2022 Progress toward the SDGs, Goal #5 Gender Equality

 

The world is not on track to achieve gender equality by 2030, and the social and economic fallout from the pandemic has made the situation even bleaker. Progress in many areas, including time spent on unpaid care and domestic work, decision-making regarding sexual and reproductive health, and gender-responsive budgeting, is falling behind. Women’s health services, already poorly funded, have faced major disruptions. Violence against women remains endemic. And despite women’s leadership in responding to COVID-19, they still trail men in securing the decision-making positions they deserve. Commitment and bold action are needed to accelerate progress, including through the promotion of laws, policies, budgets and institutions that advance gender equality. Greater investment in gender statistics is vital, since less than half of the data required to monitor Goal 5 are currently available.

Awareness of violence against older women is growing, but data remain limited

Violence against women and girls is found in all countries and affects women of all ages. Globally, 26 per cent of ever-partnered women aged 15 and older (641 million) have been subjected to physical and/ or sexual violence by a husband or intimate partner at least once in their lifetime. Limited evidence points to an intensification of violence against women during the pandemic. A 2021 rapid gender assessment survey in 13 countries, undertaken by the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), found that 45 per cent of women reported that they or a woman they know has experienced some form of violence since COVID-19.

Global awareness of violence against older women specifically is growing, but data on the subject are limited, and the nature, scale, severity and complexity of such violence may be underestimated. Less than 10 per cent of eligible data on intimate partner violence capture the prevalence of such violence among women aged 50 and older. Limited evidence from 2000–2018 found that 4 per cent and 7 per cent of women in this age group experienced physical and/or sexual violence by an intimate partner in the last 12 months. Older women, however, may be vulnerable to specific forms of violence not usually measured in surveys on violence against women, such as economic exploitation, or being ostracized or neglected.

Child marriage and female genital mutilation are persistent human rights violations holding back progress for girls and women

In 2021, nearly one in five young women were married before the age of 18. The highest rates of child marriage are found in sub-Saharan Africa and Southern Asia, where 35 per cent and 28 per cent of young women, respectively, were married in childhood. Globally, the prevalence of child marriage has declined by about 10 per cent in the past five years. However, the effects of the COVID-19 pandemic have put more girls at risk, owing to economic shocks, school closures and interruptions in social services. By 2030, up to 10 million more girls are likely to become child brides, in addition to the 100 million girls who were projected to be at risk before the pandemic.

Another persistent harmful practice and human rights violation is female genital mutilation (FGM). At least 200 million girls and women alive today have been subjected to FGM, mainly in the 31 countries where the practice is concentrated. In many countries, it remains as common today as it was three decades ago. Even in countries where the practice has become less prevalent, progress would need to be at least 10 times faster to meet the global target of eliminating FGM by 2030. Education is one key to its elimination. Opposition to FGM is highest among girls and women who are educated. Girls whose mothers have a primary education are 40 per cent less likely to be cut than those whose mothers have no education.

Progress in women’s access to leadership positions, in both political and economic spheres, remains sluggish

During the pandemic, women leaders have acted decisively and effectively to implement and manage response and recovery efforts, prioritizing measures that address the most vulnerable groups. Despite this widely acknowledged success, the pace of progress on women’s representation in decision-making positions is discouraging. As of 1 January 2022, the global share of women in lower and single houses of national parliaments reached 26.2 per cent, up from 22.4 per cent in 2015. Women’s share is slightly over one third in local governments. At this pace, it would take another 40 years for women and men to be represented equally in national parliaments.

Working women, including those in managerial positions, have been disproportionately affected by the COVID-19 pandemic. Many have had their hours reduced or left the workforce altogether due to increased unpaid care work at home. In 2019, before the pandemic, women accounted for 39.4 per cent of total employment. In 2020, women represented nearly 45 per cent of global employment losses. The share of women in managerial positions worldwide saw only slight improvement from 2015 to 2019, increasing from 27.2 to 28.3 per cent. That share remained unchanged from 2019 to 2020, which is the first year without an increase since 2013.

In many countries, women still lack the legal right to autonomy over their own bodies

Only 57 per cent of women aged 15 to 49 who are married or in a union make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care, according to data from 64 countries for the period 2007–2021. Critical to this decision-making ability is the extent to which laws prevent or enable access to relevant health care and information. Among 115 countries with data, countries had in place an average of 76 per cent of the laws and regulations needed to guarantee full and equal access to sexual and reproductive health and rights.

The effects of the COVID-19 pandemic are likely having a significant impact on women’s ability to exercise their bodily autonomy. In the first year of the pandemic, an estimated 1.4 million additional unintended pregnancies occurred in lower- and middle-income countries. This could be due to several factors. Women may have experienced financial hardships that prevented them from making their own decisions to seek health care and contraception. During lockdown periods, women may have found it harder to say no to sex due to increased tensions in the home related to health, finance and social isolation. Finally, disruption or suspension of sexual and reproductive health care may have made these essential services inaccessible to women.

Protection of women’s land and property rights still has a long way to go

Owning rights to land, specifically agricultural land, reduces women’s reliance on male partners and relatives. Yet, in 30 countries, less than half of women had ownership and/or secure tenure rights over agricultural land, according to 2009–2020 data from 36 countries. In 18 of these countries, the share of men having ownership was twice that of women. Gender-responsive policy and legal frameworks are essential to advancing women’s rights to land. However, only 15 out of 52 reporting countries included sufficient provisions in their legal frameworks to offer women good protection in this regard. The most prominent areas in which positive results have been achieved are in succession rights and in protection from being disposed in land transactions.

Accelerated progress is needed to align public financing with gender equality objectives

Building back better from COVID-19 means doing so in a way that advances gender equality and women’s empowerment. Fundamental to this goal is ensuring that the allocation and spending of public financing takes gender equality into account. According to data reported by 105 countries and areas for the period 2018–2021, only 26 per cent of countries have comprehensive systems in place to track public allocations for gender equality, 59 per cent have some features of such a system, and 15 per cent do not have the minimum elements of such a system. Accelerated action is needed to expand comprehensive implementation of gender-responsive budgeting and strengthen its monitoring and evaluation.

Database is available at https://unstats.un.org/sdgs/. 

2022 Progress toward the SDGs, Goal #4 Quality Education

 

The COVID-19 pandemic has deepened a crisis in education, with severe disruptions in education systems worldwide. School closures have had worrisome consequences for children's learning and well-being, particularly for girls and those who are disadvantaged, including children with disabilities, rural dwellers and ethnic minorities. An estimated 147 million children missed more than half of their in-person instruction over the past two years. As a result, this generation of children could lose a combined total of $17 trillion in lifetime earnings (in current value). Governments need to implement ambitious programmes to ensure that all children return to school, recover their learning losses, and have their psychosocial needs met.

Prolonged school closures have heightened the risk that children will not return to school

COVID-related school closures threaten to reverse years of progress aimed at keeping children in school. Before the pandemic, 17 per cent of children and youth globally were out of primary and secondary school, compared to 26 per cent in 2000. From March 2020 through February 2022, schools worldwide were fully or partially closed for 41 weeks, on average. Latin America and the Caribbean experienced the longest school closures - more than 60 weeks in the past two years.

The longer children are out of school, the less likely they are to return. According to a 2020 report by the United Nations Educational, Scientific and Cultural Organization (UNESCO), 24 million learners from the pre-primary to university level are at risk of not returning to school. Students from more disadvantaged backgrounds are at higher risk due to socioeconomic factors such as the need to generate income, increased care responsibilities, and early and forced marriage. Those who were unable to access distance learning during confinement are also at higher risk of not returning to school.

COVID-19 has cast a shadow on an already dire picture of learning outcomes

The COVID-19 pandemic came at a time when the world was already struggling with a crisis in learning: too many children lacked the fundamentals of reading and numeracy. Based on pre-pandemic data from 2015 to 2019, the proportion of children meeting the minimum required proficiency in reading at the end of lower-secondary school was between 70 and 90 per cent in most high-income countries. That proportion fell below 60 per cent in almost all middle- and lowincome countries, dropping to less than 10 per cent in some countries.

Learning losses due to COVID-related school closures have been documented in 4 out of 5 of the 104 countries that have carried out such studies. School closures are also likely to deepen disparities in learning: many countries that had poor learning outcomes prior to the pandemic also tended to have longer school closures.

Entrenched inequities in education have only worsened during the pandemic

Over the years, education has become much more widely accessible. That said, inequalities in access persist among various socioeconomic groups. In 2020, for example, 3 out of 4 children attended some form of organized learning one year before the official primary school age. Yet, participation was highly unequal: among countries with available data, disparities in attendance were found based on gender (39 per cent), urban or rural location (76 per cent) and household wealth (86 per cent). The data showed that girls tend to score higher than boys in reading proficiency at the end of primary school. They also showed that children living in rural areas and in the poorest households are consistently more disadvantaged in term of educational participation and outcomes than their urban, wealthier peers.

School closures during the COVID-19 pandemic have deepened inequality in education, with marginalized populations most affected. In the context of remote learning, for example, children from poorer backgrounds are less likely to have the devices and computer skills they need to get online, or a home environment conducive to learning. Ensuring a safe return to school and equity in education in the difficult transition period ahead needs to be a priority.

Countries are improving schools as they reopen, but psychosocial support for students is often overlooked

One key to encouraging school enrolment and retention is ensuring adequate facilities and services. Yet, even basic school infrastructure is far from universal. In 2019-2020, about one quarter of primary schools worldwide lacked access to electricity, drinking water and basic sanitation facilities. Only half of primary schools had computers and Internet access or facilities that were fully accessible, including for children with disabilities. In all of these areas, LDCs lag furthest behind.

Recovering from the pandemic - and building back better - will require a significant investment in school infrastructure and services. According to a recent survey by the United Nations Children's Fund (UNICEF), about half of countries with data reported taking "significant additional measures" (as opposed to a "small-scale increase in measures") in water, sanitation and hygiene services in schools after their reopening. This proportion remains similar across countries in various income groups. However, only 20 per cent of countries undertook significant measures to provide additional mental health and psychosocial support for students. This is disturbing considering the recent uptick in anxiety and depression among learners.

Database is available at https://unstats.un.org/sdgs/.

2022 Progress toward the SDGs, Goal #3 Good Health and Well-Being

 

        COVID-19 continues to pose challenges to people’s health and well-being globally and is impeding progress in meeting Goal 3 targets. Before the pandemic, gains were evident in many areas of health, including reproductive, maternal and child health, immunization coverage and treatment of communicable diseases, though progress was marred by huge regional disparities. As of mid-2022, COVID-19 had infected more than 500 million people worldwide. The latest estimates show that global “excess deaths” directly and indirectly attributable to COVID-19 could have been as high as 15 million by the end of 2021. The pandemic has severely disrupted essential health services, triggered an increase in the prevalence of anxiety and depression, lowered global life expectancy, derailed progress towards ending HIV, tuberculosis (TB) and malaria, and halted two decades of work towards making health coverage universal. As a result, immunization coverage dropped for the first time in 10 years, and deaths from TB and malaria increased. Urgent and concerted action is needed to set the world back on a trajectory towards achieving Goal 3.

COVID-19 directly and indirectly led to the deaths of nearly 15 million people in the first two years of the pandemic

            COVID-19 is now a leading cause of death. The latest estimates suggest that 14.9 million people died as a direct result of COVID-19 or from the pandemic’s impact on health systems and society in 2020 and 2021. This estimate is nearly triple as the 5.4 million officially reported COVID-19 deaths in the same period. About 84 per cent of these “excess deaths” are concentrated in South-East Asia, Europe and the Americas (as defined by WHO), and 68 per cent are in just 10 countries.

The pandemic has severely disrupted health systems and essential health services. Interruptions in essential health services were reported in 92 per cent of 129 countries surveyed at the end of 2021. These disruptions were found across all major areas of health, including maternal and child health, immunization, mental health programmes, and treatment of diseases such as HIV, hepatitis, TB and malaria. As a result, impressive strides in global life expectancy came to a sudden halt. In many parts of the world, life expectancy has fallen by one to two years.

To effectively curb the spread of COVID-19 and prevent tens of thousands of additional deaths, it is critical to ensure equitable access to safe and effective vaccines. WHO has called for 70 per cent of people in all countries to receive vaccinations by mid-2022. That said, global vaccine distribution is far from equitable. As of May 2022, only around 17 per cent of people in low-income countries had received at least one dose of a vaccine, compared with more than 80 per cent in high-income countries. For everyone’s health, it is imperative that all countries and relevant manufacturers suspend patents, prioritize vaccine supply to COVAX, and create the conditions necessary for the local production of tests, vaccines and treatments.

The pandemic has triggered a significant rise in anxiety and depression, particularly among young people

            Available data do not indicate an increase in suicide rates during the first months of the COVID-19 crisis. However, the pandemic has had a severe impact on the mental health and well-being of people around the world. In 2020, the global prevalence of anxiety and depression increased by an estimated 25 per cent, with young people and women most affected. At the same time, countries reported that services for mental, neurological and substance use conditions were the most disrupted among all essential health services, which widened gaps in mental health care. By the end of 2021, the situation had improved somewhat, but many people remain unable to get the care and support they need for both pre-existing and new mental health conditions.

            Even before the pandemic, depression, anxiety and other mental health challenges affected far too many children. It is estimated that, in 2019, more than 13 per cent of adolescents aged 10 to 19 had a diagnosed mental disorder as defined by the WHO; this translates into 86 million adolescents aged 15 to 19 and 80 million adolescents aged 10 to 14. The pandemic has added to the mental health issues facing children and young people, since many of them are still experiencing school closures, disruption of daily routines, stress over food insecurity and loss of family income, and uncertainty about the future. For the most vulnerable children, the impact of COVID-19 may also increase their exposure to multiple forms of violence and exploitation.

            It is imperative that COVID-19 response plans include mental health and psychosocial support. Increased attention and investment are particularly needed to improve mental health care for children and young people and to protect the most vulnerable children.

Progress has been made in maternal and child health, but glaring regional disparities must be addressed

            Competent skilled birth attendance is key to reducing maternal and newborn morbidity and mortality. Globally, in 2015–2021, an estimated 84 per cent of births were assisted by skilled health professionals, including medical doctors, nurses and midwives. This was an increase from 77 per cent in 2008–2014. Still, coverage in sub-Saharan Africa was 20 percentage points lower than the global average.

                Progress was also made in under-5 and neonatal mortality, though too many children are still dying. The global mortality rate of children under age 5 fell by 14 per cent from 2015 to 2020 – from 43 to 37 deaths per 1,000 live births. Similarly, the mortality rate of children in their first 28 days of life, the neonatal period, fell by 12 per cent over that same period – from 19 to 17 deaths per 1,000 live births. Even with this progress, 5 million children died before reaching their fifth birthday in 2020 alone – down from 5.9 million in 2015. Almost half of those deaths, 2.4 million, occurred in the first month of life. Sub-Saharan Africa remains the region with the highest under-5 mortality rate in the world at 74 deaths per 1,000 live births in 2020. This is 14 times higher than the risk for children in Europe and Northern America.

            The adolescent birth rate also fell worldwide. From 2010 to 2020, the rate dropped from 47.9 births to 41.2 births per 1,000 adolescents aged 15 to 19. The largest declines occurred in Central and Southern Asia, from 43.6 births to 23.7 births over the same period.

            Childbearing among girls aged 10 to 14 is much more common in countries in sub-Saharan Africa and Latin America and the Caribbean than in other parts of the world. Most countries with measurable levels of early childbearing have recorded a reduction since 2000.

            Although data to assess the total impact of COVID-19 on maternal and child health and adolescent fertility are not yet available, concern is mounting that the pandemic has inadvertently undermined achievement in those areas.

The health and economic impacts of COVID-19 have likely worsened uneven progress towards universal health coverage

            Universal health coverage (UHC) is achieved when all people can receive the good-quality health services they need without facing financial hardship from having to pay for them. Even before COVID-19, alarming trends in universal coverage were evident. The UHC service coverage index improved from a global average of 45 out of 100 in 2000 to 64 in 2015 and 67 in 2019. However, almost 1 billion people spent more than 10 per cent of their household budget on out-of-pocket health expenses in 2017, and more than half a billion were pushed into extreme poverty due to these out-of-pocket payments.

            Data are not yet available to provide a detailed and comprehensive look at the impact of COVID-19 on progress towards UHC. However, since the pandemic has led to significant disruptions in essential health services, the continuous progress made over the last two decades has likely come to a halt. With the combined health and economic impacts of COVID-19, people may be facing greater financial constraints in accessing care. Among those paying out of pocket for health services, financial hardship is likely to worsen further, particularly for those already disadvantaged.

Widespread disruptions have derailed progress against HIV, tuberculosis and malaria

            In 2020, an estimated 1.5 million people were newly diagnosed with HIV and 680,000 people died of AIDS-related causes. The incidence of HIV infections globally declined by 39 per cent between 2010 and 2020, far less than the 75 per cent target agreed to by the General Assembly in 2016. Measures to slow the spread of COVID-19, along with the added pressures on health systems, have disrupted HIV services.

                In 2020, an estimated 10 million people worldwide fell ill with TB. That year, the notification rate of new and relapse cases in TB incidence fell to 59 per cent, down from 72 per cent in 2019. Disruptions associated with the pandemic globally caused a noticeable rise in the number of TB deaths, from 1.2 million in 2019 to 1.3 million in 2020 (excluding TB deaths in people with HIV). This is the first year-on-year increase in TB deaths since 2005, and it took the world back to the 2017 level. Progress in reducing TB incidence also slowed in 2020 to less than 2 per cent per year. This is much lower than the 4 to 5 per cent annual decline required to achieve the End TB Strategy (i.e., an 80 per cent drop in new cases by 2030). Between 2018 and 2020, TB treatment reached 20 million people, only half of the global target. Due to the pandemic, TB incidence and mortality are expected to worsen, especially in 2021 and 2022.

            An estimated 241 million malaria cases and 627,000 deaths from malaria were reported worldwide in 2020. This means that 14 million more people contracted malaria and 69,000 more people died from it than in 2019. About two thirds of the additional deaths were linked to disruptions in the provision of malaria services during the pandemic. Even before COVID-19, global gains against the disease were levelling off, and the world was not on track to reach the targets set in WHO’s Global Technical Strategy for Malaria 2016–2030. By 2020, the global malaria incidence rate was 59 cases per 1,000 people at risk against a target of 35. In other words, progress against malaria was off track by 40 per cent.

                Progress towards preventing, controlling and eradicating neglected tropical diseases (NTDs) continued in 2020, despite significant disruptions to health services. The number of people globally requiring NTD treatment and care declined from 2.19 billion in 2010 to 1.73 billion in 2020. Notably, in LDCs, 48 per cent of the total population required treatment and care for NTDs in 2020, down from 79 per cent in 2010. This progress was largely due to the elimination of a number of NTDs. By the end of 2020, at least one NTD had been eliminated in 42 countries. Important declines were observed in the number of reported cases of diseases targeted for elimination and eradication, including African trypanosomiasis (sleeping sickness) in humans and dracunculiasis (Guinea-worm disease).

More children are missing out on essential vaccines due to the pandemic

         COVID-19 and associated disruptions have caused more children to miss out on essential vaccines. From 2019 to 2020, coverage of infant immunization slipped from 86 to 83 per cent. This means that 22.7 million children missed out on vaccinations in 2020, 3.7 million more than in 2019 and the highest number since 2005. In addition, 17.1 million older children did not receive vaccines through the routine immunization programme in 2020, an increase from 13.6 million in 2019.

               The consequences could be devastasting. Measles, for example, is a highly contagious disease, and the current coverage levels of 70 per cent with two doses are insufficient to prevent illness, disability and death from measles outbreaks or complications associated with the disease. What’s more, COVID-19 responses and vaccinations have diverted health system resources away from other essential services. It is therefore likely that in 2021 and beyond, too many children will continue to miss out on immunization as well as other health-care services. Recovering these to pre-pandemic levels must be an urgent global priority.

The COVID-19 pandemic has taken a heavy toll on health and care workers, who are already stretched thin in most regions

            Health and care workers remain on the front lines of the COVID-19 response. Between January 2020 and May 2021, the pandemic may have claimed the lives of 115,500 health and care workers worldwide. Greater efforts are needed for equitable distribution of COVID-19 vaccines to ensure that they have access to vaccination and personal protective equipment personnel in Northern America remains the highest in the world, at over 152 per 10,000 people. This is almost 4 times the global average, 8 times that of Northern Africa and Southern Asia, and over 15 times that of sub-Saharan Africa. Despite a steady increase in the density of medical doctors per 10,000 people globally, the disparities among regions remain high – from an estimated 40 medical doctors per 10,000 people in Europe to only 2 in sub-Saharan Africa.

Database is available at https://unstats.un.org/sdgs/.