Health Promotion Indicators Missing in the SDGs
Here is a discussion on the tension between health promotion and treatment of disease.
We are returning to the very lively discussion we held in the past on the need and challenges faced by health systems in attaining the correct balance between maintaining inborn population health through health promotion, community participation and disease prevention on the one hand and treatment of diseases and illness on the other hand. I am also inspired by what happened in my country Uganda on 8 July 2018 when President Y K Museveni walked 10 kilometers around Kampala streets accompanied by thousands of citizens including political and professional leaders during the National Physical Fitness Day and delivered a number of health promoting messages.
Further, during the 71st World Health Assembly, May, 2018, there were several debates on what the face of UHC will look like. Will it be health financing and health insurance for treatment of disease or will it be health promotion that ensures that people do not lose their inborn health and delay the need for health care for as long as possible? Surely it has to be both and UHC will need to be successful in both. The WHO definition of UHC is balanced and addresses health promotion, disease prevention and treatment of illness and mentions the need for money to achieve all aspects of UHC.
It states: “Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship”. WHO has also developed a Framework for Integrated People-Centered Health Services that includes both health promotion and treatment of diseases.
However, when we examine the current SDG Targets and Indicators on UHC that have been selected to monitor implementation and level of achievement, it is evident that health promotion has taken a back seat. Below are extracts from the Tier Classification of the SDGs from the UN SDG website dated December, 2017.
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