Ethiopia Country Health Statistics Profile



*** EXECUTIVE SUMMARY: Country Health Profile on ETHIOPIA ***



This is one of a series of Country Health Profiles produced by the Center for International Health Information (CIHI). Each profile contains descriptive information and tables on the country's health and demographic characteristics, health indicators and trends, and when available, the health care system. Profile information is compiled from CIHI's databases and reference library, as well as through research and analysis of other data sources and reports.

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Center for International Health Information (CIHI)
E-mail address: cihi@gaia.info.usaid.gov
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The Center for International Health Information (CIHI), a project managed by Information Management Consultants, Inc. (IMC), prepared this document under the Data for Decision Making Project, 936-5991.05 (CIHI-II), contract number HRN-5991-C-003041- 00, with the Office of Health and Nutrition, Bureau for Global Programs, Field Support and Research, U.S. Agency for International Development (USAID).

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*** Country Health Profile: ETHIOPIA ***



Health Statistics Report

Table of Contents
February 1995

I: Health & Demographic Overview

II: Data Notes

III: Sources

*** *** *** *** *** *** NOTE on SOURCES *** *** *** *** *** ***

Sources in this profile are referred to by a seven-digit code. Generally, the first three letters refer to an organization, agency, etc., and the first two numbers indicate the year of the publication or other source document. A complete list of sources appears at the end of the profile.

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I. A. Current Demographic and Health Indicators: ETHIOPIA

FEBRUARY, 1995

DEMOGRAPHIC INDICATORS VALUE YEAR SOURCE

Total Population 54,755,800 1993 UNP9200

Urban Population 7,106,600 1993 UNP9200

Women Ages 15-49 12,004,400 1993 UNP9200

Infant Mortality Rate 109 1993 BUC9300

Under 5 Mortality 158 1993 BUC9300

Maternal Mortality 2,000 1972 WHM9137

Life Expectancy At Birth 47 1993 UNP9200

Number Of Births 2,669,729 1993 UNP9200

Annual Infant Deaths 290,547 1993 CALXX01

Total Fertility Rate 7.0 1993 UNP9200

CHILD SURVIVAL INDICATORS VALUE YEAR SOURCE

BCG 46 1993 WHE9403

DPT 3 28 1993 WHE9403

Measles 22 1993 WHE9403

Polio 3 28 1993 WHE9403

Tetanus 2 13 1993 WHE9403

DPT Drop Out -

ORS Access Rate 50 1993 WHD9401

ORT Use Rate 68 1993 WHD9401

Modern Methods (15-49) 3 1990 BUC9401

All Methods (15-49) 4 1990 BUC9401

Adequate Nutritional Status -

Appropriate Infant Feeding -

Exclusive Breastfeeding -

Complementary Feeding -

Continued Breastfeeding -

OTHER HEALTH INDICATORS VALUE YEAR SOURCE

HIV-Urban 2 1991 BUC9200

HIV-Rural 0 1991 BUC9103

Access to potable water/Urban 91 1991 JMP9301

Access to potable water/Rural 19 1991 JMP9301

Access to sanitation/Urban 76 1991 JMP9301

Access to sanitation/Rural 7 1991 JMP9301

Deliveries/Trained Attendants 10 1988 WHM9117

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I. B. Trends in Selected Demographic and Health Indicators:

ETHIOPIA

FEBRUARY, 1995

UNDER CRUDE CRUDE AVG ANNUAL TOTAL

INFANT FIVE BIRTH DEATH GROWTH FERTILITY

MORTALITY MORTALITY RATE RATE RATE RATE

1950 177 297 53 33.2 2.0 7.3

1955 167 282 52 30.5 2.1 7.1

1960 158 267 51 28.0 2.2 6.9

1965 150 254 50 25.9 2.3 6.9

1970 144 243 50 23.9 2.3 6.8

1975 138 233 49 22.5 2.3 6.8

1980 139 236 50 23.1 2.4 6.9

1985 132 223 49 22.0 2.7 7.0

1990 115 192 49 19.0 2.9 7.0

1995 106 175 47 16.9 3.0 6.8

2000 97 159 44 14.9 2.9 6.3

SOURCE BUC9302 BUC9302 UNP9400 UNP9400 UNP9400 UNP9400

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I. C. Population Estimates: ETHIOPIA

FEBRUARY, 1995

YEAR VALUE SOURCE

1950 18,434,000 UNP9400

1955 20,418,000 UNP9400

1960 22,771,000 UNP9400

1965 25,542,000 UNP9400

1970 28,791,000 UNP9400

1975 32,221,000 UNP9400

1980 36,368,000 UNP9400

1985 41,137,000 UNP9400

1990 47,423,000 UNP9400

1995 55,053,000 UNP9400

2000 63,785,000 UNP9400

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I. D. BCG Vaccination Coverage: ETHIOPIA+-

FEBRUARY, 1995

BCG VACCINATION COVERAGE

YEAR PERCENT SOURCE

1980 -

1981 -

1982 -

1983 -

1984 -

1985 -

1986 13 WHE9100

1987 28 WHE9100

1988 27 WHE9100

1989 30 WHE9100

1990 57 WHE9100

1991 -

1992 22 WHE9301

1993 46 WHE9403

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I. E. DPT 3 Vaccination Coverage: ETHIOPIA

FEBRUARY, 1995

DPT 3 VACCINATION COVERAGE

YEAR PERCENT SOURCE

1980 -

1981 -

1982 -

1983 -

1984 -

1985 6 WHE8801

1986 7 WHE9100

1987 16 WHE9100

1988 16 WHE9100

1989 17 WHE9100

1990 44 WHE9100

1991 -

1992 13 WHE9301

1993 28 WHE9403

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I. F. Measles Vaccination Coverage: ETHIOPIA

FEBRUARY, 1995

MEASLES VACCINATION COVERAGE

YEAR PERCENT SOURCE

1980 -

1981 -

1982 -

1983 -

1984 -

1985 12 WHE8801

1986 10 WHE9100

1987 13 WHE9100

1988 15 WHE9100

1989 16 WHE9100

1990 37 WHE9100

1991 -

1992 12 WHE9301

1993 22 WHE9403

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I. G. Polio 3 Vaccination Coverage: ETHIOPIA

FEBRUARY, 1995

POLIO 3 VACCINATION COVERAGE

YEAR PERCENT SOURCE

1980 -

1981 -

1982 -

1983 -

1984 -

1985 6 WHE8801

1986 7 WHE9100

1987 16 WHE9100

1988 16 WHE9100

1989 17 WHE9100

1990 44 WHE9100

1991 -

1992 13 WHE9301

1993 28 WHE9403

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I. H. Tetanus 2 Vaccination Coverage: ETHIOPIA

FEBRUARY, 1995

TETANUS 2 VACCINATION COVERAGE

YEAR PERCENT SOURCE

1980 -

1981 -

1982 -

1983 -

1984 -

1985 4 WHE8801

1986 5 WHE9100

1987 7 WHE9100

1988 10 WHE9100

1989 20 WHE9100

1990 43 WHE9100

1991 -

1992 9 WHE9301

1993 13 WHE9403

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I. I. ORS Access, ORS and/or RHF Use Rates: ETHIOPIA

FEBRUARY, 1995

ORS ORT/RHF

YEAR ACCESS SOURCE USE SOURCE

1983 - -

1984 - -

1985 23 WHD8500 11 WHD8500

1986 23 WHD8600 -

1987 50 WHD8700 23 WHD8700

1988 50 WHD9100 38 WHD8800

1989 - 32 WHD9100

1990 - -

1991 - -

1992 50 WHD9300 68 WHD9300

1993 50 WHD9401 68 WHD9401

1994 - -

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I. J. Contraceptive Prevalence Rate: ETHIOPIA

FEBRUARY, 1995

MODERN ALL

YEAR METHODS SOURCE METHODS SOURCE

1980 - -

1981 - -

1982 - -

1983 - -

1984 - -

1985 - -

1986 - -

1987 - -

1988 - -

1989 - -

1990 3 BUC9401 4 BUC9401

1991 - -

1992 - -

1993 - -

1994 - -

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I. K. Access to Potable Water: ETHIOPIA

FEBRUARY, 1995

YEAR RURAL SOURCE URBAN SOURCE

1980 - -

1981 - -

1982 - -

1983 - -

1984 - -

1985 9 WHO9101 69 WHO9101

1986 - -

1987 - -

1988 11 WHO9101 70 WHO9101

1989 - -

1990 - -

1991 19 JMP9301 91 JMP9301

1992 - -

1993 - -

1994 - -

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I. L. Access to Adequate Sanitation: ETHIOPIA

FEBRUARY, 1995

YEAR RURAL SOURCE URBAN SOURCE

1980 - -

1981 - -

1982 - -

1983 - -

1984 - -

1985 - 96 WHO9101

1986 - -

1987 - -

1988 7 WHO9101 97 WHO9101

1989 - -

1990 - -

1991 7 JMP9301 76 JMP9301

1992 - -

1993 - -

1994 - -

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I. M. Comparative Infant Mortality Rates: ETHIOPIA

FEBRUARY, 1995

COUNTRY 1950 SOURCE 1993 SOURCE

ETHIOPIA 177 BUC9302 109 BUC9302

KENYA 146 CALXX03 59 CALXX03

UGANDA 158 CALXX03 96 CALXX03

TANZANIA 157 WBK9302 98 WBK9302

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I. N. Cross Country Comparisons



Vaccination Coverage Rates: ETHIOPIA

FEBRUARY, 1995

COUNTRY INDICATOR YEAR VALUE SOURCE

ETHIOPIA BCG 1993 46 WHE9403

DPT 3 1993 28 WHE9403

Measles 1993 22 WHE9403

Polio 3 1993 28 WHE9403

Tetanus 2 1993 13 WHE9403

KENYA BCG 1993 96 DHS9406

DPT 3 1993 87 DHS9406

Measles 1993 84 DHS9406

Polio 3 1993 87 DHS9406

Tetanus 2 1993 52 DHS9406

UGANDA BCG 1992 98 WHE9301

DPT 3 1992 71 WHE9301

Measles 1992 68 WHE9301

Polio 3 1992 70 WHE9301

Tetanus 2 1992 83 WHE9301

TANZANIA BCG 1993 90 WHE9403

DPT 3 1993 77 WHE9403

Measles 1993 77 WHE9403

Polio 3 1993 78 WHE9403

Tetanus 2 1993 72 WHE9403

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I. O. Cross Country Comparisons



ORS Access, ORS and/or RHF Use Rates: ETHIOPIA

FEBRUARY, 1995

COUNTRY INDICATOR YEAR VALUE SOURCE

ETHIOPIA ORS Access Rate 1993 50 WHD9401

ORT Use Rate 1993 68 WHD9401

KENYA ORS Access Rate 1991 65 WHD9201

ORT Use Rate 1991 69 WHD9201

UGANDA ORS Access Rate 1993 68 WHD9401

ORT Use Rate 1993 45 WHD9401

TANZANIA ORS Access Rate 1991 75 WHD9201

ORT Use Rate 1991 66 DHS9302


II. Data Notes: All profiles

February 1995

NOTES ON MORTALITY ESTIMATION

Throughout this profile, references are made to infant and under 5 mortality rates for individual countries or groups of countries. In past years, the primary source of data on infant mortality was the World Population Prospects, a set of estimates updated every two years by the Estimates and Projections Section of the Population Division of the Department of International Economic and Social Affairs, United Nations. The primary source of data on under 5 mortality was a special report published in 1988 by the same group. Where another source, such as a recent Demographic and Health Survey or a national census, was available for a given country, the reported values from that source were cited in place of the United Nations estimates if the technical staff of USAID in the Country Mission and/or the appropriate regional bureaus confirmed the validity of the alternative source.

Known as indirect estimates, those of the United Nations are generated from accepted demographic models which combine the results of all available surveys and censuses in a given country to produce a single time series of estimates and projections. When new empirical data becomes available for a given country, the entire time series of estimates and projections is updated. Thus, using conventional demographic approaches, a survey done in 1990 may generate a new estimate of a mortality rate for 1970 or 1980.

During 1993, a new set of estimates for mortality was generated for 82 countries for publication in the "World Development Report 1993" and a forthcoming UNICEF publication entitled "The Progress of Nations." Based on a curve-fitting model, the methodology applied to generate these new estimates purports to depict more accurately the trend derived from all available data sources for a country. Like the estimates generated using conventional demographic models, the entire time series might change upon the addition of a new empirical source. These estimates were made available to USAID through the courtesy of the "World Development Report" of the World Bank and UNICEF. The selection of the mortality rates was done through a consultative process involving representatives of the Office of Health in USAID s Research and Development Bureau, USAID's Regional Bureaus and, in many cases, the USAID Country Missions. The source determined to best reflect the reality in a country for the current values of infant and under 5 mortality was identified and one of a number of a computation procedures, depending on the source selected for the current value, was applied to estimate the longitudinal rates. The consideration of the additional source of data developed for the "World Development Report" and UNICEF during the consultative process has prompted some changes in the reporting of mortality rates from those reported in recent years.

DEFINITIONS

DEMOGRAPHIC INDICATORS

Total Population: The mid-year estimate of the total number of individuals in a country.

Average Annual Rate of Growth: An estimate of the rate at which a population is increasing (or decreasing) in a given year.

Infant Mortality Rate: The estimated number of deaths in infants (children under age one) in a given year per 1,000 live births in that same year. This rate may be calculated by direct methods (counting births and deaths) or by indirect methods (applying well-established demographic models).

Under 5 Mortality Rate: The estimated number of children born in a given year who will die before reaching age five per thousand live births in that same year. This rate may also be calculated by direct or indirect methods.

Maternal Mortality Ratio: The estimated number of maternal deaths per 100,000 live births where a maternal death is one which occurs when a woman is pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management. Although sometimes referred to as a rate, this measure is actually a ratio because the unit of measurement of the numerator (maternal deaths) is different than that of the denominator (live births). The measure would be a rate if the units were the same. Extremely difficult to measure, maternal mortality can be derived from vital registration systems (usually underestimated), community studies and surveys (requires very large sample sizes) or hospital registration (usually overestimated).

Crude Birth Rate: An estimate of the number of live births per 1,000 population in a given year.

Crude Death Rate: An estimate of the number of deaths per 1,000 population in a given year.

Life Expectancy At Birth: An estimate of the average number of years a newborn can expect to live. Life expectancy is computed from age-specific death rates for a given year. It should be noted that low life expectancies in developing countries are, in large part, due to high infant mortality.

Number of Births: An estimate of the number of births occurring in a given year.

Annual Infant Deaths: An estimate of the number of deaths occurring to children under age one in a given year.

Total Fertility Rate: An estimate of the average number of children a woman would bear during her lifetime given current age- specific fertility rates.

CHILD SURVIVAL INDICATORS

Vaccination Coverage In Children: An estimate of the proportion of living children between the ages of 12 and 23 months who have been vaccinated before their first birthday -- three times in the cases of polio and DPT and once for both measles and BCG. Vaccination coverage rates are calculated in two ways. Administrative estimates are based on reports of the number of inoculations of an antigen given during a year to children who have not yet reached their first birthday divided by an estimate of the pool of children under one year of age eligible for vaccination. Survey estimates are based on samples of children between the ages of 12 and 23 months.

Vaccination Coverage In Mothers: An estimate of the proportion of women in a given time period who have received two doses of tetanus toxoid during their pregnancies. This indicator is being changed in many countries to account for the cumulative effect of tetanus toxoid boosters. A woman and her baby are protected against tetanus when a mother has had only one or, perhaps, no boosters during a given pregnancy so long as the woman had received the appropriate number of boosters in the years preceding the pregnancy in question. (The appropriate number of boosters required during any given pregnancy varies with number received previously and the time elapsed.) The revised indicator is referred to as TT2+. Rates are computed using administrative methods or surveys.

DPT Drop-out Rate: An estimate of the proportion of living children between the ages of 12 and 23 months who received at least one DPT vaccination but who did not receive the entire series of three vaccinations before their first birthdays.

Oral Rehydration Salts (ORS) Access Rate: An estimate of the proportion of the population under age five with reasonable access to a trained provider of oral rehydration salts who receives adequate supplies. This is a particularly difficult indicator to measure and, therefore, it may fluctuate dramatically from year to year as improved methods of estimation are devised.

ORS and/or Recommended Home Fluid (RHF) Use Rate: An estimate of the proportion of all cases of diarrhea in children under age five treated with ORS and/or a recommended home fluid. ORT use may be determined using administrative means or surveys. In general, administrative estimates are based on estimates of the number of episodes of diarrhea in the target population for a given year and the quantity of ORS available. Thus, changes in the estimates of the frequency of diarrhea episodes can alter the ORT use rate as well as real changes in the pattern of use. Surveys are more precise in that they focus on the actual behavior of mothers in treating diarrhea in the two-week period prior to the survey.

Contraceptive Prevalence Rate: An estimate of the proportion of women, aged 15 through 44 (or, in some countries, 15 through 49), in union or married, currently using a modern method of contraception. Where sources fail to distinguish modern and traditional methods, the combined rate is shown.

Adequate Nutritional Status: An individual child of a certain age is said to be adequately nourished if his/her weight is greater than the weight corresponding to two Z-scores (two standard deviations) below the median weight achieved by children of that age. The median weight and the distribution of weights around that median in a healthy population are taken from a standard established by the National Center for Health Statistics, endorsed by the World Health Organization (WHO). The indicator for the population as a whole is the proportion of children 12 through 23 months of age who are adequately nourished.

Appropriate Infant Feeding: A composite estimate of the proportion of infants (children under age one) being breastfed and receiving other foods at an appropriate age according to the following criteria: breastfed through infancy with no bottle feeding, exclusively breastfed through four months (120 days) of age, and receiving other foods if over six months of age (181 days). Water is not acceptable in the first four months (120 days). ORS is considered acceptable at any age. Surveys are the only source of data to form this indicator. Surveys yield an estimate of how many infants are being fed correctly at the moment of the survey. They do not give an indication of the proportion of individual children fed appropriately throughout their first year of life. A number of sub-indicators may be calculated from the data used to form the composite, of which two are presented in this report.

Exclusive Breastfeeding: An estimate of the proportion of infants less than four months (120 days) of age who receive no foods or liquids other than breast milk.

Complementary Feeding: An estimate of the proportion of infants six to nine months of age (181 days to 299 days) still breastfeeding but also receiving complementary weaning foods.

Continued Breastfeeding: An estimate of the proportion of children breastfed for at least one year. In this report, all values presented for this indicator are the proportion of children 12 to 15 months of age at the time of the survey still receiving breast milk.

OTHER HEALTH INDICATORS

HIV-1 Seroprevalence, Urban: An estimate of the proportion of all persons (pregnant women, blood donors, and other persons with no known risk factors) living in urban areas infected with HIV-1, the most virulent and globally prevalent strain of the human immunodeficiency virus.

HIV-1 Seroprevalence, Rural: An estimate of the proportion of all persons living in rural areas infected with HIV-1.

Access to Improved Water, Urban: An estimate of the proportion of all persons living in urban areas (defined roughly as population centers of 2,000 or more persons) who live within 200 meters of a stand pipe or fountain source of water.

Access to Improved Water, Rural: An estimate of the proportion of all persons not living in urban areas with a source of water close enough to home that family members do not spend a disproportionate amount of time fetching water.

Access to Sanitation, Urban: An estimate of the proportion of all persons living in urban areas with sanitation service provided through sewer systems or individual in-house or in-compound excreta disposal facilities (latrines).

Access to Sanitation, Rural: An estimate of the proportion of all persons not living in urban areas with sanitation coverage provided through individual in-house or in-compound excreta disposal facilities (latrines).

Deliveries By Trained Attendants: An estimate of the proportion of deliveries attended by at least one physician, nurse, midwife, or trained traditional birth attendant.


III. Sources

BUC9103 Bureau of Census, Center for International Research, Recent HIV Seroprevalence Levels By Country, April, 1992

BUC9200 Health Studies Branch. Center for International Research. U.S. Bureau of the Census. HIV SeroprevalenceLevels, November 1992.

BUC9300 United States Bureau of the Census, Facsimile from Peter Johnson dated 3/3/93. Data prepared following the meeting on mortality estimation, 2/25/93.

BUC9302 Time series estimates of Infant Mortality generated by applying the ratio of the BUCEN estimate for 1992 to the World Population Prospects estimate for 1992 to theannual values dating back to 1950 as estimated in the World Population Prospects. Under 5 Mortality estimates are calculated by applying the appropriate Coale-Demeny model to the Infant Mortality estimates.

BUC9401 U.S. Bureau of the Census (BUCEN). International Data Base. Version dated March, 1994.

CALXX01 Calculated from the values for total population, crude birth rate and infant mortality from designated sourcesfor those variables.

CALXX03 Time series estimates of Infant Mortality generated by applying the ratio of the DHS estimate for the most current 5 year period (or IMR from other current source) to the projected value from the World Population Prospects for the same year and applying that ratio to the projected time series in the WPP. Under 5 Mortality estimates are calculated by applying

DHS9302 Bureau of Statistics, Planning Commission and Macro International Inc. Tanzania Demographic and Health Survey 1991/92. Columbia, Maryland: Macro InternationalInc., June 1993.

DHS9406 National Council for Population and Development, Central Bureau of Statistics- Office of the Vice President and Ministry of Planning and National Development and Demographic and Health Surveys-Macro International Inc. Demographic and Health Survey, 1993. Calverton, Md.: Macro International Inc., May 1994.

JMP9301 WHO/UNICEF Joint Monitoring Programme. Water Supply and Sanitation Sector Monitoring Report 1993. Sector Status as of December 1991. WHO and UNICEF. August, 1993.

UNP9200 Department of International Economic and Social Affairs, United Nations. World Population Prospects 1992. (ST/ESA/SER.A/120) New York: UN, 1992.

UNP9400 Department of International Economic and Social Affairs, United Nations. World Population Prospects 1994. (Tape) New York: UN, 1994.

WBK9302 Mortality rate time series generated from Ken Hill equations provided in a personal communication, March, 1993. The equations were developed for the World Development Report, 1993 and a UNICEF publication, The Progress of Nations.

WHD9201 Programme For Control Of Diarrhoeal Diseases. Eighth Programme Report 1990-1991. WHO/CDD/92.38. Geneva: World Health Organization, 1992.

WHD9401 Advanced Copy of Annex 1 of the WHO/CDR Annual Report, Received by facsimile, March 29, 1994.

WHE8801 World Health Organization. Expanded Programme on Immunization Information System Report, July 1988. Geneva: WHO, 1988.

WHE9100 World Health Organization. Expanded Programme on Immunization Information System Report, April 1991. (WHO/EPI/CEIS/91.1) Geneva: WHO, 1991.

WHE9301 Facsimile from WHO/EPI of the pages in the 9/93 report of the WHO EPI Information System containing the most current vaccination coverage rates. September 24, 1993

WHE9403 Download of WHO/EPI vaccination coverage files from INTERNET, August 29, 1994.

WHM9117 World Health Organization. Global Strategy for Health for All by the Year 2000: Second Report on Monitoringnm Progress. Add. 1, 1988 (WHO document EB83/2) as cited in Division of Family Health, World Health Organization. Maternal Mortality: A Global Factbook. (WHO/MCH/MSM/91.3) Geneva: World Health Organization, 1991.

WHM9137 World Health Organization. African Regional Office. Evaluation of the strategy for the health for all by the year 2000. Seventh report on the world health situation. Vol 2. Brazzaville 1987, as cited in Division of Family Health, World Health Organization. Maternal Mortality: A Global Factbook. (WHO/MCH/MSM/91.3) Geneva: World Health Organization,

WHO9101 World Health Organization. World Health Organization Disk: Water Supply and Sanitation Service Coverage. Geneva: WHO, October 29, 1991.