health metrics

RECENT POSTS

WHO Responds on Maternal Deaths Data

I wrote last week about the World Health Organization revising down its numbers on maternal mortality, noting that the UN agency had arrived at basically the same place as some Seattle-based researchers roundly criticized for previously challenging WHO’s higher estimates.

Basically, it was good news. Maternal deaths are down to about 350,000 annually as opposed to the previous estimate of half a million. That’s still unacceptably high, of course, but it is progress.

Last spring, the New York Times quoted the editor of the Lancet, Richard Horton, saying he had been pressured “to delay or hold publication” of the Seattle group’s findings because some feared the lower numbers would hurt fund-raising and cause “potential political damage to maternal advocacy campaigns.”

WHO’s Colin Mathers was gracious enough to respond, explaining that they arrived at the same place as Seattle’s Institute for Health Metrics and Evaluation but by a different path, and with a few variations.

“Maternal mortality is one of the most difficult indicators to measure,” says Mathers. Causes of maternal death are often incorrectly reported, he says, and health institutions are often loathe to report them because of the “stigma” of having high rates of maternal deaths.

Mathers’ complete response is detailed and long. For you data geeks, who want to read the whole thing, please Continue reading

Educating Mothers Saves Children’s Lives

It’s perhaps no surprise to find that better-educated mothers do better at improving the health of their children, but it may surprise some to see how much of a difference this can make — and that it matters much more than economic gain.

IHME

Child Mortality vs Maternal Education, Nicaragua

Between 1970 and 2009, mortality in children under age 5 dropped from 16 million to 7.8 million annually worldwide. Seattle researchers who studied this phenomenon in 175 countries report today in the Lancet that more than half of this reduction in child mortality (51 percent) can be attributed to improvements in education among women of reproductive age.

To the right is just one of their “scatterplots” for Nicaragua (go to their paper to get more info re the details) showing quite dramatically how child mortality plummets as maternal education rises — even if GDP per capita declines. Continue reading

World Health Organization Eats Crow, Cuts Maternal Death Numbers

WHO

World Health Organization

The World Health Organization made great progress in the global campaign to reduce maternal mortality today.

The WHO has cut its estimate of worldwide maternal mortality by more than a third — from about half a million deaths to about 350,000 deaths per year.

The UN Agency didn’t make much of a public announcement but it did issue a detailed report. However, it’s still not clear based on a cursory reading why some similar findings earlier rejected are now accepted.

Oh, if only we could so easily reduce all causes of death, disease and poverty.

Numbers in global health can sometimes flow like the tide. Continue reading

Mental Illness Disease Burden a Surprise To Everyone, Researcher Recalls

Albert Einstein said the key to solving a problem is in how you define the problem. If critical problems in global health are poorly defined, or left out of the equation, it’s going to be hard to solve them.

On Tuesday, I wrote that mental illness is often neglected when we talk about global health. I mentioned how Paul Bolton, a tropical medicine doctor working in Thailand, was converted in the 1990s from a focus on treating physical disease to expanding mental health therapies in the developing world.

Flickr, by Dierk Schaefer

Neon Brain

In short, Bolton read the 1990 Global Burden of Disease report, which was really the first comprehensive, quantitative assessment of the primary causes of death and disability worldwide. Mental illness, it turned out, was a much bigger problem than had been thought.

“Globally, neuro-psychiatric conditions are estimated to account for almost 30 per cent of all YLDs (years of life lost to disability), far in excess of any other specific category,” 1990 Global Burden of Disease report.

Yesterday, I talked to one of the author’s of Bolton’s conversion — Alan Lopez, head of population health at the University of Queensland in Australia and a professor of global health at the UW. Continue reading

Study: Foreign Aid for Anti-Malaria Bed Nets Works

Mosquito net

Flickr, by Prezius

Mosquito net

Insecticide-treated mosquito nets can prevent malaria infection, no question.

Getting people to use them as intended is another thing. Reports of people in African communities using them to catch fish, make fences or for other creative purposes has prompted some to claim bed net distribution is not effective for fighting malaria and is misguided if not counterproductive.

Others contended the nets should be sold, rather than donated, so recipients value them.

A new study by the UW’s Institute for Health Metrics and Evaluation has found that African countries who have received major support for bed net distribution are using them as intended and many more children are being protected from malaria.

Bottom line, said IHME director Dr. Chris Murray: “More money means more children sleeping under bed nets.”

How to Win Friends and Influence Global Health Policy

One of the biggest challenges in global health is getting accurate information.

I once interviewed a health official in Abidjan, Ivory Coast, who proudly handed me data showing the government had pushed its immunization coverage rates up to 120 percent. Wow! How’d they do that?

You can help those trying to improve this situation by participating in a 15-minute survey for the new Global Burden of Disease study, a massive analysis aimed at determining what kills, sickens and injures worldwide.

When Chris Murray, now director of the UW’s Institute for Health Metrics and Evaluation, and his colleague Alan Lopez did the first “Global Burden” study back in 1990, it’s fair to say they transformed the way we look at disease and health. One of the primary products of the Murray-Lopez collaboration was the DALY, or “disability adjusted life year,” measurement that they believe more accurately portrays the impact of health and disease.

World map of DALY measures

WHO

Darker and redder means unhealthier, global DALY rankings

Continue reading