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
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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
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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
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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:
GOAL 3:
ACHIEVE UNIVERSAL PRIMARY EDUCATION
PROMOTE GENDER EQUALITY AND EMPOWER
WOMEN
REDUCE CHILD MORTALITY
IMPROVE MATERNAL HEALTH
COMBAT HIV/AIDS, MALARIA AND OTHER
DISEASES
ENSURE EVIRONMENTAL SUSTAINABILITY
DEVELOP A GLOBAL PARTNERSHIP FOR
DEVELOPMENT
GOAL 4:
GOAL 5:
GOAL 6:
GOAL 7:
GOAL 8:
SUSTAINABLE DEVELOPMENT
INDICATORS RELATED TO HEALTH
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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
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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:
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PHYSICIANS,
CODERS,
STATISTICIANS,
MEDICAL RECORDS OFFICERS,
EPIDEMIOLOGISTS
SOME STRATEGIES FOR OVERCOMING
DATA QUALITY CHALLENGES
• MONITORING AND EVALUATION OF
HEALTH DATA SYSTEMS e.g,
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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