Global Health Estimates: Stronger Collaboration Needed with Low- and Middle-Income Countries
نویسنده
چکیده
Traditionally the United Nations (UN) and its specialised agencies (including the World Health Organization [WHO], the United Nations Children’s Fund [UNICEF], and the United Nations Statistics Division), as well as the World Bank and the United States Center for Disease Control and Prevention, have generated estimates of health indicators. For many countries, especially lowand middleincome countries (LMICs) where civil registration systems are not effective for various reasons, these estimates have been the only credible outputs available to policy-makers and planners—yet significant questions remain as to the authenticity of their underlying data sources [1]. Recent controversies about whether UN agencies or academics should make such estimates, and how they should be published, are timely and important [2,3]. Unfortunately, however, southern-based health organisations are conspicuous for their absence in these scenarios. Whoever compiles estimates, all institutions involved should strengthen collaboration with researchers, policy-makers, and organizations at the grass-roots level in LMICs. One southern organisation trying to make a difference in this respect is the INDEPTH Network (http://www.indepthnetwork.org), an umbrella for currently more than 40 discrete population surveillance centres in LMICs in Africa, Asia, and Oceania. Such sources have the potential to complement and strengthen both the data from traditional providers to the UN system and the publicly available data that are used by others. Here, in addition to other data sources, the INDEPTH Network is explored as an example of how health and demographic surveillance system (HDSS) data could strengthen global estimates, especially in the area of directly measured cause of death statistics. HDSSs enumerate and longitudinally follow up populations in geographically well-defined areas to record demographic and health changes that occur over time. More specifically, they collect detailed information on fertility, mortality, and migrations within those populations.
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