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Measuring Child and Maternal Health in Developing Countries: A Proposal of New Hybrid MDG Composite Indices

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Abstract

This paper proposes new hybrid composite indices from a set of Millennium Development Goals (MDGs) indicators to measure child and maternal health in developing countries. Under a multi-criteria approach, we use a normalization formula with a double reference point scheme that includes an aggregation function with two reference values: aspiration and reservation. We rely on the distance P2 method to calculate the importance (weights) of each MDG indicator in the multi-criteria approach and propose several indices with different degrees of substitutability among indicators. This hybrid approach allows us to assess the progress in child and maternal health in 90 developing countries in the framework of the MDGs, from which potential policy implications may derive for the implementation of the post-2015 sustainable development agenda.

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Notes

  1. It is estimated that 5.9 million children died before age five in 2015, which translates to the death of around 16,000 children under age five every day, due essentially to preventable diseases (UNICEF 2015b).

  2. 99 % of preventable maternal deaths occur in low and middle-income countries, and thousands of women die for preventable reasons related to childbirth and pregnancy (WHO 2015a).

  3. Direct obstetric causes, notably hemorrhage (27 %), hypertensive diseases of pregnancy (14 %) and sepsis (11 %), continue to be the leading causes of maternal deaths (WHO 2015b).

  4. UNICEF, jointly with the United Nations Population Fund (UNFPA) and the World Health Organization (WHO), recommend at least four antenatal care visits during pregnancy, as the minimum needed to provide the most important services. Nevertheless, under certain circumstances, a single antenatal care visit may already be crucial (UNICEF 2008).

  5. For instance, adolescent birth rate (MDG 5), current contraceptive use among married women 15-49 years old (MDG 5), women 15-24 years old with comprehensive, correct knowledge of HIV/AIDS (MDG 6), children under 5 sleeping under insecticide-treated bed nets (MDG 6), and children under 5 with fever being treated with anti-malarial drugs (MDG 6).

  6. That is, for the indicator 1 we reduce by half the prevalence of underweight children under-five years of age, which in 1990 was 29 % for developing countries (United Nations 2012). The result obtained is 14.5 %. This way, we calculate the aspiration value of the other indicators.

  7. The WHO Global Vaccine Action Plan for 2012–2020 has established the target of measles and rubella elimination in at least five WHO Regions by 2020 and Member States in all six Regions have set goals to eliminate measles by 2020 or before (see Durrheim et al. 2014).

  8. Although this indicator may range from 0 (no unmet needs) to 100 (no needs met), values approaching 100 % do not occur in the general population of women, since at any one time, some women wish to become pregnant and others are not at risk of pregnancy. In general terms, unmet need levels of 25 % or more are considered very high, and values of 5 % or less are regarded as very low (United Nations 2014b).

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Authors and Affiliations

  1. Department of Applied Economics (Mathematics), University of Malaga, Campus de El Ejido, 29071, Malaga, Spain

    Mariano Luque & Beatriz Rodriguez

  2. Department of Applied Economics (Economic Policy), University of Malaga, Campus de El Ejido, 29071, Malaga, Spain

    Salvador Pérez-Moreno & José A. Robles

Authors
  1. Mariano Luque
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  2. Salvador Pérez-Moreno
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  3. José A. Robles
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  4. Beatriz Rodriguez
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Corresponding author

Correspondence to Salvador Pérez-Moreno.

Appendix

Appendix

Table 8 Values of the indices and country rankings
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Luque, M., Pérez-Moreno, S., Robles, J.A. et al. Measuring Child and Maternal Health in Developing Countries: A Proposal of New Hybrid MDG Composite Indices. Applied Research Quality Life 12, 737–758 (2017). https://doi.org/10.1007/s11482-016-9487-2

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