The Sustainable Development Goals: Contextualizing Africa's Economic and Health Landscape

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Abstract

The sustainable development goals (SDGs) encompass 17 goals with targets and indicators, collectively striving to improve national, regional, continental, and global development. SDG 8 strives for improved and sustainable economic growth. Africa's population is estimated to increase markedly and rapidly over the next few decades. The African demographic dividend presents opportunities to be harnessed, but several socioeconomic challenges exist that may constrain progress for achieving the SDGs. Poverty and inequality are pervasive in Africa and constrain economic and health gains. SDG 3 aims for good health and well‐being for all ages and has 13 targets linked to 26 indicators. Collectively, SDG 3 targets aim to improve health outcomes by reducing mortality, ending epidemics, and preventing diseases to ensure affordable and quality healthcare access for all. The dynamic African health landscape and scarcity of healthcare human capital also present challenges for advancing SDG 3. The implementation of the SDGs presents major and complex challenges but ultimately yields rewards. Advancement across all SDG 3 targets is necessary for the benefit of healthier global citizens.

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Framework for assessing governance of the health system in developing countries: gateway to good governance.

Sania Nishtar, Belgacem Sabri, Sheelu Siddiqi … (2009)

Governance is thought to be a key determinant of economic growth, social advancement and overall development, as well as for the attainment of the MDGs in low- and middle-income countries. Governance of the health system is the least well-understood aspect of health systems. A framework for assessing health system governance (HSG) at national and sub-national levels is presented, which has been applied in countries of the Eastern Mediterranean. In developing the HSG framework key issues considered included the role of the state vs. the market; role of the ministries of health vs. other state ministries; role of actors in governance; static vs. dynamic health systems; and health reform vs. human rights-based approach to health. Four existing frameworks were considered: World Health Organization's (WHO) domains of stewardship; Pan American Health Organization's (PAHO) essential public health functions; World Bank's six basic aspects of governance; and United Nations Development Programme (UNDP) principles of good governance. The proposed HSG assessment framework includes the following 10 principles-strategic vision, participation and consensus orientation, rule of law, transparency, responsiveness, equity and inclusiveness, effectiveness and efficiency, accountability, intelligence and information, and ethics. The framework permits 'diagnoses of the ills' in HSG at the policy and operational levels and points to interventions for its improvement. In the case of Pakistan, where the framework was applied, a positive aspect was the growing participation and consensus orientation among stakeholders, while weaknesses were identified in relation to strategic vision, accountability, transparency, effectiveness and efficiency and rule of law. In using the HSG framework it needs to be recognized that the principles are value driven and not normative and are to be seen in the social and political context; and the framework relies on a qualitative approach and does not follow a scoring or ranking system. It does not directly address aid effectiveness but provides insight on the ability to utilize external resources and has the ability to include the effect of global health governance on national HSG as the subject itself gets better crystallized. The improved performance of the ministries of health and state health departments is at the heart of this framework. The framework helps raise the level of awareness among policymakers of the importance of HSG. The road to good governance in health is long and uneven. Assessing HSG is only the first step; the challenge that remains is to carry out effective governance in vastly different institutional contexts.

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Politics, Power, Poverty and Global Health: Systems and Frames.

Solomon Benatar (2016)

Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example 'poverty eradication,' can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term 'global health' is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on 'global health' should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions.

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Is universal health coverage the practical expression of the right to health care?

Gorik Ooms, Laila A Latif, Attiya Waris … (2014)

The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a ‘single overarching health goal’ for the next iteration of the Millennium Development Goals. The present Millennium Development Goals have been criticised for being ‘duplicative’ or even ‘competing alternatives’ to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as “by definition, a practical expression of the concern for health equity and the right to health”. Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that – to be a practical expression of the right to health – at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional. But universal health coverage is a ‘work in progress’. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care.

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Author and article information

Contributors

Marlon E. Cerf:

ORCID: http://orcid.org/0000-0001-6090-3736

marlon.cerf@mrc.ac.za

Journal

Journal ID (nlm-ta): Glob Chall

Journal ID (iso-abbrev): Glob Chall

Journal ID (doi): 10.1002/(ISSN)2056-6646

Journal ID (publisher-id): GCH2

Title: Global Challenges

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Electronic): 2056-6646

Publication date (Electronic): 21 June 2018

Publication date Collection: August 2018

Volume: 2

Issue: 8 ( doiID: 10.1002/gch2.v2.8 )

Electronic Location Identifier: 1800014

Affiliations

[ ¹ ] Biomedical Research and Innovation Platform South African Medical Research Council PO Box 19070 Tygerberg Cape Town 7505 South Africa

Author notes

[*] [* ]E‐mail: marlon.cerf@ 123456mrc.ac.za

Author information

Marlon E. Cerf http://orcid.org/0000-0001-6090-3736

Article

Publisher ID: GCH2201800014

DOI: 10.1002/gch2.201800014

PMC ID: 6607161

PubMed ID: 31565342

SO-VID: 8857a4ed-4c5a-4a49-8fe3-80b5abe45e6d

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This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date received : 15 February 2018

Date revision received : 20 April 2018

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Figures: 1, Tables: 1, Pages: 7, Words: 5841

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source-schema-version-number 2.0

component-id gch2201800014

cover-date August 2018

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.9 mode:remove_FC converted:26.09.2019

Keywords: gross domestic product,healthcare human capital,health landscape,inequality,poverty,responsible trade,subsidizing health

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Keywords: gross domestic product, healthcare human capital, health landscape, inequality, poverty, responsible trade, subsidizing health

The Sustainable Development Goals: Contextualizing Africa's Economic and Health Landscape

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UN Sustainable Development Goals

Most cited references 8

Framework for assessing governance of the health system in developing countries: gateway to good governance.

Politics, Power, Poverty and Global Health: Systems and Frames.

Is universal health coverage the practical expression of the right to health care?

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