tag:theconversation.com,2011:/uk/topics/mdgs-31541/articlesMDGs – The Conversation2019-02-26T14:34:49Ztag:theconversation.com,2011:article/1121562019-02-26T14:34:49Z2019-02-26T14:34:49ZHow Africa can catch up with the world in the fight against poverty<figure><img src="https://images.theconversation.com/files/260981/original/file-20190226-150694-4fflj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Mali one of the world's poorest countries would take about 31 years to eradicate poverty.</span> <span class="attribution"><span class="source">EPA/Nic Bothma</span></span></figcaption></figure><p>The world is making remarkable progress in combating poverty. From 2000 to 2013, the portion of the world’s population living on less than the international poverty line of US$1.90 a day fell from <a href="https://ourworldindata.org/poverty-at-higher-poverty-lines">28.5 % to 10.7 %</a>. That’s about <a href="https://www.theguardian.com/global-development/2015/jul/06/united-nations-extreme-poverty-millennium-development-goals">one billion</a> people lifted out of poverty. </p>
<p>In 2000 the United Nations launched the <a href="https://sustainabledevelopment.un.org/post2015/transformingourworld">Millennium Development Goals</a>, a coordinated international effort to eradicate poverty and raise living standards worldwide by 2030. </p>
<p>An even more ambitious global effort to eradicate poverty, called the <a href="https://sustainabledevelopment.un.org/post2015/transformingourworld">Sustainable Development Goals</a> was adopted in September 2015. This also seems to be producing significant results. An estimated <a href="https://www.nature.com/articles/s41599-018-0083-y">83 million people</a> have escaped extreme poverty in the first three years after the goals were adopted – between January 2016 and July 2018. </p>
<p>At the same time, there’s been a dramatic shift in the geography of poverty around the world. </p>
<p>Today, extreme poverty is <a href="https://nordic.businessinsider.com/poorest-countries-in-the-world-2018-5/">mostly around Africa</a>, where 23 of the world’s 28 poorest countries are found. These countries have <a href="http://www.worldbank.org/en/publication/poverty-and-shared-prosperity">poverty rates above 30%</a>. </p>
<p><a href="https://www.nature.com/articles/s41599-018-0083-y">Poverty projections</a> up to the year 2030 (the end of the Sustainable Development Goals) suggest that even under the most optimistic scenario, over 300 million people in sub-Saharan Africa will still be in extreme poverty. Thus success in poverty eradication under these goals will depend crucially on what happens in Africa.</p>
<p>According to our research, the adoption of the goals <a href="https://www.who.int/topics/millennium_development_goals/en/">in 2000</a> played a significant part in accelerating the process of poverty reduction in the world. The implementation of antipoverty programmes and poverty reduction strategies in individual countries became a routine part of national development plans. But, there was considerable disparity in how different countries responded to the development goals as well as in their capacity to implement these plans.</p>
<p>In the early 1990s, African countries such as Nigeria, Lesotho, Madagascar, and Zambia had <a href="https://www.sciencedirect.com/science/article/pii/S0305750X17304035">similar poverty levels</a> to those of China, Vietnam and Indonesia. Yet, this group has been successful in reducing poverty, while the African countries haven’t. </p>
<p>So, why this disparity and how can poverty reduction in Africa be accelerated?</p>
<h2>Poverty trends</h2>
<p>We <a href="https://www.sciencedirect.com/science/article/pii/S0305750X17304035">looked at poverty trends</a> in the developing world between 1990 and 2013. Using standard income poverty measures expressing the part of the population living on less than $1.25 and $1.90 a day, we found that poverty tended to fall faster in more poverty-ridden countries.</p>
<p>Good news? Yes, but such progress, although significant, doesn’t imply that the end of poverty is in sight everywhere. For example, if trends continue in a poverty-ridden country such as Mali, where <a href="https://www.sciencedirect.com/science/article/pii/S0305750X17304035">86.08% of people</a> were living below $1.25 a day in 1990, it would take about 31 more years to eradicate extreme poverty altogether.</p>
<p>And, even a much less poor economy like Ecuador (where 6.79% people lived on less than $1.25 a day in 1990) is predicted to take about 10 more years to eradicate extreme poverty altogether.</p>
<h2>State capacity</h2>
<p>Our research identifies a crucial role for state capacity in differing levels of poverty reduction. Sub-Saharan African states often suffer from limited institutional capability to carry out policies that deliver benefits and services to citizens. In other words, they have <a href="https://doi.org/10.1016/j.worlddev.2008.06.001">limited state capacity</a>. </p>
<p>Building state capacity depends on many variables. It is greater when ruling elites are subject to effective limits on the exercise of their power through institutionalised checks and balances. It’s also greater in countries with a longer history of statehood. For example, China, an experienced state which is centuries old, may have developed a greater ability to administer its territory - through <a href="https://link.springer.com/article/10.1023/A:1020827801137">learning by doing</a>. It has thus become more effective at delivering on policies compared to less experienced African states.</p>
<p>And our own research suggests that countries with the most effective governments reduced income poverty at up to twice the speed than countries with the weakest states. </p>
<h2>Fighting poverty in Africa</h2>
<p>The weaknesses of a state affects the fight against poverty in a number of ways.</p>
<p>Firstly, fighting poverty requires direct policy interventions. Yet poorer African countries are less effective in reaching their poor. For example, governments in sub-Saharan Africa don’t have the data and administrative know-how necessary for <a href="https://voxeu.org/article/informational-constraints-antipoverty-programmes">reliably identifying their poor</a>. This means they can’t target resources to them. Anti-poverty programmes in countries such as Malawi, Mali, Niger and Nigeria miss many of their poorest households.</p>
<p>The growing evidence on the gaps in state capacity and the importance of effective states for poverty reduction implies that, without significant improvement in governance, Africa may fall further behind in meeting the first sustainable development goal target of <a href="https://sustainabledevelopment.un.org/sdg1">ending poverty</a>. </p>
<p>To accelerate the end of poverty, African states should focus on developing enough capability for designing and delivering poverty reduction strategies. Implementing these reforms is vital. After all, improving the quality of government is not only important to accelerating poverty reduction. It’s also a <a href="https://sustainabledevelopment.un.org/sdg16">development goal in itself</a>.</p><img src="https://counter.theconversation.com/content/112156/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>M Niaz Asadullah receives funding from DfID Research Programme. He is affiliated with the Global Labor Organisation (GLO). </span></em></p><p class="fine-print"><em><span>Antonio Savoia receives funding from DfID. </span></em></p>Countries with effective governments have reduced income poverty by almost twice the speed.M Niaz Asadullah, Professor of Development Economics, University of MalayaAntonio Savoia, Senior Lecturer in Development Economics, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/732812017-03-02T07:51:17Z2017-03-02T07:51:17ZHow microfinance reduces gender inequality in developing countries<p>An increase in the proportion of women accessing microfinance services by just 15% could potentially reduce gender inequality, as measured by the <a href="http://hdr.undp.org/en/content/gender-inequality-index-gii">Gender Inequality Index</a>, by half in the average developing nation. The finding comes from a recent study published in <a href="http://www.tandfonline.com/doi/full/10.1080/13504851.2017.1287851">Applied Economics Letters</a> that also found that cultural characteristics can influence this relationship.</p>
<p><a href="http://www.un.org/womenwatch/osagi/conceptsandefinitions.htm">Gender equality</a> refers to the rights, responsibilities and opportunities of women and men, girls and boys. It does not imply that women and men are the same, but that the interests, needs and priorities of both women and men should be taken into consideration while recognising diversity across different populations.</p>
<p>While the world has achieved progress towards gender equality under the UN’s <a href="http://www.un.org/millenniumgoals">Millennium Development Goals</a>, women and girls continue to suffer discrimination and violence in many parts of the world. </p>
<p>Take girl’s education for example, <a href="http://www.un.org/sustainabledevelopment/wp-content/uploads/2016/08/5_Why-it-Matters_GenderEquality_2p.pdf">only 74 girls were enrolled in primary school for every 100 boys in 1990 in southern Asia</a>. By 2012, enrolment had ratios remained the same.</p>
<p>Girls also face barriers to entering both primary and secondary school in sub-Saharan Africa, Oceania and western Asia. Disadvantages in education translate into a lack of skills and limited opportunities in the labour market. In northern Africa, for instance, women hold <a href="http://www.un.org/sustainabledevelopment/wp-content/uploads/2016/08/5_Why-it-Matters_GenderEquality_2p.pdf">less than one in five paid jobs</a> in the non-agricultural sector.</p>
<h2>Microfinance and gender inequality</h2>
<p><a href="http://www.pbs.org/now/enterprisingideas/Muhammad-Yunus.html">Microfinance gets its popularity and fame from Mohammad Yunus</a>, who began experimenting with lending to poor women in the village of Jobra, Bangladesh, during his tenure as a professor of economics at Chittagong University, in the 1970s. In 2006, he <a href="https://www.nobelprize.org/nobel_prizes/peace/laureates/2006">won the Nobel Peace prize</a> for pioneering the concepts of microfinance and establishing the Grameen Bank in 1983.</p>
<p>Since then, various forms of microfinance programs have been <a href="https://economie.rabobank.com/PageFiles/3584/access_tcm64-75165.pdf">introduced in many countries</a>. </p>
<p>Generally speaking, <a href="http://www.microcreditsummit.org/what-is-microfinance2.html">microfinance</a> is the extension of small loans to the very poor, in combination with other financial services such as saving facilities, training, health services, networking, and peer support. This enables people to pursue entrepreneurial projects that generate extra income, thus helping them to better provide for themselves and their families.</p>
<p>The last 30 years have shown that <a href="http://digitalcommons.law.umaryland.edu/cgi/viewcontent.cgi?article=1108&context=rrgc">microfinance is a proven development tool</a> capable of providing a vast number of the poor, particularly women, with sustainable tailored financial services that enhance their welfare. </p>
<p>According to <a href="https://stateofthecampaign.org/data-reported">Microcredit Summit Campaign Report 2015</a>, 3,098 microfinance institutions had reached over 211 million clients by 2013, 114 million of whom were living in extreme poverty. Of these poorest clients, 82.6%, or over 94 million, were women. </p>
<p>Conceptually, microfinance enables poor women to engage in income-generating activities that help them become financially independent, strengthening their decision-making power within the household and society. It is through this channel <a href="http://www.journals.uchicago.edu/doi/abs/10.1086/503580">that economists argue</a> that microfinance has the potential to reduce gender inequality. </p>
<p>But country-level community-based microeconomic research from across the developing world <a href="http://www.tandfonline.com/doi/abs/10.1080/13552070512331332273">both supports</a> and <a href="http://s3.amazonaws.com/academia.edu.documents/31087316/sp03ma10.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1488351447&Signature=CGOWuonU3TA%2BiXJ%2FpTOFxbhQ8qY%3D&response-content-disposition=inline%3B%20filename%3DThe_influence_of_microfinance_on_the_edu.pdf">contradicts this premise</a>. Given this inconclusive evidence, we thought a macroeconomic approach that pulls information from many countries together might provide a clearer picture. </p>
<h2>Evidence from around the world</h2>
<p>Our study uses data from 64 developing countries from between 2003 and 2014 to examine general international trends and patterns on gender inequality and microfinance.</p>
<p>Gender inequality is measured with two popular indicators from the UN: <a href="http://hdr.undp.org/en/content/gender-development-index-gdi">Gender Development-related Index</a> (GDI) and <a href="http://hdr.undp.org/en/content/gender-inequality-index-gii">Gender Inequality Index</a> (GII). These are composite indices based on measures of differences in health, education, living standards, empowerment, and economic status. </p>
<p>The key variable of significance in our analysis is a gendered indicator of microfinance usage, defined as the proportion of female clients as a share of the total national population. We constructed this measure using microfinance data from <a href="http://www.themix.org/mixmarket">MIX Market</a>, a microfinance auditing firm. </p>
<p>We found evidence of a negative relationship between women’s participation in microfinance and gender inequality. In other words, we found that gender inequality will potentially decrease when women’s participation increases. As noted above, in the average developing nation, an increase in microfinance by around 15% is associated with a decline in gender inequality by about half. </p>
<p>But we also found that cultural characteristics that govern the relationships between men and women can potentially influence this relationship. For example, pressure on women to take on cooking and rearing responsibilities within the home could potentially limit their ability to fully adopt employment opportunities through microfinance-generated investments. </p>
<p>That religion does not necessarily play a role in explaining the interaction between microfinance and gender inequality is another one of our findings. Instead, national conservatism and microfinance firms’ adoption of culturally-appropriate local practices potentially does. Many firms acknowledge the difficulties associated with women working outside the house in certain communities, for instance, so they help women establish small businesses at home, sometimes pulling resources together across households.</p>
<h2>Policy implications</h2>
<p>More microcredit in developing nations then is clearly good news for women. Since gender inequality is measured as composite indices of health, education and income indicators, it’s natural to conclude that greater access to credit in women’s hands will mean greater access to education and health as well as income-generating opportunities. </p>
<p>Given these positive outcomes, governments and international organisations in developing nations should continue to promote microcredit institutions to indirectly empower women. But they must keep in mind that microfinance does not automatically empower women. </p>
<p>Country-specific and cultural factors play a key role in determining how microfinance interacts with gender inequality. And these should be considered when assessing the impact of microcredit in the developing world.</p><img src="https://counter.theconversation.com/content/73281/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Providing women with credit improves gender inequality.Quanda Zhang (Samuel), PhD Candidate in Economics, RMIT UniversityAlberto Posso, Associate Professor of Economics, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/718812017-01-26T07:51:05Z2017-01-26T07:51:05ZTrump’s ‘global gag rule’ will cause more abortions, not fewer<p>Two days after large numbers of <a href="https://theconversation.com/women-marching-worldwide-revive-a-long-sought-dream-global-feminism-71777">people across the globe joined Woman’s Marches</a>, US President Donald Trump <a href="http://www.newyorker.com/news/daily-comment/trump-makes-the-global-gag-rule-on-abortion-even-worse">reinstated the “global gag rule”</a>, which cuts off all US funding to international NGOs whose work includes abortion services or advocacy.</p>
<p>Fortunately, <a href="http://www.abc.net.au/news/2017-01-26/netherlands-government-launches-global-abortion-fund/8213744?WT.mc_id=newsmail&WT.tsrc=Newsmail">the Dutch government has announced a plan to compensate NGOs</a> for the funding shortfall of US$600 million over four years. Several countries within and outside the EU have indicated their support, as have private companies and foundations. </p>
<p>But it remains to be seen whether this ambitious target will be reached and what other needs will be left unmet as a result of any redirected funds. </p>
<p>Dutch Minister for International Development Co-operation, Lilianne Ploumen, who <a href="https://www.theguardian.com/global-development/2017/jan/25/netherlands-trump-gag-rule-international-safe-abortion-fund?utm_source=esp&utm_medium=Email&utm_campaign=Australia+Morning+mail+new+030615&utm_term=210232&subid=2689150&CMP=ema_1731">announced the initiative, said</a>, “I’m pro-choice and pro-women’s rights. It’s important to stand your ground.”</p>
<p>But as welcome as efforts towards replacing the funding lost to the global gag rule is, it’s important to realise that this is not a pro-life debate. It’s a global health issue that has serious implications for the most vulnerable populations – millions of men, women and children in developing countries.</p>
<h2>Threat to services</h2>
<p>Also known as the Mexico City policy, the global gag rule requires all NGOs operating abroad to refrain from advising, endorsing or performing abortions as a method of family planning. However, some NGOs operate in contexts where abortion – safe or unsafe – is the only accessible form of contraception.</p>
<p>Many international NGOs are working hard to increase access to both short-term and long-term contraception. But such a transition takes time and money.</p>
<p>NGOs that may be forced to reduce or close health services as a result of the policy are often a woman’s only source of reproductive health care. They may, in fact, be her family’s only point of medical contact for other primary health-care services, such as cervical screening, HIV prevention, testing and counselling, STI prevention and treatment, pre and post-natal care and even newborn health care.</p>
<p>Services threatened by the policy also train health professionals, including midwives and traditional birth attendants, in countries that are desperately short of qualified health personnel.</p>
<p>Most developed countries have <a href="http://www.who.int/whr/2006/06_chap1_en.pdf">33 health professionals per 10,000 people</a>; most developing countries have two health professionals for the same number of people. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4249206/">Research also shows</a> that unattended births have much higher rates of maternal and newborn death.</p>
<h2>Unintended consequences</h2>
<p>The rule was first put into place by former <a href="http://kff.org/global-health-policy/fact-sheet/mexico-city-policy-explainer/">US president Ronald Reagan in August 1984</a>. Since then, it has been lifted by Democratic presidents and reinstated by Republican presidents. </p>
<p>Unlike when Reagan implemented the policy, we now have ample evidence of its unintended health consequences. <a href="http://www.who.int/bulletin/volumes/89/12/11-091660/en/">A 2011 study showed</a>, that women were 2.73 times more likely to have an abortion under the rule. So while its intention may be to reduce the rate of abortion, the policy actually increases it.</p>
<p>Reducing access to family planning services leads to more unplanned pregnancies, more unsafe abortions and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709326/">more maternal death</a>. </p>
<p>The sexual and reproductive health research organisation, the Guttmacher Institute, quantified this in 2016. <a href="https://www.guttmacher.org/article/2016/05/just-numbers-impact-us-international-family-planning-assistance">It showed that when US$607.5 million is cut</a> from family planning and reproductive health services, 27 million women and couples are prevented from receiving family planning services and supplies. This leads to six million more unplanned pregnancies and 2.3 million more abortions, two million of which will be unsafe.</p>
<p>This may not mean much in a developed country, where deaths resulting from pregnancy and childbirth are 12 women per 100,000 live births. But it will have a huge impact on women in developing countries, where the maternal mortality rate is <a href="http://www.who.int/mediacentre/factsheets/fs348/en/">239 women per 100,000 live births</a>, and where 99% of total global maternal deaths occur.</p>
<p>In 2000, 189 countries including the United States, committed to the <a href="http://www.un.org/millenniumgoals/mdgmomentum.shtml">Millennium Development Goals</a>. These included a <a href="http://www.un.org/millenniumgoals/maternal.shtml">commitment to improving maternal health</a> by reducing maternal mortality and providing access to reproductive health services by 2015. This was one of the least successful Millennium Development Goals, <a href="http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20%28July%201%29.pdf">falling short by half</a>.</p>
<h2>Falling short</h2>
<p>While the <a href="https://www.theguardian.com/global-development/2015/apr/08/foreign-aid-spending-2014-least-developed-countries">US ranks 19th</a> worldwide as an international aid donor in terms of percentage of gross national income, USAID is the largest humanitarian donor in dollar terms. It <a href="http://humanitarianadvisorygroup.org/trump-and-humanitarianism/">allocated in excess of $USD6.42 billion</a> to humanitarian aid in 2015. </p>
<p>This means the global gag rule seriously threatens the UN Sustainable Development Goal of <a href="http://www.unwomen.org/en/news/in-focus/women-and-the-sdgs/sdg-3-good-health-well-being">reducing maternal mortality</a> to less than 70 per 100,000 live births by 2030. It also threatens the goal of ensuring access to sexual and reproductive health-care services, including family planning, information and education.</p>
<p>The rule targets family planning, which is essentially about spacing out childbirth. The health and economic benefits of child spacing are well documented and include <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785173/">reduced pregnancy-related deaths and better child survival</a>. Then, <a href="http://apps.who.int/iris/bitstream/10665/69855/1/WHO_RHR_07.1_eng.pdf">there’s reduced rates of HIV/AIDS</a>, and sexually transmitted infections, empowerment of women, enhanced education and a reduction in adolescent pregnancy.</p>
<p>These benefits lead to more advantages, including slowed population growth, natural resource conservation, climate change mitigation and economic growth, which reduces conflict and migration.</p>
<h2>The wrong debate</h2>
<p>Forcing impoverished women – in places where they have no access to health care or contraception – to have more babies has a <a href="https://www.adb.org/sites/default/files/publication/157217/adbi-rp68.pdf">detrimental impact on the entire family</a>. It places demands on scarce resources, reduces access to education, limits employment options, reduces family income and ultimately reinforces the poverty cycle.</p>
<p>The regions predicted to experience the largest population growth in the coming decades (<a href="http://www.mbctimes.com/english/india-and-nigeria-countries-with-the-fastest-growing-populations">South Asia and Africa</a>) are also the most impoverished. They have the weakest health-care systems and rely on foreign aid to provide essential services. </p>
<p>Their only hope for economic development and poverty eradication is to <a href="https://www.populationeducation.org/content/what-demographic-transition-model">undergo the demographic transition</a>, which high-income countries have already experienced. And this starts with a reduction in family size. Anyone who has worked in reproductive health in developing countries will tell you that this is what impoverished women with large families want.</p>
<p>So let’s get it right: this is not a high-income country, religiously charged pro-life debate. The global gag rule actually increases abortion demand and has consequences for a range of other health issues such as HIV/AIDS, cervical cancer and child health and well-being. </p>
<p>This misinformed, short-sighted policy is as far removed from scientific evidence as denying climate change. As a global community, we have a duty to expand access to family planning for people worldwide, particularly to the most vulnerable.</p><img src="https://counter.theconversation.com/content/71881/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Patricia Schwerdtle is an association member of MSF-Australia. </span></em></p>Also known as the Mexico City policy, the rule increases abortion demand and has consequences for a range of other health matters such as HIV/AIDS, cervical cancer and child health and well-being.Patricia Nayna Schwerdtle, Academic, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/710332017-01-16T15:19:35Z2017-01-16T15:19:35ZHow Africa can perform better in the new round of UN development goals<figure><img src="https://images.theconversation.com/files/152880/original/image-20170116-19298-ofmmx7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Former UN Secretary-General Ban Ki-moon is guided through Mbalmayo, Cameroon, a town where residents are engaged in projects to further the MDGs. </span> <span class="attribution"><span class="source">UN Photo/Eskinder Debebe</span></span></figcaption></figure><p>The aim of the United Nations <a href="https://sustainabledevelopment.un.org/post2015/transformingourworld">Sustainable Development Goals</a> is to transform lives around the world over the next 13 years. The <a href="https://sustainabledevelopment.un.org/post2015/transformingourworld">2030 agenda</a> includes commitments to 17 goals and 169 targets in tackling sustainable development challenges. These challenges are mainly in the developing world, particularly in Africa.</p>
<p>The agenda sends a strong signal that efforts are underway to help tackle the biggest challenges in the world. These include climate change, poverty, diseases, energy crisis, food insecurity and water scarcity. </p>
<p>The SDGs were agreed once the time-frame for the <a href="http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf">Millennium Development Goals</a> had come to an end.</p>
<p>African countries failed to meet a number of the <a href="http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf">Millennium Development Goals</a>. For example, it was the only continent that failed to halve extreme poverty by 2015. The continent is home to the largest number of <a href="https://ourworldindata.org/world-poverty/">poor people on earth</a>. But the poverty rate in Eastern Asian countries declined from 61% in 1990 to <a href="http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf">4% in 2015</a>. </p>
<p>This leaves a fundamental question: Why were some of the MDGs, such as the targets around poverty, not achieved and what does it mean for the implementation of the SDGs? </p>
<h2>Failures and successes</h2>
<p>Several factors contributed to the inability of many African countries to achieve MDGs. These included low income earnings, weak institutions, lack of infrastructure and poor governance. </p>
<p>Another key problem was that the MDGs were shaped by western models. African countries were expected to adopt western values as well as technologies and financial structures. Many had to lean on their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877943/pdf/rgph8_1109.pdf">development assistance to achieve growth</a>.</p>
<p><a href="http://www.sciencedirect.com/science/article/pii/S0305750X08001022">Scholars have argued</a> that meeting the targets was impossible without key areas being strengthened. These include democracy, infrastructure, industry, science, technology and the transformation of agriculture. </p>
<p>That’s not to say that the MDGs were wholly unsuccessful. The vast majority of African leaders welcomed the <a href="http://www.un.org/press/en/2015/ga11708.doc.htm">impact that they had</a>. For example, Rwanda has emphasised the significance of the MDGs in lifting one million people out of poverty <a href="http://www.un.org/press/en/2015/ga11708.doc.htm">in the country</a>. </p>
<p>But some were unconvinced about the processes that led to the targets being set up. One of the key criticisms is that the most African countries were bound to fail due to a lack of proper support for the <a href="http://www.sciencedirect.com/science/article/pii/S0305750X08001022">implementation of the MDGs</a>.</p>
<p>For example, African countries that received financial support from donors were those with relatively good institutions and democratic structures. Many, however, could not fulfil <a href="https://www.die-gdi.de/uploads/media/BP_15.2010.pdf">conditions required to attract finance</a>.</p>
<p>If the SDGs continue to be built on the same platform, it’s safe to say that they won’t be successful. Change is needed, particularly to the prevalent <a href="http://www.sciencedirect.com/science/article/pii/S0305750X08001022">top-down approach which is seen as biased and unfair</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/152858/original/image-20170116-27898-l6qpr8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Mobile health workers in Ethiopia. The country offers lessons on health success for other African nations.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/unicefethiopia/31243838020/in/dateposted/">Flickr/UNICEF Ethiopia</a></span>
</figcaption>
</figure>
<h2>Lessons from the previous round</h2>
<p>The first significant change that needs to happen is recognition that there are substantial differences – in relation to capacity, infrastructure and finance – between countries. </p>
<p>A good place to start would be to identify success stories and to work out how these can be replicated and what could be done differently. </p>
<p>For example, weak health system and poor delivery of health services continue to aid the spread of major diseases like <a href="https://www.ncbi.nlm.nih.gov/pubmed/19461091">malaria, tuberculosis and HIV/AIDS</a>. This made it difficult to achieve MDG goals to reduce child mortality, improve maternal death and combat HIV, malaria and other diseases.</p>
<p>But some countries did make significant progress. These included Ethiopia, Rwanda, Malawi, South Africa, Mauritius and Ghana. Ethiopia achieved the target of reducing HIV/AIDs prevalence between <a href="http://reliefweb.int/report/ethiopia/ethiopia-millennium-development-goals-report-2014-assessment-ethiopia-s-progress">15 and 49-year olds</a>. </p>
<p>For its part South Africa also <a href="http://beta2.statssa.gov.za/wp-content/uploads/2013/10/MDG_October-2013.pdf">achieved goals</a> on universal primary education, antenatal care coverage and complete control of malaria. </p>
<p>Ethiopia and South Africa could provide lessons for other African countries on how they can achieve the new round of goals, particularly relating to health. </p>
<p>North Africa was the only region in Africa that met the target on <a href="http://www.un.org/africarenewal/magazine/august-2010/africa%E2%80%99s-hard-road-millennium-development-goals">access to clean water</a>. Other African countries could take cues from this region on how to increase access to improved drinking water and sanitation.</p>
<p>But there is a deeper problem that African countries need to address – the lack of reliable data to assess whether goals have been attained. In fact, 61% of African countries do not have adequate data to monitor the progress on poverty reduction and <a href="http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf">other related MDG targets</a>. This makes it difficult to monitor progress. </p>
<p>There is also a need to put more effort into understanding that most of the SDGs are interlinked. So encouraging new innovation in sectors like agriculture and energy can play a significant role in tackling the impact of climate change and improving quality of life. Harnessing agribusiness innovation can also tackle poverty and hunger and create job opportunities.</p>
<h2>How the UN can help?</h2>
<p>The UN should facilitate coordination between countries as they set about planning for the SDGs. Good policies need to be designed with the involvement of regional, state and local government as well as the private sector. </p>
<p>To secure better success this time round the following four points must be taken on board:</p>
<ul>
<li><p>Top down approach must be abandoned </p></li>
<li><p>Countries must not be painted with the same brush</p></li>
<li><p>Lessons must be learnt from successes under the MDGs, and</p></li>
<li><p>National statistical data collection must be improved.</p></li>
</ul>
<p>The success of SDGs in Africa will be a key measure of the success of the global effort to achieve sustainability. But appropriate measures and structures need to be put in place to facilitate and implement the goals. The new Secretary General, Mr António Guterres and his African counterpart, Mrs Amina Mohammed, have a huge task ahead of them and must join hands with African leaders, NGOs, and regional organisations to make this effort a reality.</p><img src="https://counter.theconversation.com/content/71033/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ademola Adenle does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Millennium Development Goals failed in aspects like poverty. Lessons must be learnt to ensure that these mistakes will not be repeated by the Sustainable Development Goals.Ademola Adenle, Fellow at the School of Global Environmental Sustainability, Colorado State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/658612016-09-25T14:51:20Z2016-09-25T14:51:20ZA novel global scoring system shows Africa falling behind on health goals<figure><img src="https://images.theconversation.com/files/138963/original/image-20160923-29919-srqujg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women in Central African Republic wait for vaccinations. </span> <span class="attribution"><span class="source">Pierre Holtz for UNICEF</span></span></figcaption></figure><p>In September 2015 the United Nations General Assembly set the global development agenda for the next 15 years. The adoption of the new <a href="https://sustainabledevelopment.un.org/sdgs">sustainable development goals</a> included a range of targets to tackle the world’s health challenges. </p>
<p>As part of the <a href="http://www.healthdata.org/gbd/about">Global Burden of Disease Study collaborative network</a> we conducted <a href="http://bit.ly/2cWQ1YV">research</a> into what progress had been made towards the goals in 188 countries. To do this we developed an index built around the agreed goals and their targets. </p>
<p>The bottom line is that, with a few rare exceptions, Africa’s performance has been abysmal. Not a single African country featured among the top 10 countries that are making significant progress towards the sustainable development goals. And of the 10 countries at the bottom of the list, nine are on the African continent. </p>
<p>There are many lessons African countries will need to learn from countries that have performed well if they have any hope of attaining the sustainable development goal (SDG) targets by 2030. </p>
<p>And there is an urgent need to accelerate the pace of progress if the goals are to become a reality.</p>
<h2>Analysing the goals and measuring the targets</h2>
<p>A total of 17 sustainable development goals, along with their 169 targets and 230 indicators, were adopted at the United Nations summit on sustainable development with a deadline of <a href="https://sustainabledevelopment.un.org/post2015/transformingourworld">2030</a>. </p>
<p>The goals replaced the <a href="http://www.unmillenniumproject.org/goals/">millennium development goals</a> which expired in 2015.</p>
<p>Goal three specifically relates to health and tackles maternal and child mortality, non-communicable diseases, universal health coverage and mental health. Ambitious targets were also set to end the epidemics of HIV, TB and malaria by 2030. These three are Africa’s top infectious disease killers.</p>
<p>In addition to goal three, 10 of the other 16 sustainable development goals have health-related targets. This includes, for example, reducing poverty (goal one) and helping people to access clean water and sanitation (goal six). </p>
<p>Using the SDG targets as the baseline to analyse data from 188 countries we looked at how much progress each country had made to achieve the new targets. We used data collected between 2000 and 2015. Each country was allocated an overall SDG index score. </p>
<p>The index was created by scoring each of the 33 health-related SDG indicators and then combining them and giving a single value on a scale of zero to 100. The change in this score from year to year shows whether a country is progressing toward achieving SDG targets.</p>
<p>It is the first time the index is being used. Iceland scored the highest on the index, tallying 85. </p>
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<h2>More work is needed in Africa</h2>
<p>Of the ten countries at the bottom of the list that failed to make significant progress in achieving the health-related SDG targets, nine are African.</p>
<p>The Central African Republic scored the lowest, with 20, followed by Somalia and South Sudan with 22. South Africa is 10th on the continent with an SDG index score of 46. </p>
<p>The top performing African country in the full list was the Seychelles. It came in at number 40 in the world with a score of 71. </p>
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<p>The worst performing African countries have not managed to reduce maternal or child mortality or malaria. They have also failed to make advances in improving household air pollution or making more <a href="http://bit.ly/2cWQ1YV">safe water</a> available.</p>
<p>What was noticeable about the 10 worst performing nations was that all had experienced civil unrest, mostly because of political instability. Civil conflicts result in mass migration of people, low economic development, hunger and poor access to health services. </p>
<p>If these countries are to meet the sustainable development goals they will need to act decisively in reducing conflicts and implementing evidence-based interventions for improving the poor indicators. </p>
<p>But it’s not all doom and gloom. Some countries have made progress. </p>
<h2>Where there’s been progress</h2>
<p>Kenya and Ethiopia’s scores increased between 2000 and 2015.</p>
<p>Kenya moved from an SDG index score of 33 in 2000 to 40 in 2015.
What is significant for Kenya is that in this time the prevalence of childhood stunting reduced from 39% to 26% in <a href="http://www.healthdata.org/news-release/nations-face-challenges-overweight-children-and-adult-drinking-however-many-countries">2015</a>. This was driven by more than doubling access to health services. In 2000 <a href="http://www.healthdata.org/kenya">only 32%</a> of Kenyans who needed an essential health intervention could get it. This had increased to 70% by 2015.</p>
<p>In Ethiopia, the prevalence of childhood stunting dropped from 57% in 2000 to 41% in 2015. These improvements happened at a time when the country was able to increase funding for <a href="http://www.healthdata.org/ethiopia">child and newborn health services</a>, growing from US$ 13 million in 2000 to US$ 190 million in <a href="http://www.healthdata.org/news-release/nations-face-challenges-overweight-children-and-adult-drinking-however-many-countries">2013</a>. That’s a 14-fold increase.</p>
<p>In addition to the significant improvement in childhood stunting and increased access to health care services, many African countries also made progress in reducing <a href="http://bit.ly/2cWQ1YV">maternal and childhood mortality</a>.</p>
<h2>Changing the trajectory</h2>
<p>The analysis of these indicators suggests that substantial change is needed in the current trajectory. </p>
<p>It will require major technological leaps coupled with universal delivery, <a href="https://theconversation.com/it-will-take-more-than-36-billion-every-year-to-end-aids-62382">increased funding</a>. Most importantly it will take political will from governments. </p>
<p>In the words of <a href="http://www.healthdata.org/about/team">Professor Stephen Lim</a> of the Institute for Health Metrics and Evaluation:</p>
<blockquote>
<p>We have concrete examples of countries making important progress on a range of <a href="http://thelancet.com/infographics/sdg">health-related SDG indicators</a>. We now need to look to those countries that have seen strong progress to find out what they are doing right and how it can be applied more broadly.</p>
</blockquote><img src="https://counter.theconversation.com/content/65861/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>An index developed to gauge progress towards the sustainable development goals and their targets shows that nine of the world’s worst performing countries are in Africa.Charles Shey Wiysonge, Professor of Clinical Epidemiology at the Faculty of Medicine and Health Sciences, Stellenbosch UniversityMuki Shey, Senior Research Officer, Clinical Infectious Disease Research Initiative (CIDRI), Department of Medicine, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.