DPR Korea SRMNCAH factsheet: December 2020

DPR KOREA | 1 Country profile Value Year of data GNI (PPP) per capita NA NA Percentage of population below international poverty line NA NA Percentage of population using safely managed sanitation services including a handwashing facility with soap and water NA NA Improved sanitation40 84 2017 Handwashing facility with soap and water34 100 2009 Percentage of population using safely managed drinking water services40 61 2017 Source: 34Multiple Indicator Cluster Survey 2009 | 40Multiple Indicator Cluster Survey 2017 Demographic Value Year of data Total population65 25 779 000 2020 Total under-5 population65 1 746 000 2020 Total adolescent population (10–19 years)65 3 561 000 2020 Women in reproductive age group (15–49 years)65 6 485 000 2020 Annual number of births61 355 000 2019 Total fertility rate (births per woman)40 1.9 2017 Adolescent birth rate (per 1000 women aged 15–19 years)40 1 2017 Births registered (%)3 100 2009 Source: 65World Population Prospects 2020 | 61United Nations Population Division 2019| 40Multiple Indicator Cluster Survey 2017 | 3Countdown 2030 • Under-5 population 7% • Total adolescent population 14% • Women in reproductive age group 25% • Total fertility rate 1.9 • Adolescent birth rate 1 per 1000 population • Births registered 100% Source: 48Trends in maternal mortality 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division 51Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division 2.5% annual rate of reduction between 2010 and 2017, and the assumption that all things will remain as in 2017 considered for calculating the 2030 projection for maternal mortality ratio • 36% reduction in MMR between 2000 and 2017 Impact indicators Maternal mortality ratio (per 100 000 live births) Basic profile 75 81 139 120 106 91 89 37 200 150 100 50 0 1990 1995 2000 2005 2010 2015 2020 2025 2030 DPR KOREA SRMNCAH Factsheet December 2020 2 | DPR KOREA • Stillbirth rate (per 1000 births) is 860 • Adolescent mortality rate (deaths per 100 000 adolescents) is 660 Source: 60UN IGME database 2019 • 62% reduction in neonatal mortality rate between 1990 and 2019 Source: UN Inter-Agency estimates: Levels and Trends in Child Mortality: Report 2020 (UN IGME 2020) 3.2% annual rate of reduction between 1990 and 2019, considered for calculating the 2030 projection for neonatal mortality rate Neonatal mortality rate (per 1000 live births) SDG target NMR: 12 Achieved SDG target 1990 1995 2000 2005 2010 2015 2020 2025 2030 100 80 60 40 20 0 7 21 30 26 18 16 12 10 • 60% reduction in under-5 mortality rate between 1990 and 2019 Source: UN Inter-Agency estimates: Levels and Trends in Child Mortality: Report 2020 (UN IGME 2020) 3.2% annual rate of reduction between 1990 and 2019, considered for calculating the 2030 projection for under-5 mortality rate Under-5 mortality rate (per 1000 live births) 43 73 60 33 30 21 17 12 SDG target U5MR: 25 1990 1995 2000 2005 2010 2015 2020 2025 2030 Achieved SDG target 100 80 60 40 20 0 Nutrition indicators • 48% reduction in prevalence of LBWa between 2009 and 2017 • 41% reduction in stunting among under-5 children between 2009 and 2017 Source: 34Multiple Indicator Cluster Survey 2009 | 40Multiple Indicator Cluster Survey 2017 | 47The State of the World’s Children Reports 2019 For definition of the superscript please refer to page number 55 of the country fact sheet 201647 Underweight in adolescents 5%e Overweight in adolescents 22%d Wasting in under-5 childrenb Stunting in under-5 childrenc 100 80 60 40 20 0 32% 19% 5% 3% 200934 201740 Prevalence of anaemia in women aged 15–49, disaggregated by age and pregnancy statusf NA DPR KOREA | 3 Source: 16Global Burden of Disease study 2019 Causes of maternal deaths • 179 maternal deaths and mainly due to direct maternal disorders and infections Source: 25Global Health Observatory - World Health Organization 2017 More than 6500 under-5 children died, mainly due to: • newborn causes • pneumonia and diarrhoea • injuries Causes of under-5 deaths Source: 25Global Health Observatory - World Health Organization 2017 More than 3500 newborns died in the first month of life mainly due to: • prematurity • birth asphyxia • infections Causes of newborn deaths 0.1% 1.1%0.9% 0.2% 0% 0.2% 0% 0% 1.7% 0.4% 0.3% 0.02% 0.8% 33.9% 20.9% 15.4% 13.5% 13% 21% 20.2% 11.8% 5.8% 5% 34.2% 2.5% 0.1% 0.1% 0% 0% 19.8% 15.3% 13%11.9% 8.9% 8.2% 8% 6.2% 6% Prematurity Birth asphyxia and birth trauma Congenital anomalies Sepsis and other infectious conditions of the newborn Other communicable, perinatal and nutritional conditions Acute lower respiratory infections Injuries Meningitis/encephalitis Tetanus Diarrhoeal diseases Other noncommunicable diseases HIV/AIDS Malaria Measles Prematurity Acute lower respiratory infections Congenital anomalies Birth asphyxia and birth trauma Other noncommunicable diseases Other communicable, perinatal and nutritional conditions Injuries Sepsis and other infectious conditions of the newborn Diarrhoeal diseases Meningitis/encephalitis Tetanus HIV/AIDS Malaria Measles Other direct maternal disorders Maternal sepsis and other maternal infections Maternal haemorrhage Maternal abortion and miscarriage Maternal hypertensive disorders Ectopic pregnancy Late maternal deaths Indirect maternal deaths Maternal obstructed labour and uterine rupture Maternal deaths aggravated by HIV/AIDS 4 | DPR KOREA SRMNCAH policy survey Presence of key national policy/guidelines on SRMNCAH at the national level (Y/N) On family planning/contraception45  On sexually transmitted infections diagnosis, treatment and counselling45  On comprehensive national cervical cancer prevention and control45  On antenatal care45  On childbirth45  On postnatal care for mothers and newborns45  On management of low birth weight and preterm newborns45  On child health and development of children45  On early childhood development45  On integrated management of childhood illness45  On management of childhood pneumonia45  On management of childhood diarrhoea45  On management of malaria with appropriate recommendations for children45  On management of acute malnutrition in children45  On adolescent (10–19 years) health issues45  Multisectoral plan of action for violence against women45  On CAC/post-abortion care15   Yes  No Source: 45Reproductive, Maternal, Newborn, Child and Adolescent Health Policy Survey, 2019 | 15Global Abortion Policies Database, 2017 Causes of adolescent deaths Top 5 causes of adolescent deaths 4 Self-harm 2 Drowning 5 Interpersonal violence 3 TuberculosisRoad injury 1 Source: 24Global Health Observatory - World Health Organization 2016 DPR KOREA | 5 Source: 34Multiple Indicator Cluster Survey 2009 | 40Multiple Indicator Cluster Survey 2017 | 66Global Health Observatory - World Health Organization 2019 Coverage indicators Sexual, reproductive and maternal health • 94% got 4+ ANC visits during last pregnancy • 84% received two doses of tetanus • 92% institutional deliveries • 100% deliveries attended by skilled health personnel • 98% had a postpartum contact with a health provider within two days of delivery • More than 70% women aged 30–49 were screened for cervical cancer66 Source: 40Multiple Indicator Cluster Survey 2017 *Figures that are based on fewer than 25 unweighted cases Equity in coverage 100 80 60 40 20 0 Pe rc en ta ge o f w om en o f re pr od uc tiv e ag e (1 5– 49 ) w ho h av e th ei r n ee d fo r fa m ily p la nn in g s a tis fie d w ith m od er n m et ho d s U nm et n ee d fo r f am ily pl an ni ng (t ot al ) Pr op or tio n of w om en ag ed 1 5– 49 w ho re ce iv ed fo ur o r m or e an te na ta l c ar e vi sit s Pr op or tio n of w om en ag ed 1 5– 49 w ho re ce iv ed tw o d os es o f t et an us In st itu tio na l d el iv er y Pr op or tio n of b irt hs at te nd ed b y sk ille d he al th p er so nn el C -s ec tio n Pr op or tio n of w om en w ho ha ve p os tp ar tu m c on ta ct w ith a h ea lth p ro vi d er w ith in tw o d ay s o f d el iv er y 200934 201740 94 % 94 % 10 0% 10 0% 95 % 92 % 13 % 13 % N A 98 % N A 84 % N A 7 % 90 % N A By wealth FP satisfied with modern methods (%) FP unmet need (%) ANC 4+ visits (%) Two doses of tetanus (%)SBA (%) Institutional delivery (%) Contact with a health provider within two days of delivery (%) Poorest Richest By geography Rural Urban No education (Pre-primary or none) Secondary education 90 95 89 100 99 98 83 99 99 80 6 7 93 90 FP satisfied with modern methods (%) FP unmet need (%) ANC 4+ visits (%) Two doses of tetanus (%) SBA (%) Institutional delivery (%) Contact with a health provider within two days of delivery (%) 90 89 6 7 84 94 84 93 100 99 8795 98 99 By maternal education FP satisfied with modern methods (%) FP unmet need (%) ANC 4+ visits (%) Two doses of tetanus (%) SBA (%) Institutional delivery (%) Contact with a health provider within two days of delivery (%) 90 * * * * * * * 93 6 98 84 99 92 6 | DPR KOREA Newborn health • 136% increase in breastfeeding within the first hour birth between 2009 and 2017 • 27% got skin-to-skin contact in the first hour of birth • 99% got postnatal contact with a health provider within two days of deliverySource: 34Multiple Indicator Cluster Survey 2009 | 40Multiple Indicator Cluster Survey 2017 | 46Socio-Economic, Demographic and Health Survey 2014 Proportion of infants who were breastfed within the first hour of birth Proportion of newborns who have postnatal contact with a health provider within two days of delivery Skin-to-skin contact in the first hour of life Hospital discharge at least after 24 hours after birth Proportion of newborns who have home visits in the first week of life NA NANA NA 100 80 60 40 20 0 200934 201446 201740 18% 43% 27% 87% 99% NA 200934 201740 201947 201962 Child health and development • 97% children fully immunized • 90% received vitamin A supplements • 168% increase in taking semisolid or soft foods between 2009 and 2017 • 45% received ORS and zinc Source: 34Multiple Indicator Cluster Survey 2009 | 40Multiple Indicator Cluster Survey 2017 | 47The State of the World’s Children Reports 2019 | 62WHO vaccine-preventable diseases: monitoring system. 2020 global summary | *Figures that are based on fewer than 25 unweighted cases Pe rc en ta ge o f i nf an ts <6 m on th s w ho a re fe d ex cl us iv el y w ith b re as t m ilk In tro d uc tio n to se m iso lid o r s of t fo od s 6 –8 m on th s Pe rc en ta ge o f c hi ld re n fu lly im m un ize d M ea sle s/ M R va cc in at io n at 9 m on th s V ita m in A su pp le m en ta tio n 6– 59 m on th s Pe rc en ta ge o f c hi ld re n w ith d ia rrh oe a re ce iv in g or al re hy d ra tio n sa lts (O RS ) Pe rc en ta ge o f c hi ld re n w ith d ia rrh oe a w ho re ce iv ed O RS a nd z in c Pr op or tio n of c hi ld re n w ith su sp ec te d p ne um on ia ta ke n to an a pp ro pr ia te h ea lth p ro vi d er A nt ib io tic tr ea tm en t f or ch ild re n w ith a cu te re sp ira to ry in fe ct io n (A RI ) s ym pt om s C hi ld re n ha ve p la y th in gs a t h om eg C hi ld re n w ith in ad eq ua te su pe rv isi on h 100 80 60 40 20 0 59 % 47 % 74 % 85 % 78 % 29 % 71 % 89 %9 8%99 % 17 % 16 % 88 % * 80 % * 97 % N A 90 % N A N A 45 % Adolescent health and development Source: 40Multiple Indicator Cluster Survey 2017 For definition of the superscript please refer to page number 55 of the country fact sheet NA NA NA NA 0.1% Physical activity (>1 hour/day) or prevalence of insufficient physical activity among adolescentsi Current tobacco use (any form)j Attempted suicidek Percentage of students who were in a physical fight one or more times during the 12 months before the surveyl Percentage of women aged 20–24 who were married or in a union before age 18 100806020 400 201740 DPR KOREA | 7 RMNCH service coverage index UHC service coverage index 100 80 60 40 20 0 Total expenditure on health, per capita (USD) 100 80 60 40 20 0 Health system indicators Health financing Health workforce Source: 22Global Health Observatory - World Health Organization 2014 | 64World Health Statistics 2020 • 75 per 10 000 population availability of doctors, nurses, midwives versus 44.5 per 10 000 recommended in Global Strategy22 • 45 per 10 000 population availability of midwives and nurses versus 18 per 10 000 population in the South-East Asia Region64 NA NA General government expenditure on health as % of total government expenditure Out-of-pocket health expenditure as % of total expenditure on health 100 80 60 40 20 0 NA NA NA NA Service delivery Source: 44Provisional calculation (2021) based on available data in DHS/MICS 2012–2019; Step surveys & Nationally reported data 91% 72% 202144 8 | DPR KOREA Break-up of UHC coverage index of essential health services with RMNCH sub-index RMNCH Care-seeking behaviour of suspected pneumonia Child immunization coverage (DPT3) Pregnancy care Family planning coverage – satisfied needs Infectious disease control Noncommunicable diseases Prevalence of normal blood pressure level in population age standardized Tobacco non-use Prevalence of normal fasting blood sugar level in population Service capacity and access Health worker density (Physician, pyc., surg.) (%) Density of hospital beds, expressed as % of global threshold, 18/10 000 (proxy for basic hospital access) Health security IHR compliance (%) Source: 44Provisional calculation (2021) based on available data in DHS/MICS 2012–2019; Step surveys & Nationally reported data 82% 97% 97% 90% 28% 100% 67% 100% 68% 64% Tuberculosis (effective) treatment coverage HIV antiretroviral therapy coverage Access to basic sanitation 83% 61% - 91% 57% 76% 71% aLow birth weight (LBW): Percentage of births with a reported birth weight <2.5 kilograms regardless of gestational age bWasting in under-5 children: Children whose Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are considered thin (wasted), or acutely undernourished cStunting in under-5 children: Children whose height-for-age Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are considered short for their age (stunted), or chronically undernourished dUnderweight in adolescents: Percentage of adolescents aged 10–19 years with BMI <−2 SD of the median according to the WHO growth reference for school-age children and adolescents eOverweight in adolescents: Percentage of adolescents aged 10–19 years with BMI > 1 SD of the median according to the WHO growth reference for school-age children and adolescents fHaemoglobin levels are shown in grams per decilitre (g/dl) (For non-pregnant women <12.0 g/dl and for pregnant women <11.0 g/dl) gChildren have play things at home: Percentage of children under age 5 who play with two or more types of playthings hChildren with inadequate supervision: Percentage of children under age 5 left alone or under the supervision of another child younger than 10 years of age for more than one hour at least once during the past week iPhysical activity (>1 hour/day) or prevalence of insufficient physical activity among adolescents: Percentage of students aged 13–17 years had physical activity (>1 hour/day) or prevalence of insufficient physical activity among adolescents jCurrent tobacco use (any form): Percentage of students aged 13–17 years who currently used any tobacco products (used any tobacco products on at least 1 day during the last 30 days before the survey) kAttempted suicide: Percentage of students aged 13–17 years who seriously considered attempting suicide during the 12 months before the survey lPercentage of students who were in a physical fight one or more times during the 12 months before the survey: Percentage of students aged 13–17 years who were in a physical fight one or more times during the 12 months before the survey