1. Global burden of disease
role of intersectoral
&interdisciplinary
collaborations
2. Global burden of disease study is a
comprehensive regional and global research
programme of disease burden that assesses
mortality and disability from major diseases,
injuries and risk factors.
GBD is a collaboration of over 3600
researchers from 145 countries.
3.
4. HISTORY
• The initial GBD study was commissioned by the World Bank to
provide a comprehensive assessment of disease burden in 1990
from more than 100 diseases and injuries, and from 10 selected
risk factors (Murray and Lopez, 1996a,b; World Bank, 1993).
• Earlier attempts by Lopez and others to quantify global cause-of-
death patterns had been largely restricted to broad cause-of-death
groups and did not address nonfatal health outcomes.
5. GBD uses more than 50,000 data sources from around the world to
estimate disease burden.
Years of life lost (YLLs) due to premature death from different causes
are calculated using data from vital registration with medical
certification of causes of death.
Years lived with disability (YLDs) are estimated using sources such as
published studies on disease and injuries occurrence, cancer
registries, data from outpatient and inpatient facilities, and direct
measurements of hearing, vision, and lung function.
Disability-adjusted life years (DALYs) are the sum of YLLs and YLDs.
6.
7. How to measure the GBD??
• In GBD 2010, years of life lost due to premature death were computed by
multiplying the number of deaths by the life expectancy at the time of
death in a reference population.
8. Worldwide, the 10 leading causes of death in
1990 accounting for 52% of total deaths…
• Ischemic heart disease[6.3 million]
• Cerebrovascular disease [4.4 million]
• Lower respiratory infections[4.3 million]
• Diarrhoeal diseases[2.9 million]
• Perinatal diseases[2.4 million]
• COPDs[2.2 million]
• TB[2 million]
• Measles[1.1 million]
• Road traffic accidents[1 million]
• Lung cancer[0.9 million]
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11. • Communicable, maternal, perinatal and nutritional disorders accounted
for 17.2 million deaths.
• Non communicable diseases for upto 28.1 million.
• Deaths and injuries for 5.1 million in number.
12. UNIT OF MEASUREMENT
• Burden of disease measures the impact of living with illness and
injury & dying prematurely.
• The summary measure ‘disability adjusted life years’[DALYs]
measures the years of healthy life lost from death & illness.
13. zDALY
• To calculate the Zdaly, information on the incidence of human disease of interest
together with the natural history of the disease and the morbidity and mortality
rates are required.
Zdaly=YLL+YLD+ALE
YLL=YEARS OF LIFE LOST
YLD=YEARS OF LIFE LOST DUE TO DISABILITY
ALE=ANIMAL LOSS EQUIVALENT
THUS Zdaly is a valuable tool in public health economics priority setting.
14. Diseases that are coming under zDALY
estimate:
• cystic echinococcosis
• Brucellosis
• Q fever
• Cysticercosis
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19. Purpose of measurement
• GBD provides a tool to quantify health loss from hundreds of diseases,
injuries and risk factors so that health systems can be improved and
disparities can be eliminated.
20. DISEASES PRESENT IN THE WORLD
2021?
• Atleast 10,000 diseases are there in the world.
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33. INTERSECTORAL COLLABORATION
• It is the joint action taken by health and government sectors, as well as
representatives from private, voluntary and non profit groups, to improve the
health of population.
• Successful intersectoral initatives have early engagement of potential partners
from sectors outside health, as well as from different disciplines and levels
within health sector.
34. ROLE OF ISC:
• In 1997, the concept of inter-sectoral action for health (IAH) promoted by
WHO, was defined as “a recognised relationship between health sector and
another sector to take action on an issue to achieve health outcome to be more
effective, efficient or sustainable”. The IAH concept further emphasized that
the collaboration should be a managed process not only a conceptual one.
The 1998 WHO Health Promotion Glossary defined ISC as “cooperation
between different sectors of society such as the public sector, civil society and
the private sector”.
•
35. KEY ELEMENTS
• Think purposefully
• Consider enablers and barriers
• Build partnerships with key stakeholders
• Implement an intersectoral approach
• Contribute to the evidence base.
36.
37. AIM
• THE AIM OF COLLABORATIVE WORK IS TO FIND COMMON
GROUND & TO GENERATE COLLECTIVE ACTION TO IMPROVE
HEALTH.
38. • INTERSECTORAL ACTION should be viewed as a
“WIN-WIN”situation, whereby each party gains
something, as opposed to a competitive exercise based on
sectoral ‘imperialism’, where one sector is seen as
benefiting from the work of others fulfilling its own
purpose or mandate.
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40. Ideal nature of the developing alliance:
• The concentration along the horizontal dimension[between sectors] and
vertical dimension[within sectors].
• The choice of champions.
• Resource allocation
• The role of health sector as either a leader or facilitator.
• The connection to the political level.
41. How will collaboration across sectors & levels
takes place?
• Engage partners early on to establish shared values and alignment of
purpose.
• Establish concrete objectives & focus on visible results.
• Identify & support a champion.
• Invest in the alliance building process.
• Generate political support.
• Share leadership, accountability and rewards among partners.
43. DISADVANTAGES
• Too many faux leaders
• Conflicts in working styles
• Lack of trust among team members
44. INTERDISCIPLINARY COLLABORATION
• DEFINITION:
• A dynamic process involving two or more health professionals with
complementary backgrounds & skills, sharing common health goals &
exercising concerted physical & mental effort in assessing, planning or
evaluating patient care.
• This is accomplished thru interdependent collaboration, open
communication& shared decision making.
• This in turn generates value-added patient, organisational & staff outcomes.
45. • The term interdisciplinary are broader & include all members of healthcare
teams, professional and non professional.
• Interdisciplinary teams include
• RESEARCH
• INTERVENTIONS
• DATA GATHERING ACTIVITIES
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48. TEN CHARACTERISTICS
• Positive leadership & management attributes
• Communication strategies & structures
• Personal rewards, training & development
• Appropriate resources and procedures
• Appropriate skill mix
49. • Supportive team climate
• Individual characteristics that support interdisciplinary teamwork
• Clarity of vision
• Quality & outcomes of care
• Respecting & understanding roles.
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52. CONCLUSION
• Echoing the vision of WHO and the EPHOs, many Forum speakers stressed the vital role of intersectoral
collaboration and of a health workforce equipped with key public health competencies in the delivery of public health
services.
• Interdisciplinary collaboration has the capacity to affect both healthcare providers and patients. Research has shown
that the lack of communication and collaboration may be responsible for as much as 70% of the adverse events
currently reported.
•
WHO [EUROPE PROGRAMME OF WORK] promotes intersectoral collaboration for better health.
• THE LANCET is the publication releasing every year by WHO.
• Recent edition of THE LANCET providing information regarding GLOBAL DISEASE BURDEN studies is released in
2019.
