Monitoring Health for the SDGs v1.pptx

Presenter - Dr. K. Yuvaraj
Moderator – Dr. Sonali Sarkar
26-02-2023 1

Outline of Presentation
 Introduction (SDGs)
 Health related SDG and its targets
 Six lines of action to progress towards SDG
 India’s effort to progress towards SDG
 Newer initiatives in line with SDG
 Way forward
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Introduction
 Sustainable development – meets the need of present without
compromising future generation’s ability
 Three core elements – economic growth, social inclusion,
environmental protection
 September 2015 UN Summit – “Tranforming Our World: The
2030 Agenda for Sustainable Development”
 Underpinning elements – People, Planet, Prosperity, Peace,
Partnership
3
Source: WHO Sustainable Development Goals: Implication for health post 2015

MDG vs SDG
MDG SDG
8 goals and 21 targets 17 goals and 169 targets
Group of experts in closed doors Negotiation with 193 UN Member states
Focus on social agenda only Focus on three elements: economic growth,
social inclusion, environmental protection
Targeted developing countries Applicable to all the countries
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Source: NITI Aayog: Overview of Sustainable Development Goals

Sustainable Development Goals (SDGs)
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Health related SDG and its targets
6
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Target 3.8: Achieve universal health coverage
MDG unfinished and
expanded agenda
3.1. Reduce maternal mortality
3.2 End preventable newborn
and child deaths
3.3 End epidemics of TB, HIV,
malaria and NTD
3.7. Access to Sexual and
reproductive health services
New SDG 3 targets
3.4. Reduce NCD mortality
3.5. Prevention and
treatment of substance abuse
3.6. Halves the global death
and injuries due to RTA
3.9. Reduce deaths from
hazardous chemical and
pollution
SDG means of
implementation targets
3.a. Framework convention
for tobacco control
3.b. Access to medicines,
vaccines for all
3.c. Health financing and
health workforce
3.d. Capacity for early
warning, risk reduction

Health linkage with other targets
Risk factors for health (Direct)
2.2 End malnutrition
5.2 Eliminate all forms of violence
6.1 Universal access to safe drinking water
6.2. Universal access to adequate sanitation and hygiene
7.1. Access to affordable, reliable, modern energy
11.6. Reduce environmental impact on cities
13.1 Strengthen capacity to climate related hazards and natural disasters
16.1. Reduce all forms of violence
7

Health linkage with other targets
Determinants of health (Indirect)
1.1 Eradicate poverty
2.3 Double agricultural productivity
4.1. Quality primary & secondary education
5.1 End discrimination against women
8.6 Reduce youth unemployment
9.1 Strengthening infrastructure
11.1 Adequate, affordable, quality and resilient housing
12.5. Reduce waste generation
8

Six lines of action to progress towards SDG
1. Monitoring the health related SDGs
2. Health system strengthening
3. Health equity
4. Sustainable Health financing
5. Innovation, research and development
6. Intersectoral action for health
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Source: World Health Statistics 2017: Monitoring Health for SDGs

Monitoring of Health related SDGs – Why?
 Management tool – develop strategies and allocate resources
 Real time report card – measure progress towards SDG
 Ensure accountability – to relevant stakeholders and citizens
 Indicators – backbone of monitoring system
 Global indicator framework – 232 indicators adopted on July 2017
 Priority Health related indicators – 42 (India -13)
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Source: Global indicator framework for the Sustainable Development Goals and targets of
the 2030 Agenda for Sustainable Development

Reproductive, Maternal New born and Child Health
Indicator Progress through
MDG (Global)
Progress through
MDG (India)
Target through
SDG
To be achieved
3.1 Maternal
mortality
ratio
Declined by 37%
(341 to 216 from
2000 to 2015)
Declined by 55%
(374 to 167 from
2000 to 2012
70 per 100000
live births by
2030
Global – 68%
(annually-4.5%)
India – 58%
(annually-3.2%)
11
Rationale: Improve the data quality – indicator true value close to point estimate
Limitations: Maternal Mortality ratio captures risk of death alone while Maternal mortality rate
– Risk of death and fertility
Source: Global: World Health Statistics 2017; India: SRS data

MDG (Global)
Progress through MDG
(India)
Target through
SDG
3.1. Skilled birth
attendance
Increase by 27% from
2000 to 2016 (61 to
78%)
Increase by 34.8% from
2005-2015 (46.6 to 81.4%)
Reduce MMR to 70
per 1 lakh by 2030
12
Rationale: Important lifesaving intervention to reduce maternal mortality; determinants of
women health in marginalized settings
Source: Global: WHO: Skilled attendants at birth ; India: NFHS-4

MDG (Global)
Progress through
MDG (India)
Target through
SDG
To be achieved
3.2 Under
five mortality
Declined by 44%
(78 to 43 from 2000
to 2015)
Declined by 49%
(94 to 48 from 2000
to 2015)
25 per 1000 live
births by 2030
Global – 42%
(annually-2.8%)
India – 48%
(annually-3.2%)
13
Rationale: Key out put indicator child health and well being; reflects access to basic health
interventions
3.2 Neonatal
mortality
Declined by 34%
(29 to 19 from
2000 to 2015)
Declined by 36%
(44 to 28 from 2000
to 2013)
12 per 1000 live
births by 2030
Global – 37%
(annually-2.5%)
India – 57%
(annually-3.4%)

Infectious Diseases
MDG (Global)
Progress through
MDG (India)
Target through SDG
3.3 HIV Incidence Declined by 62%
(5.4 to 2.1 million
from 2000 to 2015)
Declined by 66%
( 2.51 lakh to 86000
from 2000 to 2015)
Ending the
HIV/AIDS epidemic
by 2030
14
Rationale: Measure progress towards prevention ongoing transmission of HIV
Source: Global: World Health Statistics 2017; India: India HIV Estimations 2015

Infectious Diseases
MDG (Global)
Progress through
MDG (India)
Target through SDG
3.3 Malaria
Incidence (per 1000
person at risk)
Declined by 41%
(160 to 94 from 2000
to 2015)
Declined by 56%
(42.7 to 18.6 from
2000 to 2015)
Ending the malaria
epidemic by 2030
15
Rationale: Measure trends in malaria morbidity, identify locations with high risk, helps in
resource allocation
Limitations: Affected by completeness of reporting, extent of diagnostic testing, under-reporting
of private facilities, estimation in places with high malaria transmission
Source: Global: World Health Statistics 2017; India: World Bank: Country wise data on Malaria

Infectious Diseases
MDG (Global)
Progress through
MDG (India)
Target through SDG
3.3 Tuberculosis
incidence
Declined by 17%
(173 to 142 per lakh
from 2000 to 2015)
Declined by 25%
(289 to 217 per lakh
from 2000 to 2015)
Ending the TB
epidemic by 2030
16
Source: Global and India: TB India 2017 Report
Rationale: Measuring the reduction in number of cases in disease burden
Limitations: Estimated with uncertainty – under-reporting and under-diagnosis of cases;
Notification rate – better proxy

Infectious Diseases
MDG (Global)
Progress through
MDG (India)
Target through SDG
3.3 Hepatitis B
vaccination coverage
Global coverage –
84%
National coverage –
62.8%
Combat hepatitis by
2030
17
Rationale: Efficient targeting of resources to ensure all children covered under vaccination
programme; reduce seroprevalence of under-5 children;
Limitations: Additional biomarker survey – help to measure progress towards the goal;
Source: Global: World Health Statistics 2017; India: NFHS-4

Infectious Diseases
MDG (Global)
Progress through
MDG (India)
Target through
SDG
3.3 People requiring
care for Neglected
tropical diseases
Declined by 21%
(2 to 1.6 billion from
2010 to 2015)
Declined by 14%
(70 to 60 million from
2000 to 2015)
Ending the epidemic
of NTDs by 2030
18
Rationale: To find out number of people requiring other forms of interventions and allocation of
resources accordingly
Limitations: Subset of large number of people at risk; Improved surveillance and case finding;
Source: Global: World Health Statistics 2017; India: WHO: Accelerating Work to overcome
the global impact of NTD;

Non communicable diseases and mental health
Indicator Current trend
(Global)
Current trend
(India)
Target through
SDG
3.4 Mortality due to
four major NCDs
Declined by 4%;
(23% to 19% from
2000 to 2015)
Increase in trend
(currently 26%)
Reduce one-third of
premature mortality
due to NCDs
19
Rationale: CVD, cancer, diabetes and chronic respiratory diseases - major causes of NCD
burden; assess the extent of burden from premature mortality;
Limitations: Large uncertainity ranges and data gaps – difficulty in global comparisons;
Use of verbal autopsy in SRS and strengthening of CRVS;
Source: Global: World Health Statistics 2017; India: WHO NCD Country Profiles

(Global)
Current trend
(India)
Target through
SDG
3.4 Suicide mortality
rate
Declined by 12%
(12.2 to 10.7 per 1
lakh 2000 to 2015)
Declined by 11%
(17.8 to 15.7 million
from 2000 to 2015)
Promotion of mental
health
20
Source: Global: World Health Statistics 2017; India: WHO NCD Country Profiles
Rationale: Second leading cause of mortality among young adults (15-29 years);
Limitations: Data impeded by stigma, social and legal considerations; less than half of member
states have well functioning death registration system;
Complete recording in registration system in linkage with police and coronial systems

(Global)
Current trend
(India)
Target through
SDG
3.5 Harmful use of
alcohol
Per capita
consumption of
alcohol 6.4 litres
Per capita
consumption of
alcohol 28.7 litres
Prevention and
treatment of harmful
use of alcohol
Rationale: Indicator of alcohol exposure in population; estimation of alcohol attributable
morbidity and mortality
Limitations: Data available (based on production, import, export, and sales or taxation) -
disaggregation by sex or age cannot be done; unrecorded APC; Triangulation of data;
Source: Global: World Health Statistics 2017; India: WHO Global Status Report on alcohol

(Global)
Current trend
(India)
Target through
SDG
3.a. Prevalence of
current tobacco use
Declined by 21%
(43.8 to 34.8 per 1
lakh 2000 to 2015)
Declined by 6%
(34.6 to 28.6% from
2010 to 2016)
Strengthen the
implementation of
WHO Framework on
Tobacco Control
22
Rationale: Enable monitoring and evaluation of impact of implementation of WHO-FCTC
Limitations: No standard protocol or definitions across member states in asking about tobacco
use; Information from subnational survey not used; WHO Tobacco Questions for Survey (TQS)
can be adopted to improve comparability of indicators;
Source: Global: World Bank: Tobacco use India: GATS 2 Report 2016-17

Injuries and violence
(Global)
Current trend
(India)
Target through
SDG
3.6 Death rate due to
road traffic injuries
2000-2013 (1.1 to 1.25
million deaths)
2000-2015 (79000 to
1.46 lakh deaths)
Halves the number of
global deaths due to
RTA
23
Rationale: Direct indicator to measure the progress towards the goal
Limitations: No data or poor completeness of vital registration data in most countries; difficulty
in making comparison;
Source: Global: World Health Statistics 2017; India: Ministry of Road Transport Report

(Global)
Current trend
(India)
Target through
SDG
13.1. Death rate due
to natural disasters
0.3 death per 1 lakh
population (2011-15)
0.4 death per 1 lakh
population (2011-15)
Strengthen resilience
and capacity to
natural disasters
Rationale: Measure global progress in implementation of Sendai Framework and towards SDG
Limitations: No National Disaster loss database in some countries; Reporting of data by event
not done;
Source: Global: World Health Statistics 2017; India: National Disaster Management Authority

(Global)
Current trend
(India)
Target through
SDG
16.1. Homicide rates
per 1 lakh population
Declined by 19%
(8 to 6.6 from 2000 to
2015)
Declined by 23%
(3.8 to 2.9 from 2010
to 2016)
Reduce all forms of
violence and related
deaths everywhere
25
Rationale: Measure of most extreme form of violence; Indicator for lack of security; assess
causes, consequence and develop interventions
Limitations: Adoption of ICCS definition of homicide in all countries
Source: Global & India: WHO Global Report on Violence prevention

Universal Health coverage
(Global)
Current trend
(India)
Target through
SDG
3.8. Household
expenditure on
health
Increase of 2% from
2000-2010 (9.7-11.7%)
with 10% threshold
Increase of 3% from
2005-2012 (21-24%)
Achieve Universal
Health Coverage
26
Rationale: Identify financial hardship caused by direct health payments;
Limitations: Frequency, data quality and comparability of surveys; No spending could also be
due to inability to spend;
Source: Global : UHC Global Monitoring Report 2017
India: Trends in catastrophic health expenditure in India

Universal Health coverage
(Global)
Current trend
(India)
Target through
SDG
3.8. Coverage of
essential health
services
Increase of 0.3% per year
since 2000; UHC service
coverage index 2015 – 64
Ranges from 46-61 in
2015;
Achieve Universal
health coverage
27
UHC service coverage index – 16 tracer indicators of health services under RMNCH, Infectious
disease, NCDs, service capacity and access; allows for country led monitoring of UHC progress;
Limitations: Explains access to services not the quality of services;
Source: Global & India : UHC Global Monitoring Report 2017

Health systems
Indicator Current trend (Global) Current trend
(India)
Target through SDG
3.c. Skilled Health
workers density
55.7% of the countries
fall below threshold of
34.5 per 10000
population
27.5 per 10000
population – 2015;
Recruitment, Training
and development of
Health workforce
28
Rationale: Progressively move to cover all health cadres; Gap in service delivery;
Limitations: Underestimation of workforce in private, NGO health sectors
Source: Global and India: World Health Statistics 2017;

Health systems
(Global)
Current trend
(India)
Target through
SDG
17.19. Death
registration
Only half of WHO
member states – 80%
registration with cause
2012 – 69.3%
registration
Measurement of
progress on
sustainable
development
29
Source: Global: World Health Statistics 2017; India: Civil Registration System report 2012
Rationale: Tracks the proportion of countries conducted at least one census and information on
the housing data needed to measure progress towards SDG

Environmental risks
Indicator Current trend (Global) Current trend (India) Target through SDG
3.9. Mortality due
to air pollution
2012 - 15% of total
global deaths; 81.2 per 1
lakh population
2012 - 133.7 per 1
lakh population;
Reduce deaths due to
chemicals and
pollution
30
Rationale: to assess the biggest environmental risk to health;
Limitations: To assess the joint effect of both household and ambient air pollution;

Environmental risks
Indicator Current trend (Global) Current trend (India) Target through SDG
3.9. Mortality due
to unsafe WASH
services
2012 – 17.1 per 1 lakh
population
2012 – 27.4 per 1 lakh
population
chemicals and
pollution
3.9. Mortality due
to unintentional
poisoning
2015 – 1.8 per 1 lakh
population
2015 – 1.9 per 1 lakh
population
chemicals and
pollution
31
Rationale: Indication of extent of inadequate management of hazardous chemicals and pollution
Limitations: Not all countries have such registration system; data need to be derived from other
sources

Environmental risks
(Global)
Current trend
(India)
Target through
SDG
6.1 Population
with improved
water source
2015 – 82% access to
improved water source
Increased by 2.6%;
87.6 to 89.9% (from
2005-2015)
Access to safe and
affordable drinking
water
6.2. Population
with improved
sanitation
2015 – 68% access to
improved sanitation
Increased by 66%;
29.1 to 48.4% (from
2005-2015)
Access to adequate
and equitable
sanitation
32
Source: Global: World Health Statistics 2017; India: NFHS-4
Rationale: “improved” water as a proxy for safe water
Limitations: Standardization of definition and data on faecal and chemical contamination

Health risks and disease outbreaks
(Global)
Current trend
(India)
Target through SDG
3.d. IHR core
capacity score
2010-16 – 76%
average core capacity
score
2010-16 – 92% core
capacity score
Strengthen capacity for early
warning, risk reduction and
management of health risks
33
IHR Core capacity score: 13 indicators - National legislation, policy and financing,
Coordination and National Focal Point communications, Surveillance, Response, Preparedness,
Risk communication, Human resources, Laboratory, Points of entry, Zoonotic events, Food
safety, Chemical events, Radio nuclear emergencies
Limitations: Self reporting, revision of questionnaire in 2017;

Health system strengthening
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Health System Strengthening
 International Health Partnership for UHC 2030
 WHO Global strategy on human resources for health: Workforce 2030
 UHC Monitoring Framework
 Coverage of essential health services
 Financial protection
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Health Equity – leave no one behind
 Improving health for whole population by including all individuals and
women empowerment
 Calculation of health equity measures helps in achieving
 Health related target (SDG3),
 Gender equality (SDG5),
 Reducing inequalities (SDG10),
 Data disaggregation (SDG 17)
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 Reform National Health Information System - reporting of Equity
relevant data
 Health inequality monitoring – Identify the level of health gap, reasons
and barriers; (Quantitative and Qualitative)
 Sources and Potential means of improvement:
 Census – Include individual or small area identifiers
 CRVS – Expand coverage, include socio-economic indicator, cause of
death, birth weight, gestational age
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 Sources and Potential means of improvement:
 Household surveys – Regular and repeated survey, Increase sample size,
comprehensive list of inequality dimensions, harmonize survey questions
over time;
 Institution based records – Standardization of records
 Surveillance system – Integrate into national health information system
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WHO Toolkit for health inequality monitoring:
 WHO Health Equity Monitor data repository and theme page –
comparable and disaggregated RMNCH data
 WHO Handbook on health inequality monitoring – Development and
strengthening of national level monitoring
 WHO Health inequality monitoring eLearning module
 WHO Health Equity Assessment Toolkit – Online tool for health
inequality analysis
 WHO Innov8 approach – Reviewing national health programmes
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Sustainable Health financing
 Increased effective coverage of priority interventions unlike MDG era
 Challenges:
 Emphasis on domestic public sources of revenue for health
 Comprehensive approach to address sustainability, system inefficiency
and expenditure management;
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SDG Health Price tag
 Model estimating financial investment required for Health System
Strengthening to achieve SDGs by 2030
 Grouped countries into five categories based on health system and
financial capacity;
 How health services can be scaled up; What investments required to
achieve health system performance targets, coverage and outcomes;
 Modelled by country and year and multiplied by country specific
prices
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SDG Health Price tag
 2 scenarios – “ambitious” and “progress”
 Both scenarios – 75% of total cost – Health workers, clinics, hospitals,
laboratories and medical equipment
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Ambitious scenario Progressive scenario
$371 billion or $58 per person $274 billion or $41 per person
7.5% GDP spent 6.5% GDP spent
Prevent 97 million premature deaths Prevent 71 million premature deaths
23 million health workers, 14 million new health workers,
415 000 new health facilities, 378 000 new health facilities,
91% of which in PHCs 93% of which in PHCs

Sustainable Health financing
Strategic priorities:
 Good health financing policy – public health spending, reduce
fragmentation, strategic purchasing
 Increase overall government budget revenues – Revenue raising
through improved national taxation system and reduced illicit financial flows
 Intersectoral co-ordination – Productive dialogue between finance
authority and health sector
 Move away from silos – Integrating externally financed programme within
existing health system
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Innovation, research and development
 Innovation – Technologies and means of implementation of activities
 Ensure availability, affordability and acceptability to appropriate health
technology
 Current trend – Less than 1% funding for NTDs contributing to 12.5%
of global burden of diseases
 New technologies (vaccines, medicines and diagnostics) becoming
expensive
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WHO Global Observatory on Health Research and Development –
January 2017
 Goals:
- Consolidate, monitor and analyse information
- Building on existing data collection mechanisms
- Supporting co-ordinated actions on health R&D
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Contents of the Observatory:
1. Monitoring
2. Benchmarking
3. Tracking indicators
4. Analysis
5. Databases and resources
6. Classifications and standards
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Intersectoral action for health
“Alignment of intervention strategies and resources between actors
from two or more policy sectors in order to achieve complementary
objectives” (Health In All Policy)
Issues to be addressed:
 Improve interdisciplinary understanding
 Recognize and address conflicts of interests,
 Identify and revamp outdated health legislation,
 Generate rewards for health promotion and disease prevention.
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Intersectoral action for health
Strategic priorities:
 Linking public health policy with national development plan
 Development of population based policies
 Economic and legal levers for products associated with health risks
 Creating health promoting physical, social and economic environment
Role of health sector:
 Initiate actions, ensure linkage between national and local government
 Join up with initiatives and partner with authorities outside health
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India’s effort to progress towards SDG
 NITI Aayog – nodal agency for implementation of SDGs
 Ministry of Statistics and Programme Implementation –
mapping with ministries for goals and targets of SDGs
 Identification of indicators - Draft released in August 2017
 Participation in High-Level Political Forum (HLPF) 2017 for
Voluntary National Review (VNR) of Implementation of SDGs
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Source: NITI Aayog: Sustainable Development Goals

 Digital knowledge hub for capacity building – to capture best practices
across India
 National Consultation meeting with stakeholders at New Delhi (2016)
 State Consultation meeting under NITI Aayog – identify initiatives
taken at state level for implementation of SDGs (2018)
 Identification of 63 priority indicators for regular monitoring – SDG
index for state’s performance
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Source: NITI Aayog: Sustainable Development Goals

Health related priority indicators (13):
 Access to safe drinking water and sanitation;
 MMR, NMR, Under-5 MR
 Immunisation of under-2 children
 Incidence of HIV/AIDS, malaria and TB
 Medical personnel per 10,000 population
 Use of family planning methods
 Stunting and wasting in under-5 children
51
Source: NITI Aayog: Meeting with States/UTs: Improving Implementation of SDGs 23rd
Jan to 13th Feb 2018

Newer initiatives in line with SDG
 National Health Policy:
 Universalisation of primary health care,
 Reduction in MMR, IMR, U5MR
 Reduction in premature mortality due to NCDs
 Increasing government expenditure on health
 Full immunization coverage by 2020
52
Source: National Health Policy 2017

RMNCH:
 Pradhan Mantri Surakshit Matritva Abhiyan (2016) – Minimum antenatal
care package at 9th of every month
 Mission Indradhanush (2014) – to achieve full immunisation coverage of
children up to 2 years and pregnant women by 2020
 Indian Newborn Action Plan (2014) – To reach single digit NMR and SBR
by 2030
 Intensified diarrhea control fortnight (2017) – zero childhood deaths due to
diarrhea
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RMNCH:
 Mission Parivar Vikas (2017) – Better service delivery and improved
access to family planning services
 Expanding basket of choices in National Family Planning Program
 Injectable Contraceptive DMPA (Antara) – a 3-monthly injection
 Centchroman pill (Chhaya) – a non-hormonal once a week pill
 Progesterone-only pills (POP) – for lactating mothers
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Infectious diseases:
 National Strategic Plan to eliminate TB by 2025
 Revised Guidelines for RNTCP (2016)
 National Framework for Malaria Elimination (2016)
 National Strategic Plan for HIV/AIDS 2017-24
 “India Fights Dengue” app (2016)
 National Dengue Day – 16th May 2016
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Non communicable diseases:
 First country to adapt the Global Monitoring Framework on Non-communicable
diseases (2013) – Reduce premature mortality from NCDs by 25% by 2025
 Under NPCDCS, Establishment of new 356 district NCD cells and 356 district NCD
clinics
 Seventh Session of Conference of the Parties to the WHO framework Convention on
Tobacco control – November 2016
 mDiabetes initiative (2016) - create awareness regarding the illness
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Mental health:
 Mental Healthcare Act (2017)
- decriminalizing suicide and offer opportunities for rehabilitation
- Access to healthcare without discrimination
- Restricted use of ECT (emergency cases only); prohibited in minors;
- Empower persons suffering from mental illness to make their own decisions
- Responsibilities of police and stigma tackling measures outlined
- Setting up mental health establishments throughout the country
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Injuries and violence:
 National Road safety Policy (2010) – importance of creating awareness about
the various aspects of road safety, and its socio-economic implications and
developing a road safety information database
 Road Transport and Safety Bill (2010) - stronger punitive action and penalty
for traffic violations
 National Disaster Management Plan (2016) - focuses on disaster resilience
and integrates the Sendai Framework for Disaster Risk Reduction as well as
the SDGs
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Universal Health coverage and Health systems:
 National Health Protection Scheme – to provide financial assistance to below poverty
line people (1,00,000 per annum)
 Increase in the budget allocation of NRHM to improve infrastructure at district and
sub-district level
 Health Index initiative – Monitor state level performance of various health indicators
 Increase in postgraduate seats – for availability of adequately trained doctors
 Digitization of ICDS – to monitor service delivery
 Centre for Integrative Medicine and Research at AIIMS
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Environmental risks:
 Pradhan Mantri Ujjawala Yojana (2016) – LPG connection to below
poverty line families
 Addition of 10th target to reduce household air pollution in National
Monitoring Framework for Prevention and Control of NCDs (2013)
 National Rural Drinking Water Programme – Every rural person to get
adequate safe drinking water and accessible at all the times
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 Swachh Bharat Mission (2014) – to achieve universal sanitation
coverage by 2nd October 2019
 Swachh swasth sarvatra (2016) - build on and leverage achievements
of two complementary programmes – Swachh Bharat Mission (SBM)
and Kayakalp
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Way forward using success stories
RMNCH - Strengthening of Maternal Mortality statistics:
 Kazakhstan – specialized surveillance system and conducted
confidential enquiries into maternal deaths
 Process - Identifying and investigating cause of death of all women in
reproductive age group
 Source of data – CRVS data, verbal autopsy, household surveys, health
care facility records, burial records
 Advantage – improve accuracy, avoids misclassification, revise and
strengthen clinical guidelines
62
Source: World Health Statistics 2017: Country Success Stories

Infectious diseases – Reduction of malaria morbidity and mortality:
 Papua New Guinea – Mass distribution of insecticide treated nets
(ITN) as essential component
 Process – Distribution of ITN, Rapid diagnostic test, combination therapy
 Source of data – National Health Information System, Household survey,
health facility surveys
 Advantage – drop in parasite prevalence, reduce in the number of
malaria cases, increase in access to ITN, rapid diagnostic tests
63

Non communicable diseases and mental health:
 Prevention of alcohol use (Russia)
 Ban on alcohol advertising, increase in excise duties and MRP of spirits
and vodka, zero tolerance policy for drink-driving
 Decrease in per-capita pure alcohol intake by 3.5 litres over a decade
 Prevention of tobacco use (Uruguay)
 Only one variant of tobacco product, size of warning labels to 80%,
national surveys to monitor the impact
64

Injuries and violence:
 Adopting “Vision Zero” from Sweden which achieved 35% reduction
in fatalities since the implementation
 Reducing mortality due to air pollution (Ireland)
 Ban on smoky coal in Dublin (1990) and extended to other cities
 Decrease in mortality by 10% from 2000 to 2015
 Plan for nationwide implementation in 2018
65

Way forward
Universal Health Coverage:
 Establishment of Monitoring system/dashboards
 Regular reporting system at National and State level on SDG status
 Regular capacity development of identified stakeholders at district and
state level
 Functioning knowledge hub – SDG wise best practice
 Samavesh – Promoting Excellence for Transformative Policy Reform
66

Way forward
Universal Health Coverage and Health Systems:
 Increasing the government expenditure on health
 Convergence between programmes of different Ministries
 Vaccinations carried out in mission mode for all available vaccines
 Research and Development for innovation of low cost devices
 Access to super specialists through electronic network
 Local manufacture of pharmaceuticals
67
Source: India and SDGs: The Way Forward – Research and Information System for
Developing Countries

Way forward
State level initiatives:
 Identify indicators for schemes
 Identify data sources and nodal officials
 Analyse adequacy of current interventions
 Review performance of district on priority indicators
 Regular update to NITI Aayog regarding progress on priority
indicators and schemes
68

Way forward
State level initiatives adopted by some states:
 Separate Unit/Cell for implementation of SDGs
 Mapping of departments for SDG goals and targets
 Draft Vision and Action Plan for SDG
 Budgetary allocation for SDG
 Setting up of monitoring framework
 Consultations/Orientation/Training for implementation and monitoring
26-02-2023 69

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