global programme on evidence for health policy presentation by the epidemiology and burden of...

Global Programme on Evidence for Health Policy

Presentation by the Epidemiology and Burden of Disease Team

of the World Health Organization

at the United Nations Expert Group Meeting to Review the United Nations Demographic Yearbook,

New York, 10-14 November 2003


WHO is constitutionally mandated to establish and maintain statistical services and to provide information in the field of health


The Epidemiology and Burden of Disease Team in WHO is responsible for the collection of cause-of-death statistics from its 192 Member States


WHO Regional Offices

•AFRO (Brazzaville)•AMRO (Washington, D.C.)•EMRO (Cairo)•EURO (Copenhagen)•SEARO (New Delhi)•WPRO (Manila)


AFROEMRO

EURO

SEAROAMRO

WPRO

WHO regions

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

© WHO 2003. All rights reserved


WHO collects cause-of-death data

• in collaboration with its regional offices based on

agreement

• by contacting some Member States directly


AFROEMRO

EURO

SEAROAMRO

WPRO

WHO regions




• Cause-of-death data are reported by year, sex, age and cause of death to WHO

• Causes of death are coded according to the International Statistical Classification of Diseases and Related Health Problems (ICD)


The WHO Mortality Database contains data since 1950 by

•ICD-6/7•ICD-8•ICD-9 (around 40 Member States)

•ICD-10 (71 Member States)


Cause of death codes

• ICD -9: about 5 100

•ICD-10: about 10 000


Training in coding underlying cause of death is provided by

• WHO collaborating centres

• WHO - PAHO/AMRO through computer-based applications in English, French, Spanish and Portuguese (InterCod)


File specifications for reporting cause-of-death data:

Field Width Field WidthCountry 4 4 yr 7Year 2 5-9 yr 7Format general 1 10-14 yr 7Format infant 1 15-19 yr 7ICD classification 3 …...Cause of death 4 (ICD codes) …...Sex 1 (1 male, 2 female, 9 unk) ……Blank 3 80-84 yr 7All ages 7 85-89 yr 70 day 7 90-94 yr 71-6 days 7 95 yr+ 77-27 days 7 Unk 728-365 days 70 yr 71 yr 72 yr 73 yr 7

•Age format:•0 (0, 1, 2, 3, 4, 5-9, 10-14,…..,80-84, 85-89, 90-94, 95+, unk•1 (0, 1, 2, 3, 4, 5-9, 10-14,…..,80-84, 85+, , unk•2 (0, 1-4, 5-9, 10-14,…..,80-84, 85+, , unk


Period of most recent data available

Developed

countries1Sub-Saharan

Africa

Amro

Region2EMRO Region

SEARO Region

WPRO

Region2 Total

Cause-of-deathNo information 2 42 2 12 7 10 75Before 1990 0 0 2 0 0 0 21990-1994 3 2 6 1 2 4 181995-1999 28 2 17 3 2 6 582000-2001 17 0 5 5 0 3 302002 7 0 1 0 0 1 9Total 57 46 33 21 11 24 192

Distribution of countries according to the availability of the most recent data permitting estimation of cause-of-death statistics, by the WHO Region.

Number of countries

(1) Developed countries include all countries in WHO European Region, USA, Canada, Japan, Australia, New Zealand

(2)Excluding developed countries


Coverage of Death Registration Mortality data (1995 onwards) by cause available in WHO



Coverage90+75-8950-74<50 (sample)<50na


Leading Causes of Death, estimates for 1990 and 2000

Source: Murray and Lopez, 1996; WHR, 2001

1990 2000Numbers (millions)

% of total deaths

Numbers (millions)

% of total deathsIschaemic heart disease 6.3 12.4 Ischaemic heart disease 6.9 12.4

Cerebrovascular disease 4.4 8.7 Cerebrovascular disease 5.1 9.2

Lower respiratory infections 4.3 8.5 Lower respiratory infections 3.9 6.9

Diarrhoeal diseases 2.9 5.8 HIV/AIDS 2.9 5.3

Perinatal conditions 2.4 4.8 C.O.P.D. 2.5 4.5

C.O.P.D. 2.2 4.4 Perinatal conditions 2.4 4.4

Tuberculosis 2.0 3.9 Diarrhoeal diseases 2.1 3.8

Measles 1.1 2.1 Tuberculosis 1.7 3.0

Road traffic accidents 1.0 2.0 Road traffic accidents 1.3 2.3

Lung cancer 0.9 1.9 Lung cancer 1.2 2.2


Dissemination of the WHO Mortality Database

• WHO web site (http://www.who.int)

• WHO Regional Offices web sites


WHO-EURO collaborates with EUROSTAT with the

• collection of cause-of-death data for the Central and Eastern European countries

• design of a questionnaire for hospital data


WHO-UN Statistical Division(UNSD)

• Cause-of-death data are provided regularly to the UNSD for publication in the Demographic Yearbook

• UNSD provides WHO with vital statistics


WHO-UN Statistical Division

• Cause-of-death data are published in the Demographic Yearbook since 1951


WHO-UN Statistical Division

• To improve communication

• To collaborate on questionnaires related to mortality information


In accordance with the stated priorities of the new Director-General of WHO, Dr J.W. Lee to assist WHO Member States to collect mortality data, WHO needs to work with UNSD to create the infrastructure and to provide the necessary tools and instruments to achieve this goal.

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