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I chose this SDG because I feel that wherever you go, there will always be people with health problems, no matter what they are. I want to connect the effect of external environments causing people's health to decay to target goal 3.4, which focuses on mental health and physical 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 diseases and medical issues in Africa, which must be addressed to reach SDG#3. I will focus on Africa, mainly Sub-Saharan Africa, and the progression in healthcare that has already been made. I want to research this because I feel that in America, although there are health issues, in comparison with less developed countries is a lot more evolved in healthcare (specifically regarding diseases). It's important to be aware of issues in other parts of the world instead of being blinded by what we only see in our own country.

I specifically want to make the connection between physical diseases/medical issues and mental health.

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red- mental health

green- examples

yellow- factors

purple- solutions

blue- research questions

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Overall targets of goal 3. The one I want to focus on is target 3.4, reduce mortality from non-communicable diseases and promote mental health. Through these different target goals, SDG#3 has slowly but surely been improving around the globe.

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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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Data on people's mental health across the globe

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Data on people's mental health across the globe

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Groups who experience discrimination face the highest suicide rates. This involves migrants, LGBTQ, and prisoners. This information can be evidence that supports the fact that mental health place a huge role in people's lives.

-how is this relevant to the people in Sub Saharan africa

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While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness.

In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour. Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, intersex (LGBTI) persons; and prisoners. By far the strongest risk factor for suicide is a previous suicide attempt.

Suicides are preventable. There are a number of measures that can be taken at population, sub-population and individual levels to prevent suicide and suicide attempts. LIVE LIFE, WHO's approach to suicide prevention, recommends the following key effective evidence-based interventions:

limit access to the means of suicide (e.g. pesticides, firearms, certain medications);

interact with the media for responsible reporting of suicide;

foster socio-emotional life skills in adolescents;

early identify, assess, manage and follow up anyone who is affected by suicidal behaviours.

These need to go hand-in-hand with the following foundational pillars: situation analysis, multisectoral collaboration, awareness raising, capacity building, financing, surveillance and monitoring and evaluation.

Suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labour, agriculture, business, justice, law, defence, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide.

Suicide rates, age-standardized

Suicide rates, crude

GHO SDGSUICIDE Crude suicide rates (per 100 000 population) REGIONAL DOT PLOT TEMPLATE - 1 DECIMAL

GHO SDGSUICIDE All age groups XTABLE TEMPLATE D 3x2 IND, TIME, DIM1 x SPATIAL, DIM2 Crude suicide rates (per 100 000 population)

Suicide rates, crude, 10-year age groups

GHO SDGSUICIDE Crude suicide rates (per 100 000 population), 10-year age groups XTABLE TEMPLATE D 3x2 IND, TIME, DIM1 x SPATIAL, DIM2

Suicide rates, crude, 15-29 and 30-49 years of age

GHO SDGSUICIDE Crude suicide rates (per 100 000 population), 15-29 and 30-49 years XTABLE TEMPLATE D 3x2 IND, TIME, DIM1 x SPATIAL, DIM2

Suicide rates, crude, among adolescents 15-19 years

GHO SDGSUICIDE Crude suicide rates (per 100 000 population), 15-19 years XTABLE TEMPLATE D 3x2 IND, TIME, DIM1 x SPATIAL, DIM2

If you have any feedback, you are welcome to write it here.

If you need to access the old Global Health Observatory data, you can do it here. But before you leave, please provide us your feedback about our new data portal.

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Who is at risk? While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness.

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Areas where SDG#3 implementation will be extremely beneficial

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Areas where SDG#3 implementation will be extremely beneficial

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According to data by the WHO, both males and females in the Solomon Islands ages 30-70 have a 40.6% probability of dying from cardiovascular disease, cancer, diabetes, or chronic respiratory disease. This is the highest probability out of all the countries involved in the World Health Organization. I can use this information for backup for a general explanation on SDG#3 and how it impacts people all around the world (before getting specific with Sub Sahran Africa).

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Dying between the exact ages 30 and 70 years from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases, probability (SDG 3.4.1)

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The GHO data repository is WHO’s gateway to health-related statistics for its 194 Member States. It provides access to over 1000 health topics indicators

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Cancer and cardiovascular disease are the highest risk factors of mortality rate for people ages 30-70. Its prevalence in Africa/Sub Saharan Africa, along with other non communicable diseases, play a role in what prevents the region from achieving SDG #3. I can use this source to show what diseases in Africa/Sub Saharan Africa contribute to the mortality/morbidity rate.

-are these diseases also the highest risk factors for people in Sub Saharan africa

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SDG Indicator 3.4.1 - Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease - German Indicators For The UN Sustainable Development Goals

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This overview contains information on the time series shown that are available in Germany and their compliance with the UN metadata. The national metadata contains supplementary methodological and country-specific information.

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The Blue Chip Foundation works towards SDG #3. I can use this to show evidence of foundations working towards SDG #3. What does this foundation do? How exactly does this foundation help support less developed countries/regions?

-how does this foundation help with people in Sub Saharan africa

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People residing in different geographies experience varying levels of difficulty in accessing health care services or life-saving vaccines. Similarly, health care infrastructure in natural disaster prone areas is often isolated or unavailable. Eliminating cultural barriers promotes inclusive societies in which healthy, productive people thrive. Individuals suffering from HIV/AIDS, malaria and other pandemics face extreme discrimination or associated stigmas that are reversed with effective responses including education and the spread of information. Once these solutions are introduced, communities transform into inclusive agents of change for sustainable development.

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Good Health & Well-Being - Blue Chip Foundation - SDGs

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People residing in different geographies experience varying levels of difficulty in accessing health care services or life-saving vaccines. Similarly, health care infrastructure in natural disaster prone areas is often isolated or unavailable. Eliminating cultural barriers promotes inclusive societies in which healthy, productive people thrive.

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Factors on why good health isn't spread everywhere

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Factors on why good health isn't spread everywhere

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Access to healthcare/healthy food sources are not equally spread. Unequal distribution leads to consequences of poor health within the population. Can this data be used and applied in Africa/Sub Saharan Africa?

-how can this be tied to Sub Saharan africa

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Sustainability - The University of Texas at Dallas

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Goal 3: Good Health and Well-Being - SDG Observatory - Sustainability - The University of Texas at Dallas

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Goal 3: Good Health and Well-Being, SDG Observatory, Sustainability, The University of Texas at Dallas, UT Dallas, UTD

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The Solomon Islands' score for death rate due to cancer, cardiovascular diseases, diabetes, or chronic respiratory diseases decreases, and major challenges remain.

I can use this information for backup for a general explanation on SDG#3 and how it impacts people all around the world (before getting specific with Sub Saharan Africa).

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The Sustainable Development Report 2022 tracks the performance of all 193 UN Member States on the 17 Sustainable Development Goals.

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Issues and challenges addressed by SDG 3 in Latin America and the Caribbean. Backup evidence for the general explanation on SDG#3 and how it impacts people all around the world. This site also shows organizations working towards SDGs.

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3. Good health and well-being | 2030 Agenda in Latin America and the Caribbean

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Solution to target 3.1 and 3.2 in Africa

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Solution to target 3.1 and 3.2 in Africa

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Sepsis is one of the most prevalent causes of death in Sub-Saharan Africa. This is mainly due to healthcare challenges, and this site provides solutions on how to beat this obstacle. I can use this source as an example of diseases in Sub Saharan Africa.

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How To Reduce MatERNAL And Neonatal Sepsis In SSA

1. Increase sepsis awareness in the community

Despite sepsis being a major cause of health loss globally, public awareness remains low, 11 with the delayed time from presentation to care in low-middle income countries (LMICs) contributing to adverse outcomes. 12 13 Increasing awareness among the public and health workers is vital for prevention. In high-income countries (HICs), strategies to increase public awareness include public service announcements of the early warning signs of sepsis, published in traditional print and electronic media . 14 With global mobile connections standing at 7.6 billion 15 and extremely high smartphone dissemination in SSA, there is potential for exploitation of this digital resource to increase sepsis awareness in LMICs. Rapid evaluation of public awareness can be measured using geospatial analysis of online information-seeking behaviours as a surrogate measure. 16

Educational messages can be accessed remotely and in real-time on mobile phones by health workers in different geographic locations, unrestricted by time and space. Mobile applications (apps) are conceptualised as a set of tools designed to undertake specific tasks and jobs. A systematic review of 42 studies to assess the effectiveness of mobile health in LMICs supports their use. 17 The use of mobile phone apps in supporting, training, data collection and reporting, emergency referrals, work planning and communication between health workers was associated with improvements in adherence to treatment algorithms, more accurate data collection and a reduction in treatment errors. 17

2. Improve sepsis surveillance networks

Sepsis surveillance systems are critical tools for comprehensively quantifying the burden of sepsis related morbidity and mortality over time. At facility level, surveillance systems alert clinicians to the early signs of sepsis, enabling initiation of timely treatment. The ideal surveillance system should be available in real-time at the point-of-care with the need for early identification of patients with sepsis strengthened by the known linear increase in the risk of mortality with each hour of delay in appropriate antibiotic treatment. 18 19 The establishment of electronic health records systems to capture vital signs and laboratory values of patients have been shown to be very effective in alerting clinicians to possible clinical deterioration due to sepsis. 20 By harnessing these existing technologies, local and regional information system networks for sepsis could be established in Africa.

3. Invest in health workers

Existing data highlight a marked disparity in annual health expenditure per capita between LMICs and HICs; however, the economic cost of maternal and neonatal sepsis in Africa is not clearly defined. 5 21 The WHA sepsis resolution advocates for well-coordinated efforts by politicians, policymakers, healthcare administrators, clinicians and researchers to reduce the impacts of sepsis. 10 Understaffing and a higher workload is a common problem in health facilities across SSA 9 and is linked to higher infection rates as well as adverse outcomes. 22 23 Addressing this challenge will require accelerated progress in health worker recruitment and training.

Training and education of health workers, especially nurses and other frontline clinicians, is vital in improving the outcomes of critically ill patients. 24 25 Retention of skilled staff should be a key consideration as 'brain drain' disproportionately affects health workers in SSA. Strategies should include improved remuneration, better conditions of service, task shifting and increased collaboration between those working in community and hospital settings. In SSA, mobile devices have been successfully used to train health workers. 26 27 Aside from promoting contact with health workers in remote and hard-to-reach areas, electronic training has the added advantage of supporting provider-to-provider communication, feedback and professional networking. Programmes targeting education of health workers in prevention and early recognition and treatment of maternal and newborn sepsis should be prioritised.

4. Improve the early identification of sepsis in facilities

Several sepsis diagnostic scoring systems have been developed to identify changes in physiological parameters which precede patient deterioration 28 and alert clinicians to promptly initiate treatment. Examples of these tools for use in the general adult population include the Modified Early Warning Score, Universal Vital Assessment Score, 29 National Early Warning Score 2 and the quick Sepsis Organ Failure Assessment (qSOFA) score. Importantly, none of these scores have been validated in pregnant women or newborns. As such, they are unlikely to account for physiological differences in these population groups. 30

The Sepsis in Obstetrics Score, developed to detect maternal sepsis, appeared promising in initial reports from the USA; however, it was not superior to general sepsis scoring systems when tested in other regions. 31 The obstetric modified SOFA score is an interesting adaptation of qSOFA that requires only clinical data for assessment and thus can be performed quickly and independently of laboratory tests. 32 The UK Modified Early Obstetrics Warning Score (MEOWS) was developed for the obstetric population to aid the identification of clinical signs of deterioration in women developing critical illness. The MEOWS is easy to administer and has been shown to have a high sensitivity (89%) and reasonable specificity (79%) in predicting maternal morbidity, though it is not specific to sepsis. 33

The shock index (SI), defined as ratio of heart rate to systolic blood pressure, has recently been identified as a consistent predictor of adverse outcomes. 34 35 Various thresholds have been proposed for use of SI as an early warning system. In a prospective study involving women with postpartum haemorrhage or sepsis, the SI was found to be a consistent predictor of adverse outcomes compared with conventional vital signs. 36

The introduction of maternal and neonatal sepsis scoring systems may be the first step towards achieving a reliable surveillance system for sepsis in SSA. Electronic surveillance tools which monitor physiological parameters should be developed to facilitate automatic recognition of the early signs of sepsis in health facilities.

5. Ensure laboratory diagnostics for sepsis are affordable and available

Infection is usually indicated by a rise in peripheral inflammatory makers such as the white blood cell count and C reactive protein. Cultures of relevant samples such as blood, urine, sputum and tissues provide microbiological confirmation of infections that give rise to sepsis. Rapid identification of pathogens from blood cultures has been shown to positively influence patient survival, length of hospitalisation and rational antibiotic prescriptions. 37 The development of local antibiograms is desirable to help facilities understand their local bacterial pathogens and match them to antibiotic choices. The establishment and maintenance of reference laboratories to support more sophisticated testing is essential.

In many LMIC settings, basic diagnostic modalities are lacking. Building local clinical microbiology laboratory capacity is an urgent priority and should incorporate regular training for staff to ensure they stay abreast with modern diagnostic methods. Recent research has focused on identifying biomarkers and molecular detection tools to increase the speed and reliability of diagnosis. 38 However, to ensure accessibility and affordability of modern diagnostic and biomarker testing, global health researchers and funders must ensure innovation in diagnostics and in their accessibility and affordability in LMIC settings.

Direct pathogen detection platforms promote the simultaneous identification of multiple bacterial and fungal species. 38 39 While there are several rapid molecular diagnostic platforms to identify bacterial and viral pathogens commercially available, none are widely available or affordable for resource-poor settings. Although rapid, innovative and low-cost testing devices will improve the identification of causal micro-organisms; to improve outcomes, this must be matched with availability of appropriate antimicrobial agents. This requires certainty of supply chains, committed funding, along with strategies at institutional level for antimicrobial stewardship to prevent the emergence of resistant organisms.

6. Improve quality of care through sepsis specific guidelines

While adherence to protocols and clinical guidelines can improve survival and outcomes in sepsis, in a survey of 185 hospitals across SSA, only 1.5% used clinical sepsis guidelines. Lack of basic facilities, equipment and medicines were identified as barriers to implementation. 7 Resource limitations profoundly impact the ability to implement internationally recommended sepsis guidelines in SSA. 40

In high-income settings, significant reductions in maternal and neonatal sepsis have been achieved through quality improvement initiatives to promote adherence to evidenced-based management of sepsis. 41 42 Quality improvement initiatives include educational programmes to increase awareness of the signs of sepsis; use of triage-based algorithms and decision support tools to screen for sepsis, 43 44 use of treatment order-sets 45 and initiatives to reduce time to antibiotics. 46

Prompt administration of antibiotics remains the cornerstone of sepsis management. In the face of a growing burden of antimicrobial resistance and antibiotic-associated infections such as Clostridioides difficile infection, a greater alignment between antimicrobial stewardship and sepsis prevention and treatment programmes is essential. 47 Complementary strategies such as de-escalation protocols and prompt discontinuation of antibiotics when no longer indicated should be incorporated into sepsis quality improvement initiatives. Little is known about antimicrobial resistance in maternity units globally 48 and this information is essential to guide policy on the safe administration of prophylactic antibiotics during childbirth.

Another obvious gap is found in the Third International Consensus on Sepsis (Sepsis-3) 1 which does not provide criteria for diagnosis of sepsis in pregnant women. The ability of clinicians in SSA countries to adhere to sepsis guidelines is also limited by shortage of appropriately trained health workers, equipment and other supporting infrastructure. 7

7. Increase access and use of vaccines to prevent the most common infections that lead to sepsis in pregnancy and the newborn period

Vaccinations are estimated to prevent 2-3 million infection-associated deaths every year among women and children. 49 Vaccines also have an indirect action on minimising antimicrobial resistance by reducing febrile illnesses and antibiotic use. 50 A vaccine for Group B Streptococcus is currently under evaluation and if effective, will have the potential to save 150 000 newborn lives every year and prevent up to 260 000 cases of maternal and newborn sepsis. 51 Seasonal influenza caused by types A, B, C and D of influenza viruses is a public health problem which can be prevented by vaccination. Although the burden of seasonal influenza in Africa is yet to be fully described, the morbidity, mortality and economic losses from this infection are likely to be very high. 52

Despite widespread availability of whole-cell pertussis (wP) vaccines, the burden of pertussis remains unacceptably high in the African continent. 53 This has been attributed to factors such as a lack of disease awareness and surveillance, diagnostic limitations and low prioritisation of this disease by policy makers. Intensified efforts to promote greater coverage with three primary doses of diphtheria-tetanus-pertussis vaccines and booster doses in older children and adolescents in Africa is also required.

Widespread protocols around immunisation for both adults and children is likely to decrease sepsis mortality in SSA. Current barriers to vaccination in this region include armed conflict, funding shortfalls, vaccine shortages and a lack of political will. 54 Measures to address these barriers include the establishment of lasting peace across the continent, improved funding for vaccination programmes and strengthening regional supply chains.

8. Strengthen infection prevention and control programmes and best practices during labour, childbirth and postnatal care

Water, sanitation and hygiene (WASH) is critical for the prevention of sepsis and provision of safe and quality care. 55 Less than 30% of delivery rooms in four East African countries reported access to a safe water supply 56 while a global review of health facilities in low-resource settings found that 40% had no water supply and 19% lacked adequate sanitation conditions. 6 Improvements in WASH could reduce the total burden of disease worldwide by as much as 10%. 57 Implementation of basic measures such as hand hygiene, reducing overcrowding in maternity and neonatal units, promoting hygienic care of the umbilical cord and kangaroo care for small and/or preterm babies have all been shown to mitigate the risk of infection. 58 59 Thus, the provision of safe water and promotion of effective hygiene practices should be emphasised and urgently prioritised in healthcare settings in SSA. This could be achieved by securing the commitment of policy makers to provide clean water in health facilities and by educating health workers and the wider population on the importance of adhering to standard hygiene practices.

9. Undertake high-quality research in pregnant and newborn African populations

There are imminent dangers in transferring effective solutions for sepsis management in HICs to LMICs. This is mirrored by recent well designed randomised controlled trials which have reflected worse outcomes for both children and adults with sepsis treated with fluid boluses in Africa. 13 60 61 The two trials conducted in Zambia comparing an early goal directed therapy (EGDT) protocol (involving intravenous fluids among other measures) to usual care found increased in-hospital mortality in the EGDT arm compared with usual care. 13 61 High-quality research led by local investigators needs to be conducted to provide answers to conundrums associated with sepsis management among pregnant and newborn populations. These include determining the ideal type and volume of resuscitation fluid for sepsis, ascertaining the role of targeted/precision medicine approaches, rapid diagnostic tests and defining predictors of sepsis long-term morbidity and mortality.

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How to close the maternal and neonatal sepsis gap in sub-Saharan Africa

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Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection.

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Small steps to achieving SDG#3 in Sub Saharan Africa regarding HIV/AIDS. Provides data and statistics on the issue. Also provides reasons as to why the issue resides within the region.

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- Sustainable Development Goal Indicators

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Asset Based solutions to SDG#3 in Africa. Instead of using domestic solutions to SDG#3, utilizing and educating people within the region is a new approach. If mental health gets affected by physical health and vice versa, how would it be possible to use asset Based Community development? How important is mental health in regards to asset Based Community development?

"enhance the professional competencies of health workers in Africa. The second is to increase support for local production of medical products in Africa."

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International Committee of the Red Cross

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Working together to address Africa’s health challenges and to achieve sustainable development goals (SDGs)

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—ICRC holds session at the Global Health Forum of Boao Forum for Asia

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African health challenges and priorities in regard to SDG #3. How do these physical issues affect mental health? "There is a global shortage of health workers and a lack of skilled labor constrains job creation in the health sector." Asset Based Community development would help with improving these issues.

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

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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…

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Targets of SDG #3 and statistics that prove the issue that resides within the world. Evidence that the issue exists. Is there data that can be connected to less developed regions such as Sub Saharan Africa?

-is there data that can be connected to ss africa

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Goal 3: Good health and well-being | Sustainable Development Goals | United Nations Development Programme

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We have made great progress against several leading causes of death and disease. Life expectancy has increased dramatically; infant and maternal mortality rates have declined, we’ve turned the tide on HIV and malaria deaths have halved. Good health is essential to sustainable development and the 20…

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Somalia is the country struggling most within the Sub-Saharan African region with SDG#3. I can use this as an example of what's happening in a specific country within Sub Saharan Africa regarding SDG #3. Why is it that Somalia is struggling so much?

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The Sustainable Development Report 2025 tracks the performance of all 193 UN Member States on the 17 Sustainable Development Goals.

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Data regarding SDG #3 within Africa as a whole. Decreasing immunization coverage is preventing certain diseases from being treated. "Lifestyle habits (diet, smoking, alcohol and drug consumption, violence, suicide, etc.), medication abuse (especially Antibiotics), and air pollution are also on the rise in this Region, and there is an increase in the mortality associated with them." It seems that mental health is an aspect of mortality within Africa.

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WHO AFRO iAHO | - Section III - Health in SDG Targets

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More factors preventing SDG#3 from being achieved throughout the world. Factors include AIDS, which is the leading cause of adolescent death within Sub Saharan Africa. There are statistics in this source that show data on child health, maternal health, and other diseases that are the leading causes of mortality.

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Goal 3: Good health and well-being | Joint SDG Fund

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Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases.

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Different ways to achieve SDG#3. These solutions have been implemented around the globe. Can these be implemented in Sub Saharan Africa?

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What are the impacts of physical diseases such as (most prevalent diseases in Africa/ss africa) on mental health in africa/ss Africa which in turn affects the solution of using Asset Based Community development within the region?

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How does poor mental/physical health have an impact on improving healthcare services via asset Based Community development in Sub-Saharan Africa?

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The connection between mental and physical health

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The connection between mental and physical health

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"In fact, while mental illness may itself be clearly visible, it can lead to plenty of related conditions that manifest in profoundly physical ways. Those living with serious mental health disorders face an increased risk of chronic medical conditions"

This article shows proof of the important connection between mental and physical health. Without good mental health, you cannot acquire good physical health, therefore being able to take care of ones mental health will result in both a better well-being and healthier physical state. There are also provided solutions that can help with improving mental health.

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Mental Health is as Important as Physical Health - WestBridge

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Explore why mental health disorders are “invisible illnesses,” their profound impact on physical health, and actionable self-care strategies to prioritize your well-being.

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More proof of the effect of mental health on physical health

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More proof of the effect of mental health on physical health

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"Previous research has found that a large percentage of individuals in need of mental health services lack access to effective, affordable, and quality mental healthcare, especially in low-income countries."

The lack of healthcare services in Sub-Saharan Africa leads to the increasing risk of people's physical and mental health. If both physical and mental health are in poor condition, the two will keep on negatively having an impact on eachother.

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Study shows link between mental and physical health

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A new study has found that individuals with severe mental illness are almost twice as likely to report physical multimorbidity, emphasizing the critical importance of addressing the intersection between mental and physical health.

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Problems connected to mental health in South Africa

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Problems connected to mental health in South Africa

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Mental health in South Africa is not able to fully be addressed, resulting in more patient deaths. The system focuses more on treating the most severe conditions rather than preventing them early on. These conditions prevent South Africa from achieving mental health and well being goals.

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Shutterstock

South Africa has taken steps towards strengthening mental health care in the last 20 years. These include reforming the Mental Health Care Act 2002 and developing a National Mental Health Policy Framework and Strategic Plan 2013-2020.

The strategic plan aims to integrate mental health into general health services to reduce the burden of untreated mental health conditions. It also aims to transform the system to provide quality mental health services that are accessible, equitable and comprehensive, particularly for community-based mental health care.

But significant information gaps have limited the country's ability to initiate a sustained response to mental health care. For example, the most up to date population based prevalence estimates of the burden of mental disorders date as far back as 2003/4.

The failure to implement the public policy on mental health was brought to light by the Life Esidimeni tragedy in 2017. Nearly 150 patients died after being moved from the Life Esidimeni Hospital to unlicensed facilities.

Read more: Patient deaths show South Africa's care for the mentally ill is in disarray

New challenges are now arising with the planned introduction of the National Health Insurance (NHI) scheme, which is intended to move South Africa closer to universal health coverage. But early evidence from NHI pilot districts show an inconsistency with the strategic plan and limited integration of mental health. If the relevant priorities aren't explicitly reflected in the policies and activities supporting the NHI, mental health is likely to remain on the back burner.

The system must be clear about the care that mental health patients are entitled to and how providers will be identified and paid. Mental health care has to be recognised as an integral part of the health care system.

South Africa needs a good grasp of the problem and the resources required to address it.

The gaps

Until recently the country knew very little about a range of important factors related to mental health care. These included: the current state of investment in mental health; whether these investments were being used optimally; where the inequities in resourcing and access lay; and what priorities and plans should be in place to address these inequities.

In response to some of the biggest information gaps, we worked with national and provincial health departments and the South African Medical Research Council. We evaluated the health system costs of mental health services and programmes in South Africa for the 2016/17 financial year. We also documented and evaluated the available resources and constraints to inform a rational approach to planning effectively to improve mental health service delivery.

Our findings offer - for the first time - a nationally representative reflection of the state of mental health spending. They draw attention to inefficiencies and constraints in existing mental health investments in the country.

The current situation

South Africa spends 5% of the total health budget on mental health services. This is in line with the lower end of international benchmarks of the recommended amount that countries should spend on mental health.

Yet, alarmingly, our study crudely estimated a treatment gap of 92%. This means that fewer than 1 in 10 people living with a mental health condition in South Africa receive the care they need. We also found huge disparities between provinces in the allocation of mental health resources. Provincial spending on mental health ranged widely across all levels of the health system. For example, in Mpumalanga, spending on mental health per uninsured South African was R58.50 while in the Western Cape it was R307.40.

Inpatient care took up 86% of the mental health care budget. Spending at specialised psychiatric hospitals made up 45% of the total. Services at the primary level of care made up only 7.9% of overall mental health spending.

This reflects a reactive mental health care system that is focused on treating the most severe conditions, rather than preventing or providing early interventions.

Mental health care users were admitted for longer periods than other patients - twice as long as other patients at district hospitals. At regional and tertiary hospitals, their admissions lasted around 6 to 8 times longer. At central hospitals, they spent almost 5 times longer. Mental health patients spent an average of 157 days in psychiatric hospitals per admission. Nearly 1 in 4 mental health patients were readmitted within three months of being discharged from any hospital. Readmissions alone consumed 18% of South Africa's total mental health spend.

This indicates a highly inefficient system that fails to help patients transition to care in their communities. There is potential for cost savings in providing continuity of care and supporting people to live well in their communities after discharge from hospital.

Other findings included:

Only three provinces had child psychiatrists in the public sector.

There was an extreme shortage of psychiatrists and auxiliary workers critical for rehabilitation and supportive services.

There wasn't alignment between the national database of NGOs licensed by the department of health and those reported through primary data collection.

A number of drugs critical for the management of chronically disabling conditions such as bipolar disorder and depression, were not routinely available.

Most district hospitals weren't compliant with the Mental Health Care Act, though they are expected to provide 72-hour assessments and subsequent referrals for further care, treatment and rehabilitation.

Way forward

For the first time, South Africa has a nationally representative reflection of the state of mental health spending and an appreciation of the inefficiencies and constraints emanating from existing mental health investments. This is one of the highest sample sizes of any costing study conducted for mental health in low- and middle-income countries.

Our study points to some obvious improvements that could be made. These include stronger service delivery at community and primary health care levels. And better referral pathways could reduce unnecessary readmissions. This would also shorten hospital stays.

The next phase must focus on accelerating the country's progress towards meeting the goals set out in the strategic plan and taking forward the recommendations of the South African Human Rights Commission Report. With these study findings in hand, the government now has a baseline from which to begin a rational planning process.

The government has asked us to help develop a mental health investment case for the country, which comes at a crucial time for the country's mental health response, in light of the recent passing of the NHI Bill. This work will involve intensive and ongoing dialogue with a range of players involved in the provision of mental health services and research across the country.

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We did the sums on South Africa's mental health spend. They're not pretty

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Less than 1 in 10 people living with a mental health condition in South Africa receive the care that they need.

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Advantages of Asset Based Community development

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Advantages of Asset Based Community development

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"leadership in asset-oriented communities has shown that people take responsibility for and assume ownership of their future, and community members demonstrate signs of self-reliance"

Not only does Asset Based Community Development help with solving issues, but the community itself is growing and creating a sustainable solution to future issues. Using Asset Based Community Development will create a domino effect for future generations to continue depending upon themselves when problems arise. This will be very beneficial to Sub Saharan africa, especially in SDG #3

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Community leadership: A comparison between asset-based community-led development (ABCD) and the traditional needs-based approach

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A comparison study was undertaken between the asset-based community-led development (ABCD) approaches versus the traditional needs-based approach to community development relating to community lead…

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What will be the effect of improving mental health in Sub Saharan Africa on Asset Based Community Development, which is the solution to improving physical diseases?