Will We Really Know if we Achieve the MDGs?

As we approach 2015, conversations about the quality of data for generating estimates of various indicators is gaining steam. According to a recent paper, very few countries are on track to meet MDGs 4 and 5 based on the estimate available. Unfortunately, the data used to generate those estimates is not as good as we would like. Additionally, countries with the highest levels of maternal and neonatal mortality are also generally those with the least reliable data.

In The Lancet this week, Peter Byass and Wendy Graham write:

Numerical assessments against the MDGs are inevitably processes that are plagued by poor and missing data, and their uneven distribution. The WHO-led Commission on Information and Accountability for Women’s and Children’s Health concluded “Countries most off-track for women’s and children’s health generally have the weakest civil registration systems”. In the absence of any reliable universal mechanism to “make each and every person count”, MDG mortality outcomes have defaulted to national-level metrics, which need detailed modelled interpretation. Although it is self-evident that the greatest numbers of avoidable deaths happen in some of the world’s largest countries, the highest individual risks can apply in smaller countries or within specific regions of larger countries—yet these important differentials are invisible. Global estimates must therefore be seen as a stop-gap approach to measuring progress.