Is it time to reassess the categorization of disease burdens in low-income countries?

Abstract

The classification of disease burdens is an important topic that receives little attention or debate. One common classification scheme, the broad cause grouping, is based on etiology and health transition theory and is mainly concerned with distinguishing communicable from noncommunicable diseases. This may be of limited utility to policymakers and planners. We propose a broad care needs framework to complement the broad cause grouping. This alternative scheme may be of equal or greater value to planners. We apply these schemes to disability-adjusted life year estimates for 2000 and to mortality data from Tanzania. The results suggest that a broad care needs approach could shift the priorities of health planners and policymakers and deserves further evaluation.

FIGURE 1—

Percentage of disability-adjusted life years (DALYs) owing to broad cause and broad care needs conditions (estimates for 2000). Note. White bars = broad cause groups; black bars = broad care needs (acute care and undetermined); gray bars = broad care needs (long-term care and management).

FIGURE 2—

Percentage of years of life lost (YLLs) due to broad cause and broad care needs conditions (Morogoro, Tanzania, 2000). Note. White bars = broad cause groups; black bars = broad care needs (acute care and undetermined); gray bars = broad care needs (long-term care and management).