HUMAN DEVELOPMENT NETWORK Health, Nutrition, and Population Series 19407 May 1999 Measuring Country Performance on Health Sele.cted Indicators for 115 Countries Jia Wang, Dean T Janilson, Edla,] Bos, Alexander Preker, and John Peabody Health, Nutrition, and Population Series This series is produced by the Health, Nutrition, and Population Family (HNP) of the WNorld Bank's Human Development Network. The series aims to provide a vehicle for publishing material on the Bank's work in the HNP sector, to consolidate the various previous publications in the sector, and to improve the standard for quality control, peer review, and dissemination of HNP publications. The series focuses on publications that expand our knowledge of HNP policy and strategy issues through thematic reviews, analytical work, case studies, and examples of best practices. The volumes in the series focus on material of global and regional relevance. The broad strategic themes of the series are proposed by its editor- ial committee, which is coordinated by Alexander S. Preker. The other members of this committee are A. Edward Elmendorf, Mariam Claeson, Armin H. Fidler, Charles C. Griffin, Peter F Heywood, Prabhat K. Jha, Jack Langenbrunner, Maureen A. Lewis, Samuel S. Lieberman, Milla Mclachlan, Judith Snavely Mcguire, Akiko Maeda, Thomas W. Merrick, Philip Musgrove, David H. Peters, Oscar Picazo, George Schieber, and Michael W"alton. HUMAN DEVELOPMENT NETWORK Health, Nutrition, and Population Series Measuring Country Performance on Health Selected Indicators for 115 Countries Jia Wang, Dean T Jamison, Eduard Bos, Alexander Preker, and John Peabody The IWorld Bank Washington, D.C (D 1999 The International Bank for Reconstruction and Development / THE WORLD BANK 1818 H Street, N.W Washington, D.C. 20433, U.S.A. All rights reserved Manufactured in the United States of America First printing May 1999 This report has been prepared by the staff of the World Bank. The judgments expressed do not necessar- ily reflect the views of the Board of Executive Directors or of the governments they represent. The material in this publication is copyrighted. The World Bank encourages dissemination o' t-o and will normally grant permission promptly Permission to photocopy items for internal or personal use, for the internal or personal use of specific clients, or for educational classroom use, is granted by the World Bank, provided that the appropriate fee is paid directly to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, U.S.A., telephone 978-750-8400, fax 978-750-4470. Please contact the Copyright Clearance Center before photo- copying items. For permission to reprint individual articles or chapters, please fax your request with complete informa- tion to the Republication Department, Copyright Clearance Center, fax 978-750-4470. All other queries on rights and licenses should be addressed to the World Bank at the address above or faxed to 202-522-2422. Jia Wang is the assistant director and senior research associate at the Center for Pacific Rim Studies, University of California, Los Angeles. Dean T. Jamison is a professor at the University of California, Los Angeles, (UCLA) and director of the Economics Advisory Service, World Health Organization. Wang and Jamison were consultants to the World Bank when this volume was prepared. Eduard Bos is a demographer, and Alexander Preker is a senior economist at the World Bank. John Peabody is an assistant professor of General Internal Medicine, Department of Medicine, UCLA, and senior scientist at the RAND Corporation. Cover graphic by Jennifer Sterling, Spot Color, Alexandria, VA. Library of Congress Cataloging-in-Publication Data Measuring country performance on health: selected indicators for 115 countries / byJia Wang ... [et al. . p. cm. - (Health, nutrition, and population) Includes bibliographical references and index. ISBN 0-8213-4409-9 1. Mortality-Developing countries-Statistics. 2. Fertility, Human-Developing countries-Statistics. 3. Life expectancv- Developing countries-Statistics. I. Wang, Jia, 1943- 11. Series: Health, nutrition, and population series. RA407.5.D44 1998 614.4'2-dc2l 98-50177 CIP Contents Foreword v 1 Introduction 1 2 Data 3 3 Methodology 4 Models of Determinants of Health Status 5 Use of Regression Residuals 6 4 Results 7 Regression Results for the Effects of Income and Education on Health Outcomes 7 Country Performance Trends across Time 10 Regional Performance Trends across Time 10 Comparing Residuals from Different Models 12 Country Performance Level Relative to the Other Countries and Economies 14 Health Improvement: Relative Contribution of Income, Education, and Technical Progress 17 5 Conclusions 20 Endnotes 21 References 22 Supplementary Tables 23 Annex A. East Asia and the Pacific: Regional and Country-Specific Indicators of Performance on Health 77 Annex B. Europe and Central Asia: Regional and Country-Specific Indicators of Performance on Health 115 Annex C. Latin American and the Caribbean: Regional and Country-Specific Indicators of Performance on Health 137 Annex D. Middle East and North Africa: Regional and Country-Specific Indicators of Performance on Health 203 Annex E. South Asia: Regional and Country-Specific Indicators of Performance on Health 239 Annex E Sub-Saharan Africa: Regional and Country-Specific Indicators of Performance on Health 255 iii iv Measuring Country Performance on Health Figures 1 Income and Under-Five Mortality (q5), 1960 and 1980 1 2 Performance on Under-Five Mortality Rate over Time 13 3 Performance Diamonds for Selected Countries, 1990 14 Text Tables 1 Education, Income, and Time as Determinants of Health Outcomes 8 2 Effects of an Additional Year of Education or an Additional $ 1,000 of Income on Health Outcomes 9 3 Regional Variation in Performance, Relative to Income and Education, 1960-90 11 4 Income and Time as Determinants of Health Outcomes 15 5 Correlation of Performance Measures between Models Estimated With and Without Education 16 6 Regional Variation in Performance, Relative to Income, 1960-90 16 7. Income, Education, and Time as Determinants of Health Outcomes: Decomposition Analysis 18 8. Accounting for Progress in Health, 1960-90: Regional Var:iation in the Relative Contributions of Technical Progress amd Changes in Income and Education Levels 18 Supplementary Tables I. List of Countries or Economies in Each Region 24 II. Comparison of Regression Coefficients Using Different Income Measures 26 III. Means and Standard Deviations of Variables Used, Overall and by Region 28 IV Country-Specific Performance Relative to Income and Education, 1960-90 IV.I Under-Five Mortality Rate 31 IV.2 Female Adult Mortality Rate 33 IV3 Male Adult Mortality Rate 35 IV4 Total Fertility Rate 37 IV5 Female Life Expectancy 39 IV6 Male Life Expectancy 41 V Country-Specific Performance Relative to Income, 1960-90 V I Under-Five Mortality Rate 43 V2 Female Adult Mortality Rate 45 V3 Male Adult Mortality Rate 48 V4 Total Fertility Rate 51 V.5 Female Life Expectancy 54 V6 Male Life Expectancy 57 VI. Country Rankings on Selected Health Indicators, Controlling for Income and Education 60 VII. Country Rankings on Selected Health Indicators, Controlling for Income Only 62 VIII. Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels VIII.1 Under-Five Mortality Rate 65 VIII.2 Female Adult Mortality Rate 66 VIII.3 Male Adult Mortality Rate 68 VIII.4 Total Fertility Rate 70 VIII.5 Female Life Expectancy 72 VIII.6 Male Life Expectancy 74 Foreword Health outcomes constitute one natural starting point for tables VI and VII then rank countries in terms of their assessment of the consequences of policies affecting performance on the selected health indicators; one con- health systems. Yet country characteristics-particularly trols for both income and education, and the other con- income and education levels-also influence health out- trols for income only Six regional annexes provide comes, and in judging countries' performance on health, graphical summaries of the results for each indicator on analysts often speak of relative performance. For exam- a country-by-country basis, along with basic relevant ple, child mortality rates in Tanzania might be judged low data for the country It is worth emphasizing that "per- relative to those of other African countries yet be quite formance" refers to countries, not their health policies; high by global standards. Far more dramatic than the variations in health policy are only one source of varia- effects of income or education, however, have been tion in health outcomes relative to income. Likewise, improvements over time: at a given income level, good health outcomes constitute only one dimension of per- performance in 1960 might be very bad indeed in 1990. formance; access, satisfaction, risk-sharing, and costs To assist in judging country performance, the authors are other major outcomes to consider. present time- and country-specific outcome indicators In one sense, the authors' goal in this report is a mod- that control either for both income and education levels est one: they take a single aspect of health system per- or for income levels alone. This report contains results for formance and describe systematically how countries 115 countries at five-year intervals in the period compare with each other and how their own perfor- 1960-90 on six health indicators-under-five mortality mance has improved (or failed to improve) over time. rates, total fertility rates, adult mortality rates for males Yet in another sense their achievement is major. and females, and life expectancy at birth for males and Performance on health outcomes is critical for human females. The World Bank's purpose in undertaking this welfare, and, until now, country decisionmakers and study was not to explain why performance differs; rather policy analysts have had no systematic way to judge per- the aim was to prepare a reference document that pro- formance. This report provides them with that capacity. vides measures that other analysts can use in assessing In the future we may expect to have performance mea- the consequences of policy sures based on better data, which are more up to date The main report describes the methods used and than those used in 1990, based on improved statistical provides an overview of results. Supplementary tables methods, and include other dimensions of outcome. Yet, IV and V contain the country performance results for to judge from initial experience in using these perfor- each indicator. In both cases performance relative to mance measures in discussions with senior gove=ment income is provided, and, when appropriate education officials, what is available here can sharpen policy dia- data were available, performance controlling for both logues with what are, in some cases, unexpected infor- income and education is also reported. Supplementary mation on performance and performance change. Christopher Lovelace Health, Nutrition, and Population, Acting Director Human Development Network v 1 Introduction Countries vary enormously, of course, in their levels of Figure 1 Income and Under-Five Mortality (q5), mortality and fertility Differences in income and edu- 1960 and 1980 cation levels account for much of this variation at any . 250 time. Even after controlling for education and income oz Indonesia, q5 = 216 levels (and income distribution), some countries show , 200| better results than others. Measuring country "perfor- 1 173 mance," after controlling for education and income or 5 2 Colombia, q5 = 122 income alone, provides an indicator for the policy ana- 0 196 lysts that allows quantitative posing of the question of E 100 \llndonesia, q5= 1960 why performance differs-over time and across coun- 50 648 tries. This, then, is a context for judging the effects of D Colombia, q5 = 19 policies explicitly designed to improve health, whether 00 ,o000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 those policies are within or outside the health sector. Per capita income (in 1985 international dollars, This report summarizes results from an extensive series adjusted for purchasing power parity) of analyses, undertaken as background to the World Note: These curves are generated from a statistical model that also in- Bank's 1997 Health, Nutrition, and Population Sector cludes female education as a determinant of under-five mortality- The Strategy paper. For the first time, it provides the health specific curves graphed here assume an average female education level policy analysts with quantitative measures of a coun- cf 3. years. try's performance over time on several key indicators- For this reason, performance must be judged not under-five mortality rate, adult mortality rates (male only relative to a country's income and education, but and female), life expectancy (male and female), and also specific to a time period. Figure 1 shows the actu- total fertility rates. al values for income and under-five mortality rates for Over time there has been a marked reduction in the Colombia and Indonesia in 1960 and 1990 and, on the mortality level associated with any given income level. curve, the predicted value. Indonesia's under-five mor- Figure 1 illustrates this point and the conceptual tality rate in 1990, for example, was 95 per 1,000 live approach we take to generate the performance mea- births, whereas the predicted rate was 68: hence its rel- sures discussed here. The upper curve shows the rela- ative performance was -33 percent. Colombia's relative tion between under-five mortality rate and income in performance in 1990 was +93 percent.' Relative per- 1960. The lower curve shows the same relation in formance is similarly calculated for adult mortality 1990, at an income of around $2,000 per capita a year. rates. For life expectancy and total fertility rate, the per- For example, mortality rates in 1990 are only about formance measure used is simply the number of years half those of 1960, which suggests enormous technical or births that the country's actual level deviates from progress. predicted. A positive performance measure on total fer- 1 2 Measuring Country Performance on Health tility rate means that the country has a higher fertility uals to construct performance measures; the third pre- rate than expected; a positive performance measure on sents the results; and the last describes the conclusions. mortality means better performance (lower mortality Supplementaly tables IV and V show country perfor- rate and higher life expectancy) than expected. mance over time for each indicator. Annexes A to F The remainder of this report is divided into four (grouped by region) graphically depict the performance parts. The first describes the data; the second summa- after controlling for income on a country-by-country rizes the methods used, the model specifications, and basis. Readers with only a limited interest in the meth- the advantages and problems in using regression resid- ods may want to go directly to the "Results" section. 2 Data The aggregate country data used here are compiled would live if prevailing patterns of mortality at the from various sources. The under-five mortality num- time of its birth were to stay the same throughout its bers are from Hill, Pande, and Jones (forthcoming); life (WDR 1993, p. 308) total fertility rate, adult mortality rate, and life * Education Level (ED, MED for male and FED for expectancy numbers are based on updated World Bank female): the average years of education in the pop- demographic files; education data are from Barro and ulation aged 15 and over, by gender (Barro and Lee Lee (1996); and per capita income figures are from the 1996) Penn World Table, Version 5.6 (Heston and Summers * Income per Capita (YPC): The real gross domestic 1996; Summers and Heston 1991). The data period product (GDP) per capita in constant international covers from 1960 through 1990, with time points sep- dollars is used as the income measure (Penn World arated by five years. The analysis focuses on the low- Tables in Heston and Summers 1996; Summers and and middle-income developing countries and coun- Heston 1991). Penn World Tables provide income tries from Europe and Central Asia; no high-income per capita numbers from 1950 through 1992. To countries are included. Supplementary table I lists the minimize changes in performance that are related included countries by region. to sudden drops or increases in income in any given The definitions of the various health outcomes, year for any given country, we used the average education, and income measures analyzed in this income of the four preceding years and the indi- report are: cated year for the indicated year. For example, the income number for the year 1970 is the average * Under-Five Mortality Rate (Q5): the probability of income from year 1966 through 1970. We also con- dying between birth and age five per 1,000 live births ducted analyses using the single-year income num- (World Development Report [WDR] 1993, p. x) bers and the average income over every 10-year * Total FerLility Rate (TFR): the number of children period to estimate health outcomes. The results that would be born to a woman if she were to live from these three equations are very similar in terms to the end of her childbearing years and bear chil- of the regression coefficients and the overall R2 val- dren at each age in accordance with prevailing age- ues. Because some of the health performance indi- specific fertility rates (WDR 1993, p. x) cators analyzed here are based on every five-year * Adult Mortality Rate (AMR, AMRM for male adults period (for example, life expectancy), we chose to and AMRF for female adults): the probability of use the average income over each five-year period dying between ages 15 and 60 per 1,000 persons as the income measure. The results (see supple- reaching age 15, by gender (WDR 1993, p. 23) mentary table II) are similar, however, whether we * Life Expectancy at Birth (LE, LEM for male and LEF average over 5 years or 10 years or use the income for female): the number of years a newborn infant numbers for the indicated year. 3 3 Methodology Multiple regression models usually take the follow- to analyze panel data on i units (individual countries) ing form over t time periods. Within the cross-sectional time-series framework, (1) Yi= cX + Xi B + e one can try to estimate the relation between indepen- dent variables and the dependent variable by using the where y is the predicted quantity, following equation: x is the vector of determining variables for country i, (2) Yi = a + XiB + ci+ E i B is the vector of coefficients to be estimated, and where ci is the country-specific effect, though its effect E is an error term. on the dependent variable could not be estimated-the effect is confounded with the residual value. This equa- One of the assumptions for ordinary least squares tion provides between-country estimations while (OLS) regression is that the error associated with ignoring the within-country variation. To get country- observation i is not correlated with the error asso- specific effects across time, country indicator vari- ciated with observation j. This assumption is able(s) can be added to an alternative form of equation clearly violated here, because in our data each (1) to reflect the same country is observed multiple country is observed multiple times. A country's times. deviation (error, in the sense it is not predicted by the model) for time 1 is related to its deviation for (3) Yit= ct + Xit B + ci + Git time 2, time 3, and so forth. However, this special form of data structure can be properly modeled The country-specific effect ci is a constant value for any with various statistical software. SAS software has a given country for all time points; in other words, it can procedure called "Repeated Measures Analysis" that only adjust the estimated value for a country up or is set to test the within-subject effects and the with- down. This will not be the approach to take if the in-subject-by-between-subject interactions (in this country-specific effect fluctuates or varies over differ- case, "country" is the subject). Hierarchical Linear ent time points. Since we believe that individual coun- Modeling (HLM, Bryk and Raudenbush 1992) is try effects on the measured health outcomes are dif- another program designed to take the nested nature ferent across countries and vary over time, we use both of data (observations nested under each country) equations (2) and (3) to estimate or model health out- into consideration while running regression analy- comes. With 0 as a function of country variance and sis. STATA (1996) is one of the other software pack- residual variance, 0 equals zero when there is no coun- ages that provide between- and within-subject try variance and 0 equals 1 when the residual variance (country, in our case) estimates. The cross-sectional is zero, and the random-effect equation takes this time-series regression method in STATA is designed form: 4 Methodology 5 (4) (Yit - Oiy) = between income and education are modeled as the (1 - O)cc + (xit - Oki)B + [(1- O)ci + (E i- 0i)]. determinants of mortalityand fertility The model spec- ification is described below: This equation, a combination of equation (2) and equa- tion (3), uses both the between- and within-country (5) LN(healthi ) = data and lets country effects vary over time. The result- A + B [LN(rgdpit)] + C (educationi,t) ing random-effect regression (with country effect vary- + ID, (timet) + XEt [LN(rgdpi1t) * (timet)] ing over different periods) provides a weighted average + XFt [LN(educationi t) * (timet)] of between (-country) and within (-country) results + EG [LN(rgdpi ) * (education,,,)] + ci t using the generalized least squares (GLS) estimator. By running a random-coefficient model, we allow the esti- where LN(healtht) is the natural log of the health out- mates to be conditioned by the sample in that the coun- come (for example, under-five mortality rate, total fer- try effect has a distribution and it is not fixed. For these tility rate, and so forth) in country i at time t; purposes, Kreft and De Leeuw (1991) suggest the use LN(rgdpi,) is the natural log of the average real of a random-coefficient model instead of a fixed-coef- income over a five-year period in country i at time t; ficient model. The random-coefficient model controls education, t is the years of education for the related for the sampling of schools instead of students direct- population in country i at time t; ly and the nested nature of the education data. timet is the time period indicator, t = 1, Following their suggestion, we used the random-coef- 6 (TimeO, 1960, is omitted); ficient model instead of the fixed-coefficient model to and E i t is the specific error term for country i at time t. get more precise estimates. The analysis procedure used here, cross-sectional A, B, C, Dt, Et Ft, and G are the regression coefficients time-series regression analysis, adjusts for multiple to be estimated. The income coefficient is an elasticity, observances of the same country in the 30-year period showing by what percentage the mortality rate would and therefore provides unbiased standard errors. To be reduced by increasing real income per capita 1 per- validate the results, we ran separate analyses using cent when all the other variables in the equation are HLM, a recently developed statistical method for ana- held constant. The education coefficient shows the lyzing multilevel data and reducing bias in the standard effects of an additional year of education on health con- errors. We found that the coefficient estimates derived ditions. The coefficients of the time indicators can be from these two methods are close to identical and that interpreted as the main effects of technical progress rel- the final country rankings are very similar. The detailed ative to 1960, but this would be technical progress results are presented in a separate report (Wang and broadly defined-changes in levels of health expendi- Jamison 1998). ture, for example, could account for part of the change. We used cross-sectional time-series regression to However, these interpretations of the effects of the pre- estimate the effects of real income, education, and time dictors on health status are true only when there are no (a proxy for technical progress generally defined) on interaction variables in the model. To get a sense of the selected health outcomes. The model specification how much health conditions can improve as a result of is described in the next section. increased income, for example, the main income (B) and all income-related interaction (Et and G) effects have to be considered. The coefficient estimates for the Models of Determinants of Health Status interactions adjust the income and time effects on health outcome measures up and down to allow for Real income per capita, education, time, interaction specific income and time effects for each time point. variables between income and time, interaction vari- Analogous equations are used to model the other ables between education and time, and interaction health performance indicators (total fertility rate, adult 6 Measuring Country Performance on Health female mortality rate, adult male mortality rate, male male adult mortality rates.) They prefer GLS to HLM life expectancy, and female life expectancy). For male because of the ease of data manipulation after the data mortality indicators, we use the average years of educa- have been imported into the program. tion for the male population aged 15 and over; we use We construct performance measures with the the female education level for all the other indicators. regression residuals to provide the most informative and empirical evidence regarding health conditions across countries over the past three decades. We Use of Regression Residuals compare country health performance using residuals after controlling for key determining variables Residuals have been widely used to identify the good (income alone or with education). This trend infor- performers on the compared measure discussed in this mation on countries' relative performance may prove report. Since early 1980, educational researchers have interesting and useful to health policymakers and been using the residuals to identify schools that are national health analysts. They could speculate as to effective in fostering their students' educational out- the cause of the magnitude of change in the regres- comes. Most recently, Tracy and Waldfogel (1997) used sion residual values after knowing that income, edu- regression residuals, instead of the usual survey meth- cation, and technical progress are not the cause of the ods, to rank business schools. They tried to distinguish change. Such changes could relate to health policy the quality of a program from the quality of its students change, a change in population age structure, a in their rankings. The use of regression residuals as a change of government, rapid income fluctuations, performance measure for comparison is a common occurrence of war, and so forth. practice in various fields, such as education, business, Performance measures using regression residuals economics, and so forth. For example, Behrman are similar to the relative performance measures used (1996) used regression residuals Lhroughout his book byjamison and others (1996). In their report, they cal- Human Resources in Latin America and the Caribbean to culated relative performance on mortality rate as the compare Latin American and Caribbean countries with amount of predicted higher than actual as a percent of other countries on their performance on income, the actual, with both measured in number of deaths schooling, and health outcomes around 1990. per 1,000. The relative performance on life expectan- A detailed discussion of the substantive and cy and total fertility rate was calculated as the amount methodological concerns about using regression resid- of actual life expectancy or total fertility rate higher uals can be found in Wang and Jamison (1998). That than predicted in years as a percent of the actual. In the report examined the robustness of residual values and study reported here, we took the difference between rankings with respect to alternative statistical estima- predicted and observed mortality rates as the relative tion procedures. Income per capita, education level, performance on mortality rate; and the difference and time were used to explain the variation found in between predicted and actual, after transforming these female and male adult mortality rates. They concluded values back to years or births, as the relative perfor- that random-effect GLS regression and HLM give mance on life expectancy and total fertility rate. By cal- almost identical regression results and residual values. culating relative performance this way, we make the (The correlation coefficients between GLS and HLM residual comparison compatible across years and residual values are equal to one for both female and across countries. 4 Results The descriptive information on the variables used is 100,000. In regard to the amount of within-country provided in supplementary table 111. From 1960 to variance in the outcome variables explained by the pre- 1990, improvement was remarkable on all the health dictors we used, the R2 within countries ranged from indicators we compared. For example, the average total 64 percent for the male adult mortality rate to 83 per- fertility rate declined from six births per woman to five. cent for the under-five mortality rate. The model pro- The under-five mortality rate decreased by more than duces the same maximum and minimum percentages half from 1960 to 1990; globally, it was 185 per 1,000 for between-country variance for the same corre- in 1960 and 84 per 1,000 in 1990. Adult mortality sponding outcome variables. The amount of overall rates declined by 122 deaths per 1,000 for males and variance explained varied from an R2 of 62 percent for by 129 deaths per 1,000 for females. At the same time, the male adult mortality rate to 82 percent for the both male and female life expectancy at birth increased under-five mortality rate. One other interesting obser- by more than 11 years. vation was that these predictors could forecast female There were also some significant changes in coun- mortality better than they can forecast male mortality: tries' income and education levels in the three decades the R2 values associated with females were consistent- from 1960 to 1990. Real income per capita (in 1985 ly higher than those for males. This could be an indi- international dollars adjusted for purchasing power cation that male health performance levels depend parity) doubled, from $1,362 to $2,795. Education in more on male behavior and are less captured by the female population increased from two to four years, income, education, and technical progress. and years of education in the male population Country levels of income per capita and education increased from three to five in the same period. significantly predict country health performance. These descriptives are also summarized and report- From 1960 through 1990, country health conditions ed separately for each region in supplementary table lll. improved with the increase in education and income per capita. Holding everything else constant, the income elasticity (LYPC in the table) for the under-five Regression Results for the Effects of Income and mortality rate in 1960 was -0.38, and by 1990 it had Education on Health Outcomes increased (in absolute terms) to -0.71 (a combination of LYPC and LYPC_T6, which is the interaction term The regression results are reported in table 1. The over- between income and time indicator for 1990), hold- all model specification, which used real income per ing female education level constant. The coefficients capita, education, time, and their two-way interactions reported in table 1 indicate that in 1990 income to explain the variance in country health conditions, became more influential in predicting better health was significant in terms of goodness of fit. The conclu- conditions (for example, under five mortality rate, sion was based on the fact that all the chi-square prob- adult mortality rate, life expectancy, and total fertility ability values associated with the equations are less rate) than in earlier years. The education effect, on the than 0.00001. In other words, the chance that the other hand, was quite constant over the three decades found relations were not true was less than 1 out of studied. For example, with everything else held con- 7 8 Measuring Cotintry Performance on Health Table 1 Education, Income, and Time as Determinants of Health Outcomes Health outcomes Determining variables LQ5 LAMRF LAMRM LTFR LLEF LLEM Constant 8.11 7.37 8.06 2.26 2.85 2.67 LYPC -0.38 -0.20 -0.27 -0.04 0.14 0.15 (5.99) (5.09) (6.99) (1.29) (8.60) (8.66) FED -0.53 -0.32 - -0.19 0.23 (4.69) (4.45) - (3.25) (8.76) - MED - -0.32 - 0.16 - - (5.76) - - (6.52) TI 1965 -0.13 0.08 0.11 0.00 0.08 0.10 (0.37) (0.36) (0.60) (0.01) (0.77) (1.02) T2 1970 -0.29 0.01 0.03 0.41 0.12 0.20 (0.78) (0.03) (0.15) (1.85) (1.19) (1.99) T3 1975 -0.21 0.18 0.14 0.53 0.10 0.17 (0.55) (0.80) (0.71) (2.47) (0.96) (1.72) T4 1980 0.06 0.26 0.21 0.54 0.11 0.19 (0.14) (1.10) (1.06) (2.44) (1.04) (1.95) T5 1985 0.78 0.32 0.38 0.63 0.05 0.14 (1.80) (1.27) (1.78) (2.66) (0.47) (1.30) T6 1990 2.17 0.74 0.58 0.88 -0.20 -0.05 (4.55) (2.84) (2.61) (3.60) (1.73) (0.50) LYPC_FED 0.05 0.03 - 0.02 -0.02 (3.29) (3.21) - (2.07) (6.78) - LYPC_MED 0.03 - - -0.02 - - (4.55) - - (4.81) LYPC_T1 1965 0.01 -0.02 -0.03 0.00 -0.01 -0.01 (0.24) (0.54) (0.87) (0.12) (0.40) (0.63) LYPC T2 1970 0.03 -0.01 -0.01 -0.05 -0.01 -0.02 (0.64) (0.32) (0.46) (1.66) (0.47) (1.27) LYPC_T3 1975 0.03 -0.01 -0.01 -0.05 -0.01 -0.02 (0.64) (0.32) (0.46) (1.66) (0.47) (1.27) LYPC_T4 1980 0.02 -0.04 -0.04 -0.07 0.00 -0.01 (0.33) (1.29) (1.35) (2.25) (0.01) (0.70) LYPC_T5 1985 -0.15 -0.07 -0.08 -0.08 0.01 0.00 (2.32) (1.80) (2.70) (2.40) (0.90) (0.28) LYPC_T6 1990 -0.38 -0.13 -0.12 -0.13 0.05 0.03 (5.58) (3.48) (3.79) (3.60) (2.82) (1.93) FED_Tl 1965 -0.01 -0.01 - -0.02 0.00 - (0.44) (0.38) - (1.76) (0.26) - FED_T2 1970 -0.02 -0.01 - -0.03 -0.01 - (1.03) (0.85) - (2.14) (1.41) FED_T3 1975 -0.04 0.00 - -0.03 -0.01 - (1.70) (0.35) - (2.72) (1.77) - FED_T4 1980 -0.05 -0.01 - -0.05 -0.01 - (2.03) (0.70) - (3.77) (1.85) - FED_T5 1985 -0.04 -0.02 - -0.05 -0.02 - (1.57) (1.12) - (3.99) (2.94) - FED_T6 1990 0.03 0.00 - -0.04 -0.02 - (1.08) (0.13) - (2.96) (3.19) - MED_T1 1965 - - 0.01 - - 0.00 - - (0.43) - - (0.40) MED_T2 1970 - - 0.00 - - 0.00 - - (0.29) - - (0.92) MED_T3 1975 - - 0.01 - - -0.01 (1.13) - - (1.96) Results 9 Health outcomes Determining variables LQ5 LAMRF LAMRMJ LTFR LLEF LLEM MED_T4 1980 - - 0.02 - - -0.01 (1.34) - (2.10) MED_T5 1985 - 0.02 - -0.02 - - (1.71) - - (3.10) MED_T6 1990 - 003 - - -0.02 - - (2.35) - - (3.30) No. of observations 407 514 514 527 525 525 No. of countries 68 81 81 82 82 82 X2 1,881.52 1,236.43 8,37.42 1,166.49 1,300.72 1,101.39 P-value 0.00 0.00 0.00 0.00 0.00 0.00 R2 within 83% 72% 64% 71% 71% 69% R2 between 83% 74% 64% 67% 79%/o 71% R2 overall 82% 71% 62% 68% 77% 70% - Not available. Note. Absolute t-values aie in parentheses. Definiitioni of acronyms may be found on page 3. stant, the coefficient associated with the education increase of $1,000 in income. For the purpose of our impact on the under-five mortality rate was -0.53 calculation, we assumed a base income level of (FED) in 1960 and -0.45 in 1990 (combining FED $2,500 per capita and an average education of 2.5 and FED_T6, which is the interaction term between years. (Since the model is not linear, the calculated education and time indicator for 1990). These obser- effect sizes will differ depending on where the base- vations are based on looking at only the coefficients. line numbers are set.) As shown in table 2, an The health improvements associated with increased increase in education level from 2.5 years to 3.5 years income and education are discussed below. while holding income at $2,500 resulted in a Using the regression coefficients reported in table decrease in under-five mortality by an average of 14 1, we calculated the numbers of deaths avoided per deaths per 1,000 over the past three decades. An 1,000 corresponding population, years of life saved, increase in income from $2,500 to $3,500, holding and numbers of births reduced per woman that education at 2.5 years, decreased the under-five mor- resulted from an additional year of education and an tality rate by another 9 per 1,000. Table 2 Effects of an Additional Year of Education or an Additional $1,000 of Income on Health Outcomes Effect of additional year of education 1960 1965 1970 1975 1980 1985 1990 Under-five mortality 15.6 15.7 16.7 16.9 15.9 12.6 6.0 Female adult mortality 20.6 20.3 21.0 18.4 19.0 19.3 15.5 Male adult mortality 15.2 12.6 15.0 9.6 8.5 6.5 3.6 Total fertility 0.4 0.5 0.5 0.5 0.5 0.5 0.4 Female life expectancy 2.5 2.5 2.2 2.0 2.0 1.6 1.5 Male life expectancy 1.7 1.6 1.5 1.2 1.1 0.8 0.6 Effect of $1,000 income increase 1960 1965 1970 1975 1980 1985 1990 Under-five mortality 10.2 9.2 8.2 8.1 8.6 10.1 11.6 Female adult mortality 11.0 11.7 10.7 12.5 12.9 13.1 16.4 Male adult mortality 20.4 21.5 20.1 21.5 22.2 23.4 24.5 Total fertility 0.0 0.0 0.1 0.1 0.1 0.1 0.2 Female life expectancy 1.5 1.4 1.4 1.6 1.6 2.0 2.7 Male life expectancy 2.0 1.9 1.7 2.0 2.0 2.4 3.0 10 Measuring Country Performance on Health When we controlled for countries' real income per actual rates. Both actual and predicted values are in capita level or education level, the net education and logarithmic form. For life expectancy and total fertili- income effects varied across different periods. Across ty rate, the actual and predicted values are compared all health indicators, the benefit associated with an in their natural form, for example, number of years and improved education level seemed to be declining when number of births. A positive measure of life expectan- we used 2.5 years of education as the baseline. The cy means the observed life expectancy for a certain additional year of education could avert 15.6 deaths country is higher than the predicted, given its income per 1,000 on under-five mortality in 1960, but and education levels. Positive perfor-mance measures decreased to a 6 deaths per 1,000 improvement in mean better performance for all health indicators but 1990. The education effect in reducing female adult total fertility rate. For total fertility rate, the perfor- mortality was relatively stable, from 20.6 deaths to mance measure is calculated as the number of births 15.5 deaths. The most dramatic declining education observed that is higher than the prediction. A country effect was for male adult mortality: holding income with a positive fertility measure is a country with a constant, an additional year of male education was higher total fertility rate than we would expect, con- associated with 15.2 fewer deaths per 1,000 in 1960, sidering its levels of income and education. but with only 3.6 fewer deaths per 1,000 in 1990. A comment is in order here. Each country in the With education held constant, an additional $1,000 sample is given the same weight, assuming the coun- income per capita could reduce male adult mortality by try population size did not have any significant effect 20.4 deaths per 1,000 in 1960 and 24.5 deaths per on the country health conditions. This is mainly a 1,000 in 1990. The respective numbers for female adult result of the lack of compatible and reliable population mortality were 11 deaths and 16.4 deaths per 1,000. data (the high-quality population data available at the The income effect on the under-five mortality rate was World Bank start in 1970). We acknowledge the pos- lowest in 1975, with 8.1 fewer deaths per 1,000, down sible estimation errors caused by the omission of the from 10.2 fewer deaths per 1,000 in 1960; it then related variable in the model. improved to 11.6 fewer deaths per 1,000 in 1990. Across all indicators, the income effect dropped in the period from 1965 through 1975 and then went up Regional Performance Trends across Time after 1975. Income had the most significant effect in 1990. Contrary to income, education had the greatest To estimate the average regional performance on impact on health indicatoTs from 1965 through 1975, health outcomes as compared with the other regions, after which the effect started to level off. That is, when we developed regional profiles. The predicted health education's impact on improving health outcomes performance is calculated for each country, for each increased, income's impact decreased, and when health measure, based on the results reported in table income's impact increased, education's impact 1. Averaging the predicted health values for each decreased. Education and income were substitutes for country within the region, we get the predicted values each other. for the region on mortality, fertility, and life expectan- cy We then get the difference between these predict- ed values against the observed regional mean perfor- Country Performance Trends across Time mance on the outcome measures in their logarithmic form. For the under-five mortality and adult mortali- We have constructed performance indicators based on ty rates, we constructed the relative performance fig- the derived regression residuals for all countries for ures; for life expectancy and total fertility rate, we cal- which we have data; these are reported in supplemen- culated the absolute difference. Table 3 shows the tary table IV For under-five mortality and adult mor- results of these analyses. These performance measures tality rates, the performance measures are the amounts are also plotted graphically and presented under the of predicted mortality rates that are higher than the regional annexes. Results 11 Table 3 Regional Variation in Performance, Relative to Income and Education, 1960-90 Year Indicators Regions 1960 1965 1970 1975 1980 1985 1990 Q5 EAP 0Yo 1% 17% 18% 20% 4% -12% ECA -26% -33% -21% -34% -24% -27% -20% LAC -8% -9% -9% -9% -11% -8% 3% MNA -20% -22% -18% -16% -12% -12% -19% SAS 5% 5% 5% 8% 2% 2% -18% SSA 3%c/. -3% -10% -9% -7% -11% -12% AMRF EAP -27% -19% -20% -22% -16% -24% -21% ECA 68% 54%/ 46% 43% 31% 19% 6% LAC 13% 15% 14% 14% 15% 18% 21% MNA 24%h 22% 8% 5% 7% 4% 3% SAS -12%o -14% -14% -8% -5% -5% -9% SSA -17% -18% -20% -22% -20% -19% -18% AMRM EAP -23%b -14% -13% -13% -6% -9% -8% ECA 59% 47% 36% 32% 20% 10% 1% LAC 12% 14% 13% 13% 12% 14% 17% MNA 14% 13% 2% 4% 5% 5% 6% SAS 7% 5% 6% 11% 12% 11% 8% SSA -16c,% -17% -21% -23% -21% -20% -20% TFR EAP 0.0 0.3 0.0 -0.2 -0.3 0.3 0.3 ECA -1.2 -0.9 -0.8 -0.5 -0.5 -0.3 -0.2 LAC 0.5 0.6 0.5 0.3 0.2 0.0 0.0 MNA 0.2 0.1 0.6 0.8 0.9 0.9 1.0 SAS -0.4 -0.5 -0.4 -0.6 -0.5 -0.6 -0.6 SSA -0.1 -0.1 -0.2 0.0 0.0 0.1 0.3 LEF EAP 2.3 1.8 2.1 1.1 1.3 -1.2 0.3 ECA 1.6 0.5 1.9 2.5 2.3 2.4 1.3 LAC 2.6 2.8 2.9 2.9 3.1 3.6 4.6 MNA 2.4 2.2 0.1 1.8 2.3 2.2 2.2 SAS 0.3 0.3 -0.7 1.1 1.0 1.3 3.1 SSA -2.6 -2.7 -3.1 -3.1 -2.2 -2.4 -1.9 LEM EAP 1.6 1.9 2.7 2.4 2.9 1.2 2.0 ECA 3.4 2.4 2.6 1.4 1.6 1.7 0.7 lAC 3.3 3.6 3.4 3.4 3.6 3.8 4.8 MNA 1.8 1.6 -0.2 1.6 2.2 2.4 2.7 SAS 3.0 2.4 2.0 2.8 2.4 2.6 3.9 SSA -3.3 -3.5 -3.9 -3.8 -3.0 -3.3 -2.8 Note: The relative regional performance on mortality is calculated as the amount the predicted mortality is higher than actual. The absolute performance for fertility is the amount by which actual is lower than predicted, and the absolute performance for life expectancy is the amount by which actual is higher than predicted The East Asia and Pacific (EAP) region shows over- fertility rate than expected, about 0.25 fewer births per all good performance in under-five mortality, fertility, woman. For adult mortality, EAP did about 15 percent and life expectancy; its performance on adult mortality, worse than expected during the three decades studied, however, is disappointing. EAP's relative performance given its education and income level. The overall trend on child mortality improved in the period from 1960 for female mortality has been quite flat, at -27 percent through 1980 and then dropped. This region was per- in 1960 and -21 percent in 1990. Performance on male forming at the expected level in 1960, improved to 20 mortality, however, has improved, from -23 percent in percent above expectation in 1980, then fell to -12 per- 1960 to -8 percent in 1990. cent in 1990. The years 1975 and 1980 were the only The EAP region had a higher than predicted female two time points where EAP countries had a lower total life expectancy at all time points but 1985. Female life 12 Measuring Country Performance on Health expectancy was about two years higher between 1960 life expectancy, females' performance measures and 1970, then changed to about one year in 1975 and range from -0.7 to 3.1 years deviated from the pre- 1980. After the negative performance in 1985, the diction, but male performance measures stay posi- region went back to its expected level in 1990. Males in tive in all time points and range from 2.0 to 3.9 the EAP region had a higher life expectancy at all time years. On adult mortality, the average performance points, with numbers ranging from 1.2 to 2.9 years. for females was about 10 percent below expecta- The Europe and Central Asia (ECA) region showed tion, but it was about 9 percent above expectation better performance on all health indicators at all time for males. points, except on the under-five mortality rate. There is Gender inequity seems to be a big problem in the no clear pattern on the under-five mortality rate, which Sub-Saharan Africa (SSA) region, where, with the has gone both up and down during the 30-year period. exception of total fertility rate before 1985 and under- For the other indicators, it seems that ECAs perfor- five mortality in 1960, the worst performance on all the mance was declining from 1960 through 1990. ECA health outcomes was found. From 1960 through 1970, was doing 68 percent better on female adult mortality the predicted total fertility rate was about 0.1 birth in 1960 and 59 percent better on male mortality2 In lower than the observed values; the difference nar- 1990, the performance had dropped to 6 percent and 1 rowed to 0 in 1975 and 1980. Male and female life percent, respectively This observation is applicable to expectancy was about 3.5 years and 2.5 years shorter all the other indicators. The performance on female life than expected, respectively, over the three decades expectancy declined from 1.6 years above expectation studied. The worst performance on life expectancy was in 1960 to 1.3 years in 1990; the performance on male for 1970, when males performed 3.9 years below life expectancy in 1960 was 3.4 years better than expectation and females, 3.1 years below expectation. expected but dropped to 0.7 years in 1990. Figures 2 and 3 show performance at the country The Latin America and the Caribbean (LAC) region level. In figure 2, performance on a single indicator has been a good performer in terms of adult mortality over time is depicted for selected countries; in and life expectancy. Life expectancy has been three to Argentina, for example, although performance relative five years higher than expected in the three decades to income is good, the figure shows a marked decline studied, given income and education levels. The in performance from 1985 through 1990. Figure 3 region's performance on adult mortality has been about shows the 1990 performance of a country on four indi- 15 percent better than predicted. For fertility, the LAC cators. These "performance diamonds" provide a visu- region's performance is improving over time. Starting al representation of performance overall and of perfor- in 1985, the total fertility rate in the region matched its mance differences across indicators. Pakistan's predicted level, given income and education. The performance, for example, was below predicted except region has had the worst performance on under-five with respect to adult male mortality rates, where per- mortality, especially in 1980, when, compared with its formance is good. Annexes A through F provide graphs previous and later performance, the relative perfor- like those in figures 2 and 3 for each country, with mance was negative-Il percent in 1980. countries grouped into the annexes by region. The Middle East and North Africa (MNA) region has performed quite well on adult mortality and life expectancy measures, but poorly on under-five mor- Comparing Residuals from Different Models tality and total fertility rates. Across all seven time points, the performance measures on under-five mor- The education data are missing for many countries tality were about 17 percent below expectation, and for which we have income and health outcome the region's total fertility rate is about 0.6 births high- information. To provide the country health profiles er per woman for these countries that lack education data, we ran Males in the South Asia (SAS) region were found a separate set of analyses using income, time, and to have more health advantages than females. On their interaction variables to predict country health Results 13 indicators. The regression results are summarized coefficient estimates, including all seven time points, in table 4. Comparison with the results reported in range from 0.81 (for under-five mortality, total fertility table 1 shows some noticeable drops in the R2 val- rate, and female life expectancy) to 0.94 (for male adult ues for all health indicators, especially for male mortality). The correlation matrix is presented in table adult mortality and male life expectancy. However, 5, which also includes the correlation coefficients for the models are still statistically significant: these each period. The high coefficients are observed predictors could substantially explain the variance throughout each period, and, interestingly, the corre- we found in the health outcome variables, based on lation coefficients become stronger over time. This may the resultant P-values associated with the chi- be related to our finding that education and income are square values. substitutes for each other, rather than being comple- To test the similarity of the residuals from the two ments. We constructed and reported this set of coun- different models (with and without education), we ran try-relative performance measures in supplementary a correlation analysis between them. The correlation table V The measures are also presented graphically for Figure 2 Performance on Under-Five Mortality Rate over Time Two countries with recent improvements in performance Ecuador Iran, Islamic Rep. of 20% 0% -22% ~ 4 -68 -69% ~~~~~~~~~7~~~~ ~8% - -7%2764-6 C% 0% -40% -24% 605 A 7i _90 Chin 4) -1.0 '4) -48%~-5%1~~-D-/ -20- U-22% -68% -69% _80% -75% -76% -76% A 400%- l | | 1 0 | | U 40%- 300/o | | | 1l 1t00 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 TwAho countries with recent deterioration in performance 60% Argentina 120% China 41% ~~~~~~~~~~~~L 100% 90% u ~~42% S 40% 40E 80%7065 30% 4) 0. o. ~~~~~~~~~~~~~~~60% 54% 20% 21% . 4 20% 3i4% 0%0/ 20% 0% 0% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Note: The bar graphs show, for each indicated year and country, the percent better (or worse) actual levels of under-five mortality are, relative to what would he predicted from the country's income level. 14 Measuring Country Performance on Health Figure 3 Performance Diamonds for Selected Countries, 1990 Examples from the South Asia region Pakistan q5 Sri Lanka q5 q45rn q45f q45m q45f tfr (qS value is for 1985) tfr Examples from the Sub-Saharan Africa region Nigeria q5 Tanzania q5 q45m- IlAo 95\ -eq45f 5m A q45f tfr tfr Note: q5 is the under-five mortality rate, tfr is the total fertility rate, q45f is the female adult mortality rate, and q+5m is the male adult mortality rate. Each axis of the performance diamond is scaled so that the midpoint of the distance between the origin and the tip of the relevant axis corresponds to performance equal to what would be predicted by income. Values better than xvould be predicted are plotted between the midpoint and the tip at a distance proportional to the country's performance on the indicator relative to the performance of the best performing country on the indicator. Likewise, values poorer than would be predicted are plotted between the midpoint and the origin. The diamond connecting midpoints of the axes depicts, then, expected performance. The shaded diamond depicts the country's perfornance. When the shaded area lies inside the expected perfor- mance box, country performance is poor; when outside, performance is good. each country, grouped alphabetically within their Country Performance Level Relative to the Other region-specific annex. For each country, we also Countries and Economies included, for reference, a summary table on trends in selected health indicators and their determinants. Each In addition to documenting the country performance table provides the observed income, education, and trends from 1960 through 1990, we constructed coun- health measures for seven time points from 1960 try rankings with their country-specific residuals. through 1990 for each of the 115 countries. These country-specific residual values from the ran- Table 6 reports only the regional performance relative dom-effect GLS regression procedure can be used to to income. examine how a country performed on the average as Results 15 Table 4 Income and Time as Determinants of Health Outcomes Health outcomes Determining variables LQS LAMRF LAMRM LTFR LLEF LLEM Constant 7.82 6.81 7.12 2.21 3.38 3.28 LYPC -0.37 -0.15 -0.16 -0.06 0.08 0.08 (7.24) (4.87) (5.94) (2.06) (6.19) (6.64) Ti 1965 -0.19 0.05 0.03 0.26 0.10 0.13 (0.61) (0.30) (0.17) (1.44) (1.30) (1.69) T2 1970 -0.08 0.10 -0.01 0.70 0.17 0.22 (0.27) (0.56) (0.08) (3.99) (2.21) (2.77) T3 1975 0.07 0.09 -0.16 0.78 0.23 0.29 (0.23) (0.53) (0.96) (4.55) (3.00) (3.81) T4 1980 0.43 0.17 -0.19 0.91 0.29 0.36 (1.39) (0.99) (1.18) (5.42) (3.94) (4.89) T5 1985 0.89 0.43 -0.09 1.14 0.35 0.44 (2.85) (2.43) (0.59) (6.76) (4.80) (5.84) T6 1990 1.26 0.69 -0.01 1.28 0.27 0.38 (3.68) (3.94) (0.07) (7.59) (3.67) (5.03) LYPC_Ti 1965 0.02 -0.02 -0.01 -0.04 -0.01 -0.01 (0.38) (0.67) (0.50) (1.53) (0.81) (1.21) LYPC_T2 1970 -0.01 -0.03 -0.01 -0.11 -0.01 -0.02 (0.17) (1.24) (0.50) (4.28) (1.28) (1.88) LYPC_T3 1975 -0.01 -0.03 -0.01 -0.11 -0.01 -0.02 (0.99) (1.49) (0.20) (5.02) (1.64) (2.52) LYPC_T4 1980 -0.04 -0.04 0.00 -0.12 -0.02 -0.03 (2.58) (2.27) (0.16) (6.09) (2.09) (3.11) LYPC_T5 1985 -0.20 -0.10 -0.02 -0.18 -0.03 -0.04 (4.57) (4.11) (0.82) (7.74) (2.47) (3.57) LYPC_T6 1990 -0.27 -0.15 -0.04 -0.21 -0.01 -0.03 (5.84) (5.90) (1.63) (8.99) (1.31) (2.70) No. of observations 465 707 707 723 728 728 No. of countries 79 114 114 115 115 115 x2 1,763.01 1,217.66 825.79 882.69 1,356.19 1,283.59 P-value 0.00 0.00 0.00 0.00 0.00 0.00 R2 within 82% 67% 57% 59% 70% 69% R2 between 56% 52% 50% 28% 53% 51% R2 overall 61% 48% 45% 35% 45% 43% Note: Absolute t-values are in parentheses. compared with the other countries. Supplementary female mortality, total fertility, and under-five mortal- table VI shows the ranking orders after controlling for ity rates, respectively Missing data on the under-five countries' income and education levels (see table 1). mortality rate, Barbados, Taiwan (China), and the for- The rankings in supplementary table VII were based on mer Yugoslavia ranked among the top 15 countries the residuals that derive from models controlling for and economies on the other five health indicators. income only (see table 4). (The various civil wars in the territory of the former Based on the results reported in supplementary Yugoslavia began in 1991 and 1992, after the end of table VI, after controlling for income and education our examination.) Costa Rica, Jamaica, and Paraguay levels, China was the only country that ranks among performed excellently on all indicators except total the top 15 good performers on all six indicators. It fertility rate; Uruguay's health performance was ranked 6th, 7th, 6th, 15th, 1st, and 3rd on male life among the top 15 for all indicators except under-five expectancy, male mortality, female life expectancy, mortality rate. At the other end of the spectrum, 16 Measuring Country Performance on Health Table 5 Correlation of Performance Measures between Models Estimated With and Without Education Correlation coefficient in indicatedyears Health indicators 1960 1965 1970 1975 1980 1985 1990 All years Under-five mortality rate 0.76 0.78 0.79 0.80 0.82 0.84 0.90 0.81 Female adult mortality rate 0.91 0.91 0.89 0.90 0.89 0.89 0.91 0.90 Male adult mortality rate 0.92 0.93 0.92 0.94 0.94 0.96 0.97 0.94 Total fertility rate 0.88 0.85 0.81 0.79 0.78 0.80 0.82 0.81 Female life expectancy 0.72 0.77 0.80 0.81 0.81 0.83 0.87 0.81 Male life expectancy 0.81 0.85 0.87 0.88 0.89 0.91 0.93 0.88 Note: Entries in the table are the correlation coefficients between residuals from a model with education, income, time indicator, and the two-way interac- tions as predictors and a similar model without education as a predictor. Performance indicators are constructed based on these residuals. Table 6 Regional Variation in Performance, Relative to Income, 1960-90 Year Indicators Regions 1960 1965 1970 1975 1980 1985 1990 Q5 EAP 16% 20% 35% 38% 41% 26% 9% ECA 54% 50% 55% 37% 39% 30% 24% LAC 9% 4% 2% 1% 1% 2% 12% MNA -39% -34% -33% -36% -38% -33% -23% SAS -10% -12% -11% -10% -14% -18% -35% SSA -3% -14% -18% -20% -25% -23% -26% AMRF EAP -21 % -1 1% -9% -10% -4% -8% -9 % ECA 100% 91% 89% 80% 66% 52% 37% LAC 27% 27% 27% 29% 31% 31% 31% MNA 17% 15% 0% -4% -5% -8% -6% SAS -23% -25% -24% -18% -12% -14% -15% SSA -25% -27% -30% -31% -31% -29% -28% AMRM EAP -15% -5% -2% -4% 2% -1% -1% ECA 90% 78% 65% 56% 38% 23% 10% LAC 21% 21% 21% 22% 19% 20% 22% MNA 14% 15% 5% 5% 7% 7% 11% SAS 1% 1% 3% 9% 13% 12% 11% SSA -21% -24% -27% -27% -27% -24% -25% TFR EAP -0.2 -0.2 -0.4 -0.8 -0.8 -0.3 -0.2 ECA -2.6 -2.7 -2.4 -1.9 -1.8 -1.5 -1.2 LAC 0.1 0.2 0.2 -0.1 -0.3 -0.4 -0.4 MNA 0.8 0.9 1.4 1.7 2.0 1.8 1.6 SAS 0.1 0.0 0.0 -0.1 0.0 -0.2 -0.3 SSA 0.2 0.2 0.3 0.5 0.6 0.6 0.6 LEF EAP 4.9 5.2 5.8 5.2 5.5 3.2 4.3 ECA 14.5 14.2 14.1 12.2 10.6 9.1 8.1 LAC 7.6 7.6 7.6 7.7 7.6 7.7 8.4 MNA 0.7 0.9 -0.5 1.0 1.9 3.1 3.6 SAS -2.5 -2.5 -2.7 -1.6 -1.0 -0.7 1.6 SSA -4.9 -5.4 -5.7 -5.9 -5.6 -5.7 -6.1 LEM EAP 4.7 5.3 6.1 5.3 5.8 3.8 4.6 ECA 13.3 12.5 11.6 9.7 8.0 6.6 5.3 LAC 6.7 6.7 6.6 6.4 6.1 6.4 7.1 MNA 1.5 1.9 0.8 2.3 3.2 4.5 5.1 SAS 1.5 1.1 1.1 1.5 1.8 1.8 3.5 SSA -5.1 -5.6 -5.9 -5.9 -5.6 -5.7 -6.1 Note: The relative regional performance on mortality is calculated as the amount the predicted mortality is higher than actual. The absolute performance for fertility is the amount by which actual is lower than predicted, and the absolute performance for life expectancy is the amount by which actual is higher than predicted. Results 17 Bolivia and Zambia were among the 15 worst per- decomposition calculations. The intention was to formers on all six health indicators. The Republic of estimate the percentage of health improvement owing Congo and South Africa were in the same category to changes in income and education levels, as well as except that data on the under-five mortality rate are the percentage owed to technical progress, from 1960 not available for either. through 1990. For this purpose, we used a simplified The picture of the best and worst country perform- version of our established model. The simplified ers on health changed a bit when education level was model (shown below) has no interaction terms; only not controlled for in the estimation. Controlling for the main effects of income, education, and time indi- income only (see supplementary table VII), two coun- cators are estimated. tries and one economy (Romania, Uruguay, and Puerto Rico) were among the top 15 performers on all six (6) LN(health,')= health indicators. Beyond this, the numbers of coun- A + B [LN(rgdp, t)] + C (educationi t) + XDt (time,) + E i,t tries compared varied across indicators. Romania where LN(health1,t) is the natural log of the health con- ranked first on male life expectancy, male adult mor- dition in country i at time t; tality, female life expectancy, and total fertility rate; it LN(rgdp, t) is the natural log of the average real held the second place for female mortality and under- income over a five-year period in country i at time t; five mortality rates. However, there was not a single education1 t is the years of education for the related country that was among the worst 15 performers on all population in country i at time t; six health indicators. With missing data on the under- timet is the time period indicator, t = 1, five mortality rate, Angola, Djibouti, Gabon, The 6 (TimeO, 1960, is omitted); and Gambia, and Somalia were the countries among the E i t is the specific error term for country i at time t. worst 15 performers on four out of the five remaining health indicators. Angola ranked 77th on total fertility Table 7 shows the regression results. The relative con- rate, Djibouti ranked 97th on total fertility rate, Gabon tribution of income, education, and technical progress was 40th on total fertility rate (although its rate is lower to health improvement from 1960 through 1990 can than the prediction), and The Gambia and Somalia be expressed mathematically in the following ways: ranked 63rd and 80th, respectively, on their perfor- mance on fertility rate. A. Percentage contribution due to change in In summary, countries varied substantially in their per- income level from 1960 through 1990 = formance levels on various health indicators, given the { 100 * B [LN(rgdpigo) - LN(rgdpi,60)] }/ same income and education levels. Each indicator should [predicted LN(healthi,60) be examined to see how a particular country of interest - predicted LN(healthigo)]; performs relative to other low- and middle-income coun- tries. These ranking orders were relative measures and B. Percentage contribution due to change in were only meant to provide analysts with model- and education level from 1960 through 1990 indicator-specific quantitative measures to facilitate their = { 100 * C (educationi 90) - (educationi90) understanding of country health performance and their / [predicted LN(healthi,60) - predicted decisionmaking related to health policies. LN(healthigo!)]; C. Percentage contribution due to technical Health Improvement: Relative Contribution of progress from 1960 through 1990 = Income, Education, and Technical Progress (100 * D6 ) / [predicted LN(healthi,60) - predicted LN(healthi90)]. To document the relative effects of income, educa- tion, and technical progress on improving health This decomposition calculation was performed for status in the past three decades, we performed each health indicator for each country that has the nec- 18 Measuring Country Performance on Health Table 7 Income, Education, and Time as Determinants of Health Outcomes: Decomposition Analysis Health outcomes Determining variables LQ5 LAMRF IAMRM LTFR LLEF LLEM Constant 7.40 7.12 7.11 2.60 3.44 3.38 LYPC -0.27 -0.17 -0.14 -0.08 0.06 0.06 (6.33) (6.25) (6.17) (3.44) (5.38) (5.50) FED -0.18 -0.10 - -0.11 0.03 (11.82) (10.07) - (13.35) (7.18) - MED - -0.05 - - 0.03 _ _ (5.64) - - (6.83) Ti 19r5 -0.06 -0.06 -0.05 -0.01 0.03 0.03 (1.73) (2.78) (2.75) (0.60) (3.51) (3.43) T2 1970 -0.08 -0.09 -0.09 -0.02 0.06 0.06 (2.14) (4.26) (4.65) (0.78) (6.29) (5.96) T3 1975 -0.15 -0.12 -0.11 -0.03 0.08 0.07 (3.91) (5.70) (5.19) (1.62) (7.91) (7.00) T4 1980 -0.23 -0.14 -0.12 -0.05 0.10 0.09 (5.81) (6.08) (5.37) (2.17) (9.11) (8.01) T5 1985 -0.38 -0.20 -0.17 -0.08 0.12 0.11 (9.07) (8.00) (7.08) (3.75) (10.92) (9.82) T6 1990 -0.52 -0.22 -0.20 -0.13 0.11 0.11 (11.14) (8.31) (8.15) (5.42) (9.28) (8.71) No. of observations 407 514 514 527 525 525 No. of countries 68 81 81 82 82 82 X2 1,645.31 1,193.56 718.18 982.83 916.65 837.86 P-value 0.00 0.00 0.00 0.00 0.00 0.00 R2 wathin 80% 71% 60% 65% 64% 63% R2 between 83% 74% 62% 68% 73% 66% R2 overall 81% 71% 58% 69% 70% 64% - Data not available. Note: Absolute t-values are in parentheses. Table 8 Accounting for Progress in Health, 1960-90: Regional Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels (%) Region Variables Average EAP ECA LAC MINA SAS SSA Income's contribution to: Under-five mortality rate 17 20 22 15 18 12 12 Female adult mortality rate 20 25 26 19 22 15 16 Male adult mortality rate 25 30 32 22 28 19 18 Female life expectancy 19 24 25 17 22 15 14 Male life expectancy 20 24 26 18 23 15 14 Total fertility rate 12 15 16 12 13 9 10 Education's contribution to: Under-five mortality rate 38 38 40 33 47 42 27 Female adult mortality rate 41 41 43 37 49 45 31 Male adult mortality rate 27 26 28 23 34 30 19 Female life expectancy 32 32 34 27 40 35 22 Male life expectancy 30 30 32 26 38 33 21 Total fertility rate 58 59 61 54 67 63 47 Results 19 Table 8 (continued) Region Variables Average EAP ECA LAC MNA SAS SSA Technical progress' contribution to: Under-five mortality rate 45 42 38 52 35 46 61 Female adult mortality rate 39 35 31 44 29 39 53 Male adult mortality rate 49 44 40 55 39 51 64 Female life expectancy 49 45 41 55 39 50 64 Male life expectancy 50 46 42 57 40 52 65 Total fertility rate 29 26 23 34 20 28 43 Note: Entries in the table show what percentage of the improvement in each health variable results from changes in income and education levels and from technical progress. For example, income growth accounted for 20 percent of the decline in under-five mortality in East Asia and the Pacific between 1960 and 1990. Mean 1960 and 1990 income and education values used in this table may be found in annexes A through F essary data on income, education, and health measures progress ranges from 32 percent in Romania to 94 per- for both 1960 and 1990. Supplementary table VIII cent in Tanzania. The relative contribution range for shows the country-specific relative contributions to income change is from -8 percent to 26 percent, and health progress of technical progress and changes in the range for education change is from -19 percent to income and education levels from 1960 through 1990. 50 percent.3 Each table shows the observed values for the health Using regional mean income and education levels, indicator in 1960 and 1990, the difference between we decomposed the overall regional health progress them in logarithmic form, and the percentage contri- that is a result of technical progress from that owing to bution of income, education, and technical progress to changes in income and education levels. The detailed health progress from 1960 through 1990. results are reported in table 8. Income change makes A comment is in order here. The decomposition cal- the largest contribution to health improvement in culation uses the difference in predicted values to mea- reducing male mortality (25 percent); it has the small- sure the amount of health progress. We expected that est effect in decreasing total fertility rate (12 percent). the relative contributions of income, education, and Education contributes the most to the total fertility rate technical progress to the predicted values would be reduction; its relative contribution ranges from 47 per- close to if not identical with the actual values. Take the cent in the SSA region to 67 percent in the MNA region. under-five mortality rate as an example. Technical Technical progress contributes the least to total fertility progress accounts for the biggest percentage of health rate reduction, ranging from 20 percent to 43 percent. improvement as compared with the amounts con- It contributes the most to increasing life expectancy, tributed by changes in income and education (supple- with an average of 42 percent for female life expectan- mentary table VIII 1). The reduction due to technical cy and 43 percent for male life expectancy 5 Conclusions The evidence base for health policy analysis has provides a comparative basis for quantitative (or been, for the most part, either anecdotal (which often qualitative) discussion of the sources of variation in provides substantial insight) or based on statistical country performance. This report contributes to the analysis of data sets at the household or provider cross-country comparative strand of policy analysis. level. These latter analyses furnish valuable informa- Its aim is not substantive. Rather, it attempts-albeit tion on the behavioral response of individual actors imperfectly-to provide a quantitative assessment of in the system to changes in their immediate environ- outcome performance that can be the starting point ment. Increasingly, however, research across coun- for discussion of the consequences of differing poli- tries-that is, at the level where policies vary- cy regimes. 20 Endnotes 1. The predicted values on the curves used in these illustra- 2. The comparison is made after considering the income and tions are for an education level of 3.3 years; the predicted education levels in the region, based on the data on Bulgaria, under-five mortality rate actually used to generate our per- Hungary, Poland, Romania, Turkey, the former U.S.S.R., and formance measures is based on the actual education level (as the former Yugoslavia. The conclusions drawn here may not well as income level) in the country in the indicated year. represent the region's actual health performance. Our calculations use the difference in logarithms to approx- 3. The declining income and education levels from 1960 imate percent change; this works well when the difference is through 1990 caused the relative contribution to be neg- small but less well for a case such as Colombia's. ative. 21 References Barro, R., and J. W Lee. 1996. "International Measures of Kreft, I. G., and J. De Leeuw. 1991. "Model-Based Ranking of School Years and Schooling Quality" American Economic Schools." International Journal of Educational Research 15:45-59. Review, AER PRpers and Proceedings :218-23. STATA (Statistics/Data Analysis). 1996. STATA References. Behrman, J. R. 1996. Human Resources in Latin America and the College Station, Tex.: STATA Corporation. Caribbean. Washington, D.C.: Inter-American Development Bank. Summers, Robert, and Alan Heston. 1991. "The Penn World Table (Mark 5): An Expanded Set of International Comparisons, Bryk, A. S., and S. W Raudenbush. 1992. Hierarchical Linear 1950-1988." QuartertyJournal of Economics 106:327-68. Models: Application and Data Analysis Methods. Newbury Park, Calif.: Sage Publications. Tracy,J., and J. Waldfogel. 1997. "The Best Business Schools: A Market-Based Approach." Journal of Business 70:1-31. Heston, Alan, and Robert Summers. 1996. "International Price and Quantity Comparisons: Potentials and Pitfalls." Wang, Jia, and D. T. Jamison. 1998. "Regression Residuals as International Macro- and Microeconomic Data 86:20-24. Performance Measures: An Assessment of Robustness in the Context of Country-Level Data." Paper presented at the Hill, K., R. Pande, and G. Jones. Forthcoming. Trends in Child annual meeting of the American Educational Research Mortality in the Developing World: 1960-1995. New York: Association, April 13-17, San Diego, Calif. UJNICEE World Bank. 1993. WMorld Development Report 1993: Investing in Jamison, D. T., J. Wang, K. Hill, and J. L. Londofno. 1996. Health. New York and London: Oxford University Press. "Income, Mortality, and Fertility in Latin America's Country Level Performance, 1960-90." Analisis Econ6mico . 1997. Health, Nutrition, and Population: Sector Strategy. 11:219-61. Washington, D.C. 22 Supplementary Tables 24 Measuring Country Performance on Health Supplementary Table I List of Countries or Economies in Each Region A. East Asia and Pacific (EAP) A. 1 CHN China C. 26 TTO Trinidad and Tobago A. 2 FJI Fiji* C. 27 URY Uruguay A. 3 IDN Indonesia C. 28 VEN Venezuela A. 4 KOR Korea, Rep. of A. 5 LAO Lao PDR D. Middle East and North Africa (MNA) A. 6 MYS Malaysia A. 7 MNG Mongolia D. 1 DZA Algeria A. 8 MMR Myanmar D. 2 BHR Bahrain* A. 9 PNG Papua New Guinea D. 3 EGY Egypt, Arab Rep. of A. 10 PHL Philippines D. 4 IRN Iran, Islamic Rep. of A. 11 SLB Solomon Islands* D. 5 IRQ Iraq' A. 12 TWN Taiwan, China* D. 6 JOR Jordan A. 13 THA Thailand D. 7 MLT Malta* A. 14 VUT Vanuatu* D. 8 MAR Morocco A. 15 WSM W9Vestern Samoa* D. 9 OMN Oman D. 10 QAT Qatar* B. Europe and Central Asia (ECA) D. 11 SAU Saudi Arabia D. 12 SYR Syrian Arab Rep.* B. 1 BGR Bulgaria, Rep. of D. 13 TUN Tunisia B. 2 HUN Hungary D.14 YEM Yemen, Rep. of B. 3 POL Poland B. 4 ROM Romania E. South Asia (SAS) B. 5 TUR Turkey B. 6 SUN U.S.S.R., the former* E. 1 BGD Bangladesh B. 7 YUG Yugoslavia, the former E. 2 IND India E. 3 NPL Nepal C. Latin America and the Caribbean (LAC) E. 4 PAK Pakistan E. 5 LKA Sri Lanka C. 1 ARG Argentina C. 2 BHS Bahamas, The* E Sub-Saharan Africa (SSA) C. 3 BRB Barbados* C. 4 BLZ Belize* E 1 AGO Angola* C. 5 BOL Bolivia F 2 BEN Benin C. 6 BRA Brazil F 3 BWA Botswana C. 7 CHL Chile E 4 BFA Burkina Faso C. 8 COL Colombia E 5 BDI Burundi C. 9 CRI Costa Rica E 6 CMR Cameroon C. 10 DMA Dominica* E 7 CPV Cape Verde* C. 11 DOM Dominican Republic E 8 CAF Central African Republic C. 12 ECU Ecuador E 9 TCD Chad C. 13 SLV El Salvador F 10 COM Comoros* C. 14 GUY Guyana* E 11 COG Congo, Rep. of C. 15 HTI Haiti E 12 CIV Cote d'lvoire C. 16 HND Honduras F 13 DJI Djibouti* C. 17 JAM Jamaica F 14 ETH Ethiopia C. 18 MEX Mexico F 15 GAB Gabon C. 19 NCI Nicaragua F 16 GMB Gambia, The C. 20 PAN Panama F 17 GHA Ghana C. 21 PRY Paraguay F 18 GIN Guinea C. 22 PER Peru F 19 GNB Guinea-Bissau C. 23 PRI Puerto Rico* F 20 KEN Kenya C. 24 KNA St. Kitts and Nevis* F 21 LSO Lesotho C. 25 SUR Suriname* F 22 LBY Liberia* Supplementary Tables 25 F Sub-Saharan Africa (SSA) (continued) F 23 MDG Madagascar F 35 SYC Seychelles* F 24 MWI Malawi F 36 SLE Sierra Leone E 25 MLI Mali E 37 SOM Somalia E 26 MRT Mauritania F 38 ZAF South Africa E 27 MUS Mauritius F 39 SDN Sudan* F 28 MOZ Mozambique F 40 SWZ Swaziland* F 29 NAM Namibia F 41 TZA Tanzania F 30 NER Niger E 42 TGO Togo F 31 NGA Nigeria F 43 UGA Uganda F 32 REU Reunion* E 44 ZAR Zaire* F 33 RWA Rwanda F 45 ZMB Zambia E 34 SEN Senegal F 46 ZWE Zimbabwe Notes: The analysis in this report groups countries by regions for several purposes. The grouping closely follows that of World Bank regional groupings, with a few exceptions that are noted. The country grouping is based on the definition in the Selected World Development Indicators (SWDI) Table 1 of World Development Report 1996, except for those countries included in the High-Income Economies (HIE) group. Note that severai of the Organisation for Economic Co-operation and Development (OECD) countries-Mexico and Turkey-are included here. The regional groupings include all countries in SWDI Table 1 of World Development Report 1996 and any other countries used in our analyses. (Kuwait and the United Arab Emirates, both high-income, are excluded within the MNA group for the purpose of these analyses.) The three-letter country code for each country (as used by the World Bank and in the Penn World Tables Version 5.6) precedes the country name. The regional groupings also include countries that are not listed in Table 1 of the SWDI but that we have included in our analyses. They are denoted by an asterisk (*). 26 Measuring Country Performance on Health Supplementary Table II Comparison of Regression Coefficients Using Different Income Measures LQ5 LAMRF LAMRM Defining variabes 1 2 3 1 2 3 1 2 3 Constant 7.39 7.40 7.46 6.99 7.12 7.32 7.03 7.11 7.26 LYPC -0.26 -0.27 -0.28 -0.14 -0.17 -0.20 -0.13 -0.14 -0.17 (6.90) (6.33) (6.05) (5.90) (6.25) (6.81) (6.01) (6.17) (6.59) FED/MED -0.19 -0.18 -0.18 -0.10 -0.10 -0.09 -0.05 -0.05 -0.04 (13.20) (11.82) (11.32) (10.80) (10.07) (.949) (5.69) (5.64) (5.41) TI 1965 -0.05 -0.06 -0.06 -0.06 -0.06 -0.06 -0.05 -0.05 -0.05 (1.56) (1.73) (1.80) (2.77) (2.78) (2.82) (2.73) (2.75) (2.79) T2 1970 -0.06 -0.08 -0.09 -0.09 -0.09 -0.09 -0.09 -0.09 -0.09 (1.86) (2.14) (2.39) (4.31) (4.26) (4.48) (4.74) (4.65) (4.85) T3 1975 -0.13 -0.15 -0.15 -0.13 -0.12 -0.13 -0.11 -0.11 -0.11 (3.73) (3.94) (4.21) (6.06) (5.69) (5.81) (5.63) (5.19) (5.29) T4 1980 -0.21 -0.23 -0.24 -0.15 -0.14 -0.14 -0.13 -0.12 -0.12 (5.61) (5.81) (6.04) (6.55) (6.08) (6.02) (5.96) (5.37) (5.29) T5 1985 -0.37 -0.38 -0.37 -0.21 -0.20 -0.18 -0.18 -0.17 -0.16 (9.39) (9.07) (8.82) (8.77) (8.00) (7.47) (8.00) (7.08) (6.58) T6 1990 -0.55 -0.52 -0.51 -0.23 -0.22 -0.21 -0.22 -0.20 -0.19 (12.26) (11.14) (10.92) (8.74) (8.31) (7.89) (8.63) (8.15) (7.67) R2 overall 83% 81% 81% 71% 71% 71% 57% 58% 58% Notes: Absolute t-values are in parentheses. Equation 1 is based on the income number for the indicated year. Equation 2 uses the average income over each five years. Equation 3 uses the average income of every 10 years. The real GDP per capita in constant international dollars, chain index, is used as the income measure (Penn World Tables, Version 5.6). Penn World Tables provide income per capita numbers from 1950 through 1992. To minimize the residuals possibly caused by sudden drops or increases in income in any given year for any given country, we calculated the years figure as the average income of the four preceding years and the indicated year. For example, the income number for the year 1970 is the average income from year 1966 through 1970. Supplementary Tables 27 LLEF LLEM LTFR 1 2 3 1 2 3 1 2 3 2.54 2.60 2.63 3.46 3.44 3.45 3.39 3.38 3.38 -0.07 -0.08 -0.08 0.06 0.06 0.06 0.06 0.06 0.06 (3.18) (3.44) (3.34) (5.53) (5.38) (4.95) (5.79) (5.50) (5.16 -0.12 -0.11 -0.11 0.03 0.03 0.03 0.03 0.03 0.03 (14.19) (13.35) (13.15) (7.66) (7.18) (7.05) (7.01) (6.83) (6.80) -0.01 -0.01 -0.01 0.03 0.03 0.04 0.03 0.03 0.03 (0.48) (0.61) (0.65) (3.57) (3.51) (3.60) (3.48) (3.43) (3.52) -0.01 -0.02 -0.02 0.06 0.06 0.07 0.06 0 06 0.06 (0.60) (0.78) (0.92) (6.49) (6.29) (6.59) (6.15) (5.96) (6.24) -0.03 -0.03 -0.04 0.08 0.08 0.08 0.07 0.07 0.07 (1.32) (1.62) (1.75) (8.36) (7.91) (8.23) (7.42) (7.00) (7.29) -0.04 -0.05 -0.05 0.10 0.10 0.10 0.09 0.09 0.09 (1.91) (2.17) (2.23) (9.81) (9.11) (9.33) (8.67) (8.01) (8.18) -0.08 -0.09 -0.08 0.13 0.12 0.12 0.12 0.11 0.11 (3.68) (3.75) (3.58) (11.95) (10.92) (10.71) (10.86) (9.82) (9.59) -0.14 -0.13 -0.13 0.12 0.11 0.11 0.12 0.11 0.10 (5.65) (5.42) (5.24) (10.16) (9.28) (9.10) (9.76) (8.71) (8.49) 70% 69% 68% 70% 70% 69% 64% 64% 63% To get a sense how different the results would be, we also conducted analyses separately, using the single year income numbers and the average income over every 10-year period. The above table provides the derived regression results. Equation 1 is based on the income number for the indicated year. Equation 2 calculates the results when the average income of each five years is used to predict health outcomes. Equation 3 has the average income of each 10 years as the predictor. Overall, the results from these three equations are very similar in terms of their regression coefficients and the overall R-squares. However, we used the average income over each five-year period as the income measure for all analyses. There are two main reasons. One reason is to facilitate correspondence with the health measures. Life expectancy figures from the updated World Bank demographic files are actually the average for each five years. The second reason to choose five-year-average numbers over the income for a single year is that improving health conditions is a cumulative process. It takes time to improve health and for the health condition to show the improvement, using any health performance measures. 28 Measunnrig Country Performance on Health Supplementary Table III Means and Standard Deviations of the Variables Used, Overall and by Region Year Variable 1960 1965 1970 1975 1980 1985 1990 All Countries YPC 1,362 1,515 1,805 2,218 2,938 2,788 2,795 (1,073) (1,243) (1,475) (2,017) (3,854) (2,952) (2,614) FED 2 2 3 3 3 4 4 (2) (2) (2) (2) (2) (2) (3) MED 3 3 4 4 4 5 5 (2) (2) (2) (2) (2) (2) (2) Q5 185 181 162 150 130 109 84 (77) (78) (78) (78) (77) (74) (65) AMRF 355 332 312 295 268 246 233 '132) (129) (130) (129) (126) (121) (123) AMRM 429 403 384 368 342 316 300 (142) (139) (141) (136) (129) (123) (123) TFR 6 6 6 6 5 5 5 (1) (1) 1) (2) (2) (2) (2) LEF 51 53 55 57 60 62 63 (10) (10) (11) (11) (10) (10) (11) LEM 48 50 52 53 56 58 59 (10) (10) (10) (10) (9) (9) (10) East Asia and Pacific YPC 1,014 1,150 1,369 1,859 2,107 2,233 2,613 (506) (564) (641) (878) (1,100) (1,262) (1,812) FED 2 3 3 4 4 5 5 (1) (1) (1) (2) (2) (2) (2) MED 4 4 4 5 6 6 7 (2) (2) (2) (2) (2) (2) (3) Q5 163 141 117 98 77 69 57 (43) (50) (49) (53) (44r) (47) (25) AMRF 410 339 309 289 248 229 208 (117) (82) (88) (103) (106) (103) (93) AMRM 478 403 366 353 311 289 268 (114) (80) (87) (89) (100) (102) (88) TFR 6 6 5 5 4 4 4 (1) (1) (1) (1) (1) (2) (1) LEF 55 57 60 62 65 65 67 (8) (8) (8) (8) (7) (8) (7) LEM 51 54 57 59 61 62 63 (7) (7) (7) (7) (6) (7) (6) Europe and Central Asia YPC 1,596 1,810 2,607 3,216 4,155 4,328 4,875 (838) (957) (1,073) (1,448) (1,497) (1,658) (1,805) FED 4 5 6 6 7 7 8 (3) (3) (3) (3) (2) (2) (2) MED 6 6 7 8 8 8 9 (2) (2) (2) (3) (2) (2) (2) Q5 114 104 72 69 50 42 32 (94) (94) (73) (68) (47) (36) (22) AMRF 124 124 107 105 107 109 i1O (21) (17) (9) (12) (10) (8) (10) AMRM 170 176 172 176 195 205 213 (13) (16) (17) (28) (33) (36) (42) Supplementary Tables 29 Year Variable 1960 1965 1970 1975 1980 1985 1990 TFR 4 3 3 3 3 2 2 (2) (2) (1) (1) (1) (1) (1) LEF 65 67 70 71 72 73 74 (8) (7) (5) (5) (4) (3) (2) LEM 61 63 65 65 66 66 66 (7) (6) (4) (4) (3) (2) (2) Latin America and the Caribbean YPC 2,277 2,558 2,950 3,356 4,018 3,872 3,967 (1,411) (1,591) (1,724) (1,890) (2,422) (2,497) (2,680) FED 3 3 4 4 5 5 5 (1) (1) (2) (2) (2) (2) (2) MED 4 4 4 5 5 5 6 (1) (1) (2) (2) (1) (1) (1) Q5 134 129 116 98 78 62 48 (62) (62) (58) (53) (49) (40) (36) AMRF 230 207 190 173 155 139 127 (73) (69) (66) (60) (56) (51) (52) AMRM 299 273 257 246 237 218 201 (86) (79) (71) (62) (66) (60) (52) TFR 6 6 5 5 4 4 3 (1) (1) (1) (1) (1) (1) (1) LEF 60 62 64 66 69 71 72 (8) (7) (7) (7) (6) (5) (5) LEM 56 58 60 61 63 65 67 (7) (7) (6) (6) (6) (5) (4) Middle East and North Africa YPC 1,854 2,207 2,779 4,219 7,071 6,006 5,100 (1,069) (1,419) (2,008) (3,405) (8,603) (5,703) (3,949) FED 0 1 1 1 2 3 3 (O) (O) (O) (1) (1) (1) (1) MED 1 2 2 3 4 4 5 (1) (1) (1) (1) (1) (1) (1) Q5 230 206 180 153 124 92 67 (49) (40) (40) (41) (45) (35) (30) AMRF 262 241 257 241 212 194 172 (59) (56) (80) (82) (58) (53) (60) AMRM 331 300 310 289 258 236 215 (73) (67) (89) (94) (66) (53) (55) TFR 7 7 7 7 6 6 5 (1) (2) (2) (2) (2) (2) (2) LEF 52 55 56 60 64 67 68 (7) (6) (7) <6) (6, (6) (7) LEM 50 53 54 58 61 64 65 (7) (6) (6) (6) (5) (5) (5) South Asia YPC 812 878 941 914 1,057 1215 1,372 (242) (231) (253) (216) (248) (376) (409) FED 1 1 1 1 2 2 3 (1) (1) (2) (2) (2) (2) (2) MED 2 2 2 3 4 4 5 (2) (2) (2) (2) (2) (2) (2) (Table contirnues on the next page) 30 Measuring Country Performance on Health Supplementary Table III (continued) Year Variable 1960 1965 1970 1975 1980 1985 1990 Q5 230 208 191 174 154 128 129 (61) (54) (55) (63) (61) (55) (13) AMRF 429 406 378 342 301 278 258 (118) (130) (117) (107) (99) (94) (95) AMRM 420 395 366 335 303 282 265 (138) (130) (112) (93) (75) (67) (69) TFR 6 6 6 6 6 5 4 (1) (1) (1) (1) (1) (1) (1) LEF 46 49 50 53 56 59 62 (10) (10) (9) (9) (9) (9) (8) LEM 47 49 51 53 56 58 60 (9) (9) (8) (7) (7) (6) (6) Sub-Saharan Africa YPC 859 920 1,043 1,184 1,305 1,266 1,269 (534) (613) (704) (910) (1,106) (1,001) (1,091) FED 1 1 1 2 2 2 2 (1) (1) (1) (1) (1) (1) (1) MED 2 2 2 3 3 3 3 (1) (1) (1) (1) (1) (2) (2) Q5 233 234 224 209 190 175 154 (66) (70) (65) (66) (68) (70) (71) AMRF 445 427 410 390 372 346 336 (78) (80) (86) (92) (92) (98) (104) AMRM 536 517 502 481 457 425 412 (76) (78) (87) (90) (87) (95) (100) TFR 6 6 6 6 6 6 6 (1) (1) (1) (1) (1) (1) (1) LEF 43 45 47 49 51 53 53 (6) (6) (7) (7) (8) (8) (10) LEM 40 42 44 46 48 50 50 (6) (6) (6) (6) (7) (7) (9) Note: Standard errors are in parentheses. Supplementary Tables 31 Supplementary Table IV Country-Specific Performance Relative to Income and Education, 1960-90 IV. 1 Under-Five Mortality Rate (%) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China - - - 33 50 62 47 Indonesia 12 7 -1 -4 -13 -30 -42 Korea, Rep. of 16 22 65 88 93 89 Myanmar - - 35 46 46 16 Papua New Guinea -2 -11 0 - - - Philippines 15 13 10 -16 -33 -43 -6 Thailand -7 8 10 16 30 22 2 Europe and Central Asia Hungary - - 20 31 33 36 46 Poland - - 43 46 37 30 37 Romania 27 33 39 40 38 34 7 Turkey -23 -29 -36 -35 -32 -35 -40 U.S.S.R., the fomer 52 51 50 27 5 -20 -24 Latin America and the Caribbean Argentina 17 15 -5 6 10 11 -6 Bolivia -81 -83 -85 -79 -74 -75 -67 Brazil -32 -31 -20 -13 -9 -30 Chile -54 -36 -28 -6 28 49 54 Colombia 7 -1 4 -10 15 37 77 Costa Rica -13 -7 11 24 69 85 101 Dominican Rep. 2 -3 -10 -10 -9 -10 -10 Ecuador -26 -25 -24 -37 -61 -46 -20 El Salvador -15 -14 -18 -24 -30 -3 21 Haiti - -8 -6 -8 -26 -14 -14 Honduras -12 -15 -13 3 7 21 42 Jamaica 62 52 49 52 73 Mexico -7 9 -7 -10 22 -22 48 Nicaragua -24 -27 -35 -37 -28 -14 10 Panama 17 18 22 27 -1 -1 16 Paraguay 38 38 32 25 12 17 33 Peru -55 -58 -62 -67 -79 -76 -55 Trinidad and Tobago 39 32 29 18 3 -3 -3 Uruguay 41 28 23 5 10 6 20 Venezuela 29 43 35 25 19 15 13 Middle East and North Africa Algeria -33 -19 -10 -18 -21 -5 17 Egypt, Arab Rep. of - - - -19 -24 -32 -35 Iran, Islamic Rep. of -52 -48 -39 -42 -41 -24 -21 Iraq 1 -2 6 5 -13 -23 -39 Jordan 38 25 27 29 25 5 9 Syrian Arab Rep. -4 0 20 22 16 6 -2 Tunisia -10 -9 -9 -2 10 15 13 Yemen, Rep. of - - - - 1 1 -29 South Asia Bangladesh 1 -5 -10 -9 -18 -17 -27 India 0 -1 1 -10 -13 -15 -16 Nepal -1 5 16 23 20 21 13 Pakistan 25 22 15 18 7 2 -47 SriLanka 1 0 -3 31 32 51 grable continues on the next page.) 32 Measuring Country Performance on Health Supplementary Table IV I (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Sub-Saharan Africa Benin - - -17 -12 -8 Botswana 26 28 16 22 18 36 Cameroon - -5 -7 -11 -14 -28 -36 Central African Rep. -22 -9 5 16 9 7 Ghana 12 9 -15 -14 -10 -1 3 Kenya 19 27 25 26 16 19 12 Lesotho -14 -26 -35 -41 - - - Liberia -7 -13 -20 -27 -28 -31 Malawi -26 -34 -39 -46 -40 -35 -26 Mali - - - -20 -12 2 Mauritius 33 29 18 29 52 52 29 Mozambique - - -31 -39 -35 - Niger - - -20 -30 -33 Rwanda - - 21 0 -9 - Senegal -40 -43 -42 -50 -38 -27 -21 Sierra Leone - -59 -56 -66 -70 -77 Sudan - - 31 41 42 - - Tanzania -16 -11 -10 -7 4 14 7 Togo 30 29 - 22 9 12 - Uganda 19 21 - 27 22 -6 Zaire - 1 0 0 - - Zambia -10 -10 -15 -15 -29 -48 -53 Zimbabwe 21 24 23 18 31 31 18 -Not available. Supplemnentary TabLes 33 Supplementary Table IV Country-Specific Performance Relative to Income and Education, 1960-90 IV.2 Female Adult Mortality Rate (%) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia arid Pacific China - - - 24 32 32 31 Fiji -14 -9 -6 -5 0 0 9 Indonesia -32 -27 -29 -22 -25 -24 -16 Korea, Rep. of -17 -35 -22 -14 -5 -9 -6 Malaysia -14 -15 -7 -4 2 2 0 Myanmar 20 15 14 15 12 3 13 Papua New Guinea -36 -40 -48 -62 -58 -54 -49 Philippines -39 -37 -42 -51 -50 -47 -37 Taiwan, China - - - - - 37 28 Thailand -14 -7 -10 -11 -6 6 21 Europe and Central Asia Bulgaria - - - - 33 19 2 Hungary - - 28 29 9 2 -4 Poland - - 44 41 30 19 13 Romania 70 44 58 44 35 26 -1 Turkey 109 102 99 94 80 59 38 Yugoslavia, the former 54 50 45 47 40 31 26 Latin America and the Caribbean Argentina 44 43 38 36 32 30 25 Barbados 51 42 6 15 38 33 33 Bolivia -38 -34 -32 -30 -30 -32 -30 Brazil 18 17 22 21 18 19 16 Chile 32 28 21 27 34 39 43 Colombia 12 15 13 1 12 19 18 Costa Rica 17 38 57 44 51 64 69 Dominican Rep. 7 17 21 27 40 49 45 Ecuador 10 14 10 -2 -9 8 20 El Salvador 7 17 29 29 19 18 18 Guyana -3 -3 -4 -11 -17 -15 -3 Haiti 7 6 4 5 5 4 -6 Honduras 11 4 -2 -2 0 23 39 Jamaica 34 33 45 46 43 45 50 Mexico 5 9 16 24 34 35 29 Nicaragua -17 -18 -18 -6 12 23 31 Panama -4 0 6 18 25 31 26 Paraguay 49 45 36 31 23 27 36 Peru -17 -16 -29 -23 -31 -28 -16 Trinidad and Tobago 19 17 11 8 -2 -3 -2 Uruguay 69 65 58 52 51 37 32 Venezuela 5 10 24 27 22 23 29 Middle East and North Africa Algeria 24 31 41 32 18 12 16 Bahrain - - - -4 -9 -14 -13 Egypt, Arab Rep. of - - - 45 27 -2 -22 Iran, Islamic Rep. oa 36 26 14 3 5 0 0 Iraq -4 -13 -9 -1 1 8 12 Jordan - - - - - -19 -2 Syrian Arab Rep. 14 6 6 -6 -15 -16 -10 Tunisia 33 34 23 9 5 3 6 Yemen, Rep. of - - - 9 8 -8 -26 (Table continues on the next page.) 34 Measuring Country Performance on Health Supplementary Table IV2 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 South Asia Bangladesh -31 -39 -34 -26 -23 -17 -17 India -6 -5 -5 -2 3 -4 -4 Nepal -16 -18 -17 -15 -12 -15 -20 Pakistan -7 -10 -10 -1 6 7 -10 Sri Lanka 13 22 9 18 19 19 27 Sub-Saharan Africa Benin -10 -18 -21 -21 -23 Botswana -21 -18 -27 -36 -23 17 14 Cameroon -24 -27 -31 -34 -38 -46 -45 Central African Rep. -6 -8 -15 -22 -20 -15 -12 Congo, Rep. of - - - - - -36 -48 Gambia, The - - - -35 -36 -31 -33 Ghana -9 -11 -26 -25 -18 -7 2 Guinea-Bissau - - - - -29 -33 -41 Kenya -13 -10 -13 -13 -23 -18 -16 Lesotho -14 -9 -5 3 -21 -38 -27 Liberia 11 20 38 53 52 46 44 Malawi -5 -5 -6 -10 -8 -20 -33 Mali -12 -8 2 11 8 7 8 Mauritius 3 1 5 6 -4 4 10 Mozambique -21 -17 -13 -17 -9 1 4 Niger -18 -21 -25 -22 -18 -17 -8 Reunion 39 26 26 31 - - - Rwanda - - -4 -13 -20 -24 -28 Senegal -33 -35 -44 -59 -60 -64 -66 Sierra Leone - -35 -46 -56 -56 -58 -53 South Africa -65 -58 -56 -51 -43 -43 -30 Sudan - - -35 -35 -33 -27 -23 Swaziland -45 -40 -27 -29 -15 -12 -12 Tanzania -39 -29 -24 -17 -13 -15 -19 Togo 11 4 -8 -8 -13 -10 -4 Uganda -10 -7 -8 -7 -9 -24 -31 Zaire -3 -7 -11 -13 -7 -6 Zambia -41 -41 -48 -50 -53 -45 -45 Zimbabwe -35 -29 -25 -23 -14 2 -14 -Not available. Supplementary Tables 35 Supplementary Table IV Country-Specific Performance Relative to Income and Education, 1960-90 IV3 Male Adult Mortality Rate (%) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China - - - 36 41 40 32 Fiji -7 1 2 10 16 20 24 Indonesia -30 -25 -27 -16 -15 -13 -6 Korea, Rep. of -24 -33 -26 -21 -12 -9 -10 Malaysia -25 -24 -17 -6 1 3 2 Myanmar 19 15 15 19 17 10 18 Papua New Guinea -22 -25 -34 -47 -48 -46 -40 Philippines -28 -23 -23 -24 -19 -15 -9 Taiwan, China - - - - - 45 37 Thailand -16 -7 -8 -4 0 6 10 Europe and Central Asia Bulgaria - - - - 24 11 0 Hungary 27 22 -1 -12 -25 Poland - - 19 14 6 -2 -10 Romania 66 39 49 22 15 6 4 Turkey 69 67 69 65 56 46 31 Yugoslavia, the former 59 52 41 44 38 28 23 Latin America and the Caribbean Argentina 27 21 15 14 14 12 11 Barbados 44 37 15 27 35 38 37 Bolivia -50 -43 -42 -33 -27 -21 -17 Brazil 21 20 21 18 15 14 10 Chile 21 19 10 12 14 20 22 Colombia 15 18 18 10 13 11 3 Costa Rica 28 46 57 45 47 61 61 Dominican Rep. 11 20 28 32 45 51 46 Ecuador 12 19 18 12 10 20 24 El Salvador 5 14 20 1 -35 -31 -6 Guyana 5 9 7 2 -7 -4 3 Haiti 2 1 3 5 7 -4 -9 Honduras 5 3 1 4 5 17 30 Jamaica 38 37 43 42 40 42 46 Mexico 7 9 9 13 16 15 18 Nicaragua -15 -17 -13 -3 4 4 24 Panama 17 21 22 29 38 39 43 Paraguay 46 45 37 36 33 33 39 Peru -20 -19 -25 -14 -13 -7 2 Trinidad and Tobago 18 15 10 7 4 0 2 Uruguay 42 40 34 33 33 27 18 Venezuela 2 2 7 3 4 6 5 Middle East and North Africa Algeria 14 24 27 26 21 18 19 Bahrain - - - -7 -5 -8 -11 Egypt, Arab Rep. of - - - 34 22 0 -13 Iran, Islamic Rep. of 41 38 34 24 10 11 28 Iraq -10 -19 -11 4 10 14 15 Jordan - - - - - -7 9 Syrian Arab Rep. 3 -5 -5 -12 -18 -18 -8 Tunisia 31 33 28 22 22 19 22 Yemen, Rep. of - - - 3 -1 -13 -27 (Table continaes on the next page.) 36 Measuring Country Performance on Health Supplementary Table IV.3 (continued) Year Region and Country 1960 1965 1970 1975 1980 1985 1990 South Asia Bangladesh -19 -23 -18 -11 -8 -3 -7 India 7 7 13 21 22 18 17 Nepal 3 0 4 7 4 1 -4 Pakistan 17 14 12 19 21 21 16 SriLanka 50 47 33 28 28 27 28 Sub-Saharan Africa Benin - - -13 -22 -25 -27 -29 Botswana -11 -8 -12 -25 -8 19 13 Cameroon -33 -33 -34 -33 -34 -41 -40 Central African Rep. -6 -20 -24 -30 -29 -23 -22 Congo, Rep. of -- - - - -39 -43 Gambia, The - - - -40 -42 -37 -40 Ghana -14 -16 -36 -31 -24 -16 -10 Guinea-Bissau - - - - -10 -15 -27 Kenya -20 -16 -19 -17 -25 -17 -14 Lesotho 7 14 18 17 -4 -23 -17 Liberia 1 7 19 27 28 29 31 Malawi -11 -11 -11 -13 -12 -12 -22 Mali -7 -5 1 3 5 8 0 Mauritius -1 -2 1 -2 -12 -12 -16 Mozambique -30 -29 -26 -29 -20 -11 -8 Niger 1 -6 -25 -26 -22 -21 -16 Reunion 27 14 5 -2 - Rwanda - - -8 -17 -21 -26 -31 Senegal -35 -37 -43 -51 -53 -60 -62 Sierra Leone - -29 -32 -40 -42 -49 -58 South Africa -50 -48 -50 -47 -39 -41 -33 Sudan - - -33 -33 -32 -27 -24 Swaziland -44 -41 -34 -30 -17 -10 -7 Tanzania -38 -27 -23 -15 -11 -9 -15 Togo 10 2 -10 -12 -22 -18 -13 Uganda -15 -8 -5 -7 -9 -22 -24 Zaire -9 -14 -17 -19 -13 -14 Zambia -51 -50 -51 -50 -48 -37 -38 Zimbabwe -32 -27 -22 -21 -12 -1 -3 -Not available. Supplementary Tables 37 Supplementary Table IV Country-Specific Performance Relative to Income and Education, 1960-90 IV.4 Total Fertility Rate (per 1,000) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China - - - -1.7 -2.2 -1.9 -1.9 Fiji 1.3 0.5 -0.2 -0.1 0.3 0.5 0.4 Indonesia -1.2 -1.0 -0.5 -0.7 -0.7 -0.9 -1.0 Korea, Rep. of 0.2 0.2 -0.5 -0.4 -0.6 -0.6 -0.5 Malaysia 0.6 0.4 0.2 -0.2 -0.2 0.4 0.5 Myanmar -0.9 -0.8 -1.2 -1.6 -1.8 -1.3 -1.5 Papua New Guinea -0.3 -0.3 -0.2 -0.1 -0.4 -0.4 -0.1 Philippines 1.8 2.0 2.0 1.8 1.6 1.4 1.1 Taiwan, China 0.0 -0.5 -1.0 -0.9 -0.8 -0.9 -0.9 Thailand 1.1 1.0 0.6 -0.2 -0.7 -1.0 -1.0 Europe amd Central Asia Bulgaria - - - - -1.1 -0.9 -0.5 Hungary - -1.2 -0.6 -0.7 -0.6 -0.5 Poland - - -1.2 -0.9 -0.4 -0.1 -0.2 Romania -2.2 -2.2 -1.3 -1.3 -1.1 -1.0 -0.5 Turkey 0.0 -0.4 -0.5 -0.7 -0.9 -0.8 -0.6 U.S.S.R.. the former -1.5 -1.0 -0.7 -0.4 -0.2 0.2 0.2 Yugoslavia, the former -2.8 -2.2 -1.9 -1.6 -1.2 -1.0 -0.8 Latin America and the Caribbean Argentina -1.9 -1.5 -0.8 -0.2 0.2 0.2 0.4 Barbados -0.4 -0.6 0.2 -0.2 -1.1 -0.9 -0.7 Bolivia 1.6 1.7 1.7 1.5 1.1 0.9 0.9 Brazil 0.6 0.4 -0.1 -0.4 -0.7 -0.9 -0.8 Chile 0.4 0.2 0.0 -0.5 -0.5 -0.3 -0.3 Colombia 1.2 1.0 0.3 0.0 -0.2 -0.4 -0.3 CostaRica 1.8 1.5 0.4 0.1 -0.1 -0.1 0.0 Dominican Rep. 1.6 1.4 1.1 0.3 -0.3 -0.5 -0.5 Ecuador 1.3 1.5 1.4 1.4 1.5 0.9 0.4 El Salvador 0.7 0.8 0.8 0.6 0.5 -0.1 -0.3 Guyana 1.3 1.3 1.0 0.3 -0.2 -0.4 -0.6 Haiti -0.4 -0.6 -0.7 -0.7 -0.2 -0.2 -0.4 Honduras 1.1 1.4 1.6 1.6 1.3 1.0 0.8 Jamaica -0.4 0.4 0.4 0.0 -0.4 -0.5 -0.7 Mexico 1.0 1.2 1,5 1.0 0.6 0.4 0.6 Nicaragua 1.4 1.4 1.7 1.6 1.4 1.2 1.0 Panama 0.9 1.1 0.9 0.5 0.6 0.3 0.5 Paraguay 1.3 1.4 1.2 0.7 0.9 0.9 0.8 Peru 1.1 1.2 1.4 0.9 0.9 0.5 0.3 Trinidad and Tobago -0.1 -0.5 -0.5 -0.3 0.3 0.1 -0.1 Uruguay -2.1 -1.7 -1.1 -0.6 -0.6 -0.4 -0.3 Venezuela 0.7 0.7 0,7 0.4 0.6 0.5 0.2 Middle East and North Africa Algeria 0.8 0.9 1.0 1.2 1.1 0.8 0.4 Bahrain - - - 1.3 0.9 0.7 0.8 Egypt, Arab Rep. of - - - -1.1 -0.8 -0.4 -0.4 Iran, Islamic Rep. of 0.6 0.6 0.9 1.0 1.0 1.5 1.5 Iraq 0.5 0.5 1.2 1.3 1.3 1.6 1.8 Jordan - - - - 2.2 2.3 2.0 Syrian Arab Rep. 0.6 1.1 1.6 2.0 2.4 2.6 2.5 (Table continues on the next page.) 38 Measuring Country Performance on Health Supplementary Table IV.4 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Tunisia 0.2 0.2 0.0 0.0 -0.2 -0.6 -0.7 Yemen, Rep. of - - - 0.5 0.6 0.8 1.6 South Asia Bangladesh 0.0 -0.3 0.0 -0.3 -0.4 -0.8 -1.3 India -0.1 -0.4 -0.8 -0.9 -1.0 -1.0 -1. 1 Nepal -1.4 -1.3 -1.2 -1.1 -1.0 -1.0 -0.7 Pakistan -0.2 -0.1 0.1 0.2 0.4 0.3 1.1 Sri Lanka -0.2 -0.2 -0.3 -0.7 -0.3 -0.6 -0.8 Sub-Saharan Africa Benin - - -0.2 -0.2 -0.4 -0.1 0.2 Botswana 0.5 0.6 0.8 1.1 1.9 1.4 0.9 Cameroon -1.7 -1.5 -0. 9 -0.1 0.5 0.7 0.9 Central African Rep. -1.4 -1.5 -1.6 -1.4 -1.3 -1.2 -0.9 Congo, Rep. of - - - - - 2.0 2.8 Gambia, The - - - -0.6 -0.5 -0.6 -0.4 Ghana 0.1 0.0 0.8 0.7 0.6 0.5 0.2 Guinea-Bissau - - - - -1.7 -1.5 -1.0 Kenya 1.3 1.4 1.6 1.7 2.2 1.5 0.7 Lesotho 0.4 0.6 0.5 0.7 1.0 1.0 0.8 Liberia -0.7 -0.7 -0.6 -0.2 -0.1 0.1 0.1 Malawi 1.1 1.2 0.9 1.3 1.2 1.4 1.2 Mali -0.6 -0.8 -1.2 -1.2 -1.1 -0.7 -0.2 Mauritius 0.1 -0.6 -1.1 -1.5 -1.3 -1.4 -1.3 Mozambique -0.6 -0.6 -0.5 -0.4 -0.7 -0.6 -0.2 Niger -0.1 -0.2 -0.2 -0.3 -0.2 0.0 0.1 Reunion -0.2 -0.2 -0.7 -1.0 - Rwanda - - 0.8 1.3 1.5 1.0 0.6 Senegal 0.0 0.0 0.0 0.5 0.5 0.6 0.6 Sierra Leone - -0.6 -0.4 0.0 0.0 0.2 0.5 South Africa 1.4 1.2 1.2 1.0 0.7 0.8 0.7 Sudan - - -0.6 -0.5 -0.5 -0.6 -0.5 Swaziland 0.4 0.6 0.9 1.9 1.9 2.4 2.8 Tanzania 1.1 1.0 0.5 0.4 0.4 0.3 0.2 Togo -0.8 -0.8 -0.9 -0.7 -0.1 0.2 0.5 Uganda 0.1 0.1 0.1 0.1 0.0 0.5 0.6 Zaire -1.1 -1.1 -1.0 -0.6 -0.3 0.0 Zambia 0.4 0.5 0.9 1.4 1.9 1.8 1.5 Zimbabwe 1.6 1.7 1.6 1.2 0.8 0.4 -0.1 -Not available. Supplementary Tables 39 Supplementary Table IV Country-Specific Performance Relative to Income and Education, 1960-90 IV5 Female Life Expectancy (Years) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China - - - - 8.7 7.3 7.4 Fiji 0.6 2.0 2 7 1.9 1.8 1.5 2.1 Indonesia -1.6 -0.4 -2.0 -0.8 -1.2 -1.0 0.4 Korea, Rep. of 2.9 -1.1 3.4 2.3 0.9 1.0 2.7 Malaysia 6.9 6.5 6.8 5.4 5.2 3.3 2.9 Myanmar 6.3 5.3 5.4 5.8 5.0 3.1 7.7 Papua New Guinea -5.8 -6.2 -6.0 -5.8 -4.0 -4.2 -2.0 Philippines -1.4 -2.7 -3.7 -6.2 -6.5 -5.1 -2.0 Taiwan, China 14.5 12.3 11.2 8.0 6.6 6.1 5.4 Thailand 0.3 2.3 2.2 2.2 3.5 2.9 3.1 Europe and Central Asia Bulgaria - - - - 4.8 4.1 2.6 Hungary - - 1.4 - 2.1 2.7 1.8 Poland - - 4.0 4.8 3.9 3.0 2.2 Romania 6.7 5.9 5.7 5.2 3.8 2.8 -1.6 Turkey 3.1 3.4 3.7 3.4 2.8 1.8 2.7 U.S.S.R., the former 1.6 0.2 2.5 2.0 2.3 3.9 2.9 Yugoslavia, the former 7.8 5.9 6.2 6.5 4.7 4.1 3.5 Latin America and the Caribbean Argentina 5.2 4.2 4.7 4.8 4.7 4.4 3.8 Barbados 5.1 5.2 -0.8 2.4 6.6 6.8 6.3 Bolivia -13.8 -12.7 -11.7 -9.7 -7.7 -6.2 -3.1 Brazil 1.4 1.4 2.4 2.2 2.2 1.6 1.3 Chile -2.2 -0.2 1.2 3.7 5.1 5.9 6.5 Colombia 3.5 4.7 4.5 2.6 4.3 3.4 3.6 Costa Rica 4.9 5.8 8.0 7.3 8.9 9.1 9.2 Dominican Rep. 1.8 3.5 2.8 3.0 4.6 5.0 5.6 Ecuador 0.8 0.6 0.7 -0.7 -1.7 0.5 2.2 El Salvador 2.2 3.4 4.2 3.7 2.1 5.0 9.0 Guyana -0.8 -0.2 -0.5 -1.7 -2.5 -1.8 1.3 Haiti -1.1 0.1 0.5 1.3 0.0 0.4 4.0 Honduras -0.5 0.2 1.4 2.5 4.3 6.1 8.9 Jamaica 11.1 9.6 10.1 8.7 8.5 7.8 8.4 Mexico 3.6 3.2 4.1 4.5 4.4 3.7 3.2 Nicaragua -3.2 -2.4 -2.4 -0.9 0.5 1.9 6.4 Panama 2.1 3.0 4.2 5.2 3.2 3.9 2.7 Paraguay 10.5 9.2 7.5 6.2 3.3 2.9 4.5 Peru -4.9 -5.0 -4.6 -4.5 -5.4 -3.7 -1.1 Trinidad and Tobago 4.4 2.8 3.0 2.9 3.4 3.5 2.2 Uruguay 7.7 7.1 6.2 5.3 5.6 4.8 4.2 Venezuela 2.1 3.7 4.9 4.7 3.9 3.8 3.2 Middle East and North Africa Algeria -0.4 1.4 2.5 2.2 1.6 3.0 4.6 Bahrain - - - -0.2 -0.8 -1.7 -0.5 Egypt, Arab Rep. of - - - 2.6 1.4 0.8 2.1 Iran, Islamic Rep. of -0.8 -2.0 -3.4 -4.1 -1.3 -0.5 1.4 Iraq -1.0 -1.9 -1.0 0.4 -2.6 -0.6 -9.3 Jordan - - - - 2.5 0.6 2.7 Syrian Arab Rep. 3.5 3.5 3.9 2.3 0.8 -0.3 1.2 (Table continues on the next page.) 40 Measuring Country Performance on Health Supplementary Table IV.5 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 l990 Tunisia 4.3 4.1 4.2 4.2 3.7 2.9 3.6 Yemen, Rep. of - - - -0.2 -1.0 -2.9 -4.1 South Asia Bangladesh -4.9 -4.5 -5.3 -3.7 -3.5 -2.3 1.0 India -0.3 -0.1 -0.3 0.3 0.8 0.2 3.1 Nepal -3.2 -3.1 -2.9 -1.3 -1.4 -1.2 2.1 Pakistan 2.2 2.1 1.1 3.4 4.0 4.5 3.0 Sri Lanka 7.9 7.1 4.0 6.7 5.1 5.1 6.4 Sub-Saharan Africa Benin - - -3.4 -3.2 -2.1 -2.4 -0.7 Botswana 2.6 3.5 2.6 2.5 0.7 -0.6 -9.1 Cameroon -3.0 -2.7 -2.7 -2.2 -2.3 -4.0 -1.2 Central African Rep. -0.8 -0.4 -1.0 -1.3 -0.3 0.0 1.7 Congo, Rep. of - - - - - -10.5 -12.3 Gambia, The - - - -8.6 -8.9 -7.5 -4.9 Ghana 2.6 2.3 -1.8 -1.7 -0.4 1.7 5.8 Guinea-Bissau - - - - -6.3 -5.9 -3.8 Kenya 3.3 4.2 3.2 3.8 1.8 2.7 3.8 Lesotho -4.8 -5.0 -5.1 -5.1 -5.6 -4.7 -2.0 Liberia 0.5 0.8 0.3 -0.2 0.4 0.8 -10.7 Malawi -3.9 -5.1 -5.5 -6.7 -5.9 -7.0 -8.4 Mali -4.0 -5.5 -2.5 -3.2 -3.2 -0.7 3.7 Mauritius 4.9 4.3 3.8 4.9 3.2 4.2 3.0 Mozambique -5.5 -5.1 -6.3 -7.0 -4.9 -4.1 -1.8 Niger -3.6 -4.4 -5.9 -4.9 -3.7 -3.4 1.6 Reunion 9.2 7.3 8.8 10.2 - - Rwanda - - 0.2 -1.8 -2.5 -4.9 -28.5 Senegal -7.3 -7.4 -7.4 -8.8 -8.0 -8.5 -5.5 Sierra Leone - -12.4 -13.6 -15.9 -16.5 -16.8 -17.2 South Africa -8.7 -6.7 -6.5 -5.7 -4.4 -4.4 -2.4 Sudan - - -2.2 -0.3 -0.2 0.0 1.4 Swaziland -7.8 -8.3 -7.6 -10.4 -8.7 -8.4 6.0 Tanzania -5.5 -3.4 -1.9 0.1 1.1 0.0 0.6 Togo 3.2 3.2 1.8 2.4 1.1 1.3 1.3 Uganda 3.8 3.9 3.9 1.4 0.3 -3.7 -3.3 Zaire 2.6 1.9 0.8 0.9 2.4 2.8 Zambia -4.6 -4.2 -5.1 -5.0 -6.2 -9.3 -12.7 Zimbabwe -0.5 0.6 0.8 1.0 2.3 5.9 3.0 -Not available. Supplementary Tables 41 Supplementary Table IV Country-Specific Performance Relative to Income and Education, 1960-90 IV.6 Male Life Expectancy (Years) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China - - 9.7 9.0 7.6 Fiji 1.8 4.2 4.3 4.7 4.7 4.6 5.1 Indonesia -2.0 -1. 1 -2.2 -0.2 -0.6 0.5 1.9 Korea, Rep. of -0.1 -1.9 1.1 0.9 0.6 1.6 1.7 Malaysia 2.3 2.9 4.3 4.4 4.6 3.8 3.7 Myanmar 5.6 4.5 4.9 5.6 5.0 3.6 7.7 Papua New Guinea -2.8 -2.9 -3.0 -3.5 -2.6 -2.7 -0.6 Philippines 1.0 0.6 0.9 0.1 0.0 1.1 3.9 Taiwan, China 10.2 7.5 8.0 7.8 7.7 7.5 6.3 Thailand 0.0 1.7 2.4 3.4 4.5 4.0 3.6 Europe and Central Asia Bulgaria - - - - 5.5 4.0 1.5 Hungary - - 4.8 - 1.7 1.4 -0.8 Poland - - 4.1 4.2 2.8 2.4 0.7 Romania 10.4 8.9 7.3 2.2 1.5 1.7 2.8 Turkey 0.6 1.0 1.6 1.5 1.1 1.2 2.0 U.S.S.R., the former 2.2 0.8 -0.7 -0.6 -1.0 0.4 -2.8 Yugoslavia, the former 8.2 6.6 6.1 6.6 4.6 4.2 3.9 Latin America and the Caribbean Argentina 3.4 2.6 2.8 3.3 3.7 2.9 2.8 Barbados 5.5 6.0 2.3 5.1 7.5 7.0 5.9 Bolivia -15.2 -14.0 -13.0 -10.1 -7.1 -4.8 -1.5 Brazil 4.3 3.8 2.8 2.3 0.7 -0.9 -2.1 Chile -1.9 -0.8 0.7 3.6 5.9 6.4 7.0 Colombia 4.9 5.6 5.9 4.3 5.9 4.4 4.0 Costa Rica 8.1 8.5 9.7 9.6 10.9 11.0 10.7 Dominican Rep. 3.7 5.2 5.0 5.0 6.5 6.8 7.6 Ecuador 2.7 3.0 2.9 2.2 1.3 2.4 4.0 El Salvador 2.6 3.5 2.8 -2.7 -6.0 1.3 6.3 Guyana 2.1 3.0 2.0 1.1 -0.4 1.5 4.6 Haiti -0.7 0.3 0.5 1.5 0.8 -1.8 1.8 Honduras 0.3 1.2 2.1 3.7 5.4 4.9 7.8 Jamaica 13.0 12.5 12.0 10.8 11.3 10.7 11.0 Mexico 3.8 3.3 1.7 2.0 2.4 2.0 2.5 Nicaragua -1.9 -1.9 -0.8 -0.6 -0.3 1.1 7.0 Panama 7.5 8.0 7.8 8.5 7.2 6.4 7.1 Paraguay 11.4 10.8 8.9 8.5 6.1 4.9 6.3 Peru -5.3 -5.1 -4.4 -3.3 -3.1 -1.2 1.8 Trinidad and Tobago 3.6 2.1 2.3 2.1 2.2 1.5 1.3 Uruguay 6.6 6.6 5.9 5.5 5.8 5.1 4.1 Venezuela 0.6 1.7 3.0 2.7 2.4 2.3 1.6 Middle East and North Africa Algeria 0.0 2.6 1.7 1.9 1.9 3.6 5.0 Bahrain - - - 0.0 0.0 -1.4 -1.4 Egypt, Arab Rep. of - - - 2.2 1.1 0.8 2.6 Iran, Islamic Rep. of 0.9 0.1 0.0 -2.0 -1.7 2.5 4.1 Iraq -0.9 -1.9 -0.2 1.3 -1.2 -0.2 -4.8 Jordan - - - - 2.9 2.2 4.1 Syrian Arab Rep. 1.2 0.6 1.2 0.5 -0.1 -0.4 0.9 (Table cortinues on the next page.) 42 Measuring Country Performance on Health Supplementary Table IV6 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Tunisia 4.9 4.7 5.1 5.4 5.2 4.3 5.2 Yemen, Rep. of - - - -1.1 -0.6 -3.0 -4.4 South Asia Bangladesh -1.7 -2.1 -2.5 -1.8 -1.6 -1.0 1.2 India 1.0 0.5 1.4 1.7 1.2 1.4 3.5 Nepal 0.3 0.4 1.2 2.4 0.8 1.2 3.3 Pakistan 4.4 3.3 1.6 3.3 3.4 3.4 2.8 Sri Lanka 11.2 9.7 8.5 8.5 8.1 7.8 8.7 Sub-Saharan Africa Benin - - -3.3 -4.1 -3.5 -4.0 -2.9 Botswana 3.9 4.3 4.8 3.7 2.9 0.7 -7.6 Cameroon -5.7 -5.0 -4.4 -3.1 -2.8 -3.9 -1.4 Central African Rep. -4.7 -4.3 -4.8 -5.0 -4.5 -3.7 -2.4 Congo, Rep. of - - - - - -12.3 -12.4 Gambia, The - - - -9.4 -10.0 -9.0 -7.1 Ghana 0.7 0.3 -5.1 -4.3 -3.5 -2.1 1.1 Guinea-Bissau - - - - -6.2 -6.8 -5.1 Kenya 0.1 0.9 0.2 1.2 -0.6 1.3 2.8 Lesotho 0.2 1.1 1.6 1.2 0.6 2.0 3.6 Liberia -0.8 -0.7 -1.1 -2.1 -1.7 -1.1 -13.1 Malawi -4.7 -5.9 -6.0 -6.3 -6.4 -7.2 -7.5 Mali -2.9 -4.6 -4.3 -4.1 -1.5 -0.8 1.1 Mauritius 3.8 2.6 2.6 3.5 2.2 1.7 0.8 Mozambique -7.4 -7.1 -7.7 -8.4 -6.4 -5.4 -3.3 Niger -4.4 -5.2 -6.4 -6.1 -4.9 -4.7 -0.6 Reunion 8.3 6.9 7.4 8.5 - - Rwanda - - -1.6 -3.2 -3.8 -5.8 -27.7 Senegal -7.3 -7.4 -7.3 -6.8 -8.8 -9.1 -5.4 Sierra Leone - -13.4 -14.3 -16.7 -17.5 -17.8 -18.9 South Africa -6.3 -5.8 -6.8 -6.0 -3.7 -5.2 -3.2 Sudan - - -3.1 -1.4 -1.3 -1.1 -0.1 Swaziland -8.2 -8.2 -8.4 -9.7 -8.3 -8.0 -5.5 Tanzania -5.5 -3.7 -2.7 -0.5 0.0 -0.5 0.1 Togo 2.3 1.7 0.0 0.2 -2.6 -2.2 -2.3 Uganda 1.5 3.4 3.3 0.3 -0.1 -3.4 -1.3 Zaire 0.2 -0.8 -1.6 -1.5 -0.7 -0.9 Zambia -8.3 -8.0 -7.3 -6.6 -6.9 -8.7 -12.2 Zimbabwe -1.0 -0.2 0.4 0.4 1.6 4.9 3.0 -Not available. Supplementary Tables 43 Supplementary Table V Country-Specific Performance Relative to Income, 1960-90 VI Under-Five Mortality Rate (%) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China 30 44 54 70 90. 94 65 Indonesia 3 1 11 6 3 -18 -31 Korea, Rep. of 43 70 97 138 149 145 Myanniar - - 26 36 37 15 Papua New Guinea -16 -27 - - - - - Philippines 54 55 58 52 39 26 42 Thailand 31 34 36 38 51 49 19 Europe and Central Asia Hungary 95 100 96 87 74 Poland 111 109 96 94 78 Romania 112 118 121 117 106 93 72 Turkey -34 -39 -49 -52 -52 -51 -43 U.S.S.R., the former 125 130 124 97 62 27 2 Latin America and the Caribbean Argentina 41 42 20 30 39 40 21 Bolivia -35 -44 -55 -55 -57 -59 -53 Brazil -13 -13 -9 -17 -22 -41 Chile -18 -4 5 28 70 86 78 Colombia 24 11 11 14 35 56 92 CostaRica 16 23 28 54 91 110 119 Dominican Rep. 17 8 12 5 1 2 3 Ecuador -7 -5 -7 -9 -22 -15 4 El Salvador -15 -13 -21 -26 -30 0 24 Haiti - -26 -24 -28 -37 -28 -29 Honduras -10 -11 -10 11 10 26 47 Jamaica 74 70 60 66 92 - - Mexico -4 -5 -11 -16 -24 -23 -33 Nicaragua -20 -25 -33 -37 -28 -8 18 Panama 61 57 56 61 52 41 59 Paraguay 64 65 66 59 48 42 52 Peru -45 -50 -45 -51 -45 -44 -29 Puerto Rico 85 67 95 104 90 83 55 Trinidad and Tobago 53 44 37 23 12 -1 7 Uruguay 69 59 56 43 40 45 45 Venezuela 21 37 20 12 16 18 17 Middle East and North Africa Algeria -51 -35 -36 -46 -50 -26 13 Egypt, Arab Rep. of - -36 -39 -44 -45 -44 -35 Iran, Islamic Rep. of -75 -68 -69 -76 -76 -48 -24 Iraq -25 -27 -27 -32 -57 -50 -42 Jordan 31 20 24 26 22 11 25 Morocco - -20 -22 -29 -38 -30 -20 Syrian Arab Rep. -23 -18 -3 -2 -9 -10 0 Tunisia -34 -32 -30 -21 -11 -5 9 Yemen, Rep. of - - - - -49 -51 -61 South Asia Bangladesh -25 -32 -42 -40 -44 -45 -49 India -13 -15 -9 -16 -17 -19 -19 Nepal -29 -25 -18 -15 -24 -21 -21 (Fable continues on the next page.) 44 Measuring Country Performance on Health Supplementary Table V.1 (contirned) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Pakistan 1 -2 -9 -9 -19 -30 -50 Sri Lanka 29 30 42 69 84 94 Sub-Saharan Africa Benin - -53 -49 -46 -44 - Botswana 32 28 24 22 29 35 Burkina Faso -24 -20 -17 -16 -19 -22 -24 Burundi -12 -7 0 -2 -2 -4 -12 Cameroon - -16 -17 -20 -25 -41 -43 Central African Rep. -47 -36 -24 -14 -21 -22 Chad - - - - -18 10 Congo, Rep of -15 -2 - - - - Cote d'lvoire - -61 -52 -47 -50 Ethiopia - - 9 9 11 11 Ghana -8 -11 -10 -13 -13 -9 -11 Kenya 8 15 20 16 22 21 12 Lesotho 36 21 14 6 - - Liberia -29 -37 -47 -52 -55 -57 Madagascar -5 -10 - - -24 -26 -28 Malawi -28 -37 -44 -41 -39 -38 -39 Mali - - - -48 -45 -36 Mauritius 36 33 28 35 58 60 36 Mozarnbique - - -67 -80 -77 - Namibia - - - - -43 -43 -50 Niger - - -60 -73 -75 Nigeria - - - - -54 -64 -60 Rwanda 14 21 -2 -22 -31 - Senegal -47 -54 -58 -60 -55 -49 -40 Sierra Leone - -83 -84 -90 -97 -104 Sudan - - 1 9 7 Tanzania 18 12 6 1 6 15 -6 Togo 2 1 - -4 -8 -4 - Uganda 2 3 - 5 -2 -37 Zaire - -22 -22 -22 - - Zambia -10 -10 -13 -15 -11 -29 -43 Zimbabwe 16 19 18 6 15 17 14 -Not available. Supplementary Tables 45 Supplementary Table V Country-Specific Performance Relative to Income, 1960-90 V.2 Female Adult Mortality Rate (%) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China -56 30 32 41 50 51 46 Fiji 11 14 20 25 31 35 37 Indonesia -40 -34 -25 -18 -16 -15 -7 Korea, Rep. of -2 -7 -1 18 32 29 22 Lao PDR - - -56 -56 Malaysia -15 -12 -1 6 13 12 10 Mongolia - - - - - -10 -5 Myanmar 7 2 3 2 0 0 8 Papua New Guinea -44 -48 -61 -70 -70 -67 -60 Philippines -15 -12 -12 -12 -8 -4 0 Solomon Islands - - - - - -16 -30 Taiwan, China - - - - - 58 40 Thailand 8 8 7 5 10 26 35 Vanuatu - - - - - -10 -15 Western Samoa - - - - - - -2 Europe and Central Asia Bulgaria - - - - 65 49 28 Hungary - - 80 74 52 39 22 Poland - - 90 83 71 62 49 Romania 118 91 105 85 73 63 50 Turkey 104 99 96 93 78 55 35 Yugoslavia, the former 71 75 70 68 60 47 40 Latin America and the Caribbean Argentina 67 67 63 61 60 55 50 Bahamas, The - - - - 36 46 50 Barbados 79 71 64 65 65 58 50 Belize - - - - - 23 33 Bolivia -9 -10 -12 -12 -16 -19 -18 Brazil 32 30 32 28 23 19 16 Chile 59 53 47 53 65 67 64 Colombia 26 25 22 20 30 35 30 Costa Rica 38 60 73 69 72 84 84 Dominica - - - - - 52 Dominican Rep. 17 25 36 40 51 60 56 Ecuador 24 28 24 19 20 32 40 El Salvador 9 19 31 33 25 23 21 Guyana 22 23 20 15 9 18 27 Haiti -4 -7 -8 -6 -2 -4 -14 Honduras 12 6 1 4 4 28 44 Jamaica 45 47 57 62 60 63 66 Mexico 13 16 21 33 46 43 43 Nicaragua -12 -14 -12 1 18 30 38 Panama 26 26 31 43 60 61 61 Paraguay 66 62 57 53 47 46 52 Peru -7 -8 -13 -6 -6 -4 5 Puerto Rico 95 98 90 90 85 75 67 St. Kitts and Nevis - - - - - -1 -5 Suriname 24 28 24 22 11 8 25 Trinidad and Tobago 36 34 26 26 19 9 10 (rable continues on the next page.) 46 Measuring Country Performance on Health Supplementary Table V2 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Uruguay 94 91 86 82 77 67 54 Venezuela 11 17 27 36 36 34 33 Middle East and North Africa Algeria 16 23 28 24 11 5 13 Bahrain - - -1 -9 -20 -15 Egypt, Arab Rep. of 33 46 48 34 19 -6 -21 Iran, Islamic Rep. of 27 19 4 0 1 -7 -3 Iraq -14 -22 -20 -6 -5 0 9 Jordan - - - - - -9 11 Malta 85 82 73 69 69 66 57 Morocco 19 12 9 11 14 9 5 Oman - - -57 -79 -58 -34 -15 Qatar - - - - -19 -13 -5 Saudi Arabia -19 -21 -28 -43 -41 -30 -15 Syrian Arab Rep. 5 -2 -4 -9 -17 -18 -8 Tunisia 19 20 12 4 1 -3 3 Yemen, Rep. of - - -24 -14 -17 -35 -50 South Asia Bangladesh -48 -56 -53 -43 -38 -32 -32 India -16 -15 -13 -7 -1 -5 -5 Nepal -36 -40 -41 -38 -37 -40 -43 Pakistan -25 -27 -25 -16 -9 -10 -11 Sri Lanka 30 40 37 40 49 47 49 Sub-Saharan Africa Angola -41 -55 -56 -55 -45 -46 -45 Benin -35 -32 -29 -35 -40 -40 -42 Botswana -21 -21 -24 -35 -14 21 17 Burkina Faso -22 -18 -16 -13 -14 -15 -14 Burundi -26 -24 -22 -25 -25 -25 -27 Cameroon -32 -36 -38 -40 -44 -52 -49 Cape Verde 16 18 15 21 15 5 9 Central African Rep. -24 -27 -34 -40 -40 -33 -30 Chad -44 -47 -46 -43 -41 -27 -22 Comoros - - - - - -16 -9 Congo, Rep. of -32 -36 -35 -31 -22 -27 -37 Cote d'lvoire -38 -42 -45 -47 -40 -25 -30 Djibouti - - -58 -57 -56 -54 -50 Ethiopia 3 -5 -12 -17 -17 -12 -5 Gabon -31 -45 -57 -65 -72 -71 -70 Gambia, The -37 -58 -51 -53 -56 -52 -52 Ghana -22 -25 -24 -24 -21 -12 -6 Guinea -39 -43 -48 -54 -59 -59 -64 Guinea-Bissau -37 -40 -48 -57 -55 -59 -67 Kenya -23 -20 -18 -20 -21 -17 -14 Lesotho 10 14 19 25 -3 -19 -13 Liberia -5 3 21 40 37 31 27 Madagascar 20 16 14 12 -3 -23 -34 Malawi -12 -12 -14 -13 -14 -24 -39 Mali -30 -29 -19 -12 -17 -18 -19 Mauritania -31 -33 -36 -40 -44 -39 -35 Mauritius 10 9 17 18 10 16 16 Mozambique -37 -34 -32 -35 -31 -23 -21 Namibia -40 45 -48 -54 -58 -58 -57 Supplementary Tables 47 Year Region and Country 1960 1965 1970 1975 1980 1985 1990 Niger -38 -42 -46 -45 -44 -43 -36 Nigeria -18 -35 -44 -54 -60 -59 -49 Reunion 45 39 39 47 61 65 71 Rwanda -19 -16 -21 -29 -35 -40 -44 Senegal -38 -42 -53 -63 -68 -75 -78 Seychelles - - - - - 33 39 Sierra Leone - -50 -62 -67 -70 -73 -68 Somalia -61 -53 -48 -42 -40 -33 -27 South Africa -41 -39 -36 -33 -30 -30 -20 Sudan - - -54 -54 -53 -48 -43 Swaziland -42 -37 -26 -14 -7 -6 -4 Tanzania -24 -21 -20 -19 -19 -17 -25 Togo -11 -19 -28 -27 -26 -20 -15 Uganda -24 -22 -21 -23 -28 -43 -46 Zaire -22 -25 -27 -28 -21 -17 - Zambia -42 -42 -46 -48 -4+ -34 -36 Zimbabwe -38 -33 -29 -27 -21 -5 -16 -Not available. 48 Measuring Country Performance on Health Supplementary Table V Country-Specific Performance Relative to Income, 1960-90 V.3 Male Adult Mortality Rate (%) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China -44 32 48 53 58 52 47 Fiji 13 16 22 27 31 32 34 Indonesia -32 -26 -18 -11 -8 -7 2 Korea, Rep. of 2 -3 -1 3 8 5 -7 Lao PDR - - - - - -47 -45 Malaysia -11 -9 0 9 15 13 11 Mongolia - - - - - 3 9 Myanmar 5 2 4 4 2 2 8 Papua New Guinea -28 -30 -39 -46 -48 -47 -39 Philippines -11 -7 -6 -5 -2 0 4 Solomon Islands - - - - - 5 -7 Taiwan, China - -- - - 54 39 Thailand 6 7 8 7 10 16 20 Vanuatu - - - - - 3 -2 Western Samoa - - - - - - 4 Europe and Central Asia Bulgaria - - - - 39 22 3 Hungary - - 49 39 13 -4 -21 Poland - - 46 32 19 10 -3 Romania 110 80 90 67 49 33 23 Turkey 73 73 75 73 65 53 40 Yugoslavia, the former 76 71 62 60 49 37 31 Latin America and the Caribbean Argentina 40 34 28 26 24 20 18 Bahamas, The - - - - -4 -3 2 Barbados 62 53 42 42 45 45 42 Belize - - - - - 26 25 Bolivia -19 -19 -20 -16 -14 -11 -8 Brazil 24 24 27 26 23 22 20 Chile 38 33 26 26 27 30 31 Colombia 23 25 23 21 22 18 11 Costa Rica 40 57 65 58 58 70 70 Dominica - - - - - 53 Dominican Rep. 15 23 35 40 52 57 53 Ecuador 21 27 26 24 24 31 33 El Salvador 6 16 26 8 -29 -27 -2 Guyana 22 24 21 15 5 7 12 Haiti -10 -10 -7 -4 0 -1 -9 Honduras 3 2 0 5 6 26 37 Jamaica 40 41 47 51 47 49 53 Mexico 13 16 19 25 26 24 26 Nicaragua -13 -12 -8 4 10 7 27 Panama 34 34 36 42 53 49 54 Paraguay 59 56 51 48 45 43 48 Peru -9 -9 -10 -1 2 5 13 Puerto Rico 73 71 51 47 48 34 27 St. KiLts and Nevis - - - - - 4 3 Suriname 22 24 20 22 13 11 16 Trinidad and Tobago 29 25 19 17 10 5 8 Uruguay 56 52 48 46 44 36 26 Venezuela 9 11 13 15 14 14 16 Supplementary Tables 49 Year Region and country 1960 1965 1970 1975 1980 1985 1990 Middle East and North Africa Algeria 9 18 27 30 28 25 28 Bahrain - - - 6 8 4 1 Egypt, Arab Rep. of 24 33 36 32 24 7 -5 Iran, Islamic Rep. of 39 41 36 34 19 19 37 Iraq -13 -17 -9 13 21 22 24 Jordan - - - - 3 18 Malta 71 68 58 53 54 56 50 Morocco 13 8 8 12 18 17 14 Oman - - -50 -63 -41 -17 -3 Qatar - - - - -11 -11 -7 Saudi Arabia -24 -24 -26 -28 -19 -6 10 Syrian Arab Rep. 3 -1 0 -2 -7 -8 1 Tunisia 22 27 25 27 29 26 30 Yemen, Rep. of -15 -14 -13 -19 -26 South Asia Bangladesh -29 -30 -27 -17 -10 -6 -8 India 8 11 19 27 31 26 25 Nepal -18 -20 -19 -12 -7 -8 -10 Pakistan 5 6 10 17 20 20 24 Sri Lanka 67 62 52 45 44 40 39 Sub-Saharan Africa Angola -32 -35 -43 -52 -43 -44 -43 Benin -33 -30 -27 -32 -34 -34 -35 Botswana -17 -16 -19 -26 -6 22 19 Burkina Faso -25 -20 -19 -17 -17 -18 -18 Burundi -26 -22 -20 -23 -23 -23 -27 Cameroon -32 -33 -34 -33 -34 -40 -38 Cape Verde 18 22 20 25 23 19 24 Central African Rep. -18 -33 -37 -40 -40 -35 -33 Chad -26 -31 -34 -42 -39 -29 -26 Comoros - - - - - -10 -5 Congo, Rep. of -37 -39 -37 -33 -25 -28 -34 Cote d'lvoire -39 -41 -42 -41 -31 -15 -18 Djibouti - - -57 -52 -49 -46 -43 Ethiopia 7 1 -5 -10 -17 -17 -13 Gabon -36 -46 -54 -56 -58 -55 -51 Gambia, The -27 -49 -51 -52 -53 -49 -49 Ghana -21 -22 -20 -18 -13 -6 -3 Guinea -15 -26 -43 -45 -49 -48 -47 Guinea-Bissau -9 -18 -28 -37 -35 -38 -47 Kenya -22 -18 -16 -16 -16 -13 -11 Lesotho 9 12 15 16 -6 -26 -20 Liberia -11 -4 10 25 26 26 26 Madagascar 5 3 4 5 -1 -16 -26 Malawi -9 -10 -12 -12 -11 -13 -29 Mali -27 -26 -22 -19 -17 -14 -20 Mauritania -32 -34 -35 -36 -37 -34 -30 Mauritius 8 8 15 11 0 -2 -7 Mozambique -39 -37 -35 -35 -31 -26 -24 Namibia -39 -41 -42 -42 -42 -40 -38 Niger -18 -26 -45 -43 -42 -41 -38 Nigeria -21 -33 -40 -48 -49 -48 -41 (Table continues on the next page.) 50 Measuring Country Performance on Health Supplementary Table V 3 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Reunion 24 17 9 4 6 8 16 Rwanda -19 -15 -20 -26 -32 -35 -40 Senegal -34 -38 -45 -49 -55 -63 -64 Seychelles - - - - - 13 10 Sierra Leone - -39 -42 -43 -46 -54 -63 Somalia -54 -53 -46 -37 -34 -31 -26 South Africa -38 -38 -38 -35 -31 -31 -23 Sudan - - -47 -45 -42 -39 -35 Swaziland -43 -39 -31 -19 -8 -2 1 Tanzania -21 -18 -17 -16 -16 -15 -23 Togo -13 -18 -25 -23 -22 -17 -13 Uganda -21 -16 -11 -14 -20 -31 -39 Zaire -21 -23 -25 -24 -18 -16 Zambia -39 -38 -40 -40 -33 -24 -27 Zimbabwe -34 -28 -23 -20 -14 0 0 -Not available. Supplementary Tables 51 Supplementary Table V Country-Specific Performance Relative to Income, 1960-90 V4 Total Fertility Rate (Births) Year Region and Country 7960 1965 7970 1975 1980 1985 1990 East Asia and Pacific China -3.0 -0.1 -0.7 -2.8 -3.4 -2.9 -2.7 Fiji 0.5 -0.4 -1.1 -1.1 -0.9 -0.7 -0.5 Indonesia -0.9 -0.9 -0.9 -0.9 -1.2 -1.2 -1.3 Korea, Rep. of -0.4 -1.1 -1.4 -1.7 -2.0 -1.9 -1.4 Lao PDR - - 1.6 1.9 Malaysia 0.8 0.5 0.1 -0.3 -0.3 0.2 0.4 Mongolia - - - - - 0.3 -0.1 Myanmar -0.6 -0.7 -1.1 -1.3 -1.5 -1.6 -1.7 Papua New Guinea 0.2 0.4 0.7 0.8 0.7 0.6 0.6 Philippines 0.9 0.8 0.8 0.2 -0.2 -0.3 -0.4 Solomon Islands - - - - 1.6 1.4 1.4 Taiwan, China -0.4 -1.1 -1.6 -1.9 -1.7 -1.5 -1.2 Thailand 0.2 0.2 -0.1 -0.7 -1.3 -1.7 -1.5 Vanuatu 1.3 0.8 Western Samoa - - - - - 0.4 0.5 Europe and Central Asia Bulgaria - - - - -2.3 -1.9 -1.4 Hungary - - -2.9 -2.2 -2.2 -1.9 -1.4 Poland - - -2.8 -2.4 -1.9 -1.6 -1.4 Romania -4.1 -4.6 -3.4 -3.2 -2.9 -2.5 -2.4 Turkey 0 4 0.1 0.0 -0.2 -0.3 -0.3 -0.1 U.S.S.R., the former -3 1 -3.0 -2.4 -2.0 -1.6 -1.0 -0.8 Yugoslavia, the former -3 3 -3.1 -2.6 -2.2 -1.8 -1.4 -1.1 Latin America and the Caribbean Argentina -2.5 -2.2 -1.5 -0.9 -0.7 -0.5 -0.4 Bahamas, The - - - - -0.3 -0.3 -0.4 Barbados -1.3 -1.6 -1.7 -1.9 -1.9 -1.7 -1.2 Belize - - - - 1.5 1.1 1.0 Bolivia 0.6 0.6 0.9 0.9 0.6 0.4 0.4 Brazil 0.2 0.0 -0.3 -0.3 -0.4 -0.5 -0.4 Chile -0.5 -0.6 -0.8 -1.4 -1.6 -1.3 -0.9 Colombia 0.8 0.8 0.1 -0.6 -0.8 -0.9 -0.6 Costa Rica 1.1 0.8 0.0 -0.6 -0.7 -0.7 -0.4 Dominica - - - - - -1.1 - Dominican Rep. 1.3 1.1 0.5 0.0 -0.6 -0.8 -0.8 Ecuador 0.9 0.9 1.0 0.6 0.5 0.1 -0.2 El Salvador 0.8 0.9 0.9 0.7 0.5 -0.2 -0.3 Guyana 0.5 0.3 0.1 -0.8 -1.3 -1.8 -1.9 Haiti 0.1 0.0 -0.1 0.0 0.1 0.1 -0.1 Honduras 1.1 1.3 1.6 1.4 1.2 0.8 0.6 Jamaica -0.6 0.0 0.2 -0.3 -0.9 -1.2 -1.2 Mexico 0.9 1.3 1.7 1.2 0.5 0.4 0.2 Nicaragua 1.4 1.6 1.8 1.6 1.4 1.1 0.7 Panama -0.1 0.0 0.1 -0.3 -0.8 -0.7 -0.7 Paraguay 0.7 0.6 0.3 -0.1 -0.1 0.3 0.3 Peru 0.9 1.1 1.0 0.5 0.0 -0.3 -0.4 Puerto Rico -1.2 -1.5 -1.4 -1.4 -1.3 -1.1 -0.7 St. Kitts and Nevis - - - - - -1.1 -0.7 Suriname 0.6 0.6 0.6 0.0 -0.1 -0.1 -0.6 Trinidad and Tobago -0.5 -0.7 -0.8 -0.6 -0.3 -0.1 -0.4 (Table continues on the next page.) 52 Measuring Country Performance on Health Supplementary Table V.4 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Uruguay -2.8 -2.5 -1.9 -1.6 -1.5 -1.3 -1.0 Venezuela 0.9 1.1 1.1 0.6 0.4 0.3 0.4 Middle East and North Africa Algeria 1.4 1.6 2.0 2.1 2.1 1.6 0.8 Bahrain - - - 2.1 1.8 1.5 1.2 Egypt, Arab Rep. of 0.8 0.7 0.1 -0.2 -0.1 -0.1 -0.3 Iran, Islamic Rep. of 1.4 1.6 2.0 2.0 2.0 2.3 1.9 Iraq 1.4 1.8 2.4 2.4 2.6 2.5 2.3 Jordan - - - - 2.3 2.2 1.7 Malta -2.4 -3.4 -3.3 -2.6 -2.2 -1.7 -1.1 Morocco 0.9 1.1 1.2 0.9 0.5 0.1 -0.1 Oman - - 3.6 5.5 6.1 5.7 4.8 Qatar - - - - 2.9 2.3 2.1 Saudi Arabia 1.5 2.0 2.9 3.5 3.9 4.0 3.6 SyrianArabRep. 1.3 1.9 2.4 2.8 3.1 3.2 2.7 Tunisia 1.0 1.0 0.8 0.7 0.4 0.1 -0.3 Yemen, Rep. of - - 1.5 2.0 2.4 2.7 3.2 South Asia Bangladesh 0.9 0.7 1.1 0.7 0.5 0.2 -0.4 India 0.3 0.0 -0.5 -0.7 -0.9 -1.0 -1.1 Nepal -0.5 -0.3 -0.1 0.3 0.6 0.5 0.5 Pakistan 0.6 0.7 1.0 1.1 1.3 1.3 1.2 Sri Lanka -0.8 -1.1 -1.4 -1.7 -1.7 -1.8 -1.7 Sub-Saharan Africa Angola 0.2 0.3 0.6 0.9 0.7 1.1 1.6 Benin 0.7 0.8 1.0 0.9 0.8 1.1 1.2 Botswana 0.4 0.5 0.6 1.1 1.6 1.4 0.9 Burkina Faso 0.0 -0.3 -0.6 -0.5 -0.2 0.3 0.8 Burundi 0.5 0.3 -0.1 0.0 0.2 0.4 0.8 Cameroon -1.4 -1.2 -0.5 0.2 0.8 1.1 1.1 Cape Verde 0.5 0.4 0.5 0.3 0.4 0.0 -0.6 Central African Rep. -0.6 -0.6 -0.6 -0.4 -0.3 -0.4 -0.2 Chad -0.3 -0.2 -0.3 -0.4 -0.4 -1.0 -0.7 Comoros - - - - - 0.4 0.4 Congo, Rep. of -0.7 -0.4 0.2 0.7 0.9 1.9 2.5 Cotedlvoire 1.1 1.4 1.8 2.1 2.5 2.3 1.6 Djibouti - - 1.2 1.3 1.4 1.2 1.0 Ethiopia -0.9 -1. 1 -1.5 -1.3 -0.7 0.1 0.5 Gabon -1.9 -1.5 -0.7 -0.1 0.4 0.9 1.6 Gambia, The 0.1 0.1 0.2 0.5 0.8 0.6 0.5 Ghana 0.7 0.7 0.7 0.7 0.7 0.6 0.5 Guinea -0.5 -0.5 -0.7 -0.4 0.1 0.5 1.0 Guinea-Bissau -0.5 -0.5 -0.5 -0.1 -0.3 -0.1 0.3 Kenya 1.7 1.7 1.7 2.0 2.0 1.3 0.5 Lesotho -0.7 -0.9 -1.0 -0.6 -0.2 0.0 -0.1 Liberia 0.0 0.1 0.4 0.7 0.8 0.9 0.9 Madagascar 0.5 0.6 0.7 0.8 0.8 0.7 0.6 Malawi 1.2 1.1 0.9 1.1 1.1 1.2 1.0 Mali 0.1 0.0 -0.4 -0.3 0.1 0.4 1.0 Mauritania 0.3 0.3 0.4 0.5 0.6 0.3 0.1 Mauritius 0.1 -0.5 -1.3 -1.7 -1.5 -1.6 -1.2 Mozambique 0.2 0.5 0.9 1.1 0.9 0.8 1.0 Namibia 0.1 0.3 0.8 1.3 1.5 1.5 1.5 Supplementary Tables 53 Year Region and country 1960 1965 1970 1975 1980 1985 1990 Niger 0.7 0.8 0.9 1.0 1.2 1.4 1.4 Nigeria 0.5 0.5 0.4 1.2 1.6 1.3 0.8 Reunion -0.4 -0.7 -1. 1 -1.5 -1.6 -1.5 -1.3 Rwanda 1.2 1.2 1.6 2.1 2.2 1.8 1.3 Senegal 0.3 0.4 0.6 0.8 1.1 1.3 1.3 Seychelles - - - - -1.0 -0.8 Sierra Leone - 0.3 0.6 0.8 0.9 1.1 1.2 Somalia 0.6 0.7 0.7 0.6 0.9 1.0 1.3 South Africa 0.6 0.6 0.7 0.6 0.5 0.5 0.5 Sudan - - 0.5 0.6 0.7 0.6 0.5 Swaziland 0.4 0.7 1.2 1.5 1.9 2.4 2.7 Tanzania 0.2 0.0 -0.1 0.1 0.2 -0.1 0.1 Togo 0.1 -0.1 0.0 0.2 0.4 0.5 0.8 Uganda 0.6 0.6 0.7 0.8 0.8 1.5 1.0 Zaire -0.4 -0.4 -0.3 0.1 0.1 0.1 - Zambia 0.4 0.5 0.9 1.4 1.4 1.1 0.7 Zimbabwe 1.9 1.9 1.8 1.7 1.3 0.8 -0.1 -Not available. 54 Measuring Country Performance on Health Supplementary Table V Country-Specific Performance Relative to Income, 1960-90 V.5 Female Life Expectancy (Years) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China 9.3 11.1 12.0 - 12.7 10.8 10.3 Fiji 9.2 9.8 10.4 10.0 9.7 9.3 9.5 Indonesia -4.5 -3.0 -1.6 -0.6 0.5 1.3 3.0 Korea, Rep. of 7.6 7.9 9.5 11.2 10.4 9.1 8.7 Lao PDR - - - - - -10.1 -7.9 Malaysia 6.7 7.8 9.2 8.8 9.0 7.8 8.0 Mongolia - - - - - 1.4 3.3 Myanmar 1.5 0.6 0.9 0.5 -0.5 -0.8 2.2 Papua New Guinea -8.0 -8.1 -7.9 -7.4 -6.3 -6.1 -4.3 Philippines 6.3 5.5 4.9 4.9 4.7 4.8 7.0 Solomon Islands - - - - 2.8 1.4 1.1 Taiwan, China 18.3 17.3 16.9 15.5 13.6 11.7 10.2 Thailand 7.2 7.1 7.1 6.4 8.0 8.3 8.3 Vanuatu - - - - - -2.0 2.7 Western Samoa - - - - 4.7 5.1 8.1 Europe and Central Asia Bulgaria - - - - 12.8 10.7 7.8 Hungary - - 15.3 - 11.2 9.3 7.8 Poland - - 16.9 15.3 12.8 11.6 10.2 Romania 22.2 21.2 19.0 16.9 14.2 11.4 11.0 Turkey 2.2 2.9 4.0 4.2 3.9 3.8 5.5 U.S.S.R., the former 19.0 17.8 16.0 12.5 10.1 8.7 6.8 Yugoslavia, the former 13.6 14.2 13.5 12.7 10.1 9.1 8.9 Latin America and the Caribbean Argentina 13.1 12.1 11.5 10.9 10.6 9.9 9.9 Bahamas, The - - - - 8.9 9.8 8.4 Barbados 14.9 14.6 13.7 13.2 12.5 11.9 10.8 Belize - - - - 5.5 6.1 7.9 Bolivia -4.5 -5.1 -5.9 -4.9 -3.7 -2.6 -0.2 Brazil 6.2 6.0 6.2 5.2 5.0 4.9 5.2 Chile 7.3 8.1 9.0 11.1 13.1 12.7 12.7 Colombia 8.1 8.2 7.6 8.2 9.5 8.5 8.5 Costa Rica 12.2 13.0 13.3 14.2 14.7 14.8 14.6 Dominica - - - - - 11.3 - Dominican Rep. 4.9 6.1 7.1 6.7 8.0 8.5 9.3 Ecuador 5.2 5.2 5.0 5.3 5.9 6.8 8.1 El Salvador 3.0 4.5 5.6 5.2 4.3 6.9 10.2 Guyana 7.7 7.9 6.7 5.8 4.7 5.6 7.7 Haiti -4.4 -3.6 -2.9 -2.6 -2.6 -2.7 -0.5 Honduras -0.1 0.9 2.2 3.9 5.4 7.3 9.5 Jamaica 14.6 14.2 14.3 13.5 13.4 12.9 13.2 Mexico 6.8 6.6 7.3 8.2 8.6 8.2 8.5 Nicaragua -1.4 -0.6 0.4 1.8 2.8 4.3 7.9 Panama 12.0 11.7 11.6 12.4 12.4 11.0 11.3 Paraguay 16.1 14.6 13.7 12.1 9.9 8,1 8.8 Peru -1.5 -1.6 0.5 0.5 1.5 2.6 4.9 Puerto Rico 18.9 17.0 17.0 15.6 14.1 13.4 11.7 St. Kitts and Nevis - - - - - 5.0 4.9 Suriname 11.1 11.5 8.9 8.2 5.8 5.6 8.1 TrinidadAndTobago 10.7 8.6 8.0 7.5 6.4 6.1 6.3 Uruguay 16.4 15.4 14.1 13.2 12.2 11.4 10.4 Venezuela 5.5 7.3 8.3 8.6 7.8 8.2 8.1 Supplementary Tables 55 Year Region and country 1960 1965 1970 1975 1980 1985 1990 Middle East and North Africa Algeria -2.3 -0.6 0.2 0.9 1.3 4.4 6.7 Bahrain - - - 3.6 2.8 2.9 4.8 Egypt, Arab Rep. of 0.0 -0.3 -0.3 -0.5 -0.6 1.2 3.0 Iran, Islamic Rep. of -2.7 -2.7 -2.8 -2.0 0.5 2.0 4.0 Iraq -3.0 -2.6 -0.7 1.7 -0.2 2.4 -6.5 Jordan - - - - 5.3 5.0 7.7 Malta 20.2 18.7 17.1 15.8 14.1 13.0 11.9 Morocco 0.4 -0.3 0.3 1.1 2.2 2.5 4.1 Oman - - -8.9 -5.3 1.2 4.0 4.6 Qatar - - - - 0.5 3.5 3.6 Saudi Arabia -7.9 -6.1 -4.8 -3.6 -1.6 2.2 3.4 Syrian Arab Rep. 1.0 1.7 2.8 3.0 2.6 3.0 5.0 Tunisia 0.1 0.4 1.8 3.4 3.8 4.1 5.5 Yemen, Rep. of - - -10.0 -6.6 -7.3 -8.4 -8.5 South Asia Bangladesh -9.9 -9.3 -9.9 -8.8 -7.9 -6.2 -3.2 India -3.7 -3.5 -3.1 -2.1 -1.5 -1.4 1.7 Nepal -9.3 -9.6 -9.5 -8.6 -8.5 -7.9 -5.1 Pakistan -3.3 -3.1 -2.8 -1.2 -0.3 0.3 2.2 Sri Lanka 13.5 12.8 11.9 12.5 13.1 11.8 12.2 Sub-Saharan Africa Angola -13.8 -14.1 -14.2 -13.8 -12.3 -12.6 -10.0 Benin -9.0 -7.8 -7.9 -8.1 -7.6 -7.5 -6.9 Botswana 1.9 2.0 2.6 2.5 3.1 1.3 -6.8 Burkina Faso -8.8 -8.4 -7.8 -8.0 -8.5 -9.3 -11.5 Burundi -4.4 -4.1 -4.9 -5.0 -5.3 -7.3 -11.0 Cameroon -6.0 -5.8 -5.3 -4.7 -4.7 -5.2 -2.7 Cape Verde 7.7 8.1 7.3 8.4 5.5 4.3 6.1 Central African Rep. -6.2 -6.2 -6.7 -7.2 -6.6 -7.0 -6.5 Chad -11.6 -12.1 -11.8 -11.2 -11.0 -9.3 -7.7 Comoros -3.4 -4.0 -4.3 -4.3 -4.5 -4.5 -1.5 Congo, Rep. of -4.7 -4.6 -5.1 -5.7 -5.1 -6.9 -8.5 C6te d'lvoire -7.9 -7.9 -7.7 -7.3 -4 4 -3.8 -4.1 Djibouti - - -13.0 -12.4 -11.9 -11.4 -9.7 Ethiopia -6.2 -6.8 -7.0 -7.9 -12.1 -9.4 -6.1 Gabon -8.8 -10.0 -10.9 -11.7 -12.1 -10.7 -9.2 Gambia, The -13,2 -13.5 -13.8 -14.1 -14.7 -14.1 -12.0 Ghana -1.4 -1.6 -1.4 -2.2 -2.0 -1.2 1.4 Guinea -12.4 -13.4 -13.5 -14.3 -15.3 -15.4 -13.3 Guinea-Bissau -11.5 -13.6 -14.0 -15.5 -14.7 -14.6 -13.4 Kenya 0.0 0.6 0.9 0.9 1.3 1.1 1.9 Lesotho 1.6 1.2 0.5 -0.2 -1.3 -1.6 -0.3 Liberia -4.4 -4.3 -4.2 -4.3 -4.1 -4.0 -17.5 Madagascar -7.0 -6.8 -5.8 -4.5 -4.0 -3.2 0.0 Malawi -6.9 -8.3 -9.2 -9.3 -9.5 -11.7 -14.5 Mali -9.8 -12.1 -9.6 -11.0 -11.5 -9.9 -6.9 Mauritania -7.7 -7.9 -7.8 -7.7 -8.0 -7.8 -5.4 Mauritius 8.0 7.7 8.2 8.8 7.7 8.9 7.9 Mozambique -10.0 -9.7 -10.5 -11.4 -11.1 -11.2 -10.3 Namibia -6.9 -6.7 -6.5 -7 0 -6.5 -5.0 -6.0 Niger -9.8 -10.8 -11.9 -11.9 -11.7 -11.9 -9.0 Nigeria -5.5 -6.2 -6.6 -9.0 -10.2 -10.0 -7.1 Reunion 11.0 11.5 12.7 14.9 13.9 14.3 13.9 (lable continues on the next page.) 56 Measuring Country Performance on Health Supplementary Table V.5 (continuted) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Rwanda -2.7 -3.1 -5.4 -7.2 -7.9 -10.4 -35.2 Senegal -8.8 -9.4 -9.7 -10.3 -10.6 -11.5 -9.6 Seychelles - - - - 11.4 10.2 10.9 Sierra Leone - -16.7 -17.5 -19.0 -20.5 -21.0 -23.0 Somalia -11.5 -11.5 -10.8 -10.3 -10.2 -9.6 -8.0 South Africa -0.7 -0.2 -0.1 -0.4 -0.1 0.3 2.1 Sudan - - -7.7 -6.3 -6.2 -6.4 -6.1 Swaziland -7.0 -6.9 -6.3 -6.0 -5.7 -5.1 -2.8 Tanzania -2.2 -2.3 -2.5 -2.1 -2.5 -4.5 -5.2 Togo -3.9 -3.9 -4.4 -3.9 -3.8 -3.9 -5.1 Uganda -0.6 -0.7 -0.4 -3.9 -6.4 -9.6 -11.2 Zaire -3.3 -3.9 -4.3 -4.2 -3.5 -3.7 Zambia -5.0 -4.6 -4.7 -4.8 -4.6 -8.4 -13.3 Zimbabwe -1.6 -0.7 -0.2 -0.4 -0.1 4.1 1.5 _ Not available. Supplementary Tables 57 Supplementary Table V Country-Specific Performance Relative to Income, 1960-90 V.6 Male Life Expectancy (Years) Year Region and country 1960 1965 1970 1975 1980 1985 1990 East Asia and Pacific China 6.9 12.4 13.7 - 13.2 11.1 10.7 Fiji 9.2 10.0 10.7 10.3 9.8 9.2 9.5 Indonesia -3.3 -2.1 -1.0 0.1 0.5 1.5 3.2 Korea, Rep. of 7.2 7.4 7.8 8.4 7.9 7.0 5.9 Lao PDR - - - - - -9.5 -7.4 Malaysia 6.4 7.7 9.2 8.9 9.0 7.9 8.1 Mongolia - - - - - 2.7 4.3 Myanmar 1.6 0.4 0.8 0.3 -0.6 -0.9 1.8 Papua New Guinea -4.5 -4.6 -4.5 -4.2 -4.1 -3.9 -2.2 Philippines 5.9 5.3 5.2 5.2 4.9 4.9 6.9 Solomon Islands - - - - 4.9 3.6 3.4 Taiwan, China 15.9 14.8 15.3 14.3 14 0 12.0 10.6 Thailand 5.9 5.8 6.5 6.1 7.0 6.9 6.9 Vanuatu - - - - - 1.8 3.9 Western Samoa - - - - 6.5 5.9 7.9 Europe and Central Asia Bulgaria - - - - 11.0 8.7 5.8 Hungary - - 12.9 - 7.7 5.9 3.6 Poland - - 13.3 11.2 8.6 7.4 5.4 Romania 21.4 19.9 17.6 15.5 12.2 9.1 8.8 Turkey 1.9 2.9 3.3 3.4 3.3 3.6 5.1 U.S.S.R., the former 14.8 12.9 9.6 6.5 4.4 4.2 0.6 Yugoslavia, the former 14.0 13.9 13.2 12.2 9.4 8.6 8.4 Latin America and the Caribbean Argentina 9.8 8.8 8.5 8.2 8.0 7.3 7.4 Bahamas, The - - - - 5.6 5.0 4.6 Barbados 12.9 12.8 12.2 12.0 11.8 11.3 10.6 Belize - - - - 5.8 5.8 6.2 Bolivia -5.8 -6.5 -7.0 -5.5 -3.7 -2.3 0.1 Brazil 5.3 5.1 4.9 4.3 2.7 2.0 1.8 Chile 4.6 5.0 6.2 8.3 10.3 10.5 11.2 Colombia 7.5 7.7 7.5 7.4 8.1 6.9 6.8 Costa Rica 12.2 12.5 12.7 13.6 14.3 14.3 14.2 Dominica - - - - - 12.3 Dominican Rep. 4.7 5.8 6.7 6.6 7.9 8.4 9.1 Ecuador 5.4 5.4 5.3 5.5 5.7 6.0 7.2 El Salvador 2.7 3.9 4.4 -1.4 -5.1 1.7 6.3 Guyana 7.4 7.5 6.0 4 5 2.7 3.6 5.6 Haiti -4.1 -3.3 -2.7 -2.3 -2.4 -2.6 -0.7 Honduras -0.6 0.4 1.3 3.0 4.6 6.5 8.4 Jamaica 13.7 13.7 13.5 13.0 12.9 12.4 12.7 Mexico 6.3 6.0 5.6 5.8 6.0 6.4 7.2 Nicaragua -1.2 -0.4 0.7 0.8 0.6 1.6 6.3 Panama 12.6 12.4 12.1 12.2 11.9 10.3 11.4 Paraguay 15.1 13.7 12.5 11.3 9.2 7.5 8.1 Peru -1.4 -1.4 0.6 0.6 1.8 2.7 5.1 Puerto Rico 16.2 14.9 13.4 12.9 11.5 9.6 8.7 St. Kitts and Nevis - - - - - 5.1 5.4 Suriname 10.3 10.4 8.4 7.9 6.0 5.4 6.5 Trinidad and lobago 9.3 7.7 7.0 6.7 5.9 6.1 6.5 (Table continues on the next page.) 58 Measuring Country Performance on Health Supplementary Table V6 (continued) Year Region and country 1960 1965 1970 1975 1980 1985 1990 Uruguay 13.0 12.2 11.0 10.3 9.8 9.2 8.5 Venezuela 4.8 6.0 6.4 6.9 6.4 6.9 7.1 Middle East and North Africa Algeria -1.5 0.4 1.6 2.5 3.2 5.9 7.8 Bahrain - - - 4.9 5.0 5.0 5.6 Egypt, Arab Rep. of 0.5 0.1 0.3 0.5 0.5 2.4 4.4 Iran, Islamic Rep. of 0.5 1.1 1.4 1.2 1.1 5.7 7.2 Iraq -2.0 -1.2 1.1 3.9 2.3 3.7 -1.4 Jordan - - - - 6.2 6.0 7.9 Malta 19.2 17.8 16.1 15.2 13.7 12.8 12.0 Morocco 0.8 -0.1 0.4 1.2 2.6 2.9 4.5 Oman - - -7.6 -3.5 2.6 5.0 5.3 Qatar - - - - 1.4 3.3 3.7 Saudi Arabia -7.4 -5.6 -4.2 -1.6 0.4 4.2 5.8 Syrian Arab Rep. 1.2 1.8 2.9 3.2 3.2 3.6 5.0 Tunisia 2.0 2.5 4.0 6.0 6.6 6.5 7.8 Yemen, Rep. of - - -7.3 -6.8 -5.3 -5.7 -5.4 South Asia Bangladesh -4.8 -4.7 -5.1 -4.5 -3.7 -3.1 -0.8 India 0.8 0.9 1.9 2.1 2.3 2.0 4.1 Nepal -5.4 -5.6 -4.9 -3.8 -3.5 -2.8 -0.8 Pakistan 0.8 0.4 0.5 1.4 1.8 1.9 3.7 SriLanka 16.0 14.3 13.1 12.5 12.2 11.1 11.5 Sub-Saharan Africa Angola -13.9 -14.1 -14.1 -13.5 -12.2 -12.5 -10.1 Benin -7.8 -6.8 -7.4 -8.0 -7.4 -7.4 -6.9 Botswana 1.5 1.3 2.2 2.3 2.5 1.3 -6.3 Burkina Faso -8.3 -7.7 -7.7 -7.6 -8.0 -8.7 -7.5 Burindi -4.6 -4.4 -5.1 -5.2 -5.8 -7.6 -11.2 Cameroon -6.0 -5.8 -5.1 -4.4 -4.2 -4.6 -2.6 Cape Verde 7.6 8.0 7.4 8.5 6.8 5.8 7.4 Central African Rep. -8.4 -8.4 -8.8 -9.0 -8.8 -8.9 -8.5 Chad -11.6 -12.2 -11.7 -11.2 -11.0 -9.6 -8.2 Comoros -1.4 -2.0 -2.2 -2.1 -2.3 -3.3 -1.5 Congo, Rep. of -7.0 -6.8 -7.0 -7.3 -7.5 -8.9 -9.7 C6te d'lvoire -8.2 -8.1 -7.6 -7.0 -3.7 -3.1 -3.5 Djibouti - - -12.9 -12.0 -11.5 -11.0 -9.6 Ethiopia -6.3 -7.1 -7.2 -8.2 -12.3 -9.7 -6.7 Gabon -9.1 -10.1 -10.6 -11.0 -11.1 -9.7 -8.2 Gambia, The -13.3 -13.5 -13.8 -13.9 -14.4 -13.9 -12.0 Ghana -1.7 -1.9 -1.6 -1.8 -1.6 -1.3 0.6 Guinea -10.5 -11.5 -11.5 -12.1 -13.0 -13.0 -11.2 Guinea-Bissau -9.8 -12.2 -14.0 -15.3 -14.4 -14.7 -13 5 Kenya -1.1 -0.5 0.0 0.2 0.4 0.5 1.4 Lesotho -0.5 -0.5 -0.5 -0.5 -1.2 -0.4 0.4 Liberia -4.4 -4.3 -4.0 -3.9 -3.7 -3.6 -17.3 Madagascar -7.0 -6.7 -5.6 -4.1 -3.6 -2.8 0.1 Malawi -5.3 -6.7 -7.6 -7.5 -7.8 -10.0 -12.6 Mali -8.3 -10.7 -10.6 -11.1 -8.6 -8.6 -7.5 Mauritania -7.8 -8.1 -7.9 -7.6 -7.8 -7.6 -5.5 Mauritius 7.7 7.1 7.1 7.4 6.3 5.7 5.5 Mozambique -10.3 -9.9 -10.4 -11.1 -10.9 -11.1 -10.3 NIamibia -6.5 -6.1 -5.6 -5.6 -4.9 -3.8 -4.6 Supplementary Tables 59 Year Region and country 1960 1965 1970 1975 1980 1985 1990 Niger -9.8 -11.0 -11.9 -11.8 -11.7 -11.9 -9.3 Nigeria -5.5 -6.5 -6.7 -8.8 -9.8 -9.7 -7.1 Reunion 7.4 7.5 8.4 9.6 9.2 9.2 9.8 Rwanda -3.0 -3.4 -5.5 -7.2 -8.2 -10.2 -33.1 Senegal -7.5 -8.2 -8.4 -7.4 -10.4 -11.1 -8.1 Seychelles - - - 9.8 8.2 8.0 Sierra Leone - -16.7 -17.2 -18.6 -20.0 -20.6 -22.8 Somalia -11.7 -11.6 -10.8 -8.4 -10.1 -9.6 -8.2 South Africa -1.8 -2.1 -2.7 -2.5 -2.1 -1.6 0.3 Sudan - - -7.3 -5.8 -5.6 -5.8 -5.7 Swaziland -7.9 -7.9 -7.4 -6.9 -6.3 -5.7 -3.5 Tanzania -2.4 -2.7 -2.7 -2.5 -2.8 -4.5 -5.2 Togo -4.0 -4.3 -4.5 -4.0 -3.9 -4.0 -5.2 Uganda -0.9 0.6 1.0 -3.1 -4.8 -7.7 -8.5 Zaire -3.5 -4.2 -4.4 -4.3 -3.8 -4.0 - Zambia -5.3 -4.8 -4.8 -4.7 -3.6 -6.8 -11.8 Zimbabwe -1.9 -1.0 -0.5 -0.5 -0.1 4.0 1.9 -Not available. 60 Measuring Country Performance on Health Supplementary Table VI Country Rankings on Selected Health Indicators, Controlling for Income and Education Health indicators Country Q5 AMRF AMRM TFR LEF LEM Algeria 49 16 17 60 35 30 Argentina 28 22 8 19 14 22 Bahrain - 48 49 68 53 54 Bangladesh 47 54 69 28 67 58 Barbados - 10 11 12 15 14 Benin - 70 62 41 62 67 Bolivia 67 73 71 77 80 78 Botswana 13 46 53 65 47 31 Brazil 54 19 21 27 38 35 Bulgaria - 27 23 4 27 21 Cameroon 50 74 74 36 63 68 Central African Rep. 34 69 56 11 52 70 Chile 32 20 10 33 32 25 China 3 7 15 1 6 6 Colombia 21 25 27 44 19 15 Congo, Rep. of - 76 75 82 79 80 Costa Rica 4 2 3 54 5 2 Dominican Rep. 39 9 14 50 20 10 Ecuador 61 21 32 75 49 24 Egypt, Arab Rep. of 57 29 30 20 39 38 El Salvador 46 45 20 51 13 43 Fiji - 31 42 55 41 17 Gambia, The - 77 73 29 77 79 Ghana 36 67 54 52 44 60 Guinea - 58 72 13 73 72 Guyana - 35 48 47 54 32 Haiti 48 41 35 30 46 50 Honduras 30 30 31 71 24 18 Hungary 9 36 28 5 42 40 India 40 24 40 17 48 37 Indonesia 45 62 67 14 55 55 Iran, Islamic Rep. of 64 14 29 66 57 48 Iraq 44 42 38 70 61 57 Jamaica 2 3 4 35 1 1 Jordan 15 39 50 81 43 26 Kenya 16 61 57 74 17 45 Korea, Rep. of 1 63 58 21 40 49 Lesotho 58 38 59 59 69 36 Liberia 52 17 7 37 56 66 Malawi 62 55 52 63 75 73 Malaysia - 51 46 48 9 20 Mali 43 40 36 22 64 65 Mauritius 7 47 34 6 16 29 Mexico 51 26 18 64 21 28 Mozambique 59 68 51 31 72 74 Myanmar 8 23 26 9 4 9 Nepal 25 37 60 15 60 39 Nicaragua 53 43 37 76 50 51 Niger 55 59 63 42 68 71 Pakistan 29 18 43 46 23 19 Panama 24 12 25 62 25 8 Papua New Guinea 38 75 79 39 71 63 Paraguay 11 5 9 73 7 4 Peru 66 56 66 67 66 64 Supplementary Tables 61 Health indicators Country Q5 AMRF AMRM TFR LEF LEM Philippines 42 66 76 80 65 44 Poland 5 33 16 10 28 27 Reunion - 28 13 24 3 5 Romania 10 13 6 3 18 16 Rwanda 31 65 61 58 81 81 Senegal 63 81 81 49 78 75 Sierra Leone 65 78 80 43 82 - South Africa - 79 78 72 70 69 Sri Lanka 20 8 22 18 8 3 Sudan 6 72 70 26 51 59 Swaziland - 71 68 78 76 76 Syrian Arab Rep. 27 49 39 79 33 47 Taiwan, China - 6 12 8 2 7 Tanzania 37 64 65 53 58 61 Thailand 26 44 41 32 34 23 Togo 18 50 44 34 30 53 Trinidad and Tobago 22 32 33 40 29 33 Tunisia 33 15 24 38 12 12 Turkey 60 1 1 23 26 42 U.S.S.R., the former 17 - - 16 37 52 Uganda 23 53 55 45 45 46 Uruguay 19 11 2 7 10 13 Venezuela 12 34 19 56 22 34 Yemen, Rep. of 41 52 45 57 59 62 Yugoslavia, the former - 4 5 2 11 11 Zaire 35 57 47 25 31 56 Zambia 56 80 77 69 74 77 Zimbabwe 14 60 64 61 36 41 - No ranking number by the country if the country is missing information on the health indlcator. 62 Measuring Country Performance on Health Supplementary Table VII Country Rankings on Selected Health Indicators, Controlling for Income Only Health indicators Country Q5 AMRF AMRM TFR LEF LEM Algeria 60 38 25 104 55 51 Angola 79 103 108 77 111 Argentina 19 10 19 15 17 20 Bahamas, The 80 20 61 28 30 44 Bahrain 81 64 49 109 47 43 Bangladesh 63 99 80 66 97 77 Barbados 82 8 9 10 11 10 Belize 83 27 23 101 38 40 Benin 84 91 90 87 96 - Bolivia 70 68 74 75 75 - Botswana 21 63 66 90 56 62 Brazil 51 30 24 36 41 45 Bulgaria 114 18 32 4 23 26 Burkina Faso 53 69 82 45 100 Burundi 37 82 87 58 86 Cameroon 57 96 100 47 81 - Cape Verde 85 41 26 54 31 19 Central African Rep. 58 89 96 35 90 Chad 34 94 93 34 108 Chile 17 11 18 18 18 23 China 8 26 16 8 14 7 Colombia 18 28 31 37 26 27 Comoros 86 66 67 62 76 73 Congo, Rep. of 39 88 94 82 83 - Costa Rica 9 7 3 38 6 5 C6te d'lvoire 71 93 91 106 85 - Djibouti 87 110 112 97 107 - Dominica 88 17 11 20 24 15 Dominican Rep. 31 22 15 42 33 28 Ecuador 40 29 20 67 37 37 Egypt, Arab Rep. of 64 35 27 50 61 59 El Salvador 43 32 58 64 39 56 Ethiopia 28 62 68 30 98 - Fiji 89 31 22 26 21 14 Gabon 90 111 114 40 101 Gambia, The 91 105 110 63 112 Ghana 42 72 73 73 68 70 Guinea 93 107 102 44 114 Guinea-Bissau 92 108 89 39 113 Guyana 94 37 36 25 36 39 Haiti 59 56 65 46 73 74 Honduras 29 40 42 93 45 48 Hungary 4 14 35 2 19 29 India 44 60 29 31 71 55 Indonesia 35 79 72 22 66 68 Iran, Islamic Rep. of 75 47 17 107 65 53 Iraq 61 59 47 111 69 63 Jamaica 7 12 10 27 5 6 Jordan 23 51 45 110 43 35 Kenya 26 73 75 98 57 66 Korea: Rep. of 1 43 55 11 22 24 Lao PDR 95 109 109 105 93 - Lesotho 25 48 57 33 64 69 Liberia 69 34 38 68 87 - Supplementary Tables 63 Health indicators Country Q5 AMRF AMRM TFR LEF LEM Madagascar 48 52 63 74 79 Malawi 62 71 71 88 103 - Malaysia 96 50 50 56 27 18 Mali 65 75 84 52 106 - Malta 97 5 4 3 2 2 Mauritania 98 92 97 60 92 - Mauritius 15 42 48 16 28 32 Mexico 45 24 28 92 32 34 Mongolia 99 57 46 51 50 49 Morocco 56 44 40 72 54 57 Mozambique 77 87 92 78 105 - Myanmar 20 49 52 23 59 64 Namibia 66 106 106 96 84 85 Nepal 55 95 70 53 99 - Nicaragua 50 46 54 100 52 60 Niger 76 98 101 89 109 Nigeria 74 101 104 84 95 - Oman 100 102 99 115 67 67 Pakistan 46 70 37 91 70 58 Panama 12 19 14 32 15 9 Papua New Guinea 52 113 103 71 91 78 Paraguay 11 13 7 59 13 11 Peru 67 55 60 61 58 61 Philippines 14 61 64 55 40 38 Poland 3 6 30 6 12 17 Puerto Rico 5 1 6 13 4 8 Qatar 101 65 69 114 51 54 Reunion 102 15 41 17 7 16 Romania 2 2 1 1 1 1 Rwanda 36 85 88 99 110 - Saudi Arabia 103 84 76 113 72 71 Senegal 73 112 113 83 102 - Seychelles 104 23 43 21 20 22 Sierra Leone 78 114 111 81 115 - Solomon Islands 105 78 59 102 53 46 Somalia 106 100 105 80 104 - South Africa 107 90 95 76 63 72 Sri Lanka 10 21 8 14 8 4 St. Kitts and Nevis 108 54 53 19 44 42 Sudan 32 104 107 70 88 - Suriname 109 36 33 49 25 21 Swaziland 110 74 83 103 82 - Syrian Arab Rep. 41 58 62 112 48 50 Taiwan, China 111 16 13 12 3 3 Tanzania 30 76 79 48 74 76 Thailand 16 39 44 24 29 30 Togo 33 77 81 57 78 - Trinidad and Tobago 22 33 34 29 34 31 Tunisia 47 45 21 65 49 41 Turkey 68 3 2 43 46 47 U.S.S.R., the former 6 115 115 7 10 25 Uganda 38 86 86 79 80 75 Uruguay 13 4 12 9 9 13 Vanuatu 112 67 56 94 60 52 (Table continues on the next page.) 64 Measuring Country Performance on Health Supplementary Table VII (continied) Health indicators Country Q5 AMRF AMRM TFR LEF LEM Venezuela 24 25 39 86 35 36 Western Samoa 113 53 51 69 42 33 Yemen, Rep. of 72 83 78 108 94 - Yugoslavia, the former 115 9 5 5 16 12 Zaire 54 80 85 41 77 Zambia 49 97 98 85 89 - Zimbabwe 27 81 77 95 62 65 - No ranking number by the country if the country is missing information on the health indicator. Supplementary Tables 65 Supplementary Table VIII Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels VIII.1 Under-Five Mortality Rate Improvement due tob Health measure in Change between Technical Region and country 196C 1990 1960 and 1990 (LN)5 Income (°/) Education ("lo) progress (96/) East Asia and Pacific Indonesia 216 95 82 20 41 38 Philippines 107 48 80 10 46 44 Thailand 148 41 128 30 26 44 Europe and Central Asia Romania 84 31 100 26 42 32 Turkey 219 70 114 19 33 48 U.S.S.R., the former 39 27 37 23 37 40 Latin America and the Caribbean Argentina 72 28 94 5 49 46 Bolivia 255 124 72 17 -3 86 Chile 155 19 210 11 31 57 Colombia 122 19 186 16 35 49 Costa Rica 124 14 218 15 29 55 Dominican Rep. 149 58 94 17 33 50 Ecuador 178 50 127 15 43 42 El Salvador 191 54 126 8 32 60 Honduras 204 51 139 9 33 58 Mexico 134 47 105 13 50 37 Nicaragua 193 65 109 -2 36 66 Panama 88 27 118 15 46 39 Paraguay 92 38 88 15 30 55 Peru 234 73 116 7 49 44 Trinidad and Tobago 61 24 93 12 44 44 Uruguay 56 24 85 4 39 57 Venezuela 75 26 106 -1 46 55 Middlc East and North Africa Algeria 255 45 173 13 39 49 Iran, Islamic Rep. of 281 59 156 7 44 48 Iraq 161 69 85 4 49 48 Jordan 139 36 135 21 46 33 Syrian Arab Rep. 200 42 156 18 44 38 Tunisia 254 48 167 20 39 41 South Asia Bangladesh 247 139 57 11 27 62 India 242 110 79 13 35 52 Nepal 300 128 85 15 17 68 Pakistan 226 138 49 18 38 43 Sub-Saharan Africa Ghana 214 127 52 -2 35 66 Kenya 205 97 75 9 38 53 Malawi 360 233 44 11 22 68 Mauritius 88 24 130 14 39 46 Senegal 297 138 77 4 14 82 Tanzania 240 161 40 25 -19 94 Zambia 213 188 12 -8 43 65 Zimbabwe 159 80 69 4 31 64 a. Difference in health measure (LN) between 1960 and 1990. b. The percentage of improvement in each country that results from changes in income and education levels and from technical progress. 66 Measuring Country Performance on Health Supplementary Table VIII Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels VIII.2 Female Adult Mortality Rate Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 (LN)' Income (°) Education (°/) progress (°/) East Asia and Pacific Fiji 264 115 83 15 49 37 Indonesia 525 219 87 25 44 32 Korea, Rep. of 341 117 107 27 53 20 Malaysia 369 142 95 25 47 28 Myanmar 372 267 33 24 29 47 Papua New Guinea 495 386 25 11 28 61 Philippines 379 208 60 12 51 37 Thailand 313 123 93 36 28 36 Europe and Central Asia Romania 115 119 -3 31 43 26 Turkey 108 118 -9 23 36 41 Yugoslavia, the former 148 101 38 25 41 34 Latin America and the Caribbean Argentina 136 90 41 6 55 40 Barbados 130 82 46 25 41 33 Bolivia 355 250 35 23 -4 81 Brazil 222 135 50 36 14 51 Chile 158 85 62 14 35 50 Colombia 237 127 62 20 38 41 Costa Rica 203 73 102 19 33 48 Dominican Rep. 271 109 91 21 36 43 Ecuador 248 120 73 18 46 35 El Salvador 287 165 55 10 37 53 Guyana 249 172 37 -9 43 65 Haiti 347 291 18 -3 38 65 Honduras 290 141 72 11 37 51 Jamaica 196 97 70 12 46 42 Mexico 250 96 96 16 53 31 Nicaragua 347 147 86 -3 42 61 Panama 241 94 94 18 49 33 Paraguay 166 117 35 19 33 48 Peru 324 173 63 9 54 37 Trinidad And Tobago 182 118 43 15 48 37 Uruguay 105 90 15 5 45 51 Venezuela 224 101 80 -2 53 49 Middle East and North Africa Algeria 259 156 51 16 42 42 Iran, Islamic Rep. of 220 174 23 9 49 42 Iraq 324 154 74 5 54 41 Syrian Arab Rep. 294 177 51 22 46 32 Tunisia 270 174 44 24 42 34 South Asia Bangladesh 538 308 56 14 31 55 India 407 241 52 17 39 44 Nepal 507 376 30 20 19 61 Pakistan 456 247 61 22 42 36 Sri Lanka 238 120 68 17 42 41 Supplementary Tables 67 Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 (LN)' Income (°/) Education (°/) progress (°) Sub-Saharan Africa Botswana 448 158 104 38 29 34 Cameroon 486 361 30 26 30 44 Central African Rep. 442 381 15 -10 34 76 Ghana 419 270 44 -2 42 61 Kenya 442 287 43 11 42 47 Lesotho 354 276 25 39 16 45 Liberia 363 198 61 5 28 67 Malawi 431 436 -1 14 25 61 Mali 490 351 33 0 11 88 Mauritius 255 126 70 18 43 39 Mozambique 467 321 37 -33 27 107 Niger 531 413 25 1 14 85 Senegal 477 506 -6 6 17 78 South Africa 444 209 75 20 14 66 Swaziland 486 196 91 20 40 40 Tanzania 498 373 29 35 -23 88 Togo 427 321 29 20 34 46 Uganda 451 461 -2 -7 29 78 Zambia 506 377 29 -11 51 60 Zimbabwe 482 270 58 6 36 58 a. Difference in health measure (LN) between 1960 and 1990. b. The percentage of improvement in each country that results from changes in income and education levels and from technical progress. 68 Measuring Country Performance on Health Supplementary Table VIII Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels VIII.3 Male Adult Mortality Rate Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 (LN)' Income f%) Education (%) progress (%) East Asia and Pacific Fiji 318 173 61 19 29 52 Indonesia 605 275 79 30 28 42 Korea, Rep. of 406 239 53 37 34 29 Malaysia 438 209 74 35 24 41 Myanmar 475 326 38 27 16 56 Papua New Guinea 521 425 20 11 20 69 Philippines 449 273 50 17 28 55 Thailand 395 207 65 43 9 47 Europe and Central Asia Romania 156 216 -33 39 26 35 Turkey 182 165 10 27 21 52 Yugoslavia, the former 172 168 2 29 29 43 Latin America and the Caribbean Argentina 217 188 14 8 35 58 Barbados 187 140 29 33 21 46 Bolivia 483 307 45 25 -17 93 Brazil 295 193 42 34 15 51 Chile 238 175 31 17 20 63 Colombia 298 222 29 28 12 60 Costa Rica 246 122 70 22 20 59 Dominican Rep. 342 157 78 25 20 55 Ecuador 312 183 53 24 27 49 El Salvador 363 284 25 12 21 67 Guyana 307 263 15 -12 18 93 Haiti 455 353 25 -3 41 61 Honduras 392 202 66 11 36 53 Jamaica 251 155 48 15 26 59 Mexico 306 173 57 20 38 42 Nicaragua 431 220 67 -3 23 80 Panama 273 146 63 23 32 45 Paraguay 219 169 26 23 17 61 Peru 404 228 57 13 32 55 Trinidad and Tobago 237 190 22 20 27 53 Uruguay 187 178 5 6 24 70 Venezuela 276 186 39 -3 28 75 Middle East and North Africa Algeria 343 193 58 16 39 45 Iran, Islamic Rep. of 239 170 34 10 40 50 Iraq 391 193 71 5 48 47 Syrian Arab Rep. 367 237 44 25 36 39 Tunisia 324 190 53 26 35 40 South Asia Bangladesh 551 322 54 14 26 60 India 398 236 52 18 32 50 Nepal 527 350 41 17 28 55 Pakistan 420 232 59 23 37 40 Sri Lanka 204 184 10 22 23 55 Supplementary Tables 69 Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 ˘LNj)a Income (°) Education (°/) progress (°O Sub-Saharan Africa Botswana 537 218 90 42 19 39 Cameroon 602 430 34 30 14 56 Central African Rep. 519 485 7 -10 28 83 Ghana 514 334 43 -2 47 55 Kenya 547 357 43 13 30 57 Lesotho 450 384 16 43 4 53 Liberia 479 254 63 4 30 66 Malawi 522 479 9 16 11 73 Mali 589 434 31 0 14 85 Mauritius 316 241 27 21 28 51 Mozambique 592 418 35 -37 8 129 Niger 543 515 5 1 13 86 Senegal 570 579 -2 6 11 83 South Africa 525 312 52 18 21 61 Swaziland 604 260 84 23 27 50 Tanzania 606 444 31 31 -17 85 Togo 548 389 34 17 38 44 Uganda 549 526 4 -8 8 100 Zambia 607 434 34 -13 36 76 Zimbabwe 571 305 63 6 31 63 Note: a. Difference in health measure (LN) between 1960 and 1990. b. The percentage of improvement in each country that results from changes in income and educat:on levels and from technical progress. 70 Measuring Country Performance on Health Supplementary Table VIII Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels VIII.4 Total Fertility Rate Improvement due tob Healthr measure in Change between Tcchnical Region and country 1960 1990 1960 and 1990 (LN)j Income (°/ Education (°/) progress (°/) East Asia and Pacific Fiji 6.4 3.1 71 8 66 26 Indonesia 5.4 3.1 57 15 62 23 Korea, Rep. of 5.7 1.8 117 15 71 14 Malaysia 6.8 3.8 58 15 65 20 Myanmsar 6.0 4.3 33 16 45 39 Papua New Guinea 6.3 5.2 20 7 43 50 Philippines 7.0 4.1 54 7 67 26 Taiwan, China 5.7 1.9 112 19 63 18 Thailand 6.4 2.3 101 24 45 31 Europe and Central Asia Romania 2.3 1.8 25 18 62 19 Turkey 6.3 3.6 58 15 53 32 U.S.S.R., the former 2.7 2.2 20 18 57 25 Yugoslavia, the former 2.7 2.2 20 15 59 26 Latin America and the Caribbean Argentina 3.1 2.9 7 3 70 27 Barbados 4.5 1.8 91 15 59 25 Bolivia 6.7 4.9 31 21 -8 88 Brazil 6.2 3.0 71 27 24 48 Chile 5.3 2.6 70 9 52 39 Colombia 6.8 3.1 78 13 56 31 Costa Rica 7.0 3.3 77 12 50 38 Dominican Rep. 7.4 3.3 80 13 54 33 Ecuador 6.9 3.7 64 11 64 26 El Salvador 6.8 4.0 53 6 54 40 Guyana 6.5 2.9 82 -5 59 46 Haiti 6.3 5.2 19 -2 53 48 Honduras 7.3 5.3 33 7 54 39 Jamaica 5.4 2.9 63 7 63 30 Mexico 6.8 3.5 67 9 70 21 Nicaragua 7.4 5.3 33 -1 58 44 Panama 5.9 3.0 66 10 67 23 Paraguay 6.8 4.5 41 12 50 38 Peru 6.9 3.6 66 5 70 25 Trinidad and Tobago 5.2 2.5 73 9 65 26 Uruguay 2.9 2.4 19 3 61 36 Venezuela 6.5 3.5 62 1 68 33 Middle East and North Africa Algeria 7.3 4.6 46 9 60 31 Iran, Islamic Rep. of 7.2 5.6 25 5 66 29 Iraq 7.2 5.9 19 3 70 28 Syrian Arab Rep. 7.3 6.3 15 13 64 23 Tunisia 7.1 3.6 69 14 60 26 South Asia Bangladesh 7.1 4.4 48 9 47 44 India 6.6 3.8 55 10 56 34 Nepal 5.8 5.7 2 14 32 54 Pakistan 6.9 5.9 16 13 59 27 Sri Lanka 53 2.5 74 10 59 30 Supplementary Tables 71 Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 (LN)5 Income (a/) Education (%/) progress (°/) Sub-Saharan Africa Botswana 6.8 5.0 31 26 46 28 Cameroon 4.9 5.8 -17 17 47 36 Central African Rep. 5.6 5.7 -1 -6 49 57 Ghana 6.9 5.9 17 -1 57 44 Kenya 8.0 5.8 33 7 59 34 Lesotho 5.8 5.1 15 30 28 42 Liberia 6.2 6.4 -2 3 43 54 Malawi 7.8 7.2 8 9 40 51 Mali 6.5 7.0 -8 0 20 80 Mauritius 5.9 2.1 105 11 60 29 Mozambique 6.3 6.5 -2 -21 39 82 Niger 7.1 7.4 -4 1 24 75 Senegal 6.4 6.2 4 4 28 68 SouthAfrica 6.5 4.2 43 15 24 61 Swaziland 6.5 6.7 -3 12 57 31 Tanzania 6.8 6.1 10 39 -61 122 Togo 6.6 6.6 0 12 51 37 Uganda 6.9 7.1 -2 -4 44 61 Zambia 6.6 6.2 6 -6 65 40 Zimbabwe 8.0 4.9 50 3 53 44 a. Difference in health measure (LN) between 1960 and 1990. b. The percentage of iniprovemnient in each country that results from changes in income and education levels and from technical progress. 72 Measuring Country Performance on Health Supplementary Table VIII Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels VIII.5 Female Life Expectancy Improvement due tob Health measure in Chanige betwneen Technical Region and country 1960 1990 1960 and 1990 (LN)' Income (%o) Education (%/) progress (%) East Asia and Pacific Fiji 61.7 73.7 18 14 38 48 Indonesia 43.4 64.5 40 24 34 42 Korea, Rep. of 56.9 74.8 27 28 44 28 Malaysia 57.4 73.0 24 25 37 38 Myanmar 46.5 59.3 24 22 21 57 Papua New Guinea 42.4 56.7 29 9 19 72 Philippines 56.2 68.2 19 12 40 49 Taiwan, China 68.6 77.2 12 32 36 32 Thailand 56.1 71.8 25 33 21 46 Europe and Central Asia Romania 68.7 73.0 6 30 35 35 Turkey 53.7 69.6 26 22 27 52 U.S.S.R., the former 72.0 74.0 3 27 30 43 Yugoslavia, the former 65.7 74.5 13 24 32 45 Latin America and the Caribbean Argentina 68.6 75.7 10 5 43 52 Barbados 68.3 77.9 13 24 32 44 Bolivia 45.6 61.0 29 18 -2 85 Brazil 57.8 70.1 19 31 9 60 Chile 60.9 77.4 24 13 26 61 Colombia 59.7 72.3 19 19 29 52 Costa Rica 64.5 78.6 20 17 24 59 Dominican Rep. 55.2 71.7 26 19 27 54 Ecuador 56.1 71.4 24 18 36 46 El Salvador 54.0 71.8 28 9 27 65 Guyana 58.9 68.0 14 -8 31 77 Haiti 44.9 58.3 26 -3 26 76 Honduras 49.7 70.1 34 10 27 63 Jamaica 66.2 75.9 14 11 35 54 Mexico 60.3 74.5 21 16 42 41 Nicaragua 50.0 68.7 32 -2 30 72 Panama 63.1 75.0 17 18 39 43 Paraguay 66.4 70.8 6 17 24 59 Peru 50.5 67.9 30 9 42 49 Trinidad and Tobago 66.7 74.0 10 14 37 49 Uruguay 71.6 75.7 6 4 33 63 Venezuela 62.8 74.7 17 -2 40 62 Middle East and North Africa Algeria 49.4 70.0 35 15 32 53 Iran, Islamic Rep. of 50.6 68.0 30 8 38 54 Iraq 50.9 57.6 12 5 42 53 Syrian Arab Rep. 52.4 69.6 28 21 37 42 Tunisia 50.1 68.7 32 23 33 45 South Asia Bangladesh 39.5 57.2 37 12 22 66 India 44.7 61.7 32 16 29 56 Nepal 38.6 54.1 34 17 13 70 Pakistan 44.4 62.6 34 21 32 47 Sri Lanka 63.7 74.2 15 16 32 52 Supplementary Tables 73 Improvement due tob Health measure in Change betwveen Technical Region and country 1960 1990 1960 and 1990 (lNO) Income (%) Education (°/) progress (%°) Sub-Saharan Africa Botswana 49.2 55.8 13 35 22 43 Cameroon 42.0 57.8 32 23 22 55 Central African Rep. 42.1 50.9 19 -8 23 85 Ghana 47.7 60.0 23 -2 30 72 Kenya 48.0 60.8 24 10 31 58 Lesotho 47.0 59.0 23 35 11 54 Liberia 44.0 41.0 7 4 19 77 Malawi 39.1 42.4 8 12 17 71 Mali 37.5 50.2 29 0 7 93 Mauritius 61.9 73.8 18 17 33 50 Mozambique 40.1 48.0 18 -25 16 109 Niger 37.5 48.1 25 1 9 90 Senegal 41.0 50.3 20 5 11 85 South Africa 52.0 66.0 24 17 9 74 Swaziland 43.5 59.8 32 19 30 51 Tanzania 43.3 51.9 18 26 -14 88 Togo 42.1 52.6 22 18 25 57 Uganda 47.1 45.8 3 -6 19 86 Zambia 44.4 45.0 1 -10 37 73 Zimbabwe 48.1 61.4 24 5 26 69 a. Difference in health measure (LN) between 1960 and 1990. b. The percentage of improvement in each country that results from changes in income and education levels and from technical progress. 74 Measuring Country Performance on Health Supplementary Table VIII Accounting for Progress, 1960-90: Country Variation in the Relative Contributions of Technical Progress and Changes in Income and Education Levels V1II.6 Male Life Expectancy Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 (LN)a Income (%) Education (°/) progress (%/) East Asia and Pacific Fiji 58.8 69.5 17 16 32 53 Indonesia 41.7 61.0 38 25 32 43 Korea, Rep. of 53.6 67.3 23 31 39 30 Malaysia 54-2 68.7 24 29 28 43 Myanmar 43.6 56.0 25 23 19 59 Papua New Guinea 43.0 55.2 25 9 22 69 Philippines 52.9 64.5 20 13 31 55 Taiwan, China 63.3 72.8 14 34 33 34 Thailand 51.9 66.3 24 37 11 51 Europe and Central Asia Romania 65.0 67.0 3 33 30 37 Turkey 50.5 65.0 25 23 24 54 U.S.S.R., the former 65.0 63.0 3 29 25 46 Yugoslavia, the former 63.3 69.5 9 24 32 44 Latin America and the Caribbean Argentina 62.5 68.6 9 6 37 57 Barbados 63.5 72.9 14 27 24 48 Bolivia 41.4 57.7 33 21 -20 99 Brazil 54.0 62.3 14 28 17 54 Chile 55.3 71.5 26 14 22 64 Colombia 56.2 66.4 17 23 14 63 Costa Rica 61.6 74.0 18 18 22 60 Dominican Rep. 52.1 67.6 26 21 22 57 Ecuador 53.4 66.4 22 20 30 50 El Salvador 50.8 64.1 23 9 23 68 Guyana 55.8 62.4 11 -9 19 90 Haiti 42.3 54.9 26 -2 43 59 Honduras 46.3 65.4 35 9 39 53 Jamaica 62.4 71.4 13 12 29 59 Mexico 57.0 68.5 18 16 42 42 Nicaragua 47.3 63.5 29 -2 24 78 Panama 60.9 70.9 15 19 35 46 Paraguay 62.5 66.3 6 19 19 63 Peru 47.8 64.1 29 10 35 55 Trinidad and Tobago 62.5 69.3 10 16 29 54 Uruguay 65.4 69.3 6 5 25 70 Venezuela 59.3 68.9 15 -2 29 72 Middle East and North Africa Algeria 47.3 67.0 35 13 43 45 Iran, Islamic Rep. of 50.9 67.0 27 8 43 49 Iraq 49.1 58.5 18 4 50 46 Syrian Arab Rep. 49.7 65.2 27 20 40 40 Tunisia 49.1 66.9 31 21 39 41 South Asia Bangladesh 41.7 56.0 29 11 28 60 India 46.2 60.6 27 14 35 50 Nepal 39.6 55.1 33 13 31 56 Pakistan 45.6 60.6 28 18 41 40 Sri Lanka 63.3 69.7 10 18 25 57 Supplementary Tables 75 Improvement due tob Health measure in Change between Technical Region and country 1960 1990 1960 and 1990 (TN)2 Income (%) Education (°) progress (°) Sub-Saharan Africa Botswana 45.9 52.4 13 35 22 42 Cameroon 39.0 54.4 33 25 16 59 Central African Rep. 37.0 45.9 22 -8 29 79 Ghana 44.5 56.0 23 -1 49 53 Kenya 44.0 57.1 26 10 32 57 Lesotho 42.0 56.4 29 37 5 58 Liberia 41.0 38.0 8 3 32 65 Malawi 37.8 41.4 9 13 12 75 Mali 36.1 46.7 26 0 15 84 Mauritius 58.7 66.8 13 17 31 52 Mozambique 37.0 44.9 19 -27 8 119 Niger 34.5 44.9 26 1 14 85 Senegal 39.4 48.3 20 5 12 84 South Africa 48.0 60.0 22 14 23 62 Swaziland 39.7 55.2 33 19 30 51 Tanzania 40.1 49.0 20 27 -20 93 Togo 39.0 49.5 24 14 42 45 Uganda 43.9 45.6 4 -6 9 98 Zambia 41.2 43.3 5 -10 37 72 Zimbabwe 44.9 58.4 26 4 33 62 a. Difference in health measure (LN) between 1960 and 1990. b. The percentage of improvement in each couintry that results from changes in income and education levels and from technical progress Annex A East Asia and Pacific: Regional and Country-Specific Indicators of Performance on Health This annex provides information, for 15 countries in the East Asia and Pacific region, on performance relative to income for six health indicators. For each country, the annex includes a figure with panels displaying values of the six indicators over the period from 1960 through 1990. Panel A: Under-Five Mortality Rate Panel B: Female Adult Mortality Rate Panel C: Male Adult Mortality Rate Panel D: Total Fertility Rate Panel E: Female Life Expectancy Panel F: Male Life Expectancy In addition, each country profile includes a table with the values at five-year intervals for each health indicator, for per capita GDP (in 1985 international dollars adjusted for purchasing power), and for the average years of edu- cation for males and females aged 15 years and over. Two regional profiles are presented before the country profiles. One shows regional performance relative to income for the six indicators; it is directly analogous to the country profiles. The second shows regional perfor- mance relative to education as well as income levels. This gives a sense of the extent to which performance on health relative to income results from educational differences. Also preceding the country profiles is a figure show- ing "health performance diamonds" that depicts the overall performance of each country in the region in 1990. The main text discusses the methods used and provides tabular summaries of results, including country-spe- cific results on performance that control for education as well as income. 77 Contents Regional Performance over Time (Figures A and AA) 79, 80 Country-Specific Health Performance Diamonds, 1990 (Figure AAA) 81 Country-Specific Performance 1. China 84 2. Fiji 86 3. Indonesia 88 4. Korea, Republic of 90 5. Lao People's Democratic Republic 92 6. Malaysia 94 7. Mongolia 96 8- Myanmar 98 9. Papua New Guinea 100 10. Philippines 102 11. Solomon Islands 104 12. Taiwan, China 106 13. Thailand 108 14. Vanuatu 110 15. Western Samoa 112 78 Annex A 79 Figure A East Asia and Pacific Region: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 100% 0-0 z.E~~~~~. 0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~~~~~~~~-. U 0 50% -38% 41% -5 -1.0- 8 0 ~~~~35% 26% 20% 5 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% 10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel F: FMale Life Expectancy 50% 1 o0.0 0J 5.8 ~~~ 2 K 1 96 125 N S | g~~~~~~~~~~~~~~~~~~~52 . 196 19517 951901519 0 0o 5D2 5.2 4.3 u-m E.-.,9o~-4 3.2 o -21% -50%- . 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50% --10.0 - 0%I I ,-% -% so6.1 5.8 3. 46 u 2% -1-25.3 -15% 04. 0 ~ ~ ~ ~ ~~~~~~~~~~~~~~~~~50 - -50%00 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 so Measuring Country Performance on Health Figure AA East Asia and Pacific Region: Performance Relative to Income and Education Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortalitv Rate Panel D: Total Fertility Rate 50% 1.0 17° 18% 20% 0 0.3 0.3 o - ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~030.3 C 0~~~~~~~~~~~~~~~~~~~~~~~~. 0% 1% L 0.0 O 0 -12% ° -0.2 -0.3 -50% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 5.0 2.3 18 2.1 1.8~~~~~. _0 9D2 1.1 1.3 -16% 0.3 -19% -20% -22% -24% ~-21% % 0.0 -27% 0-2% 24 -2 7 l -1.2 A 0 -50% -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy -6% ~~~ ~~~~~~~~~~2,7 2.4 209 60/1- -9% -8% 16 19 2.0 _ 12 -50% o -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex A 81 Figure AAA East Asia and Pacific Region: Country-Specific Health Performance Diamonds, 1990 China Fiji qS q5 / q45m q4Sf q45m q q45f tfr (q5 value is missing) tfr Indonesia q5 Korea, Rep. of q5 q4m Ac-9q45f q4Sm q4M (q5 value is for 1985) tfr Lao PDR q5 Malaysia q5 q45m 5 q \ q95f (q5 value is missing) tic tfs (Figure continues on the next page.) 82 Measuring Country Performance on Health Figure AAA (continued) Mongolia q5 Myanmar q5 q45m q45f q45m q45f (q5 value is missing) tfr (q5 value is for 1985) tfr Papua New Guinea q5 Philippines q5 q45m q45f q45m q45f (q5 value is missing) tfr tr Solomon Islands q5 Taiwan, China q5 q45m q45f q45rn q45f (q5 value is missing) [fT tr (Figure continues on the next page.) Annex A 83 Figure AAA (continued) Thailand q5 Vanuatu q5 A A q45m qq45 C45m q451 (q5 value is missing) tfr tfr Western Samoa q5 q45m R * q45f (q5 value is missing) tfr Note: q5 = under-five mortality rate; tfr = total fertility rate; q45f = female adult mortality rate; q45m = male adult mortality rate. Each axis of the performance diamond is scaled so that the midpoint of the distance between the origin and the tip of the relevant axis corresponds to per- fonniance equal to what would be predicted by iiicome. Values better tban would be predicted are plotted between tlle midpoint and the tip at a distanice proportional to the country's performance on the indicator relative to the performance of the best-performing country on the indicator. Likewise, values poorer than would be predicted are plotted between the midpoint and the origin. The diamond connecting midpoints of the axes depicts, then, expected performance. The shaded diamond depicts the country's performance. When the shaded area bies inside the expected performance box, country perfor- mance is poor; when outside, performance is good. 84 Measunng Coutntry Performance on Health Table A.1 China: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-fivemortalityrate' 173 144 115 85 60 44 45 Female adult mortality rateb 631 258 233 197 168 149 141 Male adult mortality rateb 691 317 249 222 200 192 185 Female life expectancyc 56.8 60.4 63.9 - 69.3 70.3 70.6 Male life expectancyc 51.5 58.8 62.5 - 66.4 67.1 67.5 Total fertility rated 3.4 6.4 5.8 3.4 2.5 2.5 2.1 Determinants Income per capitae 567 498 619 733 832 1,071 1,300 Female education (years)f - - - 3.4 3.7 4.0 4.4 Male education (years) -- 5.3 5.7 5.8 7.3 - Not available. a. Under-five mortality rate: the probability cf dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 85 Figure A.1 China: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 120% 0.0 100%/4 90% 94% ' 14. I 40%~~~ 30ob 32% | | l | ~~~~~~~~12.0 11. i -108 07 80% 70% 5 0~~~~~~~~~5 1 60% 'j -2.0 - u40% 30% -3.0 -- -2.8 ~~~~~~-2.7 20% 030 -0 - -2.9 -3.4 0 %/0 -4.0 LL 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% --16.0 41 50% 51% 4% 14.01.0 12.7 40%k 30% 32% 12.0 .8 13 O 0%/ 8.0 6.0 "-40% 4.0 2.0 -8% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80%/ 16.0 4% 53% 5%5 7 /14013.7 13.2 40% 3%12.0 11.1 10.7 0 ~~~~~~~~~~~~~~~~~~~10.0 0% , 8.0 6.9 ~3-40%k -n 4.0 -44% ~~~~~~~~~~~~~~~2.0 -80%/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 86 Measuring Country Performance on Health Table A.2 Fiji: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - - _ Female adult mortality rateb 264 235 207 178 152 130 115 Male adult mortality rateb 218 286 257 230 209 190 173 Female life expectancyc 61.7 64.2 66.7 69.0 71.0 72.5 73.7 Male life expectancyc 58.8 61.3 63.6 65.5 67.0 68.3 69.5 Total fertility rated 3.4 6.4 5.8 3.4 2.5 2.5 2.1 Determinants Income per capitae 2,108 2,214 2,312 3,082 3,574 3,486 3,565 Female education (years)f 4.5 4.4 4.8 5.7 6.4 7.3 7.5 Male education (years)1 5.7 5.2 6.1 6.7 7.2 7.8 8.2 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the sante throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e Income per capita is measured in l 985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and nale populations aged 15 to 60. Annex A 87 Figure A.2 Fiji: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 0.5 10% E E) 0% l l l l l l | 3 0.0 o : ~~~~~ ~ ~ ~ ~ ~~~~~~~~~-1.0 - -0.7 05 > -10%o-11 11 0 0- -20% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0- ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ -~~~~~14.0 40%/ - - 35% 37 20~9.8 _04 0 . 9.7 9.3 9.5 0. -20% -2.0: 0% i T T T , , ,0.0 - - q 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 14.0 40% 34% 12.0 1017 104 3 98 31E 1 22% n l 111 111.0 9210.0 0. 92 9.5 5 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~ ~~~~~8.0 > 20% t 16% 60 > ~~~~~~~~~~~~~~~~~~~~4.0 0 2.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 88 Measuring Country Performance on Health Table A.3 Indonesia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 216 204 172 153 124 109 95 Female adult mortality rateb 525 468 405 346 308 262 219 Male adult mortality rateb 605 544 478 412 368 323 275 Female life expectancyc 43.4 47.0 50.5 54.0 58.0 62.0 64.5 Male life expectancyc 41.7 45.0 48.0 51.5 54.5 58.5 61.0 Total fertility rated 5.4 5.5 5.5 5.1 4.4 3.7 3.1 Determinants Income per capitae 638 632 654 835 1,122 1,560 1,784 Female education (years)f 1.0 1.2 2.2 2.3 3.0 3.5 4.1 Male education (years)f 2.2 2.5 3.6 3.7 4.4 4.5 5.1 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 89 Figure A.3 Indonesia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% -6 0.0 20% 1- 1% S 3%0^ -2.0/. 3 -1.0 -q9 09 30. -.9 -20% 0- 0-~~~~~~~~~~~~~~~~~~~~~~~~~~~-. -12 _1.2 -. -40 -40%-30 -60%k - -2.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 10% 4.0 3.0 A -32%-42.0 1-3 -10% 7 . cc~~~~~~~~~~~~~~~~~m ci0.0 .~-30% -2.0/ -400/0 ~~~~~~~~~~~~~~-4.5 -50% - -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 10% 2% 4.032 5 9~~~~~~~~~~~~~~~~~~~~~~L C -11% '-' 0~~~~~~~~~~~~~~~~.0 -10% 0.5~-18 c .~~~ -30% -26% 9~-7%0. -32% 0 20-. -50%/ - -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 90 Measuring Country Performance on Health Table A.4 Republic of Korea: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 127 87 55 28 18 13 - Female adult mortality rateb 341 331 280 206 156 136 117 Male adult mortality rateb 406 399 356 311 270 247 239 Female life expectancyc 56.9 59.4 64.0 68.8 71.0 72.5 74.8 Male life expectancyc 53.6 56.0 59.0 62.4 64.6 66.2 67.3 Total fertility rated 5.7 5.0 4.3 3.5 2.6 2.1 1.8 Determinants Income per capita' 912 983 1,370 2,057 2,967 3,708 5,615 Female education (years)1 3.0 4.2 3.9 5.5 6.8 7.8 9.0 Male education (years)t 5.6 6.6 6.0 7.8 9.1 9.6 10.9 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 91 Figure A.4 Republic of Korea: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 200% 0 0.0 180% 149% 14a/ 160°%% 138% 0145% -04 = 140 % | -1.0 a 120% 97% 100%-141. t 80% 70%k -2.0-1 a- ~~~~~~~~~~~~~~~~~~~~~~~~~~~-1.7 > 60% +43% 1 -2.0 1.9 40%t > A 20% 0% -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% T 32% 14.0 29%0/ 22% ~~~12.0 11.2 1. 20% 18% | | 1020 2 9.5 9.1 8.7 2 0% 1 7.6 79 ci ci ~~~~~~~~~~~~~~~~~~~8.0 C ~ ~ ~ ~ ~ ~ ~ ~~~~~~~~~ ~~~~~6.0 0% o~~~~~~~~~~~~~~~~ 4.0 -2% -1% -7/7% 2.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 14.0 20% 12.0 8% 10.0 8 2% ~~~~3% 7. ..7297. . - 007 lI.|2 a 5.97 0 96 .26 6.017 9018 19 9016 90 9518 9519 4.070 2.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 92 Measuring Country Performance on Health Table A.5 Lao People's Democratic Republic: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' _ _ - - - - - Female adult mortality rateb 481 500 510 483 439 415 389 Male adult mortality rateb 586 602 610 580 531 498 464 Female life expectancy' 41.8 41.8 41.8 45.0 47.5 50.0 52.5 Male life expectancyc 39.1 39.1 39.1 42.1 44.5 47.0 49.5 Total fertility rated 6.2 6.2 6.2 6.4 6.7 6.7 6.7 Determinants Income per capitae - - - - - 1,308 1,326 Female education (years)f - - - - _- - Male education (years)- - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 93 Figure A.5 Lao People's Democratic Republic: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40%0o 3.0 E U 20% ˘ 1.9 -0 0%~~~~~~~~~~~~~~~~~~~C ° 0% I I I I I I .I. 1.0 -40% 0.0 I 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -2.0 , -20%0o C 111 l iil % -4.0 2 -40% -6.0 -8.0 -7.9 a -60% -56% -56% -10.0 -10.1 -80% -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% I I i i -2.0 -20% -40% -6.0 1960 -47% 17 195181951919016 19-45% -47% ~~~~~-8.0 -60% -. -10.0 -. -80%/ 1. 1960 1965 1970 1975 1980 1985 1990-20 1960 1965 1970 1975 1980 1985 1990 94 Measuring Country Performance on Health Table A.6 Malaysia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' - - - - - - - Female adult mortality rateb 369 323 267 222 185 157 142 Male adult mortality rateb 438 390 334 286 248 222 209 Female life expectancy' 57.4 61.0 64.7 67.1 70.0 71.6 73.0 Male life expectancyc 54.2 57.8 61.4 63.5 66.0 67.5 68.7 Total ferLility rated 6.8 6.3 5.6 4.7 4.2 4.1 3.8 DetLerminants Income per capitae 1,320 1,574 1,845 2,515 3,286 4,207 4,365 Female education (years)f 1.5 2.0 2.6 3.2 3.8 4.6 5.3 Male education (years)f 4.2 4.7 5.2 5.7 6.4 6.6 6.8 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant International dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 95 Figure A.6 Malaysia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 2.0 C 10% u 1.0 0 i D 0 -0.3 -0.3 -20% 00.0 0~~~~~~~~~~~~~~~~~~~~~~~~~~~. O .- ~~~~~~~~~~~~~~~~~~~-0.3 -0.3 -20% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 30% 12.0 20% 1 10.0 9.2 8.8 9.0 u 10% 6%9. 10'- 0 1 10E 10% 1.0 0 0~~~~~~~~~~~~~~~~~~~~. ~20% t 65 3%1.0-92 8. 90 -30%~~~~~~~~~~~~~~~ ] o 4.0 b 8 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 3~-0%120- -20% 15% 2.0 0 0%~~~~~~~~~~~~~~~~~~~. 30%60 -2 0 0/. 2.0~~~~~~~~19019519017518018519 -30% 12.0 200%95 90195090.98099 96 96 9.2 8.97 19.0185 90 96 Measuring Country Performance on Health Table A.7 Mongolia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' _ _ - - - _ _ Female adult mortality rateb 396 361 331 302 273 242 211 Mateadultmortalityrateb 476 431 391 355 320 285 251 Female life expectancyc 49.5 52.5 55.0 57.5 60.0 62.5 65.0 Male life expectancyc 47.0 50.0 52.5 55.0 57.5 60.0 62.3 Total fertility rated 6.0 6.0 5.9 5.7 5.4 5.0 4.2 Determinants Income per capitae - - - - - 1,808 1,899 Female education (years)f - - - Male education (years)f - - ND available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 97 Figure A.7 Mongolia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 1.0 60% 80 0.3 Ł 40% 20%; 0.0 ' I I I I 11_ - _ CL s -0.1~~~~~~~~~~~~~~~~~~. >20% a 0% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% - 6.0 5.0 10% = 4.0 20°b 3 0.0 ~ i + i | | _ | *_3 C- ~ ~ ~ ~ ~ ~ ~ ~ ~ 5 -10% 1.0 -200% 0.0 I I 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 2Q% 60 U 9% 5.0 4.3 10% H l ;- 0% ~ I I I 3.0~ 2.7 '4 4)~~~~~~~~~~~~~~~~~~~ 2.0~~~~~~~~~~. -10% 1.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 98 Measuring Couintry Performance on Health Table A.8 Myanmar: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - 179 151 134 140 Female adult mortality rateb 372 354 336 323 313 291 267 Male adult mortality rateb 475 446 419 398 384 357 326 Female life expectancyc 46.5 49.0 51.4 52.9 54.3 56.8 59.3 Male life expectancyc 43.6 45.9 48.3 49.7 51.1 53.5 56.0 Total fertility rated 6.0 6.0 5.9 5.5 5.1 4.7 4.3 Determinants Income per capitae 276 380 400 414 467 565 547 Female education (years)f 0.8 0.9 1.0 1.1 1.3 2.0 2.2 Male education (years)f 1.5 1.6 1.7 1.7 1.9 2.8 2.8 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the ferrale and male populations aged 15 to 60. Annex A 99 Figure A.8 Myanmar: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60% 0.0 2 ~ ~ ~ ~ ~ ~ ~ ~ ~ -. 6-1.70. 1 40% -1.0 ~ ~ ~ -. o ~ ~ ~ ~ ~ 8 2.2 20% 15% -1.1 '2 -1.3 e4 -1.5 -1.6 0 ~~~~~~~~~~~~-1.7 0% I ° -2.0- 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 10% -8 8% 2.2 8% 7- 2.0- 1. E 6% -0. ,, 2% 1| l,i 1. X -0.6 |~~~~~~~~~~~0. , . E , a , , -0.9~~~~~~~~~~~~~~~0. 4% ~~3% 2% 2% .2 0.0 2% -05-0.8 0% 0% 0% -2.0 -2% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 10% 5%~~~~~~8 8% 1.8~~~~~~~~~~~~~~~~~~~~~~. 4%~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~4 2% ~~~~2% 2% 0.0 2%O/ 0 ~ ~ ~ ~ ~~~~~-. 0 % -0.9 -2% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 100 Measuring Country Performance on Health Table A.9 Papua New Guinea: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate" 204 197 - - - - - Female adult mortality rateb 495 467 483 501 478 436 386 Male adult mortality rateb 521 484 496 518 514 481 425 Female life expectancyc 42.4 44.9 47.6 50.0 52.7 54.7 56.7 Male life expectancyc 43.0 45.4 47.7 49.5 51.2 53.2 55.2 Total fertility rated 6.3 6.3 6.2 6.0 5.7 5.4 5.2 Determinants Income per capitae 1,235 1,504 1,842 1,911 1,791 1,647 1,563 Female education (years)j 0.8 0.9 0.8 1.1 1.2 1.5 1.9 Male education (years)f 1.4 1.4 1.4 1.9 2.1 2.4 2.7 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult Mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific ferLility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 101 Figure A.9 Papua New Guinea: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% I _ I I I I 1.0 -7 0.7 0. 0 0.70. 0.6 0.6 -20% -1% 0.4 l l l l 0~~~~~~~~~~~~~~~~~~~~~~~~. 80 - 0.4 -40% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -2.0 -20% 8 - -4.0 > -40% -4.3 44% ~~~~~~~~~~~~0-6.0 -48% -6.3 -6.1 * 60%- -60% -8.0 -7.4 -6 1 O/o -6 0 O/o -8.0 -8.1 1 -80% ~~~-70% -70% -67% 1. -80% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% ~~~~~~~~~~~~~~~~-2.0 -20% ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-2.2 0~~~~~~~~~~~~~~~~~~~-. -28% -30% ~-. -40% -r -46 4. -4.2 -4.1 -3.9 _46 48% -47% 5 -60% -8. -80% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 102 Measuring Country Performance on Health Table A.1O Philippines: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 107 94 82 75 69 65 48 Female adult mortality rateb 379 336 314 292 259 229 208 Male adult mortality rateb 449 402 376 353 323 295 273 Female life expectancyc 56.2 57.8 59.4 61.5 63.7 65.9 68.2 Male life expectancyc 52.9 54.6 56.4 58.3 60.2 62.2 64.5 Total fertility rated 7.0 6.8 6.5 5.6 4.9 4.5 4.1 Determinants Income per capitae 1,079 1,213 1,345 1,528 1,785 1,771 1,662 Female education (years)f 3.9 4.1 4.7 5.9 6.5 6.7 7.0 Male education (years)f 4.6 4.7 4.9 6.1 6.6 6.7 6.9 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probabJlity of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specinc levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 103 Figure A.10 Philippines: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 2.0 - 60% _54% 55% 58% 8 l l | l l 39 42% 1.0 0.8 0.8 E 40% _ 20% ~ lR | l | | 26% 0. . 0~~~~~~~~~ c ~~~~~~~~~~~ 0.0 20% 0 > | L L | l L L | I L 02-0.3 -0.4 0% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 10% 10.0 0 0%. 8.0 7.0 U 0% 1 U U ' U ' U ' U ' ' 6 0 5.5 |6.3 6.0 E [ [ [ [ [ [ < t | 4.4.9 4.9 4.7 4.8 W -10%/ -8% -12% 12% -12% 2.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult MortaLity Rate Panel F: Male Life Expectancy 10% T 10.0 o 4% C 0% 8.0 6.9 0%o . . . |_ 5.91 0E I ° | | | ' | ' | ' 11E ' < 6.0 5.3 5.2 5.2 4.9 4.9 o | 111 1|1 | -2% 4. > -10% 7% -6% - 4.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 104 Measuring Country Performance on Health Table A.11 Solomon Islands: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - Female adult mortality rateb - - - - _ 265 273 Male adult mortality rateb - - - - - 287 299 Female life expectancyc - - - - 61.4 62.1 62.7 Male life expectancyc - - - - 59.9 60.6 61.2 Total fertility rated - - - - 6.8 6.3 5.8 Determinants Income per capita' - - - - 1,603 1,592 1,818 Female education (years)f - - -- - - Male education (years)f - - - _ _ _ _ - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 105 Figure A. 11 Solomon Islands: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 2.0 60% 1.6 1.5 1.4 1.4 40% .~20% 0 .5 0% II I I 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% 6.0 10% d 0% - 4.0 .>-20% I -6% o > 2.0 - - 1.4 11 -30%-0% ; _400% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% -- 6.0 - 4 10% 115%11 0% - 4.0- 3.6 3.4 -10%--%. -30% O./ot l 1+ -40% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 106 Measuring Country Performance on Health Table A.12 Taiwan, China: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ - - - - - - Female adult mortality rateb - _ - - _ 95 91 Male adult mortality rateb - - - - _ 143 144 Female life expectancyc 68.6 70.2 72.6 74.2 75.2 76.0 77.2 Male life expectancyc 63.3 64.7 67.7 69.2 71.5 72.0 72.8 Total fertility rated 5.7 4.8 3.8 3.0 2.6 2.2 1.9 Determinants Income per capitae 1,189 1,455 1,955 2,795 3,908 4,976 7,090 Female education (years)f 2.8 3.2 3.9 5.3 6.1 6.4 6.9 Male education (years)f 4.9 5.9 6.6 7.4 9.0 8.8 9.0 - Not available. a. Under-five mortality rate: the probabilty of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant intemational dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 107 Figure A. 12 Taiwan, China: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% - 0.0 10% C -0.5 -0.4 g -1.0 O 0% k I I I I z -1.1 -1.2 -1.5 n. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-1.5 -10% ~ < 2 -1.6 -1.7 -20% -2.5 1960 1965 1970 1975 19B0 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 20.0 18.3 17.3 16.9 58% 15.5 60% 1. 15.0 13.6 11.7 5 ~~~~~~~~~~~40% 10.2 ° 40% 10.0 U 20%~ | | | a 5.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% 20.0 8 60% 54% 15.9 14.8 15.3 14.3 14.0 6 15.0 12.0 ~ 40% _ , _ _ _ __310.6 a. 0 Q10.0 C 20% ~ 5.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 108 Measuring Country Performance on Health Table A.13 Thailand: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 148 122 102 85 58 44 41 Female adult mortality rateb 313 282 259 246 210 158 123 Male adult mortality rateb 395 356 327 312 280 239 207 Female life expectancyc 56.1 58.9 61.6 63.2 67.4 70.2 71.8 Male life expectancyc 51.9 54.6 57.7 59.3 62.6 64.9 66.3 Total fertility rated 6.4 6.3 5.6 4.6 3.6 2.8 2.3 Determinants Income per capitae 820 1,045 1,349 1,594 2,009 2,346 3,002 Female education (years)f 3.6 3.1 3.5 3.5 4.0 4.9 5.3 Male education (years)f 5.0 4.5 4.7 4.5 4.8 5.5 5.9 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex A 109 Figure A.13 Thailand: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60% - 1.0 51% 49% 2 0.2 0.2 o 3%i 30.0 = 40%-- 36% 8 0 -0.138 31% G -1.0 -0.7 X 20°% - - 1 . 5 | | 19% 1.3 20% - llR - lll - - * -2.0 -1.7 0% -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40%0- 35% 10.0- 8.0 8.3 8.3 8.0 7.2 7.1 7.1 26% 6.4 c 6.0 ° 20%- | * z z i z | |.4.0 >~ ~ 8 10% l 1 l N 8% ~ %8% 7% _ a 8% - | _ 5% / 2.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% 10.0 8.0 7.0 6.9 6.9 26 5.9 5.8 6.5 6.1 20% 020% 6.0 196021650197 1975 980 195 19901960 165 197 1975 980 195 199 10%> o 6% 7% 8% 7% I ~~~~~~~~~~~~~~~2.0 0%0/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 110 Measuring Coantry Performance on Health Table A. 14 Vanuatu: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Ulnder-five mortality rate' - - - - - - Female adult mortality rateb - - - - 243 241 Male adult mortality rateb - - - - - 287 288 Female life expectancyc - - - - 53.7 59.1 64.0 Male life expectancyc - - - - 56.2 59.1 61.5 Total fertility rated - - - - - 6.1 5.3 Determinants Income per capitae - - - - - 1,774 1,679 Female education (years)f - - - - - - Male education (years)f - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. AnnexA 111 Figure A.14 Vanuatu: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60% 2.0 -1 40% - - o ': ~~~~~~~~~~~~~~~~~1.0 - 0.8 , 20% l l l l l 0% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy U 40% - 4.0- -E 1 | 2.0- | 2 a 0 -15% -2.0 , 20 0%t/ I I I I I 0.0 16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 10% T- 6.0 1 ~~~~~~~~3% T3.9 4.0 2.0~ ~ ~ ~~~~~~~~~. 010 -2.0 -20% l7- l 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 112 Measuring Country Performnance on Health Table A.15 Western Samoa: Trends in Selected Health indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - ----- Female adult mortality rateb - - - ---202 Male adult mortality rateb - - - - - - 262 Female life expectanicyc - - - 64.3 64.0 66.0 70.0 Male life expectancyc - - - 61.0 62.0 63.0 66.0 Total fertility rated - - 6.7 - - 5.3 4.8 Determinants Income per capital - - - 1,943 1,671 1,977 Female education (years)f - ------ Male education (years)f - ------ - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching sge 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the Lime of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and mnale populations aged 15 to 60. Annex A 113 Figure A. 15 Western Samoa: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60% 1.0- F U 40% - ; 0.5 - 0.5 0.4 12~~~~~~~~~~~~~~~~~~~~I ~-20%0 0% I I I I I 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 10% 10.0 -8 8.1 8.0 -7 Q 5% 6.0 5.1 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~4.7 o 4.0 > 2.0 -2% -5% 0.0 I 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 10% 10.0 7.9 8.0 40/ ~~~~~~~~~~~~~~~6.5 5% ,05.9 EF 6.0 0. 0 ~~~~~~~~~~~~~~~~~~4.0 (0 0 2.0 -5% ~~~~~~~~~~~~~~~~~~0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex B Europe and Central Asia: Regional and Country-Specific Indicators of Performance on Health This annex provides information, for seven countries in the Europe and Central Asia region, on performance rel- ative to income for six health indicators. For each country, the annex includes a figure with panels displaying val- ues of the six indicators over the period from 1960 through 1990. Panel A: Under-Five Mortality Rate Panel B: Female Adult Mortality Rate Panel C: Male Adult Mortality Rate Panel D: Total Fertility Rate Panel E: Female Life Expectancy Panel F: Male Life Expectancy In addition, each country profile includes a table with the values at five-year intervals for each health indicator, for per capita GDP (in 1985 international dollars adjusted for purchasing power), and for the average years of edu- cation for males and females aged 15 years and over. l Two regional profiles are presented before the country profiles. One shows regional performance relative to income for the six indicators; it is directly analogous to the country profiles. The second shows regional perfor- mance relative to education as well as income levels. This gives a sense of the extent to which performance on health relative to income results from educational differences. Also preceding the country profiles is a figure show- ing "health performance diamonds" that depicts the overall performance of each country in the region in 1990. The main text discusses the methods used and provides tabular summaries of results, including country-spe- cific results on performance that control for education as well as income. 115 Contents Regional Performance over Time (Figures B and BB) 117, 118 Country-Specific Health Performance Diamonds, 1990 (Figure BBB) 119 Country-Specific Performance 1. Bulgaria 122 2. Hungary 124 3. Poland 126 4. Romania 128 5. Turkey 130 6. U.S.S.R., the former 132 7. Yugoslavia, the former 134 116 Annex B 117 Figure B Europe and Central Asia Region: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 100% 0.0 X ˘~~~~~~~~~~~~~~~~~~~~~~~~~~~ -1.0- 0I 1 54% 55% -1.2 5050%1 50% l50% 39% Rc -2.0- i i i 3 -1.9 -1.8 30% 4) l 0 | ll ll1 1|l lgi24% -2.4 9 -3.0 -2.6 -2.7 0% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 150% T 25.0 - 20.0 + 100% 8 100% t 118 91% 89% 14.5 14.2 14.1 c I llg gg ER 80% m 15.0 12.2 c | | | | | 66% U | | R | 10.6 02 52% 1009.1 | | | | | | C ~~~~~~~~~~10.0 t ll8.1 50% t 37% * 44 4) *a 504 * 4) 0 ~~~~~~~~~~~~~~~~~~~5.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 150% - 25.0 20.0 8 100% 90% 0 | | 78% 'v 15.0 13.3 12.5 o5 I S l| l l l 65% 11.6 0 ~~~~~~~~56% 9.7 4) 5 i~~~~~~~~~~~~~~~~~o.o a 50% 38% 18 6.6 23% .~~~~~~~~~~~~~~~~~~ ~~5.3 10% 0 ~~~5.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 118 Measuring Country Performance on Health Figure BB Europe and Central Asia Region: Performance Relative to Income and Education Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 0.0 -0.2 E ~~~~~~~~~~~-0.3 c -0.5 -0.5 o -21% ~~~~~~~~~~~~-2o 0 _ -0.8 v~ ~~~~~- 1no -/ I 91.9l03 &> | | | 1 | 31~~~-2 % C1-0 || 9 -26% I24% -1 0 -0.9 -33% -1.2 4, ~ ~ ~ ~ ~ -4 -50% ~~~~~~~~~~~~~~~~-2.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 100%/ 5.0 68% 4, ~~54% , I 8 46% 52.5 23 2.4 50% 43 1 31% 0 1.6 4) 4, ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~1.3 I | i | 11 22tK u 0 | | |0 1s 4-60 9 9 8 9 lo6 6 7 9 0 996% 0% I 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 100% 5.0 3.4 59% 47% ~ ~~~~~~~~52.4 2. 0 0/ 3% 32% .214 1.6 1.7 0~~~~~~~~~~~~~~~. 10% 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 19835 1990 Annex B 119 Figure BBB Europe and Central Asia Region: Country-Specific Health Performance Diamonds, 1990 Bulgaria Hungary q5 q5 q45m q45f q45n q45f (q5 value is missing) tfr tr Poland Romania q5 qs q45f~~~45 q5 q45m q 45r 55 tfr tfr Turkey U.S.S.R., the former q5 q5 q45m q45m X145f (insuffic:ent data) tfr tfr (Figure continues on the next poge.) 120 Measuring Country Performance on Health Figure BBB (continued) Yugoslavia, the former q5 q45m Nq4if (q5 value is missing) tft Note: q5 = under-five mortality rate; tfr = total fertility rate; q45f = female adult mortality rate; q45m = male adult mortality rate. Each axis of the performance diamond is scaled so that the midpoint of the distance between the origin and the tip of the relevant axis corresponds to per- formance equal to what would be predicted by income. Values better than would be predicted are plotted between the midpoint and the tip at a distance proportional to the country's performance on the indicator relative to the performance of the best-performing country on the indicator. Likewise, values poorer than would be predicted are plotted between the midpoint and the origin. The diamond connecting midpoints of the axes depicts, then, expected performance. The shaded diamond depicts the country's performance. When the shaded area lies inside the expected performance box, country perfor- mance is poor; when outside, performance is good. 122 Measuring Country Performance on Health Table B.1 Bulgaria: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - _ _ Female adult mortality rateb 126 116 106 105 106 107 107 Male adult mortality rateb 174 169 172 183 190 202 211 Female life expectancyc 71.7 73.1 73.9 74.1 74,4 74.7 74.4 Male life expectancyc 68.1 68.7 68.7 68.7 68.5 68.4 67.6 Total fertility rated 2.3 2.1 2.2 2.2 2.1 2.0 1.7 Determinants Income per capitae - - - - 3,926 4,472 6,333 Female education (years)f 5.4 5.7 5.9 6.3 6.8 7.2 9.0 Male education (years)f 7.0 7.1 7.4 7.7 7.9 8.4 9.4 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjuisted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 50. Annex B 123 Figure B. 1 Bulgaria: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 0- 0.0 8 10%-E EC U -1.0 ook -~~~~~~~~~~~~~~~~~~C C) ~~~~~~~~~~~~-1.4 0 -2.0 -1.9 a -10% c-.0 -2.3 -20% - -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80oo - 12.8 65% 12.0 - 10.7 60% C) ~~~~~~~49% 7.8 2 40% | 13 < 8.0 28% 2 20% > 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80%/ 12.0 11 0 60% C ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~8.7 8 39% . ,2 40% > . . *22% C CC 20% I4.0 0% ~~~~~~~~~~~~~~~~~0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 124 Measuring Country Performance on Health Table B.2 Hungary: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' 53 46 40 31 24 19 16 Female adult mortality rateb 120 112 106 104 116 114 118 Male adult mortality rateb 174 177 184 197 238 253 275 Female life expectancyc 71.3 72.3 72.9 - 73.5 73.8 73.8 Male life expectancyc 66.8 67.0 67.0 - 65.8 66.0 65.0 Total fertility rated 2.0 1.8 2.0 2.4 1.9 1.8 1.8 Determinants Income per capitae - - 3,358 4,006 4,891 5,194 5,515 Female education (years)f 6.3 6.9 8.5 8.4 8.7 8.6 8.5 Male education (years)f 7.0 7.4 7.7 7.6 9.5 9.3 9.4 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be horn to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex B 125 Figure B.2 Hungary: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 120% 100% 0.0 95% 96% 87% 80 U 7A0/ l | l | | |-2.0 -1.0 5 80%/ -1.4 .-2.0 -. -o~ ~ ~ ~ ~~~~~~~-. a 40% 0 -2.2 -2.2 >'3 l l | | -3.0 9 -2.9 0% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 100% % 7%80° 16.0 15.3 U 60% 52% 12011.2 O ~~~~~~~~~~~~39% 9.3 1Z~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~3 40% ~~~~~~~~~~~22%k 7.8 .0 8 -- - 20% 0 -40°0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 19B5 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 100%T 80% 16.0 I I ~~~~~~~~~~~~~~~~~~~~~12.9 6 20% 49 0 E -40% 0 m 39° 12.0 100% 80% 16.0~~~~~3%7. 200k r- 1/ 8.0 .2 5.9~~~~2. 60% 493 c '212~~~~~~~~~-4 .0 420% 240% 0 5. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 126 Measuring Country Performance on Health Table B.3 Poland: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Uinder-five mortality ratea - - 36 29 24 21 18 Female adult mortality rateb 115 106 98 96 96 97 97 Male adult mortality rateb 177 180 194 212 223 232 241 Female life expectancy' 71.0 73.0 74.1 75.0 75.1 75.2 75.2 Male life expectancy' 65.8 66.9 67.0 67.0 66.7 66.8 66.0 Total fertility rated 3.0 2.5 2.2 2.2 2.3 2.3 2.1 Determinants Income per capitae - - 2,941 3,832 4,865 3,914 4,319 Female education (years)' 6.6 6.7 7.6 7.8 8.5 8.5 9.3 Male education (years)f 7.5 7.6 8.2 8.5 9.1 9.1 9.7 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex B 127 Figure B.3 Poland: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 160% 00 120%o 111% 109% -24 4) ~~~~~96% 94% 80% -2.0 -. _ 40% -3.0 -2.8 0% - -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20.0 16.9 100% 90% 83% 15.3 't 60% 1 | g 71% 62% 15.0 12.8 6) 49) C >, ~~~~~~~~~~~~~~~~~~10.0 - 20% 5.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20.0 100% 8) i15.0 13.3 E 60% 46% 32% 10.0 8.6 C. ~~~~~~~~~19% 5o 5 20% 10% C: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~" ~~~~~~5.0 0. -20% 1 -3% 0. 1 19 17 1 1 1 1990 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 128 Measuring Country Performance on Health Table B.4 Romania: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 84 68 56 46 39 34 31 Female adult mortality rateb 115 138 109 119 120 118 119 Male adult mortality rateb 156 195 160 183 200 215 216 Female life expectancyc 68.7 70.6 71.3 72.2 72.5 72.3 73.0 Male life expectancyc 65.0 66.4 66.8 67.5 66.9 66.3 67.0 Total fertility rated 2.3 1.9 2.9 2.6 2.4 2.3 1.8 Determinants Income per capitae 431 514 703 1,032 1,451 1,699 2,040 Female education (years)f 5.2 5.3 5.4 5.7 5.9 6.1 8.9 Male education (years)f 6.7 6.9 7.1 9.8 9.8 9.7 10.0 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specihc levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex B 129 Figure B.4 Romania: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 160% 0 0 -1.0 1 112% 118% 2 117% 8 120% 10615%2. 2 . 91% | xe I 19.0% -2. 80% 1965 1995 8090 300-- 140% 4O1 ,% 90%219.-6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 30.0- 118% 120% --105% 22.2 21.2 850k ~~~~~~~~20.0 - 90 1. ~, 80% 7%12 o >~~~~~~~~~~~~ to~~~~~~1.0 - ~u 40%c U 0% 0 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 30.0- 120% -110% 21.4 90% 19.9 80% 6%15.5 "S ~~~~~~~~~12.2 9.1 8.8 40% . 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 130 Measuring Country Performance on Health Table B.5 Turkey: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 219 211 201 171 133 105 70 Female adult mortality rateb 108 105 99 93 98 111 118 Male adult mortality rateb 182 169 155 150 153 159 165 Female life expectancy' 53.7 56.5 60.0 62.5 64.6 66.4 69.6 Male life expectancyc 50.5 53.4 55.9 58 0 60.0 62.2 65.0 Total fertility rated 6.3 5.9 5.3 4.8 4.3 3.9 3.6 Determinants Income per capitae 1,635 1,748 2,096 2,560 3,000 2,947 3,462 Female education (years)f 1.1 1.3 1.7 1.9 2.3 2.7 3.1 Male educatuon (years)1 2.7 3.2 3.3 3.4 4.1 4.2 4.5 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between ag,e 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a wornan if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1 985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex B 131 Figure B.5 Turkey: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate E0% 1.0Tali -20% L0 4 0.4 80T~~~~~. > -40%- 34% 0 02.0 -52%/ -52% -51% -0.3 -0.3 -80%- -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female life Expectancy 8.0 T 120% t 9 1280% 104% % 7596% 63% m .0 5 5 C ~~~~~~~~~~~78%42 Cs ~~~ ~~~4.0 4.2 3.8 80% C ° %-- 2.9 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 197519801985 19902.2 Cs ~~~~~~~~~~~~~~3 5 /o Cs 40% 5 2.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 6.0 120% - 6.0 . 80% --3 73 75 73% 65% Co ~~~~~~~~~~~~~~~~~~3.6 Cs~~~~~~~~~~~~~~3 Cs40 -- 293.3 3.4 3.3 Cs ~~~~~~~~~~~~~~40%/ > 40%1. Cs Cs ~~~~~~~~~~~~~~~~~~2.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 132 Measuring Country Performance on Health Table B.6 U.S.S.R., the former: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 39 33 29 30 31 30 27 Female adult mortality rateb _ - - - - - - Male adult mortality rateb - - - - Female life expectancyc 72.0 73.0 74.0 73.0 73.0 74.0 74.0 Male life expectancyc 65.0 65.0 64.0 63.0 63.0 65.0 63.0 Total fertility rated 2.7 2.5 2.4 2.4 2.4 2.5 2.2 Determinants Income per capitae 2,397 2,756 3,665 4,733 5,808 6,706 7,453 Female education (years)' 7.6 8.2 8.8 9.0 9.0 9.3 10.3 Male education (years)f 8.5 8.9 9.6 9.6 9.6 9.9 10.8 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born Lo a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex B 133 Figure B.6 U.S.S.R., the former: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0.0 150% -4.0 125% 3%124% 25.0 -0.8 10% 97% .0 100% 62% - -2.0 -1.6 0-2.0 2 50% 2%F-2.4 2c 1-3.0 2% ~~~~-3.1 -3.0 0% - -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 10% 25.0 20.0 19.0 17.8 16.0 615.0 12.5 C 10.1 B. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ io~~~~~~1.0 8.7 4) 4) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~6.8 -o 0~~~~~~~~~~~~~~~~~~~C 5.0 -10% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male AdUlt Mortality Rate Panel F: Male Life Expectancy 10% --25.0 20.0 14.8 9 ~~~~~~~~~~~~~~~~~~~~50 12.9 .9 0%I I696 C- ~~~~~~~~~~~~~~~~~~~~~~ 10.0 - 4) 4) ~~~~~~~~~~~~~~~~~~~~~~~~~~6.5 4.4 4.2 4) ~~~~~~~~~~~~~~~~~~~~5.0 0.6 -10% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 134 Measuring Country Performance on Health Table B.7 Yugoslavia, the former: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' - - - - - - Female adult mortality rateb 148 128 121 110 106 104 101 Male adult mortality rateb 172 165 166 160 164 168 168 Female life expectancyc 65.7 68.6 70.6 72.5 72.6 73.7 74.5 Male life expectancyc 63.3 65.2 66.8 68.1 67.7 68.8 69.5 Total fertility rated 2.7 2.5 2.4 2.4 2.3 2.3 2.2 Determinants Income per capitae 1,921 2,220 2,879 3,925 5,141 5,366 5,004 Female education (years)f 3.5 4.5 4.9 5.0 5.6 5.9 6.2 Male education (years)f 5.0 6.0 6.8 6.9 7.6 7.8 8.0 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons i:aching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex B 135 Figure B.7 Yugoslavia, the former: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 0.0 10%-_ 0% F-1.0- l S ll l 0 -_1.4-1.1 Ui. , , | , , , , -2.0 -1.8 - n l E . l l l l -2.2 -10% - - -3.0- -2.6 .3 > _3 3-3.1 -20% - -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 100% T 20.0 - 8/0% t71% 70% 68% 16.0 14.2 13.5 700/b 68% 60% 13.6 12.7 g 60% t 12.0 10.1 e 1 1 1 1 1 1 0 4047% 9.1 8.9 40% 40% 8.0 .5 20% 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 100% T 20.0 80% 76% 71% 16.0 14.0 13.9 13 12 60% 49% ,c- 12.08. 84 tS | E | S tR I | g 9 4 ~~~~~~~~~~~~~~~~~~~~~~8.6 8.4 37% 40% t .2 8.0 20% 0a 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex C Latin America and the Caribbean Regional and Country-Specific Indicators of Performance on Health This annex provides information, for 28 countries in the Latin America and the Caribbean region, on performance relative to income for six health indicators. For each country, the annex includes a figure with panels displaying values of the six indicators over the period from 1960 through 1990. Panel A: Under-Five Mortality Rate Panel B: Female Adult Mortality Rate Panel C: Male Adult Mortality Rate Panel D: Total Fertility Rate Panel E: Female Life Expectancy Panel F: Male Life Expectancy In addition, each country profile includes a table with the values at five-year intervals for each health indicator, for per capita GDP (in 1985 international dollars adjusted for purchasing power), and for the average years of edu- cation for males and females aged 15 years and over. Two regional profiles are presented before the country profiles. One shows regional performance relative to income for the six indicators; it is directly analogous to the country profiles. The second shows regional perfor- mance relative to education as well as income levels. This gives a sense of the extent to which performance on health relative to income results from educational differences. Also preceding the country profiles is a figure show- ing "health performance diamonds" that depicts the overall performance of each country in the region in 1990. The main text discusses the methods used and provides tabular summaries of results, including country-spe- cific results on performance that control for education as well as income. 137 Contents Regional Performance over Time (Figures C and CC) 139, 140 Country-Specific Health Performance Diamonds, 1990 (Figure CCC) 141 Country-Specific Performance 1. Argentina 146 2. Bahamas, The 148 3. Barbados 150 4. Belize 152 5. Bolivia 154 6. Brazil 156 7. Chile 158 8. Colombia 160 9. Costa Rica 162 10. Dominica 164 11. Domincan Republic 166 12. Ecuador 168 13. El Salvador 170 14. Guyana 172 15. Haiti 174 16. Honduras 176 17. Jamaica 178 18. Mexico 180 19. Nicaragua 182 20. Panama 184 21. Paraguay 186 22. Peru 188 23. Puerto Rico 190 24. St. Kitts and Nevis 192 25. Suriname 194 26. Trinidad and Tobago 196 27. Uruguay 198 28. Venezuela 200 138 Annex C 139 Figure C Latin America and the Caribbean Region: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 50% 1.0 - C 8 Cd = BX ~~~~~~~~~~~~~~~~~~~~0.1 0.2 0.2 o 0.0 9 %212% -0.3 & & 4 /° 2% 1% 1% 2% o S -0.4 -0.4 0 0/_ CM _ 0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% -- 10.0 8.4 7.6 7.6 7.6 7.7 7.6 7 oC 27% 27% 27% 29% 31% 31% 31% C- '-' ~~~~~~~~~~~~~~~~~~~5.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50o 10.0 7.1 6.7 6.7 6.6 6.4 6.1 6.4 21% 21% 21% 2 2%2% 19% 2 2%/ 5.0 0% - 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 140 Measuring Country Performance on Health Figure CC Latin America and the Caribbean Region: Performance Relative to Income and Education Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 500/o 1 0- Ł 05 06 05 o8 -% -909%-1. 8 0 ., -50 8% - 9 -1.o -9 8 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% - 0o-0 = ~~~ ~ ~~~~~~~~~~~21% <; 5.0 -4.6 z 13% ~~15 % 14% 14% 1%1 |1 2.8 2.9 2.9 3-1 36 0 3 - . -0% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel : FMale Adult Mortality Rate Panel F: Male Life Expectancy 50% 10.0 4.8 ao 18% 501 33 3 6 34 34 3.6 12 % 13% 13% 12% 2.6 2.8 2.9 2.9 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex C 141 Figure CCC Latin American and the Caribbean Region: Country-Specific Health Performance Diamonds, 1990 Argentina 5 The Bahamas 5 q45m q45f q45m q45f (q5 value is missing) Barbados q5 Belize q5 q45m q45f q45m q45f (q5 value is missing) (q5 value is missing) tir tfr Bolivia q5 Brazil q5 q45m q45f q45m q45f tfr tfr (Figure continues on the next page.) 142 Measuring Couantry Performance on Health Figure CCC (continued) Chile Colombia q5 q5 c1451n +q45f q45m q45f tfr tfr Costa Rica Dominica q5 q5 q45m q45f q45m - \ . q45f tfr (insufficient data) tfr Dominican Rep. Ecuador q5 q5 q45m q45f q45m "I 5 f (q5 value is missing) tfr tfr Annex C 143 Figure CCC (continued) El Salvador Guyana q5 q5 q45m q45f q45m q45f lit~~~~~~~~ tfr (q5 value is missing) tfr Haiti Honduras q5 q q45m - q45f q45m q45f tfr tfr Jamaica q5 Mexico q5 q45m -q45f q45m q4 (q5 value is missing) tfr tfr (Figure continues on the next page.) 144 Measuring Country Performance on Health Figure CCC (continued) Nicaragua Panama q5- q5 q45m q45f q45m q45f tfr tfr Paraguay Peru q5 q45m q45f 45m q45f tfr tfr Puerto Rico St. Kitts and Nevis q5 q5 q45m q4f q45f tic (q5 value is missing) tfr ~~~~~~~~~~~~~~~~~~~~~~~tfr Annex C 145 Figure CCC (continued) Suriname Trinidad and Tobago qS qS q45m q45f q4in q45f (q5 value is missing) tr tfr Uruguay q5 Venezuela q5 q45m qc45 q45m $ q45f tfr tfr Note: q5 = under-five mortality rate; fr = total fertility rate; q45f = female adult mortality rate; q45m = male adult mortality rate. Each axis of the performance diamond is scaled so that the midpoint of the distance betxveen the origin and the tip of the relevant axis corresponds to per- formance equal to what would be predicted by income. Values better than would be predicted are plotted between the midpoint and the tip at a distance proportional to the country's performance on the indicator relative to the performance of the best-performing country on the indicator. Likewise, values poorer than would be predicted are plotted between the midpoint and the origin. The diamond connecting midpoints of the axes depicts, then, expected performance. The shaded diamond depicts the country's performance. When the shaded area lies inside the expected performance box, country perfor- mance is poor; when outside, perfornance is good. 146 Measuring Country Performance on Health Table C.1 Argentina: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 72 66 71 53 38 29 28 Female adult mortalitv rateb 136 122 116 110 102 95 90 Male adult mortality rateb 217 212 212 211 205 197 188 Female life expectancy' 68.6 69.3 70.8 72.2 73.7 74.6 75.7 Male life expectancy' 62.5 62.8 64.1 65.4 66.8 67.6 68.6 Total fertility rated 3.1 3.1 3.1 3.3 3.3 3.1 2.9 Determinants Income per capitae 4,353 4,664 5,256 5,955 6,129 5,642 5,261 Female education (years)f 5.1 5.3 6.1 6.3 7.1 7.2 8.2 Male education (years); 5.4 5.6 6.4 6.3 7.0 7.0 8.1 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 147 Figure C.1 Argentina: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 600/o% 0.0 41% 42% 40%16.0 80% ~~~~~~~~~9 40/ 16.0 -0. 40% -. 0 60%- m 12.0 a- Ch-°a! g||| ' 20% a 30 0% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 16.0 - 67% 67% 63 / 13.1 6% 61% 60%k1.1 1. 8 60% ~ ~ ~~~~~~~~5%12.0 - 0g 1. z 8. 20 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% 16.0 8 60% 12.0 40% 40% 28% 26% 24% 20% 18% 8.0 9.8 ~~~~~~~~8.8 8.5 8.2 8.0 28% .~~~~~~~~~0 ~~ 20% - 4.020 18 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 148 Measuring Country Performance on Health Table C.2 The Bahamas: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - - - - Female adult mortality rateb 202 170 164 141 118 88 70 Male adult mortality rateb 274 274 274 270 254 220 186 Female life expectancy' 67.3 68.6 69.9 71.2 73.6 76.8 77.9 Male life expectancyc 61.0 62.9 63.2 63.5 65.7 67.2 68.7 Total fertility rated 3.7 3.6 3.5 3.4 3.3 2.8 2.2 Determinants Income per capitae - - - - 9,729 11,056 12,550 Female education (years)' - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age Five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 149 Figure C.2 The Bahamas: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 0.0 E 0m -0.3 -0.3 o2 0% I I I I I I | -0.5 -0.4 -20% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 12.0 9.8 60% 46% 50% 8.9 8.4 8.0 40% 36% 20% ~~~ 20% .s~~~~~~~~~~~~~~ 4.0 60% -2 0% >/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectanicy 80%/ 12.0 60% 0~~~~~~~~~~~~~~~~~~~~~~. 40% 5.6 U 0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. 0- 20% s.o 4. 2% ~~~~~ 4.0 to 0 -40% -3% -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 150 Measuring Country Performance on Health Table C.3 Barbados: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ - - - - - - Female adult mortality rateb 130 127 121 109 98 90 82 Male adult mortality rateb 187 188 193 183 167 151 140 Female life expectancyr 68.3 70.1 72.0 73.9 75.5 76.9 77.9 Male life expectancy' 63.5 65.2 56.9 68.7 70.5 71.9 72.9 Total fertility rated 4.5 3.9 3.1 2.5 2.1 1.9 1.8 Determinants Income per capita' 2,666 3,000 3,981 5,086 5,912 6,130 7,250 Female education (years)f 5.1 5.3 9.8 9.8 6.8 7.5 7.8 Male education (years)f 5.9 5.8 9.6 9.6 6.7 7.4 8.0 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 151 Figure C.3 Barbados: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 30.0 10%/ 16.0- 49 1. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: FMale Adult Mortality Rate Panel E: FMale Life Expectancy o9% 16.0 -- 80%/ 12.9 13723.82. 1 6200% 50%I I 40% 209/o 4~~~~~~~~~~~-.0 20% -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel F: Fmale Life Expectancy 100% 79% ~~~~~~~~~~~~~~~~16.0 149 4. 80% 1291211%2 1.01. 62% 12.0 - 13 1. 60% 53 8.0 E 40% -~20% ' . 0% --0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 152 Measuring Country Performance on Health Table C.4 Belize: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - _ _ _ Female adult mortality rateb - - - - _ 150 123 Male adult mortality rateb - - - - - 205 194 Female life expectancyc - - - - 67.1 69.0 71.7 Male life expectancyc - - - - 63.3 64.6 65.8 Total fertility rated - - 6.9 - 5.8 5.3 4.8 Determinants Income per capita' - - - - 3,943 3,187 3,211 Female education (years)f - - - - Male education (years)f - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probabilty of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the samiie throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 153 Figure C.4 Belize: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 2.0 S ~~~~~~~~~~~1.5 10% 3 u S S 11 1.0 0% I 1.0 E. -10% -20% 0.0I 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% 12.0 - 40% %33% 7.9 30% 2 8.0 6.1 23% 5.5 L20%/ .5 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50% 12.0 T 40%o Uc | 8.0 30% 26% 25% O/o 5.8 5.8 6.2 20 +0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 154 Measuring Country Performance on Health Table C.5 Bolivia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 255 251 243 206 171 148 124 Female adult mortality rateb 355 328 306 286 273 261 250 Male adult mortality rateh 483 451 421 387 357 328 307 Female life expectancyc 45.6 47.3 49.0 52.2 55.6 58.6 61.0 Male life expectancy' 41.4 42.9 44.6 48.0 51.9 55.1 57.7 Total fertility rated 6.7 6.6 6.5 6.2 5.6 5.2 4.9 Determinants Income per capita' 1,138 1,251 1,517 1,771 1,995 1,845 1,667 Female education (years)f 4.3 4.0 3.8 3.8 3.8 4.0 4.2 Male education (years)f 6.4 6.0 5.7 5.8 5.5 5.5 5.6 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education; the average years of education in the female and male populations aged 15 to 60. Annex C 155 Figure C.5 Bolivia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 -20% 8 u~~~~~~~~~~~~~~~~~ -40%0/ -35% (00 0.9 0.9 P -40% 15 5 F o | |-44% 1.0 -- ; -60% 53% 0.6 0.6 . oI55% 55% -570/ -506 . 0.6 -80% 59,0 P ~~~~~~~~~~~~~~~~~~~~~~~~~~0.4 0.4 U -80%~ .> | | | | | | | | -100% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0%0/ 2.0 - 0.0 -10%02 -9% -lo%' -2.0 ] -12% -12% -2.6 0) -160 a -4.0 -2 00/. - - .2 ~~~~~~~~~~~~~~~~~~-3.7 t -20% -19% -18% 0)-6.0 -5.1 -. a g a 1 ~~~~~~~~~~~~~~~~~~~~-5.9 -30% -8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 2.0 0.0 0 ti | | | l_S1%-8% <-2.0 ; | m m S ~~-14% U jj j j j- 2 | S B E -16% _ -4 0 t E E E -3.7.0 -20% -19% -20% 0- ~~~~~~~~~~~~~~~~~~~-5.8 -, -6.5 -30% -8.0 -7.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 156 Measuring Country Performance on Health Table C.6 Brazil: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 177 159 135 111 86 81 - Female adult mortality rateb 222 206 186 171 161 149 135 Male adult mortality rateb 295 272 248 233 221 207 193 Female life expectancyc 57.8 59.9 62.2 64.3 66.6 68.5 70.1 Male life expectancyc 54.0 55.9 57.6 59.5 60.2 61.4 62.3 Total fertility rated 6.2 5.7 5.0 4.5 3.9 3.4 3.0 Determinants Income per capita' 1,660 1,891 2,139 3,151 3,982 3,914 4,226 Female education (years)f 3.1 3.2 3.2 2.9 3.1 3.3 3.7 Male education (years)f 2.6 2.8 3.5 3.1 3.2 3.4 3.9 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 157 Figure C.6 Brazil: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 1.0 0 0.5 -20% -13%-13% -17% E -22% *0 ;-40%- E =~~~~~~~~~~~~~~~~- 0.0-_ g .t -40%-41% -0.5 -0.3 _004 A a -0.5 A) -60% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 8.0 T 32% 32% 32 30% 2 8 6.2 6.0 6.2 28%0 1965 1970 1975 1980 185 1990 1960 19656.0 5.2 5.0 4.9 5.2 19%5 20% °4.0 CA 'l 1 4 4 | | * - | | | 2.72.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% --8.0 24% ~27% 26% 6.0 5.3 5.1 49 24%23 22% 4.3 20% ~2 20% 4.0 CA.- ~~~~~~~~2.7 A) 9 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~2.0 1.8 0% 0.0 1960 1965 1970 1975 1980 1985 i99o 1960 1965 1970 1975 1980 1985 1990 158 Measuring Country Performance on Health Table C.7 Chile: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 155 121 97 67 37 24 19 Female adult mortality rateb 158 151 146 130 109 95 85 Male adult mortality rateb 238 229 232 229 218 193 175 Female life expectancyc 60.9 63.8 66.8 70.6 74.2 75.9 77.4 Male life expectancyc 55.3 57.6 60.5 63.9 67.4 69.6 71.5 Total fertility rated 5.3 4.9 4.0 3.3 2.9 2.8 2.6 Determinants Income per capita' 2,738 3,133 3,505 3,579 3,431 3,524 4,008 Female education (years)f 5.1 4.9 5.5 5.6 6.3 6.4 6.7 Male education (years)f 5.4 5.3 5.8 5.8 6.4 6.6 6.8 a. Under-five mortality rate: the probability of dying between bi-th and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infar.t would live if the prevailing age-specific levels of mortal.ty at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 159 Figure C.7 Chile: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0.0 100% - 6 A 18% a -1.6~~~~78 0~~~~_. -50% -2. 80% - -~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~E 16.0 - 0. 0% -1 -1.4 0) %-1.6 -50% - -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 8% Panel B: Female Adult Mortality Rate 160Panel E: Female Life Expectancy 65%k 67% 6% 13.1 12.7 12.7 60% ~ 5% 3%12.0 1. 0) ~~~~~~~~~~~~~~~~~~~~~~~~~9.0 4o0/ -, .i5 20% . . 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% --16.0 60% 12.0 10.3 10.5 1. E ~~38% - 40% -- 33% . 0~~~~~~~~~0 26%/ 26% 27% 31% a. 20% > 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 160 Measuring Country Performance on Health Table C.8 Colombia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate, 122 127 113 91 58 36 19 Female adult mortality rateb 237 218 209 196 162 136 127 Male adult mortality rateb 298 273 262 255 237 225 222 Female life expectancyc 59.7 61.8 63.4 66.3 69.9 71.1 72.3 Male life expectancyc 56.2 58.3 59.9 61.8 64.6 65.5 66.4 Total fertility rated 6.8 6.5 5.5 4.4 3.8 3.4 3.1 Determinants Income per capitae 1,663 1,781 1,987 2,405 2,772 2,949 3,206 Female education (years) 3.1 2.8 2.9 4.2 4.5 4.9 5.1 Male education (years)f 3.4 3.3 3.2 4.5 4.3 4.3 4.3 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. I Fducation: the average years of education in the female and male populations aged 15 to 60. Annex C 161 Figure C.8 Colombia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 120% - 2.0 92% C % 1.0 0.8 0.8 cC 0-805 0.1 0.0 40%--4 5% ,;''0| | g g 24%iolliOl4% E X L a l° -0.6 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 50/ Panel B: Female Adult Mortality Rate 120Panel E: Female Life Expectancy 40% --35% 8.1 8.2 8.2 . 8.5 8.5 U 0% 24Yo25% 4 30% 30% 8.0 -0. -. -0.6 3 20% 11% 26t -0.8 20%~~~~~~~~~~ 0> -2| | | | | ° 4.0- | | | | R l l R R 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50% 12.0 T 2O 926% 2965%1970 1975 1980 1985 1990 80 60 8.19 8.2 0 8275 198.1985 8.50 C- ~ ~ ~ ~ ~~~~~~~~~~~~~~~80 30%o 0.023 20% 11%~~~~~~~~~~~~~~~. ~ 0% C).- 25%196 295% 23% 17 9018 19 9016 90 9518 9519 162 Measuring Country Performance on Health Table C.9 Costa Rica: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 124 104 85 54 29 20 14 Female adult mortality rateb 203 148 118 114 100 82 73 Male adult mortality rateb 246 189 163 169 159 132 122 Female life expectancyc 64.5 67.5 70.2 73.3 76.1 77.7 78.6 Male life expectancyc 61.6 63.9 66.1 68.9 71.6 73.1 74.0 Totalfertilityrated 7.0 6.4 5.1 4.1 3.7 3.4 3.3 Determinants Inccme per capita' 2,001 2,262 2,692 3,189 3,671 3,195 3,381 Female education (years)f 4.0 4.2 3.9 5.1 5.2 5.4 5.6 Male education (years)f 4.1 4.2 4.0 5.2 5.2 5.4 5.5 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 163 Figure C.9 Costa Rica: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 150% 1 2.0 10% 91. C 100% 1 1.0 0.8 ' 54% | ;m 0.0 Fn1- ~~~~~~~~~~~~~~~~~~0.0 50% Ig l I ,x 4)o 4-~~~~28 / -. 23% 28% -1.0 -0.6 -0.7 -0.7 0% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 100% T20.0 84% 84% 80% 73% 69 72% 16.0 1 14.2 14.7 14.8 14.6 60% 69% 12.2 13.0 13.3 160% 12.0 40% + 70% 70% 16.0 + 13.6 14 3 14.3 1$82 > 4.0 X 20% n | |5 0% 199 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 100% ~~~~~~~~~~~~~~~20.0 800/. ~65% 70% 70% 16.0 13.6 14.3 14.3 14.2 60 57%0 58% 58% 12.2 12.5 12.7 42~~0 40% a 8.0 20% 4) 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 164 Measuring Country Performance on Health Table C.10 Dominica: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ _ _ _- - Female adult mortality rateb - - - - 119 113 Male adult mortality rateb _ _- - - 163 154 Female life expectancyc - - - - 73.0 73.5 74.0 Male life expectancyc - - - - 70.0 70.5 71.0 Total fertility rated - - - - - 3.3 2.8 Determinants Income per capitae - - - - - 2,563 - Female education (years)f - - - -. - Male education (years)f - - - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d, Total fertility rate is the number of children thaL would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Fducation: the average years of education in the female and male populations aged 15 to 60. Annex C 165 Figure C.1O Dominica: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 150% 0.0 100%~~~~~~~~~~~~~ 50% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 8%P-anel B: Female Adult Mortality Rate Panel E: Female Life Expectancy -16.0 60% 52% 12.0 11.3 400/. 8.0- *> 200%- i>4.0~ (0% 0% I II-.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% 16.0 60% 53% 12.0 11.3 400%- & .0 20% C> 4.0 1~~~~~ 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 166 Measuring Country Performance on Health Table C.11 Dominican Republic: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 149 145 127 110 92 73 58 Female adult mortality rateb 271 230 192 168 138 114 109 Male adult mortality rateb 342 293 246 218 183 160 157 Female life expectancyc 55.2 58.7 61.8 64.0 67.6 70.3 71.7 Male life expectancyc 52.1 55.4 58.1 60.3 63.7 66.3 67.6 Total fertility rated 7.4 7.0 6.2 5.2 4.3 3.7 3.3 Determinants Income per capitae 1,187 1,342 1,436 1,880 2,138 2,218 2,259 Female education (years)f 2.6 2.5 3.3 3.4 3.6 3.9 4.5 Male education (years)f 2.8 2.7 3.5 3.7 3.9 4.2 +.4 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d Total fertility rate is the number of children that would be born to a wornan if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 167 Figure C. 11 Dominican Republic: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% -- 2.0 17%1 1.3 1u l O. | 8Y 0 0.1 a oY 1 = E a 2 -0 6 o a2-0 8 80% 12.0 - 10% -S I 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel F: FMale Life Expectancy 80% 12.0 - 56%28.5 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 80% 125%0 -~~~~ 20% 17% ~ ~ ~ ~ ~~~6% . 60% 0.08. 6.1~~~~~~~~~. 60%l/ 5245. . 8.06. 66 I 40 35. -240%47 0% 0. (1~~~~~~~~~~~~~~~~. 23% 4~~~~~~~~~~~~~~.0 -~20% -15%0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 168 Measuring Country Performance on Health Table C.12 Ecuador: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 178 158 140 117 98 72 50 Female adult mortality rateb 248 219 208 200 176 140 120 Male adult mortality rateb 312 275 258 249 229 197 183 Female life expectancyc 56.1 58.2 60.5 63.2 66.6 69.5 71.4 Male life expectancyc 553.4 55.4 57.4 59.7 62.5 64.7 66.4 Total fertility rated 6.9 6.8 6.4 5.7 5.0 4.3 3.7 Determinants Income per capitae 1,407 1,501 1,818 2,247 3,043 3,025 2,805 Female education (years)f 3.0 3.1 3.4 4.4 5.9 5.7 5.9 Male education (years)f 3.5 3.6 3.7 4.8 6.4 6.1 6.0 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant intemational dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 169 Figure C.12 Ecuador: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% - 2.0 4 %G 0% 3 O 9 0.9 1.0 X -5% -k53.>i° | | > -22% -7> 0. 0.9~~~~~~~~~-. 0 -40% -1 .0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 60% 10.0 0.5~~~. 8.0- . 60% - -70 6.8 6.0 . 5.2 '> , 20%SE f 41 19 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 6% Panel C: Fmale Adult Mortality Rate 1. Panel F: FMale Life Expectancy 8.0 7~~~~~~~~~~~~~.2 8.0~~~~~~~~~~~. % 40% 31% ~~~~~~~~~~~~~~~~ ~6.0 5.2 5. s.0 . 28%~~~~~~3 2 7%0 26 24% 24 21% c ~~19 2%4.0 20% . 0 2.0 0%0/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 170 Measuring Country Performance on Health Table C.13 El Salvador: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 191 168 161 149 125 84 54 Female adult mortality rateb 287 235 193 178 178 174 165 Male adult mortality rateb 353 305 259 300 410 387 284 Female life expectancyc 54.0 57.8 61.1 62.6 63.9 68.0 71.8 Male life expectancyc 50.8 54.1 56.6 52.4 50.7 59.0 64.1 Total fertility rated 6.8 6.7 6.4 5.9 5.4 4.6 4.0 Determinants Income per capitae 1,430 1,607 1,832 1,935 2,190 1,795 1,825 Female education (years)t 1.8 2.0 2.2 2.4 3.0 3.2 3.4 Male education (years)f 2.2 2.4 3.3 3.4 3.5 3.6 3.6 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1.000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Educaticti: the average years of educationi iu the feirmale aild miiale pupulationls aged 15 to 60. Annex C 171 Figure C.13 El Salvador: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% - 2.0 24% X 20% 0.9 C . .I | 9 1 0 0.8 -c ~~~~~~~~~~0.5 ~2 0% 4 0 0.0 fl-20% -1%-13%02 -21% -0.3 -26% _30% -40% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 60% -- 12.0 - 10.2 19% 25% 23/ 21/ 8.0 * 5.6 5.2 6.9 20% --jj 2 4.5 4.3 < -40°fi a -4.0 -60% ~ -8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 60% - 12.0 40% 26% .> -5. 1~~~~~~~ -4~~~~~~~~~.06. -60% 8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 600- 4- a 0~~~~~~~~~~~~~~~~~~1.0 - 40020% 2 0/ 2 -0% -29%-7%4.4. -2%~~~~~~~~~~~~~-. -60% -8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 172 Measuring Country Performance on Health Table C.14 Guyana: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - - - - Female adult mortality rateb 249 230 217 213 210 192 172 Male adult mortality rateb 307 284 274 280 294 285 263 Female life expectancyc 58.9 61.0 62.1 63.2 64.2 66.1 68.0 Male life expectancy' 55.8 57.5 58.0 58.3 58.4 60.4 62.4 Total fertility rated 6.5 6.1 5.5 4.4 3.6 3.2 2.9 Determinants Income per capitae 1,532 1,516 1,766 1,963 2,118 1,473 1,284 Female education (years)f 4.3 4.2 4.4 4.8 5.2 5.5 5.8 Male education (years)f 4.7 4.6 4.6 4.9 5.3 5.5 5.6 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probabiLity of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average yeats of education in the female and male populations aged 15 to 60. Annex C 173 Figure C.14 Guyana: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% 2.0 ~ 20% 1.0 0 0.3 E 20%- >20.0 -2 0% -3.0 C- '-~~~~~~~~~~~~~~ ~~-1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 1030 - 7.7 7.9 7.7 27% .06.7 2) 2 2 o/ 23 5.6f ^il| | f 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel F: FMale Life Expectancy 40% - 10.0- 8.0 20% 2- 4.2 6.7 201 198 4 15% C4.0 2.0 0%0. 0.0 1960 1965 1970 1975 1980 1985 1990 1Q60 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% --10.0 8.0 7. . 24% 6.0 5.6 2% 21% -~6.0 20% ~~~~~~~~~~~~~~~~~~~~~~~~~4.5 o ~~~~~~~~15% 3.6 12% k 4.0 0~~~~~~~~~~~ .2 ~~~~~~~~~~~~~~~~~~2.7 7% 5% ~~~~~~2.0 0%0/ 0.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 174 Measuring Country Performance on Health Table C.15 Haiti: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-fve mortality ratea - 236 221 211 200 160 148 Female adult mortality rateb 347 336 326 306 275 267 291 Male adult mortality rateb 455 434 411 384 348 335 353 Female life expectancy' 44.9 47.6 50.0 52.2 54.4 56.4 58.3 Male life expectancyc 42.3 44.9 47.1 49.2 51.2 53.1 54.9 Total fertility rated 6.3 6.2 6.0 6.0 5.9 5.7 5.2 Determinants Income per capitae 924 890 850 872 955 937 867 Female education (years)1 0.7 0.7 0.9 1.0 1.7 1.8 2.0 Male education (years)f 0.9 1.0 1.5 1.5 2.2 4.1 3.9 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 175 Figure C.15 Haiti: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 a 0% 0 a 0.1 0.1 0E1 ~~~ -20% ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~ 0.0~ ~ 00 . -26% -28% -28% -29% ° 0.1 -0.1 < -40% -37% 2 M) > -60% 0/ -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy a 0 -14% 0.0 ~ ~ ~ ~ ~ ~~~~~~-. 0% -2.0 .>41% -1%-4% -2 -7% -6% I -io% _~~8% . 40-3.6 _ > ~~~~~~~~~~~~~~~~~~~-4.4 -14% -20% 1 - -6.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 10% 0.0 0% -0.7 O 0% -2.0 -2.3 -2.4 -. .0~~~~~~~-%-- -2.7 & 10% -7% a ~~~~~~~~~~~~~~~~~-3.3 -10% -10%/ -9% .34. -20% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 176 Measuring Countrv Performance on Health Table C.16 Honduras: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 204 191 170 122 101 74 51 Female adult mortality rateb 290 287 283 258 237 175 141 Male adult mortality rateb 392 374 361 329 306 237 202 Female life expectancyc 49.7 52.7 56.2 59.9 63.8 67.7 70.1 Male life expectancy' 46.3 49.2 52.1 55.6 59.4 63.2 65.4 Total fertility rated 7.3 7.4 7.4 7.0 6.5 5.9 5.3 Determinants Income per capitae 1,048 1,065 1,190 1,275 1,487 1,417 1,401 Female education (years)f 1.8 1.9 2.1 2.6 2.7 3.1 3.4 Male education (years)f 2.0 2.2 2.3 2.7 2.9 5.1 5.0 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 177 Figure C.16 Honduras: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 80% ~ ~ 2.0 60%- - 47% c 1.6 C)15 90 9 18 18 19 1.3 1.4 6 40% 6 11.2 4) ~ ~ ~ ~ ~ ~ ~ ~ ~ 4 420% 1.0 0.8 X 0%% 7.3 |0.6 () 4)F 4 '% | | t 20% 1%A%-10% >) -40% 40.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 60%T 16.0T 44% 40%- 37% 12.0 95 11) ~~~~~~~28% 7.3 ~. 08.0 20% -12%/ 3.9 6% C4.0 2.2 4) ~~~~~~~~~~~~~~~~~~~~~~~~~~0. 1 0. It 0% >0.0 - 0 -20% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 60.--Panel C: Male Adult Mortality Rate 160Panel F: Male Life Expectancy 40% 37% 12.0 26%8. 8.065 20% 446 0% % 6%/1 4.030 a- (0~~3- OkC/ 2 . .~0% 0. -20% -4.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 178 Measuring Country Performance on Health Table C.17 Jamaica: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 74 69 64 50 34 - - Female adult mortality rateb 196 174 142 124 121 109 97 Male adult mortality rateb 251 230 199 183 186 173 155 Female life expectancyc 66.2 68.1 70.8 72.3 73.6 74.8 75.9 Male life expectancyc 62.4 64.5 66.6 68.0 69.2 70.4 71.4 Total fertility rated 5.4 5.7 5.4 4.5 3.8 3.3 2.9 Determinants Income per capitae 1,667 1,895 2,432 2,900 2,595 2,344 2,409 Female education (years)f 2.7 3.2 3.4 3.9 4.3 4.8 5.1 Male education (years)' 2.4 2.7 3.0 3.6 3.8 4.1 4.4 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dolLars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 179 Figure C.17 Jamaica: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 120% 1.0 92% 0.2 u 74% 0 .0. 0 180% 70% 0.0 C-~ ~ ~~~~~-. . 0 40% 6 -1.0 >~ -1.2 -1.2 0% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 100% 20.0 8 0 O/o ~~~~~~66%16 16 142 43 13.5 13.4 12.9 13.2 6 2%' 60%k 6 3%O C~60% 212.0 45% 7 l &40% .28.0 ~~~~ 20% 0~~~~~~~~~~~~~~~4.0 20% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 100% --20.0 80% -- 16.0 ~ ~~~~~~~~13.7 13.7 13.5 13.0 12.9 12.4 12.7 60% 51% 53% 212.0 47% 47% 49k 4 40%/ 41% 40% .28.0 20% 0 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 180 Measuring Country Perforrnance on Health Table C.18 Mexico: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 134 123 111 94 76 54 47 Female adult mortality rateb 250 218 188 152 121 106 96 Male adult mortality rateb 306 272 246 222 205 188 173 Female life expectancyc 60.3 62.2 65.3 68.6 71.2 73.0 74.5 Male life expectancyc 57.0 58.5 60.1 62.2 64.4 66.8 68.5 Total fertility raLed 6.8 6.7 6.5 5.6 4.6 4.0 3.5 Determinants Income per capitae 2,723 3,078 3,730 4,587 5,351 5,791 5,457 Female education (years)f 2.5 2.7 2.9 3.3 4.4 4.9 6.4 MvIale education (years)f 3.0 3.1 4.5 4.6 5.2 5.5 7.0 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 181 Figure C.18 Mexico: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% -10% -5% 2.0 1.7 0 -11% -20% -16% & 1.32 2 -~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. ~~. -30% ~~~-24% -23% 533% 0 0.4 -40% 0.2 -50 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 60% T 12.0 46% 43% 43% 8.2 8.6 8.2 8.5 U 40% 33% 81 6.8 6.6 C 21% WO 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C Male Adult Mortality Rate Panel F: Male Life Expectancy 13% ~ 19 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 182 Measuring Country Performance on Health Table C.19 Nicaragua: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 193 176 165 150 120 89 65 Female adult mortality rateb 347 318 283 235 189 161 147 Male adult mortality rateb 431 390 348 301 277 273 220 Female life expectancyc 50.0 53.4 56.8 60.0 62.6 65.5 68.7 Male life expectancy' 47.3 50.5 53.7 55.3 56.5 59.0 63.5 Total fertility rated 7.4 7.3 7.0 6.6 6.2 5.8 5.3 Determinants Income per capita' 1,584 1,953 2,348 2,428 2,272 1,865 1,499 Female education (years)f 2.1 2.1 2.8 2.8 3.1 3.4 3.7 Male education (years)f 2.4 2.9 3.0 3.2 3.4 3.5 3.7 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 183 Figure C.19 Nicaragua: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% 3.0 20% - 88 3.0 - 18% 0 % - 30% 8 2.0 1.8 0% 1m6 09 0 % > 0.0 - 0.4 E | | |~~~~~~~~~1. 1. & -20% - 200%1 1.0 o -400% -2833 -600% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 60% 12.0 40% 3% 380/8. 7.9 20% 4.0 27% 8.0 21% 20% X04% L 2 _ % 4 0 - 1.6 0 0.0 -20% -12% -14% -102 a14 0-1.4 -40% - -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 60% --12.0 40% 27% 8.0 6.3 20% 0~~~~~~~~~4 . 0 0% 0.7 0.8 06 1 O 0~~~~~~~~~~~~~~~~~~. . -2% 1%-12% -40% ~~~~~~~~~~~~~~~-4.0 _ 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 184 Metasutring Coutinry Performance on Health Table C.20 Panama: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 88 79 68 53 47 38 27 Female adult mortality rateb 241 214 185 150 117 101 94 Male adult mortality rateb 273 247 225 201 172 160 146 Female life expectancyc 63.1 65.5 68.0 71.1 73.1 74.2 75.0 Male life expectancy' 60.9 63.1 65.0 67.2 68.6 69.4 70.9 Total fertility rated 5.9 5.8 5.3 4.5 3.8 3.4 3.0 Determinants Income per capita' 1,494 1,856 2,336 2,867 3,021 3,500 3,111 Female education (years)f 4.6 4.5 4.8 5.1 6.7 6.7 8.0 Male education (years)f 4.7 4.5 4.8 4.9 6.6 6.4 7.8 a. Undler-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would he born to a woman if she were to live to the end of her childbearing years anid bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constanit international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 185 Figure C.20 Panama: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 80%- 1.0 61% 61% 59% 0 5573 56% 00 0.1 60%/ 52% 0. 0 mm I I 41% t ~~~~ 40% -01~~~~~~~~~~~~~~~~~~-. -1.0 -0.8 -0.7 -0.7 200% 0% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 16.0 60% 60% 61% 61% 1 12.0 11.7 11.6 12.4 12.4 11.3 60 60 19217.9509018 99 9016 17 9518 1985 1190 o ~~~~~43% U E 40% 3%8.0 2 6%O 26% 2 20% lo 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% T 16.0 171960 196 124 1270 129751 90198 11.4 60% --53% 4% 54% 12.0 1. 0 40% -34% 34o 36% C)8.0 200% $ 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 186 Measuring Country Performance on Health Table C.21 Paraguay: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 92 84 76 70 59 48 38 Female adult mortality rateb 166 160 157 153 144 130 117 Male adult mortality rateb 219 213 211 208 198 185 169 Female life expectancyc 66.4 67.0 68.1 68.7 69.3 69.9 70.8 Male life expectancyc 62.5 63.1 63.7 64.4 64.9 65.4 66.3 Total fertility rated 6.8 6.6 6.0 5.3 4.9 4.8 4.5 Determinants Incomepercapitae 1,208 1,248 1,344 1,541 2,059 2,265 2,041 Female education (years)f 3.3 3.4 3.9 4.1 4.9 4.8 4.8 Male education (years)f 4.0 3.9 4.5 4.6 5.3 5.2 5.2 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specifc levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertiiity rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 187 Figure C.21 Paraguay: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 80% ~ ~ 2.0 64% 65% 66% 60% X 59% 8 60%- ~ l | | lR 48% 52% 3 1.0 0.7 0.6 C C 0 42% | : L L 0.3 0.3 0.3 ° 40% ~ | | | | 2 0O S | | l ---I _ l 00.0 _ 2 L + 0 a; ~~~~~~~~~~~~~~~~~~~~~~~~~~-0.1 -0. 0 20% -. 0% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 20.0 66% 62% 16.1 I0 5 57%/ 16.0 14.6 80% 53% 52% 1201 0 47% 12.1 ~~~~~~ 40% ~~~~~~~~~~~~~~~~~~~~~~~8.1 8.8 .0 8. 1 20% 1 4.0 0~~~~~~~~~~~~~~~~~~~~~. 0% 0.0 1960 1965 1970 1975 1980 1985 199o 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% --20.0- 60% -- 590/. 56% ~~~~~~~~16.0 15.1 1. 60% 56% 13.780o 8% 2. 40% 51% 48% ~~~45 48% C 12.0 125 11.3 9281 c 8.0 20%0 0 4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 188 Measuring Country Performance on Health Table C.22 Peru: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 234 213 178 160 126 102 73 Female adult mortality rateb 324 290 282 245 229 204 173 Male adult mortality rateb 404 364 348 307 287 261 228 Female life expectancyc 50.5 53.0 57.3 59.4 62.1 65.0 67.9 Male life expectancyc 47.8 50.1 53.9 55.7 58.4 61.1 64.1 Total fertility rated 6.9 6.7 6.1 5.3 4.6 4.0 3.6 Determinants Income per capita' 1,876 2,334 2,644 2,962 2,924 2,748 2,606 Female education (years)f 2.6 2.7 3.8 4.1 5.4 5.6 5.9 Male education (years)f 4.0 4.0 5.3 5.2 6.8 6.5 6.5 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortahity rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 189 Figure C.22 Peru: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 T E 1.1 -20% 10T 1V -60% -50% -51% .>-1.0 0 ~~~~~~~~0.5 -29% -40%- 0. -2.00 -45% -45% -450/44 -60% -- -50% -51% - >~~~~~~~~~~~~~~~ -0.3 -0.4 .-1.0 t -80% -. -100% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% T 8.0 4.9 -13% _4.0 1960 196519701975 1980 195 99 1960 1965 1970 1975 1980 1985 19905 0.5 Panel ~ -6 C:% MaeAutMraiyRt ae :MmlieEpcac 2-7% T 8.0 T 1135 a200. % 40 T2 7 I o -9-6%-0 -. -14 -. -20% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% --8.0 13% 6.0 5.1 5 O/o ~~~~~4.0 E 0% B2.0 a- ~~~~~~~~~~~~~~~~~~~~0.0 -90/' -9% C. -~~~~10% -. 14 -. -20% ---4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 190 Measutring Country Performance on Health Table C.23 Puerto Rico: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 55 55 34 25 22 17 15 Female adult mortality rateb 110 93 89 82 78 74 67 Male adult mortality rateb 167 151 169 169 159 165 158 Female life expectancyC 72.5 73.5 76.2 77.0 77.5 78.8 79.3 Male life expectancyC 67.0 68.2 69.0 70.2 70.5 70.5 71.4 Total fertility rated 4.6 3.9 3.2 2.9 2.6 2.3 2.2 Determinants Inccme per capitae 2,760 3,878 5,137 6,148 6,607 6,852 8,170 Female education (years)f _ - - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 191 Figure C.23 Puerto Rico: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 140%k 0.0 120% 4 240A 100% -5% 8 O. 80% 67% 10.4 0 ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~~~~-. E 60% 40%o .2 -1.4 -1.4 -1.3 -1.5 G 20% (A 1W5 || | 1960 1965 197>175190 98 190190165190 97 1801 0%k -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 120% 24.0 100% 0/ 51 98% 9 0%9 90% 8%20.0 18.9 80% 16.0141 34 600/o 12.0 C~~~~~~~~~~~~~~~~~~~~~~~~ ~-40% .2 8.0 t 20% 4. 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1965 1990 10 - Panel C: Male Adult Mortality Rate 240Panel F: Male Life Expectancy 100% 20.0 16.2 80% --3 71% 16 0 1. 34 1 60% 51% 47 48% 12.0 . 4 0% 02 4.0 20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 192 Measuring Country Performance on Health Table C.24 St. Kitts and Nevis: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - -_ - Female adult mortality rateb - - - - _ 190 165 Male adult mortality rateb _- - - - 255 227 Female life expectancyc - - - - 66.0 68.0 70.0 Male life expectancyc - - - - 62.0 64.0 66.0 Total fertility rated - - - - - 3.1 2.7 Determinants Income per capitae - - - - - 3,268 4,382 Female education (years)f - - - - - - - Male education (years)f - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adurt mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant woutd live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 193 Figure C.24 St. Kitts and Nevis: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 0.0 E~~El t 3; -0.5 -0.7 -20% 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 10% -- 8.0 5% 6.0 5.0 4.9 0 1/.~~~~~ ~ 4.0l i 0~~~~~~~~~~~~~~~~~~~~~~~~/ C 5 OX > 2.0 %) -5°O S l l l l l +% -109% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 8.0 5% 3% 60 5.1 Ł % 0 2.0 -10% 1 198 1 I I I I 1 11 1990 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 1914 Measuring Country Performance on Health Table C.25 Suriname: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _- - - - - Female adult mortality rateb 235 206 191 190 187 170 137 Male adult mortality rateb 294 267 253 251 250 233 216 Female life expectancy' 63.4 65.7 66.0 66.5 67.0 68.9 71.5 Male life expectancy' 59.7 61.5 62.0 62.5 63.1 64.6 65.8 Total fertility rated 6.6 6.3 5.6 5.0 4.4 3.9 3.2 Determinants Income per capitae 1,983 2,082 2,856 2,514 3,460 3,615 2,920 Female education (years)f - - - - - - - Male education (years)f - - _ _ _ _ - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. fotal fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years cf education in the female and male populations aged 15 to 60. Annex C 195 Figure C.25 Suriname: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 0.6 0.6 0.6 z . E ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-0.1I -O. I > 0.5 0 a -0.6 -20% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% -16.0 20% - - 10.0 350/o~ ~ ~ ~~~~~~~~ 3 -0. 30% - ~ 12 0 - 10 3 10.4 -202% -1- 22% I 20% 22% t l lll l 8 4 9.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel E: FMale Life Expectancy 40%/ 16.0- 30% 24% 201 2%5% 12.0 11.1 11.5 20% 7.9~~~~~~~~~~~~~~~~~. 20S1%8.0 8.6.1 ~~~ 20% 5~~~~~~~13 .8 5.6 >) 10% 5 40 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 196 Measuring Country Perjormance on Hearth Table C.26 Trinidad and Tobago: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 61 58 55 51 39 31 24 Female adult mortality rateb 182 163 161 149 139 129 118 Male adult mortality rateb 237 220 222 221 219 205 190 Female life expectancyc 66.7 67.0 68.1 69.7 71.2 72.8 74.0 Male life expectancyc 62.5 62.8 63.4 64.7 66.2 68.1 69.3 Total fertility rated 5.2 4.4 3.6 3.4 3.3 3.0 2.5 Determinants Income per capitae 4,924 6,315 6,620 7,697 10,095 10,303 8,387 Female education (years)f 4.4 4.6 5.2 5.5 7.3 7.1 7.3 Male education (years)t 4.8 5.0 5.4 5.8 7.2 6.8 7.1 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of educaticn in the female and male populations aged 15 to 60. Annex C 197 Figure C.26 Trinidad and Tobago: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 80% 0.0 60% -53% -0.1 44% -0.3 Ug 40°/O- | 37% L-0.5 -0.4 40% -0.5 o ~~~~~~~2 3 -co -0.6 1960 206519701975 198019126 -0.7190. -0% T -1.0 G 40% t3% 3%$W . 0%~~~~~~~~~~ -20% -1.5 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 600%o Panel B: Female Adult Mortality Rate 16.0 Panel F: Female Life Expectancy 12.0 tO.7 40% 36% 8 34%86 26% 26% 8.0 | *98' 1,''S '> t 5 9 58.0 7 1960 1965 267 197 6.4 6.1 6.3 20% ~~~~~19% 20%~~~~~~~~~~~~~~~ 9% 10% .~~~~ 4.0 Co ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 6k Panel C: Male Adult Mortality Rate 160Panel F: Male Life Expectancy 12.0 400% 9.3 a 2 9 % 7.7 Co ~~~25% 8 ac 7.0 6.7 6.5 20% 19% 17% 10% 8% 2: 4.0 ~~~~ ~~~~~~~~~~~5.9 6.1 5 0~~~~~~~~~~~5'.C 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 198 Measuring Country Performance on Health Table C.27 Uruguay: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 56 60 56 54 43 32 24 Female adult mortality rateb 105 100 98 95 91 90 90 Male adult mortality rateb 187 182 183 182 176 175 178 Female life expectancyc 71.6 71.9 72.2 73.2 74.3 75.3 75.7 Male life expectancyc 65.4 65.5 65.6 66.4 67.8 68.9 69.3 Total fertility rated 2.9 2.9 2.9 3.0 2.7 2.5 2.4 Determinants Income per capitae 4,060 3,840 3,855 4,136 4,632 4,359 4,610 Female education (years)f 5.3 5.2 5.8 6.3 6.3 7.2 7.3 Male education (years)' 5.4 5.1 5.5 6.1 6.0 6.6 6.9 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 199 Figure C.27 Uruguay: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 100% 0.0 80% 0 2 260% - -200-56% 0 430/ TUb~~~~~~~45 45/,1yo-. C- ~~~~~~~~~3 %-2.0 16.0 -2. 20% 0% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 120% --20.0 16.4 94 1 86% 8 2%O 16.0 154 14.1 1. 77% 13.211. C %--67% '212.0 10.4 0~~~~~~~~~~~~~~~~~~4/ C8.0 40% C 0 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 120% --20.0 16.0 0) 80% 13.0 12.2 C ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ , ~~~~~~12.0 110 10.3 56% 520/. 9,2~~~~~~C 8.5 56% 52 48% 46% 4492 C- ~~~~~~~~36% C 8. 40% 26-C 0 4.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 200 Measuring Country Performance on Health Table C.28 Venezuela: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 75 60 62 58 42 33 26 Female adult mortality rateb 224 190 157 135 123 112 101 Male adult mortality rateb 276 248 231 227 219 203 186 Female life expectancyc 62.8 66.1 68.9 70.7 71.8 73.5 74.7 Male life expectancy' 59.3 61.5 63.6 64.8 65.9 67.7 68.9 Total fertility rated 6.5 6.2 5.4 4.7 4.2 3.8 3.5 Determinants Income per capitae 6,630 6,999 7,520 7,455 7,944 6,639 6,321 Female education (years)f 2.6 2.8 3.2 3.7 5.4 5.6 5.0 Male education (years)f 3.3 3.3 3.2 3.6 5.6 5.7 4.9 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex C 201 Figure C.28 Venezuela: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60% 2.0 2 ˘ 40%- 37% 1 1.1 1.1 84 20 4 ) : i t i G | | 1 °04 0.4 0.9~~~~~~~~~. 21% 2% 0. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 60% 12.0 8.3 86 7.8 8.2 8.1 U 40% 6- % 36% 34% 330 8.0- 78 2 0%4 T al5.5 1960 1965 1970 1975 1980 1985 1990 1960 1969 1970 1975 1980 1985 19sO Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 6....,eo - 12.0 ,,40%; 8.0 +6.9 6.9 7.1 27%~~~~~~~~~~~~~~~~~~~~~~~. t 20% 17 1 16 4.0 1160 119 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex D Middle East and North Africa Regional and Country-Specific Indicators of Performance on Health This annex provides information, for 14 countries in the Middle East and North Africa region, on performance relative to income for six health indicators. For each country, the annex includes a figure with panels displaying values of the six indicators over the period from 1960 through 1990. Panel A: Under-Five Mortality Rate Panel B: Female Adult Mortality Rate Panel C: Male Adult Mortality Rate Panel D: Total Fertility Rate Panel E: Female Life Expectancy Panel F: Male Life Expectancy In addition, each country profile includes a table with the values at five-year intervals for each health indicator, for per capita GDP (in 1985 international dollars adjusted for purchasing power), and for the average years of edu- cation for males and females aged 15 years and over. Two regional profiles are presented before the country profiles. One shows regional performance relative to income for the six indicators; it is directly analogous to the country profiles. The second shows regional perfor- mance relative to education as well as income levels. This gives a sense of the extent to which performance on health relative to income results from educational differences. Also preceding the country profiles is a figure show- ing "health performance diamonds" that depicts the overall performance of each country in the region in 1990. The main text discusses the methods used and provides tabular summaries of results, including country-spe- cific results on performance that control for education as well as income. 203 Contents Regional Performance over Time (Figures D and DD) 205, 206 Country-Specific Health Performance Diamonds, 1990 (Figure DDD) 207 Country-Specific Performance 1. Algeria 210 2. Bahrain 212 3. Egypt, Arab Republic of 214 4. Iran, Islamic Republic of 216 5. Iraq 218 6. Jordan 220 7. Malta 222 8. Morocco 224 9. Oman 226 10. Qatar 228 11. Saudi Arabia 230 12. Syrian Arab Republic 232 13. Tunisia 234 14. Yemen, Republic of 236 204 Annex D 205 Figure D Middle East and North Africa Region: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 3.0 0 2.S E , | E fl | 0 1.8 - < T 01 1 7 | | | | | | | l | 111 1101 101 l igl E | 0 U l | l l l | i , l l | | | l | 3 2.0 - 1.6 1.4 2 506-c1| 33 l 33 -23%09 1960 1965 19701975 1980 1985 1990 1960 1965 1970 1975 19801985.o 0.8 .0 %34% -33% 033 -a ~~~~~-36% -39/ -38% -50% --0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% --10.0 17% 15% 0 | *|E 5.0 3.6 = [ | | 0% < 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~3.1 0% 0% 0.7 09 1.0 Q | ~~~~~~-4%X -5% -8% -6 < 001EiEiIus l _ I a 0 -0.5 -50% -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50% T 10o0 14% 15% 11 7% 11% 5.1 2.3 - 0% - 196001965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 0.0 -50% -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 206 Measuring Country Performance on Health Figure DD Middle East and North Africa Region: Performance Relative to Income and Education Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 2.0 -12% -12% El | | 18% -16%01 -20% -19% 0.9 0.9 1.0 -22% 1.0 0. -~~~~ 0.6~~~0. q) 0.6~~~~~~~~~~~~~~~~ 0.2 0. -50% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% 5.0 - 2.4 2.2 2.3 2.2 2.2 24% 22% 1+111 1 | | 8% ~~~~5% 7% 4% 3 % C _ o % 0.0 I 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50% -- 5.0 2.2 2.4 2.7 1.8 1.6 1.6 4- S 0.0 14% 13% ° -0.2 >) - - '4 * l 2% 4% 5% % 6% 0 % I ~ ~ ~ ~ I*~2/.InI * °%- ll i gii > _ , 111 1 | + + i | {-5.0~ 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex D 207 Figure DDD Middle East and North Africa Region: Country-Specific Health Performance Diamonds, 1990 Algeria q5 Bahrain q5 q45m q45f q45m q45f tfr (q5 value is missing) tfr Egypt, Arab Rep. of Iran, Islamic Rep. of q5 q5 q45m q45f q45m q45f tfr tfr Iraq Jordan q45m q45f q45m $ q45[ tfr tfr (Figure continues on the next page.) 208 Measuring Country Performance on Health Figure DDD (continued) Malta Morocco q5 q5 q45m- - q45f q45m - AA 6 k, q45f (q5 value is missing) tfr tfr Oman Qatar q5 q5 q45m9 X q45i q45f (insutficient data) (q5 value is missing) tfr trf Saudi Arabia Syrian Arab Rep. q5 qs q45m- - q45f q45Am eq45f (q5 value is missing) ttr tfr Annex D 209 Figure DDD (continued) Tunisia Yemen, Republic of q5 qS q45m - q45f q45m q45f tfr tfr Note: q5 = under-five mortality rate; tfr total fertility rate; q45f = female adult mortality rate; q45m = male adult mortality rate. Each axis of the performance diamond is scaled so that the midpoint of the distance between the origin and the tip of the relevant axis corresponds to per- formance equal to what would be predicted by tncome, Values better than would be predicted are plotted between the midpoint and the tip at a distance proportional to the country's performance on the indicator relative to the performance of the best-performing country on the indicator. Likewise, values poorer than would be predicted are plotted between the midpoint and the origin. The diamond connecting midpoints of the axes depicts, then, expected performance. The shaded diamond depicts the country's performance. When the shaded area lies inside the expected performance box, country perfor- mance is poor; when outside, performance is good. 210 Measuring Country Performance on Health Table D.1 Algeria: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 255 214 192 176 139 83 45 Female adult mortality rateb 259 229 201 193 197 185 156 Male adult mortality rateb 343 300 258 238 226 211 193 Female life expectancyc 49.4 52.5 55.5 58.5 61.5 67.0 70.0 Male life expectancyc 47.3 50.4 53.5 56.5 59.5 64.5 67.0 Total fertility rated 7.3 7.4 7.4 7.3 6.8 5.8 4.6 Determinants Income per capitae 1,723 1,513 1,713 2,060 2,626 2,887 2,854 Female education (years)f 0.7 0.9 0.7 1.1 1.6 2.3 3.0 Male education (years)f 1.1 1.1 2.3 2.8 3.4 4.3 5.1 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the iiumber of childreni that would be born to a woman if she were to live to the end of her childbearinig years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 211 Figure D.1 Algeria: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% 3.0 13% o 2.0 ~~~~ ~~~~~~~~~~~~~~~~~~~~2.1 2.1 ~~~~ 0% ~~~~~~~~~~~~ 2.0~~~~~~~~. 40% -20 - -40% .0- 6. > ~~-35% -36% z -3 46% 0. -51% ~~~-50% -80% 0 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 40% -- 12.0 28% 8.0 7 23% 2L X% 4 4.0 196021953 19701975 190 1985199 1 19 0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -~~~~~~~4.0 -. 0 uo-17 00 . 30% ~ ~ 13 S 0~~~~~~~~~~~~~~~~~~~~~~~~. ~~~~~ 20%~~~~~~~~~~~~~ 5% -4~~0 .0 0% - . m I _~~~~~~~~~~~~8. 0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 212 Measuring Country Performance on Health Table D.2 Bahrain: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 llealth indicators Under-five mortality ratea _ - - - - - - Female adult mortality rateb 163 206 206 185 175 173 147 Male adult mortality rateb 226 263 263 237 215 208 201 Female life expectancyc 58.8 62.0 65.4 66.9 68.5 69.7 72.9 Male life expectancy' 55.3 58.1 61.7 63.8 66.0 67.0 68.6 Totalfertilityrated 7.1 7.1 6.6 5.9 5.3 4.6 4.0 Determinants Income per capita' - - - 10,151 12,934 10,367 9,062 Female education (years)f 0.7 1.1 2.0 2.6 3.1 3.7 4.6 Male education (years)f 1.2 2.1 3.2 3.6 3.8 4.1 4.8 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 213 Figure D.2 Bahrain: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% 3.0 E 2.1 t.8 s 2.0 1.5 20%0-o 1.2 1.0 0°/0 0.0 1960 1965 1970 1975 1980 1985 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% 8.0 6.0 0% 4.8 n -1% I -||| E _ X I l I l l | | >>40 3.6 -90k ~~~~~~~~~~~~~2.8 2.9 -20%/ 5 -20o - 2.0 -40%- 00 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% T 8.0 1% 1 6.0 5.6 0% I I iii 1 - I ~~~~~~~~~~~~~~~~~~~~~~. 5.0 5.0 0% 4.0 -20% 2.0 -40% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 214 Measuring Country Performance on Health Table D.3 Arab Republic of Egypt: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - 258 235 215 175 129 95 Female adult mortality rateb 246 197 179 193 204 230 248 Male adult mortality rateb 337 282 255 255 257 273 289 Female life expectancy' 48.6 51.C 53.4 55.3 57.8 62.3 64.8 Male life expectancyc 46.2 48.5 50.8 52.9 55.3 59.8 62.4 Total fertility rated 7.0 6.8 6.1 5.4 5.2 4.7 4.0 Determinants Income per capitae 759 925 1,075 1,212 1,482 1,825 1,906 Female education (years)' - - - 0.9 1.6 2.4 3.2 Male education (years)f - - _ 2.2 3.1 4.7 5.4 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and nale populations aged 15 to 60. Annex D 215 Figure D.3 Arab Republic of Egypt: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 U 2 -20% 0-. C 4%_5-444)02- -.10 -40% 235%6.0- -39% .) -6%01 -0.1 -44% -45% -44% -0.2 -0.3 -60% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 80% - 6.0 - 60% 46% 48% 8 40% - 3336 34 4.0 3.0 4)4% 4 4 4 4 ) 20% >. 2.0 1.2 4) 0~~~~~~~~~~~~~~~~~~. . -40% > -.0 19016-9617%9018 9016 9517 9518 9519 ~'-20% 0 03 -0.3 os -6 -40% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% --6.0 4.4 60% - 33% 36% ~~~~~~~~~~~~4.0 5 40%32 24% ~~~~~~24 . 20% 2Ž2.0 ~~~ 0% o.i 0.3 ~~~~~~~~~~~~~~~050.5 0.5 4) 5% ~~~~~~~~~~~~~~~~ ~~0.0mm E -20%0 -40% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 216 Measuring Country Performance on Health Table D.4 Islamic Republic of Iran: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 281 232 191 158 130 87 59 Female adult mortality rateb 220 212 219 204 190 193 174 Male adult mortality rateb 239 212 204 196 221 212 170 Female life expectancyc 50.6 52.9 55.5 59.0 63.0 65.5 68.0 Male life expectancy' 50.9 53.5 56.2 58.2 59.4 65.0 67.0 Total fertility rated 7.2 7.1 6.8 6.3 6.1 6.2 5.6 Determinants Income per capita' 2,540 3,029 4,075 5,502 5,147 3,872 3,370 Female education (years)f 0.4 0.8 1.0 1.5 2.0 2.5 3.1 Male education (years)' 1.2 1.9 2.2 2.9 3.6 4.1 4.7 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would hve if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 217 Figure D.4 Islamic Republic of Iran: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 3.0 -- 2.3 -20% -- 10 0 8.2.002.0 2.0 1.9 -24% 2 2.0 1.6 2- -40%a -48%~~~~~~~~~. a -60% - 8 27% 4.0~~~~~~~~~~~~~~~~~~~. < -80% L _ .''' -68% -69% -7 -76- -75% -6/o-6/ 100% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 60% 10.0 8.0 0 40%k 6.0 4.0 o 27% - 4.02* F 2~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. 204% 2 -2.0 -4.0- 0% 1 0% -2.0 IM~~~~~~~~~~~~~~~~~~~-. -3% -4.0 -2.7 -2.7 -2.8 -. -7% -20% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 60% --10.0 8.0 7.2 41% 36% 34 7 6.0 5.7 40% a ~~~~~~~~~~~~~~~~ ~~~~4.0 o 20% 19% 19% .~~~~~~~~~~~~Ž 2.0 0.5 1.1 1.4 1.2 1.1 0 ~~~~~~~~~~~~~~~~~~~~0. 0% -2.0 -4.0 -20% -6.0- 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 218 Measuring Country Perfornance on Health Table D.5 Iraq: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 161 141 123 108 93 80 69 Female adult mortality rateb 324 307 277 224 191 172 154 Male adult mortality rateb 391 362 316 247 207 199 193 Female life expectancyc 50.9 53.9 57.9 62.3 63.3 66.5 57.6 Male life expectancy' 49.1 52.1 56.1 60.5 61.5 63.5 58.5 Total fertility rated 7.2 7.2 7.1 6.8 6.5 6.3 5.9 Determinants Income per capitae 2,991 3,863 4,352 4,819 6,969 4,661 3,496 Female education (years)f 0.1 0.4 0.8 1.1 1.7 2.5 3.1 Male education (years)f 0.5 1.2 1.9 2.6 3.6 4.5 5.0 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1.000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the numbe- of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 219 Figure D.5 Iraq: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0%- 4.0- -20% 3.0 2.4 2 .6 2.5 5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~2.3 -25% 279' -27% 5b' a 40% -32% t 2.0 -42% - 1.4 > -50% -1 C6 02 Q 1.0 60~~~~~/ ~~-57% . ~~~~~~~~3 ~~~~~~~~~~~~0. -430% 0 1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 8.0 - 20% | | | 4.0 1.7 2 .44 0 9% -90 -20% -0.717 a -8. 5 0%-2% 20 -40% - -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% 8.0 210% 2132% 4%4.0 11 3 CO ~~~~~~~ ~ ~~~~~~~~~~~~0.0 rII 0% _O4.0 -2.0 1 L -20% -13% C -17% ~~~~~~~~~0-8.0 -40% ---12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 220 Measuring Country Performance on Health Table D.6 Jordan: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 139 126 107 86 64 50 36 Female adult mortality rateb - - - - - 200 152 Male adult mortality rateb _ _ _ _ - 251 205 Female life expectancyc - - - - 66.0 68.3 71.7 Male life expectancyc - - - - 62.9 65.2 67.7 Total fertility rated - - - - 6.9 6.2 5.4 Determinants Income per capitae 989 1,417 1,624 2,072 2,990 3,673 3,372 Female education (years)f 1.2 1.6 2.1 2.5 3.3 4.4 5.3 Male education (years)f 3.4 3.8 4.4 5.0 5.2 6.0 6.6 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 221 Figure D.6 Jordan: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate bo% -3.0 3 0 E- 2.3 o 2.2 40% -3 2.0 1.7 31%/ 0 24%h 26% 25% 0o 20% 2 2%O . 20% 1.0 11% ° > 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 30% IL0o 20% t8. 7.7 g 10% 11% lUn 6.0 5.3 50 0 0% . 4.0 -10% - 2.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 30%/ 10.0 20%; 18% 8.0 7.9 6.2 6.0 E 10% 3 6.0 0% I+III 4.0 a -10% 2.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 222 Measuring Country Performance on Health Table D.7 Malta: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - - _ _ Female adult mortality rateb 135 129 126 117 101 88 81 Male adult mortality rateb 192 185 185 182 162 141 134 Female life expectancyc 70.8 71.4 72.8 74.3 75.8 77.3 78.2 Male life expectancyc 67.0 67.5 68.5 70.0 71.3 72.8 73.6 Total fertility rated 3.6 2.5 2.0 2.3 2.1 2.0 2.1 Determinants Income per capitae 1,312 1,382 1,960 2,711 4,024 4,942 5,956 Female education (years)f - - - - - Male education (years)f - - _ _ - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearir.g years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant mnternational dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 223 Figure D.7 Malta: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60%/ 0.0 E =- -1!.0 ~ -1.7 20% -2.2 ._ .o -3.0- -2.6 0% I I I I I I -4.0- ~~~~~~~-3.4 -3.3 ~ 0% - 4o 1g60 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 100% 24.0 85% 82% 20.2 100%~~~~~~~~~~~~~~7 13.00 80%- 691% 69%2.- 1. * 60% 0 11L . 1 9 6 0 1 9.5 1 9 7 0 1 9 7 5 1 9 8 0 l g 8 5 1 9 6 0 1 9 6 5 1 9 7 0 1 9 7 5 1 9 8 0 1 9 8 5 1 9 9012 .0 0~~~~~~~~~~~~~~~~~~ -~20% 0 4.0 0% 0.0 1960 1965 11970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 100%/ 24.0 19.2 80% -71% 68% 2. 78 1. 12.0 A .5 ~~~~~~~~~~~~~~~~~~8.0 2o% ~~~~~~~~~~~~~~~~~4.0 0%k 0.0 1960 1963 1970 1975 1980 1985 1990) 1960 1965 1970 1975 1980 1983 1990 224 Measuring Country Performance on Health Table D.8 Morocco: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - 201 187 173 147 109 76 Female adult mortality rateb 281 268 258 236 207 197 184 Male adult mortality rateb 370 347 330 303 264 246 234 Female life expectancyc 49.2 51.8 54.5 57.5 61.3 63.8 66.3 Male life expectancyc 46.7 49.0 51.4 54.1 57.9 60.4 62.8 Total fertility rated 7.2 7.1 7.0 6.4 5.5 4.8 4.1 Determinants Income percapitae 804 1,168 1,257 1,420 1,832 1,910 2,112 Female education (years)f - - - - - - - Male education (years)f - - _ _ _ _ _ - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 225 Figure D.8 Morocco: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0%- 2.0 -10% 1 1-2 u ~~~~~~~~~~~~~~~~~0.9 0.9 -20%-38 -20% -20% 0 -30% ~~227 350% -1 -.0 ZD'40 %I - :.: ttI 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 30% 6.0 4.1 19%0/ 4.0 u 20% 2.2 2.5 14% ~ ~~~%2.011 10% ~~~~~~%9% .2 0.4 0.3 100% E agli -0.3 0% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 30% --6.0 4.5 4.02. 2 0%0.1% 7 2.6 13% ~~~~~~~~~~.'2.0 1.2 0. .2 ~~~~~~~~1%0.8 0 10%/ 8% 8% 0.0 -0.1I 0% ~~~~~~~~~~~~~~~-2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 226 Measuring Country Performance on Health Table D.9 Oman: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - - - Female adult mortality rateb 325 290 390 442 326 213 157 Male adult mortality rateb 423 382 466 509 389 271 217 Female life expectancyc 42.3 46.0 50.2 56.1 64.6 69.8 71.8 Male life expectancyc 40.4 44.0 47.8 53.8 61.6 66.2 67.7 Total fertility rated 7.2 7.2 8.2 9.7 10.0 9.1 7.8 Determinants Income per capitae - - 4,968 6,069 6,615 7,729 7,408 Female education (years)f - - - - - Male education (years)1 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 227 Figure D.9 Oman: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 6.1 6.0 . 4.8 OO/D -10% -l l ll3.6 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0%0/ 12.0 -20% ~~~~~~~~~~~~~~~~~8.0 -20%- | l 5 % 4.0 4.6 g;-40%/o -34% > 40 . 4) -60%- i i o _ t - -4.0 -40% a -80% 7 0o -8.0 -100%/ -12.0 -. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% -17 5. 5.3%120 -20% | | | 4oj ~~~~~~~~~~~~~~~~~~~~~~2.6 ; -60% -50% - -4. C-~ ~ ~ ~ ~ ~ ~~~~~~~~~~~~-. > -63% 03.5 79% -80% -8.0 -7.6 -100% / -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 228 Measuring Country Performance on Health Table D.10 Qatar: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - - - Female adult mortality rateb 175 200 219 193 159 132 112 Male adult mortality rateb 243 258 275 252 224 210 194 Female life expectancyc 56.6 60.8 64.4 67.6 69.8 73.0 74.2 Male life expectancyc 53.5 57.3 60.7 63.5 65.4 67.6 68.8 Total fertility rated 7.0 7.0 6.9 6.6 5.8 4.9 4.5 Determinants Income per capitae - - - - 33,946 22,878 16,326 Female education (years)f - - - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability or dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specitbc levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 229 Figure D.10 Qatar: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 4.0 E 2.9 3.0 (A ~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~2.3 21 : -10% - 2 0-~~~~~~~~~~~~~~~~~~~~~. -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0%- I ' 5.0- -500 4 .0 3.5 3.6 B,-10%- _ ll <3.0 30% - o.0 0130. 5 0~~~~~~~~~~~~~~~~~~~~~. 4) I 1| 21 .0+3. -2% 119 - 1.0 0.5 -30% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% I I 5.0 3.0~~~~~~~~~~~. _ -20% p p k3~ . 4) ~ ~ ~ ~ ~~~~~~~~~~~~~ ~~~1.0 -30% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 230 Measuring Country Performance on Health Table D.11 Saudi Arabia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - - _ FemaLe adult mortality rateb 326 292 275 278 241 188 158 Male adult mortality rateb 419 373 345 330 283 228 192 Female life expectancyc 47.1 51.3 55.5 59.9 64.1 69.1 70.5 Male life expectancyc 44.8 48.6 52.4 57.6 61.4 66.4 68.0 Total fertility rated 7.2 7.3 7.3 7.3 7.3 7.0 6.6 Determinants Income per capitae 3,884 4,964 6,997 10,938 12,725 10,923 7,134 Female education (years)f - - - - - - Male education (years)f - - - _ _ _ - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the ave.age years of education in the female and male populations aged 15 to 60. Annex D 231 Figure D.1 1 Saudi Arabia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% l l l l 5.0 : 3.9 4.0 4.0 -3.5 3.6 3.0 F-10%/ 2.0 Ł5 2.0 -1.5 -200% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% - - 12.0- - 8.0 4.0 -2 -20% -.0 -1%-21% -40%--28% 10% -4.0 -3.6 Q % g1g1g1|111S1l 40 04-30% -40%- -24%-24%426%-28.8-8-04o -l 11 l -3.6 .> -40% S ~~~ ~ ~~~~~~~~~~~~~-8.0 -6.1 . -4%-41% -60% -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% 12.0 8.0 42 5.8 0% 4.0 -20% 0.0 -24% -24% -269'. -4.0 -. A ~~~~~~~~~~~~~~~~~~~~-7.4 -60% -12.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 232 Measuring Country Performance on Health Table D.12 Syrian Arab Republic: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortaLity rate' 200 167 128 97 74 56 42 Female adult mortality rateb 294 285 268 251 237 210 177 Male adult mortality rateb 367 352 328 309 299 274 237 Female life expectancyc 52.4 55.5 58.7 61.9 64.4 66.9 69.6 Male life expectancyc 49.7 52.5 55.4 58.3 60.8 63.2 65.2 Total fertility rated 7.3 7.6 7.7 7.6 7.4 7.0 6.3 Determinants Income per capitae 1,575 1,844 2,060 2,981 4,151 4,332 3,884 Female education (years)t 0.6 0.8 1.1 1.6 2.4 3.2 3.9 Male education (years)f 2.1 2.7 3.2 4.0 4.9 5.7 6.3 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 233 Figure D.12 Syrian Arab Republic: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 4.0 3.1 3.2 0% 3 2.8 2.7 o 0% - _ I I 2.4 -3% -2% / 1.9 U 2 i,; | la uh ; i 1 3 | |-9% | 2.0 -10% ,n 1.3 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% 8.0 5% |R 6.0 -5.0 x -2 18% I Q o -9% S | g ~~ ~ ~ ~~~~~~-8% >'402.8 3.0 26 3.0 -20% 0.0 -10% 0 0- 1.0 N | g 17% 1. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% T 8.0 8 °% | | 3 1 % I 1 I%Ig 6.0 50 6.0 ~~~~~~~~~~~~5.0 i 0% *1 - 2 0% 0 ~ ~ ~~~~~~~~~~~~~~~~~~. u 0 . | ~~~~~~~~-7%K a(8%0 2,9 3.2 3.2 1 -2 198 9,6in*8T 2.6~~~~ 2~ -40% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 234 Measuring Country Performance on Health Table D.13 Tunisia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 254 226 201 145 100 70 48 Female adult mortality rateb 270 246 249 242 224 204 174 Male adult mortality rateb 324 287 276 251 227 212 190 Female life expectancyc 50.1 52.6 56.1 60.6 63.6 66.4 68.7 Male life expectancy' 49.1 51.6 55.1 59.6 62.6 64.9 66.9 Total fertility rated 7.1 7.0 6.5 5.9 5.3 4.4 3.6 Determinants Income per capitae 1,101 1,174 1,299 1,801 2,310 2,670 2,756 Female education (years)f 0.3 0.5 0.9 1.5 2.0 2.3 3.0 Male education (years)f 1.0 1.4 2.1 3.0 3.9 4.3 4.9 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 235 Figure D. 13 Tunisia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% - 2.0 20% 9% -60% -1.U 40% - 08 0.7 F ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~0.4 3% - 8-0.1 8 -20% 4) ~~~~~~~~~~- / 0.0 t -40% 340/ -32% -30% 0 ~~~~~~~~~~~~~-0.3 -60% - -1.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female life Expectancy 40% -- 10.0 30% - 8.0 19,% % 20% 6.0 505 20% 6.0 1960 1965 19702 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 4.1 o ~~~~~~~~~~~~~~~~~~~~~~~~~~~~3.4 38 lw 10%/ . 4) 1% 9 1.8 -~~~~~~ 0% ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~2.0 00 0.1 0.4 -10% 0.0~~~~~~-3 Im 1960 1965 1970 1975 1980 1965 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 400% - 10.0 29% ~~30% 7.8 30%0/ 27% 2% 27% 26% 8.0 22%k 6.6 6.5 20% '26.0 10% ~~~~~~~~~~~~~~~~~~~~~~~4.0 10% ~~~~~~~~~~~4.0 4) ~~~~~~~~~~~~~~~~~22.5 2.0 '~0% 0 2.0 -lo% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 236 Measuring Country Performance on Health Table D.14 Republic of Yemen: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - 198 160 129 Female adult mortality rateb 469 426 388 324 304 329 336 Male adult mortality rateb 539 492 449 415 382 373 363 Female life expectancyc 37.8 40.3 42.8 48.5 50.5 52.0 53.0 Male life expectancyc 37.4 39.9 42.3 45.0 49.0 51.0 52.3 Total fertility rated 7.5 7.7 7.7 7.9 7.9 7.8 7.6 Determinants Income per capitae - - 815 961 1,244 1,413 1,770 Female education (years)f - 0.0 0.1 0.2 0.5 Male education (years)f - - 0.2 0.7 1.7 2.7 - Not available. a. Under-live mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex D 237 Figure D.14 Republic of Yemen: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0%- 4.0 5 l l l | | < 3.2 -20% 2.4 27 2.0 9 -40% - 2.0 1.5 _ -60% -490 n5 -61% -80% 0.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% o. 0.0 I -20% -14% _7% -4.0 5 ~~~~-24% o2 -40%/o t -35% y -8.0 -6.6 0 | 111 O | 11 -8.4 -8.5 -60% i -50% -12.0-10.0 -0 / 0-10 -80% -16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% no111 1 I . -20% -151 I 14% 1 3%/6 -4.0 -20% t -26% -5.3 -5.7 -5.4 -40% -7.3 -60% > -12.0 -80% l -16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex E South Asia Regional and Country-Specific Indicators of Performance on Health This annex provides information, for five countries in the South Asia region, on performance relative to income for six health indicators. For each country, the annex includes a figure with panels displaying values of the six indicators over the period from 1960 through 1990. Panel A: Under-Five Mortality Rate Panel B: Female Adult Mortality Rate Panel C: Male Adult Mortality Rate Panel D: Total Fertility Rate Panel E: Female Life Expectancy Panel F: Male Life Expectancy In addition, each country profile includes a table with the values at five-year intervals for each health indicator, for per capita GDP (in 1985 international dollars adjusted for purchasing power), and for the average years of edu- cation for males and females aged 15 years and over. Two regional profiles are presented before the country profiles. One shows regional performance relative to income for the six indicators; it is directly analogous to the country profiles. The second shows regional perfor- mance relative to education as well as income levels. This gives a sense of the extent to which performance on health relative to income results from educational differences. Also preceding the country profiles is a figure show- ing "health performance diamonds" that depicts the overall performance of each country in the region in 1990. The main text discusses the methods used and provides tabular summaries of results, including country-spe- cific results on performance that control for education as well as income. 239 Contents Regional Performance over Time (Figures E and EE) 241, 242 Country-Specific Health Performance Diamonds, 1990 (Figure EEE) 243 Country-Specific Performance 1. Bangladesh 244 2. India 246 3. Nepal 248 4. Pakistan 250 5. Sri Lanka 252 240 Annex E 241 Figure E South Asia Region: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 1.0 2 46 -23% -25°b -24% -2% .5 25- 10%-50%3 -il/c 01 00 0-0 _ccn0 I 0 - -0.2 -0.3 0~~~~~~~~~~~~~-. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 50 5.0 52 /B c 0.0 E15 0 7 8 9 91 1 1 15 -01 9 >~ *12% 14 5 18% 410--5 -. -23% -25%1 -24%0 -2.5 -2.5 -2.7 -50% -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50% 5.0 4) ~~~~~~~~13% 12% 1 1%o 1.5 11 i.8 1 cc 1% 1% 3% 0% 00 C-5 -50% ~~~~~~~~~~~~~~~~-5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 242 Measuring Country Performance on Health Figure EE South Asia Region: Performance Relative to Income and Education Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 50% 0.0 U ~~~~~8% 5% 5% 5% 2fOI -0.4 i 0 °%- / g+ -0.5 -0.4 0.5 U -o ~~~~ ~ ~~~~~~~~~~~~~~~~~~~-0.6 -0.6 a ~~~~~~~~~~~-0.6 .< ~~~ ~ ~ ~ ~ ~~~~-18% °2 9 -50%/o - a -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% 5- 3.0 3.1 U 11 10 1.3 0.3 0.3 2 0% J 0.0 _ |5-8% -5% -5% - -0.7 -12% -14% -14% -50% -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 500% 5.0 3.9 3.0 24 2.8 2.4 2.6 24 2.02. S 7% 5% 6% 11% 12% 11% 8% *m IE EoEII 0 0/0 ~~~~~~~~~~~~~~~~0.0 -50% -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex E 243 Figure EEE South Asia Region: Country-Specific Health Performance Diamonds, 1990 Bangladesh India q5 q5 q45m t t 4 a-5f q45m g g > / q45f tfr tfr Nepal Pakistan q5 q5 q45m q45f q45m 45f tfr tfr Sri Lanka q5 q45m f 45f (q5 value is for 1985) tfr Note: q5 = under-five mortality rate; tfr total fertility rate; q45f = female adult mortality rate; q45m = male adult mortality rate. Each axis of the performance diamond is scaled so that the midpoint of the distance between the origin and the tip of the relevant axis corresponds to per- formance equal to what would be predicted by income. Values better than would be predicted are plotted between the midpoint and the tip at a distance proportional to the country's performance on the indicator relative to the performance of the best-performing country on the indicator. Likewise, values poorer than would be predicted are plotted between the midpoint and the origin. The diamond connecting midpoints of the axes depicts, then, expected performance. The shaded diamond depicts the country's performance. When the shaded area lies inside the expected performance box, country per-or- mance is poor; when outside, performance is good. 244 Measuring Country Performance on Health Table E.1 Bangladesh: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 247 237 237 233 207 171 139 Female adult mortality rateb 538 536 486 439 388 338 308 Male adult mortality rateb 551 518 473 431 383 340 322 Female life expectancyc 39.5 42.5 44.1 46.1 49.3 53.5 57.2 Male life expectancyc 41.7 44.1 45.6 47.1 50.1 53.1 56.0 Total fertility rated 7.1 6.8 7.0 6.7 6.2 5.5 4.4 Determinants Income per capita' 944 1,044 1,162 917 1,025 1,138 1,315 Female education (years)f 0.1 0.2 0.3 0.5 1.0 1.2 1.4 Male education (years)f 1.0 1.4 1.4 2.0 2.7 2.8 3.0 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. t. Education: the average years of education in the female and male populations aged 15 to 60. Annex E 245 Figure E.1 Bangladesh: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0o% 2.0 20/ C.)1|1 1!01 | | | | ,o 1. -2-20% 2 -c~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. -3 2 0.0 M w -40% 0. 007 o) -25% l E S l -42% -40% -44% -45% 0 ~ ~ ~ ~~~~~~~~~~-. -49%_ -60% -1 0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -20% T 9 lS E N E! SS DEN FS | *| Ei -2.0 8 [ [ [ [ [ [ [ | -4.0 -3.2 I 400o -32% -32% -6.0 t ~~~~~~~-38% 43% ~~~~~~~~~~~~~~~~~~~~-6.2 4) -48% -. -60% -56%.-53o -7.9 0 -10.0 -93 -8.8 -9.9 -9.9 -80% -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0 0 - 6% -2.0 -0.8 -10% -8% -20% -17%-4031 C t g | S ~~~~~~~~~~~~ ~~~~~-4.0 + 7-3.1 C -3.7 -29% -30% 427% C-47 _ -45 -40% - -6.0 -.+1 I -8.0 -60% t) = 0 a -10.0 -80% / -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 246 Measuring Country Performance on Health Table E.2 India: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 l990 Health indicators Under-five mortality ratea 242 221 202 195 173 143 110 Female adult mortality rateb 407 375 353 313 279 268 241 Male adult mortality rateb 398 361 324 285 261 253 236 Female life expectancyc 44.7 47.3 49.3 52.4 55.2 57.9 61.7 Male life expectancyc 46.2 48.7 51.2 53.3 55.6 57.8 60.6 Total fertility rated 6.6 6.3 5.8 5.4 5.0 4.5 3.8 Determinants Income per capitae 716 785 727 792 854 978 1,184 Female education (years)f 0.8 0.9 1.2 1.6 1.9 2.3 2.8 Male education (years)f 2.5 3.0 3.3 3.8 4.6 4.9 5.4 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex E 247 Figure E.2 India: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 1.0 -10% 20.0 -_1.7-16%-7 r -20% -170/o -19% 19%0 .7 80.9 -30% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 60% 6.0 4.0 40% 0 rs -2.0 20% - u 0% Ok I,m E ~~~~~~~~~~~~~~ ~~-2.0- 0 -2.1~~~~~~L -. -~~~~ -20% 70. 5% -5 -401 20/ 16% -15% -134 4. -40/% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Paniel C: Male Adolt Mortality Rate Panel F: Male Life Expectancy 60% --6.0 40 0/. ~~27% 3% 26%o 25%/. 1.9 2.1 2.3 20 19% II li 20% 2.0 08 C 8% 11% 0..o 0 0%a c~-2.0 -20%~~~~~~~~~~~~~~~~ -4.0 -40% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 248 Measuring Country Performance on Health Table E.3 Nepal: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 300 264 232 205 179 151 128 Female adult mortality rateb 507 494 476 441 395 382 376 Male adult mortality rateb 527 512 482 431 376 360 350 Female life expectancy' 38.6 40.5 42.5 45.4 48.3 51.2 54.1 Male life expectancyc 39.6 41.5 44.0 47.0 49.9 52.8 55.1 Totalfertilityrated 5.8 6.0 6.4 6.5 6.4 6.1 5.7 Determinants Income per capitae 628 634 648 679 907 924 959 Female education (years)f 0.0 0.1 0.1 0.1 0.2 0.5 0.7 Male education (years)f 0.2 0.3 0.4 0.6 1.6 2.1 2.5 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant internatinnal dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex E 249 Figure E.3 Nepal: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 1.0 0.6 -0 -240% -1o.0- 1960 196 1970 195 1980 185 19901960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy -20% -4 -2-1.0 @~~~~~~~~~~~~~~ -6%-> .0- -io.a S -8160-8.5 -60% -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Fmale Adult Mortality Rate Panel F: Fmale Life Expectancy 0% 0.0 -2.0 -. ci ~ ~ ~ ~ ~ ~ ~ ~ 8 u -200/o -412.010 -4.0 -2.8 -20% -183% -3.8 -3.5 8 -20% -19%~-8 /. 7. 40% -41% -400/o ~ ~ ~ a-5. -40% ~ ~ ~~~~~~~~-4%-810_019 86- -60%0/ -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 250 Measuring Country Performance on Health Table E.4 Pakistan: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 226 198 183 170 161 144 138 Female adult mortality rateb 456 426 381 334 291 267 247 Male adult mortality rateb 420 384 339 307 283 261 232 Female life expectancyc 44.4 47.5 50.5 53.8 56.9 60.1 62.6 Male life expectancyc 45.6 48.0 50.6 53.1 55.6 58.1 60.6 Total fertility rated 6.9 7.0 7.0 7.0 7.0 6.6 5.9 Determinants Income per capita' 602 736 952 927 1,018 1,173 1,350 Female education (years)f 0.2 0.4 0.6 0.7 1.1 1.1 2.8 Male education (years)f 1.2 1.6 2.4 2.4 3.0 3.1 5.4 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex E 251 Figure E.4 Pakistan: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel L: Tlotal Fertility Rate 20% 2.01 0% 1.3 1.3 20% -9 -9% PE 1.0 -) -60% --% 0. -40%~~~~~~~~~~~~~~~~~ 00 600 % -27%-25 -80% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 40% 6.0 4.0 20% 2.2 0 ~~~~~~~~~~~~~~~~~~~~2.0 0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~0 F 0% . 0 0 0 -2.0 .C200/-%-0 1 a- -25% -2%-25% 31%0 -. . .3. - 2.8 -40% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% 6.06 T 20%/ 20%/ 2+ 4.037 20% 60I 0%20 . 2.0 08~0.4 0.5 f Cl ~ ~ ~ ~ E 0% >. 0.0 0~~~~~~~~~~~~~~~~~~ 20 %CO -2. -40% ~~~~~~~~~~~~~~~~-6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 252 Measuring Country Performance on Health Table E.5 Sri Lanka: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 133 122 100 69 48 32 Female adult mortality rateb 238 201 196 181 152 135 120 Male adult mortality rateb 204 201 214 222 210 197 184 Female life expectancyc 63.7 65.0 66.0 68.5 71.5 73.0 74.2 Male life expectancy' 63.3 63.5 64.0 65.0 67.0 68.5 69.7 Total fertility rated 5.3 4.9 4.3 3.9 3.5 2.9 2.5 Determinants Income per capita' 1,172 1,190 1,216 1,255 1,482 1,860 2,050 Female education (years)f 3.3 3.4 4.4 4.0 5.1 5.4 5.6 Male education (years)f 4.5 4.7 5.0 5.4 6.0 6.2 6.3 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d Total fertility rate is the ntumber of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex E 253 Figure E.5 Sri Lanka: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 120% --0.0 94% 80% 69% -1.0 0.8 F~~~~~~~2 -1.1 no 42°o% n | JQ -1.l-l^4 > 40% -29% 30% l -2.0 -1.7 17 -1.8 -1.7 0% -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 20.0 T 16.0 60%0/o1. 1. 12.8 12513.1 c t 49% 47% 49% '' t 12 8 11.9 12.5 11.8 12.2 8 03% ||| |~|40%i 40% 30% 4.0 2 67% 4 62% 16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 80% ~ ~ ~ ~~~~~40 9 20.0 67% 62% 16~~~~~~~~~~~~~.0 1~240% 0 4.0 0%I/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex F Sub-Saharan Africa Regional and Country-Specific Indicators of Performance on Health This annex provides information, for 46 countries in the Sub-Saharan Africa region, on performance relative to income for six health indicators. For each country, the annex includes a figure with panels displaying values of the six indicators over the period from 1960 through 1990. Panel A: Under-Five Mortality Rate Panel B: Female Adult Mortality Rate Panel C: Male Adult Mortality Rate Panel D: Total Fertility Rate Panel E: Female Life Expectancy Panel F: Male Life Expectancy In addition, each country profile includes a table with the values at five-year intervals for each health indicator, for per capita GDP (in 1985 international dollars adjusted for purchasing power), and for the average years of edu- cation for males and females aged 15 years and over. Two regional profiles are presented before the country profiles. One shows regional performance relative to income for the six indicators; it is directly analogous to the country profiles. The second shows regional perfor- mance relative to education as well as income levels. This gives a sense of the extent to which performance on health relative to income results from educational differences. Also preceding the country profiles is a figure show- ing "health performance diamonds" that depicts the overall performance of each country in the region in 1990. The main text discusses the methods used and provides tabular summaries of results, including country-spe- cific results on performance that control for education as well as income. 255 Contents Regional Performance over Time (Figures F and FF) 258, 259 Country-Specific Health Performance Diamonds, 1990 (Figure FFF) 260 Country-Specific Performance 1. Angola 268 2. Benin 270 3. Botswana 272 4. Burkina Faso 274 5. Burundi 276 6. Cameroon 278 7. Cape Verde 280 8. Central African Republic 282 9. Chad 284 10. Comoros 286 11. Congo, Republic of 288 12. C6te d'lvoire 290 13. Djibouti 292 14. Ethiopia 294 15. Gabon 296 16. Gambia, The 298 17. Ghana 300 18. Guinea 302 19. Guinea-Bissau 304 20. Kenya 306 21. Lesotho 308 22. Liberia 310 23. Madagascar 312 24. Malawi 314 25. Mali 316 26. Mauritania 318 27. Mauritius 320 28. Mozambique 322 29. Namibia 324 30. Niger 326 31. Nigeria 328 256 Annex F 257 32. Reunion 330 33. Rwanda 332 34. Seychelles 334 35. Senegal 336 36. Sierra Leone 338 37. Somalia 340 38. South Africa 342 39. Sudan 344 40. Swaziland 346 41. Tanzania 348 42. Togo 350 43. Uganda 352 44. Zaire 354 45. Zambia 356 46. Zimbabwe 358 258 Measuring Country Performance on Health Figure F Sub-Saharan Africa Region: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 50% 2.0 2 5~~~~~~~~~~~~~ / (0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 'C- I0 1 | | | S T - *; i! I X 11 1.0 >--27% -29 % 0. _ _5.7 _ 5.6 -5.6 7 6 a ~~~~~~~~~~~~~~~~~~C -50% -10.0 I 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 196 19517C9518-9519 96 9517 9518 9519 S o 2.- -5.0 (2 30% 31~ 241% 290% -28%/ -50%A -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Annex F 259 Figure FF Sub-Saharan Africa Region: Performance Relative to Income and Education Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 50% 1.0 3% 00 X 3% 3 0( 0.1 03 0° E 0.0- I A 0. -50% 0 -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy - 0> -3.1 -3. -50% 05.0 5 -17% -18% %20% 22% 2 9% -2.21 _2.4 C -2.6 -. (4(4 ~~~~~~~~~~~~~~~~~~~~~~~~-3.1 -3.1 -50%/ -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -21% -2% 21% -0 2%_ (4 -3.3 A 0 ~~~~~~~~~~~~~~~~~~~-. -3.5 - . -3.8 -50%/ -5.0- 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 260 Measuring Country Performance on Health Figure FFF Sub-Saharan Africa Region: Country-Specific Health Performance Diamonds, 1990 Angola qs Benin q5 q45m q45f q45m k q45f (q5 value is missing) (q5 value is missing) tfr tfr Botswana q5 Burkina Faso q5 /45m q45f q45m q45f (q5 value is for 1985) tfrtf Burundi Cameroon q5 q45m + q45f q45m A q45f tfr tfr Annex F 261 Figure FFF (continued) Cape Verde Central African Rep. q5 q5 q45mrn, ,5 , qf5f q45m q451 (q5 value is for 1985) (q5 value is for 1985) tf Chad Comoros qS5 q45m q45f q45m , -20% tl -16% -19% c i -4.0t ci| -26% a0 & -40% t-8.0 t-6.3 -60% -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 274 Measuring Country Performance on Health Table E4 Burkina Faso: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 i970 1975 1980 1985 1990 Health indicators Under-five mortality rate' 314 295 278 262 241 218 197 Female adult mortality rateb 456 430 407 379 362 349 338 Male adult mortality rateb 586 554 526 494 467 446 429 Female life expectancyc 38.2 40.2 42.6 44.2 46.2 47.9 45.4 Male life expectancyc 35.7 38.0 39.7 41.6 43.6 45.4 46.5 Total fertility rated 6.4 6.4 6.4 6.5 6.5 6.8 7.0 Determinants Income per capitac 486 404 392 387 449 490 515 Female education (years)1 - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. tncome per capita is measured in 1985 constant inLernational dollars, thaL is, dollars adjusLed for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 275 Figure F4 Burkina Faso: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate > -24% -2% 0 T -40% -1.0 , S -11.5-17 -20%~~~~~~~~~~~ _ 0.2 -.0 ._ t -2-20% -17% - 16 0. 0 -40% 0 1-..-. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 4, ~~~~~~~~~~~~~~~~~~-5.0 5 -13% -15%/) -14% -20%/ -2 2 0/. ~ ~ ~ ~ ~ ~ 10 8 -8.4 -8.5 4) 0 .-11.5 -40% 10 1960 1965 1970) 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0%C/ 0.0 -5.0 -20% _ -18%0-i8.7 -400% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 276 Measuring Cotintry Performance on Health Table F5 Burundi: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 250 241 233 215 195 181 168 Female adult mortality rateb 457 441 432 420 400 383 379 Male adult mortality rateb 568 544 532 516 489 468 460 Female life expectancyc 43.6 45.1 45.6 47.6 49.6 50.0 46.1 Male life expectancyc 40.4 41.9 42.4 44.4 46.0 46.5 43.0 Total fertility rated 6.8 6.8 6.8 6.8 6.8 6.8 6.8 Determinants Income per capitae 640 496 399 442 483 501 546 Female education (years)f - - - - - - - Male education (years)f - - - - - - - Not available. a. Under-five mortality rate: the probability of dying hetween birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specifc levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 277 Figure E5 Burundi: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 2. 0 a ~~~~~~~~~~~~~~~~1.00. 0% 0/ 0.5 2 0% I 110.3 02 0 0.0 -20% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 Q -5.C 4.4 -4.1 s -20% -7.3~~~~~~~~~~~~~4. -. -. -2 20/o-10.0 -2 4% -25% -25% -25%/ V 227011. -40% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -4.6 -. -5.1 -5.2 -20% ~-22% _2% 23% -23% -23% 7. -10.0 - U,-26% -7 -11.2 -40% ---15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 278 Measuring Country Performance on Health Table E6 Cameroon: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - 235 215 197 172 148 127 Female adult mortality rateb 4-86 472 452 433 415 392 361 Male adult mortality rateb 602 575 544 515 489 461 430 Female life expectancyc 42.0 44.5 47.3 50.0 52.5 55.0 57.8 Male life expectancyC 39.0 41.5 44.3 47.0 49.5 52.0 54.4 Total fertility rated 4.9 5.2 5.7 6.3 6.5 6.2 5.8 Determinants Income per capitae 641 673 763 843 1,004 1,361 1,371 Female education (yearsf 1.0 1.0 1.2 1.5 1.8 2.1 2.5 Male education (years)f 2.6 2.6 2.7 2.9 3.1 3.4 3.6 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying betwseen age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 279 Figure F.6 Cameroon: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 8 . > 1.0 -20% -16% 17% 049 -25% 0.0 Panel B: FMale Adult Mortality Rate Panel F: FMale Life Expectancy -40% 0.0 A -410 -5.0 -60% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 196 1965 19017 98 9519 ~.-4.0 40 - -360% _38% -40% -5.2 -520% -9 -60% ---8.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% ~~~~~~~~~~~~~~~~~~0.0 -2.0 - -20% 0 ~~~~~~~~~~~~~~~~~~~~-4.0 - -32 33%oi' -34 -33 -38.6 -40% -3%>5. -40% -6.0 - -6.0 -5.8 -60% --8.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 280 Measunng Country Performance on Health Table E7 Cape Verde: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ _ _ _ _ Female adult mortality rateb 315 296 279 257 249 242 218 Male adult mortality rateb 384 357 335 310 292 272 245 Female life expectancy' 54.5 57.0 59.0 61.5 61.5 63.5 65.5 Male life expectancy' 51.5 54.0 56.0 58.5 59.5 61.5 63.5 Total fertility rated 7.0 7.0 7.0 6.9 6.5 5.5 4.5 Determinants Income per capitae 469 441 577 516 694 961 1,031 Female education (years)f - - - - - - Male education (years)f - - - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 281 Figure E7 Cape Verde: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40%- 1. 0.5 20°b-k 0.4 0-504 L0 0% . 00_ilI_ _ _ _|_ -20%0o 0 > -0.6 -40% -1.o 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 12.0 77 8.1 8.4 8.07. 21% 6.1 220% 16 18% 4 )| 11 | 200/o 16% 15% 15% 4.3 4)1|1 11 1| * R 9% 4.0 5 9 4 0 _ _ _ _ _ - _ , _ ,I I 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% T 12.0 8.0 ~~8.5 25% 7.6 ~~~~~~~~~747.4 @ 1 22% 2 3% 24% 88.0 7 8 6.8 18% 20% 19 5.8 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 282 Measuring Country Performance on Health Table E8 Central African Republic: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 343 286 238 198 193 190 - Female adult mortality rateb 442 430 440 444 424 395 381 Male adult mortality rateb 519 574 571 567 540 5C5 485 Female life expectancyc 42.1 44.1 45.6 47.0 49.6 51.0 50.9 Male life expectancyc 37.0 39.0 40.4 42.0 44.1 45.8 45.9 Total fertility rated 5.6 5.7 5.7 5.8 5.8 5.7 5.7 Determinants Income per capita' 704 685 699 726 743 631 591 Female education (years)f 0.2 0.2 0.3 0.5 0.7 0.9 1.2 Male education (years)f 1.0 1.1 1.3 1.6 1.9 2.2 2.5 - Not available. a. Under-five mortaLity rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, doLars adjusted for purchasing power. f. Educatmon: the average years of education in the female and male populations aged 15 to 60 Annex F 283 Figure E8 Central African Republic: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 0.0 0 1960 195 19701975 19018 9016 95 9017 9018 902 - 20% °-1% -0.3 -0.2 -24% -21% -22% - 0.0 0-~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~~~~~~~~~~-. . 40 -403-4% ~~ -40% -36% 5 ~~~~~~~~ -0.6 -0.6 -0.6 --47% -60% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 0% 0.0 1 -200% -4.0 -30% -6.2 -6.265 -40% 34 3%-8.0 -7.2 -40% -40% -60% -12.0 1060 1065 1970 1975 1900 1085 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0%00 -20% Cs-4.0 C)~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~C 0~~~~~~~~~~~~~~~~~~~~~~~~~. Cs 0~~-3% Ž -40% 37- -35% -33% ' -s.o) Cs ~ ~ no' -40%37Cs -4 -8.4 -8.4 -~~~~~~~~~~~~~~~~-8.5 C4 _~~~~~~~~~~~0-.4 -. 8.8 -9.0 -8.8 -8.9 -60% -12.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 284 Measuring Country Performance on Health Table F9 Chad: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - 206 186 - Female adult mortality rateb 533 517 492 470 449 422 397 Male adult mortality rateb 554 554 554 586 556 520 487 Female life expectancyc 37.0 38.6 40.6 42.6 44.6 47.1 48.3 Male life expectancyc 34.0 35.5 37.5 39.4 41.4 43.8 45.1 Total fertility rated 6.0 6.0 6.0 5.9 5.9 5.9 5.9 Determinants Income per capitae 756 761 716 640 603 372 393 Female education (years)f - - - - - - - Male education (years)f - - - _ _ _ _ - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 285 Figure E9 Chad: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 0.0 10% -0.3 -0.2 -0.3 0% I I I I I III -~~~~~~~~~~~~~0.4 -0.4 I 0%- i | i | S-1.0 -047 -1.0 -20% -18% -40% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -4.0 -20% S ~~~~~~~~~-22% o ll li | | l -270k% -8.0 -7 -40% -9.3 %-41% -116 -12 1 -11.8 -11.2 -11.0 -47% -46% _ -60% - -16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -4.0 a -20% -26% -26% -8.0 -29% 8. A -3 9% 1-8.2-116 -12.2 -11.7 -60% -16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 286 Measuring Country Performance on Health Table EIO Comoros: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - - - Female adult mortality rateb _ _ _ 330 307 Male adult mortality rateb - - - - - 389 365 Female life expectancyc 44.0 46.0 48.0 50.0 51.0 53.5 56.0 Male life expectancyc 43.0 45.0 47.0 49.0 50.0 51.5 53.0 Total fertility rated - - - - - 6.5 6.3 Determinants Income per capitae 543 616 709 758 589 649 600 Female education (years)' - - - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged l5 to 60. Annex F 287 Figure EIO Comoros: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% , .0 2 0% ,# o% - I ~I I I I I I C -= 0.4 C- -2()%- g: | 0.4 -40%- 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 C -9-4.3 -4 3 _4.5 -4.5 0) C -16% -200%o 8.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 Ij~~~~ -1.4 i -1.5 ,> | -5% | -2.0 -2.2 21 -2.3 -4.0 .3 0) -10% C -20% 8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 288 Measuring Country Performance on Health Table F 11 Republic of Congo: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 209 173 - - - - - Female adult mortality rateb 448 438 395 346 298 263 273 Male adult mortality rateb 583 563 514 460 408 368 370 Female life expectancyc 45.3 47.3 49.3 51.3 53.9 55.2 54.1 Male life expectancyc 40.1 42.1 44.1 46.1 47.7 49.3 48.9 Total fertility rated 5.4 5.7 5.9 6.0 6.0 6.3 6.6 Determinants Income per capitae 1,123 1,093 1,333 1,706 1,766 2,509 2,356 Female education (years)f - - - - - 3.9 4.5 Male education (years)f - - - - - 6.0 5.8 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 289 Figure Eli Republic of Congo: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 4.0 - 3.0 2.5 -2% o C - 2.0 - 1.002 0.7 0V .I n i o ~~~~~~~~~~~~~~~~~~~~~1.0 -nn_n 0. V -15% -1.0 -0.7-04 -20% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0%0. 0.0 C -20% -4.0 -22% -4.7 -4.6 -5.1 -5.1 - 2 -32% | S -31% -27% _ . - 5.7 S, -40% t -36% -35% -37% 3 -8.0 -6.9 ci V n [-8.5 -60% -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy I 0/ l 1 0 .i II FIE 20% 04.0 -40% -7.0 -7.3~~~~~~~~~~4. c -20% A E E E E -374 o _3n 37% -7.5 a I a I ~~~~~~~~~~~~~~~~~~~~~~~~~~-8.9 -9.7 -60% 0 -12.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 290 Measuring Country Performance on Health Table E12 Cote d'Ivoire: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - 292 237 193 157 - - Female adult mortality rateb 476 449 428 408 346 287 294 Male adult mortality rateb 594 558 526 497 421 348 352 Female life expectancyc 42.1 44.6 47.1 49.7 55.0 57.0 56.5 Male life expectancyc 38.9 41.4 43.9 46.4 52.0 54.0 53.5 Total fertility rated 7.2 7.4 7.4 7.4 7.4 7.1 6.3 Determinants Income per capita' 1,120 1,288 1,487 1,709 2,057 1,638 1,409 Female education (years)f - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at bi-th: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbear;ng years and bear children at each age in accordance with preva.ling age-specific fertility rates. e. Income pzr capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 291 Figure E12 Cote d'lvoire: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate -47°b~~~~~~~~~~~~~~~~~~4 -20% 3 3.0 2.5 1960 1965 1970 1975 1980 1985 1990 1960 19651970 2197 1980198519902.3 2 (A~~~~~~~~~~~~~~~~~~~~~~~~~~~. t -40% -~~~~~~~~~~~~~~~ ~2.0 181.6 -40%1.4 0- 1.1~~~~~47 50 2 . -60% ---52% -50 - 1 0 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -20% -. -3.8 -4.1 2 ~~~~~~~~~~~~25Oo-4.4 C -40) 0- -38-40% 7.7-870 -42% ~~~-40% 4 -7.9 -7.9 -. -60% ~~~~~~~~~~~~~~~~-12.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% 15 40-.3.1 180/0 -3.-7. .~-40%5 > -8.0 -7 6 4) ~~~-41%/ -42%k -41%/ r -8.2 -. -60% -12.0 J 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 292 Measuring Country Performance on Health Table E13 Djibouti: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ _ - - - _ Female adult mortality rateb 519 492 470 449 428 410 387 Male adult mortality rateb 534 514 586 556 527 501 472 Female life expectancyc 38.6 40.6 42.6 44.6 46.6 48.6 50.0 Male life expectancyc 35.5 37.5 39.4 41.4 43.4 45.4 46.7 Total fertility rated 6.6 6.6 6.6 6.6 6.6 6.4 6.0 Determinants Income per capital - - 1,898 1,716 1,549 1,240 1,097 Female education (years)f - - - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probabilty of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education m the female and male populations aged 15 to 60. Annex F 293 Figure E13 Djibouti: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 u 3 12 1.3 1.4 12 z 1.2~~~~~~~~~~~~0 . C- ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~ 1.0~~~~~~~~~~~~. 0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. 0. -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 C)-20% E t | | | | | mn ~~~ ~ ~ ~~~~~5.0; ° -40% .6-10.0 _-60% 54 -56% % -50 -9.7 -30?o _57L -12.4 -11.9-11. -80% 1 -15.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% C-C ~~~~~~~~~~~~~~~430 Co -49% -46% ~ ~ ;-10.0 ~~ -60% ~~~-52% -9.6 -80% -12.9 ~~~~~~~~~~~~~~~~-12.0 -11.5 -11.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 294 Measuring Country Performance on Health Table E14 Ethiopia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - 239 226 213 201 - Female adult mortality rateb 391 403 411 413 401 376 358 Male adult mortality rateb 475 478 482 479 491 476 448 Female life expectancyc 38.5 40.5 42.6 43.6 41.5 46.6 49.1 Male life expectancyc 35.4 37.4 39.4 40.4 38.4 43.4 45.9 Total fertility rated 5.8 5.8 5.8 5.9 6.5 7.3 7.5 Determinants Income per capitae 252 272 296 304 312 319 312 Female education (years)f - - - - - - - Male education (years)- -Not availabLe. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate; the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total ferLility rate is the number of children that would be born to a woman if she were to live to the end of her childbearirig years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 295 Figure E14 Ethiopia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 3 01 5 0. 2 O% X % S '' 111 |~~~~~~~~~ i O 1x 1 1960 1965 1970 1975 1980 1985 1990-0. .. o -~~~~~11% -12% 0 7. -0. a -1-.1 CC ~~~~~~~~~~~~~~~~~>-1.3 -1L5 0% 2-.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% o- -1o 3% -4.0 1 0% 19 U - -~~_5 5%-.2-. 211 -~~~~~~~~~8.0 -6268 -7.0 -. a- -20% ~~~~-17%/ -17% 9-* > 12.0 0 ~~~~~~~~~-12.1 40t% -16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% --0.0 11 ~~~~~~~~~~~~~~-4.0 0% .0 -s.0 - 6.3 _71 -7.2 -6.7 a-~~~~~~-0 c -20% -17% -17% .5 -9.7 CC ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~ ~~~-12.0 -12.3 -40%/ -16.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 296 Measuring Country Performance on Health Table E15 Gabon: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality raLet - - - - - - Female adult mortality rateb 415 421 421 408 387 359 332 Male adult mortality rateb 532 531 521 500 474 437 402 Female life expectancy' 43.1 44.6 46.6 48.7 50.7 53.2 55.2 Male life expectancyc 39.9 41.4 43.4 45.4 47.4 49.9 51.9 Total fertility rated 4.1 4.1 4.2 4.3 4.5 4.8 5.2 Determinants Income per capitae 1,789 2,303 3,217 4,563 5,636 4,312 3,707 Female education (years)f - - - - - - - Male education (years)f - - - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 297 Figure E 15 Gabon: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% - 3.0 - E 2.0 1.6 C U 1.0 0.4 c o% I I I I I I 15 0.0 C -1.0 -20% -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -200% E'4 | W N ' , g _ _ _ _5.0 E -40% __31% 4- * l CN| c.4) ~-45% ~ -60%- -1 l ll l l-57% -10.0 -8.8 -9.2 -65% -5 7 -10.0 A -80% -72% -71% -70% -10.9 -10.7 -11 7 -12.1 -100% - ~ -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% F 1 li i i i l 1|l < ~~~~~~~~-5.0 | -40% -36% ( 5.0 -46% *51% -60% -54% 56% -58%-5 -10.0 -9.1 55 -8.2 A l a | ~~~~~~~~~~~~~-10.1 -9.7 -80% t I -10.6 -11.0 -11.1 -100% 1 -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 298 Measuring Country Performance on Health Table E16 The Gambia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - - - - Female adult mortality rateb 514 598 519 492 466 449 432 Male adult mortality rateb 578 687 655 623 584 556 530 Female life expectancyc 34.5 36.5 38.6 40.6 42.6 44.6 46.6 Male life expectancyc 31.5 33.5 35.5 37.5 39.4 41.4 43.4 Total fertility rated 6.4 6.5 6.5 6.5 6.5 6.4 5.9 Determinants Income per capita' 602 615 730 854 1,042 810 821 Female education (years)f - - - 0.5 0.5 0.7 1.0 Male education (years)f - - 1.1 1.3 1.8 2.4 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 299 Figure E16 The Gambia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 0.8 -08 0.6 E m 0.5 0.5 t 0% X° I , I I I 0.2 C., ~~~~~~~~~~~~~~~~~~20.1 - 0.1 U~~~~~~~~~~~~~~~~~~ -20 0 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 i990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 - -20%0- -5.0 '1 -40965 10 9 98 9 -10.0 C-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~1. > 6% -5%-51% -5% 52% -52% -~-0 13J. 2 -13.5 -38-41-47 1. 1. _56% 11 17 11 -80% ~~~~~~~~~~~~~~~-20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% -5.0 -27%5 -0 -40% ---10.0 Cd C'S -9 -901.-4%-12.C -80% -20.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 300 Measuring Country Performance on Health Table E17 Ghana: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 214 200 187 172 157 143 127 Female adult mortality rateb 419 400 377 358 334 299 270 Male adult mortality rateb 514 489 459 432 400 362 334 Female life expectancyc 47.7 49.7 51.8 53.0 55.0 57.5 60.0 Male life expectancyc 44.5 46.4 48.4 50.0 52.0 54.0 56.0 Total fertility rated 6.9 6.9 6.7 6.6 6.5 6.4 5.9 Determinants Income per capitae 871 918 932 992 948 816 830 Female education (years)f 0.5 0.6 2.1 2.0 2.0 2.0 2.0 Male education (years)f 1.5 1.7 4.5 4.7 4.9 5.2 5.3 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the niumber of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 301 Figure El 7 Ghana: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% - 1.0 - 0 0.7 0.7 0.7 0.7 0.7 0.6 >. -25% -24% -24% . 2 2 -2.00.5 -8% -10%-% 0~~ -11% -1131%13 00I -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 1 2.0 T -60% 0.0 -120 -0 2 -20% -22% ~~~~~-210%-. -25% -24. -24% 1 -26 -. -40% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 2.0 -3%06 -6% 0.0 -13% -20% -21 2%-2%-8 -40% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 302 Measuring Country Performance on Health Table E18 Guinea: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ - - - - - - Female adult mortality rateb 535 518 534 527 507 488 495 Male adult mortality rateb 526 554 636 613 589 560 529 Female life expectancyc 34.8 36.3 37.8 39.3 41.0 43.0 45.0 Male life expectancyc 33.8 35.3 36.8 38.3 40.0 42.1 44.0 Total fertility rated 5.9 5.9 6.0 6.0 6.1 6.4 6.5 Determinants Income per capita' 526 570 519 603 769 742 759 Female education (years)f - - - - - - - Male education (years)f - - - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 303 Figure E18 Guinea: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20%0- 2.0 E 1.0 C) 'S B 1.0 0.5 S 0% ~ I I I I I I I o 0.0 .° -1.0 -0.5 -0.5 7 -20% 0 -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -20% -5.0 -3-% ci XT ^, :n ST *E -60% -540. -13.4 -13.5 -13.3 159% 1590/ _ 114.3 15.3 15.4 -640% 1.3-5 -80% -20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% --15% -5.0 8 ~~-26% a ~~~~~~~-43% .2-io.s 1. 'S -~~~~~~~~.450% -11115-2 -49% -48% -47% > -1-12.1 -13.02. .5-60% -is.0 _13.0 10 -80% -20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 304 Measuring Country Performance on Health Table E19 Guinea-Bissau: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - _ _ - Female adult mortality rateb 530 506 513 517 517 513 533 Male adult mortality rateb 497 512 528 539 535 524 544 Female life expectancyr 35.6 36.0 38.1 39.1 40.9 43.3 44.4 Male life expectancy' 34.3 34.5 35.0 36.0 37.9 39.9 41.3 Total fertility rated 5.9 5.9 5.9 6.0 6.0 6.0 6.0 Determinants Income per capita' 503 557 653 816 598 618 659 Female education (years)f - - - - 0.3 0.4 0.5 Male education (years) - - - - 0.3 0.6 0.8 - Not available a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance w-ith prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 305 Figure E19 Guinea-Bissau: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate -c-0.3 a ~~~~~~~~~~~~~~~~~~~~~-0.5 -o 5 -O.S -67% ~ ~ ~ 80% -1 -0-0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -20% -5.0 -40% -Ž- -10.0 1 40% > ~~~~-48% C J. 4 -600% 5 51-015.0 -13.6 -140 -13.4 24~ ~~~~~7 59% 0 .5- 14.7 -14.6 -67% -80%/ -20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -9% u -20%/ -18 -5.0 2 ~~~~-28% co C~~~~~~~~~~8/oQ-. -47% > ~~~~~~-12.2 -Z) -60% 0 -15.0 -14.0 144-13.5 -15.3 -1. -14.7 -80% -20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 306 Measuring Country Performance on Health Table E20 Kenya: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 205 180 156 140 115 105 97 Female adult mortality rateb 442 411 379 357 339 311 287 Male adult mortality rateb 547 507 467 437 417 386 357 Female life expectancy' 48.0 50.5 53.0 55.5 58.0 59.9 60.8 Male life expectancyc 44.0 46.5 49.0 51.5 53.8 55.9 57.1 Total fertility rated 8.0 8.1 8.1 8.1 7.9 7.0 5.8 Determinants Income per capitae 648 602 667 815 877 839 893 Female education (years)t 0.8 0.9 1.4 1.4 2.4 2.4 2.9 Male education (years)f 2.2 2.4 3.0 3.0 4.5 4.3 4.6 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 307 Figure E20 Kenya: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40%0- 3.0 C 2.0 2.0 o 22% 21%1.7 E Cl aAat| l -420% -8 2160 1965 1970 1975 19 0 /95 90 195 99 C-~~~~~~~~~~~~~~~~~~~~~:L 0% 0.0~~~~~~~~~~~~~~~~~ . 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Feinale Adult Mortality Rare Panel E: Fenmale Life Expectancy 0% 4.0 I) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~1.9 -20% . -20% -20%/ -210% .C 0. >0. -40% ---2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% ~~~~~~~~~~~~~~~~~~4.0 - C ~ ~~~~~~~~~~~~~-1 . -1.4 ,2 -2 0%-18 -16% -16%/ -16% 0.4 0.5 C- 0 ~~~~ ~~~~~~~~~~~~~~~~~~~0.0 0.2I 0.0 -0.5 -40% -. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 308 Measuring Country Performance on Health Table E21 Lesotho: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 203 200 190 173 - - - Female adult mortality rate b 354 314 277 239 279 305 276 Male adult mortality rateb 450 404 365 329 371 424 384 Female life expectancyc 47.0 49.5 51.5 53.5 55.6 57.8 59.0 Male life expectancyc 42.0 45.0 47.5 50.0 52.3 55.5 56.4 Total fertility rated 5.8 5.8 5.7 5.7 5.6 5.4 5.1 Determinants Income per capitae 313 376 471 622 935 1,012 987 Female education (years!f 3.3 3.4 3.5 3.7 3.8 3.9 4.1 Male education (years)f 2.8 2.6 2.4 3.0 2.9 2.9 3.1 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 309 Figure E21 Lesotho: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 60% 0.0 0.0 -0.1 E -0.2 0 u 40% -36% -0.6 -0.7 0 -21%-0.9 -1.0 -09 20%2t% 140O 0-~~~~~~~~~~~~~~~~~~~~~~~~. 20%- 14% .o 6% > 0% -2.0 1960 1965 1970 1975 1980 1 985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 4.0 1 ~~~25% 20% 1 14% 2.0 1.6 1.2 0% 0.0 U | ~~~~~~~~-3% -0.2 6 0.3 *> -20% ; S -13% > -2.0 -1.3 -1.6 , -19% 0 -40% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% T 4.0 20% / 12% 15% 16% 2.0 CC 0 llR E E | S 0.4 o 0% I> 0 0.0 fi 1-6 i.o l-0.5 -0.5 _0.5 -0.4 *_-20% - 2.0 -1.2 0 -20%0t -26% -40% -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 310 Measuring Country Performance on Health Table E22 Liberia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 284 277 270 252 235 219 - Female adult mortality rateb 363 311 241 188 185 190 198 Male adult mortality rateb 479 419 340 281 268 256 254 Female life expectancyc 44.0 46.5 49.0 51.0 53.0 55.0 41.0 Male life expectancyc 41.0 43.5 46.0 48.0 50.0 52.0 38.0 Total fertility rated 6.2 6.3 6.5 6.5 6.5 6.5 6.4 Determinants Income per capitae 717 781 929 1,010 999 908 788 Female education (yearsif 0.3 0.4 0.5 0.8 1.0 1.2 1.3 Male education (years)f 1.0 1.2 1.5 2.4 2.8 3.1 3.0 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a wooman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant internationa' dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 311 Figure E22 Liberia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 -20% 0.9 0.9 31.0 0.8 0.4 0~~~~0 a -5%~~~~~~-2 2 -60% _550 0.-7. -80% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 60% 0.0 40% 40% 37 5.0 3 1 Ok% 2 5°t-4.4 -4.3 -4.2 -4.3 -4.1 -4.0 21% D 20% -10.0 3% a) >~ 0% -15.0 -5% -20% - -20.0 -17.5 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 60% 0.0I I I I IIII 40% -5.0 4 43 40 39 37 36 25% 26% 26% 26% ~ ~ -. 40 -. 37 -. 20 1. U C3 -15.0~~~~~~~~~~~~~~~~~~~~~~~~~~1. -20% -20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 312 Measuring Country Performance on Health Table E23 Madagascar: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 186 183 - - 175 173 170 Female adult mortality rateb 264 258 250 245 278 336 377 Male adult mortality rateb 377 365 351 338 353 398 434 Female life expectancyc 43.3 45.3 48.0 51.0 53.0 55.5 58.0 Male life expectancy' 40.4 42.4 45.0 48.0 50.0 52.5 55.0 Total fertility rated 6.6 6.6 6.6 6.6 6.5 6.5 6.3 Determinants Income per capitae 1,191 1,149 1,121 1,084 951 800 696 Female education (years)f - - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevaiLing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 313 Figure E23 Madagascar: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 -5% 0 -10% °2 -20% - 1.0 0 0.8 a1 0.60. 0.7 0.6 _2 9 %.5 ° -40% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 2.0T 2A 20% 16% 14% 12% 0.0 5 -2.0 5 0% o [ i. ~ -4.0 -3.2 -20% 4. -4.0 > S -23% -6.0 5 - -5.8 5 -40% -34% 0 -8.0 -7.0 -6.8 -60% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 40% T 2.0 0.1 0.0 20% -2.0 c t-5% 3% 4% 5% - +o < -20% t -16 a 3-4.0 - -2.8 I% 16% -1% ~~~~~~~~~~~~~~-4.1 C) -~~~~~~~~~~ -6.0 ~~~~~~~~~-5.6 -20% -160% C)6.7 C) 0 ~~~~~~~~~~~~~~~~~~~-8.o -7.0- -26% -40% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 314 Measuring Country Performance on Health Table E24 Malawi: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 360 354 347 303 271 252 233 Female adult mortality rateb 431 407 388 365 349 380 436 Male adult mortality rateb 522 501 479 452 429 423 479 Female life expectancyc 39.1 40.2 41.7 43.7 45.7 45.6 42.4 Male life expectancyc 37.8 38.9 40.3 42.4 44.2 44.2 41.4 Total fertility rated 7.8 7.8 7.8 7.7 7.6 7.6 7.2 Determinants Income per capitae 374 393 450 496 532 504 506 Female education (years)1 1.1 1.2 1.2 1.7 1.7 1.9 2.1 Male education (years)f 2.7 2.9 2.7 3.3 3.7 3.9 3.4 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 315 Figure F24 Malawi: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 4-)11 111 | E E E IID ii 11 11 11 li 1.2 -200 I. ._1 1. 1 _ -20%t> I-1. 2 0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. _39% 4 -15.0 , -14.5 t -s ~~~~~~~~~~~~~~~~~~~~1.0 -40% - -20 0 -44% S -60%O/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 0% 0.0 -20% -12% -12% -14% -13% -14 % -5.0 c, -.- -58-6.9 2~~~~~~~~~~~~~~~~~~~~~~~~~. o -24 % c 1. -8.3.0 -40% 4,-11.7 40 -39% t -15.0 ) 0 I-14.5 -60% -20.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 4)0% III-~'0.0 -l20% -2% -10/.I-11%-5.0 4, 4- ~~~~~~~~~~~~~~~~~~~~-6.7 -. 0 S -10.0 -~~~~~~~~~~~~~~~~~~~~7.6 -7.5 78 4) ~~~~ ~ ~~~~~~~-2 9 0/ -10.0 a. 0~~~~~~~~~~~~~~~~~~~~~~. -40% > s.o-12.6 -20.0 -60% 20 1960 1965 1970 1973 1980 1983 1990 1960 1965 1970 1975 1980 1985 1990 316 Measuring Country Performance on Health Table E25 Mali: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ - _ 345 291 246 Female adult mortality rateb 490 467 416 368 362 356 351 Male adult mortality rateb 589 568 537 497 454 425 434 Female life expectancyc 37.5 37.0 41.0 41.6 43.6 47.5 50.2 Male life expectancyc 36.1 35.5 37.0 38.5 43.4 45.6 46.7 Total fertility rated 6.5 6.5 6.5 6.5 6.6 6.9 7.0 Determinants Income per capitae 535 477 417 436 518 515 537 Female education (years)f 0.2 0.2 0.3 0.4 0.4 0.5 0.5 Male education (years)f 0.5 0.5 0.7 0.9 1.1 1.2 1.3 - Not available. a. Under-five mortality rate: the probabil:ty of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 317 Figure E25 Mali: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 1 2.0 -1 0 ~~~~~~~~~~~~~~~~1.0 > -20%/o 0 ~~~~~~~~~~~~~~~~~~~~~~~~~~0.1 0.1 0.0 -40% -36%/ 0 co -450%o C0)3 -48% 0/ -0.4 -. -60% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0%0/ 0.0 _3 0 2O -5.0 C ~ ~ Pae C:MlCdl)otlt aePae :Ml ieEpcac -20% -17% _18% -. a ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~ ~~~~-10.0 B ~~~~~~~~~~~~~~~~~~~~~~~~~~98-9.9 -30% -29% -12.1 -11 -11.5 _40% ' -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 C. -5.0 F -20% C)~~~~~~~~~~~~~-0 -. -27% -26% CC Ł ~~~~~~~~~~~~~~~~~~~~~~~11.1 -40% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 318 MeasLtirng Country Performance on Health Table E26 Mauritania: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 I lealth indicators Under-five mortality ratea _ _ _- - _ _ Female adult mortality rateb 466 445 433 427 416 386 365 Male adult mortality rateb 587 561 539 524 505 469 441 Female life expectancyc 41.0 43.0 45.1 47.1 49.1 51.1 53.1 Male life expectancyc 38.0 39.9 41.9 43.9 45.9 47.9 49.9 ToLat fertility rated 6.5 6.5 6.5 6.5 6.3 5.9 5.6 Determ;nants Income per capitae 780 825 856 890 990 887 807 Femalc education (years)f - - - - - Male education (years)f - - - - - - - Not available. a Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number cf years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 319 Figure E26 Mauritania: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% I I I I 1.0 - 0.6 -20% 0-4 -3 0 Dt't(!o g | l*I | a00 0-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Feiiiale Adult Mortality Rate Pariel E: Fernale Life Expectancy Con, C) O 0% 02. -0% -.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel F: FMale Life Expectancy 60% -10.0 -20% -3 5 5 09 > 36% ~~~-40% -39%> -44% 0 -80 7777 -77 7.9 -7.8 _ -8. 0 -7.8 -60%-- -10.0t 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -2.0 -20% -4.0 -32% -34 -359/ -36% CC-5. ~~~ -40% ~~~~~~37%> 0Z -8.0 0- ~~~~~~~~~~~~~~~~~~~~~~~-7.8 81 -7. -7.6 -7.8 -7.6 -60% ---10.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 320 Measuring Country Performance on Health Table E27 Mauritius: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate" 88 83 83 68 38 29 24 Female adult mortality rateb 255 233 2058 193 181 153 126 Male adult mortality rateb 316 291 268 274 277 262 241 Female life expectancyc 61.9 63.5 65.3 67.6 69.5 72.5 73.8 Male life expectancyc 58.7 59.7 60.7 62.4 64.0 65.1 66.8 Total fertility rated 5.9 5.0 3.8 3.2 2.8 2.3 2.1 Determinants Income per capitae 2,946 3,179 2,869 2,925 4,168 4,014 5,353 Female education (years)f 2.5 2.7 3.5 3.4 4.4 4.8 5.0 Male education (years)f 3.8 4.3 5.0 5.1 6.1 6.1 6.2 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth the number of years a newborn infant wooLld live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income pe. capita is measured in 1985 constant international dolLars, that is, dollars adjusted for purchasing power f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 321 Figure E27 Mauritius: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 1.0 58% 60% W 60% 0.1 0.0 J>2; 40% 36% 2% 35% 36% a- t 20%~ | l! | l || >-280/ -S -1.0 20% 0 _1l6 0% -3.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 30% 12.0 20% 17% 18% 16% 16% 10.0 8.8 8.9 8.0 8.27.77.9 a10% 9% 10% -~8.0 10% 6.0 01 1 a- 0~~~~~~~~~~~~~~~~~~~~. -10% 2.0 -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 30% T 12.0 20% + 15% 10.0 11% ~~~~~~~~~~~~7.7 8% 8% R 8.0 7.1 7.1 7.4 10% 6.3 (0 ta| i | | °°,° 5 6 0 | | | | i 5.7 15. a- a ~~~~~~~~~%6.0 0% ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~ ~~~4.0 -10% -7% 2.0 -20% 010 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 322 Measuring Country Petformance on Health Table E28 Mozambique: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - 281 283 285 - - Female adult mortality rateb 467 418 382 370 361 331 321 Male adult mortality rateb 592 538 498 482 468 435 418 Female life expectancyc 40.1 42.6 44.1 45.1 46.2 47.7 48.0 Male life expectancyc 37.0 39.4 40.9 41.9 42.9 44.4 44.9 Total fertility rated 6.3 6.5 6.5 6.5 6.5 6.5 6.5 Determinants Income per capitae 1,153 1,233 1,414 1,484 1,054 862 765 Female education (years)f 0.1 0.1 0.2 0.2 0.4 0.5 0.6 Male education (years)f 0.9 1.0 1.1 1.1 1.2 1.2 1.2 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,COO live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would lve if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 323 Figure E28 Mozambique: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 -2 -20%08o 0 U U -400%. 1.1 1.0 -40% .1.0 0.9 0.9 0.8 -60% _-D 0 a~~~~~~~~~~~~~~~~~~~~~~~~. a o -67% . 0.5 6 - 80%> _, - 77% S S S | l ! | | | |0.2 -80% -77% -100% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -20% -5.0 ''-> t lE 8 - S _~~21%-I F e E ||| | ~~~~~-23% 40% t3 -340% -32% _3%-31% o 9 l5 | 1 60%k - 35% -10.0 0 -10.5 .7-10.3 -60% -15.0- 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 00 - 0.0 u -20% -5.0 a |1 11 | 11 | ~~~~-24% m 1 1 1 | | | g a | E E 1E -26% -24% o -40% ~~~ -5%-35 a2 10.0 '39 > -10.3 -3 -10.4 -11.1 -10.9 11.1 -60% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 324 Measuring Country Performance on Health Table E29 Namibia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _- - - 108 97 86 Female adult mortality rateb 454 430 405 382 366 346 318 Male adult mortality rateb 548 515 482 451 427 403 373 Female life expectancyc 45.0 47.5 50.0 52.5 55.0 57.6 57.2 Male life expectancyc 42.5 45.0 47.5 50.0 52.5 54.8 54.6 Total fertility rated 6.0 6.0 6.0 6.0 5.9 5.7 5.4 Determinants Income per capitae 1,790 2,080 2,465 3,578 3,837 2,942 2,781 Female education (years)f - - - - - - - Male education (years)f -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortali.y at the time of its birth were to stay the same throughout .ts life. d. Total fertility rate is the number of children that would be born to a woman if she were to 'ive to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 325 Figure E29 Namibia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 l 1.5 1.5 1.5 -20% o1.3 S ' M TW ^tH 1E | | E I | S~~~-S O - 0. C~~~~~~~~~~~~~~~~~~~ -> -40% -45% -31% ; -6.0 0 -6.9 -6.8 -6.5 -6 5 -6.0 n -60% 54% ~~~~~~~- 0.30. -80% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 0% 0.0 -20% -2.0 1960 1965 1970197 190 185 190 960196 190 195 180 985199-4.0 -40% (2 C~~-4%.2-. -60% -5%> -6.9 -6.7 -6.5 _7.0 _ -~~~~~~~~~58% -58'! -57% 1 .o 6. -80% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0%0/ 0.0 -20% -2.0 F _ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~ ~~-4.0 -. -40% -- (23940%-38% -49 4.6 ~~j _~~41% -42% -42% -42% C40 -6.0-56 5. U .~~~~~~~~~ -6.5 ~~~~~~~~~~~-6.1 60% -8. ( 60 0 -80% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 326 Meastu-ing Country Performance on Health Table F.30 Niger: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _- - _ 300 310 321 Female adult mortality rateb 531 510 490 470 453 433 413 Male adult mortality rateb 543 544 611 588 562 533 515 Female life expectancyc 37.5 39.1 40.6 42.1 44.1 46.1 48.1 Male life expectancyc 34.5 36.0 37.5 39.0 40.9 42.9 44.9 Total fertil ty rated 7.1 7.2 7.2 7.3 7.4 7.5 7.4 Determinants Income per capitae 532 607 754 692 656 646 539 Female education (years)f 0.1 0.1 0.1 0.2 0.3 0.4 0.5 Male education (years)f 0.5 0.5 0.5 0.8 0.9 1.0 1.2 - Not available. a. Ulnder-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortalty rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adj usted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 327 Figure E30 Niger: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 -20% E 1.4 1.4 o r 1.2 l 11.0 8-60% 0. -100 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0%0/ 0.0 -260% -5.0 8 - -11.9 -11.8 -11.7 -11.9 -60% i -15.0 1 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 8-20% -5.0 C- ~ ~ -6 .2~~~~~~~~~~~~~-. U ~~~~~~~~~~-42%k -41% -3%-9.8 (4 45% 0 ~~~~-3%-11.0 -45% ~~~~~~~~~~~~-11.9 -11.8 -11.7 -11.9 -60% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 328 Measuring Country Performance on Health Table E31 Nigeria: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - 196 193 190 Female adult mortality rateb 429 481 502 473 453 428 401 Male adult mortality rateb 551 592 605 571 535 506 476 Female life expectancyc 42.0 43.6 45.1 46.6 48.1 50.0 52.0 Male life expectancyc 39.0 40.4 41.9 43.4 44.9 46.7 48.8 Total fertility rated 6.8 6.9 6.9 6.9 6.9 6.5 6.0 Determinants Income per capitae 562 583 588 1,112 1,421 1,265 952 Female education (years)f - - - Male education (years)f -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male popula:ions aged 15 to 60. Annex F 329 Figure F.31 Nigeria: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0%0/ 2.0 1.6 20 1599 1.3 -60%/ -54% 0 .4 -o T 0 -60%-59Q,6 0~~~~~~~~~~~~~-4/ -80% 0 1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: FMale Adult Mortality Rate Panel E: FMale Life ExpecLancy -0% .> -60% _% -48°o > -10.0 -8.8 9 8 9 > -20% t a I -64% ~ ~ ~ ~~ -. -80% 0 -5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: FMale Adult Mortality Rate Panel F: FMale Life Expectancy 0%0. -20% -21% -5.0 2 -40% 55% -0% 6. -48% -49% -48% I's5:C -10.0 -. -60% -.8 :. -80%~ ~ ~~-6%-9%-02 1. -80% ~~~~~~~~~~~~~~~-15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 330 Measuring Country Performance on Health Table F32 Reunion: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - - - - Female adult mortality rateb 208 199 180 153 121 100 85 Male adult mortality rateb 316 310 309 310 282 248 213 Female life expectancy' 60.9 64.1 68.1 72.5 74.0 77.0 77.7 Male life expectancyc 54.4 57.1 60.4 63.5 65.5 67.9 69.4 Total fertility rated 5.8 5.2 4.4 3.6 3.1 2.7 2.4 Determinants Income per capita' 1,092 1,334 1,771 2,042 2,554 3,043 3,194 Female education (years)f 2.2 3.0 3.2 3.8 - - - Male education (years)f 1.9 2.7 2.9 3.2 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newbom infant would live if the prevailing age-specific Levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the ave.age years of education in the female and male populations aged 15 to 60. Annex F 331 Figure E32 Reunion: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 0.0 10% E-0.4 0 0~~~~-. o 0% I I I I I I I I 0 -1.0 .4 > I 1.3 1 1 -10% U -0% t I° s I I -E -1.05 1. C -n -1.1. -10% ~~~~~~~~~~~~~~~~~~~~~~~15-1.5 0 ~~~~~~~~~-1.6 -20% -2.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 80% 71% 20.0 T 65% 80% ~ ~ ~ ~ ~~1 14.9 n C60% 15.0 13.9 14.3 13.9 0 ~~~~~~~~~~~~~~~~~~~~~~~~12.7 ° l K 11.519 9 39% 39% o 40% t 10.0 t 20% 0 5.0 0% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 80% --20.0 - 60% 15.0 9.6 9.2 9.2 9.8 40% o 10.0 8 0. o ~~~~~~~~~~~~~~~~~~~~7.4 7.5 24% 2 0% *17% 16% 5.0 0% B EI m . 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 332 Measuring Country Performance on Health Table E33 Rwanda: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 206 191 209 227 218 - - Female adult mortality rateb 438 418 403 407 409 396 409 Male adult mortality rateb 545 520 502 504 503 485 493 Female life expectancyc 44.6 45.7 46.2 46.6 48.1 48.3 23.1 Male life expectancyc 41.4 42.5 43.0 43.4 44.6 45.1 22.1 Total fertility rated 7.5 7.8 8.1 8.4 8.3 7.6 6.8 Determinants Income per capitae 537 428 563 631 698 809 757 Female education (years)f - - 0.5 0.8 1.0 1.1 1.3 Male education (years)f - - 1.5 1.8 2.0 2.1 2.4 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dcllars adjusted for purchasing power. f. Education: Lhe average years of education in the female arid male populatiouls aged 15 to 60. Annex F 333 Figure E33 Rwanda: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% - 3.0 - 21% 20% --14% 2 2.2 O ~~~~~~~~2.1 (S ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~1.8 2.0 - 1.6 0%/ 0 °%- 1 lffl1-2% 1.2 1.2 1.3 c-20%--2% l 10--|| | 51.0 -60% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 - lo im .1 - -2.7 -3.1 a I I -10.0 -7.2 .7gg > -20% -16% -10.4 0 2~~~~~~~~~~~~~~ ~~~-20.0 w -40%/ -5 -40% a --30.0 < | ~~~~~~~~-44% -60% -40.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -3.0 -3,+ 5. -10.0 -7.2 -82 a-20% -15% -10.2 E 1-19% -20% o [ -2e;% g 1 m >> -20.0 -32% ~~~~~0 j-40% a35% -40% > -30.0 -33.1 -60% -40.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 334 Measuring Country Performance on Health Table E34 Seychelles: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ - - - - - - Female adult mortality rateb - - - - _ 139 113 Male adult mortality rateb _ - - - _ 237 221 Female life expecuancyc - - - - 71.5 72.8 75.1 Male life expectancyc - - - - 66.0 66.8 67.9 Total fertility rated - - - - - 3.3 2.9 Determinants Income per capitae 1,258 1,310 1,484 1,777 2,484 2,895 3,524 Female education (years)f - - - - - - - Male education (years)f - Not available. a. Under-five mortality rate: the probability of dying between birth and age fve, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. c. Income per capita is measured in 1985 constant international doltars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 335 Figure E34 Seychelles: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0.0 t 60% 0 u . -0.5 0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~~~~~~~~~~~-. 20% -1.0 o% - I I I -1.5 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 50% 14.0 39% 12.0 11.4 10.9 40% 1. 40%- 33% 11 10.0 30% /8. 0~~~~~~~~~~~~~~~~~~~~~~. 20%6. C) (A_ ' 4.0 10% ~~~~~~~~~~~~~~~~~~2.0 0%0/ 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 50%O -- 14.0 - 12.0 40°-o 9.8 Q 10 .0O - _ T 8.2 8.0 U 30% < 8.0 0 6.0 o 20% 13% 0 10% 4.0 t 10% 2.0 0% I 196i 1 01. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 336 Measuring Country Performance on Health Table E35 Senegal: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 297 288 279 263 218 175 138 Female adult mortality rateb 477 461 489 518 516 513 506 Male adult mortality rateb 570 554 572 580 586 596 579 Female life expectancyc 41.0 42.6 44.2 45.2 47.0 48.3 50.3 Male life expectancyc 39.4 40.8 42.2 44.7 43.7 45.1 48.3 Total fertility rated 6.4 6.4 6.5 6.6 6.7 6.6 6.2 Determinants Income per capitae 1,047 1,117 1,126 1,103 1,148 1,164 1,156 Female education (years)1 1.2 1.1 1.1 1.6 1.6 1.6 1.7 Male education (years)f 2.3 2.2 2.2 2.9 2.8 2.8 2.9 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 337 Figure E35 Senegal: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 -20%03 1.3 1.3 ~~~2 -40%~~~~~~~~4% . E47% ao || | lo .8|49% 0C A -60% -54% -55_% 03 -58% -600/C) -80% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 00% 0.0 -20% -5.0 1 -40% -600/o -- -5 63% -~~~ -80% -~~~~68% -10.3-06 -80% -75% r ~~~~78%-11.5 -100% A~~~~~~~~~_8%-5.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0%/ 0.0 -20% -5.0 -40% -34% iao >) -49% -60% ~~~~~-55%o -10.4 11 C- ~~~~~~~~-63% -64% -80% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 338 Measuring Country Performance on Health Table E36 Sierra Leone: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 390 396 360 345 335 325 - Female adult mortality rateb 522 506 534 530 527 517 492 Male adult mortality rateb 585 569 552 542 540 558 601 Female life expectancyc 33.5 35.0 36.5 36.7 37.0 38.4 35.9 Male life expectancyc 30.6 32.0 33.5 33.7 34.0 35.3 32.9 Total fertility rated 6.2 6.3 6.5 6.5 6.5 6.5 6.5 Determrinants Income per capitae - 1,019 1,160 1,174 1,135 1,035 892 Female education (years)t 0.4 0.4 0.5 1.0 1.1 1.2 1.4 Male education (years)f 1.0 1.0 1.2 2.1 2.3 2.5 2.9 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 339 Figure E36 Sierra Leone: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0 2.0 - -20% Q ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~1.2 -40%03 1.1 0.9 zo -60% -/ 1.0 t 0.8 $ ~~~~~~0.6 Y -80% - -83% -84% 0.3 C~ -100%/ -90%/ -97% C -1040/o -120% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel F: Female Life Expectancy 0% 0.0 I -20% -5.0 -10.0 4 -40% -100% 1 -15.0 ~1-60% 150 C- ~ ~ ~ ~ ~ ~ ~ -20.0 ~~~~~~~~~~-16.7-1. _6% 67% 70' -68% -9. -20.5 -21.0 -c-80% -70% 73% 0-25.0 -23.0 -100% A30.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy C)0% 0.0 -20% -5.0-- Cd ~~~~~~~~~~~~~~~~-10.0 -40% -42% -43 4% C -15.0 -60% -54% a1. C- ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -T -630k ~ C -18. -63% ..~ 26 0 -20.6 -~~~~ -80% 0 ~~~~~~~~~-25.0 -22.8 IV00% -30.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 340 Measrintg Country Performance on Health Table F37 Somalia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' - - - - _ - - Female adult mortality rateb 599 515 476 449 412 370 337 Male adult mortality rateb 687 645 592 543 500 465 426 Female life expectancyc 38.5 40.5 42.5 44.0 46.5 49.0 50.5 Male life expectancyc 35.4 37.4 39.3 42.7 43.2 45.7 47.1 Total fertility rated 6.7 6.7 6.7 6.7 6.7 6.8 6.8 Determinants Income per capitae 1,103 1,120 959 752 866 794 796 Female educaLion (years)f - - - - - - - Male education (years)f - - - - - - - - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 341 Figure E37 Somalia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% - l l l 2.0 1.3 & ~~~~~~~~~~~~~~1.0 i -20% - 1.0 0.7 0.7 6 06 0.6 -40% 0.0 L 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -20% -80% -5.0 1-40% 196 0~ ~ ~ ~~~~~~~~~~~~~~~2-. _ 60% -10.0> -08-10.3 -10.2-96 8. -61% ~~~~~~~~~~~~~-11.5 -11.5 -00% j--15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mlortality Rate Panel F: Male Life Expectancy 0% 0.0 -20% U ~~~~~~~~~~~~~~~~~~-5.0 -40% ~~~-37% -34%U .0 b~~~~-4%-0. 8 -10.0 ~ ~ ~ -0. $1. -10.1-9. -80% -15.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 342 Measuring Country Performance on Health Table E38 South Africa: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - - - - - - - Female adult mortality rateb 444 394 348 311 281 249 209 Male adult mortality rateb 525 484 452 424 392 357 312 Female life expectancyc 52.0 54.5 57.0 59.0 61.0 63.5 66.0 Male life expectancyc 48.0 49.5 51.0 53.0 55.0 57.5 60.0 Total fertility rated 6.5 6.2 5.7 5.3 4.9 4.6 4.2 Determinants Income per capita' 2,202 2,417 2,918 3,444 3,407 3,490 3,308 Female education (years)f 4.3 3.9 4.5 4.3 4.1 4.7 4.8 Male education (years)' 4.2 3.9 4.7 4.6 3.2 5.7 5.8 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 343 Figure E38 South Africa: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 o ~~~~~~0.7 0.6 0.6 0.6 05 0.5 0.5 ,2 0% I I I) I Ei 0.5~~~~~~~~~~~~~~~ -20% 0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 4.0 2.1 8 -20% 2.0 -20% -30% -30%0. -330~~~~~~~~ -40% 56 0.0 > -40%~i i - . 1%-36% -41% -0.2 -0 40 - r) -0.7 -. -60% - -2.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 2.0 | | | | | | | | [ ~~~~~~~~~~~~~~~~~~~~~~0.3 8 -20% 0.0 8 ~~~~~~~~~-23% -31% -31%/ > 4% -38% -38% -38% _4 8 f:4 | S t-2.7 -2.5 -60% -4.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 344 Measuring Country Performance on Health Table E39 Sudan: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 204 190 176 153 132 - - Female adult mortality rateb 499 520 525 506 462 425 398 Male adult mortality rateb 611 619 615 588 537 496 464 Female life expectancyc 41.1 43.1 45.1 48.1 50.6 52.4 52.4 Male life expectancyc 38.3 40.3 42.3 45.3 47.8 49.6 49.6 Total fertility rated 6.7 6.7 6.7 6.7 6.6 6.3 5.9 Determinants Income per capita' - - 817 774 907 850 799 Female education (years)f 0.1 0.2 0.3 0.4 0.6 0.7 1.0 Male education (years)f 0.7 0.8 1.0 1.3 1.6 1.8 2.0 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at cach age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 345 Figure E39 Sudan: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 1.0 S 0.7 0~~~~~~~~~~~~~~~~~~ 0.6 0.6 E 9% > 0.5 l | ! | l | | | l 0.5 0~~~~~~~~~~~~~~~~~/ 0 C~~~~~~~~~~~~~7/ o°b 0 | 7qf W 11 |0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -2.0 -200% 0~~~~~~~~~~~~~~~~~~~-. -40% -43% C-6.0 -480A -~~a6.3 -6.2 -6.4 -. a 0 ~~~~~~~~~~~~~~~~~~~~~~-7.7 --80% -10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy -80% -10.0 -20% -2.0 -4.0 C -39%b -42% -. -47% ~ ~ ~ ~ ~ ~ ~ -60-5.8 -56-5.8 -. .~~~~ -60% F ~~~~~~~~~~-8.0 -7.3 -80% ~~~~~~~~~~~~~~~-10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 346 Measuring Country Performance on Health Table E40 Swaziland: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea _ _ - - - - - Female adult mortality rateb 486 410 336 273 232 209 196 Male adult mortality rateb 604 525 447 379 321 280 260 Female life expectancyc 43.5 46.5 49.6 52.3 54.8 57.3 59.8 Male life expectancyc 39.7 42.4 45.1 47.6 50.2 52.7 55.2 Total fertility rated 6.5 6.5 6.5 6.5 6.5 6.7 6.7 Determinants Income per capita' 1,248 1,651 2,033 2,498 2,821 2,687 2,389 Female education (years)F 1.9 2.1 2.1 3.7 3.4 3.7 4.1 Male education (years)f 2.4 2.3 2.8 4.2 4.0 4.5 4.8 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 347 Figure E40 Swaziland: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 4.0 3.0 2.7 u ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~2.4 0 4)~~~~~~~~~~~~~~~~~~~~~~~. '4~ ~ ~ ~~~~~~~~~~~~~~~~~~. E_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -z 1.9 i.4 l -20% I I I I 2.0 1.5 0%~~~~~~~~~~~~~~~ '4 1.0 0.7l 0.4~ ~ ~ ~~~~~~~-. -20% °0.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20%L 0.0-_ 1 i i 1 11 1| C, -2.0- 11 1 26111 1|11 | | 1111 o|2. U l i | _~~~7% -6% -4% ,, -4.0- * * | 2. i2-20%- -% -60 5. o- -6.3 -6.0 -5.7 -40% -7.0 -6.9 -2% -60% --10.0- 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% 0.0 o -2.0 0% u _ %201| |*o C i 111 lil -19% = 6-4.0 -40% 4 ) -31% t 11 | * -6.5 -20% 0 -61.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 198-5.7 > -31% ~~~~~~~~~~~.-6.3 -40% ~~~~~~~~~~~~~~~~-8.0 --74-6.9 -43% -39% ~~~~~~~~~~~-7.9 -7.9 -60% ---10.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 348 Measuring Country Performance on Health Table E41 Tanzania: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality rate' 240 228 218 203 176 157 161 Female adult mortality rateb 498 456 419 388 370 364 373 Male adult mortality rateb 606 557 513 476 451 438 444 Female life expectancyc 43.3 45.7 48.1 50.7 52.6 52.5 51.9 Male life expectancyc 40.1 42.5 44.9 47.3 49.1 49.4 49.0 Total fertility rated 6.8 6.8 6.8 6.8 6.8 6.5 6.1 Determinants Income per capitae 319 340 409 471 507 457 537 Female education (years)f 2.7 2.3 2.0 1.8 1.8 2.0 2.1 Male education !years)f 4.1 3.6 3.3 3.1 3.1 3.4 3.2 a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to sLay the same throughout its life. d. Total fertility rate is the nuniber of children that would be born to a womrlani if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f EduLcation: the average years of eduication in the female and male populations aged 15 to 60. Annex F 349 Figure E41 Tanzania: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 40% -lo - 0 U 20% 1% 15% 0 2 0 2 o 6--E06% 6 & -01 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-01 0% I I*l -20%- -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -2.0 -212 23 -2.5 -2.1 0 -20% 17% -4. 0. -21%-20%-19% -19% --. 4,~~~~~~~~~~~-. -24%-25% > -6.0 -5.2 -400h% -8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Mlale Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -2.0 - 4, ~~~~~~~~~~~~~~~~~-2z 2.7 -2.7 -2.5 ~~ -20% -18% ~-17% -16% -16% -15% b.-. 2.8 -20/ 1% -23%.0 -. > -5.2 4, ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~-6.'0 -40% ~~~~~~~~~~~~~~~~8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 350 Measuring Country Performance on Health Table F.42 Togo: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 267 240 - 194 175 157 - Female adult mortality rateb 427 433 431 402 375 346 321 Male adult mortality rateb 548 543 529 491 457 420 389 Female life expectancyc 42.1 44.6 47.1 49.7 52.2 54.1 52.6 Male life expectancyc 39.0 41.4 43.9 46.4 48.8 50.7 49.5 Total fertility rated 6.6 6.6 6.6 6.6 6.6 6.6 6.6 Determinants Income per capitae 367 400 546 600 688 636 641 Female education (years)O 0.0 0.2 0.3 0.5 1.2 1.5 1.7 Male education (years)f 0.4 0.8 1.3 1.8 3.5 4.0 4.3 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be bom to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 351 Figure E42 Togo: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% 2.0- E ; 2°t 1% u ~~~~~~ ~~~~~~~~1.0 0 .4 0. o % 2 % _0 04 ~~~1%/ .4 0 0.0 ~ 0 _4% -4% o0.0 r - F I i -8% -0. -20% -1.0 - 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 0.0 -2.0 C~~~~~~~~ _ -15% -4.0 -19% 197-3.9 -3 -3.9 -3.8 -198 -20/c 0~~~F -4.4 -2%-26% -60-5.1 04 ~~~~~-28% -2% ) -. -40% -8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 -2.0 -13%k -13% 4)-2% 22 -4. 0 _4. -4.0 -3. -4.0 > '5:~-2% -6.0 -5.2 -40% -8.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 352 Measuring Country Performance on Health Table E43 Uganda: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 224 204 - 172 180 190 - Female adult mortality rateb 451 419 393 382 395 406 461 Male adult mortality rateb 549 496 447 446 463 464 526 Female life expectancyc 47.1 49.1 51.6 49.9 49.1 49.1 45.8 Male life expectancyc 43.9 47.5 49.9 47.5 47.5 47.6 45.6 Total fertility rated 6.9 7.0 7.1 7.1 7.2 7.2 7.1 Determinants Income per capitae 595 596 641 642 577 816 529 Female education (years)f 0.6 0.6 0.8 0.8 0.8 1.0 1.4 Male education (years)f 1.8 1.8 2.1 2.1 2.1 2.2 2.1 - Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 353 Figure E43 Uganda: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 20% - - 2.0 - 3% 5% , 2% 1.5 -2% 1: 0- Pv . 1 1.0 ,2 -20% -E 1.0- 0 0B 0~~~~~~~~~~~~~~~~~~~~~~~~~~~. V-40%~ 0^ 0.6 0.6 0 S -40% a . -60%- 0.0 _ 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 0% 5.0 T 0.0 a U, -20% t0. >0. -0.416. 24% -22% -21% -23% -. 1. -4% 12-5.0 -60% -15.0~~~~~~~~~~~~~~~~~~~~~~-. 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 5.0 > 0.0 -20% / o t s - -16% -14% -9-6 -60% C -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 C-) ~~~~~~1%0. 00. 0-~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~~~~~~~~~~~~-. -60% -15.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 354 Measuring Country Performance on Health Table E44 Zaire: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea - 272 245 221 - - - Female adult mortality rateb 457 440 420 398 378 360 - Male adult mortality rateb 568 543 516 487 461 438 - Female life expectancyc 43.6 45.6 47.6 49.7 51.7 53.4 - Male life expectancy 40.4 42.4 44.4 46.4 48.2 50.0 - Total fertility rated 6.0 6.1 6.2 6.4 6.6 6.7 - Determinants Income per capital 472 538 624 668 525 467 450 Female education (years)f 0.3 0.4 0.6 0.8 1.1 1.4 1.6 Male education (years)f 1.4 1.6 1.9 2.4 2.9 3.8 4.1 -Not available. a. Under-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant in-emational dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and male populations aged 15 to 60. Annex F 355 Figure E44 Zaire: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 0 1.0 C | I WV 0.1 0.1 0.1 S-20% o 0.0 -223'o 22% -22%/ 4) < -0.4 -0.4 -40% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 40% 60.0 -2.0 1 -20%6 117 _ ~~~~~~-27% -28% -43 -4±2 -40% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 0% 0.0 4)4) ~~~~~~~~~~~~~~~~-2.0 -20% -23% -2%Z-4.0 -3.5 -25% -24/. -3.8 -4.0 4) ~~~-4.2 0 . ~~~~~-4.4 -4.3 -400% -6.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 356 Measuring Country Performance on Health Table E45 Zambia: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 213 195 181 162 149 168 188 Female adult mortality rateb 506 474 460 440 413 366 377 Male adult mortality rateb 607 569 546 521 482 424 434 Female life expectancyc 44.4 46.9 49.0 51.0 52.6 50.6 45.0 Male life expectancyc 41.2 43.7 45.7 47.7 50.2 48.7 43.3 Total fertility rated 6.6 6.6 6.8 7.1 7.1 6.7 6.2 Determinants Income per capitac 949 961 1,083 1,189 1,030 888 750 Female education (years)f 1.6 1.7 2.0 2.2 3.0 3.2 3.5 Male education (years)f 3.8 4.1 4.0 4.3 5.6 5.8 5.9 a. Ulnder-five mortality rate: the probability of dying between birth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f Education: the average years of education in the female and male populations aged 15 to 60. Annex F 357 Figure E45 Zambia: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 0% 2.0 o -20% - -0% 1.4 -13. . 0~~~~~~~~~~~~~~~~~~ 8 a'~~~~~~~~-3 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: FMale Adult Mortality Rate Panel F: FMale Life Expectancy 0% 0. -1. -20% -15.0 1960 1965 1970 1975 1980 1985 -400 1960.4 96 197 1975 14 8 9 05. 0 -60% 0.0~~~-3% 8. 40%k _3%0.0 - 3 -20% -5.0% 44o 0 60 150-s. 4. 13.4.3-. 0.0. c~-40% 36 E-5.0 -8.4 -42% ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~48 -. -424-47 E- 5. -2 7 0/.15. -13. 460% 1960 1965 1970 1975 1960 1985 1990 1960 1965 1970 1975 1980 1985 1990 358 Measuring Country Performance on Health Table E46 Zimbabwe: Trends in Selected Health Indicators and Their Determinants, 1960-90 Year 1960 1965 1970 1975 1980 1985 1990 Health indicators Under-five mortality ratea 159 147 137 129 107 86 80 Female adult mortality rateb 482 435 391 353 321 250 270 Male adult mortality rateb 571 517 469 425 389 312 305 Female life expectancyc 48.1 50.7 53.3 55.6 57.6 64.2 61.4 Male life expectancyc 44.9 47.4 49.8 52.0 54.0 60.5 58.4 Total fertility rated 8.0 8.0 7.8 7.3 6.8 6.0 4.9 Determinants Income per capitae 1,027 940 1,006 1,253 1,181 1,280 1,165 Female education (years)t 1.3 1.4 1.6 1.6 1.6 2.0 2.7 Male education (years)f 2.0 2.3 2.4 2.6 2.7 3.4 4.2 a. Under-five mortality rate: the probability of dying between b.rth and age five, expressed per 1,000 live births. b. Adult mortality rate: the probability of dying between age 15 and 60, expressed per 1,000 persons reaching age 15. c. Life expectancy at birth: the number of years a newborn infant would live if the prevailing age-specific levels of mortality at the time of its birth were to stay the same throughout its life. d. Total fertility rate is the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children at each age in accordance with prevailing age-specific fertility rates. e. Income per capita is measured in 1985 constant international dollars, that is, dollars adjusted for purchasing power. f. Education: the average years of education in the female and maile populations aged 15 to 60. Annex F 359 Figure E46 Zimbabwe: Performance Relative to Income Level, Selected Health Indicators, 1960-90 Panel A: Under-Five Mortality Rate Panel D: Total Fertility Rate 3.0 40% - o 2.0 1.9 1.9 1.8 2.017 U OQ l | | l ~~~~~~~~~~~~~~~~~~~~~~~~~~~1.3 0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. F ~~~~19% 18%10 + 20% 16% 15% 17% 190 4 % - 6.0 114% i %-0 -'| '| 'Ii'E 'l 0 4 . '~0.0 -20%4 | -1% -1% -.16% S 0% -1.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel B: Female Adult Mortality Rate Panel E: Female Life Expectancy 20% - 6.0 - 4.0 1 0% ON 2.0 t -20% -16I o0o 1 0-~~~~~~~~~~~~~~~~~~~~~~. 4) ~~~~~~-21% > 40 290/ -27%> -60% --4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Panel C: Male Adult Mortality Rate Panel F: Male Life Expectancy 20% --6.0 - 0% ~~~~~~~~~0% 0% 4.0 z 2.0 F -20%~~~~20k . -400% --34% -60%/ -4.0 1960 1965 1970 1975 1980 1985 1990 1960 1965 1970 1975 1980 1985 1990 Distributors of World Bank Group Publications Prices and credit terms vary from Chinese Corporation for Promotion FINLAND IRAN country to country. Consult your of Humanities Akateeminen Kirjakauppa Ketab Sara Co. Publishers ocal distrioutor before placing an 52, You Fang Hu Tong, PO. Box 128 Khaled Eslamboli Ave., 6th Street order. Xuan Nei Da Jie FIN-00101 Helsinki DelafroozAlley No.8 Beijing Tel: (358 0)121 4418 PC. 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