Millennium Development Goals Approaches Research Articles

The geography of maternal and newborn health: the state of the art

As the deadline for the millennium development goals approaches, it has become clear that the goals linked to maternal and newborn health are the least likely to be achieved by 2015. It is therefore critical to ensure that all possible data, tools and methods are fully exploited to help address this gap. Among the methods that are under-used, mapping has always represented a powerful way to ‘tell the story’ of a health problem in an easily understood way. In addition to this, the advanced analytical methods and models now being embedded into Geographic Information Systems allow a more in-depth analysis of the causes behind adverse maternal and newborn health (MNH) outcomes. This paper examines the current state of the art in mapping the geography of MNH as a starting point to unleashing the potential of these under-used approaches. Using a rapid literature review and the description of the work currently in progress, this paper allows the identification of methods in use and describes a framework for methodological approaches to inform improved decision-making. The paper is aimed at health metrics and geography of health specialists, the MNH community, as well as policy-makers in developing countries and international donor agencies.

Youth under construction: the United Nations’ representations of youth in the global conversation on the post-2015 development agenda

As the 2015 deadline for the Millennium Development Goals approaches, youth have been ushered into the United Nation's decision-making processes for global development in the post-2015 era with a sense of uncontested urgency. Through the “global conversation” – a large scale participatory process involving consultations with youth and other groups – participation has featured prominently in the making of the post-2015 global development agenda. Using discursive analysis of reports produced on the global conversation, we argue that the UN is reconstructing youth as a social category and identity through such processes. We also conclude that by constructing youth as “asset”, “risk” and “good citizens in the making”, the UN seeks to draw young people into global development primarily as subjects of neoliberalism.

The post-2015 debate and the place of education in development thinking

As the end date for the Millennium Development Goals approaches so the focus on goals, visions and policies for development after 2015 becomes ever heightened. However, there has been relatively little engagement by educational research community in these debates. What then is being written about education in the key post-2015 documents? How is education's role in development conceptualised by those most central to shaping new accounts? I explore these issues through an analysis of a key text on post-2015, the High Level Panel Report of May 2013 (UN HLP, 2013), and an exploration of a year's worth of posts on 30 prominent blogs and websites discussing post-2015 matters. This leads me to two further, interlinked questions: what are the implications of potential marginalisation and irrelevance from these debates for the field of international education and development research? What are the potential dangers for the field of closer engagement in these debates and their growing use of social media? The academic international education and development community may be more comfortable in keeping these policy debates at a distance, but this may play against the strong educational research drive to engage in social science that makes a difference. If there is to be engagement with post-2015 then alternative ways of developing practices of research, action and dialogue need further strengthened. This may include interdisciplinary dialogues around such issues as early childhood development, the role of professions in development or environmental sustainability. Engagement with the post-2015 debate would also require a careful analysis of how best to engage with the instrumentalised accounts of education that are dominant in the policy-advocacy arena. This would entail more strategic positions on the uses and dangers of social media. At the same time, engagement with development studies as well as the development policy community requires a reappraisal of epistemological and methodological stances.

Women and NCDs: Overcoming the neglect

Two in every three deaths among women are caused by non-communicable diseases (NCDs) – largely heart disease, stroke, cancer, diabetes and chronic respiratory diseases. The global discourse on health, however, largely views women in terms of their reproductive capacity, a persisting myth reflecting gender bias that shifts the focus away from NCDs, violence, and other injuries. Risk factors for NCDs are similar for men and women. Because fewer women actively smoke than men, and drink in less harmful ways, in most parts of the world, the impact of major NCD risk factors is far less in women than in men. In the area of diagnosis and treatment, gender bias can result in women being asked fewer questions, and receiving fewer examinations and fewer diagnostic tests for coronary heart disease and other NCDs compared with men with similar symptoms. In response to a UN meeting in September 2011, member states of WHO have agreed to a global goal to reduce avoidable NCD mortality by 25% by 2025 (‘25 by 25’). A set of voluntary targets and indictors have been agreed upon, although none of them are gender specific. Most require changes at the policy level that will ensure that women – and children – will also benefit. As the 2015 deadline for the Millennium Development Goals approaches, women and NCDs should be central to the sustainable human development agenda.

Post-2015: How to Design Goals for (Inter)National Action?

United Nations (UN) Member States agreed to start negotiations towards a universal sustainable development agenda. A major challenge is to design goals that guide future action at the national and international levels. These “Goals” usually refer to global development priorities at the highest aggregated level. “Targets” are subcomponents of goals that are needed to achieve the overarching goal. “Indicators” help to monitor progress towards the targets. At the national level, countries prefer to set their own targets and indicators based on their own circumstances and needs. At the international level, setting global minimum standards for all citizens, or agreeing on global environmental ceilings, can ensure better development outcomes for all countries. International development goals can foster coherence in aggregating national actions in addressing global challenges. They can create accountability across countries and ensure comparability on development progress. Combining national development targets and international development goals within one unified agenda, however, is challenging in at least two ways.First, a balance has to be found between flexibility at the local level and a strong basis for accountability at the global level. National level target-setting takes account of local development conditions and allows room for flexibility in addressing complex development challenges. Goal-setting at the global level will, however, prescribe goals to be met by all countries, which may be more or less consistent with the targets set at the national level. Second, it is difficult to define ambitious goals that are meaningful in a heterogeneous world. Countries differ regarding income, poverty, equality and geography, for instance. Global standards and rules need to be ambitious, yet they have to be fair towards all countries. Designing a universal development agenda has to address the differentiation of countries and integrate national- and international-level development goals within one agenda. This paper examines three approaches for designing the post-2015 agenda: 1) the Millennium Development Goals approach (top-down negotiation), 2) the inductive approach (bottom-up) and 3) the two-tier-list approach (a hybrid of the two).Each approach is characterised by different advantages and disadvantages that decision-makers negotiating the post-2015 agenda need to consider carefully. This paper proposes five key questions for judging the merits of each approach: How are global and national development goals linked? How does the approach influence negotiations? Are sectorspecific and cross-cutting goals included? How does the approach foster accountability? How communicable will the future agenda be? In light of these considerations, the two-tier-list approach would allow for combining a list of global goals to foster global collective action with nationally set targets and indicators. The two-tier-list approach offers the greatest potential for designing an ambitious, communicable, accountable and relevant future development agenda.

Poverty, education, gender and the Millennium Development Goals: Reflections on boundaries and intersectionality

The article considers the Millennium Development Goals (MDGs) concerned with poverty, education and gender (MDG 1, MDG 2 and MDG 3). Despite considerable achievements associated with the MDG approach, which entails international and national target setting and monitoring, a sharp distinction between areas of social policy is entailed. In addition the approach suggests sufficiency, for example providing a minimum level of education or gender parity, rather than a fuller notion of equality, is good enough. These processes of classification, which entail horizontal and vertical boundaries, are examined, partly drawing on Bernsteinian ideas, and partly through reflections on the concept of intersectionality. Data collected from discussions in Kenya and South Africa with administrators in national and provincial government and teachers implementing the poverty, education and gender MDGs are explored. These show a tendency to work primarily with ideas based on lines, associated with the MDG targets rather than to think more complexly about structure, agency and context in addressing inequality. Thus professionals who confront problems of poverty, gender inequality and inadequate education in day-to-day work lack appropriate resources or processes for gathering information or reflexively engaging with it. The missing resources are partly financial, in that there are not budgets of time or money to attend to making connections. But in addition they are conceptual. Ideas which take a direction to social justice. In the place of a reasoned and reflexive professional language of practice, everyday ideas that connect poverty with gender and schooling are expressed. These tend to reproduce social distance and blame. Putting intersectional ideas to work in ways that consciously and creatively challenge existing sites of exclusionary power appeal key in success or frameworks to the MDGs.

New life in old frames: HIV, development and the ‘AIDS plus MDGs’ approach

There have been recent indications that the primacy of AIDS among global health issues may be under threat. In this article we examine one response to have emerged from the AIDS policy community as a result of this perceived threat: the ‘AIDS plus Millennium Development Goals (MDGs)’ approach, which argues that the AIDS response (the focus of MDG6) is essential to achieving the other MDG targets by 2015, stressing the two-way relationship between AIDS and other development issues. By framing AIDS in this way, the AIDS plus MDGs approach draws on an established narrative of a ‘virtuous circle’ between health and development, but at the same time makes some important concessions to critics of the AIDS response. This article – the first critical academic analysis of the AIDS plus MDGs approach – uses this case to illuminate aspects of the utilisation of framing in global health, shedding light both on the extent to which new framings draw upon established ‘common sense’ narratives as well as the ways in which framers must adapt to the changing material and ideational context in which they operate.

Evaluating the scale-up for maternal and child survival: a common framework

Programs to reduce mortality among women and children are the target of new resources and redoubled commitment as the 2015 date for achieving the Millennium Development Goals approaches. The need for a common evaluation framework to guide the collection, analysis and synthesis of evidence is increasingly evident. This paper presents such a framework in four parts: (1) a conceptual model for the scale-up to MDGs 4 and 5 for maternal and child survival; (2) recommended indicators for each part of the model that bring together the work of various existing technical groups and prioritize a limited number of indicators for standardization and common use; (3) guidelines for documenting program implementation and contextual factors that may affect program implementation and its effectiveness in reducing maternal and child mortality; and (4) design considerations in evaluating the scale-up. We first present an overview of what is known and/or agreed upon within each of these areas, and in the discussion highlight areas of uncertainty or where there are gaps to be addressed.

The ‘AIDS and MDGs’ Approach: what is it, why does it matter, and how do we take it forward?

Progress towards the Millennium Development Goals (MDGs) has been mixed, and many observers have noted the tendency for development actors to address individual MDGs largely in isolation from one another. This in turn has resulted in missed opportunities to catalyse greater interdisciplinary collaboration and innovation towards MDG achievement. The term ‘AIDS and MDGs’ is gaining currency as an approach that aims to explore, strengthen and leverage the links between AIDS and other health and development issues. Drawing from academic literature and from MDG country reports, this article sets out three important pillars to an AIDS and MDGs approach: 1) understanding how AIDS and the other MDGs affect one another; 2) documenting and exchanging lessons learned across MDGs; and 3) creating cross- MDG synergy. We propose broader policy level implications for this approach and how UNDP and other partners can take this agenda forward. Because the MDGs explicitly locate HIV within a broader international commitment to human development targets, they provide a critical platform for development partners to galvanise resources, political will and momentum behind a broader, systematic and structural approach to HIV, health and development.

Parasitic Diseases: Chemotherapy with a Twist

The neglected tropical diseases (NTDs) consist of a group of parasitic and bacterial infections that affect 120% of the world’s current population. Up to 90% of those affected live in remote, rural areas or in urban slums in Africa, Asia, and Latin America, areas that are characterized by a vicious circle of sustained poverty and endemic diseases that makes people unable to care for themselves. The overall aim of the Millennium Development Goals approach [1] is to lift 1 billion of the least privileged people out of such situations, promising substantial benefits for vulnerable populations around the world. Control of the NTDs is a critical component of this endeavour and should be dealt with at an early stage, because it would have immediate knock-on effects on other health-related conditions, such as malaria morbidity and human immunodeficiency virus transmission. Soon after the creation of the People’s Republic of China, Chairman Mao Zedong initiated his celebrated campaign against the most common NTDs by famously attacking the snail, which is the intermediate host of schistosomiasis, in his poem “Farewell to the God of Plague” [2].