Surgically avertable burden of obstetric conditions in low- and middle-income regions: a modelled analysis

Higashi, H., Barendregt, J. J., Kassebaum, N. J., Weiser, T. G., Bickler, S. W. and Vos, T. (2015) Surgically avertable burden of obstetric conditions in low- and middle-income regions: a modelled analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 122 2: 228-236. doi:10.1111/1471-0528.13198


Author Higashi, H.
Barendregt, J. J.
Kassebaum, N. J.
Weiser, T. G.
Bickler, S. W.
Vos, T.
Title Surgically avertable burden of obstetric conditions in low- and middle-income regions: a modelled analysis
Journal name BJOG: An International Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 1471-0528
1470-0328
Publication date 2015-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/1471-0528.13198
Open Access Status
Volume 122
Issue 2
Start page 228
End page 236
Total pages 9
Place of publication Chichester, West Sussex United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2015
Language eng
Formatted abstract
Objective

To quantify the burden of maternal and neonatal conditions in low- and middle-income countries (LMICs) that could be averted by full access to quality first-level obstetric surgical procedures.

Design

Burden of disease and epidemiological modelling.

Setting

LMICs from all global regions.

Population

The entire population in 2010.

Methods

We included five conditions in our analysis: maternal haemorrhage; obstructed labour; obstetric fistula; abortion1; and neonatal encephalopathy. Demographic and epidemiological data were obtained from the Global Burden of Disease 2010 study. We split the disability-adjusted life years (DALYs) of these conditions into surgically ‘avertable’ and ‘non-avertable’ burdens. We applied the lowest age-specific fatality rates from all global regions to each LMIC region to estimate the avertable deaths, assuming that the differences of death rates between each region and the lowest rates reflect the gap in surgical care.

Main outcome measures

Deaths and DALYs avertable.

Results

Of the estimated 56.6 million DALYs (i.e. 56.6 million years of healthy life lost) of the selected five conditions, 21.1 million DALYs (37%) are avertable by full coverage of quality obstetric surgery in LMICs. The avertable burden in absolute term is substantial given the size of burden of these conditions in LMICs. Neonatal encephalopathy constitutes the largest portion of avertable burden (16.2 million DALYs) among the five conditions, followed by abortion (2.1 million DALYs).

Conclusions

Improving access to quality surgical care at first-level hospitals could reduce a tremendous burden of maternal and neonatal conditions in LMICs.
Keyword Burden of disease
Maternal conditions
Neonatal conditions
Surgery
Obstetrics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 26 Dec 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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