and
about one half of these deaths occur during the first month of the infant’s life. Egypt achieved a great
progress in reducing the number of infant mortality. The 151 poor villages also achieved a great progress
(about 28.1 per 1000 live births) although most of these poor villages are in rural Upper Egypt.
4.3 Proportion of 1 year-old children immunized against measles
Globally, the percentage of children under one year of age who have received at least one dose of measles
vaccine is about 85%. At the national level, the situation improved during 1998-2007 and since 2008, it has
been decreasing. The indicator provides a measure of the coverage and the quality of the child health-care
system in the country. Immunization is an essential component for reducing under-five mortality rate. In the
151 poor villages the proportion was very low, about 50.30%.
20
Summary of Goal 4:
According to figure 4, the situation of mortality rates of children under five and infant in the 151 poor villages
is in the same range of the national situation, but the proportion of 1 year old children immunized against
measles is very low in the 151 poor villages, which indicates that more targeting of poor areas of this service is
needed.
Egypt has achieved a great progress in reducing child mortality rates, but still needs to take certain
geographical areas into consideration such as the 151 poorest villages.
21
Goal Five: Improve Maternal Health
Maternal health goes beyond the survival of pregnant women and mothers, since it is globally established that
for every woman who dies from causes related to pregnancy or childbirth, it is estimated that there are 20 others
who suffer from pregnancy-related illnesses or experience other severe consequences that would require
intensive attention to reproductive health including family planning. Progress on MDG 5 is influenced by the
national efforts to reduce child mortality, achieve vaccination coverage, and implement integrated management
of child health and disease initiative. Improving maternal health, reducing maternal mortality and increasing
accessibility to reproductive care have been key concerns of several national health strategies and interventions.
This goal includes two targets and six indicators, as follows:
Target 5.A: Reduce the maternal mortality ratio by three quarters between 1990 and 2015
5.1 Maternal mortality ratio
5.2 Proportion of births attended by skilled health personnel
Target 5.B: Achieve universal access to reproductive health by 2015
5.3 Contraceptive prevalence rate
5.4 Adolescent birth rate
5.5 Antenatal care coverage (at least one visit and at least four visits)
5.6 Unmet need for family planning
5.1 Maternal mortality ratio
Worldwide, maternal mortality has nearly halved since 1990. An estimated 287,000 maternal deaths occurred
in 2010 worldwide, which indicates a decline of 47 per cent from the rate estimated since 1990. However, this
level is still far from that which is intended to be achieved in 2015. In Egypt, the trend of maternal mortality
ratio from 1990 until 2010 (most updated) shows that Egypt is very close to the 2015 target as it decreased from
230 in 1990 to 66 in 2010, which is estimated by a decrease of nearly 71% as shown in figure 5.1.
22
5.2 Proportion of births attended by skilled health personnel
In Egypt, progress has been made in increasing the proportion of births attended by skilled health personnel as
this proportion has more than doubled from 1990 (36.5%) until 2008 (79%).
The progress achieved at the national level has not been attained at the poorest level for the latter is still lagging
behind the 1990 proportions; only 12.3% of births at the poorest level are attended by skilled health personnel,
which reveal a big gap in the poorest villages compared to the national average.
5.3 Contraceptive prevalence rate
In Egypt, contraceptive prevalence rate has increased from 47.6% in 1990 to 60.3% in 2008. However, there has
not been a high increase especially since 2003. Even if the gap between the national level and poorest villages is
not very wide, the poorest are still lagging behind the 1998 national rates.
230
150
100
78
66
0
50
100
150
200
250
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Figure 5.1: Maternal mortality ratio per 100,000 live births - Across years
36.5
40.7
46.3
56.4 55.2
60.9
69.4
74.2
78.9
Poorest villages
12.3
0
20
40
60
80
100
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Figure 5.2: Proportion of births attended by skilled health personnel
23
5.4 Adolescent birth rate
Worldwide, levels of adolescent birth rate range from less than 2 to approximately 230 births per 1000
adolescent women (15-19) years-old. The rate of 50 or more per 1000 women is considered high and the rate of
10 or less per 1000 women is regarded as low. Fewer teens are having children in most developing regions, but
progress has slowed.
In Egypt, adolescent birth rate has decreased since 1990 to 49.5 which is not high if compared with other
developing countries, but may be regarded a high rate according to UN targets. The poorest villages are even
below the 1990 national level since 133 per 1000 teen women are having children.
47.6 47.1 47.9
51.7
56.1
60 59.2 60.3
Poorest villages
51.3
0
20
40
60
80
100
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 5.3: Contraceptive prevalence rate
68.8 66.9
53.4 48 49.5
Poorest villages
133
0
30
60
90
120
150
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 5.4: Adolescent birth rate per 1000 women
24
5.5 Antenatal care coverage (at least one visit and at least four visits)
Worldwide, more pregnant women are receiving care with the recommended frequency, but gaps still exist in
regions most in need. In Egypt, trends reveal a general increase in the antenatal care coverage (of at least one
visit) since 1990, which reached 73.6%. The poorest villages are lagging behind more than 10 years behind the
national levels.
For the at-least-four-visits indicator, the increase has tripled since 1990 and reached 66% in 2008 and the
poorest villages are still lagging behind the national rates before 2003.
52.1 52.9
39.1
52
47.2
52.9
68.7 69.6
73.6
Poorest villages
56.5
0
20
40
60
80
100
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 5.5 : Antenatal care coverage (at least one visit)
22.5
28.3 31.8 33.1 36.7
55.6 58.5
66
Poorest villages
44.8
0
20
40
60
80
100
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 5.5 : Antenatal care coverage (at least four visits)
25
5.6 Unmet need for family planning
Worldwide, the unmet need for family planning remains persistently high in regions with low levels of
contraceptive use. However, in the poorest villages in Egypt there are around 12.9% unmet needs for family
planning, also at the national level the percentage is promising to some extent (11.6%).
Summary of Goal 5:
In Egypt, the situation at the national level shows a big progress according to the most recent values of the
different indicators of Goal 5, which reveals that the majority of indicators will reach the target of 2015.
However, when comparing this national situation to the situation of the poorest villages in Egypt, it was found
that a wide gap at all indicators reached 67% in the births attended by skilled health personnel (79% percent at
the national level compared to 12% in the poorest villages). Also the unmet needs for family planning in the
poorest villages are 12.9% compared to 11.9% at the national level. Even when considering antenatal care
coverage and contraceptive prevalence rates that look closer than other indicators, there is still a considerable
gap between the national level and the poorest villages' level. The poorest villages are lagging years behind the
national level in improving maternal health. The concentration of maternal health government programs at the
poorest villages is essential.
22.9 20.2
14.5 13.7 11.8 12.3 11.6
0
20
40
60
80
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 5.6: Unmet need for family planning
26
27
Goal Six: Combat HIV/AIDS, Malaria and Other Diseases
Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS
6.1 HIV prevalence among population aged 15-24 years
6.2 Condom use at last high-risk sex
6.3 Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS
6.4 Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years
Target 6.B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
6.5 Proportion of population with advanced HIV infection with access to antiretroviral drugs
Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
6.6 Incidence and death rates associated with malaria
6.7 Proportion of children under 5 sleeping under insecticide-treated bed nets
6.8 Proportion of children under 5 with fever who are treated with appropriate anti-malarial drugs
6.9 Incidence, prevalence and death rates associated with tuberculosis
6.10 Proportion of tuberculosis cases detected and cured under directly observed treatment short course
Human Immunodeficiency Virus (HIV) is a virus that weakens the immune system, ultimately leading to
Acquired Immuno Deficiency Syndrome (AIDS). HIV destroys the body’s ability to fight off infection and
disease, which can ultimately lead to death. Without treatment, median survival from the time of infection is
about 10.5 years for males and 11.5 years for females. Malaria is an infectious disease caused by the parasite
Plasmodium and transmitted via the bites of infected mosquitoes. Malaria is serious in its own right, but also
increases the risk of death from other conditions. In addition, malaria imposes an economic burden on families,
particularly those who are least able to pay for prevention and treatment and most affected by loss of income
due to the disease. The disease represents a financial burden to malaria-endemic countries that must use scarce
resources to provide bed nets, insecticides and drugs in an effort to control the disease. Tuberculosis is an
infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs.
Detecting tuberculosis and curing it are key interventions for addressing poverty and inequality. Prevalence and
deaths are more sensitive markers of the changing burden of tuberculosis than incidence (new cases), but data
on incidence are more comprehensive and give the best overview of the impact of global tuberculosis control.
28
Worldwide, new HIV infections continue to decline in the hardest-hit regions. Comprehensive knowledge of
HIV transmission remains low among young people, along with condom use. At the end of 2011, 8 million
people were receiving antiretroviral therapy for HIV or AIDS in developing regions. This total constitutes an
increase of over 1.4 million people from December 2009, and the largest one-year increase ever. The global
estimated incidence of malaria has decreased by 17 per cent since 2000, and malaria-specific mortality rates by
25 per cent. Countries with improved access to malaria control interventions witnessed child mortality rates fall
by about 20 per cent. Thanks to increased funding, more children are sleeping under insecticide-treated bed nets
in sub-Saharan Africa. The anti-tuberculosis drive is closing in on a 50 per cent cut in the 1990 death rate and
more TB patients are being successfully treated.
6.2 Condom use at last high-risk sex
Worldwide, condom use remains low among young women in most countries. The limited condom use may be
linked with restrictions on availability. In Egypt, the same situation exists, where according to the most recent
data, the percentage of condom use at last high-risk sex is 1.2%. Data is not available for the poorest villages.
6.3 Proportion of population aged 15-24 years with comprehensive correct
knowledge of HIV/AIDS
Worldwide, comprehensive knowledge of HIV transmission remains low among young people. Such
knowledge remains low in sub-Saharan Africa (26 per cent among young women and 35 per cent among young
men, aged 15-24). In Egypt, the situation is worse as this percentage is 18% among men and 5% among women
according to the 2008 data. Data is not available for the poorest villages.
4.4 4.2
2.9
2.1 1.8 1.5 1.7 1.2
0
5
10
15
20
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 6.2: Condom use at last high-risk sex
29
6.5 Proportion of population with advanced HIV infection with access to
antiretroviral drugs
Worldwide, at the end of 2011, 8 million people were receiving antiretroviral therapy for HIV or AIDS in
developing regions. This total constitutes an increase of over 1.4 million people since December 2009, and the
largest one-year increase ever. In Egypt, data of 2010 shows that this proportion is 10% only which is very low
compared to world progress. Data is not available for the poorest villages.
6.6 Incidence and death rates associated with malaria
The global estimated incidence of malaria has decreased by 17 per cent since 2000, and malaria-specific
mortality rates by 25 per cent. Egypt might be in the path of imported cases. As the country is geographically
located close to malaria endemic areas, exogenous cases are still reported. Between 1998 and 2009, 442
imported malaria cases occurred, the majority (93.0%) imported either through the southern border with Sudan
or Egyptians returning from malaria endemic countries (Ministry of Health, 2010). But in general Egypt has
succeeded in rolling back malaria.
6.9 Incidence, prevalence and death rates associated with tuberculosis
Globally, incidence rates associated with tuberculosis peaked at 141 per 100,000 people in 2002 and have been
falling since then. Mortality and prevalence rates of tuberculosis are falling in most regions. It is estimated that
there were 1.4 million deaths from tuberculosis in 2010, including 350,000 people with HIV. In Egypt, great
progress has been made to the incidence rates, where the rates decreased in 2010 to 28 per 100000 of the
population compared to 79 in 1990; the poorest villages have better rate of 15 per 100000 of the population.
79 74 72 70 67
59
48
44 42 42 41 40 38 35 33 32 32 32 31 30 28
Poorest villages
15
0
20
40
60
80
100
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 6.9: Incidence rates associated with tuberculosis per 100000 of the population
30
Prevalence rates associated with tuberculosis also lowered to 0.8 per 100000 of the population while for the
poorest villages this rate is 5.
Death rates almost halved since 1990: death rates associated with tuberculosis per 100000 of the population
were 34 and decreased to 18 in 2010.
6.10 Proportion of tuberculosis cases detected and cured under directly observed
treatment short course
Worldwide, more tuberculosis patients are being successfully treated. This is also the case in Egypt, where more
tuberculosis patients are being successfully treated: the proportion is 88% at the 2010 levels. The poorest
villages are lagging behind years compared to the national level since 35% only of tuberculosis cases are
detected and cured under DOTS.
4.1 3.7 3.6 3.5 3.3 2.7
1.9 1.7 1.6 1.6 1.7 1.6 1.6 1.7 1.4 1.4 1.2 1.2 1.2 1 0.8
Poorest villages
5
0
5
10
15
20
1990199119921993 1994 1995 1996 19971998199920002001 2002 2003 20042005 2006 2007 2008 20092010 2011 2012
Figure 6.9: Prevalence rates associated with tuberculosis per 100000 of the population
34 34 34 33 32 32 30 29 28 27 26 25 24 23 22 21 20 20 19 19 18
0
10
20
30
40
50
60
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 6.9: Death rates associated with tuberculosis per 100000 of the
population
31
In conclusion, Egypt is generally progressing well towards achieving goal six of the MDGs. Egypt is considered
of low HIV epidemic prevalence compared to the global average, has rolled back Malaria except for imported
cases, and has reduced the cases of tuberculosis. The data for the poorest villages on most of these indicators is
lacking, but the above diagram demonstrates a comparison with the national averages concerning tuberculosis.
Luckily enough, there are less rates of incidences associated with tuberculosis at the poorest 151 villages
compared to the national rate (15% compared to 28%). However, the rate of cases that are identified and cured
at the poorest villages is much less than the national average (35% compared to 88%). This points out to the
lack of proper diagnostic health services that are at reach to the poorest villages. This conclusion is expected to
be confirmed if data for the other indicators of the goal were available.
Summary of Goal 6:
In Egypt, it is very difficult from the available information to assess the HIV epidemic status in the country or
the speed of the HIV epidemic growth. No population based surveys have been conducted and thus at present
there is no precise estimate of the HIV prevalence in Egypt. In the past years, Egypt has been considered in the
first stage of “low HIV epidemic” of prevalence <1.0 % in the general population and did not exceed 5 % in any
11
18
45
17 20
57
64
75
70 67
62 61
66
70 72 73
65 65 63 65 64
0
20
40
60
80
100
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Figure 6.10: Proportion of tuberculosis
cases detected under DOTS,(midpoint)
52
62
51
78
83 85 87
82
88
80
70
79
87 89 89 88
Poorest
villages
35
0
20
40
60
80
100
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Figure 6.10: Proportion of tuberculosis cases
detected and cured under DOTS
32
of the high risk groups. In 2007, the HIV prevalence in adults aged 15 years or above is estimated as 18 per
100,000 (World Health Organization, 2009).
Between 1998 and 2009, Egypt has succeeded in rolling back malaria; 442 imported malaria cases occurred in
the country, the majority (93.0%) are plasmodium falciparum imported either through the southern border with
Sudan or Egyptians returning from malaria endemic countries (Ministry of Health, 2010).
Egypt has achieved the global targets in case detection and treatment success and is ranked as a country with
intermediate incidence of Tuberculosis. Egypt is classified as one of the 36 worldwide countries having
achieved the global targets in both case detection and treatment success under DOTS (World Health
Organization, 2009). Incidence rate is 28% and the proportion of tuberculosis cases detected and cured under
DOTS is 18% in 2010. Surprisingly, the poorest villages show better performance with regard to tuberculosis
than the national level.
33
Goal Seven: Ensure Environmental Sustainability
Target 7.A: Integrate the principles of sustainable development into country policies and programmes
and reverse the loss of environmental resources
7.1 Proportion of land area covered by forest
7.2 CO2 emissions, total, per capita and per $1 GDP (PPP)
7.3 Consumption of ozone-depleting substances
Target 7.B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss
7.4 Proportion of fish stocks within safe biological limits
7.5 Proportion of total water resources used
7.6 Proportion of terrestrial and marine areas protected
7.7 Proportion of species threatened with extinction
Target 7.C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water
and basic sanitation
7.8 Proportion of population using an improved drinking water source
7.9 Proportion of population using an improved sanitation facility
Target 7.D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum
dwellers
7.10 Proportion of urban population living in slums
The natural resources base and ecosystems must be managed sustainably to meet people’s food requirements
and other environmental, social and economic needs. Climate change, increased water scarcity and conflicts
over access to resources all pose challenges to environmental sustainability and food security. In addition,
hunger and poverty often compel the poor to over-exploit the resources on which their own livelihoods depend.
MDG 7 aims to ensure environmental sustainability.
Worldwide, forest area increase in Asia is helping to slow global losses. Of all developing regions, South
America and Africa saw the largest net losses of forest areas between 2000 and 2010. In the 25 years since the
adoption of the Montreal Protocol on Substances that Deplete the Ozone Layer, there has been a reduction of
over 98 per cent in the consumption of ozone-depleting substances. Since 1990, protected areas have increased
34
in number by 58 percent. Growth in protected areas varies across countries and territories. The world has met
the target of halving the proportion of people without access to improved sources of water. Between 1990 and
2010, more than two billion people gained access to improved drinking water sources. Eleven per cent of the
global population—783 million people—remains without access to an improved source of drinking water and,
at the current pace, 605 million people will still lack coverage in 2015. Access to improved sanitation facilities
increased from 36 per cent in 1990 to 56 per cent in 2010 in the developing regions as a whole. The share of
urban slum residents in the developing world declined from 39 per cent in 2000 to 33 per cent in 2012.
7.1 Proportion of land area covered by forest
Worldwide, South America and Africa saw the largest net losses of forest areas between 2000 and 2010.
Oceania also reported a net loss, largely due to severe drought and forest fires in Australia. In Egypt, natural
forests are not one of the natural environmental resources characterizing the country. But a program for the safe
use of treated wastewater is implemented in order to plant 400 thousand feddan forests by using 2.4 billion m3
of treated wastewater. However, the rate of progress is still very slow.
7.2 CO2 emissions, total, per capita and per $1 GDP (PPP)
This indicator is defined as the total carbon dioxide (CO2) emissions from energy, industrial processes,
agriculture and waste (minus CO2 removal by sinks), presented as total emissions, emissions per unit
population of a country, and emissions per unit value of a country’s gross domestic product (GDP) , expressed
in terms of purchasing power parity (PPP).
Worldwide, carbon dioxide (CO2) emissions decreased globally—by 0.4 per cent, down from about 30.2 billion
metric tons in 2008 to some 30.1 billion metric tons in 2009. From 1990 through 2008, emissions increased
0 0.1 0.1 0.1
0
10
20
30
40
50
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.1: Proportion of land area covered by forest
35
almost annually, particularly since 2002. But even with the unprecedented dip, 2009 emissions were still 39 per
cent above the 1990 level.
In Egypt, the total CO2 emissions (thousand metric tons of CO2 (CDIAC))are highly increasing from 1990 until
2009 which indicates a high decrease in air quality.
For the per capita CO2 emissions, there is also an increase from 1.34 in 1990 to 2.71 in 2009.
Emissions per unit of economic output were higher in the developing regions 0.6 kilograms of CO2 per dollar
of economic output (GDP), versus 0.37 kilograms in the developed regions. Egypt is closer to the situation of
developed regions as the value in 2010 reached 0.
75944
78716
81264
93156
85313
95723
102031
108202
122243
125393
141326
125452
127194
158880
160582
174641
187505
199221
210321
216137
0
50000
100000
150000
200000
250000
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.2: CO2 emissions, total
1.34 1.36 1.38 1.55 1.4 1.54 1.62 1.69 1.87 1.89 2.09 1.82 1.81 2.22 2.2 2.35 2.48 2.59 2.69 2.71
0
5
10
15
20
25
30
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.2: CO2 emissions, per capita
36
7.3 Consumption of ozone-depleting substances
Worldwide, a reduction of over 98 percent in the consumption of ozone-depleting substances has been
achieved. Egypt is a party of the Montreal Protocol on Ozone Protection and has developed a national strategy.
Consumption of ozone depleting CFC has decreased gradually during the period from 1994 to 2010
reaching706 tons.
7.5 Proportion of total water resources used
In Egypt, most recent data for this indicator is in 2000 and the proportion is 113.8. This situation reflects the
problem of water scarcity and the need to provide water sources to all sectors to meet the increasing demand
fostered by national development plans.
0.38 0.38 0.42 0.37 0.4 0.41 0.41 0.44 0.43 0.46 0.39 0.39 0.47 0.46 0.48 0.48 0.47 0.47 0.46 0.12 0
0
5
10
15
20
25
30
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.2: CO2 emissions, per $1 GDP (PPP)
4,476
3,983
6,276
6,600
2,737
2,881
2,945
2,785
2,816
2,750
2,746
2,704
1,944
1,663
1,644
1,349
1,092
861
726
790
706
0
1000
2000
3000
4000
5000
6000
7000
8000
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.3: Consumption of ozone-depleting substances
37
7.6 Proportion of terrestrial and marine areas protected
Worldwide, more areas of the earth’s surface are being protected: since 1990, protected areas have increased in
number by 58 percent. In Egypt, the percentage is very low (6.1%) and there is no change made in this
percentage since 2003.
7.8 Proportion of population using an improved drinking water source
Worldwide, the proportion of people using an improved water source raised from 76 per cent in 1990 to 89 per
cent in 2010. In Egypt, this indicator covers almost all the country for 99% of Egyptians are using an improved
drinking water source. The poorest villages have lower percentage (84%) than the national level.
2.1
2.1 2.2 2.2 2.2 2.2
4.0
4.0
4.4
4.4
4.4
4.4
5.4
6.1
6.1
6.1
6.1
6.1
6.1
6.1
6.1
0
5
10
15
20
25
30
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.6: Proportion of terrestrial and marine areas protected
93 94 94 94 94 94 95 95 96 96 96 96 97 97 97 98 98 98 99
99
99
Poorest villages
84
0
20
40
60
80
100
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Figure 7.8: Proportion of population using an improved drinking water source
38
7.9 Proportion of population using an improved sanitation facility
Worldwide, access to improved sanitation facilities increased from 36%in 1990 to 56% in 2010 in the
developing regions as a whole. In Egypt, the situation is even better than the global situation since 95% of
Egyptians are using improved sanitation facilities. The poorest villages are not only lagging behind years than
the national level, they have almost no access to an improved sanitation facility.
7.10 Proportion of urban population living in slums
The share of urban slum residents in the developing world declined from 39% in 2000 to 33% in 2012. The
situation in Egypt is better as the proportion of urban population living in slums declined from 50.2% in 1990 to
13.1% in 2009.
50.2
39.2
28.1
17.1 14.4
13.1
0
10
20
30
40
50
60
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.10: Proportion of urban population living in slums
72 73 74 75 77 79 80 81 83 84 86 87 89 90 91 93 94 95 95 95 95
Poorest villages
2
0
20
40
60
80
100
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 7.9: Proportion of population using an improved sanitation facility
39
Summary of Goal 7:
Progress has been achieved in Egypt in the areas of expanding forests, thereby rationalizing the management
and utilization of natural resources, increasing the proportion of those using improved drinking water sources
and sanitation, and reducing the number of those living in slum areas. Despite the progress made in accessing
improved drinking water source and sanitation facility, the poorest villages are suffering from lack of improved
sanitation facility. Only 2% of the poorest villages have an access to improved sanitation facility compared to
95% at the national level. This points out to the need to continue with the national efforts to provide improved
drinking water source and to concentrate efforts on providing improved sanitation facilities, which are almost
lacking in rural areas.
40
Goal Eight: Develop a Global Partnership for Development
Target 8.A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial
system
Includes a commitment to good governance, development and poverty reduction – both nationally and
internationally
Target 8.B: Address the special needs of the least developed countries
Includes: tariff and quota free access for the least developed countries' exports; enhanced programme of debt
relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt; and more generous
ODA for countries committed to poverty reduction
Target 8.C: Address the special needs of landlocked developing countries and small-island developing
states (through the Program of Action for the Sustainable Development of Small Island
Developing States and the outcome of the twenty-second special session of the General
Assembly)
Target 8.D: Deal comprehensively with the debt problems of developing countries through national and
international measures in order to make debt sustainable in the long term
Official Development Assistance (ODA)
8.1 Net ODA, total and to the least developed countries, as percentage of OECD/DAC donors’
gross national income
8.2 Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social
services (basic education, primary health care, nutrition, safe water and sanitation)
8.3 Proportion of bilateral official development assistance of OECD/DAC donors that is untied
8.4 ODA received in landlocked developing countries as a proportion of their gross national
incomes
8.5 ODA received in small island developing States as a proportion of their gross national
incomes
41
Market access
8.6 Proportion of total developed country imports (by value and excluding arms) from
developing countries and least developed countries, admitted free of duty
8.7 Average tariffs imposed by developed countries on agricultural products and textiles and
clothing from developing countries
8.8 Agricultural support estimate for OECD countries as a percentage of their gross domestic
product
8.9 Proportion of ODA provided to help build trade capacity
Debt sustainability
8.10 Total number of countries that have reached their HIPC decision points and number that
have reached their HIPC completion points (cumulative)
8.11 Debt relief committed under HIPC and MDRI Initiatives
8.12 Debt service as a percentage of exports of goods and services
Target 8.E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs
in developing countries
8.13 Proportion of population with access to affordable essential drugs on a sustainable basis
Target 8.F: In cooperation with the private sector, make available the benefits of new technologies,
especially information and communications
8.14 Telephone lines per 100 population
8.15 Cellular subscribers per 100 population
8.16 Internet users per 100 population
Goal 8 - global partnership for development - is about the means to achieve the first seven MDGs. Many
environmental global problems: climate change, loss of species diversity, and depletion of global fisheries can
only be solved through partnerships between rich and poor countries. The objective of MDG 8 is to assist all
developing countries in achieving the goals through a strengthened global partnership for international
development cooperation, including providing development assistance, improved access to markets and debt
relief.
Worldwide, tariffs imposed by developed countries on products from developing countries have remained
largely unchanged since 2004, except for agricultural products. Bilateral aid to sub-Saharan Africa fell by
42
almost 1 percent in 2011.There has been some success of debt relief initiatives reducing the external debt of
heavily indebted poor countries but 20 developing countries remain at high risk of debt distress. During this
time, developing countries were influenced by the 2009 economic downtown and in 2011 the debt to GDP ratio
decreased for many developing countries. Vulnerabilities remain. Expected slower growth in 2012 and 2013
may weaken debt ratios. Resources available for providing essential medicines through some disease-specific
global health funds increased in 2011, despite the global economic downturn. There has been little improvement
in recent years in attaining the availability and affordability of essential medicines in developing countries.74
per cent of inhabitants of developed countries are internet users, compared with only 26 per cent of inhabitants
in developing countries. The number of mobile cellular subscriptions worldwide by the end of 2011 reached 6
billion.
8.12 Debt service as a percentage of exports of goods and services
In Egypt, there is a noticeable decrease in the debt service as a percentage of exports of goods and services. The
percentage decreased in 2010 to 5.7 compared to 23.7 in 1990.
8.13 Proportion of population with access to affordable essential drugs on a sustainable basis
Only 24% of the people living in the poorest villages are having access to affordable essential drugs when
needed.
23.7
18 17.9
15 14 14.6
12.5
10.4 11.2
9.9
8.5 9.5
11 11.1
7.3 6.8 6 5.8 5.4 6.1 5.7
0
5
10
15
20
25
30
35
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 8.12: Debt service as a percentage of exports of goods and services
43
8.14 Telephone lines per 100 population
The telephone lines per 100 population achieved an increase from 1990 to 2008 and then decreased to 10.6 in
2011. This is perhaps due to the increase in accessing cell phones as a communication tool. Poorest villages
have better value of 24% than the national level.
8.15 Cellular subscribers per 100 population
Cellular subscribers per 100 population achieved an increase from 1990 to 2011 reaching 101. The poorest
villages have lower value of 46% than the national level which is lower than the half.
2.8 3.1 3.4 3.7 4.0 4.4 4.8 5.4 6.1 7.1 8.1
9.7
11.1 12.2 13.1 14.1 14.4 14.6 15.1
12.9 11.9
10.6
Poorest villages
24.0
0
5
10
15
20
25
30
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Figure 8.14: Telephone lines per 100 population
0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.1 0.1 0.7 2.0 4.1 6.4 8.1 10.5
18.4
23.8
39.1
52.7
69.4
87.1
101.1
Poorest villages
46
0
20
40
60
80
100
120
19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012
Figure 8.15: Cellular subscribers per 100 population
44
8.16 Internet users per 100 population
Worldwide, 74 per cent of inhabitants of developed countries are internet users compared to only 26 per cent of
inhabitants in developing countries. Egypt’s achievement in the internet users per 100 population is noticeable,
which reached 35.6 in 2011, but this percentage is still not big enough.
Summary of Goal 8:
In Egypt, external debt has witnessed considerable improvement over the period (1990/91-2008/09). External
debt as a percent of GDP fell from above 100% in 1990/91 to 16.7% in 2008/09 and debt service as percentage
of current account receipts fell from above 25% in 1990/91 to 6% in 2008/09. Egypt has witnessed significant
development in the last few years in the field of information and communication technology. However,
0 0 0.01 0.03 0.06 0.09 0.2 0.3 0.6 0.8
2.7
4.0 5.2
11.7 12.6
16.1
18.0
24.3
30.2
35.6
0
5
10
15
20
25
30
35
40
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Figure 8.16: Internet users per 100 population
45
telephone lines per 100 populations are only 10.6 at the national level, but this is replaced by cellular
subscribers per 100 populations which reached 101. The poorest villages are lagging behind the national level
with regard to cellular communication.
Conclusion:
This report has used the indicators of the Millennium Development Goals (MDGs) to compare the status of
development in the poorest 151 villages in Egypt to the national average. The comparison reveals that the
poorest villages are lagging behind; the gap in many cases is alarming and indicative of stark inequalities that
raise concern and call for action. Research results, therefore, point out to the responsibility of the government
to continue its 1000 villages’ development program. The research also provides valuable background
information as to what this national program should focus on. For instance, the provision of vocational
training and technical education in those villages will improve education indicators (MDG2) and will impact
positively on poverty alleviation (MDG1). Also, the provision of basic healthcare facilities in the poorest
villages can improve indicators under MDGs 4, 5 and 6. Last but not least, the provision of improved water and
sanitation services in the poorest villages (MDG7) will improve the quality of life generally and reduce health
hazards in those villages. It is recommended to collect information for the MDGs indicators at the villages’
level and to periodically compare them to the national average to ensure equity and to offer orientation to
programs of spatial targeting of poverty.
SCC was established in 2007 as a joint initiative between the Egyptian Cabinet’s Information
and Decision Support Center, IDSC and the United Nations Development Program, UNDP, with
the support of the Italian-Egyptian Debt for Development Swap Program and the Government
of Japan.
SCC was established based on the recommendations of the Egyptian Human Development
Report titled “Choosing Our Future: Towards a New Social Contract” which presents a vision of
Egypt centered on the ambitious proposal of a new Social Contract. SCC’s mission is to provide
technical support to the human development efforts in Egypt using a rights-based approach
rooted in the principles of good governance and citizenship.
SCC aims to monitor progress towards the achievement of the Millennium Development Goals
(MDGs) in Egypt, and strives to build a national consensus on the concept of the Social Contract
and its implications, in addition to rebuilding trust between the government and citizens, as well
as supporting efforts to empower civil society.
For more information on SCC, please visit www.socialcontract.gov.eg
The Social Contract Center
106 Kasr El Aini St., Cairo Center Bldg.
Floor 13 – Cairo, Egypt
Tel: 2792 3198/27922971
Fax: 27961386
Email: scc@socialcontract.gov.eg
www.socialcontract.gov.eg
© All Rights Reserved, Social Contract Center - 2014
The Social Contract Center

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Progress in MDGs

  • 1.                    Progress towards Achieving the MDGs in Egypt:
  • 2. 2014 The Social Contract Center Mahmoud El Kholy Director, SCC Noha Abed Deputy Director, SCC Equitable Development Observatory Dr. Mai Gadallah Unit Head Enas Aly Bassant Yousef Hend Ibrahim Nouran Shakra Eman Refaat Quality Control Unit Nadia Abd El Azim Unit Head Communication Unit Wesam Ghazi Unit Head Aya Noureldeen Progress towards Achieving the MDGs in Egypt:               By: Bassant Yousef Eman Refaat
  • 3. 1 Where poorest villages in Egypt stands from the MDGs? Progress towards Achieving the MDGs in Egypt: The Poorest Villages Compared to the National Level By: Basant Yousif and Eman Refaat (Draft) Set by the United Nations Development Program (UNDP) as human development goals to be achieved by 2015 and adopted by world leaders in 2000, the Millennium Development Goals (MDGs) provide a framework for the entire international community to work together towards a common end, thereby making sure that human development reaches everyone, everywhere. The MDGs also provide concrete, numerical benchmarks for different dimensions of human development that, if achieved, would cut world poverty by half, save tens of millions of lives, and billions more people will have the opportunity to benefit from global economy. The eight MDGs are: Goal 1: Eradicate extreme poverty and hunger Goal 2: Achieve universal primary education Goal 3: Promote gender equality and empower women Goal 4: Reduce child mortality rates Goal 5: Improve maternal health Goal 6: Combat HIV/AIDS, malaria, and other diseases Goal 7: Ensure environmental sustainability Goal 8: Develop a global partnership for development These eight MDGs break down into 21 quantifiable targets that are measured by 60 indicators. Thus a framework is provided for the entire UN system to work coherently towards a common end. The MDGs can be achieved through sound national development policies, effective investment in key human development sectors and international support. This is true even in the poorest countries and those recovering from conflict and natural disasters. Less than Two Years to the Deadline!! April 5th, 2013 marked the 1000-day milestone until the 2015 target date to achieve the MDGs. All countries will have to report on their progress towards achieving the MDGs. In Egypt it is important to measure the progress on regular intervals to get a sense of what would be achieved by the target date and to take corrective
  • 4. 2 measures to improve the achievement rate. However, measuring the progress towards the MDGs provides a picture of the achievement of human development indicators at the national level; i.e. using averages of data representing the national level. This does not provide enough representation of the conditions of the most vulnerable groups, who mostly exist in the countryside, hence does not sufficiently inform social development policies at a time when Egypt is keen on progressing on the path of social justice. This paper attempts to compare the situation of human development at the national level to the level of the poorest 151 villages in Egypt, where 84% of citizens are poor, using the MDGs benchmarks with a view to testing and highlighting evident inequalities between the two levels. The results of the paper, hence, points out the legitimate need of the Egyptian government to continue its strategy of spatial targeting of poverty through the continuation of the 1000 villages program. This paper analyzes data from two surveys; these two surveys are conducted as part of the monitoring and evaluation system with regard to the poorest 1000 village government initiative in Egypt1 . The first survey includes 151 poor villages in the 1000 poorest villages in Egypt, it was conducted in the period between November-December 2009, and the second survey is Maternal Child Health (MCH), it covered 109 villages of the 151 villages of the first survey, it was conducted in January 2011. For national level, the data is from The official United Nation Site for MDGs indicators2 . 1 The first phase of the initiative consists of choosing the poorest 151 village according to the poverty map definition (designed by the World Bank and the Egyptian ministry of planning). 2 http://mdgs.un.org/unsd/mdg/Data.aspx.
  • 5. 3 Goal One: Eradicate Extreme Poverty and Hunger This goal aims to reduce poverty by half according to three integrated targets. Further geographical targeting as well as support for most vulnerable families are essential for achieving this goal. Target 1.A measures income inequality, the proportion of poor people, and the amount of resources they need to move above the poverty line. Target 1.B measures employment rates of population and the proportion of vulnerable families. Target 1.C measures rates of population suffering from hunger and the nutritional status of children. Target 1.A: Halve, between 1990 and 2015, the proportion of people whose income is less than $1.25 a day 1.1 Proportion of population below $1 (PPP) per day 1.2 Poverty gap ratio 1.3 Share of poorest quintile in national consumption Target 1.B: Achieve full and productive employment and decent work for all, including women and young people 1.4 Growth rate of GDP per person employed 1.5 Employment-to-population ratio 1.6 Proportion of employed people living below $1 (PPP) per day 1.7 Proportion of own-account and contributing family workers in total employment Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger 1.8 Prevalence of underweight children under-five years of age 1.9 Proportion of population below minimum level of dietary energy consumption Target 1.A: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day. 1.1 Proportion of population below $1 (PPP) per day At the national level, according to the latest update which indicated the proportion of population below $1 (PPP) per day, there was a decrease from 4.5 % in 1991 to 1.7% in 20083 (under the thin red line which indicates the target proportion). In the 151 poor villages4 , the proportion was 55%. 3Based on nominal per capita consumption averages and distributions estimated from household survey data. 4Household survey in the 151 poor villages “The 1000 poorest village initiative.”
  • 6. 4 0.6% 0.3% 0.3% 0.4% 0.4% 0% 1% 2% 3% 4% 5% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.2 Poverty gap ratio 1.2 Poverty gap ratio At national level, the poverty gap ratio indicated the per capita amount of resources needed to eliminate poverty through proper targeted cash transfers by different types of subsidies. Although the poverty gap ratio decreased from 0.6% in 1991 to 0.3% in 1996, it increased to 0.4% in 2005 and it remained constant until 20085 . On other hand, the poverty gap in the 151 poor villages in Egypt was 35% in 2009. 5 Based on nominal per capita consumption averages and distributions estimated from household survey data. 4.50% 2.50% 1.80% 2% 1.70% 0% 1% 2% 3% 4% 5% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.1 Proportion of population below $1 (PPP) per day
  • 7. 5 8.70% 9.50% 9.00% 9.00% 9.20% Poorest villages 12% 0% 5% 10% 15% 20% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.3 Share of poorest quintile in national consumption Inequality in the distribution of income is reflected in the percentage shares of national consumption of the population ranked according to the consumption levels. The share of poorest quintile in national consumption was 8.7% in 1991 and then it went up to 9.5% in 1996. Afterwards, it slightly went down to 9.2% in 2008. In the 151 poor villages, it was 12%. Because of the high level of economic growth and the adoption of pro-poor policies, target one, which is only limited to extreme poverty, has been achieved. Target 1.B: Achieve full and productive employment and decent work for all, including women and young people 1.4 Growth rate of GDP per person employed In 1992 the growth rate of GDP per person employed was negative which led to a high inflation rate6 of about 19.7. But it became positive in 1995 and reached about 2.21, which did not last long; it went down to -1.19 in 2002 and remained negative7 . 6 http://data.worldbank.org/indicator/NY.GDP.DEFL.KD.ZG 7 Household or labor force survey -1.50% -0.94% -0.36% 2.21% 1.46% 0.74% -1.19% -0.74% -1.02% -5% -3% -1% 1% 3% 5% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 1.4 Growth rate of GDP per person employed
  • 8. 6 3.10% 1.70% 1.20% 1.30% 0% 1% 2% 3% 4% 5% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.6 Proportion of employed people living below $1 (PPP) per dayconsumption 42% 39% 46% 45% 46% 45% 42% 44% 45% 44% 41% 47% 44% 46% 64% 62% 70% 71% 72% 71% 72% 70% 72% 71% 68% 74% 70% 71% 20% 16% 21% 19% 19% 18% 12% 16% 17% 16% 15% 18% 17% 20% Poorest villages 56% 0% 20% 40% 60% 80% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.5 Employment-to-population ratio Total Men Women 1.5 Employment-to-population ratio Employment-to-population ratio slightly fluctuated between 39% and 45.8% from 1990 to 2007. This ratio is higher among men than women and it is even higher in the 151 poor villages in Egypt; 56%: 76% among men and 36% among women. 1.6 Proportion of employed people living below $1 (PPP) per day Globally, 456 million workers lived below the poverty line in 2011, each worker earning less than $1.25 a day. At the national level, the proportion of employed people living below $1 per day was 3.1% in 1991 and then went down to 1.3% in 2005.
  • 9. 7 14% 14% 13% 13% 12% 11% 12% 9% 10% 12% 14% 13% 13% 14% 10% 9% 9% 9% 10% 9% 8% 8% 8% 9% 9% 9% 9% 9% 33% 34% 30% 30% 23% 22% 26% 17% 20% 26% 32% 32% 33% 34% 0% 10% 20% 30% 40% 50% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.7 Proportion of own-account and contributing family workers in total employment Total Men Women 10.5% 8.2% 10.8%10.2% 9.4% 8.7% 5.4% 6.8% Poorest villages 14.10% 0% 10% 20% 30% 40% 50% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.8 Prevalence of underweight children under-five years of age 1.7 Proportion of own-account and contributing family workers in total employment Globally, vulnerable employment —insecure, poorly paid jobs, more likely to be held by women and youth— was estimated by49.1 per cent of the total employment in 2011, with a decrease from 54.4 per cent in 1991. At the national level, it fluctuated from 9.3% to 14.2% during the period of 1993 – 2007; the proportion was very high among women. These proportions are typical of a large section of the agricultural sector, which is characterized by a low growth in the formal economy and a large rural economy. When there is a large number of contributing family workers, there is likely to be poor development: little job growth and widespread poverty. This target is not likely to be achieved by 2015 because of the challenges that face youth and women in the Egyptian society. If this target is achieved, poverty will decrease. Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger 1.8 Prevalence of underweight children under-five years of age About 850 million people, or nearly 15 percent of the global population, are estimated to be undernourished.
  • 10. 8 Despite some progress, nearly one in five children under the age of five in the developing world is underweight. Children in rural areas are nearly twice as likely to be underweight as those in urban areas. At the national level, it was 10.5% in 1991 and decreased over 17 years and became 6.8 % in 2008. But the prevalence in the 151 poor villages was higher by about 14.1%8 than the national percentage in 1990 because of poverty and malnutrition. 1.9 Proportion of population below minimum level of dietary energy consumption Globally, the proportion of population below minimum level of dietary consumption was 13 % in 2006/08. This is due to the fact that more than 42 million people have been uprooted by conflict or persecution. At the national level, it was 5 %; this proportion remained constant during 1990-2011 without any improvement9 . This target is possible to be achieved by 2015 if positive changes take place. Summary of Goal 1: According to the above figure, the percentage of employment to population ratio in the 151 poor villages is higher than that at the national level because agricultural labor is highly demanded in villages. Yet, given the very low payment of such labor and its irregular pattern, the poverty rate in the 151 villages is still higher than the national level. Reducing the proportion of population below $1 (ppp) per day to half was achieved at the national level, while in the 151 poor villages the same proportion is in deterioration, it was 55% in 2009. Therefore, there is a need for geographical targeting and for supporting poor families in order to reduce the proportion. Also, transferring a higher degree of consumption to raise the poor above the poverty line is needed in order to reduce the poverty gap in the 151 poor villages and achieve an acceptable poverty gap. 8 Maternal Child Health survey. 9 Source: SOFI 2011. 5% 0% 10% 20% 30% 40% 50% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 1.9 Proportion of population below minimum level of dietary energy consumption
  • 11. 9
  • 12. 10 92% 93% 94% 95% 96% 97% 97% 95% 98% 98% 96% 95% 96% 96% 97% 98% 99% 100% 97% 100% 100% 88% 90% 91% 93% 94% 96% 95% 93% 95% 96% 85%85% 90% 95% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2.1 Net enrolment ratio in primary education Total Boys Girls Goal Two: Achieve Universal Primary Education Education is a fundamental human right and essential for the practice of all other human rights. It promotes individual freedom and empowerment and yields important development benefits. Reducing dropout and gender gap in primary education are the main tasks which were adopted by the different and consecutive governments since 1990. Target 2.A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling 2.1 Net enrolment ratio in primary education 2.2 Proportion of pupils starting grade 1 who reach last grade of primary 2.3 Literacy rate of 15-24 year-old, women and men 2.1 Net enrolment ratio in primary education Globally, enrolment in primary education in developing regions reached 90 per cent in 2010, which went up from 82 per cent in 1999.This means that more kids than ever are attending primary school. In 2010, 61 million children of primary school age were out of school. More than half of them (33 million) were in sub-Saharan Africa. At the national level in Egypt, the situation improved as the net enrolment ratio in The poorest villages' level
  • 13. 11 96% 94% 93% 92% 93% 95% 97% 93% 96% 99% 101% 100% 98% 96% 93% 95% 97% 101% 94% 98% 100% 91% 91% 90% 91% 91% 93% 92% 90% 93% 97% 85% 90% 95% 100% 105% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2.2 Proportion of pupils starting grade 1 who reach last grade of primary Total Boys Girls 85% 85% 88% 90% 88% 91% 79% 82% 84% Poorest villages 80% 50% 60% 70% 80% 90% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2.3 Literacy rate of 15-24 year-old, women and men Total Men Women primary education increased during 2000-2010 and the gender gap narrowed down. Net enrolment ratio in primary education is expected to increase by 2015. This ratio in the 151 poor villages was lower than that in total Egypt in 1990, which means that more targeting is needed to increase the percentage. 2.2 Proportion of pupils starting grade 1 who reach last grade of primary Globally, the proportion of pupils starting grade 1 who reach final grade of primary education was 90.2% in 2012 which means that more effort is necessary to enroll about 61 million who remain out of school. At the national level, the cohort of pupils enrolled in grade 1 of the primary level of education in a given school year who are expected to reach grade 5 fluctuated from 92.1% to 101% in the period of 1999-2010. But, this percentage increased during the period 2009-2010. There is a narrow gender gap and the female proportion could reach 100% by 2015. 2.3 Literacy rate of 15-24 year-old, women and men
  • 14. 12 Gender gaps in youth literacy rates are also narrowing. Globally, there were 95 literate young women for every 100 young men in 2010, compared with 90 women in 1990. At the national level, the number of adult people (15-24 years old) who can read and write is higher among males and was reflected in the literacy rate of both sexes. In the 151 poor villages the literacy rate was 80.3% and is higher among males than females by 13%. Summary of Goal 2: According to the above figure, the net enrolment ration in primary education in the poorest 151 villages is a bit lower than the national average (85% compared to 98%). This shows that previous government efforts to ensure access to primary had an equitable coverage. Also, literacy rate of (15-24) years-old in the poor villages is close to the national rate; it is 80.3% and 87.5% respectively. Moreover, the gender gap in 151 poor villages is little higher than national gender gap. Thus, there is no huge difference between the national level and poor villages' level. This goal is likely to be achieved by 2015 if Egypt succeeds in reducing dropout rates and eliminating class density especially in poor villages.
  • 15. 13
  • 16. 14 83% 91% 92% 93% 94% 95% 96% 94% 94% 95% 96% 96% Poorest villages 91.83% 50% 60% 70% 80% 90% 100% 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 3.1 Ratios of girls to boys in primary education Goal Three: Promote Gender Equality and Empower Women The Egyptian governments during 1990-2012 were achieving a great progress in the elimination of gender gap. At the educational level, gender gaps are very likely to be realized before 2015. But the share of women in wage employment in non-agricultural sector is very low and needs more targeting to reduce the gap. Finally, the proportion of seats held by women in parliament is still less than 50% and is not expected to be achieved by 2015. Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 3.1 Ratios of girls to boys in primary, secondary and tertiary education 3.2 Share of women in wage employment in the non-agricultural sector 3.3 Proportion of seats held by women in national parliament Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 3.1 Ratios of girls to boys in primary, secondary and tertiary education Globally, the ratio of girls to boys in primary education was 97% in 2010, in secondary education was 97% and in tertiary education was 108%. At the national level, gender gap in primary education is narrow and can be eliminated by 2015. But in the 151 poor villages, the gender gap is somewhat wide although basic education is mandatory by law for both sexes.
  • 17. 15 59% 77% 91% Poorest villages 61.24% 50% 60% 70% 80% 90% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 3.1 Ratios of girls to boys in tertiary education 79% 91% 92% 93% 93% 94% 96% 96% Poorest villages 74.25% 50% 60% 70% 80% 90% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 3.1 Ratios of girls to boys in secondary education In secondary education, all over Egypt, the gender gap is almost eliminated. But in the 151 poor villages, the gap still exists and is about 25.75 %, meaning that the trend is that more boys go to secondary education than girls. This can point out to important social phenomena such as early marriage for girls. Tertiary education increased during 1991-2010 and the gender gap was significantly decreased around 10%. But in the 151 poor villages, the gender gap in this type of education is much wide than the national average, about 38.76%.
  • 18. 16 21% 19% 18% 19% 19% 19% 19% 20% 21% 19% 21% 22% 20% 19% 18% 18% 19% 18%18% Poorest villages 13.70%0% 20% 40% 60% 80% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 3.2 Share of women in wage employment in the non-agricultural sector 3.2 Share of women in wage employment in the non-agricultural sector Globally, the share of women in wage employment in the non-agricultural sector was 39.6 in 2010. At the national level, the share of women in wage employment in the non-agricultural sector expressed as a percentage of total employment in the sector slightly fluctuated during 1991-2009 but was still low. The non-agricultural sector includes industry and services. In the 151 poor villages, the situation was not different from the rest of Egypt, which was so low, about 13.7%. This percentage is not expected to be achieved by 2015. 3.3 Proportion of seats held by women in national parliament Globally, the proportion of seats occupied by women was 19.7%. At the national level, during 1990-2012 women representation in the national parliament didn't exceed more than 12 female members. In 2010, the 3.9% 2.0% 2.0% 2.0% 2.0% 2.4% 2.4% 2.4% 2.9% 2.0% 2.0% 1.8%1.8% 1.8% 12.7% 2.0% 0% 5% 10% 15% 20% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 3.3 Proportion of seats held by women in national parliament
  • 19. 17 female ratio increased to 12.7%, but this ratio lasted for not more than a month when the January 25th Revolution broke out. This proportion is not expected to increase by 2015. Summary of Goal 3: According to figure 3 there is a considerable gap between the national level and the 151 poor villages with respect to secondary and tertiary education as a result of the high dropout rates in these levels of education and early marriage in rural areas, particularly poorest villages. This means that the development programs targeting the 151 poorest villages should only continue, but also include gender promotion programs. Furthermore, the share of women in wage employment and in parliamentary elections is low across Egypt and the poorest villages are no exception. However, the activation of the economic and political role of women still needs special attention in the poorest villages as the geographic scope of programs in such fields usually target urban areas.
  • 20. 18 80.8 76.0 71.2 66.8 62.4 58.5 54.6 51.0 47.6 44.4 41.5 38.7 36.3 33.9 31.6 29.5 27.6 25.8 24.1 22.5 21.1 Poorest villages 36.6 0 20 40 60 80 100 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 4.1 Under-five mortality rate (per 1000 live births) Goal Four: Reduce Child Mortality Since 1990, Egypt adopted social protection of children in its policy agenda. More geographical and socioeconomic targeting is needed to continue progress at all levels. The under-five mortality rate was achieved in 2008 when it was reduced by two- thirds. There is a remarkable increase in measles coverage. Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate 4.1 Under-five mortality rate 4.2 Infant mortality rate 4.3 Proportion of 1 year-old children immunized against measles Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate 4.1 Under-five mortality rate Globally there is about 57 deaths per 1000 live births. At the national level, over the past 20 years, Egypt has made significant progress concerning the under-five-year child mortality rate, reduced by 70% between 1990 and 2008. The rate at the poorest villages was higher than the Egyptian national rate which was about 36.6 per 1000 live births; this rate is acceptable comparable to the global average. 4.2 Infant mortality rate
  • 21. 19 59.7 56.7 53.6 50.8 47.9 45.3 42.7 40.2 37.8 35.6 33.5 31.5 29.7 28.0 26.2 24.6 23.2 21.8 20.4 19.1 18.0 Poorest villages 28.1 0 20 40 60 80 100 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 4.2 Infant mortality rate (per 1000 live births) 89% 89% 89% 89% 89% 92% 92% 98% 96% 98% 97% 97% 98% 97% 98% 98% 97% 92% 95% 96% Poorest villages 50.30% 0% 20% 40% 60% 80% 100% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 4.3 Proportion of 1 year-old children immunized against measles Globally, there are about 44 deaths of children under 12 months per 1000 live births. At the national level, currently 9 out of 10 deaths of children under the age of 5 take place before the child's first birthday, and about one half of these deaths occur during the first month of the infant’s life. Egypt achieved a great progress in reducing the number of infant mortality. The 151 poor villages also achieved a great progress (about 28.1 per 1000 live births) although most of these poor villages are in rural Upper Egypt. 4.3 Proportion of 1 year-old children immunized against measles Globally, the percentage of children under one year of age who have received at least one dose of measles vaccine is about 85%. At the national level, the situation improved during 1998-2007 and since 2008, it has been decreasing. The indicator provides a measure of the coverage and the quality of the child health-care system in the country. Immunization is an essential component for reducing under-five mortality rate. In the 151 poor villages the proportion was very low, about 50.30%.
  • 22. 20 Summary of Goal 4: According to figure 4, the situation of mortality rates of children under five and infant in the 151 poor villages is in the same range of the national situation, but the proportion of 1 year old children immunized against measles is very low in the 151 poor villages, which indicates that more targeting of poor areas of this service is needed. Egypt has achieved a great progress in reducing child mortality rates, but still needs to take certain geographical areas into consideration such as the 151 poorest villages.
  • 23. 21 Goal Five: Improve Maternal Health Maternal health goes beyond the survival of pregnant women and mothers, since it is globally established that for every woman who dies from causes related to pregnancy or childbirth, it is estimated that there are 20 others who suffer from pregnancy-related illnesses or experience other severe consequences that would require intensive attention to reproductive health including family planning. Progress on MDG 5 is influenced by the national efforts to reduce child mortality, achieve vaccination coverage, and implement integrated management of child health and disease initiative. Improving maternal health, reducing maternal mortality and increasing accessibility to reproductive care have been key concerns of several national health strategies and interventions. This goal includes two targets and six indicators, as follows: Target 5.A: Reduce the maternal mortality ratio by three quarters between 1990 and 2015 5.1 Maternal mortality ratio 5.2 Proportion of births attended by skilled health personnel Target 5.B: Achieve universal access to reproductive health by 2015 5.3 Contraceptive prevalence rate 5.4 Adolescent birth rate 5.5 Antenatal care coverage (at least one visit and at least four visits) 5.6 Unmet need for family planning 5.1 Maternal mortality ratio Worldwide, maternal mortality has nearly halved since 1990. An estimated 287,000 maternal deaths occurred in 2010 worldwide, which indicates a decline of 47 per cent from the rate estimated since 1990. However, this level is still far from that which is intended to be achieved in 2015. In Egypt, the trend of maternal mortality ratio from 1990 until 2010 (most updated) shows that Egypt is very close to the 2015 target as it decreased from 230 in 1990 to 66 in 2010, which is estimated by a decrease of nearly 71% as shown in figure 5.1.
  • 24. 22 5.2 Proportion of births attended by skilled health personnel In Egypt, progress has been made in increasing the proportion of births attended by skilled health personnel as this proportion has more than doubled from 1990 (36.5%) until 2008 (79%). The progress achieved at the national level has not been attained at the poorest level for the latter is still lagging behind the 1990 proportions; only 12.3% of births at the poorest level are attended by skilled health personnel, which reveal a big gap in the poorest villages compared to the national average. 5.3 Contraceptive prevalence rate In Egypt, contraceptive prevalence rate has increased from 47.6% in 1990 to 60.3% in 2008. However, there has not been a high increase especially since 2003. Even if the gap between the national level and poorest villages is not very wide, the poorest are still lagging behind the 1998 national rates. 230 150 100 78 66 0 50 100 150 200 250 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 5.1: Maternal mortality ratio per 100,000 live births - Across years 36.5 40.7 46.3 56.4 55.2 60.9 69.4 74.2 78.9 Poorest villages 12.3 0 20 40 60 80 100 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 5.2: Proportion of births attended by skilled health personnel
  • 25. 23 5.4 Adolescent birth rate Worldwide, levels of adolescent birth rate range from less than 2 to approximately 230 births per 1000 adolescent women (15-19) years-old. The rate of 50 or more per 1000 women is considered high and the rate of 10 or less per 1000 women is regarded as low. Fewer teens are having children in most developing regions, but progress has slowed. In Egypt, adolescent birth rate has decreased since 1990 to 49.5 which is not high if compared with other developing countries, but may be regarded a high rate according to UN targets. The poorest villages are even below the 1990 national level since 133 per 1000 teen women are having children. 47.6 47.1 47.9 51.7 56.1 60 59.2 60.3 Poorest villages 51.3 0 20 40 60 80 100 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 5.3: Contraceptive prevalence rate 68.8 66.9 53.4 48 49.5 Poorest villages 133 0 30 60 90 120 150 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 5.4: Adolescent birth rate per 1000 women
  • 26. 24 5.5 Antenatal care coverage (at least one visit and at least four visits) Worldwide, more pregnant women are receiving care with the recommended frequency, but gaps still exist in regions most in need. In Egypt, trends reveal a general increase in the antenatal care coverage (of at least one visit) since 1990, which reached 73.6%. The poorest villages are lagging behind more than 10 years behind the national levels. For the at-least-four-visits indicator, the increase has tripled since 1990 and reached 66% in 2008 and the poorest villages are still lagging behind the national rates before 2003. 52.1 52.9 39.1 52 47.2 52.9 68.7 69.6 73.6 Poorest villages 56.5 0 20 40 60 80 100 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 5.5 : Antenatal care coverage (at least one visit) 22.5 28.3 31.8 33.1 36.7 55.6 58.5 66 Poorest villages 44.8 0 20 40 60 80 100 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 5.5 : Antenatal care coverage (at least four visits)
  • 27. 25 5.6 Unmet need for family planning Worldwide, the unmet need for family planning remains persistently high in regions with low levels of contraceptive use. However, in the poorest villages in Egypt there are around 12.9% unmet needs for family planning, also at the national level the percentage is promising to some extent (11.6%). Summary of Goal 5: In Egypt, the situation at the national level shows a big progress according to the most recent values of the different indicators of Goal 5, which reveals that the majority of indicators will reach the target of 2015. However, when comparing this national situation to the situation of the poorest villages in Egypt, it was found that a wide gap at all indicators reached 67% in the births attended by skilled health personnel (79% percent at the national level compared to 12% in the poorest villages). Also the unmet needs for family planning in the poorest villages are 12.9% compared to 11.9% at the national level. Even when considering antenatal care coverage and contraceptive prevalence rates that look closer than other indicators, there is still a considerable gap between the national level and the poorest villages' level. The poorest villages are lagging years behind the national level in improving maternal health. The concentration of maternal health government programs at the poorest villages is essential. 22.9 20.2 14.5 13.7 11.8 12.3 11.6 0 20 40 60 80 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 5.6: Unmet need for family planning
  • 28. 26
  • 29. 27 Goal Six: Combat HIV/AIDS, Malaria and Other Diseases Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS 6.1 HIV prevalence among population aged 15-24 years 6.2 Condom use at last high-risk sex 6.3 Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS 6.4 Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years Target 6.B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it 6.5 Proportion of population with advanced HIV infection with access to antiretroviral drugs Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases 6.6 Incidence and death rates associated with malaria 6.7 Proportion of children under 5 sleeping under insecticide-treated bed nets 6.8 Proportion of children under 5 with fever who are treated with appropriate anti-malarial drugs 6.9 Incidence, prevalence and death rates associated with tuberculosis 6.10 Proportion of tuberculosis cases detected and cured under directly observed treatment short course Human Immunodeficiency Virus (HIV) is a virus that weakens the immune system, ultimately leading to Acquired Immuno Deficiency Syndrome (AIDS). HIV destroys the body’s ability to fight off infection and disease, which can ultimately lead to death. Without treatment, median survival from the time of infection is about 10.5 years for males and 11.5 years for females. Malaria is an infectious disease caused by the parasite Plasmodium and transmitted via the bites of infected mosquitoes. Malaria is serious in its own right, but also increases the risk of death from other conditions. In addition, malaria imposes an economic burden on families, particularly those who are least able to pay for prevention and treatment and most affected by loss of income due to the disease. The disease represents a financial burden to malaria-endemic countries that must use scarce resources to provide bed nets, insecticides and drugs in an effort to control the disease. Tuberculosis is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. Detecting tuberculosis and curing it are key interventions for addressing poverty and inequality. Prevalence and deaths are more sensitive markers of the changing burden of tuberculosis than incidence (new cases), but data on incidence are more comprehensive and give the best overview of the impact of global tuberculosis control.
  • 30. 28 Worldwide, new HIV infections continue to decline in the hardest-hit regions. Comprehensive knowledge of HIV transmission remains low among young people, along with condom use. At the end of 2011, 8 million people were receiving antiretroviral therapy for HIV or AIDS in developing regions. This total constitutes an increase of over 1.4 million people from December 2009, and the largest one-year increase ever. The global estimated incidence of malaria has decreased by 17 per cent since 2000, and malaria-specific mortality rates by 25 per cent. Countries with improved access to malaria control interventions witnessed child mortality rates fall by about 20 per cent. Thanks to increased funding, more children are sleeping under insecticide-treated bed nets in sub-Saharan Africa. The anti-tuberculosis drive is closing in on a 50 per cent cut in the 1990 death rate and more TB patients are being successfully treated. 6.2 Condom use at last high-risk sex Worldwide, condom use remains low among young women in most countries. The limited condom use may be linked with restrictions on availability. In Egypt, the same situation exists, where according to the most recent data, the percentage of condom use at last high-risk sex is 1.2%. Data is not available for the poorest villages. 6.3 Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS Worldwide, comprehensive knowledge of HIV transmission remains low among young people. Such knowledge remains low in sub-Saharan Africa (26 per cent among young women and 35 per cent among young men, aged 15-24). In Egypt, the situation is worse as this percentage is 18% among men and 5% among women according to the 2008 data. Data is not available for the poorest villages. 4.4 4.2 2.9 2.1 1.8 1.5 1.7 1.2 0 5 10 15 20 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 6.2: Condom use at last high-risk sex
  • 31. 29 6.5 Proportion of population with advanced HIV infection with access to antiretroviral drugs Worldwide, at the end of 2011, 8 million people were receiving antiretroviral therapy for HIV or AIDS in developing regions. This total constitutes an increase of over 1.4 million people since December 2009, and the largest one-year increase ever. In Egypt, data of 2010 shows that this proportion is 10% only which is very low compared to world progress. Data is not available for the poorest villages. 6.6 Incidence and death rates associated with malaria The global estimated incidence of malaria has decreased by 17 per cent since 2000, and malaria-specific mortality rates by 25 per cent. Egypt might be in the path of imported cases. As the country is geographically located close to malaria endemic areas, exogenous cases are still reported. Between 1998 and 2009, 442 imported malaria cases occurred, the majority (93.0%) imported either through the southern border with Sudan or Egyptians returning from malaria endemic countries (Ministry of Health, 2010). But in general Egypt has succeeded in rolling back malaria. 6.9 Incidence, prevalence and death rates associated with tuberculosis Globally, incidence rates associated with tuberculosis peaked at 141 per 100,000 people in 2002 and have been falling since then. Mortality and prevalence rates of tuberculosis are falling in most regions. It is estimated that there were 1.4 million deaths from tuberculosis in 2010, including 350,000 people with HIV. In Egypt, great progress has been made to the incidence rates, where the rates decreased in 2010 to 28 per 100000 of the population compared to 79 in 1990; the poorest villages have better rate of 15 per 100000 of the population. 79 74 72 70 67 59 48 44 42 42 41 40 38 35 33 32 32 32 31 30 28 Poorest villages 15 0 20 40 60 80 100 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 6.9: Incidence rates associated with tuberculosis per 100000 of the population
  • 32. 30 Prevalence rates associated with tuberculosis also lowered to 0.8 per 100000 of the population while for the poorest villages this rate is 5. Death rates almost halved since 1990: death rates associated with tuberculosis per 100000 of the population were 34 and decreased to 18 in 2010. 6.10 Proportion of tuberculosis cases detected and cured under directly observed treatment short course Worldwide, more tuberculosis patients are being successfully treated. This is also the case in Egypt, where more tuberculosis patients are being successfully treated: the proportion is 88% at the 2010 levels. The poorest villages are lagging behind years compared to the national level since 35% only of tuberculosis cases are detected and cured under DOTS. 4.1 3.7 3.6 3.5 3.3 2.7 1.9 1.7 1.6 1.6 1.7 1.6 1.6 1.7 1.4 1.4 1.2 1.2 1.2 1 0.8 Poorest villages 5 0 5 10 15 20 1990199119921993 1994 1995 1996 19971998199920002001 2002 2003 20042005 2006 2007 2008 20092010 2011 2012 Figure 6.9: Prevalence rates associated with tuberculosis per 100000 of the population 34 34 34 33 32 32 30 29 28 27 26 25 24 23 22 21 20 20 19 19 18 0 10 20 30 40 50 60 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 6.9: Death rates associated with tuberculosis per 100000 of the population
  • 33. 31 In conclusion, Egypt is generally progressing well towards achieving goal six of the MDGs. Egypt is considered of low HIV epidemic prevalence compared to the global average, has rolled back Malaria except for imported cases, and has reduced the cases of tuberculosis. The data for the poorest villages on most of these indicators is lacking, but the above diagram demonstrates a comparison with the national averages concerning tuberculosis. Luckily enough, there are less rates of incidences associated with tuberculosis at the poorest 151 villages compared to the national rate (15% compared to 28%). However, the rate of cases that are identified and cured at the poorest villages is much less than the national average (35% compared to 88%). This points out to the lack of proper diagnostic health services that are at reach to the poorest villages. This conclusion is expected to be confirmed if data for the other indicators of the goal were available. Summary of Goal 6: In Egypt, it is very difficult from the available information to assess the HIV epidemic status in the country or the speed of the HIV epidemic growth. No population based surveys have been conducted and thus at present there is no precise estimate of the HIV prevalence in Egypt. In the past years, Egypt has been considered in the first stage of “low HIV epidemic” of prevalence <1.0 % in the general population and did not exceed 5 % in any 11 18 45 17 20 57 64 75 70 67 62 61 66 70 72 73 65 65 63 65 64 0 20 40 60 80 100 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 6.10: Proportion of tuberculosis cases detected under DOTS,(midpoint) 52 62 51 78 83 85 87 82 88 80 70 79 87 89 89 88 Poorest villages 35 0 20 40 60 80 100 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 6.10: Proportion of tuberculosis cases detected and cured under DOTS
  • 34. 32 of the high risk groups. In 2007, the HIV prevalence in adults aged 15 years or above is estimated as 18 per 100,000 (World Health Organization, 2009). Between 1998 and 2009, Egypt has succeeded in rolling back malaria; 442 imported malaria cases occurred in the country, the majority (93.0%) are plasmodium falciparum imported either through the southern border with Sudan or Egyptians returning from malaria endemic countries (Ministry of Health, 2010). Egypt has achieved the global targets in case detection and treatment success and is ranked as a country with intermediate incidence of Tuberculosis. Egypt is classified as one of the 36 worldwide countries having achieved the global targets in both case detection and treatment success under DOTS (World Health Organization, 2009). Incidence rate is 28% and the proportion of tuberculosis cases detected and cured under DOTS is 18% in 2010. Surprisingly, the poorest villages show better performance with regard to tuberculosis than the national level.
  • 35. 33 Goal Seven: Ensure Environmental Sustainability Target 7.A: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources 7.1 Proportion of land area covered by forest 7.2 CO2 emissions, total, per capita and per $1 GDP (PPP) 7.3 Consumption of ozone-depleting substances Target 7.B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss 7.4 Proportion of fish stocks within safe biological limits 7.5 Proportion of total water resources used 7.6 Proportion of terrestrial and marine areas protected 7.7 Proportion of species threatened with extinction Target 7.C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation 7.8 Proportion of population using an improved drinking water source 7.9 Proportion of population using an improved sanitation facility Target 7.D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers 7.10 Proportion of urban population living in slums The natural resources base and ecosystems must be managed sustainably to meet people’s food requirements and other environmental, social and economic needs. Climate change, increased water scarcity and conflicts over access to resources all pose challenges to environmental sustainability and food security. In addition, hunger and poverty often compel the poor to over-exploit the resources on which their own livelihoods depend. MDG 7 aims to ensure environmental sustainability. Worldwide, forest area increase in Asia is helping to slow global losses. Of all developing regions, South America and Africa saw the largest net losses of forest areas between 2000 and 2010. In the 25 years since the adoption of the Montreal Protocol on Substances that Deplete the Ozone Layer, there has been a reduction of over 98 per cent in the consumption of ozone-depleting substances. Since 1990, protected areas have increased
  • 36. 34 in number by 58 percent. Growth in protected areas varies across countries and territories. The world has met the target of halving the proportion of people without access to improved sources of water. Between 1990 and 2010, more than two billion people gained access to improved drinking water sources. Eleven per cent of the global population—783 million people—remains without access to an improved source of drinking water and, at the current pace, 605 million people will still lack coverage in 2015. Access to improved sanitation facilities increased from 36 per cent in 1990 to 56 per cent in 2010 in the developing regions as a whole. The share of urban slum residents in the developing world declined from 39 per cent in 2000 to 33 per cent in 2012. 7.1 Proportion of land area covered by forest Worldwide, South America and Africa saw the largest net losses of forest areas between 2000 and 2010. Oceania also reported a net loss, largely due to severe drought and forest fires in Australia. In Egypt, natural forests are not one of the natural environmental resources characterizing the country. But a program for the safe use of treated wastewater is implemented in order to plant 400 thousand feddan forests by using 2.4 billion m3 of treated wastewater. However, the rate of progress is still very slow. 7.2 CO2 emissions, total, per capita and per $1 GDP (PPP) This indicator is defined as the total carbon dioxide (CO2) emissions from energy, industrial processes, agriculture and waste (minus CO2 removal by sinks), presented as total emissions, emissions per unit population of a country, and emissions per unit value of a country’s gross domestic product (GDP) , expressed in terms of purchasing power parity (PPP). Worldwide, carbon dioxide (CO2) emissions decreased globally—by 0.4 per cent, down from about 30.2 billion metric tons in 2008 to some 30.1 billion metric tons in 2009. From 1990 through 2008, emissions increased 0 0.1 0.1 0.1 0 10 20 30 40 50 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.1: Proportion of land area covered by forest
  • 37. 35 almost annually, particularly since 2002. But even with the unprecedented dip, 2009 emissions were still 39 per cent above the 1990 level. In Egypt, the total CO2 emissions (thousand metric tons of CO2 (CDIAC))are highly increasing from 1990 until 2009 which indicates a high decrease in air quality. For the per capita CO2 emissions, there is also an increase from 1.34 in 1990 to 2.71 in 2009. Emissions per unit of economic output were higher in the developing regions 0.6 kilograms of CO2 per dollar of economic output (GDP), versus 0.37 kilograms in the developed regions. Egypt is closer to the situation of developed regions as the value in 2010 reached 0. 75944 78716 81264 93156 85313 95723 102031 108202 122243 125393 141326 125452 127194 158880 160582 174641 187505 199221 210321 216137 0 50000 100000 150000 200000 250000 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.2: CO2 emissions, total 1.34 1.36 1.38 1.55 1.4 1.54 1.62 1.69 1.87 1.89 2.09 1.82 1.81 2.22 2.2 2.35 2.48 2.59 2.69 2.71 0 5 10 15 20 25 30 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.2: CO2 emissions, per capita
  • 38. 36 7.3 Consumption of ozone-depleting substances Worldwide, a reduction of over 98 percent in the consumption of ozone-depleting substances has been achieved. Egypt is a party of the Montreal Protocol on Ozone Protection and has developed a national strategy. Consumption of ozone depleting CFC has decreased gradually during the period from 1994 to 2010 reaching706 tons. 7.5 Proportion of total water resources used In Egypt, most recent data for this indicator is in 2000 and the proportion is 113.8. This situation reflects the problem of water scarcity and the need to provide water sources to all sectors to meet the increasing demand fostered by national development plans. 0.38 0.38 0.42 0.37 0.4 0.41 0.41 0.44 0.43 0.46 0.39 0.39 0.47 0.46 0.48 0.48 0.47 0.47 0.46 0.12 0 0 5 10 15 20 25 30 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.2: CO2 emissions, per $1 GDP (PPP) 4,476 3,983 6,276 6,600 2,737 2,881 2,945 2,785 2,816 2,750 2,746 2,704 1,944 1,663 1,644 1,349 1,092 861 726 790 706 0 1000 2000 3000 4000 5000 6000 7000 8000 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.3: Consumption of ozone-depleting substances
  • 39. 37 7.6 Proportion of terrestrial and marine areas protected Worldwide, more areas of the earth’s surface are being protected: since 1990, protected areas have increased in number by 58 percent. In Egypt, the percentage is very low (6.1%) and there is no change made in this percentage since 2003. 7.8 Proportion of population using an improved drinking water source Worldwide, the proportion of people using an improved water source raised from 76 per cent in 1990 to 89 per cent in 2010. In Egypt, this indicator covers almost all the country for 99% of Egyptians are using an improved drinking water source. The poorest villages have lower percentage (84%) than the national level. 2.1 2.1 2.2 2.2 2.2 2.2 4.0 4.0 4.4 4.4 4.4 4.4 5.4 6.1 6.1 6.1 6.1 6.1 6.1 6.1 6.1 0 5 10 15 20 25 30 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.6: Proportion of terrestrial and marine areas protected 93 94 94 94 94 94 95 95 96 96 96 96 97 97 97 98 98 98 99 99 99 Poorest villages 84 0 20 40 60 80 100 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 7.8: Proportion of population using an improved drinking water source
  • 40. 38 7.9 Proportion of population using an improved sanitation facility Worldwide, access to improved sanitation facilities increased from 36%in 1990 to 56% in 2010 in the developing regions as a whole. In Egypt, the situation is even better than the global situation since 95% of Egyptians are using improved sanitation facilities. The poorest villages are not only lagging behind years than the national level, they have almost no access to an improved sanitation facility. 7.10 Proportion of urban population living in slums The share of urban slum residents in the developing world declined from 39% in 2000 to 33% in 2012. The situation in Egypt is better as the proportion of urban population living in slums declined from 50.2% in 1990 to 13.1% in 2009. 50.2 39.2 28.1 17.1 14.4 13.1 0 10 20 30 40 50 60 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.10: Proportion of urban population living in slums 72 73 74 75 77 79 80 81 83 84 86 87 89 90 91 93 94 95 95 95 95 Poorest villages 2 0 20 40 60 80 100 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 7.9: Proportion of population using an improved sanitation facility
  • 41. 39 Summary of Goal 7: Progress has been achieved in Egypt in the areas of expanding forests, thereby rationalizing the management and utilization of natural resources, increasing the proportion of those using improved drinking water sources and sanitation, and reducing the number of those living in slum areas. Despite the progress made in accessing improved drinking water source and sanitation facility, the poorest villages are suffering from lack of improved sanitation facility. Only 2% of the poorest villages have an access to improved sanitation facility compared to 95% at the national level. This points out to the need to continue with the national efforts to provide improved drinking water source and to concentrate efforts on providing improved sanitation facilities, which are almost lacking in rural areas.
  • 42. 40 Goal Eight: Develop a Global Partnership for Development Target 8.A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system Includes a commitment to good governance, development and poverty reduction – both nationally and internationally Target 8.B: Address the special needs of the least developed countries Includes: tariff and quota free access for the least developed countries' exports; enhanced programme of debt relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt; and more generous ODA for countries committed to poverty reduction Target 8.C: Address the special needs of landlocked developing countries and small-island developing states (through the Program of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly) Target 8.D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term Official Development Assistance (ODA) 8.1 Net ODA, total and to the least developed countries, as percentage of OECD/DAC donors’ gross national income 8.2 Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and sanitation) 8.3 Proportion of bilateral official development assistance of OECD/DAC donors that is untied 8.4 ODA received in landlocked developing countries as a proportion of their gross national incomes 8.5 ODA received in small island developing States as a proportion of their gross national incomes
  • 43. 41 Market access 8.6 Proportion of total developed country imports (by value and excluding arms) from developing countries and least developed countries, admitted free of duty 8.7 Average tariffs imposed by developed countries on agricultural products and textiles and clothing from developing countries 8.8 Agricultural support estimate for OECD countries as a percentage of their gross domestic product 8.9 Proportion of ODA provided to help build trade capacity Debt sustainability 8.10 Total number of countries that have reached their HIPC decision points and number that have reached their HIPC completion points (cumulative) 8.11 Debt relief committed under HIPC and MDRI Initiatives 8.12 Debt service as a percentage of exports of goods and services Target 8.E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries 8.13 Proportion of population with access to affordable essential drugs on a sustainable basis Target 8.F: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications 8.14 Telephone lines per 100 population 8.15 Cellular subscribers per 100 population 8.16 Internet users per 100 population Goal 8 - global partnership for development - is about the means to achieve the first seven MDGs. Many environmental global problems: climate change, loss of species diversity, and depletion of global fisheries can only be solved through partnerships between rich and poor countries. The objective of MDG 8 is to assist all developing countries in achieving the goals through a strengthened global partnership for international development cooperation, including providing development assistance, improved access to markets and debt relief. Worldwide, tariffs imposed by developed countries on products from developing countries have remained largely unchanged since 2004, except for agricultural products. Bilateral aid to sub-Saharan Africa fell by
  • 44. 42 almost 1 percent in 2011.There has been some success of debt relief initiatives reducing the external debt of heavily indebted poor countries but 20 developing countries remain at high risk of debt distress. During this time, developing countries were influenced by the 2009 economic downtown and in 2011 the debt to GDP ratio decreased for many developing countries. Vulnerabilities remain. Expected slower growth in 2012 and 2013 may weaken debt ratios. Resources available for providing essential medicines through some disease-specific global health funds increased in 2011, despite the global economic downturn. There has been little improvement in recent years in attaining the availability and affordability of essential medicines in developing countries.74 per cent of inhabitants of developed countries are internet users, compared with only 26 per cent of inhabitants in developing countries. The number of mobile cellular subscriptions worldwide by the end of 2011 reached 6 billion. 8.12 Debt service as a percentage of exports of goods and services In Egypt, there is a noticeable decrease in the debt service as a percentage of exports of goods and services. The percentage decreased in 2010 to 5.7 compared to 23.7 in 1990. 8.13 Proportion of population with access to affordable essential drugs on a sustainable basis Only 24% of the people living in the poorest villages are having access to affordable essential drugs when needed. 23.7 18 17.9 15 14 14.6 12.5 10.4 11.2 9.9 8.5 9.5 11 11.1 7.3 6.8 6 5.8 5.4 6.1 5.7 0 5 10 15 20 25 30 35 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 8.12: Debt service as a percentage of exports of goods and services
  • 45. 43 8.14 Telephone lines per 100 population The telephone lines per 100 population achieved an increase from 1990 to 2008 and then decreased to 10.6 in 2011. This is perhaps due to the increase in accessing cell phones as a communication tool. Poorest villages have better value of 24% than the national level. 8.15 Cellular subscribers per 100 population Cellular subscribers per 100 population achieved an increase from 1990 to 2011 reaching 101. The poorest villages have lower value of 46% than the national level which is lower than the half. 2.8 3.1 3.4 3.7 4.0 4.4 4.8 5.4 6.1 7.1 8.1 9.7 11.1 12.2 13.1 14.1 14.4 14.6 15.1 12.9 11.9 10.6 Poorest villages 24.0 0 5 10 15 20 25 30 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 8.14: Telephone lines per 100 population 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.1 0.1 0.7 2.0 4.1 6.4 8.1 10.5 18.4 23.8 39.1 52.7 69.4 87.1 101.1 Poorest villages 46 0 20 40 60 80 100 120 19901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012 Figure 8.15: Cellular subscribers per 100 population
  • 46. 44 8.16 Internet users per 100 population Worldwide, 74 per cent of inhabitants of developed countries are internet users compared to only 26 per cent of inhabitants in developing countries. Egypt’s achievement in the internet users per 100 population is noticeable, which reached 35.6 in 2011, but this percentage is still not big enough. Summary of Goal 8: In Egypt, external debt has witnessed considerable improvement over the period (1990/91-2008/09). External debt as a percent of GDP fell from above 100% in 1990/91 to 16.7% in 2008/09 and debt service as percentage of current account receipts fell from above 25% in 1990/91 to 6% in 2008/09. Egypt has witnessed significant development in the last few years in the field of information and communication technology. However, 0 0 0.01 0.03 0.06 0.09 0.2 0.3 0.6 0.8 2.7 4.0 5.2 11.7 12.6 16.1 18.0 24.3 30.2 35.6 0 5 10 15 20 25 30 35 40 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Figure 8.16: Internet users per 100 population
  • 47. 45 telephone lines per 100 populations are only 10.6 at the national level, but this is replaced by cellular subscribers per 100 populations which reached 101. The poorest villages are lagging behind the national level with regard to cellular communication. Conclusion: This report has used the indicators of the Millennium Development Goals (MDGs) to compare the status of development in the poorest 151 villages in Egypt to the national average. The comparison reveals that the poorest villages are lagging behind; the gap in many cases is alarming and indicative of stark inequalities that raise concern and call for action. Research results, therefore, point out to the responsibility of the government to continue its 1000 villages’ development program. The research also provides valuable background information as to what this national program should focus on. For instance, the provision of vocational training and technical education in those villages will improve education indicators (MDG2) and will impact positively on poverty alleviation (MDG1). Also, the provision of basic healthcare facilities in the poorest villages can improve indicators under MDGs 4, 5 and 6. Last but not least, the provision of improved water and sanitation services in the poorest villages (MDG7) will improve the quality of life generally and reduce health hazards in those villages. It is recommended to collect information for the MDGs indicators at the villages’ level and to periodically compare them to the national average to ensure equity and to offer orientation to programs of spatial targeting of poverty.
  • 48. SCC was established in 2007 as a joint initiative between the Egyptian Cabinet’s Information and Decision Support Center, IDSC and the United Nations Development Program, UNDP, with the support of the Italian-Egyptian Debt for Development Swap Program and the Government of Japan. SCC was established based on the recommendations of the Egyptian Human Development Report titled “Choosing Our Future: Towards a New Social Contract” which presents a vision of Egypt centered on the ambitious proposal of a new Social Contract. SCC’s mission is to provide technical support to the human development efforts in Egypt using a rights-based approach rooted in the principles of good governance and citizenship. SCC aims to monitor progress towards the achievement of the Millennium Development Goals (MDGs) in Egypt, and strives to build a national consensus on the concept of the Social Contract and its implications, in addition to rebuilding trust between the government and citizens, as well as supporting efforts to empower civil society. For more information on SCC, please visit www.socialcontract.gov.eg The Social Contract Center 106 Kasr El Aini St., Cairo Center Bldg. Floor 13 – Cairo, Egypt Tel: 2792 3198/27922971 Fax: 27961386 Email: scc@socialcontract.gov.eg www.socialcontract.gov.eg © All Rights Reserved, Social Contract Center - 2014 The Social Contract Center