In much of Eastern Europe and Central Asia achieving the Millennium Development Goals' infant and maternal mortality targets would produce small gains in life expectancy. Targets for the reduction of adult mortality based on European Union levels are better alternatives in these countries.

The Millennium Development Goals (MDGs) constitute a framework for measuring development. Three out of the eight MDGs are directly related to health. They set targets for reductions in child and maternal mortality as well as mortality related to HIV/AIDS, malaria and other diseases. These goals are more appropriate to developing countries than to most countries in Eastern Europe and Central Asia. This is because these levels of mortality are highest in developing countries and because data on infant, child and maternal mortality are more commonly available.

Researchers from the London School of Hygiene and Tropical Medicine and the World Bank carried out a study to determine the impact of different scenarios on life expectancy in Eastern Europe and Central Asia. One such scenario is the achievement of the targets set in the MDGs for infant, child and maternal mortality. The other is a reduction in deaths from cardiovascular disease and external causes (injuries, homicide etc.) among adults to European Union levels. The study's findings suggest that the latter scenario would result in the highest gains in life expectancy in Eastern Europe and Central Asia. In particular, the researchers note that:

• Reaching the MDGs for infant, child and maternal mortality would result in an average gain in years of life of between 0.68 and 1.24 years.
• By contrast, a reduction in adult mortality would result in the highest gains in life expectancy. The average gain in years of life would be 7.75.
• Some countries of the former Soviet Union like Russia, Turkmenistan and Ukraine would make even greater gains in life expectancy with 10.09, 9.70 and 8.67 years of life added to current life expectancies.

The researchers call for the implementation of health improvement strategies selected on a country by country basis.  The article proposes the following policy lessons:

• Systems of data collection must improve and be standardised. In particular, countries should adopt the World Health Organisation’s definition of 'live birth'.
• The misreporting of infant deaths must be reduced.
• All countries must stop charging fees for registering deaths.
• Health targets and policy interventions should be adapted to the context of individual countries. In the case of countries in Easter Europe and Central Asia, this would mean concentrating on the reduction of adult mortality rates.
• Central Asian and Eastern European countries need international assistance to implement policy interventions appropriate for a reduction in adult mortality. In particular, these regions need more emphasis on health promotion and disease prevention.

Source(s):
'Millennium Development Goals for health in Europe and Central Asia: relevance and policy implications', World Bank Working Paper 33, B. Rechel et al, 2004

Funded by: The World Bank

id21 Research Highlight: 7 November 2005

Further Information:
Martin McKee
European Centre on Health of Societies in Transition
London School of Hygiene and Tropical Medicine
Keppel Street
London WC1E 7HT
UK

Tel: +44 20 79272229
Fax: +44 20 75808183
Contact the contributor: Martin.McKee@lshtm.ac.uk

London School of Hygiene and Tropical Medicine, UK

World Bank

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