{"id":556,"date":"2011-12-15T22:46:43","date_gmt":"2011-12-15T22:46:43","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=556"},"modified":"2011-12-16T12:01:13","modified_gmt":"2011-12-16T12:01:13","slug":"could-millennium-development-goals-be-bad-for-your-health","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2011\/12\/15\/could-millennium-development-goals-be-bad-for-your-health\/","title":{"rendered":"Could Millennium Development Goals be bad for your health?"},"content":{"rendered":"

A recent paper by a Belgian team discusses the health impact of the Millennium Development Goals (MDG) in sub-Saharan Africa, and highlights the potential short-termism of a strategic approach focussed on \u201cquick wins\u201d.\u00a0 Many of the health issues discussed touch on sexual health.<\/p>\n

The year 2001 saw poverty become the focus of the global political agenda, when the 189 countries of the UN in the General Assembly established eight goals to be achieved by 2015. The goals (MDG) have given rise to funding instruments called Global Health Initiatives (GHI) which have tended to favour \u201cvery high short-term impact that can be immediately implemented\u201d over more complicated and long-term developments.<\/p>\n

The MDGs directly affecting sexual health are: MDG 6 \u2013 eradicate HIV\/AIDS & Malaria<\/strong>; MDG 4 \u2013 reduce child mortality<\/strong> (because of vertical transmission of HIV\/AIDS); MDG 5 \u2013 improve maternal health<\/strong> (because the 2005 World Summit included within this goal \u201cachieving universal access to reproductive health\u201d).\u00a0 Indirectly and in the longer term, MDG 2 \u2013 achieve universal primary education<\/strong> and MDG 3 \u2013 empower women<\/strong> affect issues of behaviour change likely to impact on sexual health.\u00a0 MDG 1 \u2013 eradicate hunger<\/strong>, 7 \u2013 ensure sustainability<\/strong>, 8 \u2013 develop global partnership<\/strong> primarily affect health issues other than sexual health.<\/p>\n

In general, the paper argues that an emphasis on \u201cquick impact\u201d interventions is not always beneficial:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Initiatives have been developed in parallel to, rather than in integration with, the existing health systems, with resulting distortions in provision of care.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0The focus on short term, community-based initiatives can result in deployment of resources away from longer-term strategies that require indigenous health services development and inter-sectoral approaches to health planning.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The assessment of progress on the basis of data that is not disaggregated for socio-economic status and other equity parameters can result in strategies that achieve global targets at the cost of neglecting the neediest population sub-groups.<\/p>\n

A glance at the recent (2011) UNAIDS report will reveals the tension between this \u201chigh-<\/p>\n

impact intervention\u201d approach and much current thinking in the health policy area.<\/p>\n

More specifically, the authors argue that while anti-retrovirals therapy (ART) may appear to be a \u201cquick impact\u201d intervention, sustaining progress in this area is going to require health service development in the longer term.\u00a0 Expanding access to sexual and reproductive health services, while classed as a health-related \u201cquick win\u201d, has actually suffered a decrease in funding over the decade.\u00a0 The paper also gives the example of contraceptive use in Kenya as a case of how apparent improvements overall can mask a deterioration in the situation of the most underprivileged (those classed \u201cno education\u201d).<\/p>\n

The recommendations of this paper include:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 More attention to health systems development essential to the future delivery of the aims embodied in MDGs 4, 5 and 6;<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Not neglecting the role of MDGs 2 & 3 (universal education and empowering women) in securing improved maternal and child health long term;<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Not allowing achievement of MDGs to be at the expense of continued efforts to improve the social determinants of health.<\/p>\n

Fabienne Richard et al., \u201cSub-Saharan Africa and the health MDGs: the need to move beyond the \u201cquick impact\u201d model\u201d, Reproductive Health Matters<\/em>, Vol. 19, Issue 38, November 2011<\/p>\n

http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0968808011385795<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

A recent paper by a Belgian team discusses the health impact of the Millennium Development Goals (MDG) in sub-Saharan Africa, and highlights the potential short-termism of a strategic approach focussed on \u201cquick wins\u201d.\u00a0 Many of the health issues discussed touch on sexual health. The year 2001 saw poverty become the focus of the global political […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[264,1613],"tags":[],"class_list":["post-556","post","type-post","status-publish","format-standard","hentry","category-health-policy","category-sexual-health-services"],"yoast_head":"\nCould Millennium Development Goals be bad for your health? - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2011\/12\/15\/could-millennium-development-goals-be-bad-for-your-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Could Millennium Development Goals be bad for your health? - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\"A recent paper by a Belgian team discusses the health impact of the Millennium Development Goals (MDG) in sub-Saharan Africa, and highlights the potential short-termism of a strategic approach focussed on \u201cquick wins\u201d.\u00a0 Many of the health issues discussed touch on sexual health. 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