Are cost effective interventions enough to achieve the millennium development goals?
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ABSTRACT:
SUBMITTER: Wibulpolprasert S
PROVIDER: S-EPMC1283260 | biostudies-literature | 2005 Nov
REPOSITORIES: biostudies-literature
Publications
Are cost effective interventions enough to achieve the millennium development goals?
Wibulpolprasert Suwit S Tangcharoensathien Viroj V Kanchanachitra Churnrurtai C
BMJ (Clinical research ed.) 20051101 7525
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Project description:BackgroundThere is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up.MethodsA systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches.ResultsWe identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations.ConclusionsThe current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.
| S-EPMC3260120 | biostudies-literature
Project description:Achieving the 17 United Nations sustainable development goals (SDGs) in China largely depends on the transition of cities toward sustainable development. However, significant knowledge gaps exist in evaluating the SDG index at the city scale and in understanding how to simulate pathways to achieve the 17 SDGs for Chinese cities by 2030. This study aimed to quantify the SDG index of 285 Chinese cities and developed a forecasting model to simulate the performance of each SDG in each city until 2030 using varied scenarios. The results indicated that although the SDG index in Chinese cities increased by 33.97% during 2005-2016, Chinese cities, which continued their past paths, achieved an average of only five SDGs by 2030. To promote the joint achievement of all SDGs, we designed different paths for all SDGs of each of the 285 cities and simulated their SDG index until 2030. Under the scenarios, 216 Chinese cities (75.79%) could achieve 9-13 more SDGs in 2030 and the overall SDG index can improve from 74.57 in 2030 to 97.49 (target score 100) by adopting more intensive path adjustment. We lastly determined a cost-effective path for each SDG of each city to promote joint achievement of all SDGs by 2030. The proposed simulation model and cost-effective path serve as a foundation for other countries to simulate SDG progress and develop pathways for achieving SDGs in the future.
| S-EPMC9382565 | biostudies-literature
Project description:In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the "big three" diseases--namely HIV, tuberculosis (TB), and malaria--has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda.
| S-EPMC4440802 | biostudies-other
Project description:Reducing child mortality is a key global health challenge. We examined reasons for greater or lesser success in meeting under-five mortality rate reductions, i.e. Millennium Development Goal #4, between 1990 and 2015 in Sub-Saharan Africa where child mortality remains high. We first examined factors associated with child mortality from all World Health Organization African Region nations during the Millennium Development Goal period. This analysis was followed by case studies of the facilitators and barriers to Millennium Development Goal #4 in four countries - Kenya, Liberia, Zambia, and Zimbabwe. Quantitative indicators, policy documents, and qualitative interviews and focus groups were collected from each country to examine factors within and across countries related to child mortality. We found familiar themes that highlighted the need for both specific services (e.g. primary care access, emergency obstetric and neonatal care) and general management (e.g. strong health governance and leadership, increasing community health workers, quality of care). We also identified methodological opportunities and challenges to assessing progress in child health, which can provide insights to similar efforts during the Sustainable Development Goal period. Specifically, it is important for countries to adapt general international goals and measurements to their national context, considering baseline mortality rates and health information systems, to develop country-specific goals. It will also be critical to develop more rigorous measurement tools and indicators to accurately characterize maternal, neonatal, and child health systems, particularly in the area of governance and leadership. Valuable lessons can be learned from Millennium Development Goal successes and failures, as well as how they are evaluated. As countries seek to lower child mortality further during the Sustainable Development Goal period, it will be necessary to prioritize and support countries in quantitative and qualitative data collection to assess and contextualize progress, identifying areas needing improvement.
| S-EPMC7067162 | biostudies-literature
Project description: Not available
| S-EPMC4464219 | biostudies-literature
Project description:ObjectiveThe breadth of research on the impact of nutrition-specific policies to address child undernutrition is not well documented. This review maps the evidence base and identifies gaps on such policies.DesignWe systematically searched Medline, Embase, PAIS Index for public policy, Scopus and Web of Science databases to identify eligible studies. Key study characteristics, including research design, type of policy, time span of policy before impact assessment, child age at outcome assessment and types of outcomes assessed, were abstracted in duplicate.SettingLow-, middle- and high-income countries.ParticipantsStudies were eligible for inclusion if they aimed to assess the impact of population-level nutrition-specific policies on undernutrition among children under 10 years of age.ResultsOf the 5646 abstracts screened, eighty-three studies were included. A range of policies to address child undernutrition were evaluated; the majority were related to micronutrient fortification. Most studies were observational, reported on mandatory regional or sub-national polices, were conducted in high-income countries and evaluated policies within 1 year of implementation. A narrow set of health outcomes were evaluated, most commonly iodine deficiency disorders and neural tube defects.ConclusionsNutrition policies were commonly associated with improved child nutritional status and health. However, this evidence is primarily based on limited settings and on a limited number of outcomes. Further research is needed to assess the longer-term impact of a broader range of nutrition policies on child health, particularly in low- and middle-income countries.
| S-EPMC10195300 | biostudies-literature
Project description: Not available
| S-EPMC1468466 | biostudies-literature
Project description:PurposeTo highlight ongoing and emergent roles of nurses and midwives in advancing the United Nations 17 Sustainable Development Goals by 2030 at the intersection of social and economic inequity, the climate crisis, interprofessional partnership building, and the rising status and visibility of the professions worldwide.DesignDiscussion paper.MethodsLiterature review.FindingsRealizing the Sustainable Development Goals will require all nurses and midwives to leverage their roles and responsibility as advocates, leaders, clinicians, scholars, and full partners with multidisciplinary actors and sectors across health systems.ConclusionsMaking measurable progress toward the Sustainable Development Goals is critical to human survival, as well as the survival of the planet. Nurses and midwives play an integral part of this agenda at local and global levels.Clinical relevanceNurses and midwives can integrate the targets of the Sustainable Development Goals into their everyday clinical work in various contexts and settings. With increased attention to social justice, environmental health, and partnership building, they can achieve exemplary clinical outcomes directly while contributing to the United Nations 2030 Agenda on a global scale and raising the profile of their professions.
| S-EPMC8717679 | biostudies-literature
Project description:OBJECTIVE: To analyse trends in under-five mortality rate in South Africa (1990-2011), particularly the contribution of AIDS deaths. METHODS: Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data. RESULTS: Differences between the models resulted in varying point estimates for under-five mortality but the trends were similar, with mortality increasing to a peak around 2005. The three models showing the contribution of AIDS suggest a maximum of 37-39% of child deaths were due to AIDS in 2004-2005 which has since declined. Although the rate of progress from 1990 is not the 4.4% needed to meet Millennium Development Goal 4 for child survival, South Africa's average annual rate of under-five mortality decline between 2006 and 2011 was between 6.3 and 10.2%. CONCLUSION: In 2005, South Africa was one of only four countries globally with an under-five mortality rate higher than the 1990 Millennium Development Goal baseline. Over the past 5 years, the country has achieved a rate of child mortality reduction exceeded by only three other countries. This rapid turnaround is likely due to scale-up of prevention of mother-to-child transmission of HIV, and to a lesser degree, the expanded roll-out of antiretroviral therapy. Emphasis on these programmes must continue, but failure to address other aspects of care including integrated high-quality maternal and neonatal care means that the decline in child mortality could stall.
| S-EPMC3815090 | biostudies-other
Project description:A study was conducted in Sylhet at Jaintiapur Upazila to determine the prospects of Moringa-based homestead concerning Sustainable Development Goals. A household survey was conducted following a simple random sampling of 135 farmers and following a semi-structured questionnaire and interview schedule with 100 farmers (40 identified Moringa-based adopters and 60 non-adopters). The final questionnaire was prepared after pilot testing, which contained data on common species diversity, and the perception of farmers regarding SDGs indicators of "no poverty, zero hunger, good health, and well-being, gender equality, affordable and clean energy, decent work and economic growth". The extent of agreement was recorded following the points Likert scale high (3) to no change (0), and the SDG index (SDGI) value was calculated. The 10 key informant interviews were conducted with non-adopters to get insights into their perception regarding Moringa-based homesteads. The findings revealed that the status of plant species diversity such as betel nut (100 %), mango (100 %), bean (99 %), and arjun (90 %) was higher in comparison to non-adopters where the status of the respective species was 92 %, 99 %, 89 %, and 73 % respectively. The perception assessment revealed that 100 % of adopters and 90 % of non-adopters believed that Moringa-based homesteads had the potential to increase access to food, nutrition, and medicinal resources. While the majority of 70 % of adopters, and 90.5 % non-adopters disagreed that it had the potential to ensure government access and non-government credit resources. Among the Moringa-based homestead adopters, the gross income derived from Moringa sales was 2828.57 ± 1481.45, where 55 % of homesteads were identified to have Moringa plants between 3 and 5, and homesteads solely supplied fuel materials for 40 % of households. Gender participation was quite evident for homestead farming activities, where female participation was higher in planting, weeding, irrigation, and fencing. Homesteads provided both on-farming and off-farming income opportunities where major responses were found for poultry farming (96 %), vegetable farming (95 %), and day labor (97 %). Farmers were found to practice climate-smart practices of homestead agroforestry (100 %), rainwater harvesting (99 %), weeding (98 %), and management of debris (95 %) in their respective homesteads. The results disclosed that Moringa-based homestead in Sylhet can be a potential option for attaining SDGs indicators of escalation of household income (SDGI = 90), access to food, nutrition, and medicinal resources (SDGI = 103.6), facilitation of natural treatment of diseases (SDGI = 104.6), de-escalation of gender discrepancy in terms of production activities (SDGI = 103.64), own source of fuel (SDGI = 58.44), both off-farm and on-farm income opportunity (SDGI = 100.52), ecosystem health maintenance by resilient practices (SDGI = 104.6). Farmers ranked food security capacity as a major motivational factor, while the low economic return was a major demotivational factor. The escalation of Moringa-based homesteads needs to be prioritized while facilitating credit, and institutional support to extend encouragement to non-adopters for wider integration of Moringa-based homesteads, and appropriate utilization of the existing resources for greater profitability.
| S-EPMC11425126 | biostudies-literature