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The goal I want to investigate is Goal #3 which is Good Health & Well-Being. I am passionate about this goal because I believe that it is the most important one of them all as what do we live for if not for happiness which can be better achieved with good health and well-being.

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The pandemic and other ongoing crises are hindering progress in achieving SDG3, exacerbating existing health inequalities and threatening progress towards universal health coverage. As a result, 68 million children are known to be un- or under-vaccinated as of 2022 from TB and malaria increased. This has been particularly challenging in low- and middle-income countries, where health systems were already under-resourced before the pandemic. The pandemic has also highlighted the need for stronger global health security systems to prevent and respond to future pandemics. Overcoming these setbacks and dealing with longstanding shortcomings in health-care provision requires an urgent strengthening of health systems.

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Goal 3 | Department of Economic and Social Affairs

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Ensure healthy lives and promote well-being for all at all ages

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I think I want to research the inaccessibility of healthcare in rural areas which must be addressed to reach SDG #3. I will focus on South Asia and medical programs.

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The goal aims to ensure healthy lives and promote well-being at all ages.

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This website page showed me the different targets of SDG 3 and the potential ways that they can be implemented. One of the methods that sticks out to me is through the development of medicine and vaccines.

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Targets of Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages

3.1. Maternal mortality
By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births.

3.2. Neonatal and child mortality
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 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births.

3.3. Infectious diseases
By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, and combat hepatitis, waterborne diseases and other communicable diseases.

3.4. Noncommunicable diseases
By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment, and promote mental health and well-being.

3.5. Substance abuse
Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

3.6. Road traffic
By 2020, halve the number of global deaths and injuries from road traffic accidents.

3.7. Sexual and reproductive health
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.

3.8. Universal health coverage
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.

3.9. Environmental health
By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.

Goal 3 - Means of implementation for the targets

3.a. Tobacco control
Strengthen the implementation of the WHO Framework Convention on Tobacco Control in all countries, as appropriate.

3.b. Medicines and vaccines
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 TRIPS and Public Health, which affirms the right of developing countries to the fullest use of the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS agreement) regarding flexibilities to protect public health and, in particular, provide access to medicines for all.

3.c. Health financing and workforce
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.

3.d. Emergency preparedness
Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

Target 3.8. Universal health coverage
This target can be seen as an overarching one that supports the achievement of the other targets. It is derived from the Millennium Development Goals, the new targets and the means of implementation.

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Targets of Sustainable Development Goal 3

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3.1. Maternal mortality By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births. 3.2. Neonatal and child mortality 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 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births.

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COVID-19 affected a lot of the progress that was made. This article also shares multiple issues that have been hindering development in goal 3. Some of these would include inequality, bad reach of universal healthcare, aging populations, and reduced progress in mortality rate.

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The COVID-19 pandemic has ravaged global health, undoing nearly 10 years of progress in life expectancy. While most health-related indicators are moving in the right direction globally, current trends are insufficient to meet targets set for 2030.

The maternal mortality ratio is largely stuck at a level more than three times the 2030 target. Under-5 deaths reached an historic low in 2022, but progress has slowed. Without accelerated declines, 35 million children will not live to see their fifth birthday by 2030.

The global response to infectious diseases has saved millions of lives and paved the way for healthier communities. Inequalities and emerging threats jeopardize these accomplishments, however, underscoring the need for sustained efforts and innovative strategies.

More than half the world's population is not covered by essential health services, while an ageing health workforce must now meet growing demands from an ageing population. Ensuring universal health coverage without financial hardship is crucial to healthy lives and well-being for all.

© UNICEF/Thoko Chikondi

The world is not on track to achieve Goal 3. Changing course requires prioritizing the achievement of universal health coverage, strengthening health systems, investing in disease prevention and treatment, and addressing disparities in access to care and services, especially for vulnerable populations.

The COVID-19 pandemic turned back progress in life expectancy and gains in combating communicable diseases

The COVID-19 pandemic has significantly affected global health, reversing steady progress in life expectancy over the past two decades. Prior to the pandemic, global life expectancy rose consistently, from 66.8 years in 2000 to 73.1 years in 2019, reflecting years of improvements in health and related areas. COVID-19 swiftly reversed this positive trend, with global life expectancy plummeting to 71.4 years by 2021, back to the level of 2012.

Before the pandemic, non-communicable diseases had been steadily increasing as the leading cause of death, accounting for 59.5 per cent of all deaths in 2000 and 73.9 per cent in 2019. The share of communicable diseases dropped from 32.2 per cent in 2000 to 18.2 per cent in 2019. As COVID-19 emerged as a new infectious disease and started to take a toll on human lives, the share of deaths due to communicable diseases jumped back to the 2005 level (28.1 per cent) in 2021, while the share of deaths due to non-communicable diseases decreased to 65.3 per cent. COVID-19 ranked among the top three leading causes of death globally in 2020 and 2021, with striking regional variations.

Progress towards universal health coverage has slowed, leaving billions without care and subject to catastrophic costs

Essential health service coverage is measured using an index, reported on a score of 0 to 100, based on 14 indicators across four domains: reproductive, maternal, newborn and child health; infectious diseases; non-communicable diseases; and service capacity and access. The global score on the index increased remarkably from 45 in 2000 to 65 in 2015. Progress slowed thereafter, however, reaching a score of only 68 in 2021. The proportion of the population lacking essential health services fell by approximately 15 per cent between 2000 and 2021. Yet minimal progress after 2015 left about 4.5 billion people without coverage in 2021, especially in rural and poorer populations.

Financial hardship due to out-of-pocket health spending has worsened since 2015, affecting 2 billion people in 2019. They included 1 billion people facing catastrophic health expenditures exceeding 10 per cent of their household budget and 344 million driven deeper into extreme poverty by health costs. The proportion of the population with catastrophic expenditures increased from 12.6 per cent in 2015 to 13.5 per cent in 2019.

An ageing health workforce struggles to meet rising demands from an ageing population

Progressing towards universal health coverage requires addressing the global shortage of health workers. Yet data from 2015 to 2022 reveal stark disparities, with low-income countries experiencing the lowest health worker density and distribution. Per 10,000 people, these countries had medians of only 1.1 medical doctors, 7.5 nursing and midwifery personnel, 0.04 dentists and 0.2 pharmacists, compared with medians in high-income countries of 35.6 medical doctors, 76.8 nursing and midwifery personnel, 7.0 dentists and 8.8 pharmacists.

Health systems are experiencing increased strains in catering to the mounting health needs of an ageing global population, more so because the health workforce itself is ageing. An estimated 1.8 million additional health workers are needed in 54 countries, primarily high-income ones, to replace retiring health professionals and maintain the current age-standardized density of health workers.

Share of countries with an ageing workforce, by health occupation, 2017‒2022 (percentage)

Note: A health workforce is considered "ageing" when the share of health workers aged 55 years and above exceeds that of health workers aged 35 years and below.

Declines in maternal mortality have stalled, with wide disparities by region and income

Between 2015 and 2020, the global maternal mortality ratio declined only marginally from 227 to 223 maternal deaths per 100,000 live births, over three times higher than the 2030 target of 70. Sub-Saharan Africa and Southern Asia account for 87 per cent of maternal deaths. In 2020, the maternal mortality ratio in low-income countries was 430 maternal deaths per 100,000 live births compared to 13 in high-income nations. The average maternal mortality ratio for very high and high alert fragile states was 551 in 2020, more than twice the global average. Achieving the 2030 target requires an annual reduction rate of 11.6 per cent between 2021 and 2030.

Skilled birth attendance has improved globally, rising from 80 per cent of births in 2015 to 86 per cent in 2023. Improved care quality could save the lives of up to 1 million newborns and 150,000 mothers annually. Yet progress is stalling; 18 million births occurred without skilled assistance in 2023. In sub-Saharan Africa, only 73 per cent of births were attended by skilled personnel in 2023, the lowest rate worldwide. In contrast, Eastern and South-Eastern Asia achieved a rate of 96 per cent.

Improvements in adolescent birth rates and access to modern contraceptives do not benefit all women and girls equally

The adolescent birth rate for women aged 15‒19 years declined to 41.3 births per 1,000 women in 2023, from 47.2 in 2015 and 64.5 in 2000. For girls aged 10‒14 years, the rate fell from 3.3 births per 1,000 girls in 2000 to 1.8 in 2015 and 1.5 in 2023. Yet 13.1 million babies, approximately 10 per cent of the total number of births, were born to adolescent mothers in 2023. Central and Southern Asia witnessed the largest drop-offs in adolescent birth rates between 2000 and 2023, with a 72 per cent reduction in the 15-19 age group and a 90 per cent decrease in the 10‒14 cohort. Sub-Saharan Africa continued to have the highest rates globally, at 97.9 births per 1,000 women aged 15‒19 and 4.4 per 1,000 girls aged 10‒14 in 2023.

The proportion of women of reproductive age (15‒49 years) who have their need for family planning satisfied with modern methods has climbed from 76.5 per cent in 2015 to 77.6 per cent in 2024, corresponding to an additional 75 million women using modern contraceptive methods globally. By 2030, this proportion is projected to reach 78.2 per cent, a net increase of 45 million women. This marks a fair improvement but still falls far short of universal access.

Adolescent birth rate, by age group, 2000 and 2023 (births per 1,000 women or girls in each age group)

*Excluding Australia and New Zealand.

Under-5 deaths hit a record low in 2022; achieving the SDG target could save 9 million lives by 2030

Global under-5 deaths reached a historic low of 4.9 million in 2022, down from 9.9 million in 2000 and 6.0 million in 2015. Nearly half these deaths (2.3 million) occurred during the neonatal period (the first 28 days of life). The under-5 mortality rate was 37 deaths per 1,000 live births in 2022, a 51 per cent reduction since 2000 and a 14 per cent reduction from 2015. The global neonatal mortality rate fell to 17 deaths per 1,000 live births in 2022, a 44 per cent reduction since 2000 and a 12 per cent reduction since 2015.

Unfortunately, the annual rate of reduction in under-5 mortality contracted from 3.8 per cent in 2000‒2015 to 2.1 per cent in 2015-2022. The neonatal mortality rate followed a similar pattern, declining from 3.0 per cent to 1.8 per cent. If current trends continue, an estimated 35 million children will die before reaching their fifth birthday by 2030. If all countries met the target for under-5 mortality, an estimated 9 million lives could be saved by 2030. As of 2022, 134 countries had already met the target. Seven more were on track but 59 countries, nearly three quarters of which are in sub-Saharan Africa, will need faster progress to meet the target.

Under-5 and neonatal mortality rate, 2015‒2022 (deaths per 1,000 live births)

*Excluding Australia and New Zealand.

Efforts to combat communicable diseases have prevented millions of deaths but are threatened by inequalities and emerging threats

HIV/AIDS: The world has made significant strides in combating HIV. In 2022, an estimated 1.3 million new infections represented a 27 per cent decrease since 2015 and a 38 per cent reduction since 2010. Sub-Saharan Africa, the region most affected by HIV, has more than halved new infections annually since 2010. In 2022, 29.8 million of the 39 million people living with HIV were receiving life-saving treatment. Increased access to treatment has averted 20.8 million AIDS-related deaths in the past three decades. In addition, the integration of HIV testing and treatment with maternal and childcare services has prevented over 3.4 million HIV infections in children since 2000. Stronger linking of services for HIV and tuberculosis has averted an estimated 6.4 million tuberculosis-related deaths among people living with HIV from 2010 to 2022.

Not everyone is benefiting equally from these advancements, however. In 2022, 43 per cent of the 1.5 million children living with HIV were not receiving treatment. Every week, 4,000 adolescent girls and young women acquired HIV; 3,100 lived in sub-Saharan Africa. Almost a quarter of new HIV infections were in Asia in 2022. Steep increases of new HIV infections have continued in Northern Africa and Western Asia. These worrying trends are primarily due to a lack of preventive services for people from marginalized and key populations, punitive laws, violence, social stigma and discrimination.

HIV incidence rate, 2010 and 2022 (number of new infections per 1,000 uninfected adults aged 15‒49 years)

Tuberculosis: The reported number of people newly diagnosed with tuberculosis reached 7.5 million in 2022, the highest figure since global monitoring began in 1995 and above the previous historical peak of 7.1 million in 2019. Worldwide, an estimated 10.6 million people developed tuberculosis in 2022, up from 10.3 million in 2021 and 10.0 million in 2020. The disease remains the world's second leading cause of death from a single infectious agent, with an estimated 1.3 million deaths in 2022. This was down from the estimated 1.4 million deaths in both 2020 and 2021 and almost back to pre-pandemic levels. The global net decrease in tuberculosis-related deaths between 2015 and 2022, however, was 19 per cent, well below the target of a 75 per cent reduction by 2025. The estimated disease incidence rate was 133 new cases per 100,000 population in 2022, a fall of 8.7 per cent since 2015. A return to the pre-pandemic downward trend may occur in 2023 or 2024.

Tuberculosis estimated incidence rate and case notification rate, 2015‒2022 (new cases per 100,000 population per year)

Malaria: An estimated 249 million malaria cases occurred globally in 2022, 16 million more than in 2019 before the pandemic. The disease claimed an estimated 608,000 lives in 2022, an increase of 32,000 compared to 2019. Since 2015, insecticide-treated net use among young children and pregnant women in sub-Saharan Africa has stagnated at around 56 per cent. In 2022, an estimated 58 per cent of at-risk pregnant women did not receive the recommended preventive malaria therapy, and about one third of children with fever did not receive care from a health provider. Alongside disruptions caused by COVID-19, the global malaria response faces increasing threats, including drug and insecticide resistance, humanitarian crises, funding constraints, delays in programme implementation and climate change impacts. Despite these challenges, some important achievements sustain progress towards elimination in many countries with a low malaria burden, with 25 countries reporting fewer than 10 cases in 2022. Thirteen countries have been certified malaria-free since 2015.

Malaria case incidence, 2015‒2030 (cases per 1,000 population at risk)

Neglected tropical diseases:
In 2022, 1.6 billion people required treatment and care for neglected tropical diseases, a 26.1 per cent decline from 2010. The proportion of the population living in LDCs who required interventions for these diseases decreased from 79 per cent to 45 per cent during this period. As of December 2023, 50 countries, territories and areas had eliminated at least one neglected tropical disease, demonstrating the power of comprehensive interventions combining mass and individual treatment, vector control, veterinary public health and provision of safe water and sanitation.

Progress has not been fast enough to meet the target of reducing the global population requiring interventions for neglected tropical diseases by 90 per cent between 2010 and 2030. Achieving this target demands a renewed effort to scale up interventions, particularly in high-burden countries, many of which are LDCs.

Twenty-one million children missed out on lifesaving vaccines in 2022

Between 2000 and 2019, the proportion of children receiving three doses of the diphtheria, tetanus and pertussis (DTP3) vaccine rose from 72 to 86 per cent, then dipped to 81 per cent in 2021 before rebounding to 84 per cent in 2022. In 2022, 20.5 million children missed at least one routine vaccine and 14.3 million received no vaccines at all. Coverage of two doses of the measles vaccine and three doses of the pneumococcal conjugate vaccine increased in 2022, reaching 74 per cent and 60 per cent, respectively, following stagnation in 2020‒2021. Global coverage of the human papillomavirus (HPV) vaccine, critical for women's and girls' health, stood at only 15 per cent in 2022, despite 130 countries introducing it in their national immunization services by the end of the year.

Treatment reaches only marginal shares of people with drug and alcohol disorders

Newly available estimates reveal that globally, only about 1 in 11 individuals with drug use disorders received related treatment in 2022. Coverage decreased from 11 per cent to under 9 per cent between 2015 and 2022, and has notably decelerated in the Americas and Asia. Treatment coverage for women consistently lags behind that for men across all regions, with over 13 per cent of men receiving treatment compared to less than 6 per cent of women in 2022. Data on access to treatment for those with alcohol use disorders indicate a dire situation, with coverage ranging from 0.3 per cent to a maximum of 14 per cent in reporting countries. Considering that approximately 283 million people or 5 per cent of the adult population lives with alcohol use disorders, hundreds of millions are going without needed treatment and care.

More than 9 in 10 deaths caused by air pollution occur in lower- and middle-income countries

Particulate air pollution caused approximately 104 deaths per 100,000 people annually by 2019, despite a slight decrease in the global mortality rate attributed to household and ambient air pollution since 2010. Ninety-three per cent of the burden fell on low- and middle-income countries in 2019, primarily in Asia and Africa. Non-communicable diseases accounted for 85 per cent of air pollution-related deaths, while acute lower respiratory infections made up the remaining 15 per cent. Concerningly, 31 per cent of deaths from acute lower respiratory infections occurred in children under age 5.

Oceania (excluding Australia and New Zealand), sub-Saharan Africa and most of Asia have the highest mortality rates attributable to air pollution. This is largely due to significant exposure to air pollution in households, a large proportion of which rely on polluting fuels and technologies for cooking, lighting and heating. Health risks from household air pollution are particularly high among women and children, who tend to spend more time in and around cooking stoves.

Age-standardized mortality rate attributed to household and ambient air pollution, 2010-2019 (deaths per 100,000 population)

* Excluding Australia and New Zealand.

Official development assistance for health has scaled up but with a major share spent on COVID-19

Total net official development assistance (ODA) for medical research and basic health sectors has significantly increased in recent years, primarily driven by the global response to the COVID-19 pandemic. ODA for basic health care from all donors more than doubled in real terms between 2015 and 2022, rising from $10.5 billion to $21.1 billion (in constant 2022 prices). It rose 4.4 per cent in 2022 compared to 2021. In 2022, COVID-19 control constituted the largest share of ODA for basic health care at 42 per cent, totalling $8.8 billion, of which $1.6 billion was for COVID-19 vaccine donations. Between 2020 and 2022, COVID-19 control received $22.5 billion in total ODA. Other ODA expenditure in 2022 comprised $3.7 billion on infectious disease control, $2.4 billion on malaria control and $2.2 billion on basic health care. By region, sub-Saharan Africa received the largest volume and share of aid for basic health care, amounting to $6.6 billion.

Total official development assistance to medical research and basic health sectors, 2015-2022 (billions of constant 2022 US dollars)

Goal 2

United Nations Statistics Division

Development Data and Outreach Branch

New York, NY 10017

Fax: +1 (212) 963 9851

Email: statistics@un.org

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This article shows that mental health is one of the biggest factors of this goal. There can be no development on this goal without the improvement of mental health. "According to the WHO, only 49 countries, or 25% of World Health Organisation member states, have effectively integrated mental health into primary health care systems."

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Editorial: Mental health stigma and UN Sustainable Development Goals

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Mental health has long been declared as human right (1), and, as noted by the World Health Organisation (2), there can be no health or sustainable development without mental health. In relation to sustainable development, the United Nations (3), under the 2030 Agenda for Sustainable Development, outline 17 Sustainable Development Goals (SDGs), which provide a blueprint for United Nations Member States working in partnership to improve health, education, economic growth, and reduce inequality, in addition to tackling climate change (1, 3).

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Immunization has been a super effective tool in reducing mortality. It prevents about 2-3 million deaths annually.

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Advancing sustainable development goals through immunization: a literature review

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Immunization directly impacts health (SDG3) and brings a contribution to 14 out of the 17 Sustainable Development Goals (SDGs), such as ending poverty, reducing hunger, and reducing inequalities. Therefore, immunization is recognized to play a…

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This article made me realize that the biggest struggles that prevent development in India includes the lack of accessibility and awareness in healthcare.

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In my last blog, I outlined some of the key priorities of the Indian government in relation to the UN's SDGs. However, there are a number of challenges facing India in achieving these targets, including:

SDG 1 - No Poverty:

Coordination between Central Government and State Governments is necessary, tailoring central plans to state-level conditions and strengths.

There is great imbalance in poverty levels between states and between urban and rural areas.

Keeping infrastructure, like housing and sanitation, and employment up with levels of urbanisation is difficult due to financial limitations and the sheer rate of urbanisation.

SDG 2 - Zero Hunger:

Supply chain management and transport infrastructure deficiencies mean that food supplies often do not reach the consumer market.

At the production stage, climate change poses a huge challenge. Adapting to climate change through new techniques and technology is essential. For small farmers in particular, access to and affording technology and other adaptive measures is restricted.

SDG 3 - Good health and well-being

Private healthcare can be expensive and varies in quality and costs of services in India. While, public healthcare - though much cheaper - is unreliable. A balance between affordable healthcare and suitable quality is needed; technology can play a key role here.

Accessibility - particularly in rural areas, healthcare is lacking. State discrepancies, as is the case for most of the SDGs, is also of note.

Awareness - preventive care, from diet to lifestyle, are often underappreciated. In this way, education can play a vital role in improving health outcomes and reducing pressure on healthcare services.

SDG 5 - Gender Equality

Female labour force participation in India is declining and currently stands at 17.5 per cent. The ratio is even worse in high level positions where women can really bring about significant change to gender norms.

Inequalities continue to exist in women's access to and ownership of land. In rural India, where 75 per cent of rural women workers are engaged in agriculture, women's operational landholding is only 14 percent.

SDG 9: Industry, Innovation and Infrastructure

Falling growth rate and a rising fiscal deficit has somewhat restricted the Government's spending power, while unemployment and low consumption rates are further problems.

India's spending on R&D as a percentage of GDP has been stagnant at 0.6 to 0.7 percent in the last two decades, far less than advanced countries.

Infrastructure standards are low, pricing out more technologically-advanced firms from competing in the market.

These challenges and the goals they pursue are interlinked. For example, improving infrastructure such as road and rail networks can also help to alleviate poverty by attracting investment and creating jobs, enable transport of goods to work towards zero hunger, and reduce inequalities between areas as connections improve.

With hundreds of millions still living in poverty according to different indicators - from income, to health, to education - India needs support if it is to attain the SDGs.

UK companies are already contributing to these and other goals in India. The UKIBC is collating case studies of UK companies supporting India's endeavours towards the SDGs. If your company would like to feature on the UKIBC SEI website, contact kealan.finnegan@ukibc.com with information on the work that your company is doing to support socio-economic development in India.

Next time, I will look at the SDGs from a state level, comparing states on their current achievements working towards the SDGs and priorities and needs for the future. Due to the contrasting environments, resources, climates and economic conditions, India's states are performing on variable levels and need different forms of support for development.

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India's challenges to achieving the SDGs - UK India Business Council

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In my last blog, I outlined some of the key priorities of the Indian government in relation to the UN's SDGs. However, there are a number of challenges facing India in achieving these targets, including: SDG 1 - No Poverty: Coordination between Central Government and State Governments is necessary, tailoring central plans to state-level conditions [...]

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Between and within countries, progress is extremely unequal. There's a 31-year gap between the shortest and longest life expectancies which is not good at all.

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One fact I learned is that over the last 15 years, the child mortality rate has been cut in half which shows the progress that has been made in improving health for younger children.

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Goal 3: Good health and well-being - The Global Goals

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Ensure healthy lives and promote well-being for all at all ages.

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There are many issues in India that currently affect its development on the goal. The main ones I noticed are high maternal and infant mortality rates, communicable diseases such as malaria, and non-communicable diseases such as heart disease.

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Public Health Challenges in India: Seizing the Opportunities

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India is presently in a state of transition — economically, demographically, and epidemiologically — in terms of health. While the last decade has seen remarkable economic development particularly in terms of gross domestic product (GDP) growth rate,(1) unfortunately this progress is accompanied by growing disparities between the rich and the poor. There is strong evidence to suggest that this income inequality or disparity between the different socioeconomic classes is associated with worse health outcomes.(2) Widening the gap between the rich and the poor has damaging health and social consequences. While financial inclusion and social security measures are being implemented by the Government to bridge economic inequalities, health sector too must ensure that health disparities between and among social and economic classes are also addressed adequately.

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There are many initiatives in India which have helped with the development of the goal. The National Health Mission which aims to provide more accessible and affordable healthcare along with the Ayushman Bharat health insurance scheme which provides free healthcare services to the underprivileged are the two main ones which have helped the lower class population. This article also showed me that tobacco abuse is one of the biggest health issues in the region.

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What are India’s Achievements with Respect to SDG3?

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S M Sehgal Foundation, a sustainable rural development NGO in India, shares the achievements of the country regarding SDG3. Here are a few initiatives by the government of India.

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Modi is one of the only major national leaders to prioritize the cleaning of India. He plans to improve sanitation through the improvement in the waste management system (through properly built toilets and and sewage treatment plans) and the cleaning of Indian rivers such as the Ganga. Many medical programs have also been implemented for things like immunization.

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Modi’s health agenda fit to walk not run

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India’s Modi-led progress on sanitation, rivers and life insurance is overshadowed by the need for a professionally staffed public health service.

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Malnutrition is a big issue faced by many women in India. They usually present themselves in nutrient deficiencies, especially anemia. This article made me realize that there are a lot of programs for the improvement of maternal health such as the Poshan Abhiyaan which actually aims to rid India of all malnutrition altogether.

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India Steps Up to Strengthen Maternal Health and Achieve SDG 3

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Madhu Raghavendra and Amiya Kumar Das highlight that India is strengthening its maternal health governance through comprehensive national programmes that address health and social inequities to achieve its Sustainable Development Goals.

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6% of the world's deaths occur due to substance abuse such as alcohol poisoning. This website showed me the date about SDG 3 around the world and I was surprised to see that the highest alcohol consumption is found in Europe and Central Asia.

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Fewer women and babies are dying during pregnancy, childbirth, and soon after than ever before recorded. But both Sub-Saharan Africa and South Asia have some way to go to reduce the deaths of mothers to fewer than 70 deaths per 100,000 live births (target 3.1) and neonatal mortality to fewer than 12 per 1,000 live births (target 3.2; figure 3a). In these two regions only half the births were attended by skilled health staff, far fewer than the nearly 90 percent or more elsewhere across the globe. Fewer pregnancies would reduce the number of maternal deaths, but more than 50 percent of married women in low-income countries report that their demand for family planning is not satisfied by modern contraceptive methods.

Ending the epidemics of AIDS, tuberculosis, and malaria

AIDS, tuberculosis, and malaria together affect hundreds of millions of people worldwide, and putting an end to these diseases is a priority under Goal 3 (target 3.3). While the incidence of HIV infection has been declining globally since 1995, the disease is still prevalent in Sub-Saharan Africa, where 3 of every 1,000 uninfected people ages 15-49 contracted it in 2015 (figure 3b). The number of people living with HIV, now at more than 36 million globally, continues to rise since access to antiretroviral therapy increases survival rates. ¹

The incidence of tuberculosis, also declining since the early 2000s, remains a global health challenge, especially in Sub-Saharan Africa (276 new cases per 100,000 people in 2015) and South Asia (220; figure 3c). Worldwide there were 10.4 million new tuberculosis cases and 1.4 million deaths due to tuberculosis in 2015. ²

Tackling premature mortality from noncommunicable diseases and suicide

As the incidence of, and deaths from, communicable diseases such as malaria and tuberculosis fall, the share of deaths from noncommunicable diseases increases. Globally, premature death (before age 70) caused by the four major noncommunicable diseases-cardiovascular disease, cancer, diabetes, and chronic respiratory disease-declined 16 percent between 2000 and 2015. To reduce it by one-third by 2030 requires accelerating the current trend (target 3.4). Nine of the 12 highest national rates in 2015 were in East Asia and Pacific or Europe and Central Asia, with Papua New Guinea the highest, where the probability of 30-year-old people dying from these noncommunicable diseases before their 70th birthday is 36 percent (figure 3e).

Mental health is also a focus of target 3.4. Suicide accounts for 8.2 percent of deaths among young adults ages 15-29 globally and is the second leading cause of death after road traffic injuries for that age group.3 Suicide rates for all ages tend to be higher in Europe and Central Asia and in high-income countries (figure 3f).

Preventing substance abuse

In 2012, 3.3 million deaths-6 percent of deaths worldwide-were attributed to alcohol consumption, predominantly through injuries or noncommunicable diseases.4 Global consumption was 6.3 liters of pure alcohol per person ages 15 and older in 2015, equivalent to 3 liters of beer (4 percent alcohol) a week. Consumption was highest in Europe and Central Asia (10.2 liters of pure alcohol per person a year) and lowest in the Middle East and North Africa (0.8 liters; figure 3g). Goal 3 includes in its agenda preventing and treating harmful use of alcohol (target 3.5).

In 2015 the global incidence of malaria was about 94 per 1,000 persons at risk (figure 3d). Sub-Saharan Africa bears the highest burden, with an incidence of 234 per 1,000 persons at risk. Countries with the highest incidence include Mali (449 per 1,000 persons at risk) and Burkina Faso (389 per 1,000 persons at risk).

Extending financial protection

Universal health coverage strives for people having access to health care without suffering undue financial hardship. Achieving it would prevent people from falling into poverty due to illness and give people the opportunity to lead healthier and more productive lives (target 3.8).

Health care financing in many low- and middle-income countries is still dominated by high out-of-pocket expenditures (figure 3h). Weaknesses in prepayment mechanisms such as taxation or health insurance-and user fees imposed at the point of service-often impede access to care, especially for the poorest.

A meaningful measure of universal coverage needs to reflect the ability of a health system to protect people from the financial risks associated with paying for health care. Universal coverage should offer protection from catastrophic health expenditures-out-of-pocket payments representing a large share of household consumption, usually with a specific threshold. It should also protect people from impoverishing out-of-pocket payments.

The latest available consumption survey data for 110 countries show that in the median country about 7 percent of the population face out-of-pocket payments in excess of 10 percent of their total consumption, including 3 percent for whom health payments represent 15 percent or more of their consumption.5 Every year, 0.74 percent of people are pushed into extreme poverty (living on less than $1.90 a day) by out-of-pocket health payments, and 12 percent of those already below the $1.90 line are driven deeper into poverty. These problems prevail more in countries relying heavily on out-of-pocket payments to fund health care (figure 3i).

Filling the data gaps

Systematically collecting health data is challenging. Even a basic indicator like under-five mortality requires two complete counts, of live births and child deaths by precise age, which are not always available. More complex data, such as cause of death, require even more detailed, complete, and correctly coded information. Civil registration and vital statistics systems to record these life events remain weak in many countries. Only an estimated half or fewer deaths worldwide are registered with cause of death information. In some countries a verbal autopsy (based on interviews with friends and family members) determines the probable cause of out-of-facility deaths, but distinguishing among noncommunicable causes of death using this method remains a challenge.6 Effective monitoring of the Goal 3 targets will require greater investment in such data collection systems.

Notes

1. Joint United Nations Programme for HIV/AIDS. 2016. AIDS by the Numbers 2016. Geneva. http://www.unaids.org/en/resources/documents/2016 /AIDS-by-the-numbers.

2. World Health Organization. 2016. Global Tuberculosis Report 2016. Geneva. http://who.int/tb
/country/en/.

3. World Health Organization. 2016. Global Health Estimates 2015: Deaths by Cause, Age and Sex, by Country and by Region, 2000-2015. Geneva. http://www.who.int/healthinfo/global_burden _disease/en/.

4. World Health Organization. 2014. Global Status Report on Alcohol and Health 2014. Geneva. http://www.who.int/substance_abuse /publications/global_alcohol_report/en/.

5. These 110 countries have more than 80 percent of the world population.

6. World Health Organization. 2016. World Health Statistics 2016: Monitoring Health for the SDGs. Geneva. http://who.int/gho/publications /world_health_statistics/en/.

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This article shows that America does not have the healthiest population due to extreme disparities and diseases.

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America’s Health Rankings® Health Disparities Report reveals urgent need to address maternal mortality, mental health, food insecurity

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What challenges limit the success of the NHM and what can be done to solve them?

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NHM was approved to continue for another 5 years because it met all of its targets. It is one of the main contributors to India improving public health. Each issue is slowly getting solved: maternal mortality rate, mortality rate, malaria, etc

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Cabinet approves continuation of National Health Mission for another five years

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NEW DELHI: The Union Cabinet on Wednesday reviewed the progress under the National Health Mission (NHM) over the last three years and was informed that with sig

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This article showed me that the NHM faces many challenges. These would include lack of infrastructure in rural areas, shortage of medical professionals, social and cultural barriers, inconsistent implementation, and issues of funding.

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National Health Mission, Objectives, Components, Challenges

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National Health Mission (NHM) was launched in 2013 subsuming the National Rural & Urban Health Mission. Check more Objectives, Components, Funding, Challenges of NHM

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Health is the foundation of every social, economic, and environmental goal. All the SDGs are extremely tied together which means that the goals should all develop together.

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Healthy Lives and Well-being for Everyone: Why SDG 3 matters and how we can achieve it

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Creating a sustainable world—and reaching economic, environmental and social goals—depends on having a thriving and healthy human population. We explore how Sustainable Development Goal 3 plans to achieve that.

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The Ayushman Bharat Health Scheme consists of two interconnecting components which are the Health and Wellness Centers (HWCs) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY).

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Apart from above mentioned critical components of PM-JAY's ecosystem following are some other key components working as the support system for the smooth implementation of the scheme.

Capacity Development

Capacity building activities under PM-JAY attempt to address more than just training and cover all aspects of building and developing sustainable and robust institutions and human resource. Capacity building in PM-JAY has three components:

Setting up sustainable institutional structures,

Building and strengthening the human resource and institutional capacity, and

Sustaining knowledge and skill through knowledge management and use of appropriate tools. The roles of institution as well as each of its personnel at national, State and district level were defined as were their specific skill sets required. These personnel were further categorised on the basis of role and appropriate knowledge and skill areas were mapped for capacity development.

The NHA has taken the leadership role in assessing the requirements, making available resources, devising strategies for enabling States to undertake capacity building activities and providing technical assistance to States. Standardised learning content on identified thematic areas is being developed by the NHA. States can customise these materials and deliver through various methodologies as per their annual training plan. Monitoring and quality assurance measures with feedback mechanism have also been put in place to ensure effectiveness and efficiency. Partnerships and networks are being created with Government and non-Government institutions having expertise in various fields to support the capacity building initiatives in PM-JAY.

Capacity building initiatives in PM-JAY started with the orientation of SHA officials followed by various workshops for personnel from specific portfolios like IT, fraud control, claim management, etc. Workshops for ISAs and banking partners were also organised. Master trainers were created at the State level who in turn trained more than 10,000 Pradhan Mantri Arogya Mitras (PMAMs) at empanelled hospitals before the beginning of the programme. Learning materials were also made available in the portal to facilitate State and district level trainings. An e-learning platform is now being developed with the support of the National Skill Development Council (NSDC) for training and certifying Arogya Mitras. Various workshops, cross learning forums and thematic trainings are planned in the upcoming days.

Monitoring and Evaluation

Monitoring and Evaluation under PM-JAY Monitoring and Evaluation (M&E) is key for successful implementation and ensuring the intended results of such a large insurance scheme. The NHA at the Central level is continuously keeping track on periodic basis on these UHC dimensions (coverage, benefits and financial protection) through the following functional domains:

Beneficiary management

Transaction management

Provider management

Support function management (comprising functions such as capacity development, grievances, frauds and abuse, call centre, etc.)

A strong real-time online MIS is set up at the national level to review Key Performance Indicators (KPIs) and achievement of results with respect to the targets defined under the domains. The various dashboards developed using business intelligence tools help in identifying the gaps and provide an overview of the performance made. To mention a few: the operations dashboard presents an update of KPIs of beneficiary information system, pre-auth dashboard helps to access state and district wise distribution of pre-auth, status of empanelled hospitals, portability dashboard gives us the picture of interstate and intrastate portability and their KPIs on claim portability by specialty, procedure, age and gender.

Most of the States, which do not have their own schemes, are using the NHA software. However, States with their own schemes are either using the above or their own software followed by API integration to ensure the flow of data from State to Central servers.

In order to provide a comprehensive picture of the progress made by all the functional domains, factsheets are developed monthly at the State and National level. The factsheet compares the progress made since the inception of the scheme across States with the progress made in each month. The average claim size, total number of pre-auths generated, pending approvals, nomenclature of the packages used at public and private facilities are some of the important indicators included in the factsheet. The triggers and outliers (if any) identified through the dashboards and factsheet are further drill down to districts level.

To assess and comprehend the impact of PM-JAY, evidence generation is done through evaluation studies in collaboration with premiere research institutions and in partnership with development agencies such as GIZ, WHO and World Bank. The objective of these evaluation studies is to understand the impact of the scheme on various parameters including but not limited to out-of-pocket expenditure, access to health, health seeking behaviour, etc. These research studies provide critical inputs for evidence-based decision-making and carrying out mid-course corrections.

Fraud Prevention, Detection and Control

For a programme of this scale, magnitude and complexity as that of PM-JAY, it is critical to put in a place a strong anti-fraud mechanism not only from financial perspective but also to safeguard people's health from unethical behaviour and malpractices. The National Health Authority is cognizant of the issue and has taken a number of steps to safeguard the programme from the inception. Some of the key actions taken in this regard are listed below.

A. Policy and Design Level

A transparent tendering process implemented for selection of insurance company, Implementing Support Agency and other service providers. Tightly worded legal document for service delivery as per pre-defined Service Level Agreements have been developed with penalty clauses and punitive action to deal with fraudulent activities on the part of any agency involved in delivering services under PM-JAY.

Hospital empanelment process has been developed with a two-tiered structure approach involving district level and State level committees, having due representation of senior officials - civil surgeon, chief medical officer and nodal officers of the district. The entire process is web enabled whereby a hospital can track the status of its empanelment from application to approval by the State Nodal Age.

IT system and processes have been designed with checks and balances along with defined roles and responsibilities, role-based logins and audit trails for all processes - beneficiary identification, transaction management system, funds flow, claims payment etc. Further, all pre-authorisation and claims transactions are carried out on-line basis for efficiency and complete transparency.

The process of pre-authorisation has been designed such as to ensure maximum efficiency while avoiding abuse and fraud. Minimum requirements for claims investigation and medical audit have been laid down.

The tendency of health care providers to overcharge, bill extra and other related issues have been taken care of by introducing all-inclusive package rates. However sufficient flexibility has been given to treat patients requiring medical management and the list for procedures shall be enhanced as more experience and insights are gained.

Comprehensive Anti-fraud Guidelines were released by the Minister of Health and Family Welfare on August 27, 2018, laying down detailed strategy, processes, systems and manpower for anti-fraud both at National and State levels.

National Health Agency Tollfree - 14555 set up on 24x7 basis for facilitating beneficiary reporting and feedback

Whistleblower Policy has been adopted at the NHA level and shared with States for adoption on a similar pattern

B. Operational and System Level

Capacity building workshop for fraud control and medical audit organised for SHAs, ISAs and Insurance partners

Fraud Investigation Manual released for uniform and effective process, data capture

Monitoring and analysis of utilisation trends done through regular MIS and dashboards, watching abuse prone packages, suspect transactions/hospitals on regular basis

Top analytics firms shortlisted for carrying out 'proof of concept' for triggering suspect transactions and entities through rule engines and artificial intelligence layer on top of Transaction Management System

Mobile App - Kaizala app is being customised for field investigations and medical audit, test deployment underway

Procedure specific documentation and checklist being developed for controlling abuse and leakages, integration with IT underway

Adjudication guidelines and capacity building programme for SHAs, ISAs to be rolled out

Watch and action against fake websites, Mobile Apps providing misleading information or collecting money or data from public

National Anti Fraud Unit

NHA has a "Zero Tolerance" approach towards Fraud and Abuse under PMJAY. Towards this end, the National Anti Fraud Unit (NAFU) has been set up with the primary responsibility for prevention, detection and deterrence of fraud and abuse under PM-JAY.

NAFU works closely with State Ant Fraud Units (SAFU) in order to ensure the effective implementation of the Scheme, free from any fraudulent/ abusive activity from any entity involved in PM-JAY implementation such as providers, beneficiaries, ISAs or payers.

NAFU carries our following key activities:

Provide leadership stewardship to the national anti-fraud efforts under PMJAY;

Develop, review and update the national anti-fraud framework and guidelines based on emerging trends;

Provide mentoring support to states in setting up and institutionalising their in-state anti- fraud efforts;

Capacity building of states on anti-fraud measures under PMJAY;

Liaise with the national IT team / agency to ensure that the IT platform is periodically updated with fraud triggers based on review of trends;

Conduct audits and investigation of suspect cases/entities;

Set up Forensics practice for detection and triangulating fraud/abuse related data with the overall service utilisation trends emerging under PMJAY;

Provide evidence-based insights to states on trends emerging from state-specific fraud data analytics;

Handle all fraud related complaints that the NHA may receive directly and liaise with the states from any complaints specific to states as per Anti- Fraud Guidelines

Establish whistle blower mechanism, public disclosure guidelines, and other deterrent measures.

Grievance Redressal

Grievance redressal system is designed to address grievances of all PM-JAY stakeholders based on the principles of natural justice while ensuring cashless access to timely and quality care remains uncompromised. A three-tier Grievance Redressal Committee structure has been set up at National, State and district levels for this purpose. The CEO of NHA will be the Chairperson at the National level while the CEO of SHA will chair the State Grievance Redressal Committee. The District Magistrate or an officer of the rank of Additional District Magistrate shall be the Chairperson of the District Grievance Redressal Committee. These committees will track and monitor the grievances and its status, collect additional information from parties involved, facilitate hearings, review records, adjudicate and issue orders on grievance and ensure compliance of committee orders.

The aggrieved parties can submit grievances through offline (letter) or through an online portal (https://cgrms.pmjay.gov.in) developed by NHA. Other communication channels like telephone call, fax, e-mails, and SMS are also accepted for registering a grievance. The National Call Centre (14555 / 1800 111 565) is also integrated to the Grievance Portal for addressing grievances received through the call-centre. The committee can also register grievances based on social media or public forums findings/reports. Based on predefined criteria, grievances will be handled either by the respective individual/organisation who is responsible to take action or by the committees at an appropriate level. But at any level, the grievance should be addressed within 30 days of receipt. The right to appeal for any party is valid for 30 days from the date of the decision. Non-compliance with the decisions of the committee within another 30 days will also attract a penalty for the defaulter. The online portal has the provisions to designate and track grievances to respective officials and monitor compliance with the alert system.

Call Centre

One of the important aspects of one of the world's largest government-supported health schemes of the size and complexity as that of PM-JAY is to ensure that entitled beneficiaries of the programme can reach out to know the details of the scheme, have recourse to raise a query or a grievance, seek information and support at any time during day or night, especially during hour of need. If the profile of beneficiaries includes a sizeable population which is rural based, even less educated and less aware, the mechanism needs to be further simplified and made easily accessible, involving least effort and no expense. Therefore, a National Helpline - 14555 was set up by then National Health Agency on August 24, 2018 - which is operating 24x7 since the launch and has answered more than 42 lakh calls since inception. The call centre is manned by 300 plus trained agents who work round the clock to manage the calls and further plans are in offing to expand capacity. All major regional languages are supported by the call centre team.

The Helpline is toll-free which means that the caller does not incur any call charges, the same are borne by NHA. Operating on 24x7x365 basis, the call centre provides services/information to the beneficiaries such as details about the scheme - coverage, benefits, how and where to avail benefits, name and address of empanelled hospitals etc. Besides beneficiaries, other stakeholders like hospitals, Arogya Mitras and field functionaries also call the Helpline for support.

The call centre is also engaged in outbound calling and more than 3 lakh outbound calls have been made to beneficiaries for collecting their feedback post discharge from hospital, to know their experience, whether any difficulty faced during the process, etc. Outbound calls are also made to hospitals to help them complete application for support, hand-holding and training for providing services to PM-JAY beneficiaries and to encourage these hospitals to raise pre-authorisation.

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Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage

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Mauritania does not seem to be developing as well as other African countries as it is not on track for any of them.

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A gap analysis of SDG 3 and MDG 4/5mortality health targets in the six Arabic countries of North Africa: Egypt, Libya, Tunisia, Algeria, Morocco, and Mauritania

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Background: The United Nations Assembly adopted the Sustainable Development Goals to succeed the Millennium Development Goals in September 2015. From a European perspective, the development of heal…

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I was surprised to learn that although most of the leading countries in the SDG index, there is still a large disparity between different countries.

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New SDSN Report Reveals the State of Sustainable Development in Europe and Priorities for the Newly Established EU Leadership

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Paris, France (January 29, 2025) — The Europe Sustainable Development Report 2025 (ESDR), a new report released today by the UN Sustainable Development Solutions Network (SDSN), reveals waning SDG advancement and persistent social, environmental, and biodiversity challenges across the European Union (EU) underscoring the need for the new EU leadership to reaffirm its commitment to the Sustainable Development Goals (SDGs).

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How has the Ayushman Bharat health scheme reduced medical costs and what can be done to improve its reach across Indian states?