---Filling Vital Gaps in Global Epidemiology

Wednesday, 26th of September 2012

FILLING VITAL GAPS IN GLOBAL EPIDEMIOLOGY

Full text is at http://ije.oxfordjournals.org/content/41/3/579.full?etoc

The International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) Network is an umbrella organization for a group of independent health research centres operating health and demographic surveillance system (HDSS) sites in low- and middle-income countries (LMICs). Founded in 1998, it brought together a number of existing HDSS sites, and since then has encouraged newer HDSS sites to join.1

The purpose of this Editorial is to set the scene for a series of profiles from INDEPTH HDSS member sites, the first examples of which are published in this edition of IJE.2–5 All these profiles will follow a set pattern, to facilitate a systematic understanding of the multiplicity of HDSS sites involved in the Network and the various ways in which they are operated by their parent institutions. This Editorial therefore, follows the same general pattern as the individual profiles, but seeks to explore the epidemiological basis on which the HDSSs operate in general, and the role of the Network, rather than dealing with site-specific issues.

At the central level, the INDEPTH Network operates from its base in Accra, Ghana, as an international NGO and is also registered as a not-for-profit entity in the USA. The emphasis on the Network’s position as a Southern-led and -based organization was an important founding tenet, and this is very welcome in a world where vestiges of colonialism still occasionally surface in relation to health data and policy. Day-to-day operations are led by the Executive Director (O.S.), and governance and oversight are provided by an international Board of Trustees and a Scientific Advisory Committee (chaired by P.B.).

Why was the INDEPTH Network set up and what does it cover now?

The raison d’être behind the emergence of the Network was the apparently intractable lack of reliable population-based data on health across many LMICs in Africa, Asia and Oceania. Recognizing that there are no quick fixes in terms of achieving universal individual registration of populations in LMICs,6 the Network represents a medium-term attempt to break the link between material and data poverty.7 Epidemiology in many LMICs suffers from a dual lack of reliable population data and human capacity to make use of them. The immediate consequence is that health policy making often lacks its essential evidence base, with the possible effect of failing to use scarce resources effectively in some of the world’s poorest countries.

There are considerable global disparities in terms of epidemiological research output per population. Figure 1 shows the countries of the world shaded by a crude measure of this, namely the number of PubMed hits for a search on (‘epidemiology’ and ) per 1000 population. Much of Africa and Asia falls under the level of 0.05 per 1000, corresponding to rates which represent less than one-twentieth of some of the world’s leading countries in terms of epidemiological output. Superimposed on the map in Figure 1 are the current 43 HDSS sites run by 36 member centres of the INDEPTH Network. Although the locations of these sites are somewhat serendipitous, rather than being strategically planned, it is evident that there is considerable coverage across the areas of the world that lack substantial epidemiological output. Thus, it is clear that the INDEPTH Network, through these 43 sites in 20 countries, collectively following a population of 3.2 million people, does indeed offer possibilities for filling some of the global gaps in epidemiology.

Expand+International Journal of Epidemiologyije.oxfordjournals.org

First published online: April 28, 2012