NCDs in South Asia(cont...)

Methods to describe the health situation in South Asia

Mortality data in the region are limited. Therefore, to describe the health situation, we use age-standardized undiscounted disability-adjusted life years (DALYs), which measure the
number of years a person would lose due to disability and premature mortality. Death rates
are presented where possible. A number of health surveys have been carried out in the
region; they are very useful at the country level, but often not comparable at the regional
level (Chapter 3).

Because of the methodology used to estimate DALYs, the death of a child contributes more DALYs than the death of an older person. An advantage of using DALYs to measure the burden of disease is that it considers years with disability and thus includes conditions that, although not fatal, can be a large economic and social burden.

Disability-adjusted life years (DALYs)

south Asian researchers have raised concern over the weights used in DALYs to measure disability, since these have not been fully validated in the region. In addition, for countries with no data, DALYs have been calculated by extrapolating the level and composition of death and disability from countries of similar epidemiologic and economic profiles, allowing

assessment only by broad groups of diseases and leading conditions within those groups. Yet despite these caveats, DALY estimates have been reasonably close when compared to new data, such as those from surveys or special studies. Other benefits of using DALYs are that this indicator has been used around the world and that there is a global commitment to continue providing and adjusting these estimates. However, more work is need on collecting and analyzing NCD data in South Asia.

IHD is the leading cause of both deaths and forgone DALYs among working-age adults (15–69 years) in South Asia (Table 1.3). The forgone DALYs pattern is somewhat different from the pattern for deaths and reflects the chronic debilitating nature of many conditions.