Monitoring of action on the social determinants of health and Sustainable Development Goal indicators
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1 Monitoring of action on the social determinants of health and Sustainable Development Goal indicators Frank Pega Dept of Public Health, Environmental & Social Determinants of Health
2 Overview Monitoring action on the social determinants of health (SDH) Policy and evidence base rationales SDH action indicators: a typology SDH action indicators in monitoring systems: a global stock take Sustainable Development Goal (SDG) indicators for SDH action SDG indicator system: introduction SDG indicators for SDH action Towards a WHO SDH action monitoring system
3 Monitoring of action on the social determinants of health
4 Policy frameworks: action on SDH 2008 Commission on Social Determinants of Health Final Report 1. Improve daily living conditions 2. Tackle the inequitable distribution of power, money, and resources 3. Measure and understand the problem and assess the impact of action CSDH Rio Political Declaration on the Social Determinants of Health 1. Adopt better governance 2. Promote participation 3. Further reorient the health sector 4. Strengthen global governance 5. Monitor progress WHO 2011
5 Policy frameworks: action on SDH 2008 Commission on Social Determinants of Health Final Report 1. Improve daily living conditions 2. Tackle the inequitable distribution of power, money, and resources 3. Measure and understand the problem and assess the impact of action CSDH Rio Political Declaration on the Social Determinants of Health 1. Adopt better governance 2. Promote participation 3. Further reorient the health sector 4. Strengthen global governance 5. Monitor progress WHO 2011
6 Policy frameworks: action on SDH 2008 Commission on Social Determinants of Health Final Report 1. Improve daily living conditions 2. Tackle the inequitable distribution of power, money, and resources 3. Measure and understand the problem and assess the impact of action CSDH Rio Political Declaration on the Social Determinants of Health 1. Adopt better governance 2. Promote participation 3. Further reorient the health sector 4. Strengthen global governance 5. Monitor progress WHO 2011
7 Conceptual framework: action on SDH CSDH 2008
8 Conceptual framework: action on SDH CSDH 2008
9 Policy rationale for SDH action monitoring Year Recommendation 2008 Commission on Social Determinants of Health: final report nd World Health Assembly (194 countries): Resolution countries: Parma Declaration on Environment and Health countries: Rio Political Declaration on the Social Determinants of Health th World Health Assembly (194 countries): Rio Political Declaration in Resolution WHO European Regional Office: European Review of Social Determinants of Health and the Health Divide th World Health Assembly (194 countries): Resolution Pega under review
10 Evidence base rationale for SDH action monitoring Considerable body of evidence on social policies and programmes More evidence needed on: human rights frameworks governance structures and mechanism environmental policies and programmes Pega under review
11 SDH-focused indicators: typology Pega under review
12 SDH action indicators: typology Pega under review
13 SDH action indicators: typology Pega under review
14 SDH action indicators in international health monitoring systems 38% no indicators 23% 1 or 2 indicators 38% 3 or more indicators Pega under review
15 SDH action indicators in national health monitoring systems 30% no indicators 40% 1 or 2 indicators 30% 3 or more indicators Pega under review
16 Sustainable Development Goal indicators for SDH action
17 The SDGs: A game changer UN 2015
18 SDG indicators 17 goals, 169 targets, 230 indicators Most indicators finalised Several co-indicators for two or more targets (multisectoral action) Data availability preliminarily judged Guardian agencies identified UN 2016
19 SDG indicators for SDH action 42 relevant indicators Types of interventions: governance (67%), environmental (21%), and social (12%) Domains: education (17%), gender equality (17%), sanitation (12%), and climate change (12%) Action areas, Rio Political Declaration: 1 national governance (57%), 2 community participation (7%), 3 health sector reorientation (0%), 4 global governance (26%), 5 monitoring (12%) 93% of indicators not MDG indicators Data availability: Tier I (38%), Tier II (19%), and Tier III (43%) Pega under review
20 Towards the WHO SDH Action Monitoring System
21 WHO SDH Action Monitoring System Need for the monitoring system Policy and evidence base rationale provided SDH actions not currently regularly monitored Structure of monitoring system the 5 domains according to 5 action areas of Rio Political Declaration Basket of core indicators for SDH-focused interventions Indicators interlinking action on the SDH and SDGs First global monitoring report in 2017
22 Conclusions
23 Conclusions Need to monitor SDH action SDH action indicators: Human rights interventions Governance structures and mechanisms Social policies and programs Environmental policies and programs SDH-focused health monitoring systems do not currently commonly include SDH action indicators 42 novel SDG indicators for SDH action WHO has committed to SDH action monitoring, with a first monitoring report in 2017
24 References Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: WHO. Pega F, Valentine N, Rasanathan K, et al (under review) Sustainable Development Goal indicators for action on the social determinants of health: fostering multisectoral partnerships using a Health in All Goals lens UN General Assembly (2015) Transforming our world: the 2030 Agenda for Sustainable Development (Resolution 70/1). New York, NY: UN. United Nations Economic and Social Council. Report of the Inter-agency and Expert Group on Sustainable Development Goal Indicators. New York, NY: United Nations Economic and Social Council, WHO (2012) Rio Political Declaration on the Social Determinants of Health. Rio de Janeiro, Brazil: WHO.
25 Monitoring action on the social determinants of health and Sustainable Development Goal indicators Frank Pega, PhD Dept of Public Health, Environmental & Social Determinants of Health
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