SEATTLE - A mapping system enabling global health researchers to examine communities in 5-by-5-kilometer blocks finds significant differences in child death rates within African nations.
Researchers for the Local Burden of Disease project at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington use "geospatial analysis," which examines health data that are "tagged" with locations for computer modeling, to identify patterns of death and disease within nations' states or provinces. Information on child deaths is often incomplete, and these techniques produce researchers' best estimates.
"We have seen significant improvements in the fight against many diseases," said Dr. Simon I. Hay, IHME's Director of Geospatial Science. "However, most studies focus on illnesses or deaths nationwide. By conducting analyses at the community level, we are able to identify where interventions will have the greatest impact, thereby accelerating much-needed progress on some of the world's most difficult problems. These efforts are especially crucial as we strive to reach the new and ambitious targets established in the United Nations' Sustainable Development Goals."
Researchers also have visualizations from which to compare and contrast data among nations and by health conditions. See: http://vizhub.healthdata.org/geospatial/under5
This study on under-5 mortality in 46 African nations represents IHME's second 5-by-5-kilometer mapping project over the past several months. The first, which focused on prevalence of malaria, found that Nigeria's densely populated southern area had the nation's most malaria deaths, while rural areas in the north saw the highest rates of death.
As in the malaria study, this paper on under-5 deaths, published today in the international medical journal, The Lancet, found that rates of death in Nigeria varied widely: The overall child mortality rate nationally was 115 deaths per 1,000 live births, as compared to a low of 55 per 1,000 in one area, and a high of 215 in another area..
"Tailoring child health interventions to subnational regions with the highest number and rates of mortality is essential to making further progress on achieving the relevant SDG targets," said Dr. Stefan Peterson, Associate Director and Chief of Health at UNICEF in New York. "We already know which interventions will save the most lives, so the first step in such tailoring is pinpointing where young children are dying."
One of the SDG targets stipulates that by 2030 countries reduce under-5 mortality rates to no more than 25 per 1,000 live births per year, and neonatal mortality rates to 12 per 1,000 live births or below per year.
"A few African countries - Botswana, Egypt, and Ethiopia - are well-positioned to achieve this goal," Dr. Hay said. Dr. Hay also noted that some countries, the national level, may appear to be well positioned to achieve the UN's goals for the child mortality, however when examining in-country data at the community level, progress is much more nuanced.
This study is an example of what some experts now call "precision public health" - the availability of more and better-quality data, along with increased computing power, that provides more specific and tailored health analyses.
"Everyone deserves the chance to live a healthy and productive life, no matter where they live," said Dr. David Blazes, Senior Program Officer, Epidemiology & Surveillance, at the Bill & Melinda Gates Foundation. "IHME produces very precise information so that the best public health decisions can be made with the most appropriate information for any local community. This should be possible everywhere, including Africa, and Dr. Hay's work powers this type of precision public health."
The study's authors anticipate extending their analyses of under-5 mortality to countries outside of Africa, eventually producing 5-by-5-kilometer estimates for areas that account for 95% of the world's deaths of children under 5. Other Local Burden of Disease researchers at IHME are conducting research on additional health problems, including inadequate child nutrition, diarrheal diseases, poor access to clean water and sanitation.
"In the future, we intend to integrate our Local Burden of Disease work with our work on injuries, deaths, and risk factors in the annual Global Burden of Disease study," said Dr. Christopher Murray, IHME's Director. "Our goal is to increasingly refine our research and to provide policymakers, clinicians, academicians, and others the most complete and accurate information possible to help enable all people to live longer, healthier lives."
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Established in 2007, the Institute for Health Metrics and Evaluation (IHME) is an independent global health research center at the University of Washington in Seattle that provides rigorous and comparable measurement of the world's most important health problems and evaluates strategies to address them. IHME makes this information available so that policymakers, donors, practitioners, researchers, and local and global decision-makers have the evidence they need to make informed decisions about how to allocate resources for improving population health. For more information, visit http://www.healthdata.org.
Journal
The Lancet