Sustainable Development Goals

The objective of this study was to describe the conceptual and implementation approach of selected digital health technologies that were tailored in various resource-constrained countries. Drawing from our multi-year institutional experience in more than 20 high disease-burden countries that aspire to meet the 2030 United Nations Sustainable Development Goal 3, we screened internal project documentation on various digital health tools that provide clarity in the conceptual and implementation approach. Taking into account geographic diversity, we provide a descriptive review of five selected case studies from Bangladesh (Asia), Mali (Francophone Africa), Uganda (East Africa), Mozambique (Lusophone Africa), and Namibia (Southern Africa). A key lesson learned is to harness and build on existing governance structures. The use of data for decision-making at all levels needs to be cultivated and sustained through multi-stakeholder partnerships. The next phase of information management development is to build systems for triangulation of data from patients, commodities, geomapping, and other parameters of the pharmaceutical system. A well-defined research agenda must be developed to determine the effectiveness of the country- and regional-level dashboards as an early warning system to mitigate stock-outs and wastage of medicines and commodities.

The Global Burden of Disease 2015 article on maternal mortality by Nicholas Kassebaum and colleagues (Oct. 8, p. 1775) contains a serious error reflecting a basic misunderstanding of the Sustainable Development Goal (SDG) target for maternal mortality. The report states that “only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1”. This is a dangerous and inaccurate interpretation of the global goal. The SDG target is a global target, not a country target. To achieve the global target for maternal mortality reduction requires every country to reduce its national maternal mortality ratio from baseline by two-thirds in that timeframe. It is probably safe to assume that no country has succeeded in reducing its maternal mortality ratio by two-thirds since the SDGs were launched in September 2015.

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