Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapters (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
Disease Control Priorities
Author: Haile T. Debas, Peter Donkor, Atul A. Gawande, Dean T. Jamison, Margaret Kruk, Charles Mock
Publisher: World Bank Publications
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume.The DCP3 evaluation of these conditions produced three key findings:i. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, non-sexually transmitted infections, infertility, and violence against women.ii. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems.iii. There is a large difference in how RMNCH conditions affect different income groups and investments in RMNCH can lessen the disparity in terms of both health and financial risk.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
More children born today will survive to adulthood than at any time in history. It is now time to emphasize health and development in middle childhood and adolescence--developmental phases that are critical to health in adulthood and the next generation. Child and Adolescent Health and Development explores the benefits that accrue from sustained and targeted interventions across the first two decades of life. The volume outlines the investment case for effective, costed, and scalable interventions for low-resource settings, emphasizing the cross-sectoral role of education. This evidence base can guide policy makers in prioritizing actions to promote survival, health, cognition, and physical growth throughout childhood and adolescence.
The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportionally on low- and middle-income countries. Injury Prevention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year.
Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.
Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.
Volume 3, Cancer, presents the complex patterns of cancer incidence and death around the world and evidence on effective and cost-effective ways to control cancers. The DCP3 evaluation of cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packages that are cost-effective and suited to low-resource settings. Main messages from the volume include: -Quality matters in all aspects of cancer treatment and palliation. -Cancer registries that track incidence, mortality, and survival †“ paired with systems to capture causes of death are important to understanding the national cancer burden and the effect of interventions over time. -Effective interventions exist at a range of prices. Adopting "resource appropriate" measures which allow the most effective treatment for the greatest number of people will be advantageous to countries. -Prioritizing resources toward early stage and curable cancers is likely to have the greatest health impact in low income settings. -Research prioritization is no longer just a global responsibility. Providing cancer treatment requires adequate numbers of trained healthcare professionals and infrastructure beyond what is available in most LMICs, especially low income countries. Careful patient monitoring is a requirement of good quality cancer care and this often involves laboratory tests in addition to clinical examination. Even if financing were immediately available to build or expand a cancer control system, reaching capacity will take many years.
Author: Adam L. Kushner
Publisher: JHU Press
A teenage mother arrives by donkey cart to a hospital after attempting to deliver her baby in the bush. A young father faces the loss of a leg after receiving a gunshot wound that will not heal. A man walks miles to a hospital for a pain in his side caused by an appendix that burst five days earlier. Without access to surgical resources, millions of people with conditions like these become disabled or die. In Operation Health, Adam L. Kushner argues that not only are severe medical conditions— like a strangulated hernia or obstetric fistula—treatable by surgical means in low-income countries; they are, in fact, surgically preventable. Although the World Bank estimates that 11 percent of the global disease burden is treatable by surgery, more than a quarter of the world’s population lacks access to straightforward and life-saving surgical procedures. Operation Health makes a strong and compelling justification for adding surgical care to the global health agenda by providing an overview of dangerous but repairable medical conditions common in developing countries. Every chapter opens with a vignette by Kushner which tells the remarkable story of the patients and situations he encountered in the field. Carefully crafted case studies demonstrate the power of surgery to heal people suffering from potentially debilitating conditions, including clubfoot, obstructed labor, and broken bones. The chapters—written by world-renowned surgical experts—cover related medical topics such as epidemiology, women’s health, cancer, and trauma in locations from Sierra Leone to Nepal, Ghana, Mongolia, and elsewhere. This detailed and compassionate book will be of great interest to medical professionals, students, public health policy makers, philanthropic donors, and those with a general interest in global health.
Disease Control Priorities in Developing Countries
Author: Dean T. Jamison, Joel G. Breman, Anthony R. Measham, George Alleyne, Mariam Claeson, David B. Evans, Prabhat Jha, Anne Mills, Philip Musgrove
Publisher: World Bank Publications
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
The New Public Health
Author: Theodore H. Tulchinsky, Elena A. Varavikova
Publisher: Academic Press
The New Public Health has established itself as a solid textbook throughout the world. Translated into 7 languages, this work distinguishes itself from other public health textbooks, which are either highly locally oriented or, if international, lack the specificity of local issues relevant to students' understanding of applied public health in their own setting. This 3e provides a unified approach to public health appropriate for all masters' level students and practitioners—specifically for courses in MPH programs, community health and preventive medicine programs, community health education programs, and community health nursing programs, as well as programs for other medical professionals such as pharmacy, physiotherapy, and other public health courses. Changes in infectious and chronic disease epidemiology including vaccines, health promotion, human resources for health and health technology Lessons from H1N1, pandemic threats, disease eradication, nutritional health Trends of health systems and reforms and consequences of current economic crisis for health Public health law, ethics, scientific d health technology advances and assessment Global Health environment, Millennium Development Goals and international NGOs
The World Bank will publish the nine volumes of Disease Control Priorities, 3rd edition, in 2015–16. Volume 1— Essential Surgery —identifies 44 surgical procedures as essential on the basis that they address substantial needs, are cost effective, and are feasible to implement. This report summarises and critically assesses the volume's five key findings. First, provision of essential surgical procedures would avert about 1·5 million deaths a year, or 6–7% of all avertable deaths in low-income and middle-income countries. Second, essential surgical procedures rank among the most cost effective of all health interventions. The surgical platform of the first-level hospital delivers 28 of the 44 essential procedures, making investment in this platform also highly cost effective. Third, measures to expand access to surgery, such as task sharing, have been shown to be safe and effective while countries make long-term investments in building surgical and anaesthesia workforces. Because emergency procedures constitute 23 of the 28 procedures provided at first-level hospitals, expansion of access requires that such facilities be widely geographically diffused. Fourth, substantial disparities remain in the safety of surgical care, driven by high perioperative mortality rates including anaesthesia-related deaths in low-income and middle-income countries. Feasible measures, such as WHO's Surgical Safety Checklist, have led to improvements in safety and quality. Fifth, the large burden of surgical disorders, cost-effectiveness of essential surgery, and strong public demand for surgical services suggest that universal coverage of essential surgery should be financed early on the path to universal health coverage. We point to estimates that full coverage of the component of universal coverage of essential surgery applicable to first-level hospitals would require just over US$3 billion annually of additional spending and yield a benefit–cost ratio of more than 10:1. It would efficiently and equitably provide health benefits, financial protection, and contributions to stronger health systems.
What's In, What's Out
Author: Amanda Glassman, Ursula Giedion, Peter C. Smith
Publisher: Brookings Institution Press
Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.
Author: David Feldman, J. Wesley Pike, Francis H. Glorieux
Vitamin D, a steroid hormone, has mainly been known for its effects on bone and osteoporosis. The current therapeutic practices expand into such markets as cancer research, pediatrics, nephrology, dermatology, immunology, and genetics. This second edition includes over 100 chapters covering everything from chemistry and metabolism to mechanisms of action, diagnosis and management, new analogs, and emerging therapies. This complete reference works is a must have resource for anyone working in endocrinology, osteology, bone biology, or cancer research. *Most comprehensive, up-to-date two-volume set on Vitamin D *New chapters on squamous cell cancer, brain cancer, thyroid cancer and many more *Further sections on emerging uses for treatments of auto-immune diseases and diabetes *Over 600 illustrations and figures available on CD