Healthcare coverage, access to contraception, and child mortality rates improved since 2000

Healthcare coverage, access to contraception, and child mortality rates have improved since the Millennium Development Goals were adopted in 2000, according to new research involving School of Population and Public Health (SPPH) faculty.

Published yesterday (September 21) in The Lancet, the research measured 188 countries’ progress towards 11 health-related Sustainable Development Goals (SDG) adopted by the United Nations General Assembly in September 2015, by analyzing 33 health-related indicators from 1990 to 2015 using the Global Burden of Diseases, Injuries, and Risk Factors Study 2015. These indicators included under-five and neonatal mortality rates, under-five stunting, wasting, and overweight, and met need with modern contraception. The research also provided analysis of changes in indicators since 2000, to give an idea of possible future trajectories.

The Global Burden of Disease Collaboration, which includes Professors Carolyn Gotay and Michael Brauer, Dr. Hans Krueger and Dr. Farshad Pourmalekis, is coordinated by the Institute for Health Metrics and Evaluation. It created an index (SDG index) to rank the countries, compiling scores out of 100 (the best observed value over the time period) for each indicator to produce an overall ranking. These rankings show which nations are closest to achieving the SDG targets, the Institute says.

The median score was 59 in 2015, with Iceland coming out on top at 85, Canada in at ninth with 81, the USA in at 28th with 75, and the Central African Republic the lowest at 20.

The study found that countries’ performance in the childhood overweight indicator “considerably” worsened. Socio-demographic index, which measures income per capita, average educational level and total fertility rate, was highly predictive of the overall health-related SDG index, highlighting the general importance of income, education, and fertility, the authors said, but was a poor predictor of indicators such as intimate partner violence and mortality due to war.
“This highlights that a focus on increasing income and education and decreasing fertility alone will likely not be sufficient to meet the SDGs.”

The research also found that fewer people are dying from air pollution. Research co-author, and Professor Michael Brauer, said these results showed some signs of progress for deaths related to air pollution.

“Yet a major challenge remains to ensure healthy air for the majority of the world’s population.”
Professor Michael Brauer

The paper provided possible case studies for understanding the drivers of progress on achieving SDGs, identifying countries with the largest improvement in the SDG index from 2000 to 2015, separated by SDI information into quintiles. These countries were Timor-Leste among low SDI countries; Tajikistan among low-middle SDI countries; Colombia among middle SDI countries; Taiwan among middle-high SDI countries; and Iceland among high SDI countries. These countries had “implemented a range of policies and interventions that may have contributed to their progress”.

Photo credit: GBD 2015 SDG Collaborators

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