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Implementation of health and health-related sustainable development goals: progress, challenges and opportunities – a systematic literature review
  1. Wafa Aftab1,
  2. Fahad Javaid Siddiqui2,3,
  3. Hana Tasic2,
  4. Shagufta Perveen1,
  5. Sameen Siddiqi1,
  6. Zulfiqar Ahmed Bhutta2,4
  1. 1Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
  2. 2Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3The Academia, Health Services and Systems Research, Duke-NUS Medical School, Singapore
  4. 4Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Zulfiqar Ahmed Bhutta; zulfiqar.bhutta{at}aku.edu

Abstract

Introduction While health is one of the Sustainable Development Goals (SDGs), many other ‘health-related’ goals comprise determinants of health. Integrated implementation across SDGs is needed for the achievement of Agenda 2030. While existing literature is rich in normative recommendations about potentially useful approaches, evidence of implementation strategies being adopted by countries is limited.

Methods We conducted a systematic review with qualitative synthesis of findings using peer reviewed and grey literature from key databases. We included publications examining implementation of health and health-related SDGs (HHSDGs) at national or subnational level published between June 2013 and July 2019.

Results Of the 32 included publications, 24 provided information at the national level while eight provided information for multiple countries or regions. Our findings indicate that high-level political commitment is evident in most countries and HHSDGs are being aligned with existing national development strategies and plans. A multisectoral, integrated approach is being adopted in institutional setups but evidence on effectiveness of these approaches is limited. Funding constraints are a major challenge for many countries. HHSDGs are generally being financed from within existing funded plans and, in some instances, through SDG-specific budgeting and tracking; additional funding is being mobilised by increasing domestic taxation and subsidisation, and by collaborating with development partners and private sector. Equity is being promoted by improving health service access through universal health coverage and social insurance schemes, especially for disadvantaged populations. Governments are collaborating with development partners and UN agencies for support in planning, institutional development and capacity building. However, evidence on equity promotion, capacity building initiatives and implementation approaches at subnational level is limited. Lack of coordination among various levels of government emerges as a key challenge.

Conclusion strengthening implementation of multisectoral work, capacity building, financial sustainability and data availability are key considerations to accelerate implementation of HHSDGs.

  • health policy
  • systematic review
  • public health
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Footnotes

  • Handling editor Seye Abimbola

  • Twitter @Wafaftb, @fjsepi

  • Contributors ZAB conceptualised the study. SS, ZAB, WA and FJS developed methodology. WA, FJS, SP and HT facilitated data collection and organisation. WA, SP, FJS and HT conducted the analysis. WA and FJS drafted the manuscript and ZAB, SS, SP and HT critically revised it. All authors approved the final version.

  • Funding As coordinator of the BRANCH Consortium (Bridging Research and Action in Conflict Settings for the Health of Women and Children), the SickKids Centre for Global Child Health has received funding for BRANCH research activities, including this systematic review, from the International Development Research Centre (IDRC) (108416-002 and 108640-001), the Norwegian Agency for Development Cooperation (Norad) (QZA-16/0395), the Bill & Melinda Gates Foundation (OPP1171560), and UNICEF (PCA 20181204). Aga Khan University has received funding for BRANCH activities from the Family Larsson-Rosenquist Foundation.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was not required for this systematic review of the published literature.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The datasets generated and/or analysed during the study are available from the corresponding author on reasonable request.