The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69132

Adnan A. Hyder, MD, MPH, PhD¹, Salman A. Wali, MD, MPH¹, Abdul Ghaffar, MD, MPH, MHA², and Tayyeb I Masood, MBBS, MPH³. (1) Department of International Health, Division of Community Health and Health Systems, Johns Hopkins University, 615 N. Wolfe Street, Suite E-8132, Baltimore, MD 21205, 410-955-1253, ahyder@jhsph.edu, (2) Health Systems, Global Forum for Health Research, 20 avenue Appia, 1211 Geneva 27, Switzerland, (3) Health Systems, Health Services Academy, 12-D West, Bewel Plaza, Blue area, Islamabad, Pakistan

Introduction: In developing country settings, with inadequate vital registration systems, finding valid and reliable data is the greatest challenge in determining the burden of disease. The Federal Bureau of Statistics in Pakistan maintains a surveillance system that records vital events of nationally representative samples across the country. Results are reported in Pakistan Demographic Survey (PDS). This study uses the mortality data reported in PDS-1997 to assess the burden of premature mortality for Pakistan. Methods: PDS-1997 is a surveillance system involving quarterly enumeration of vital events. The adjusted mortality data from PDS was used to estimate the burden of premature mortality. The cause of death data was redistributed into three categories: infections, maternal and perinatal conditions, and malnutrition; chronic, non-communicable diseases; and injuries. Burden of premature mortality was calculated using the Healthy Life Year (HeaLY) methodology. Results: Burden of premature mortality for Pakistan was 47 million HeaLYs for the year 1997. This translates into a rate of 367 HeaLYs per 1000 population. More than half of the HeaLYs are being lost due to infection, maternal and perinatal conditions, and malnutrition, chronic non-communicable conditions result in the loss of nearly 40% of the HeaLYs. 6% of total HeaLYs are lost due to injuries. Conclusion: In the absence a system maintaining reliable information regarding vital events, PDS provides a good alternate source of such information. This data provides statistical information that can be used to aid policy making for health care systems and future research.

Learning Objectives:

At the conclusion of this presentation, the learners will be able to:
• Discuss the application of community-based surveillance data to create a national burden of disease profile.
• Discuss data challenges in developing countries.
• Apply HeaLY methods in developing country settings to get the national estimates of the burden of premature mortality.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.