Medicine and Health Sciences Commons^™

Enhancing Patient Safety In Spain: Streamlining Adverse Event Detection In Occupational Healthcare Records, Diego Moya, Rafael Manzanera, Jordi Ortner, Marta Torres, Joan Carles Serfaty, Carme Sauri, Ma. Lourdes D. Jimenez, Jose Joaquin Mira

Ateneo School of Medicine and Public Health Publications

Background

Given the lack of previous studies on adverse events (AEs) in the area of occupational healthcare in Spain, it is very important to begin to understand this phenomenon in order to act on it. The objective was to accurately quantify AE occurring in occupational healthcare in MC Mutual during May 2021.

Methods

We conducted a review of a representative random sample of 250 clinical records to identify AEs through an active search audit, focused on the frequency, type, severity, and preventability of these events, categorized using standardized scales.

Results

We detected seven AEs in the sample of clinical records, …

Cancer Disparities In Southeast Asia: Intersectionality And A Call To Action, Erin Jay G. Feliciano, Frances Dominique V. Ho, Kaisin Yee, Joseph A. Paguio, Michelle Ann B. Eala, Janine Patricia G. Robredo, Kenrick Ng, Jasmine Lim, Khin Thuzar Pyone, Catherine A. Peralta, Jerickson Abbie Flores, J. Seth Yao, Patricia Mae G. Santos, Christian Daniel U. Ang, Gideon Lasco, Jeffrey Shi Kai Chan, Gary Tse, Enrico D. Tangco, T. Peter Kingham, Imjai Chitapanarux, Nirmala Bhoo-Pathy, Gerardo D. Legaspi, Edward Christopher Dee

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Global Burden Of Cardiovascular Diseases And Risks, 1990-2022, George A. Mensah, Valentin Fuster, Christopher J.L. Murray, Gregory A. Roth, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Patient Satisfaction With Telemedicine In The Philippines During The Covid-19 Pandemic: A Mixed Methods Study, Alicia Victoria G. Noceda, Lianne Margot M. Acierto, Morvenn Chaimek C. Bertiz, David Emmanuel H. Dionisio, Chelsea Beatrice L. Laurito, Girrard Alphonse T. Sanchez, Arianna Maever Loreche

Ateneo School of Medicine and Public Health Publications

Background: The capacity to deliver essential health services has been negatively impacted by the COVID-19 pandemic, particularly due to lockdown restrictions. Telemedicine provides a safe, efficient, and effective alternative that addresses the needs of patients and the health system. However, there remain implementation challenges and barriers to patient adoption in resource-limited settings as in the Philippines. This mixed methods study aimed to describe patient perspectives and experiences with telemedicine services, and explore the factors that influence telemedicine use and satisfaction. Methods: An online survey consisting of items adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & …

Corrigendum: Comparing Tobacco And Alcohol Policies From A Health Systems Perspective: The Cases Of The Philippines And Singapore, Gianna Gayle H. Amul, Jean-Francois Etter

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Leveraging National And Global Political Determinants Of Health To Promote Equity In Cancer Care, Edward Christopher Dee, Michelle Ann B. Eala, Janine Patricia G. Robredo, Duvern Ramiah, Anne Hubbard, Frances Dominique V. Ho, Richard Sullivan, Ajay Aggarwal, Christopher M. Booth, Gerardo D. Legaspi, Paul L. Nguyen, C. S. Pramesh, Surbhi Grover

Ateneo School of Medicine and Public Health Publications

Health and politics are deeply intertwined. In the context of national and global cancer care delivery, political forces-the political determinants of health-influence every level of the cancer care continuum. We explore the "3-I" framework, which structures the upstream political forces that affect policy choices in the context of actors' interests, ideas, and institutions, to examine how political determinants of health underlie cancer disparities. Borrowing from the work of PA Hall, M-P Pomey, CJ Ho, and other thinkers, interests are the agendas of individuals and groups in power. Ideas represent beliefs or knowledge about what is or what should be. Institutions …

Measuring Quality Of Care For Universal Health Coverage In The Western Pacific, Arianna Maever Loreche, Veincent Christian F. Pepito, Kenneth Y. Hartigan-Go, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

To deliver on the promise of universal health coverage, regions and countries need to invest in high-quality health systems and put quality of care at the forefront of priority setting and agenda. The Western Pacific Region and its member countries should establish measurements and standards to ensure delivery of high-quality services. In order to effectively do so, individual and system capacities to measure and use quality-of-care data should be strengthened, localized initiatives to develop quality-of-care measures of practice and policy relevance need to be carried out, accountability mechanisms should be in place, and the role of quality as a driver …

The Viral Picture Of Well-Being: Biggest Concerns, Losses, And Unintended Gifts Of Covid-19 In The Philippines, Ma Teresa Tuason, Kelly Perniciaro, Richel Lamadrid, Jego Mallillin, C. Dominik Güss

Ateneo School of Medicine and Public Health Publications

The COVID-19 pandemic revealed more than anticipated about global human functioning and resiliency. This Philippines-based study replicated a recent U.S. COVID analysis on psychological well-being (PWB). Factors examined herein were grouped into categories for analysis: 1) predictors of PWB, 2) areas of greatest stress or worry (biggest concerns), 3) perceived or real losses across SES, and 4) identified “unintended gifts” across PWB. Participants (n = 1345) were volunteers who responded to an online survey from August to September 2021, peak of the Delta variant. Three general groups of predictors (biological, psychological, and socio-economic) contributed to PWB. A regression model containing …

Using An Online Calculator To Describe Excess Mortality In The Philippines During The Covid-19 Pandemic, Julius Migriño Jr, Ma Rosario Bernardo-Lazaro

Ateneo School of Medicine and Public Health Publications

Objective

Excess mortality is an indicator of the impact of the coronavirus disease (COVID-19) pandemic. This study aims to describe excess mortality in the Philippines from January 2020 to December 2021 using an online all-cause mortality and excess mortality calculator.

Methods

All-cause mortality datasets from 2015 to 2021 from the Philippine Statistics Authority were obtained and analysed using the World Health Organization Western Pacific Regional Office All-Cause Mortality Calculator. Expected mortality, excess mortality and P-scores were obtained using two models, 5-year averages and negative binomial regression, for total deaths and by administrative region.

Results

Reported national all-cause mortality exceeded the …

The Policy Environment Of Self-Care: A Case Study Of The Philippines, Leonardo Jaminola Iii, Jana Marie Negre, Veincent Christian F. Pepito, Arianna Maever Loreche, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

Self-care is the ability and empowerment of individuals to maintain health through informed health-care decisions, with or without the support of a health provider. High-income countries have made advances to their conceptualization, research and institutionalization of self-care, given its reported benefits to patients, the health system and economy. A similar undertaking in low- and middle-income countries (LMICs) with already fragile health systems is warranted as highlighted by the coronavirus disease 2019 pandemic. Our article therefore aimed to describe and analyse the policy environment of self-care using the Philippines as a case study, which may have relevance to other similar countries …

Role Of Oxides Of Nitrogen In The Ozone-Cardiorespiratory Visit Association, Xerxes Seposo, Kayo Ueda, Chris Fook Sheng Ng, Lina Madaniyazi, Seiji Sugata, Ayako Yoshino, Akinori Takami

Ateneo School of Medicine and Public Health Publications

Ozone (O3)-induced health effects vary in terms of severity, from deterioration of lung function and hospitalization to death. Several studies have reported a linear increase in health risks after O3 exposure. However, current evidence suggests a non-linear U- and J-shaped concentration-response (C-R) function. The potential increasing risks with decreasing O3 concentrations may seem counterintuitive from the traditional standpoint that decreasing exposure should lead to decreasing health risks. Tus, the question of whether the increasing risks with decreasing concentrations are truly O3-induced or might be from other C-R mechanisms. If these potential risks were not accounted for, this may have contributed …

Covid-19 Vaccine Hesitancy In Asean: Insights From A Multi-Wave Survey Database From July 2020 To March 2021, Kenneth Y. Hartigan-Go, Ronald U. Mendoza, Madeline Mae A. Ong, Jurel K. Yap

Ateneo School of Medicine and Public Health Publications

Objectives

Early studies on COVID-19 vaccine hesitancy showed varied intensity across countries, which was linked to various factors such as socio-economic conditions, information sources, and issues of trust in government, scientific experts, and the health sector. This study aims to evaluate the determinants of vaccine hesitancy to offer insights into the strategies that may be successful in designing communications campaigns for enhanced vaccination uptake.

Methods

Through logistic regression, this study examines correlates of survey data from five Southeast Asian countries, namely Indonesia (ID), Malaysia (MY), Philippines (PH), Thailand (TH), Vietnam (VN) collected by the Massachusetts Institute of Technology Initiative on …

The Prevalence Of Sars-Cov-2 Antibodies Within The Community Of A Private Tertiary University In The Philippines: A Serial Cross Sectional Study, Lourdes S. Tanchanco, Jenica Clarisse Y. Sy, Angel Belle C. Dy, Myla D. Levantino, Arianna Maever L. Amit, John Wong, Kirsten Angeles, John Paul Vergara

Ateneo School of Medicine and Public Health Publications

The COVID-19 pandemic has caused a public health emergency in all sectors of society, including universities and other academic institutions. This study determined the seroprevalence of SARS-CoV-2 antibodies among administrators, faculty, staff, and students of a private tertiary academic institution in the Philippines over a 7 month period. It employed a serial cross-sectional method using qualitative and quantitative COVID-19 antibody test kits. A total of 1,318 participants were tested, showing 47.80% of the study population yielding IgG antibodies to SARS-CoV-2 virus. A general increase in seroprevalence was observed from June to December 2021, which coincided with the vaccine roll-out of …

University Students’ Overall And Domain-Specific Physical Activity During Covid-19: A Cross-Sectional Study In Seven Asean Countries, Areekul Amornsriwatanakul, Hanif Abdul Raman, Apichai Wattanapisit, Ira Nurmala, Ma. Henrietta Teresa O. De La Cruz, Josip Car, Michael Chia

Ateneo School of Medicine and Public Health Publications

This research investigated the overall and domain-specific physical activity (PA) of university students in the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was applied to socioeconomic (SE) and PA online data collected from 15,366 students across 17 universities in seven Association of Southeast Asian Nations (ASEAN) countries. Statistical analyses using logistic regressions established SE–PA relationships. Over half (60.3%) of ASEAN university students met age-span specific PA guidelines. Students participated in recreational PA the most, followed by study-related activities and 44.1% of students engaged in >8 hrs/day of sedentary time (ST). Compared to students with a normal body mass index …

The Clusters Of Health-Risk Behaviours And Mental Wellbeing And Their Sociodemographic Correlates: A Study Of 15,366 Asean University Students, Apichai Wattanapisit, Hanif Abdul Raman, Josip Car, Khadizah H. Abdul-Mumin, Ma. Henrietta Teresa O. De La Cruz, Michael Chia, Michael Rosenberg, Moon-Ho Ringo Ho, Surasak Chaiyasong, Trias Mahmudiono

Ateneo School of Medicine and Public Health Publications

Background

This study investigated, through cluster analysis, the associations between behavioural characteristics, mental wellbeing, demographic characteristics, and health among university students in the Association of Southeast Asian Nations (ASEAN) University Network – Health Promotion Network (AUN-HPN) member universities.

Methods

Data were retrieved from a cross-sectional self-administered online survey among undergraduate students in seven ASEAN countries. A two-step cluster analysis was employed, with cluster labels based on the predominant characteristics identified within the clusters. The ‘healthy’ cluster was assigned as the reference group for comparisons using multinomial logistic regression analysis.

Results

The analytic sample size comprised 15,366 university students. Five clusters …

Prevalence Of Health-Risk Behaviors And Mental Well-Being Of Asean University Students In Covid-19 Pandemic, Hanif Abdul Raman, Areekul Amornsriwatanakul, Khadizah H. Abdul-Mumin, Denny Agustiningsih, Surasak Chaiyasong, Michael Chia, Supat Chupradit, Le Quang Huy, Katiya Ivanovitch, Ma. Henrietta Teresa O. De La Cruz

Ateneo School of Medicine and Public Health Publications

The prevalence of epidemiological health-risk behaviors and mental well-being in the COVID-19 pandemic, stratified by sociodemographic factors in Association of South East Asian Nations (ASEAN) university students, were examined in the research. Data were collected in March–June 2021 via an online survey from 15,366 university students from 17 universities in seven ASEAN countries. Analyzed data comprised results on physical activity, health-related behaviors, mental well-being, and sociodemographic information. A large proportion of university students consumed sugar-sweetened beverages (82.0%; 95%CI: 81.4, 82.6) and snacks/fast food daily (65.2%; 95%CI: 64.4, 66.0). About half (52.2%; 95%CI: 51.4, 53.0) consumed less than the recommended daily …

Arsenic In Groundwater Sources From Selected Communities Surrounding Taal Volcano, Philippines: An Exploratory Study, Geminn Louis C. Apostol, Sary Valenzuela, Xerxes Seposo

Ateneo School of Medicine and Public Health Publications

Arsenic (As) is a highly toxic, carcinogenic trace metal that can potentially contaminate groundwater sources in volcanic regions. This study provides the first comparative documentation of As concentrations in groundwater in a volcano-sedimentary region in the Philippines. Matched, repeated As measurements and physico-chemical analyses were performed in 26 individual wells from 11 municipalities and city in Batangas province from July 2020 to November 2021. Using the electrothermal atomic absorption spectrometric method, analysis of the wells revealed that in 2020, 23 out of 26 (88.46%) had As levels above the WHO limit of >10 ppb while 20 out of 26 wells …

What Does “Good” Community And Public Engagement Look Like? Developing Relationships With Community Members In Global Health Research, Gary Hickey, Katie Porter, Doreen Tembo, Una Rennard, Martha Tholanah, Peter Beresford, David Chandler, Moses Chimbari, Tina Coldham, Lisa Dikomitis, Biggy Dziro, Peter O. Ekiikina, Maria I. Khattak, Cristian R. Montenegro, Noni Mumba, Rosemary Musesengwa, Erica Nelson, Clement Nhunzvi, Caroline Mae Ramirez, Sophie Staniszewska

Ateneo School of Medicine and Public Health Publications

Community and public engagement (CPE) is increasingly becoming a key component in global health research. The National Institute for Health Research (NIHR) is one of the leading funders in the UK of global health research and requires a robust CPE element in the research it funds, along with CPE monitoring and evaluation. But what does “good” CPE look like? And what factors facilitate or inhibit good CPE? Addressing these questions would help ensure clarity of expectations of award holders, and inform effective monitoring frameworks and the development of guidance. The work reported upon here builds on existing guidance and is …

Covid-19 Vaccine Brand Hesitancy And Other Challenges To Vaccination In The Philippines, Arianna Maever L. Amit, Veincent Christian F. Pepito, Lourdes S. Tanchanco, Manuel Dayrit

Ateneo School of Medicine and Public Health Publications

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, …

Determinants Of Consistent Condom Use Among Filipino Women: Results From The 2017 Philippine National Demographic And Health Survey, Veincent Christian F. Pepito, Arianna Maever L. Amit, Clinton S. Tang, Ryan Gabriel C. Molen, Luis Miguel B. Co, Neil Andrew K. Aliazas, Sarah J. De Los Reyes, Lourdes S. Tanchanco

Ateneo School of Medicine and Public Health Publications

Background: Consistent condom use in women, defined as the self-reported usage of male condom in every sexual encounter of the respondent with her most recent partner in the last 12 months, had been perennially low in the Philippines. This is despite consistent condom use being a tested and proven public health intervention to prevent unwanted pregnancy and sexually transmitted infections. Considering the high fertility rate, teenage pregnancy rate, and the rapidly increasing incidence of HIV in the country, we identified the determinants of consistent condom use in the Philippines.

Methods: We used data from the individual recode of the 2017 …

Covid-19 Vaccine Brand Hesitancy And Other Challenges To Vaccination In The Philippines, Arianna Maever L. Amit, Veincent Christian F. Pepito, Lourdes S. Tanchanco, Manuel Dayrit

Ateneo School of Medicine and Public Health Publications

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, …

How Comprehensive And Effective Are Waste Management Policies During The Covid-19 Pandemic? Perspectives From The Philippines, Geminn Louis C. Apostol, Angelina Gabrielle A. Acolola, Michelle Alexandra Edillon, Sary Valenzuela

Ateneo School of Medicine and Public Health Publications

This study presents a comprehensive analysis on policies governing the management of COVID-19 waste in the Philippines, highlighting gaps in pre-existing policies and opportunities for further policy development and adaptation in the context of present and future public health emergencies. A hybrid search strategy and consultative process identified fifty (50) policy documents directly impacting the management of wastes (general domestic, healthcare, and household healthcare waste) released prior to and during the pandemic. Content analysis revealed comprehensive policy coverage on managing general domestic waste and healthcare waste. However, there remains a dearth in policies for managing household healthcare waste, an emerging …

Prevalence And Determinants Of Home Delivery In Urban And Rural Philippines: Evidence From The 2017 National Demographic And Health Survey, Arianna Maever L. Amit, Veincent Christian F. Pepito, Sarah J. De Los Reyes, Clinton S. Tang, Neil Andrew K. Aliazas, Lourdes S. Tanchanco

Ateneo School of Medicine and Public Health Publications

Background: Women’s choice of place of delivery has implications on maternal and child mortality. This study aims to provide an updated and detailed comparison of prevalence and determinants of home delivery in the Philippines, and in urban and rural communities.

Methods: Based on data from the 2017 Philippine National Demographic and Health Survey (NDHS), we estimated the prevalence of home delivery and determined factors influencing women’s decision to deliver at home. Analyses were restricted to data from 7229 women who were cohabiting or married, and their last-born child using logistic regression methods for survey data.

Results: There remain a considerable …

Outmigration And Unequal Distribution Of Filipino Physicians And Nurses: An Urgent Call For Investment In Health Human Resource And Systemic Reform, Janine Patricia G. Robredo, Bradley Ong, Michelle Ann B. Eala, Raymond John Naguit

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Exposure To Family Planning Messages And Teenage Pregnancy: Results From The 2017 Philippine National Demographic And Health Survey, Veincent Christian F. Pepito, Arianna Maever L. Amit, Clinton S. Tang, Luis Miguel B. Co, Neil Andrew K. Aliazas, Sarah J. De Los Reyes, Raymundo S. Baquiran, Lourdes Bernadette S. Tanchanco

Ateneo School of Medicine and Public Health Publications

Background

Teenage pregnancy is known to have physical, emotional, and psychosocial effects. Because of these risks, family planning and contraception messages have been disseminated in various forms of media, but their association with teenage pregnancy has not been studied previously in the Philippines. This study aims to examine the association between exposure to various family planning and contraception messages disseminated in various media channels and pregnancy among Filipino women aged 15–19. The study also intended to examine interactions between the different media channels where these family planning and contraception messages are being disseminated on their effect on teenage pregnancy.

Methods …

Association Between Teenage Pregnancy And Family Factors: An Analysis Of The Philippine National Demographic And Health Survey 2017, Kozue Tabei, Erlinda Susana S. Cuisia-Cruz, Chris Smith, Xerxes Seposo

Ateneo School of Medicine and Public Health Publications

Adolescence is a key developmental period in one’s life course; health-related behaviors of adolescents can be linked to lifelong consequences, which affect their future health. Previous studies highlight the role of family and its significant association with adolescents’ health. In East Asia and the Pacific, the Philippines is the only country that is showing an upward trend of teenage pregnancy while other countries in the region have declining teenage pregnancy rates. Against this backdrop, this study investigated the association between teenage pregnancy and family factors, specifically parent structure. Data for the study were extracted from the Philippine National Demographic and …

Factors Affecting Retention In The Philippine National Rural Physician Deployment Program From 2012 To 2019: A Mixed Methods Study, Erika Louise L. Flores, Edric Matthew R. Manahan, Miguel Paulo B. Lacanilao, Isabella Ma. Beatriz T. Ladaw, Mico Martin B. Mallillin, Nikolai Thadeus Q. Mappatao, Juan Alfonso Leonardia, Veincent Christian F. Pepito

Ateneo School of Medicine and Public Health Publications

Background

To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment.

Methods

A descriptive, mixed-methods, explanatory design was …

Global, Regional, And National Mortality Among Young People Aged 10–24 Years, 1950–2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Joseph L. Ward, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Adolescent Morality Collaborators, 646 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods

We report trends in estimated total numbers of deaths and mortality rate …

Global, Regional, And National Sex-Specific Burden And Control Of The Hiv Epidemic, 1990–2019, For 204 Countries And Territories: The Global Burden Of Diseases Study 2019, Deepa Jahagirdar, Hmwe Hmwe Kyu, Veincent Christian F. Pepito, Gbd 2019 Hiv Collaborators, 395 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic.

Methods

To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal …

Global, Regional, And National Sex Differences In The Global Burden Of Tuberculosis By Hiv Status, 1990-2019: Results From The Global Burden Of Disease Study 2019, Jorge R. Ledesma, Hmwe Hmwe Kyu, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Tuberculosis Collaborators, 328 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019.

Methods

We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital …