• The region is expected to surpass the first Millennium Development Goal (MDG) target—to reduce poverty by half by 2015. The share of people living in extreme poverty in SAR is expected to fall to 18 percent by 2015, well below the targeted 21.5 percent. The total number of poor people living on less than $1 a day in the region as of 2004 was 462 million.

• Real per capita income growth in South Asia (SAR) has been stronger in the period since 2000 than in any time since the 1960s, with per capita GDP growth estimated to be 6.8 percent in 2006.

• Per capita GDP growth in India is expected to be 7.5 percent in 2006, pushing up the regional growth rate. Other countries in the region are also doing well, with the exception of Nepal, although Nepal’s poverty rate fell by 11 percentage points in eight years. Growing income inequality is of concern in India.

• Country Policy and Institutional Assessment, or CPIA, scores show that quality of environmental institutions and policies in developing countries (especially SAR) is worse than for those globally.

Fragile states

• Prospects for improved growth and poverty reduction are dimmer in fragile states, where extreme poverty is increasingly concentrated. Just one of the world’s 35 fragile states is in South Asia—Afghanistan. 

Gender

• The gender literacy ratio remains low. In 2002, 82 percent of males aged 15-24 were literate, but only 65 percent of females. Globally, the lowest ratio was in Afghanistan—just 36 literate young women for every 100 literate young men.

• The women’s labor force participation rate in South Asia is among the lowest in the world. Even when employed, women are less likely to be engaged in industry or service sectors. They constitute only about 18 percent of all non-agricultural wage employment.

• Although the share of women in national parliament nearly doubled over the 1990s, it remains low: The regional average was 10 percent in 2000-05.

• In SAR, girls have a distinct health disadvantage as seen in sex-disaggregated under-five mortality data – girls are less likely to survive childhood than boys are.

• Childbearing among teenagers can bring disproportionate health risks to the mother and the baby. In 2000-04, the percentage of adolescent (15-19) mothers was high in India (21 percent) and Bangladesh (33 percent).

• The sex ratio in India is skewed, particularly so in the northwestern states of Punjab and Haryana, where the sex ratio of males to females (0-4 years) have historically been high, rising sharply with the spread of sex-selective abortion in the 1980s and 1990s.

As a region, South Asia is off-track on all the human development goals, but countries vary. Some experts think SAR is lagging on this set of goals but doing better on the poverty reduction goal because the human development goals are ambitious and complicated.

Nutrition 

• In striking contrast to its strong growth performance, SAR has the highest rates of malnutrition in the world. This is likely to continue even if the MDG target is achieved. Three of eight South Asian countries are off track.

• Underweight prevalence among children younger than five is between 38 and 51 percent in the large countries—Afghanistan, Bangladesh, India, and Pakistan.

Universal Primary Completion

• Progress on the primary completion target has been especially strong. The region could reach the goal at the current rate of progress.

• The hardest groups to reach with primary education are those who are “doubly disadvantaged”: girls from ethnic, religious, or caste minorities.

• The primary completion rate for girls in South Asia is estimated to be 77 percent, as compared to 86 percent for boys.

• Despite significant improvements in girls’ primary school enrollment, most of the SAR countries failed to achieve gender parity in secondary school enrollment. Bangladesh and Sri Lanka are notable for achieving parity in school enrollments.

Child Mortality

• High under-five mortality (100 per 1,000 live births) indicates that SAR needs to improve child health outcomes overall, and to reduce girls’ health disadvantages.

• Bhutan has made strong progress recently, lowering its under-five mortality rate from 166 per 1,000 births in 1990 to 75 in 2005, an annual decline of 5.3 percent.

• In Bangladesh, children in the poorest quintile are showing faster average annual reduction in child mortality (3.3 percent) than the population as a whole.

Maternal Health

• World Bank staff estimates show that most countries in South Asia are seriously off-track. South Asia had an estimated 564 maternal deaths per 100,000 live births in 2000, as compared to 10 in 100,000 in developed countries.

• Only 37 percent of births were attended by skilled health personnel in 2004.

• In countries with lowest assisted births, women in the richest quintile are six times more likely to have access than in the poorest quintile.

Communicable Diseases

• The number of people in East, South, and S.E. Asia with access to antiretroviral therapy increased from fewer than 300,000 (2002) to over 1.3 million (end-2005).

• Evidence exists that reversing the spread of HIV/AIDS is possible. In India, declines have been recorded in four southern states.

• Progress against tuberculosis has been slow. TB incidence was 180 per 100,000 people in 1990; in 2004 it had declined to 174. In Afghanistan, there was no change in TB incidence between 1990 and 2003 (333 per 100,000 people).

Using Resources Wisely

The Role of Quality in MDG Progress

• Doctors surveyed in India completed only 26 percent of tasks required for a patient presenting with TB (India’s foremost killer among infectious diseases) and only 18 percent of tasks required for a child with diarrhea (Das & Gertler, 2007).

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• In 2005, South Asia saw a big increase in ODA, more than a third of which was in the form of humanitarian assistance (primarily to Pakistan and Sri Lanka) in response to the tsunami and earthquake that struck the region.

• Afghanistan is one of the top recipients of increased aid between 2001 and 2005.  It joins the Maldives and Sri Lanka in the small group of countries worldwide that have seen more than a 50 percent expansion of ODA in this period.

• ODA to India more than doubled but is still not equal to levels seen before 2003.