Historically, women's reproductive health has been overlooked on a global scale despite the substantial and long-lasting impact that reproductive tract diseases have on a woman’s educational, professional, and personal lives. According to the results from the Global Burden of Disease Study 2019, female reproductive tract diseases, including gynecologic disorders and sexually transmitted infections, are highly prevalent among women, ranking as the 2nd and 6th prevalent diseases globally in 2019 (1). Despite their high prevalence, these conditions often account for fewer years lived with disability (YLDs) compared to other similarly common diseases, such as type 2 diabetes. Although some of this difference may appropriately reflect the difference in the average nonfatal health loss suffered by individuals with these conditions, it raises questions about the completeness of current data inputs, accuracy of disease assumptions used to convert prevalence to YLDs, as well as the limitations of the existing disease burden measurement framework.
The current YLD estimation framework used for the Global Burden of Disease Study (GBD) relies on point-prevalence, and in some ways, is agnostic to chronicity and recurrent illness. This is to say that a disease with short duration experienced once by a large number of people may contribute the same number of YLDs to total burden as a chronic or recurrent disease experienced by a smaller group of individuals. It is reasonable to suspect that symptoms and functional limitations that occur chronically or repeatedly have a cumulative effect that is more than additive and can also have a long-term impact on activities of daily living such as school, child-rearing, household chores, work, and other economic activity. Extending beyond the GBD’s standard approach of measuring health loss at a single point in time, we propose to develop a framework using high-quality, multi-dimensional longitudinal datasets, such as the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study, to guide more nuanced estimation of YLDs for chronic or recurrent conditions related to women’s reproductive health to capture long-term effects female reproductive health disease has on women’s well-being over time. This framework will provide a more comprehensive view of the impact of female reproductive health diseases on women’s lives and can be used to inform policy and develop tailored interventions and treatments to address the disparate burden faced by this population.
References:
1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1204–22.