Monitoring Sustainable Health Development at the Municipal Level in Brazil: Evidence from the MSDHI
1
René Rachou Institute, Fundação Oswaldo Cruz (Fiocruz), Belo Horizonte, Brazil
2
Ministry of Health, Brasília, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1305
ABSTRACT
INTRODUCTION:
The 2030 Agenda for Sustainable Development provides a comprehensive framework to address global challenges through their interrelated Sustainable Development Goals (SDGs). Progress toward these goals depends on policies that are sensitive to local contexts, as territories differ widely in their social, demographic, and health system characteristics. The Municipal Sustainable Development Health Index (MSDHI) was therefore developed to monitor health-related targets of the 2030 Agenda at the municipal level in Brazil.
METHODS:
The MSDHI methodology followed a systematic eight-step procedure and combined multiple health-related indicators grouped into thematic subindexes: (1) Reproductive and maternal health, (2) Newborn and child health, (3) Infectious diseases, (4) non-communicable diseases, (5) Injuries and violence, (6) Environmental risks, and (7) Universal health coverage and health systems. We estimated the MSDHI for all 5,570 Brazilian municipalities, using publicly administrative data from 2018 to 2022. We conducted a set of descriptive, comparative, and dispersion analyses to examine the distribution and relative performance of the MSDHI and its subindexes across municipalities. The results were further analyzed by grouping municipalities with similar levels of population size, vulnerability, as well as through within-state comparisons.
RESULTS:
The analysis reveals pronounced inequalities in MSDHI scores across Brazilian municipalities, even after stratifying by population size and vulnerability. Even among municipalities classified as having satisfactory relative performance, the subindexes reveal specific thematic areas that remain below desired levels, requiring targeted policy attention. Regarding federal states, we found substantial within-state heterogeneity in municipal MSDHI. The coefficient of variation averages 48.6%, ranging from 18.9% to 129.6%, indicating that even within the same state, municipalities may differ in their levels of sustainable health development.
CONCLUSIONS:
The results highlight that monitoring inequalities trough MSDHI may help translating empirical evidence into equity-oriented policies.
The 2030 Agenda for Sustainable Development provides a comprehensive framework to address global challenges through their interrelated Sustainable Development Goals (SDGs). Progress toward these goals depends on policies that are sensitive to local contexts, as territories differ widely in their social, demographic, and health system characteristics. The Municipal Sustainable Development Health Index (MSDHI) was therefore developed to monitor health-related targets of the 2030 Agenda at the municipal level in Brazil.
METHODS:
The MSDHI methodology followed a systematic eight-step procedure and combined multiple health-related indicators grouped into thematic subindexes: (1) Reproductive and maternal health, (2) Newborn and child health, (3) Infectious diseases, (4) non-communicable diseases, (5) Injuries and violence, (6) Environmental risks, and (7) Universal health coverage and health systems. We estimated the MSDHI for all 5,570 Brazilian municipalities, using publicly administrative data from 2018 to 2022. We conducted a set of descriptive, comparative, and dispersion analyses to examine the distribution and relative performance of the MSDHI and its subindexes across municipalities. The results were further analyzed by grouping municipalities with similar levels of population size, vulnerability, as well as through within-state comparisons.
RESULTS:
The analysis reveals pronounced inequalities in MSDHI scores across Brazilian municipalities, even after stratifying by population size and vulnerability. Even among municipalities classified as having satisfactory relative performance, the subindexes reveal specific thematic areas that remain below desired levels, requiring targeted policy attention. Regarding federal states, we found substantial within-state heterogeneity in municipal MSDHI. The coefficient of variation averages 48.6%, ranging from 18.9% to 129.6%, indicating that even within the same state, municipalities may differ in their levels of sustainable health development.
CONCLUSIONS:
The results highlight that monitoring inequalities trough MSDHI may help translating empirical evidence into equity-oriented policies.
| eISSN: | 2654-1459 |
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