Improving Health, Focus where it counts!

​SDG 3: GOOD HEALTH AND WELL-BEING 
The sustainable development goals (SDGs) are a new, universal set of goals, targets and indicators that UN member states will be expected to use to frame their agendas and political policies until 2030. Amongst the seventeen goals, goal number three is specifically related to health. Health, however, is also related to most of the remaining sixteen goals, such as reducing poverty (Goal one), improving education (Goal 4), and providing access to clean water and sanitation (Goal six).

The third Sustainable Development Goal, aiming at improving Health and Well-being, consists of thirteen targets.

1. By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
2. By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.
3. By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
4. By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
5. Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.
6. By 2020, halve the number of global deaths and injuries from road traffic accidents
7. By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
8. Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
9. By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.
10. Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.
11. Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.
12. Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States.
13. Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

 
Seychelles has achieved some of the targets under SDG 3 before it was even launched. Maternal and child mortality were already low compared to many other countries with similar GDP. Our vaccination programmes work well and our reproductive health care services are available to everyone. Having health care services which are fully funded by the state have enabled us to stand out on a global scale, especially when it comes to Universal Health Coverage.
 
Despite these achievements, our health system still faces challenges. Firstly, improvement is required in the quality and delivery of health services. Secondly, we need to find new solutions for retention of health care workers, and reduce the current high turnover of health care professionals. Thirdly, we need to tackle the increasing levels of non-communicable diseases such as diabetes and hypertension, and put more effort in combating the HIV and AIDS epidemic in the country.
 
One of the ways we could improve health is to increase the amount of resources we put into prevention. The World Health Organisation’s definition for health indicates that health is not merely the “absence of disease”. Yet, in many cases, the burden of diseases in a country has been the main factor in determining the level of health in its community. The constant distress of health care systems across the world could be explained by the fact that wellness and prevention are systematically neglected. There is a tendency to spend most of the funds in reacting to emergencies, creating more of a sick-care system or disease management system, rather than a health care system. Even if it is important to help ill people to get their health back, it is remarkably more efficient to keep them healthy in the first place.
 
Improving health status of the country requires effective cross-departmental action. Aside from the health care system, other determinants of health are education, food, housing, socio-economic status and the living environment. Effective communication across all governmental departments, leading to a broader context of government action on health will have a greater impact than improving the health care system alone.
 
More efforts are required when it comes to recruitment, development, training and retention of the health workforce. The high turnover of health workers makes improving quality of the system challenging. We may even need to start questioning whether we are sacrificing quality by giving free healthcare, and whether having free healthcare is sustainable.
 
Finally, the community needs to get involved in improving and promoting health, independently of the Ministry of Health. The sense of responsibility for one’s own health by adopting healthy practices can do wonders for the community. This type of promotion started off well in 2014 when the theme “My Health, My Responsibility” was first launched. Schools created activities under that theme without any contribution from the ministry. The power the community has in combating non-communicable diseases such as diabetes and hypertension, just by improving lifestyles, should not be underestimated. The health sector can enhance that by increasing the health literacy with innovative health education programmes, and other sectors can contribute by creating an environment to facilitate healthy choices. If we could all stop the blaming games regarding our health and start changing the things that are in our control, then I foresee nothing but the building of a happier and healthier Seychelles!
 
Join the global conversation. Use the hashtags #sey4sdg , download the SDG Action app, visit globalgoals.org – help make the SDGs famous and tell the leaders of the world that this is what we want.
 
You can also visit http://www.globalgoals.org/take-action/ and choose an NGO to get involved with: Global Citizen, Save The Children, UNICEF, UNDP – the choice is yours.
 
Contributed by Dr Naomi Adeline