Putting Countries Back on “The Path to Achieving the Sustainable Development Goals"

Overview Interventions Outcomes Partners

Sub-Saharan Africa has made significant progress on a number of health outcomes including an increase in skilled birth attendants (from 41 to 61 percent between 2000 and 2019) as well as reduction in under-five mortality (down from 153 deaths per 1000 live births in 2000 to 77 deaths per 1000 in 2019). However, progress has been uneven between, and within countries, with differentials based on socioeconomic characteristics, urban or rural residence, and geography.

The COVID-19 pandemic threatens the world and Africa in particular. The actions that countries undertake to build their capabilities today will determine the magnitude of the pandemic but also long-term effects of countries’ progress towards achieving the Sustainable Development Goals (SDGs), which could potentially be exacerbated by the deep inequalities being exposed by the pandemic. As key resources are being redirected to combating the pandemic, they leave behind gaps in health systems management and social services.

In order to make progress towards achieving the SDGs, evidence-based micro-planning and targeting is essential, including identification of hot-spots where there is slowest progress to target interventions. There are many interventions that have been shown to improve maternal, newborn, child, and adolescent health and nutrition, yet their uptake is low. The challenge for African countries with limited resources is identifying those interventions that have the greatest potential to change lives that should be scaled up. Cost effectiveness analysis to estimate the costs and gains of interventions is needed to help policymakers in prioritising the allocation of resources.

While COVID-19 has the potential to halt or reverse the utilisation of essential services, we can now leverage this moment of change to enact profound systems and norms change and get back on track to achieving the SDGs. The main aim of the project is to use data and evidence to develop a roadmap of essential interventions that have the greatest potential to change people’s lives and to help countries deliver on SDGs commitments.

The project’s interventions are guided by its five main objectives (in bold):

Analysis of the potential effects of Covid-19 on health service delivery/uptake in Africa (Ethiopia, Kenya, and Nigeria) and projected impact on children, youth and health outcomes. AFIDEP will investigate the potential effects of COVID-19 on health service delivery, by looking at trends before and during COVID-19 periods. Recommendations will be made to ensure resilience in health service delivery during pandemics;
Critical analysis of various evidence-based interventions that have the greatest potential to change people’s lives at scale and support countries achieve SDGs despite the effects of Covid-19;
Develop country roadmaps to achieving SDGs and to advocate on evidence uptake to help countries take bold and transformational decisions;
Micro-planning and targeting based on the roadmap. Analyses of secondary data such as Demographic and Health Surveys (DHS), Multiple Indicator Surveys (MIS) to highlight sub-national indicators of maternal, new-born, neonatal, child, and adolescent health, nutrition, WASH and NTDs. AFIDEP will implement micro-planning to map areas where interventions are required and could have the most health impact once implemented.

Here are the key outcomes achieved:

Analysis of the potential effects of COVID-19 on health service delivery/uptake in Africa (Ethiopia and Kenya) and projected impact on women’s and children’s health outcomes.

The project analysed the impact of COVID-19 on maternal healthcare utilisation, with a particular focus on subnational variations, to identify hotspots of healthcare disruption requiring targeted interventions. The findings offered policymakers vital insights for prioritising resources for accelerating recovery. To understand how access to healthcare changed during the pandemic, the project followed monthly data from Ethiopia and Kenya’s health systems, looking at patterns before COVID-19 and as it unfolded. Interrupted time series and counterfactual analyses measured shifts in healthcare usage trends, while geospatial mapping identified the most affected regions or counties, providing a clear picture of high-impact areas.

Read more about the analysis here

Critical analysis of various evidence-based interventions that have the greatest potential to change people’s lives at scale and support countries in achieving SDGs despite the effects of COVID-19.

The project conducted a critical review of evidence-based interventions that could significantly impact health outcomes and support countries in progressing toward the SDG targets, despite COVID-19’s challenges. This included an in-depth review of systematic reviews on adolescent pregnancy prevention, covering various socioeconomic groups across both low- and high-income countries. Effective interventions identified included skill-building, peer-led initiatives, and abstinence programs, while results for information-only and counselling interventions were mixed.

Read more about the systematic review here

We also synthesised evidence on interventions for improving healthcare service utilisation among pregnant women in LMICs. We found that mobile health interventions were effective in improving a wide range of outcomes on the maternal health continuum. In addition, interventions involving male partners were effective in improving skilled birth attendance, postnatal visits, and maternal ART uptake and retention, but were not effective in increasing the number of adequate ANC visits during pregnancy. While our results provide important insights on effective interventions, further research is needed to identify interventions for increasing early ANC initiation.

Read more about the systematic review here

Tracking tracked SDG indicators related to Maternal, Newborn and Child Health to help stakeholders and countries realign with SDG 3.

Our research uncovered factors influencing demand for modern contraception and tracked progress in contraceptive coverage in Ethiopia, Kenya, and Nigeria. The analysis utilised multilevel modelling, geospatial analysis, and data comparison from three countries across two time periods: the beginning of the SDG era (around 2015) and halfway to the SDG target date (around 2020). The results showed the presence of demographic, geographic and socio-economic disparities in the demand for family planning satisfied with modern methods (mDFPS), and that some geographic sub-national areas have made progress while others have regressed, but the majority have remained stagnant.

Key Details

Dates:	October 2020 to Present
Aim:	Back-On-Track seeks to use data and evidence to develop a roadmap of essential interventions that have the greatest potential to change people’s lives and to help countries deliver on SDGs commitments.
Where:	Ethiopia , Kenya , Nigeria
Project Manager:	Michael Chipeta