Daniel Helldén’s research while affiliated with Karolinska Institutet and other places

Despite efforts to realize Agenda 2030, the sustainable development goals (SDGs) may not be achieved. This already now impacts public health and healthcare, including the training of providers. “Sustainable health” addresses this urgency by emphasizing health as key to achieving the SDGs. While the UN developed a competency framework for teachers in 2011, the specific competencies needed to train in sustainable health remain unclear. Transformative learning (TL) is crucial to integrating sustainable development in higher education (HE), yet its application in the education of health professionals is limited. TL entails a profound transformative journey that reshapes perceptions and experiences, necessitating a shift in the educator’s role from information provider to facilitator of transformative processes. According to a 2019 literature review on TL for healthcare students, teachers need detailed and practical guidelines on how to implement TL. We aimed to develop an evidence-based matrix outlining a) the educational strategies needed to ensure that students develop sustainable health competencies, and b) the competencies teachers need to use these strategies in a quality-assured way. We conducted a literature review to identify key dimensions of teacher competencies and educational strategies for sustainable health. We surveyed teachers at Karolinska Institutet to assess the relevance of these competencies and teachers’ confidence in using them. Focus group discussions were conducted, to explore barriers and enablers to develop competencies and use educational strategies. We present a competency framework for HE teachers, accompanied by recommended educational strategies and self-assessment tools to gauge further training needs. To be used by teachers and educational developers, it will be openly accessible in Swedish and English. This study contributes to enhancing competencies in training health professionals to contribute to achieving sustainable health for all. Key messages • Educators need to be equipped with competencies to lead transformative learning processes to enable future generations of health professionals to achieve sustainable health for all. • Educators need to be supported to transform their role and practice to provide relevant training for future health care providers.

The international response to the COVID-19 pandemic provided opportunities for countries to use digital technologies for vaccine deployment and associated activities, but misaligned digital investments could weaken or fragment national systems. In this review of 311 funding applications from 120 country governments to four donor agencies (UNICEF; Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the World Bank) up to May 1, 2022, we found that 272 (87%) of the applications included at least one digital aspect and that substantial funding has been dedicated towards digital aspects from donors. The majority of digital aspects concerned immunisation information systems, vaccine acceptance and uptake, and COVID-19 surveillance. As the global community sets its sights on a COVID-19-free world, continued coordinated investments in digital health and health information systems for pandemic preparedness and response will be key to strengthening the resilience of health systems.

There is great urgency for action to achieve the Sustainable Development Goals, especially in fragile settings, which face acute and complex challenges. Yet, the public sector may be limited in its capacity to address these appropriately, with devastating effects on the health of people and environment now and in the future. The challenges to sustainable health require professionals who are trained relevant competences. In 2020, Karolinska Institutet, Sweden, and Makerere University, Uganda, developed the Centre of Excellence for Sustainable Health under which a new partnership was established with Benadir University, Somalia, Kinshasa School of Public Health, the Democratic Republic of Congo, and Tinkr, Norway to develop training on innovation for sustainable health. The aim of “Managing Innovation for Sustainable Health” (MISH) is to strengthen the capacity to contribute to achieving sustainable health through innovation in the public sector. It targets managers in Somalia, DRC and Uganda from the public and private sector, academia, and civil society. It is one year long, part-time and delivered online with one study trip. It features three modules covering Agenda 2030 and Sustainable Health; Multisectoral Collaboration and Implementation Science; and Innovation and Innovation Management. Integration of participants’ learnings into their professional role, mutual learning between participants, and an emphasis on applicability, all underpin the learning strategies of the program. Quality is monitored through expectation surveys, baseline mid and final impact assessments, module and final program evaluations. MISH has trained about 50 managers, 85% of which say that the training was useful. All partners are represented in both operational and strategic organizational bodies of the program. Our model shows what is possible through collaborative online international learning delivered by partnerships defined by teamwork, trust, and a dedication to true impact. Key messages • There is great urgency for action to achieve sustainable health especially in fragile settings. • There is momentum for higher education to leverage the opportunities of the covid-19 to rethink learning for the global challenges.

Background: The Sustainable Development Goals (SDGs) are integrated, indivisible and interdependent and interact and affect each other directly and indirectly. However, the 2030 Agenda does not attempt to identify or characterise these interactions. Evidence: The SDG Synergies approach was developed to enable the investigation of the strength and nature of interactions between SDGs based on the perception of a multistakeholder group. Two examples are given to concretely demonstrate how this approach overcomes present challenges and can be applied to situate health within the 2030 Agenda. Policy Options and Recommendations: There are clear benefits to situate desired health policy outcomes within the 2030 Agenda, and the SDG Synergies approach can be used as lever for including health aspects in traditional non-health sectors. Although focusing on specific health policies cannot be substituted with multisectoral policies alone, utilizing tools and methods such as the SDG Synergies approach can help policy makers put health at the centre of the SDGs. Conclusion: SDG Synergies is an impactful approach for policy makers to gain a systemic understanding of how broader sustainable development shape the health and well-being of people and vice versa.