Can Jiangsu province achieve the health-related Sustainable Development Goals and Healthy Jiangsu 2030 goals? A systematic analysis on the current situation and projected attainment

Abstract Background Despite relative affluence, Jiangsu, China, faces challenges brought by disease burdens, regional disparities, ageing, and migrant workforce, in achieving the health-related Sustainable Development Goals (SDGs) and Healthy Jiangsu 2030 goals. Therefore, we aimed to assess the current situation, gaps, and projection of Jiangsu attaining these goals. Methods We did a systematic analysis using a combination of quantitative and qualitative methods. We collected quantitative data from national and provincial health-related government agencies and the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016). We did semi-structured interviews with key stakeholders at provincial and sub-provincial levels. We also included other policy documents and grey literatures. On the basis of the model developed by the SDG Collaborators of GBD 2016, we did projections to assess the attainment of the quantitative health targets in Jiangsu. We also explored the gender disparities. Our study protocol was reviewed and approved by the Institutional Review Board of Duke University. Findings At baseline in 2015, Jiangsu performed well in indicators related to child under-nutrition and maternal and child health, meeting targets of the SDGs early. By 2030, Jiangsu is expected to meet targets in mental health, environmental health, and universal health coverage. However, our projections indicate that Jiangsu will not achieve the targets in exclusive breastfeeding, child overweight, infectious diseases, and non-communicable diseases, according to current trajectories. 7–28 day exclusive breastfeeding rate is expected to increase to 25·6%, a huge gap compared with the 6-month 50% target. Child overweight rate (1–4 years) was projected to increase by 2·6% compared with the zero increase target. The incidence of HIV/AIDS were projected to decrease to 0·9 per 100 000 population and tuberculosis to 15·3 per 100 000 population in 2030, suggesting that ending these epidemics would be highly improbable. New cases of hepatitis B virus and hepatitis C virus infections were projected to decrease by 45·3%, which is far from the 90% target. Large gender disparity was seen in non-communicable diseases, such as premature mortality and smoking rates. Interpretation The provincial Government of Jiangsu needs to take immediate and concerted actions to meet the SDGs and the Healthy Jiangsu 2030 goals. Funding Bill u0026 Melinda Gates Foundation (grant number OOP1148464 )