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Sustainable Development Goals indicator list does not fully measure health impoverishment

Author: Kate Jackson, ehospice
02 March 2016

The final list of proposed indicators to measure progress towards the Sustainable Development Goals (SDGs) has been published by the UN Inter-Agency and Expert Group (IAEG) on Sustainable Development Goal (SDG) Indicators.

The final list for consideration by the Statistical Commission of the UN Economic and Social Council was released last Friday, 26 February. The indicator measuring coverage of essential health services has been included, although the indicator measuring health impoverishment has been removed. 

In place of the health impoverishment indicator, the framework will measure the “number of people covered by health insurance or a public health system.”

According to Universal Health Coverage (UHC) advocates, this new indicator does not guarantee financial risk protection, does not ensure the poorest are prioritised, and does not have a universal definition that applies for all countries.  

The Worldwide Hospice Palliative Care Alliance (WHPCA), along with the International Association for Hospice and Palliative Care, and the International Children’s Palliative Care Network, released a report last year entitled: ‘Palliative Care and the Global Goal for Health’.

The report made recommendations for the inclusion of palliative care within the Global Goal for Health, and illustrated how this Goal and accompanying targets could support a focus on improving palliative care for people with life-threatening and life-limiting illness globally.

A key aspect of the report is UHC, including financial risk protection. The report argued that: “People should not face poverty or financial hardship because they need to access essential health care services.”

The authors noted that: “financial risk occurs through paying for costly treatment not covered by national health insurance, loss of income by the person who is ill or their carers, or costly travel when treatment and care services are situated far away from the family home.”

Many factors contribute to health impoverishment, and relying on an indicator that measures only one aspect of this complex problem is inadequate.

UHC advocates have drafted a letter urging the IAEG to revert to an earlier indicator measuring how many people are impoverished paying for health.

The letter was sent earlier today, 29 February, and will be supplemented with further advocacy.

Dr Stephen Connor, WHPCA Executive Director, said: “The WHPCA has signed on to the letter protesting this change, which does not address the severe financial and real-world impact that life limiting illness can have on patients and their families.”

You can join the Global Coalition for Universal Health Coverage by visiting the UHC Day website.

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