Honorary Clinical Senior Lecturer, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK.
Visiting Professor, Healthy and Sustainable Settings Unit, University of Central Lancashire, Horse Close Farm, Cawder Lane, Skipton, BD23 2TD, UK.
Public Health. 2020 Mar;180:180-184. doi: 10.1016/j.puhe.2019.10.020. Epub 2020 Jan 22.
United Nations member states agreed Agenda 2030 and the Sustainable Development Goals (SDGs) in 2015. Countries report their progress through Voluntary National Reviews. In this paper, we look at the extent to which the World Health Organisation (WHO) Europe SDG Roadmap (the Roadmap) on Agenda 2030 implementation is reflected in the first 20 Voluntary National Reviews (VNRs) submitted from the WHO European region. In particular, we wanted to look at how integrated the three dimensions of sustainable development were, the identification of health co-benefits and potential-added value from the health sector.
This was a semi-quantitative analysis of 20 VNRs using an ordinal scale (no evidence, limited evidence, good evidence). Results are presented as frequency tables by criteria and by country.
We devised an assessment template consisting of 41 criteria based on the nine key areas and a selection of the proposed areas for action in the Roadmap. Each VNR was then assessed and scored against these criteria to produce country-specific and average scores for each of the nine key areas and the 25 measures we selected.
Countries generally have good evidence on key areas such as governance, monitoring, leaving no-one behind and multipartner cooperation. They have less evidence on the key areas of health determinants, healthy settings, health literacy and investing for health. Many countries link the economic and environmental dimensions of sustainable development but not the interplay with the social (health and well-being) dimension. Some countries specifically highlighted commitments to support developing nations but few recognised the impact of domestic policies on planetary boundaries or the health of future generations.
We found little evidence that the health sector has had a major strategic influence on actions which affect wider determinants (or health co-benefits). The WHO Europe SDG Roadmap offers a means and an opportunity for redressing this weakness, but this may require health professionals to work within their communities across all three dimensions of sustainable development.
联合国会员国于 2015 年通过了 2030 年议程和可持续发展目标(SDGs)。各国通过自愿国家审查报告其进展情况。在本文中,我们研究了世界卫生组织(世卫组织)欧洲 2030 年议程实施情况路线图(路线图)在提交给世卫组织欧洲区域的前 20 次自愿国家审查(VNR)中反映的程度。特别是,我们想研究可持续发展三个维度的综合程度,确定卫生共同效益和卫生部门的潜在附加值。
这是对 20 次 VNR 进行的半定量分析,使用的是有序尺度(无证据、有限证据、充分证据)。结果按标准和国家以频数表的形式呈现。
我们根据路线图中的九个关键领域和拟议的行动领域制定了一个评估模板,其中包含 41 个标准。然后,对每个 VNR 进行评估,并根据这些标准进行评分,为九个关键领域中的每一个以及我们选择的 25 项措施生成国家特定和平均分数。
各国在治理、监测、不让任何人掉队和多方合作伙伴关系等关键领域通常具有充分的证据。它们在健康决定因素、健康环境、健康素养和投资促进健康等关键领域的证据较少。许多国家将可持续发展的经济和环境维度联系起来,但没有将其与社会(健康和福祉)维度联系起来。一些国家特别强调支持发展中国家的承诺,但很少有国家认识到国内政策对行星边界或子孙后代健康的影响。
我们发现几乎没有证据表明卫生部门对影响更广泛决定因素(或卫生共同效益)的行动产生了重大战略影响。世卫组织欧洲 SDG 路线图提供了一种手段和机会,可以纠正这一弱点,但这可能需要卫生专业人员在可持续发展的所有三个维度内在其社区内开展工作。