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BMJ Glob Health ; 4(5): e001849, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637032


Health facility data are a critical source of local and continuous health statistics. Countries have introduced web-based information systems that facilitate data management, analysis, use and visualisation of health facility data. Working with teams of Ministry of Health and country public health institutions analysts from 14 countries in Eastern and Southern Africa, we explored data quality using national-level and subnational-level (mostly district) data for the period 2013-2017. The focus was on endline analysis where reported health facility and other data are compiled, assessed and adjusted for data quality, primarily to inform planning and assessments of progress and performance. The analyses showed that although completeness of reporting was generally high, there were persistent data quality issues that were common across the 14 countries, especially at the subnational level. These included the presence of extreme outliers, lack of consistency of the reported data over time and between indicators (such as vaccination and antenatal care), and challenges related to projected target populations, which are used as denominators in the computation of coverage statistics. Continuous efforts to improve recording and reporting of events by health facilities, systematic examination and reporting of data quality issues, feedback and communication mechanisms between programme managers, care providers and data officers, and transparent corrections and adjustments will be critical to improve the quality of health statistics generated from health facility data.

Lancet ; 393(10176): 1119-1127, 2019 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-30876707


BACKGROUND: With global survival increasing for children younger than 5 years of age, attention is required to reduce the approximately 1 million deaths of children aged 5-14 years occurring every year. Causes of death at these ages remain poorly documented. We aimed to explore trends in mortality by causes of death in India, China, Brazil, and Mexico, which are home to about 40% of the world's children aged 5-14 years and experience more than 200 000 deaths annually at these ages. METHODS: We examined data on 244 401 deaths in children aged 5-14 years from four nationally representative data sources that obtained direct distributions of causes of death: the Indian Million Death Study, the Chinese Disease Surveillance Points, mortality data from the Mexican Instituto Nacional de Estadística y Geografía, and mortality data from the Brazilian Institute of Geography and Statistics. We present data on 12 main disease groups in all countries, with breakdown by communicable and nutritional diseases, non-communicable diseases, injuries, and ill-defined causes. To calculate age-specific and sex-specific death rates for each cause, we applied the national cause of death distribution to the UN mortality envelopes for 2005-16 for each country. FINDINGS: Unlike Brazil, China, and Mexico, communicable diseases still account for nearly half of deaths in India in children aged 5-14 years (73 920 [46·1%] of 160 330 estimated deaths in 2016). In 2016, India had the highest death rates in nearly every category, including from communicable diseases. Fast declines among girls in communicable disease mortality narrowed the gap by 2016 with boys in India (32·6 deaths per 100 000 girls vs 26·2 per 100 000 boys) and China (1·7 vs 1·5). In China, injuries accounted for the greatest proportions of deaths (20 970 [53·2%] of 39 430 estimated deaths, in which drowning was a leading cause). The homicide death rate at ages 10-14 years was higher for boys than for girls in Brazil, increasing annually by an average of 0·7% (0·3-1·1). In India and China, the suicide death rates were higher for girls than for boys at ages 10-14 years. By contrast, in Mexico it was higher for boys than for girls, increasing annually by an average of 2·8% (2·0-3·6). Deaths from transport injuries, drowning, and cancer are common in all four countries, with transport accidents among the top three causes of death for both sexes in all countries, except for Indian girls, and cancer in the top three causes for both sexes in Mexico, Brazil, and China. INTERPRETATION: Most of the deaths that occurred between 2005 and 2016 in children aged 5-14 years in India, China, Brazil, and Mexico arose from preventable or treatable conditions. This age group is important for extending some of the global disease-specific targets developed for children younger than 5 years of age. Interventions to control non-communicable diseases and injuries and to strengthen cause of death reporting systems are also required. FUNDING: WHO and the University of Toronto Connaught Global Challenge.

Causas de Morte/tendências , Doenças Transmissíveis/mortalidade , Saúde Global/tendências , Doenças não Transmissíveis/mortalidade , Transtornos Nutricionais/mortalidade , Ferimentos e Lesões/mortalidade , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Carga Global da Doença/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Humanos , Índia/epidemiologia , Masculino , México/epidemiologia , Mortalidade/tendências , Suicídio/estatística & dados numéricos , Suicídio/tendências
Am J Prev Med ; 34(6): 486-94, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18471584


BACKGROUND: Physical inactivity is an important risk factor for chronic diseases, but for many (mainly developing) countries, no prevalence data have ever been published. OBJECTIVE: To present data on the prevalence of physical inactivity for 51 countries and for different age groups and settings across these countries. METHODS: Data analysis (conducted in 2007) included data from 212,021 adult participants whose questionnaires were culled from 259,526 adult observations from 51 countries participating in the World Health Survey (2002-2003). The validated International Physical Activity Questionnaire (IPAQ) was used to assess days and duration of vigorous, moderate, and walking activities during the last 7 days. RESULTS: Country prevalence of physical inactivity ranged from 1.6% (Comoros) to 51.7% (Mauritania) for men and from 3.8% (Comoros) to 71.2% (Mauritania) for women. Physical inactivity was generally high for older age groups and lower in rural as compared to urban areas. CONCLUSIONS: Overall, about 15% of men and 20% of women from the 51 countries analyzed here (most of which are developing countries) are at risk for chronic diseases due to physical inactivity. There were substantial variations across countries and settings. The baseline information on the magnitude of the problem of physical inactivity provided by this study can help countries and health policymakers to set up interventions addressing the global chronic disease epidemic.

Exercício , Saúde Global , Adolescente , Adulto , Distribuição por Idade , Idoso , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Organização Mundial da Saúde
Soz Praventivmed ; 49(4): 269-75, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15357529


OBJECTIVES: The WHO Global InfoBase assembles country-level chronic disease risk factor prevalence data from WHO's member states. METHODS: The focus of this report is recent, nationally representative data. The risk factors of choice are those that make the greatest contribution to mortality and morbidity from chronic disease, can be changed through primary intervention and are easily measured in populations. RESULTS: Eight risk factors fit these criteria. They are: tobacco and alcohol use, patterns of physical inactivity, low fruit/vegetable intake, obesity, blood pressure, cholesterol and diabetes. Important to the data collection is the need to display prevalence data for these eight risk factors by age group(s) and sex and with some measure of the uncertainty of the estimate. CONCLUSIONS: This tool can be used by countries to evaluate the quality of the data that they have for chronic disease surveillance. The aim is to improve risk factor data quality and to standardize data, either through common survey instruments or by using existing country data to model risk factor estimates. These "harmonized" estimates will allow for comparisons over time and between countries.

Doença Crônica/mortalidade , Vigilância da População , Saúde Pública/estatística & dados numéricos , Causalidade , Comparação Transcultural , Bases de Dados Factuais , Europa (Continente) , Comportamento Alimentar , Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Fatores de Risco , Organização Mundial da Saúde