Exploring the Sustainable Development Goals
Partnering for Healthand Well-Being
by Allison Kooser
For the past few months, we have been exploring the Sustainable Development Goals—the set of benchmarks the UN created as global guidelines for development and poverty alleviation. These goals are inextricably linked with one another. Like the body described in 1 Corinthians 12:20-26, where each unique body part only functions correctly as part of the whole, each Sustainable Development Goal relies upon the others in order to work well. Therefore, we as a global community must work toward all of the goals simultaneously.
The most sustainable changes happen when we address all of the SDGs, all at once.
But how can Opportunity International, an organization specializing in financial tools and services, make progress toward a goal like SDG 3: Ensuring Healthy Lives and Promoting Well-Being for All? How can we improve global health when we are not doctors or public health professionals?
We know that health is foundational. Without good health and well-being, people cannot work. They cannot go to school or contribute to their families or innovate or work on their farms if they are too ill to get out of bed. And they certainly can’t transform their lives, or the futures of their families and communities if they don’t survive their early childhoods.
Economic poverty puts people at higher risk of poor health, and these health risks make economic poverty more severe. It’s a vicious cycle that is difficult to escape.
Our core work—investing in entrepreneurs and farmers and educators—suffers when health suffers.
In the same way that the goals and solutions are reliant upon one another, so too are the problems themselves.
At our core, we specialize in creating opportunities for people around the world. What those opportunities look like can vary—often it is a business loan or a savings account that entrepreneurs use to work their way out of poverty. With financial services and training, farmers are buying better seed and growing more crops; rural mothers are saving valuable time by using their mobile phones to conduct transactions and grow their businesses; school leaders are building more classrooms, better bathrooms, and sturdier roofs to give more children a better education.
Poverty is complex, and cannot be solved with one organization or one solution—which is why Opportunity International is building innovative programs and partnerships around the world to make collective progress in the fight to end extreme poverty.
And through these innovative solutions and partnerships, we are working to achieve Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all ages.1
In outlining Sustainable Development Goal 3, the UN noted three primary areas of attention for health initiatives: 1) Child Health, 2) Maternal Health and 3) HIV/AIDS, malaria and other diseases. Each of these categories has a unique set of challenges and solutions, and through Opportunity’s partnerships and initiatives, we are tackling each one.
Healthy pregnancies, deliveries, infancies and early childhoods set children up to succeed later in life—and conversely, health challenges in the first few years of life can lead to lifelong developmental delays. In order to build the next generation of world changers, we must first make sure that the youngest members of our world are well cared for and healthy.
In 2015, 5.9 million children died before their fifth birthdays, and “more than half of these early child deaths were due to conditions that could be prevented or treated with access to simple, affordable interventions.” 2 Without access to medical care during pregnancy and delivery, “2.7 million babies die every year in their first month of life and a similar number are stillborn. Within the first month, up to half of all deaths occur within the first 24 hours of life, and 75% occur in the first week.” 3
Over the past few decades, we have made dramatic progress decreasing childhood mortality, but we still have a long way to go. About 80% of child deaths occur in sub-Saharan Africa and Southern Asia—regions in which Opportunity International works—and children born into poverty are almost twice as likely to die before the age of five than those born into wealthier families.4 Without resources, mothers are less likely to give birth in a health facility or with a skilled birth attendant—two practices that significantly increase a child’s chance of survival.5 And without training in healthcare best practices, women can’t learn the power of breastfeeding, skin-to-skin contact and other early behaviors that can improve a newborn’s health outcomes.
Once a child is a bit older, she is at risk of common preventable and treatable illnesses that can be particularly dangerous for young children. Without access to either health centers or health knowledge, parents are often unable to diagnose, treat or appropriately care for their ailing children, turning a simple sickness into an insurmountable problem.
Children who are undernourished, a condition affecting 795 million people worldwide,6 are at increased risk of these common ailments such as diarrhea, pneumonia and malaria. In fact, the role of nutrition is so significant that
nutrition-related factors contribute to about 45% of deaths in children under 5 years of age.
In addition, without adequate nutrition, children are at risk of stunting, which can lead to an underdeveloped brain and increased risks of chronic diseases in adulthood.
The more we learned about child health, the more we realized that our existing financial tools, coupled with new partnerships, could address many of the health challenges young children face. We have developed tools and services that help families make their homes safer and healthier for new babies and children of all ages.
In Colombia, our Roof and Floor program provides loans to for home improvement projects. Families use these loans to put a roof over their children’s heads, cover dirt floors with tile or build a designated kitchen or bathroom that can be kept clean. With a sturdy roof overhead, children are not exposed to the elements; and with a solid floor, children can safely play at home.
In India, we began providing loans so that families could purchase toilets for their homes and communities. This simple solution to a major sanitation problem enables families to keep their homes and neighborhoods cleaner and more sanitary for everyone—especially for women and girls who are at risk of suffering from illnesses or infections due to unsanitary practices during menstruation.
Finally, as we explored in April, Opportunity International is also actively fighting global hunger by investing in smallholder farmers around the world.9 By equipping farmers to feed their families and communities, we are able to curtail malnutrition, childhood stunting and the countless health challenges that either arise as a direct result or are made more severe because of undernourishment.
For children to be healthy, first their mothers must be healthy. Yet so many girls and women face countless health challenges stemming from poor sanitation, risks in pregnancy and childbirth and other risks exacerbated by extreme poverty. Healthy moms can better care for their children and ensure healthy families—building healthy futures for the whole community.
Between 800 and 1,500 women die each day from preventable causes related to pregnancy and childbirth, including bleeding, infections, hypertensive disorders and obstructed labor—preventative problems that make up about 80 percent of maternal deaths worldwide.10
Like childhood illnesses and death, maternal health mirrors the gap between the rich and the poor. “Less than 1% of maternal deaths occur in high-income countries,” and nearly two-thirds of maternal deaths occur in sub-Saharan Africa.11 Without access to prenatal care or skilled birth attendants, women face countless risks when it comes to their pregnancies and deliveries. These risks are made more severe by the same challenges that their children face—undernourishment and a lack of education.
Before becoming mothers, adolescent girls face their own health challenges related to childbearing. Without access to adequate sanitation facilities at school, they are often forced to forego their educations for several days each month. And without access to contraception or knowledge of family planning, they often have many children in rapid succession, often beginning at a young age. These young and frequent pregnancies further heighten the risks associated with childbearing and delivery, while simultaneously causing young girls to leave school and immediately begin caring for their own families.
Opportunity’s Education Finance plays a unique role in address maternal health. By ensuring that girls are able to stay in school, even as they reach puberty, we are not only equipping the current generation of women with the skills they need to thrive, but we are improving the odds of survival for both the girls and their future children.
Investing in education for girls improves women’s health during pregnancy and childbirth. Educated women are far more likely to seek skilled birth attendants and prenatal care, reducing both maternal and infant mortality.
If all women complete primary education, maternal mortality would fall 66%—from 210 to 71 deaths per 100,000 births.12
In addition, Opportunity invests in schools by providing loans to school proprietors so that they can build appropriate sanitation facilities. With access to private bathrooms, girls are able to stay in school—allowing them to complete their educations, delay their first pregnancies and learn valuable basic health skills in the classroom. By staying in school, girls are less likely to get pregnant early, meaning that they will have fewer children overall, which “could mean more resources per child and better health and survival rates for mothers and children.”13 The value of this education extends to the next generation as well; educated girls are better equipped to care for the needs and health of their own children once they become mothers.
Education is one of the secret weapons to address countless health challenges. Through all of our education initiatives, we are sparking lifelong and community wide transformation—for health, poverty alleviation, job creation and more.
For communities in extreme poverty, health risks are made even more severe because of a lack of resources and knowledge. In order to tackle some of the biggest health challenges we face today such as HIV, AIDS and malaria, we must first educate and equip communities with the skills and tools they need to prevent and treat these common ailments.
In addition to health challenges facing women and children in the developing world, many regions in which Opportunity works are at increased risk of HIV/AIDS, malaria and a range of preventable or treatable diseases. These illnesses are often caused or made worse by unsafe or unhygienic practices such as unprotected sex, not washing hands, open defecation or not using bed nets to protect against mosquitoes—practices that could easily be adopted or changed with adequate training and education.
According to the UN, “Unhealthy environmental conditions increase the risk of both communicable and infectious diseases...In 2012, an estimated 889,000 people died from infectious diseases caused largely by fecal contamination of water and soil and by inadequate hand-washing facilities and practices resulting from poor or non-existent sanitation services.14
In 2001, the UN General Assembly “declared HIV/AIDS to be ‘a global emergency,’” and two-thirds of HIV infections are in sub-Saharan Africa.15 The correlation between poverty and HIV/AIDS works in both directions; more than 95% of HIV infections are in developing countries where there is less education about sexually transmitted disease and mother-to-child transmission, less access to affordable contraception and less voluntary HIV testing, but at the same time, poverty increases as households “lose one or more breadwinners to AIDS." 16
Poverty makes the AIDS crisis worse, and the AIDS crisis makes poverty worse.
Africa also carries a “disproportionately high share of the global malaria burden. In 2015, the region was home to 90% of malaria cases and 92% of malaria deaths.” 17 Without access to simple preventative measures like bed nets, people are at high risk for malaria. Young children, pregnant women and immunosuppressed populations are at particularly high risk for the disease—populations that are already vulnerable to a number of other ailments.
In India, Opportunity International has partnered with Healing Fields Foundation to train women as Community Health Leaders (CHLs) who learn healthcare best-practices and are trained to provide basic health services in their communities. Following their six-month training, CHLs undertake a six-month internship where each woman educates 200 families on the link between health and hygiene, promoting simple-but-life-saving behaviors like giving birth in a hospital, breastfeeding on the first day of a child’s life and getting medical checks for infants and lactating mothers.
As our Community Health Leaders in India finish their initial internships, many women establish healthcare businesses as a source of income for themselves, which range from selling sanitary napkins, rehydration salts and mosquito nets to connecting families to microloans for building toilets and improving clean water supply. By providing much-needed health supplies to vulnerable communities, these CHLs are not only a source of valuable education, but also of life-changing tools.
Similarly, Opportunity has partnered with local medical clinics in Nicaragua to train more than 260 women on basic health topics, equipping them to serve and care for their families and communities with this new knowledge.
As Opportunity continues to pursue partnerships and innovative solutions, we are ever-mindful of the interconnectedness of so many of our global goals. We recognize that as we work to address education and hunger and job creation, those goals both require and lead to good health.
We are encouraged by the steps our clients have taken to improve sanitation—in homes, in schools and in communities—and we continue to invest in and support education as a mechanism through which we can improve health outcomes for mothers, children and populations more broadly.
Most of all, we recognize that seeking partners who are experts in global health development will help us better serve the needs of our clients and their neighbors. As we move toward our goal of ending extreme poverty, health will continue to be a critical element of sustainable development—and one that we cannot address alone. We work in partnership with global experts to foster lasting change, and together, we work to achieve Sustainable Development Goal 3: healthy lives and well-being for all.
Allison is a professional storyteller, freelance writer, and avid traveler. She spent the last year backpacking around the world meeting and interviewing incredible people with remarkable stories, eating amazing food, and climbing very scary mountains. Now, she lives in Chicago where she runs a small business helping nonprofit organizations identify, create, and share their stories, equipping them to better do the work they were born to do. When she's not working, you can usually find her reading a book, planning her next trip, or baking the best cookies on the planet.
10 Half the Sky Fast Facts, http://www.halftheskymovement.org/page/-/fastfacts.pdf
12 UNESCO, 2013. “Education Transforms Lives”