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Re: DHS-8-PGSSC-OOP-Template [message #17380 is a reply to message #17368] Fri, 15 March 2019 21:22 Go to previous messageGo to next message
Robert Riviello is currently offline  Robert Riviello
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Treating patients (often by saving their life from injury, cancer, and surgical emergencies) into destitution is a morally repulsive byproduct of our health care delivery systems. We need to understand who, how, and to what extent patient are impoverished and /or face financial catastrophy - to improve, and advocate for financial risk protection
Re: DHS-8-PGSSC-OOP-Template [message #17386 is a reply to message #16792] Fri, 15 March 2019 21:37 Go to previous messageGo to next message
Greg is currently offline  Greg
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PGSSC wrote on Mon, 04 March 2019 17:09
Thank you for reviewing our proposal for new indicators within the Demographic and Household Survey (DHS) regarding emergency and essential surgical care. The collection of these indicators is a critical step towards the delivery of safe, affordable, equitable access to surgical services as a component of universal health coverage and we consider the DHS as the best forum to derive these data points.

The questions we propose are a product of the Lancet Commission on Global Surgery (LCoGS), a body of work spanning three years involving 25 commissioners and a diverse group of academic, governmental and civil society collaborators from 110 countries. Of the six indicators proposed by the LCoGS, four were published in the World Development Indicators by the World Bank and all six are included in the World Health Organization's Global Reference List of 100 Core Health Indicators. Nevertheless, there currently are no mechanisms in place to collect the data required for these indicators, creating a critical gap in knowledge for surgical care strengthening.

The new indicators in this proposal span four existing DHS modules. For clarity, they are listed in the table below. Of particular interest are the questions on out-of-pocket expenditure and household expenditure to enable the calculation of financial risk protection for all medical interventions captured by the DHS (both surgical and medical), a core component of Sustainable Development Goal 3.8. The remaining questions were taken from a successful pilot DHS survey in Zambia. In the development of this application, we have been fortunate to count on a number of international partners to provide expert review and the indicators proposed are a culmination of these consensus building discussions. Please refer to Appendix A for a full list of international stakeholders who support this application.

Proposed Indicators:
1. Risk of impoverishing and catastrophic expenditure

Data Utility:
1. World Bank: World Development Indicators
Re: DHS-8-PGSSC-OOP-Template [message #17388 is a reply to message #16792] Fri, 15 March 2019 21:42 Go to previous messageGo to next message
Jacob.Lepard is currently offline  Jacob.Lepard
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Beyond the simple availability of medical care the ability to afford it without catastrophic expenditure is a necessary component of effective medical and surgical care delivery. Unless we are able to effectively track these metrics then nothing can be done for them. The proposed indicators in this document are strengthened by their international collaborative support. They represent the work of a broad group with expertise in the field. I strongly support the collection of this financial data as proposed in this document.
Re: DHS-8-PGSSC-OOP-Template [message #17393 is a reply to message #16792] Fri, 15 March 2019 21:58 Go to previous messageGo to next message
ryorlets is currently offline  ryorlets
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Universal health coverage cannot be achieved without financial risk protection, as indicated by catastrophic and impoverishing expenditure. These indicators can be measured by the data collected in this proposed module.
Re: DHS-8-PGSSC-OOP-Template [message #17399 is a reply to message #17393] Fri, 15 March 2019 22:26 Go to previous messageGo to next message
IsaacWasserman is currently offline  IsaacWasserman
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As powerful as modeling studies are, the only way to progress past the realm of the theoretical, and anchor ourselves in the realm of the real is to collect robust data. When surgery playing a role in nearly 1/3rd of all human disease, I can think of no better area to invest in better data collection. This will help evaluate ongoing projects, as well as steer new ones. Thank you for expanding into this important sphere.
Re: DHS-8-PGSSC-OOP-Template [message #17402 is a reply to message #17399] Fri, 15 March 2019 22:27 Go to previous messageGo to next message
IsaacWasserman is currently offline  IsaacWasserman
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As powerful as modeling studies are, the only way to progress past the realm of the theoretical, and anchor ourselves in the realm of the real is to collect robust data. When surgery playing a role in nearly 1/3rd of all human disease, I can think of no better area to invest in better data collection. This will help evaluate ongoing projects, as well as steer new ones. Thank you for expanding into this important sphere.
Re: DHS-8-PGSSC-OOP-Template [message #17410 is a reply to message #16792] Fri, 15 March 2019 23:14 Go to previous messageGo to next message
Emily Smith is currently offline  Emily Smith
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Healthcare expenditures is the strongest predictor of poverty in many of the communities I work in various LMICs. I strongly support collecting this data point systematically in DHS.
Re: DHS-8-PGSSC-OOP-Template [message #17429 is a reply to message #17410] Sat, 16 March 2019 00:01 Go to previous message
Msydlowski is currently offline  Msydlowski
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It is essential DHS incorporate the collection of this indicator to understand the burden of obtaining care for patients and to determine if oop deters patients from seeking care.
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