SUSTAINABLE DEVELOPMENT: A SOCIAL

PERSPECTIVE

Beverly Andrews

Biostatistician

Caribbean Epidemiology Centre

Epidemiology Division

DIMENSIONS OF SUSTAINABLE DEVELOPMENT

• ECONOMIC DIMENSIONS

• PHYSICAL ENVIRONMENT

• SOCIAL ENVIRONMENT

SOCIAL DIMENSIONS OF SUSTAINABLE DEVELOPMENT

• POPULATION

• EDUCATION

• HEALTH

• DEMOCRATIZATION AND GOVERNANCE

HEALTH ASPECTS OF SUSTAINABLE DEVELOPMENT

VISION FOR HEALTH• More than the absence of disease• Includes mental, spiritual and emotional

health components .• Encompasses the physical and social

environment as well as the individual’s genetic makeup and lifestyle

IMPACT OF HEALTH ON DEVELOPMENT

• Productivity Losses

• Burden of disease

• Reduction in life expectancy

• Allocation of financial resources to prevention and control of diseases

• Travellers Health and Tourism (e.g.SARS)

REGIONAL PRIORITIES FOR HEALTH

• HEALTH SYSTEMS DEVELOPMENT• HUMAN RESOURCE DEVELOPMENT• FAMILY HEALTH• FOOD AND NUTRITION• CHRONIC NON COMMUNICABLE

DISEASE• MENTAL HEALTH• ENVIRONMENTAL HEALTH

MILLENIUM DEVELOPMENT GOALS

GOAL 1: ERADICATE EXTREME POVERTY AND HUNGER

GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION

GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN

GOAL 4: REDUCE CHILD MORTALITY

GOAL 5: IMPROVE MATERNAL HEALTH

GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES

GOAL 7: ENSURE EVIRONMENTAL SUSTAINABILITY

GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR

DEVELOPMENT

SUSTAINABLE DEVELOPMENT INDICATORS RELATED TO HEALTH

• UNDER 5 MORTALITY RATE• INFANT MORTALITY RATE• MATERNAL MORTALITY RATIO• PREVALANCE AND MORTALITY RATES

RELATED TO HIV/AIDS, MALARIA AND TB• PROPORTION OF 1 YEARS OLD CHILDREN

IMMUNISED AGAINST MEASLES• HIV PREVALENCE AMONG 15-24 YEAR OLD

PREGNANT WOMEN

SOURCES OF SUSTAINABLE HEALTH INDICATORS

• HOSPITAL MEDICAL RECORDS

• POPULATION HEALTH SURVEYS

• CENSUSES

• LEGAL SOURCES: BIRTH AND DEATH CERTIFICATES

• EPIDEMIOLOGICAL SURVEYS

CHALLENGES WITH RESPECT TO GENERATING HEALTH DATA • Data collection instruments not standardized and

comparable• Data collection instruments not accurately

completed e.g. death certificates• Non standardization of coding practices in

countries• Non standardized definitions of health events• Data formats for submitting data to regional

agencies are not standardized.• Datedness of data

CHALLENGES WITH RESPECT TO GENERATING HEALTH DATA • Under-analysis of health data by member

countries

• Need for revision of data collection instruments

• Need for introduction of new data collection instruments

• Stigma associated with reporting diseases such as HIV/AIDS on death certificates

SOME STRATEGIES FOR OVERCOMING DATA QUALITY CHALLENGES

• CAPACITY BUILDING VIA TRAINING WORKSHOPS FOR VARIOUS TARGET AUDIENCES:

• PHYSICIANS,• CODERS, • STATISTICIANS, • MEDICAL RECORDS OFFICERS, • EPIDEMIOLOGISTS

SOME STRATEGIES FOR OVERCOMING DATA QUALITY CHALLENGES

• MONITORING AND EVALUATION OF HEALTH DATA SYSTEMS e.g,

• vital registration systems, • communicable disease surveillance systems, • HIV/AIDS surveillance systems, • health standards in hotels

• MAKE RECOMMENDATIONS FOR STRENGTHENING OF SYSTEMS

SOME STRATEGIES FOR OVERCOMING DATA QUALITY CHALLENGES

• ELECTRONIC DISCUSSION FORUMS FOR DISCUSSION OF ISSUES, METHODOLOGIES, DEFINITIONS

• CARISURVNET: CLEARINGHOUSE FOR PUBLIC HEALTH ISSUES e.g. SARS

SOME STRATEGIES FOR OVERCOMING DATA QUALITY CHALLENGES

• SOFTWARE FOR CAPTURING HEALTH DATA FOR USE IN COUNTRIES:

• MORTBASE :• An MS-ACCESS based data entry, validation and

analysis tool for mortality data. • Software would allow for the calculation of

indicators such as infant mortality

SOME STRATEGIES FOR OVERCOMING DATA QUALITY CHALLENGES

• Manuals of operations and procedures

PRIORITY NEEDS FOR GENERATION OF DEVELOPMENT INDICATORS

• Training programmes for physicians, statistical officers of health and epidemiologists

• Survey and data analysis capacity needs strengthening in the areas of behavioural risk factor surveillance.

• Building awareness among data producers about the importance of the data and data quality.

PRIORITY NEEDS FOR GENERATION OF DEVELOPMENT INDICATORS

• Data analysis skills need to be strengthened among statistical officers of health and epidemiologists.

• Emphasis to be placed on data quality monitoring.

• Need for training in data management