Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years
The use of the disability-adjusted life year (DALY) as the unit in which to calculate the burden of disease associated with reproductive ill-health has given rise to considerable debate. Criticisms include the failure to address the problem of missing and inadequate epidemiological data, inability t...
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| Format: | Article |
| Language: | English |
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The World Health Organization
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| Series: | Bulletin of the World Health Organization |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000500010&lng=en&tlng=en |
| _version_ | 1797285056527466496 |
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| author | C. AbouZahr J.P. Vaughan |
| author_facet | C. AbouZahr J.P. Vaughan |
| author_sort | C. AbouZahr |
| collection | DOAJ |
| description | The use of the disability-adjusted life year (DALY) as the unit in which to calculate the burden of disease associated with reproductive ill-health has given rise to considerable debate. Criticisms include the failure to address the problem of missing and inadequate epidemiological data, inability to deal adequately with co-morbidities, and lack of transparency in the process of ascribing disability weights to sexual and reproductive health conditions. Many of these criticisms could be addressed within the current DALY framework and a number of suggestions to do so are made. These suggestions include: (1) developing an international research strategy to determine the incidence and prevalence of reproductive ill-health and diseases, including the risk of long-term complications; (2) undertaking a research strategy using case studies, population-based surveillance data and longitudinal studies to identify, evaluate and utilize more of the existing national data sources on sexual and reproductive health; (3) comprehensively mapping the natural history of sexual and reproductive health conditions - in males and in females - and their sequelae, whether physical or psychological; (4) developing valuation instruments that are adaptable for both chronic and acute health states, that reflect a range of severity for each health state and can be modified to reflect prognosis; (5) undertaking a full review of the DALY methodology to determine what changes may be made to reduce sources of methodological and gender bias. Despite the many criticisms of the DALY as a measurement unit, it represents a major conceptual advance since it permits the combination of life expectancy and levels of dysfunction into a single measure. Measuring reproductive ill-health by counting deaths alone is inadequate for a proper understanding of the dimensions of the problem because of the young age of many of the deaths associated with reproductive ill-health and the large component of years lived with disability from many of the associated conditions. |
| first_indexed | 2024-03-07T17:57:40Z |
| format | Article |
| id | doaj.art-4f8e4bfe4fd34356a9719830f81cc891 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:57:40Z |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-4f8e4bfe4fd34356a9719830f81cc8912024-03-02T11:46:17ZengThe World Health OrganizationBulletin of the World Health Organization0042-968678565566610.1590/S0042-96862000000500010S0042-96862000000500010Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life yearsC. AbouZahr0J.P. Vaughan1World Health OrganizationLondon School of Hygiene and Tropical MedicineThe use of the disability-adjusted life year (DALY) as the unit in which to calculate the burden of disease associated with reproductive ill-health has given rise to considerable debate. Criticisms include the failure to address the problem of missing and inadequate epidemiological data, inability to deal adequately with co-morbidities, and lack of transparency in the process of ascribing disability weights to sexual and reproductive health conditions. Many of these criticisms could be addressed within the current DALY framework and a number of suggestions to do so are made. These suggestions include: (1) developing an international research strategy to determine the incidence and prevalence of reproductive ill-health and diseases, including the risk of long-term complications; (2) undertaking a research strategy using case studies, population-based surveillance data and longitudinal studies to identify, evaluate and utilize more of the existing national data sources on sexual and reproductive health; (3) comprehensively mapping the natural history of sexual and reproductive health conditions - in males and in females - and their sequelae, whether physical or psychological; (4) developing valuation instruments that are adaptable for both chronic and acute health states, that reflect a range of severity for each health state and can be modified to reflect prognosis; (5) undertaking a full review of the DALY methodology to determine what changes may be made to reduce sources of methodological and gender bias. Despite the many criticisms of the DALY as a measurement unit, it represents a major conceptual advance since it permits the combination of life expectancy and levels of dysfunction into a single measure. Measuring reproductive ill-health by counting deaths alone is inadequate for a proper understanding of the dimensions of the problem because of the young age of many of the deaths associated with reproductive ill-health and the large component of years lived with disability from many of the associated conditions.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000500010&lng=en&tlng=enreproductive medicinecost of illnesshealth status indicatorsquality of lifedisability evaluationsexually transmitted diseasesmaternal mortalitylongitudinal studies |
| spellingShingle | C. AbouZahr J.P. Vaughan Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years Bulletin of the World Health Organization reproductive medicine cost of illness health status indicators quality of life disability evaluation sexually transmitted diseases maternal mortality longitudinal studies |
| title | Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years |
| title_full | Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years |
| title_fullStr | Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years |
| title_full_unstemmed | Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years |
| title_short | Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years |
| title_sort | assessing the burden of sexual and reproductive ill health questions regarding the use of disability adjusted life years |
| topic | reproductive medicine cost of illness health status indicators quality of life disability evaluation sexually transmitted diseases maternal mortality longitudinal studies |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000500010&lng=en&tlng=en |
| work_keys_str_mv | AT cabouzahr assessingtheburdenofsexualandreproductiveillhealthquestionsregardingtheuseofdisabilityadjustedlifeyears AT jpvaughan assessingtheburdenofsexualandreproductiveillhealthquestionsregardingtheuseofdisabilityadjustedlifeyears |