Export citation

Search in Google Scholar

Measuring the health-related Sustainable Development Goals in 188 countries : a baseline analysis from the Global Burden of Disease Study 2015

Journal article published in 2016 by Collaborators, Johan Ärnl, Stephen Ss Lim, Kate Allen, Zulfiqar A. Bhutta ORCID, Lalit Dandona, Mohammad H. Forouzanfar, Nancy Fullman, Peter W. Gething, Ellen M. Goldberg, Simon I. Hay, Mollie Holmberg, Yohannes Kinfu, Michael J. Kutz, Heidi J. Larson and other authors.
This paper is available in a repository.
This paper is available in a repository.

Full text: Download

Question mark in circle
Preprint: policy unknown
Question mark in circle
Postprint: policy unknown
Question mark in circle
Published version: policy unknown


Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. ; Bill & Melinda Gates Foundation. We thank the countless individuals who have contributed to the Global Burden of Disease Study 2015 in various capacities. The data used in this paper came from the 2009–10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana, and the Economic Growth Centre (EGC) at Yale University. It was funded by the Economic Growth Center. At the same time, ISSER and the EGC are not responsible for the estimations reported by the analyst(s). HBSC is an international study carried out in collaboration with WHO/EURO. A list of principal investigators in each country can be found online. The Panel Study of Income Dynamics is primarily sponsored by the National Science Foundation, the National Institute on Aging, and the National Institute of Child Health and Human Development and is conducted by the University of Michigan. This analysis uses data or information from the LASI Pilot micro data and documentation. The development and release of the LASI Pilot Study was funded by the National Institute on Ageing/National Institute of Health (R21AG032572, R03AG043052, and R01 AG030153). Collection of these data was made possible by the US Agency for International Development (USAID) under the terms of cooperative agreement GPO-A-00-08-000_D3-00. The opinions expressed are those of the authors and do not necessarily reflect the views of USAID or the US Government. Data for this research were provided by MEASURE Evaluation, funded by the USAID. Views expressed do not necessarily reflect those of USAID, the US Government, or MEASURE Evaluation. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with licence number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law—2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. We thank the Russia Longitudinal Monitoring Survey, RLMS-HSE, conducted by the National Research University Higher School of Economics and ZAO “Demoscope” together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology RAS for making these data available. This research used data from the National Health Survey 2009–10, and we gratefully acknowledge the Ministry of Health, Survey copyright owner, for use of the database. All results of the study are those of the authors and in no way committed to the ministry. The following individuals acknowledge various forms of institutional support: Simon I Hay is funded by a Senior Research Fellowship from the Wellcome Trust (#095066) and grants from the Bill & Melinda Gates Foundation (OP1119467, OPP1093011, OP1106023, and OP1132415). Amanda G Thrift is supported by a fellowship from the Australian National Health and Medical Research Council (GNT1042600). Panniyammakal Jeemon is supported by the Wellcome Trust–DBT India Alliance, Clinical and Public Health, Intermediate Fellowship (2015–20). Boris Bikbov, Giuseppe Remuzzi, and Norberto Perico acknowledge that their contribution to this paper has been on behalf of the International Society of Nephrology (ISN) as a follow-up of the activities of the GBD 2010 Genitourinary Diseases Expert Group. Tonatiuh Barrientos-Gutierrez and E Filipa de Castro acknowledge that the data shared on Water and Sanitation for Mexico, was derived from the “Encuesta Nacional de Niños, Niñas y Mujeres en México 2015”, which is the implementation in Mexico of the Multiple Indicators Cluster Survey (MICS) carried out with the financial support of UNICEF. Miriam Levi would like to acknowledge the institutional support received from CeRIMP, Regional Centre for Occupational Diseases and Injuries, Tuscany Region, Florence, Italy. Charles Wolfe's research was funded/supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. No individuals acknowledged receiving additional compensation for their efforts. ; Peer-reviewed ; Publisher Version