Avoidable mortality--a tool for policy evaluation in developing countries?

Abstract

In addition to identifying the diseases and injuries that contribute most to loss of health, health planners want to know how much of this can be avoided and at what cost. This information can also be used to evaluate the performance of health systems. The concept of avoidable deaths was initially proposed to assess the quality of health services. In 1976, Rutstein et al. proposed a list of sentinel conditions from which ‘disease, disability or death’ should not occur if appropriate care was provided—the ‘airplane crashes of the health care system’.1 The concept of avoidable deaths was expanded to include some preventable causes of death and adopted widely to summarize regional variations in health outcomes, particularly in Europe, Australia and New Zealand.2 The most recent international analyses of avoidable deaths have returned to a narrow focus, including only causes for which a significant proportion of deaths would be avoided given adequate personal health services, in order …