Pakistan ranks 149th out of 188 countries in health-related index

The Global Burden of Disease Study, the first global analysis that assesses the United Nations’ health-related Sustainable Development Goals (SDGs) in 188 countries, has ranked Pakistan at 149.

Launched at a special event at the UN General Assembly in New York and published in The Lancet, the analysis assesses countries by creating an overall index score on a scale of zero to 100. Pakistan shares the score of 38 with Bangladesh and Mauritania – six places behind India and way behind Iran.

“These analyses are critically important for Pakistan, where limited data make the transition from MDGs to the SDGs even more challenging. These data allow the country to set a baseline based on recent performance and also set a trajectory for achieving the health and health-related SDGs,” said Professor Zulfiqar Bhutta, founding director of the Aga Khan University’s Centre of Excellence in Women and Child Health, Co-Director of the SickKids Centre for Global Child Health, and co-author of the study.

The analysis shows that expanded health coverage, greater access to family planning and fewer deaths of newborns and children under the age of five are among several health improvements contributing to progress toward achieving SDGs. However, hepatitis B, childhood obesity, violence and alcohol consumption have worsened.

Iceland ranks the first at 85 with the United Kingdom and Canada among the top 10 at 82 and 81 respectively. With a score of 26, Afghanistan is among the bottom 10; the Central African Republic being the lowest at 20.

Kenya’s SDG index score increased between 2000 and 2015 from 33 to 40. The prevalence of childhood stunting there dropped as a percentage of the population from 39 percent in 2000 to 26 percent in 2015. One potential driver of the decrease in stunting in the country is the concurrent increase in access to health services. In 2015, 70 percent of Kenyans who needed an essential health intervention received it, in contrast to just 32 percent in 2000.

To see how nations compare to others, countries were divided into five categories, based on a combination of education, fertility and income per capita. This new categorisation goes beyond the historical “developed” vs. “developing” or economic divisions based solely on income.

 The researchers note that these gains will need to be sustained, and in many cases accelerated, to achieve the ambitious SDG targets. The findings also highlight the importance of income, education and birth rates as drivers of health improvement, and that investments in those areas alone will not be sufficient.

“We know that international targets can motivate countries and motivate donors,” said Dr Christopher JL Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, which led the study. “The international Global Burden of Disease collaboration is committed to providing an independent assessment of progress toward the Sustainable Development Goals.”

The proportion of countries that have accomplished individual targets varies greatly. For example, more than 60 percent of the 188 countries studied shows maternal mortality rates below 70 deaths per 100,000 live births, effectively hitting the SDG target. In contrast, no nation has reached the objective to end childhood overweight or to fully eliminate infectious diseases like HIV or tuberculosis.

“We have concrete examples of countries making important progress on a range of health-related SDG indicators,” said Dr Stephen S Lim, professor of Global Health at IHME and lead author of the study. “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.”

As part of its activities to support SDGs, the AKU has pledged to invest more than $85 million over the next decade in support of the Global Strategy for Women’s, Children’s and Adolescents’ Health, which is designed to help achieve Goal 3 of the Sustainable Development Goals, requiring countries to ensure good health and well-being for people of all ages.