Disease Control Priorities

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.

About this Series: From its inception, the Disease Control Priorities series has focused attention on delivering efficacious health interventions that can result in dramatic reductions in mortality and disability at relatively modest cost. The approach has been multidisciplinary, and the recommendations have been evidence-based, scalable, and adaptable in multiple settings. Better and more equitable health care is the shared responsibility of governments and international agencies, public and private sectors, and societies and individuals, and all of these partners have been involved in the development of the series. Disease Control Priorities, third edition (DCP3) builds on the foundation and analyses of the first and second editions (DCP1 and DCP2) to further inform program design and resource allocation at the global and country levels by providing an up-to-date comprehensive review of the effectiveness of priority health interventions. In addition, DCP3 presents systematic and comparable economic evaluations of selected interventions, packages, delivery platforms, and policies based on newly developed economic methods. DCP3 presents its findings in nine individual volumes addressed to specific audiences. The volumes are structured around packages of conceptually related interventions, including those for maternal and child health, cardiovascular disease, infectious disease, and surgery. The volumes of DCP3 will constitute an essential resource for countries as they consider how best to improve health care, as well as for the global health policy community, technical specialists, and students. About this Volume: Essential Surgery demonstrates surgery's contribution to global public health. Data on the surgical burden of congenital anomalies, disease, disability, and trauma are presented, along with health and economic analyses of procedures, platforms, and packages to improve care in settings with severe budget limitations. Readers will gain comprehensive knowledge of the challenges and successes found in implementing surgical care strategies within low- and middle-income countries. Practitioners and researchers demonstrate that even small hospitals can deliver effective basic surgical services, and health care delivery structures already in place can be leveraged to provide affordable and quality surgical care.

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.

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.

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.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

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.

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.

Improve cancer control in low-resource settings. This volume, Cancer, part of the 3rd edition of Disease Control Priorities, analyzes interventions for effectiveness, cost-effectiveness, affordability, and feasibility in low- and middle-income countries (LMICs). The intent is to help governments of LMICs commit to locally appropriate national cancer control strategies. This state-of-the-art book on cancer shows, with extensive data and probing analyses, that both mortality and suffering from cancer can be dramatically reduced, even in the less affluent countries, through a combination of preventive measures, early diagnosis, and early treatment. This volume provides valuable, specific policy analyses on the full range of interventions, packages, and policies relevant to its health topic. This book is for policy makers, health professionals, researchers, and students interested in cancer control in developing countries. - Understand the changing global burden of cancer. - Discover effective interventions for cancer prevention, treatment, and palliation. - Learn about the costs and feasibility of developing health system infrastructure for cancer services.