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Estimating National Burden of Disease    

The Burden of Disease in Andhra Pradesh 1990s

Dr. Prasanta Mahapatra

  
An Overview

The concept of health underwent significant changes during the twentieth century. A twentieth century hallmark was the WHO's founding definition, in 1948, of health as "a state of physical, mental and psychological well being, and not merely the absence of disease". But mere enlightenment is usually not enough to change the way we do things. The epidemiological transition from high to low mortality conditions made it necessary to look at new ways of measuring population health by combining the mortality and morbidity experience. These transitions produce characteristic changes in disease profile and age composition, namely: (a) reduced incidence or prevalence of infectious diseases, (b) increased prevalence of non - communicable and degenerative diseases, and (c) increase in proportion of elderly and geriatric population. Each of these changes has its impact on the measurement of health status. Rising costs of health care, provided added impetus towards development of summary measures of health status to facilitate cost-effectiveness studies. Although, the WHO adopted an inclusive definition of health in 1948, conventional measures of health status like the life expectancy, infant mortality rate, and disease specific measures of morbidity continued to provide the basic framework of indicators of health status. By end of the twentieth century, after 52 years of its founding, WHO adopted a set of summary measures of population health status. These new measures are being commonly referred to as burden of disease measures, since they combine the impact of diseases on mortality as well as morbidity. The World Health Report, 2000 (WHR, 2000) contained a set of health status measurements for different countries using the Burden of disease framework. Publication of the WHR 2000 has stimulated interest in National Burden of Disease studies. This book describes the experience and insights from the first National Burden of Disease study started after publication of the Global Burden of Disease (GBD) estimates in the World Bank's World Development Report, 1993. The Andhra Pradesh Burden of Disease study was started in 1993. However, it took about seven years for the study to partially complete, leading to publication of these results. This book is result of this long exercise. The book describes in detail various aspects of the NBD estimation process, focusing on the Andhra Pradesh state in India. A major concern addressed by the book is how to anchor NBD estimates to local data and there by provide a strong foundation of evidence and information for policy. Although the book revolves around the AP state in India, its contents has wider application and will be a useful guide for National Burden of Disease Studies


Free Downloads:
Chapter-1: Introduction
Chapter-8: Local age preference, age weight and discounting parameters for computation of DALYs
Appendix-1-1: The DALY Formula


Persons who bought the Estimate of National Burden of Disease book can download the errata page which has been added.

To order a copy of the book, please write to ihs@ihs.org.in
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