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World Health Organization : Year 1998 ; World Health Organization, Reproductive Health(Technical Support), No. 98.28: Dalys and Reproductive Health ; Report of an Informal Consultation

By World Health Organization

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Book Id: WPLBN0000109093
Format Type: PDF eBook
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Reproduction Date: 2005
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Title: World Health Organization : Year 1998 ; World Health Organization, Reproductive Health(Technical Support), No. 98.28: Dalys and Reproductive Health ; Report of an Informal Consultation  
Author: World Health Organization
Volume:
Language: English
Subject: Health., Public health, Wellness programs
Collections: Medical Library Collection, World Health Collection
Historic
Publication Date:
Publisher: World Health Organization

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Organization, W. H. (n.d.). World Health Organization : Year 1998 ; World Health Organization, Reproductive Health(Technical Support), No. 98.28. Retrieved from http://hawaiilibrary.net/


Description
Medical Reference Publication

Excerpt
1. INTRODUCTION The informal consultation on 'DALYs and Reproductive Health' held at the World Health Organization (WHO), Geneva, 27-28 April 1998, provided an important opportunity to discuss the use of the Disability Adjusted Life Year (DALY) as a metric for the estimation of the burden of disease due to reproductive ill-health. The group of experts from 12 countries, were drawn from both reproductive health and measurement of disease fields (see List of Participants Annex 2). The purpose of this report is to summarise these discussions, in particular: to clarify the value judgements and assumptions made in using the DALY metric to estimate the global burden of disease; to highlight major concerns and gaps in the 1990 Global Burden of Disease (GBD) analysis; to identify improvements for the GBD exercise for 2000, and to suggest further research to better capture the burden of reproductive ill health. This document is, therefore, not a detailed critique of the DALY methodology as such, since ample literature already exists on this topic (Anand and Hanson 1997, Paalman et a1 1998 among others). Rather it represents an analysis of the difficulties inherent in estimating the GBD due to reproductive health conditions using the DALY methodology.

Table of Contents
CONTENTS 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Rationale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Objectives of the consultation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 The development of the DALY and links to the GBD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 What are DALYs and how are they measured? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 The concept of reproductive health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Capturing the burden of reproductive ill health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Problems in measuring the full burden of reproductive ill health . . . . . . . . . . . . . . . . . . . . . 8 3 . The epidemiological database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3.1 Range and quality of data used in the GBD study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3.2 Measuring reproductive morbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.3 What data exist? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 6 3.4 Improving the use of existing data sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 3.5 Neglected areas of reproductive health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 3.6 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 4. Valuing health states . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 4.1 Major concerns raised . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 4.2 Micro-study on the valuation of health states in a resource poor setting . . . . . . . . . . . . . . 22 4.3 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 5 . Capturing the gender dimension in the GBD . . . . . . . . . . . . . . . . . . . . . 25 5.1 Gender differences in health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 5.2 Gender bias in the DALY methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 5.3 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 6 . Conclusions and recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 7 . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Annex 1 : Classification of Reproductive Mortality and Morbidity . . . . . . . . . . . . . . . . . . . . . . . 33 Annex 2 : List of Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

 

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