RESUMO
BACKGROUND: Non-communicable diseases (NCDs) have received political attention and commitment, yet surveillance is needed to measure progress and set priorities. Building on global estimates suggesting that Peru is not on target to meet the Sustainable Development Goal 3.4, we estimated the contribution of various NCDs to the change in unconditional probability of dying from NCDs in 25 regions in Peru. METHODS: Using national death registries and census data, we estimated the unconditional probability of dying between ages 30 and 69 from any and from each of the following NCDs: cardiovascular, cancer, diabetes, chronic respiratory diseases and chronic kidney disease. We estimated the contribution of each NCD to the change in the unconditional probability of dying from any of these NCDs between 2006 and 2016. RESULTS: The overall unconditional probability of dying improved for men (21.4%) and women (23.3%). Cancer accounted for 10.9% in men and 13.7% in women of the overall reduction; cardiovascular diseases also contributed substantially: 11.3% in men) and 9.8% in women. Consistently in men and women and across regions, diabetes moved in the opposite direction of the overall reduction in the unconditional probability of dying from any selected NCD. Diabetes contributed a rise in the unconditional probability of 3.6% in men and 2.1% in women. CONCLUSIONS: Although the unconditional probability of dying from any selected NCD has decreased, diabetes would prevent Peru from meeting international targets. Policies are needed to prevent diabetes and to strengthen healthcare to avoid diabetes-related complications and delay mortality.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/prevenção & controle , Mortalidade/tendências , Neoplasias/prevenção & controle , Insuficiência Renal Crônica/prevenção & controle , Transtornos Respiratórios/prevenção & controle , Desenvolvimento Sustentável , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/mortalidade , Feminino , Humanos , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/mortalidade , Peru/epidemiologia , Prognóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/mortalidade , Transtornos Respiratórios/epidemiologia , Transtornos Respiratórios/mortalidade , Taxa de SobrevidaRESUMO
OBJECTIVES: Early life interventions are considered essential for reducing the burden of health inequalities over the life course. This paper tests this issue empirically focusing on whether access to antenatal care can later reduce children's health and educational inequalities. METHODS: Data came from the Young Lives Project for Ethiopia, Peru, Vietnam, and the State of Andhra Pradesh in India. We selected children born in early 2001/2002 and who were followed longitudinally in 2006/2007. We used multilevel mixed effects linear regression models to estimate the parameters of interest. RESULTS: We found a positive and significant relationship between mothers' access to antenatal care and their children's cognitive development in all countries. In addition, we found a positive and significant relationship between antenatal care and children's cognitive development for stunted children but only in Peru and Vietnam. CONCLUSIONS: We conclude that (1) antenatal care has the potential to change the negative consequences of early nutritional deficiencies on later cognitive development in Peru and Vietnam; (2) differentials in the quality of antenatal care services could explain the cross-country differentials in the role of early life interventions found here.