Can the census help us reach our global goals?

On September 25, 2015, the UN General Assembly adopted the Sustainable Development Goals (SDGs) to be completed by 2030.  Seventeen goals with 169 targets fall neatly within a framework of People, Planet, Prosperity, Peace, and Partnership.

sdgs-globalgoalsforsustainabledevelopment-05

To estimate the likelihood of reaching these goals in the next 14-odd years, it is helpful to evaluate the shortcomings of the SDGs’ predecessor.  Established in 2000, the Millennium Development Goals (MDGs) consisted of 8 goals to be achieved by 2015.  Called the “most successful anti-poverty movement in history,” the MDGs made inroads in reducing global poverty, but there is still much to do.

A literature review finds that the MDGs were more favorable to wealthy countries, which for all intents and purposes had met or exceeded the 8 goals prior to inception.  In the development stage, only 22% of member parliaments were involved. Others argue that the MDGs ignored local and governmental capacity in poorer countries and limited policy growth by narrowing focus.  Rather than setting goals realistic for each country’s individual baseline and capacities, the MDGs ‘ghettoize the problem of development and locates it firmly in the third world.’  The final limitation of the MDGs speaks to issues of data collection and surveillance in developing countries.  Reliance on national averages and aggregated data ignored the world’s poorest, meaning they would be the last to benefit.

A video recently released by WHO’s YouTube page culminates with the sentiment “The world needs better health data and ICD is delivering it.”

The ICD or International Classification of Diseases allows global users to share health information about mortality and morbidity.  ICD counts deaths as well as diseases, injuries, symptoms, reasons for encounter, factors that influence health status, and external causes of disease.

ICD is less useful and utilized in developing countries.  In the least developed countries, health records, including birth and death records, are not well recorded and may be based on second-hand information or less scientific means such as verbal autopsies.  Is the ICD accessible to developing countries, ostensibly the same countries who share the largest burden of poverty and disease?  What are the fundamental gaps in data collection and utilization that must be ratified before progress is observed?

One of the first steps to usable data is the census.  A timely, accurate census is the foundation for public health policy and development:

Census data can, for example, highlight sex-ratio imbalance, identify trends in migration, fertility, nuptiality and population ageing. Such information is the bedrock of almost all aspects of human, social and economic development. It helps governments determine the number of schools, hospitals or highways to be constructed, or the kind of programs that should target young and older people, as well as women. Censuses thus contribute to reducing poverty, ensuring sustainable development and supporting reproductive rights and gender equality.

The United Nations Population Fund provides technical and financial support to assist developing countries with census efforts.  When a developing country conducts a census, the results can be unexpected.  Afghanistan’s 2010 census – its first since 1979 – found lower fertility rates and higher contraceptive use than anticipated.  In very remote areas, there is limited data to base projections on, such as in areas of Myanmar where there was no reliable data even on total population.

The 2030 Agenda is built on the assumption that every country will be able to identify and locate the most vulnerable groups, but over 109 countries in the world today don’t have vital statistics and registration. We still need to develop better ways to reach those who have historically gone uncounted.

– Dr. Babatunde Osotimehin, UNFPA Executive Director

Without accurate census information, are we putting the proverbial cart before the horse?

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