Equity: Tool for Achieving the Health Sustainable Development Goals

Ifesinachi Sam-Emuwa is an Atlas Corps Fellow working with the ACTION Secretariat on a one-year fellowship. In addition to many other accomplishments, Ifesinachi has over eight years of professional experience in the nonprofit sector working with the Treasureland Health Builders Initiative.


Having worked in the non-profit sector in Nigeria for close to a decade, one may say that Nigeria -- through domestic resource mobilization and the building of political will -- has what it takes to guarantee that all its people can have equitable access to healthcare services.

But working in a middle-income country with limited resources has opened my eyes to better understand and use the equity lens to see how people's social status or disability can affect whether they can access all healthcare needs without constraints or limitation. 

Generally speaking, in developing countries, services are basically centered on who can afford them or who they are closer to -- only few people want to go through the stress of trying to reach the most affected because they are either in hard-to-reach places, or they are persons with disabilities and the right equipment or facilities are not available to better reach them. 

Health Equity: Key To Sustainable Development
I have seen that for health catastrophes to be averted, health equity should be in the heart of every health programming and that this should be a concern to everyone -- especially governments, development partners, and civil society organizations. The ACTION infographic on health equity has been designed to show why we must focus attention on reaching the unreached. When health interventions are not properly focused on the people most in need, society suffers. 

As a fellow with the ACTION team, I have had the opportunity to dig deep into health equity from a policy level, and look at different global health policy documents to see how health equity is reflected. “Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential” (Braveman, P. 2006). 

Looking at the United Nations Sustainable Development Goals (SDGs), which will officially launch in September and will drive the global development agenda for the next 15 years, the goal that directly speaks to health is Goal 3: “Ensure healthy lives and promote wellbeing for all at all ages". Under SDG-3 are nine targets that cover a wide range of health issues, from maternal and child health to environmental health.

To achieve SDG 3, health equity must be at the forefront of every health intervention. This means a ‘no one left behind’ strategy must be employed, with health interventions targeting the poor, hard-to-reach populations, and persons with disabilities to ensure everyone is reached. Health equity must be considered during all aspects of health programming -- design, planning, implementation, and evaluation.

In its recent report, the World Health Organization says 400 million people have no access to essential health services;  and if this trend continues, we may never achieve the health SDGs and 68 million children could die of preventable causes by 2030. Generally, women, children and persons with disabilities are disproportionately represented among the populations that are left behind. This is especially true in developing countries, where resources are limited and there is little political will to mobilize domestic resources for health. The lack of interest among political leaders to prioritize equitable access to health will guarantee the poorest-of-the-poor and hard- to-reach communities are left behind.

Equity and fairness have been the lenses that have helped me to implement health programs in Nigeria focusing on disadvantaged, vulnerable, marginalized and hard-to-reach individuals. Through this work, I have seen firsthand that by prioritizing equitable access to health we can insure that all people, no matter where they live or how much money they have, are reached with life-saving health interventions.