Progress on SDG Goal 3; Ensure Healthy Lives and Promote Well-Being for All at All Ages.

Progress on SDG Goal 3; Ensure Healthy Lives and Promote Well-Being for All at All Ages.

SDG goal number 3 touches on health, one of the basic human rights enshrined in the international human rights instruments and WHO (World Health Organisation). It is expected that every human being has access to the highest attainable healthcare both physically and mentally. Unfortunately, not all people as would be anticipated have access even to the most basic healthcare.

The UN set out to ensure that all humans live healthy and fulfilling lives by 2030. To do this, they set out some targets and indicators to be monitored to track the progress towards achieving that objective.

Key targets would be reduced maternity mortality levels, ending all preventable deaths under 5 years of age, fighting infectious diseases, reducing mortality from non-communicable diseases and promoting mental health, preventing and treating substance abuse, reducing road injuries and deaths, universal health access and reproductive care and family planning and education, achieve universal health coverage and reduce illness and deaths from hazardous chemicals and pollution.

In addition, all countries would strive to implement the WHO framework convention on tobacco control, and undertake to support research, development and access to affordable vaccines and medicines. They also pledged to increase health financing to support the health workforce in developing countries and improve early warning systems for global health risks.

As you have seen, the starting point was bold, especially for countries that have been struggling with providing affordable and sustainable healthcare access for their vulnerable members of society such as pregnant women, the elderly, children and the poor.

Maternal Mortality and deaths under 5 years of age.

Maternal mortality is measured by the number of deaths related to pregnancy or deaths within 42 days of pregnancy termination per 100,000 live births and the proportion of births that are attended by skilled healthcare personnel. Deaths under 5 years of age are measured by the probability per 1,000 that a newborn child will die before age 5 and by the probability per 1,000 that a child will die within the first 28 days of their life subject to age-specific mortality rates of that period.

Looking at these two indicators over the last 20 years, the mortality rates have been decreasing steadily which is commendable. By 2020, only 3 countries globally reported over 1,000 maternal deaths per 100,000 live births. Australia and a large part of Europe such as Ireland, the UK, Sweden, Finland, Norway, Poland, Germany, and Italy had less than 10 deaths.

In Africa, Algeria, Egypt, Libya, Tunisia, and Morocco had the lowest numbers at less than 100 deaths per 100,000 live births. In terms of births attended by skilled health workers by 2021, most countries had above 50% of births attended by at least a skilled healthcare worker(s) except countries like Haiti, Angola, Madagascar, Somalia, Ethiopia, Chad, Niger, Nigeria and the Central Africa Republic with less than 50%.

Under 5 mortality rates, 5 countries globally had rates between 10-20% by 2021 which is a serious concern. Whereas most African countries had between 2-10%, we must push these rates to 0-0.5% like most European countries and Australia. America too needs to get below the 0.5% mark.

Communicable and Non-communicable diseases

Transmissible diseases to be fought include HIV/AIDS, Tuberculosis, Malaria, hepatitis B infections and other neglected tropical infections. Non-communicable disease mortality rates to be reduced are those resulting from cardiovascular diseases, cancer, diabetes, chronic respiratory diseases and suicides as a result of mental health issues.

Malaria is still prevalent in Africa with between 50-300 cases reported per 1,000 people at risk as of 2020. These numbers are supposed to be at zero by 2030. China is at zero, as are Paraguay, Argentina, Iraq, Turkey, Malaysia and a few others. As for TB, a lot of Central, East and South African countries have reported cases of 200-500 cases per 100,000 as of 2022. By 2030 this number needs to be at Zero. America, Canada, some countries in Europe, Australia, Saudi Arabia, and Egypt have less than 10 TB cases per 100,000 people which is admirable.

Globally new HIV infections were at 0.2 % per 1,000 uninfected persons for all ages by 2021 but these numbers need to be at less than 0.03% by 2030. However, new HIV infection preferences vary from country to country. For instance, while that one for Kenya was 0.73% for all ages in 2021, Tanzanias’ was 0.95%, Nigeria’s was 0.34%, Congo’s was 2.39%, and South Africa’s was 4.19%. Compare that to Germany at 0.03%, the US at 0.11% or Italy at 0.02%

Child hepatitis B infections need to be eliminated by 2030 and A lot of African countries need to work on this more as the numbers indicate greater than 2.5% positive tests for hepatitis B per 100,000 population. For mortality due to non-communicable diseases, a lot of countries globally especially in Parts of Europe, Asia, Africa and South America reported a 15-25% chance that 30-year-olds would not celebrate their 70th birthday due to deaths caused by non-communicable diseases. This is alarming. If the number is anything to go by, what are your chances? This calls for the promotion of healthy lifestyles and the development of healthcare capabilities to treat these diseases.

Interestingly, many African countries are doing fairly well in terms of deaths due to suicide. The numbers have been low consistently for some time now. Russia, the United States, Lesotho, South Africa, Guyana, South Korea and Ukraine reported some of the highest deaths due to suicide per 100,000 people in a given population in 2019. Lesotho and Guyana led at 76.6 and 39.5 deaths per 100,000 people respectively. The funniest bit is that there is no defined target level for the suicide rate.

Universal health coverage and well-being

By 2030, all road traffic deaths need to be halved. In 2019, there were 250,025 and 211, 975 deaths in China and India respectively due to road injuries. These are many deaths. Many countries need to triple their efforts in reducing road accidents and injuries. For alcohol disorders for people aged 15 and over, Hungary and Russia had the highest rates at 21.2% and 20.9 % of the population in 2016. North Africa and part of Asia had less than 1% of disorders due to alcohol in 2016 which should be the case for all other countries.

There is a generally positive trajectory globally regarding meeting the family planning needs of women. Countries like the US, Russia, India, South Africa, Kenya, Morocco, Namibia, Myanmar, and Sweden have met their women’s family planning needs at over 70%. These countries are distributed across the various continents globally and point to a general improvement overall.

Adolescent birth rates (10-14 years) are still high in Mauritania, Brazil, DRC, Chad, Zambia, Mozambique, Madagascar, Niger, Venezuela, Colombia, and Ecuador at an average of 5 per 1,000 women in that age group. All these countries need to double their efforts to reduce the numbers to zero.

Regarding Universal Health Coverage(UHC), West, Central and East African countries should hasten their efforts to increase their universal health coverage to over 50%. Kenya had a 53.34% UHC coverage by 2021 and needs to catch up with the rest of the world which is at over 75% as needs Zambia, Bolivia, Indonesia, Cambodia, Myanmar, Iraq, Mongolia, Libya et cetera.

Africa needs to work on reducing deaths associated with household and ambient air pollution. West, Central, Eastern and South Africa, Pakistan, Papua New Guinea and India need to reduce deaths associated with unsafe water, sanitation and hygiene to below 20 per 100,000 to be at par with the rest of the world. Sanitation and safe water for drinking and domestic purposes is a global priority for all people.

Expenditure on healthcare needs to be increased for a number of the countries which we have seen have high numbers of deaths be it due to diseases, pollution, substance abuse or accidents to ensure the capability of response in terms of machinery and personnel. More health workers must be trained, and more research and development must go into drug and healthcare technology research. Our health is a priority that needs to be addressed by all means.

We can agree that many countries are in the race to provide sustainable healthcare for their citizens, but more needs to be done. As Africa needs to address maternal mortality, increase access to basic medicines and reduce deaths due to infectious diseases, India and China need to address deaths due to accidents and Europe and America need to work on their citizen’s mental health to reduce suicide and drug abuse cases. Cumulatively much is to be done to achieve SDG goal 3 objectives.

There are many benefits of a healthy population to the economy.

Geoffrey Ndege

Geoffrey Ndege

Geoffrey Ndege is the Editor and topical contributor for the Daily Focus. He writes in the areas of Science, Manufacturing, Technology, Innovation, Governance, Management and International Emerging Issues. For featuring, promotions or support, reach out to us at info@dailyfocus.co.ke
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