2030 Agenda: Study assesses the evolution of 40 health indicators in Brazil and Ecuador

A partnership between researchers from the United Kingdom, Brazil and Ecuador resulted in an article published in the journal Public Health, which analyzes the evolution of 40 health-related indicators linked to the United Nations (UN) Sustainable Development Goals (SDGs) in the two American countries. The research, with the participation of the Center for Data and Knowledge Integration for Health (Cidacs/Fiocruz Bahia), was conducted by the Research Unit on Social and Environmental Determinants of Health Inequalities (Sedhi), funded by the British agency NIHR, which, in line with monitoring the progress of the 2030 Agenda for Sustainable Development, aims to contribute to generate knowledge on global health.

"From the data used, we identified that, between 1990 and 2019, Brazil and Ecuador substantially reduced both chronic malnutrition (stunting) and acute malnutrition (wasting), neonatal mortality rates, the prevalence of neglected tropical diseases, the incidences of tuberculosis and malaria, as well as mortality rates attributable to unsafe water, sanitation and hygiene. Both countries have greatly increased vaccination coverage, by around 200%," explains Laís Cardoso, researcher at the Federal University of Minas Gerais (UFMG), linked to the Sedhi Research Unit, and co-author of the article.

The SDG Index showed a positive percentage change of 46% in Brazil and 24% in Ecuador between 1990 and 2019. Trend analyses from 1990 to 2017 and projections to 2030 indicate that both countries will increase their SDG Index by 70 for Brazil and 65 for Ecuador.

"When we look specifically at Brazil and Ecuador, South-South cooperation emerges as an important tool. We understand that, although the goals of the 2030 Agenda and the respective indicators for sustainable development are global in scope, their fulfillment depends on regional contexts and local capacities. And these capacities can be strengthened or expanded through alliances between nations," Cardoso points out.

According to the study, in 2019, Brazil and Ecuador showed marked differences in various health and development indicators. Brazil recorded a higher percentage of well-certified deaths compared to Ecuador, 83.6% and 69.4% respectively, indicating greater accuracy in mortality records.

The homicide rate in Brazil has doubled compared to Ecuador, with Brazil having a rate of 27.5 per 100,000 and Ecuador, 13.3/100,000. While indicators such as child malnutrition, maternal mortality and infant mortality showed improvements, others such as HIV incidence, alcohol consumption and homicide rates showed worrying trends.

Between 1990 and 2019, the following indicators worsened: disaster mortality rate, prevalence of child overweight, HIV incidence, alcohol consumption, prevalence of non-intimate partner violence, homicide rate, physical violence, sexual violence, child sexual abuse and suicide mortality rate (only in Brazil).

On the other hand, a positive change greater than 20% was observed in both countries for skilled birth attendance. Family planning served by contraceptive methods, universal health coverage, immunization coverage and the density of health professionals have also increased. The positive percentage change in the vaccination coverage score was the highest for both countries (424% for Brazil and 357% for Ecuador).

The study was conducted in collaboration with researchers in Brazil from the Federal University of Minas Gerais (UFMG), the Federal University of Ceará (UFC), the Fluminense Federal University (UFF) and Cidacs/Fiocruz Bahia; in Ecuador, from the School of Medicine at the International University of Ecuador; and, in the United Kingdom, from the School of Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine; the University of Washington; the University of London; and the University of Glasgow.

Sedhi and NIHR

The Research Unit on Social and Environmental Determinants of Health Inequalities (SEDHI) of the National Institute for Health and Care Research (NIHR) aims to carry out research into the impact of public policies on social inequalities in health. Sedhi seeks to contribute to the field of global health by building and developing quality data sources in Brazil and Ecuador, creating and improving rigorous, large-scale analysis methodologies, and through innovative approaches that enable discoveries with the potential to support collective and individual decision-making to improve the health of the population.