Burden of disease methods: analytic reflections

Methods to measure the burden of disease (BOD) on populations have been employed for decades, but have only received increasing attention in the past twenty years. At the same time, a number of concerns have also been raised, especially with the use of summary measures of population health. Seven BOD studies were funded by the Global Forum for Health Research (Global Forum) to explore the application of BOD methods in developing countries. This chapter is based on these studies and reviews the lessons learned during the process of a BOD study and reflects on what can be improved. In this chapter we briefly revisit the key components of a BOD exercise. In addition to describing the major elements of a BOD study, a special effort has been made to link them with the objectives, principles and innovations from the seven Global Forum studies (see Appendix 1). Then the overall strengths and challenges of these BOD studies are discussed. An extrapolation of these findings to assist with the process of implementing such an exercise at the national level to inform health decision-making is the topic of the next chapter.