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Table 4 Summary lessons from conducting 1999 and 2004 BOD, Thailand

From: Burden of disease in Thailand: changes in health gap between 1999 and 2004

  Challenges Achievements
1. Methodological issues   
1.1 Inadequacy of data Incompleteness of mortality data from routine vital registration Direct technique estimation of completeness were applied by using time series from the Survey of Population Change
  Poor quality of COD in vital registration Verbal autopsy and medical record investigation were conducted to verify COD from vital registration
  Unavailability of a number of morbidity and disability data Use of regional estimates from literature review and GBD estimates Information from developed country settings were applied in some instances Consensus meeting with disease experts
  Inconsistency of data sources over time Most datasets maintain consistency
1.2 Adaptation on methods Classification of disease was not particular fit with tropical diseases Leptospirosis was added but there was no disability weight values in the GBD
  Unavailability of DW Estimation was derived from the close matched conditions
2. Institutional capacity   
2.1 Generating BOD evidence Fragmentation of mortality and morbidity data sources, time consuming to collate datasets The capacity of the Thai Working Group on BOD hosted by IHPP was gradually institutionalized
Oversight committee provides continued and invaluable supports
Comprehensive assessment of demographic, epidemiologic, and health services data on mortality and morbidity
Trust based networking with data owners, data users, and disease experts
Results have been further utilized in cost-effectiveness assessment
National financial commitments and support: the 1999 and 2004 BOD assessments were local research grants. Technical supports from WHO and international experts are invaluable.
2.2 Translation BOD into policy decision   BOD were referenced during national policy formulation process and policy documents, e.g. the Thai Health Promotion Foundation master plan and its 2006 annual report
Results were applied in prioritizing health investment fostering resources in primary preventions of chronic NCD, in particular tobacco and alcohol
Awareness and increased investments in road safety and HIV preventions.