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Global health statistics: living longer, living better, reducing inequalities

Global health statistics: living longer, living better, reducing inequalities. Colin Mathers World Statistics Day, 20 October 2010. Global health statistics. WHO is constitutionally mandated to "establish and maintain ….. epidemiological and statistical services" and

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Global health statistics: living longer, living better, reducing inequalities

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  1. Global health statistics: living longer, living better, reducing inequalities Colin Mathers World Statistics Day, 20 October 2010

  2. Global health statistics • WHO is constitutionally mandated to • "establish and maintain ….. epidemiological and statistical services" and • "assist in developing an informed public opinion among all peoples on matters of health" (WHO Constitution 1947)

  3. Information & Evidence work at WHO Data Generation Data Compilation Analysis and synthesis of data Dissemination and use Core indicators and statistics Norms and standards Databases Flagship publications Classifications and terminology World Health Statistics Surveillance Disease-specific: eg. HIV, TB, malaria Disease registers Methods and tools for data collection (including ethics) Global Health Observatory Life expectancy etc Registration data Multi-country data collection Health related MDGs Data archive (surveys) WHO website Comprehensive estimates Health and health-related statistics Population health surveys, vital registration Deaths by cause, age, sex Health research Burden of disease (overall summary of lost healthy years) Country system and capacity building Health metrics network Comparative risk assessment Systematic reviews of evidence and meta-analyses Health information systems (including population surveys) Vital registration systems

  4. WHO Core Indicators(DRAFT October 4, 2010) Inputs & processes Outputs Outcomes Impact

  5. Global Health Observatorywww.who/gho • WHO's portal to data and analyses for monitoring global health. • Direct access to major databases • World Health Statistics online tables • Critical data and analyses for key health themes and indicators • Country profiles by theme: core health indicators, MDGs etc • Interactive data tables and visualisations • Indicator and Metadata Registry; standards for metadata • Topical reports: Women and Health, Africa • Resource inventory; web-based registry of country data reports

  6. Database example: the WHO Mortality Databasehttp://www.who.int/healthinfo/morttables/en/ • Data are reported on an annual basis by country, year, sex, age and cause of death from civil registries • Causes of death are coded according to the International Statistical Classification of Diseases and Related Health Problems (ICD) • Historical data since 1950 with data coded to ICD 6, 7, 8, 9 and 10th revision • ICD 11th revision currently in alpha draft (release 2011)

  7. Coverage of the WHO Mortality Database Of the reporting countries, half are developed providing 75% of the deaths included, but only 33% of estimated global deaths

  8. Cardiovascular disease mortality trends

  9. Analysis and synthesis: maternal mortality 24 countries had no nationally representative data that met inclusion criteriaTrends for 172 countries 1990-2009 estimated by an interagency working group - input data sets, analysis programs, estimates and report on WHO website

  10. Maternal mortality ratios at country level www.who.int/maternal_health/en

  11. Is the pace of change sufficient?MDG 6: Combat AIDS, malaria and other diseases Prevalence of TB Incidence of HIV infection • Malaria: • 38 countries on track to reduce the malaria-related burden of disease • 9 African countries; 29 outside Africa

  12. The poorest are least likely to use health care:especially use of skilled care during childbirth Data for 47 developing countries

  13. Types of health statistics • Unadjusted health statistics derived directly from primary data collection with no adjustments or corrections. • Adjusted health statistics corrected to deal with known biases, use of indirect techniques. • Predicted health statistics based on a model relating the quantity of interest to covariates. • Forecasting: past relationships to predict future • Farcasting: missing primary data

  14. Comprehensive estimates: deaths by cause, age, sex Adult mortality rates by major cause group and region, 2004

  15. Comparative risk assessment Percentage of disability-adjusted life years (DALYs)attributed to 19 leading risk factors, by country income level, 2004

  16. Addressing the challenges • Assist Member States to build sound information systems that can generate high frequency data to monitor change • Promote and assist countries to implement and scale up vital registration systems • Work with research partners to develop innovative methods to collect information on mortality and cause of death in populations without vital registration (MOVE-IT) • Develop improved methods for dealing with incomplete and biased health data to generate comparable estimates of core indicators across countries • Improve transparency and replicability of statistics • Improve dissemination and access (Global Health Observatory)

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