The incidence and patterns of serious diseases in rich and poor countries differ and they’re changing. In low-income countries more than half the population dies from communicable diseases, or maternal, prenatal, or nutrition conditions. In middle- and high-income countries more than two-thirds die from noncommunicable diseases. However, as health care and targeted medicine in poorer countries improve, the incidence of diseases such as malaria and HIV are starting to fall, whilst deaths due to heart attacks and strokes are on the increase.
Sustainable Development Goal 3 looks to ensure healthy lives and promote well-being for all ages. One of its aims is to reduce deaths and adverse consequences of non-communicable diseases and injuries—for example, by halving the number of global deaths and injuries from road traffic accidents by 2020. Traffic injuries caused 27 deaths per 100,000 people in low-income countries in 2013, three times more than in high-income countries. Rates in middle-income countries are also high.
The Millennium Development Goals focused on improving health conditions in low- and middle-income countries, covering maternal mortality, child mortality, infectious diseases, and sexual and reproductive health. The Sustainable Development Goals (SDGs) cast a wider net by covering all ages, all countries, and more health conditions. New targets have been introduced for noncommunicable diseases, mental health, substance abuse, injuries, universal health coverage, and pollution. Sustainable Development Goal 3 also seeks to end preventable deaths of children, reduce maternal mortality, end epidemics, and achieve universal health coverage.
The global maternal mortality ratio declined dramatically between 1990 and 2015, from 385 maternal deaths per 100,000 live births to 216. Despite this 44 percent decline, the Millennium Development Goal target of reducing the maternal mortality ratio by three-quarters was not met. The decline will need to accelerate considerably for the global maternal mortality ratio to fall below 70 per 100,000 live births by 2030 (SDG Target 3.1).
Providing mothers with skilled attendants at delivery and access to hospital treatments is key to treating life-threatening emergencies such as severe bleeding and hypertensive disorders. Worldwide, the proportion of. Improvements are evident across all income groups, but an average of less than half of births are attended in low-income countries, compared with 58 percent in lower middle-income countries and nearly 100 percent in upper middle-income countries.
SDG 3 aims to ensure universal access to sexual and reproductive health care services (target 3.7). The percentage of women of reproductive age who have their need for family planning satisfied with modern methods is one indicator for assessing progress. Another is the fertility rate of adolescent women (ages 15–19), as women who give birth at an early age are likely to bear more children and are at greater risk of death or serious complications from pregnancy. The adolescent fertility rate has been declining worldwide but remains high in low-income countries, at 98 births per 1,000 women ages 15–19.
Under-five mortality has been substantially reduced over the past 25 years: In 2015 the global under-five mortality rate in 2015 was less than half the rate in 1990, falling just short of the Millennium Development Goal target of a two-thirds reduction. SDG 3 aims to end preventable deaths of newborns and children under age 5 and to reduce the under-five mortality rate in every country to below 25 deaths per 1,000 births (target 3.2). For this to happen, progress needs to accelerate especially in many low-income and lower middle-income countries.
One target of the Millennium Development Goals was to halt and begin to reverse the incidence of tuberculosis by 2015. This was achieved globally:The Sustainable Development Goal target is to end tuberculosis and other communicable and waterborne epidemics by 2030 (target 3.3).
Challenges with data gaps and the need for better data
. Maternal mortality ratios require precise information on the cause of death, and child mortality rates rely on accurate estimates of the number of births and child deaths. Adolescent fertility rates require reliable estimates of the number of births by the age of the mother and the size of the female adolescent population.
Gaps exist because the key data sources, such as civil registration and vital statistics (CRVS) systems, are weak in many low and middle income countries. Inter-agency groups generate trend estimates for these mortality targets but they are largely dependent on household survey data for many low- and middle-income countries. Moreover, well functioning health information systems are needed to monitor progress toward targets for communicable and noncommunicable diseases, injuries, universal health care, mental health, and substance abuse.