Appendix.

Appendix

MAJOR HEALTH PROBLEMS AMONG FEMALES IN DEVELOPING COUNTRIES AND
COST-EFFECTIVE INTERVENTIONS, 1990

                                   Total DALYs       Percentage
Age group/                          lost from     of total disease
main causes                       all diseases     burden for each
of disease                         (millions)       age group (a)

Ages 0-4                               250
  Respiratory infections                                18,5
  Perinatal causes                                      17.2
  Diarrheal disease                                     16.2
  Childhood cluster (c)                                 10.7
  Congenital problems                                    6.5
  Malaria                                                4.7
  Protein-energy malnutrition                            2.4
  Vitamin A deficiency                                   2.3
  Iodine deficiency                                      1.3
  Falls                                                  1.2
Ages 5-14                              67
  Intestinal helminths                                  12.3
  Childhood cluster (c)                                  8.6
  Respiratory infections                                 7.9
  Diarrheal disease                                      7.1
  Tuberculosis                                           5.7
  Malaria                                                4.9
  Motor vehicle injuries                                 3.7
  Anemias                                                3.0
  Epilepsy                                               2.6
  STDs and HIV                                           2.4
Ages 15-44                             155
  Maternal causes                                       18.0
  STDS                                                   8.9
  Tuberculosis                                           7.0
  HIV                                                    6.6
  Depressive disorders                                   5.8
  Self-inflicted injuries                                3.2
  Anemia                                                 2.5
  Respiratory infections                                 2.5
  Osteoarthritis                                         2.2
  Motor vehicle injuries                                 2.1
Ages 45-59                             49
  Cerebrovascular diseases                               8.7
  Tuberculosis                                           5.6
  Ischemic heart disease                                 4.7
  Peri-, endo- and myocarditis                           3.2
  Cataracts                                              3.1
  Periodontal disease                                    3,1
  Chronic obstructive pulmonary
    diseases                                             2.8
  Diabetes mellitus                                      2.8
  Osteoarthritis                                         2.7
  Cancer of the cervix                                   2.6
Ages 60+                               60
  Cerebrovascular diseases                              16.5
  Ischemic heart disease                                11.6
  Chronic obstructive pulmonary
    diseases                                             8.1
  Alzheimer's disease and other
    dementias                                            4.8
  Respiratory infections                                 4.6
  Peri-, endo- and myocarditis                           3.6
  Diabetes mellitus                                      2.4
  Tuberculosis                                           1.9
  Falls                                                  1.8
  Cataracts                                              1.6

                                        Cost-             Cost of
Age group/                          effectiveness      intervention
main causes                          of existing         per DALY
of disease                        interventions (b)        saved

Ages 0-4
  Respiratory infections                 High             $20-50
  Perinatal causes                       High               --
  Diarrheal disease                      High             $10-170
  Childhood cluster (c)                  High             $10-25
  Congenital problems                 Unassessed            --
  Malaria                                High               --
  Protein-energy malnutrition            High               $63
  Vitamin A deficiency                   High              $1-4
  Iodine deficiency                      High              $8-37
  Falls                               Unassessed            --
Ages 5-14
  Intestinal helminths                   High             $15-30
  Childhood cluster (c)                  High             $10-25
  Respiratory infections                 High               --
  Diarrheal disease                      High               --
  Tuberculosis                           High              $3-5
  Malaria                                High             $5-250
  Motor vehicle injuries              Unassessed            --
  Anemias                                High               --
  Epilepsy                            Unassessed            --
  STDs and HIV                           High              $3-5
Ages 15-44
  Maternal causes                        High             $60-110
  STDS                                   High             $10-15
  Tuberculosis                           High              $3-5
  HIV                                    High              $3-5
  Depressive disorders                 Moderate             --
  Self-inflicted injuries             Unassessed            --
  Anemia                                 High              $4-13
  Respiratory infections                 High               --
  Osteoarthritis                      Unassessed            --
  Motor vehicle injuries               Moderate             --
Ages 45-59
  Cerebrovascular diseases               Low                --
  Tuberculosis                           High              $3-5
  Ischemic heart disease               Moderate             --
  Peri-, endo- and myocarditis        Unassessed            --
  Cataracts                              High             $20-40
  Periodontal disease                 Unassessed            --
  Chronic obstructive pulmonary
    diseases                           Moderate             --
  Diabetes mellitus                    Moderate             --
  Osteoarthritis                      Unassessed            --
  Cancer of the cervix                   High            $150-200
Ages 60+
  Cerebrovascular diseases               Low                --
  Ischemic heart disease               Moderate             --
  Chronic obstructive pulmonary
    diseases                           Moderate             --
  Alzheimer's disease and other
    dementias                         Unassessed            --
  Respiratory infections                 High               --
  Peri-, endo- and myocarditis        Unassessed            --
  Diabetes mellitus                    Moderate             --
  Tuberculosis                           High              $3-5
  Falls                               Unassessed            --
  Cataracts                              High               --

(a.) Percentages do not total 100% because only the ten main causes
of disease for each age group are listed.

(b.) Interventions of high cost-effectiveness ate those that can be
implemented for less than $100 per disability-adjusted life year
(DALY) saved; those of moderate cost-effectiveness cost between $250
and $999 per DALY saved; and those of low cost-effectiveness cost
more than $1,000 per DALY saved. (Few interventions are in the range
of $100 to $250 per DALY saved.) "Unassessed" indicates diseases for
which preventive and therapeutic interventions have not been evaluated
in terms of cost-effectiveness.

(c.) Vaccine-preventable diseases of childhood.

Source: World Bank 1993b.