Per cent (%)

Within United Nations Sustainable Development Goals, Health Target 3.5 calls to “strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol” with an indicators 3.5.1 on “coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for SUD”.

The coverage of treatment interventions for substance use disorders (alcohol and drug use disorders) is defined as the number of people who received treatment in a year divided by the total number of people with substance use disorders (alcohol and drug use disorders) in the same year.

This indicator is disaggregated by two broad groups of psychoactive substances: (1) drugs and (2) alcohol.

The treatment contact coverage for alcohol and drug use disorders is calculated for those countries which provided nationwide data on the number of people receiving treatment services at least once in a year, dividing it by the total number of people with alcohol or drug use disorders in the same year and multiplying by 100.

The indicator is computed by dividing the number of people receiving treatment services at least once in a year by the total number of people with substance use disorders in the same year:

Global and regional aggregates are produced when enough data at the country level are available (a minimum number of countries and a minimum percentage of population coverage). The global level is computed as aggregation of regional estimates.

N/A

Every 4-5 years

Every 4-5 years

Preferred data sources: The data generated by the WHO Global Survey on Progress on SDG health target 3.5 served as the main source of the data for the numerator (number of people in treatment). The data collection tool included a section that specifically focused on service coverage for substance use disorders (SUDs). Data of prevalence of alcohol use disorders used as denominator are taken from WHO Global Information System on Alcohol and Health (indicator on Alcohol use disorders (15+), 12 month prevalence) and estimates of the prevalence of drug use disorders are produced by the Institute for Health Metrics and Evaluation (IHME), and published through the Global Burden of Disease (GBD) study.

Should be interpreted in conjunction with the indicator on Service Capacity Index for Substance Use Disorders (SCI-SUD).

krupchankad@who.int

Dzmitry Krupchanka

A number of challenges have been identified in approaching the contact coverage for reporting the SDG 3.5.1 indicator. First, there is a deficit of data suitable for these purposes at the global, regional and national levels. Even when data on a number of service contacts are routinely collected, the availability of and access to these data for research purposes are limited in the majority of countries. Second, in many countries there is a lack of—or insufficient –capacity to work with existing routinely collected health data for reporting purposes. Third, nationwide routinely collected health data are unavailable or incomplete in many countries, while the quality of available data is largely unknown due to the lack of data validation exercises. Fourth, in an attempt to compare information across countries/perform cross-country comparisons, one can face problems due to the diversity of health information systems. For example, in some countries service utilization is assessed through the number of cases (treatment episodes), while in other countries through the number of people who get in touch with services in a given year. In addition, an estimation of the proportion of people with SUD in need of treatment within any particular period of time presents supplementary challenges as well as the overall complexity of defining treatment needs (normative, felt or expressed). In fact, not all people with normative needs (having a SUD) will look for treatment (felt and expressed needs), and not all who receive care (contact coverage) will benefit from treatment (effective coverage), while some people might have spontaneous remission without formal treatment or receiving support outside of health services (e.g., from mutual support groups). And, finally, one of the key challenges when it comes to SUD is that treatment and care services in many countries are distributed across different sectors (such as medical, social, criminal justice), and governmental and non-governmental structures that complicate further collection, collation and analysis of available information. In some countries, treatment services for AUD and DUD are provided in different facilities and even coordinated by different ministries, therefore, it might be difficult to obtain disaggregated data to measure coverage separately for AUD and DUD, although such information is relevant for various stakeholders and decision makers.