Coherently addressing the 17 Sustainable Development Goals requires planning tools that guide policy makers. Given the integrative nature of the SDGs, we believe that integrative modelling techniques are especially useful for this purpose. In this paper, we present and demonstrate the use of the new System Dynamics based iSDG family of models. We use a national model for Tanzania to analyse impacts of substantial investments in photovoltaic capacity. Our focus is on the impacts on three SDGs: SDG 3 on healthy lives and well-being, SDG 4 on education, and SDG 7 on energy. In our simulations, the investments in photovoltaics positively affect life expectancy, years of schooling and access to electricity. More importantly, the progress on these dimensions synergizes and leads to broader system-wide impacts. While this one national example illustrates the anticipated impact of an intervention in one specific area on several SDGs, the iSDG model can be used to support similar analyses for policies related to all the 17 SDGs, both individually and concurrently. We believe that integrated models such as the iSDG model can bring interlinks to the forefront and facilitate a shift to a discussion on development grounded in systems thinking.

Policy coherence to achieve the SDGs : using integrated simulation models to assess effective policies (SPECIAL FEATURE : Sustainability Science and Implementing the Sustainable Development Goals)

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In two previous publications, we have described and summarised key findings from the global systematic review and country consultations related to our assessment of the progress in implementing the health and health-related sustainable development goals (HHSDGs). Although it has been only 5 years but current evidence on the implementation of sustainable development goal (SDG) evaluations to date suggests that a vast majority of countries are off-target in relation to several outcome indicators1–3 and there are no clear strategies for integration across health and other sectors.

This paper will summarise the key learnings from this exercise and propose a strategy for enhancing integration and implementation of HHSDGs in low-income and middle-income countries (LMICs).

Our systematic review4 of the global evidence on the implementation of HHSDGs highlighted several important factors:

1. There are as yet no standardised metrics regarding progress and implementation globally that cover HHSDGs. The Institute of Health Metrics and Evaluation has developed and proposed a global SDG index, which has also been used to track progress5; however, this has as yet not received widespread acceptance or recognition. At …

https://gh.bmj.com/content/bmjgh/5/9/e002963.full.pdf

What will it take to implement health and health-related sustainable development goals?

Successful delivery of nutrition programs and the sustainable development goals.

This study aims to conduct a comparative analysis of the SDG in healthcare achievement in Austria and Ukraine and to determine possible lessons for Ukraine based on best EU and world experiences. To identify existing challenges and perspectives a comparative analysis of key indicators of healthcare expenditures and health financing systems in Austria and Ukraine was carried out. Results indicate that in Ukraine there is a substantial lack of public funding for healthcare (only 682 US dollars per capita in 2018), a poor share of voluntary health insurance (less than 1%), significant amounts (on average 50%) of expenditures of the population in general spending on health. On the contrary, in Austria, there is sufficient public funding for healthcare (5,879 US dollars per capita in 2018), more than 5% share of voluntary health insurance, moderate amounts (on average 25%) of expenditures of the population in general spending on health. Austria’s experience as an EU-member country with a successful example of a financing strategy for the healthcare system is a sound example for Ukraine. The alternative financing tools (e.g. result-based financing, impact investment, public-private partnership) can be used as an additional financing mechanism of healthcare funding in Ukraine. The use of these instruments along with the improvement of the fiscal policy, social security, and governance based on Austrian experience can cut the existing financing gap to achieve SDG targets in healthcare in Ukraine.\nAcknowledgmentThis study is financed equally by the Austrian Federal Ministry of Education and Science and the Ministry of Education and Science of Ukraine.

/pdf/sdg-3-and-financing-instruments-in-austria-and-ukraine-38j4tc3ast.pdf

SDG 3 and financing instruments in Austria and Ukraine: Challenges and perspectives

Objectives: The Sustainable Development Goals (SDGs) re-orient action towards improving the social and ecological determinants of health and equity. SDG 17 calls for enhanced policy and institutional coherence and strong multi-stakeholder partnerships. Intersectoral action (IA) has a promising history in public health, including health promotion and global health. Some experts see IA as crucial to the SDGs. Yet less is known about how IA is conceptualized and what promising models exist with relevance to the SDGs. We sought to investigate how IA is understood conceptually and empirically. Methods: We conducted a narrative review of global public health and political science literatures and grey literature on the SDGs to identify theoretical models, case studies and reviews of IA research. Results: Multiple competing conceptualizations of IA exist. Research has focused on case studies in high-income countries. More conceptual clarity, analyses of applications in LMICs, and explorations of political and institutional factors affecting IA are needed, as is attention to power dynamics between sectors. Conclusion: IA is required to collaborate on the SDGs and address equity. New models for successful implementation merit exploration.

Examining Intersectoral Action as an Approach to Implementing Multistakeholder Collaborations to Achieve the Sustainable Development Goals

Evidence on early achievements, challenges and opportunities would help low-income and middle-income countries (LMICs) accelerate implementation of health and health-related sustainable development goals (HHSDGs). A series of country-specific and multicountry consultative meetings were conducted during 2018–2019 that involved 15 countries across five regions to determine the status of implementation of HHSDGs. Almost 120 representatives from health and non-health sectors participated. The assessment relied on a multidomain analytical framework drawing on existing public health policy frameworks. During the first 5 years of the sustainable development goals (SDGs) era, participating LMICs from South and Central Asia, East Africa and Latin America demonstrated growing political commitment to HHSDGs, with augmentation of multisectoral institutional arrangements, strengthening of monitoring systems and engagement of development partners. On the other hand, there has been limited involvement of civic society representatives and academia, relatively few capacity development initiatives were in place, a well-crafted communication strategy was missing, and there is limited evidence of additional domestic financing for implementing HHSDGs. While the momentum towards universal health coverage is notable, explicit linkages with non-health SDGs and integrated multisectoral implementation strategies are lacking. The study offers messages to LMICs that would allow for a full decade of accelerated implementation of HHSDGs, and points to the need for more implementation research in each domain and for testing interventions that are likely to work before scale-up.

/pdf/global-strategies-and-local-implementation-of-health-and-3xi2b5kbkp.pdf

Global strategies and local implementation of health and health-related SDGs: lessons from consultation in countries across five regions.

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition (94.54%), affecting employment and income activities (>80%). Caregivers experienced discrimination (15.27%) and violence (12.6%) during the pandemic. Levels of depression (34%), general anxiety (20%), and COVID-19 related anxiety (14%) were highly prevalent. There were significant associations between mental health outcomes and economic and socio-demographic factors, violence and discrimination experiences, residency, and perceptions of COVID-19 as a threatening condition. Caregivers high burden of mental health problems highlights the urgent need to provide accessible mental health support. Innovative and multi-sectoral approaches will be required to maximize reach to underserved communities in informal settlements and tackle the root causes of mental health problems in this population.

/pdf/mental-health-during-covid-19-pandemic-among-caregivers-of-3kumwdrxv9.pdf

Anil Khamis

Papers

Global strategies and local implementation of health and health-related SDGs: lessons from consultation in countries across five regions.

Mental Health during COVID-19 Pandemic among Caregivers of Young Children in Kenya's Urban Informal Settlements. A Cross-Sectional Telephone Survey.