Challenge
To improve global health, we need to understand what diseases are causing the most harm. However, it's very challenging to create reliable, internally consistent estimates of global mortality and morbidity.
"If you added up all the health claims at the time [early 1990's], the result would have meant that the world's population was dying three times over." -Chris Murray, creator of the Global Burden of Disease study
Research Approach
As a WHO scientist, I worked on the Global Burden of Disease. I helped collect and model estimates for many cross-cutting disease conditions and led efforts to estimate global infertility.
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Definition Development
Created the first standardized demographic definition of infertility to enable consistent measurement across different countries and healthcare contexts.
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Survey Analysis
Analyzed 277 demographic health surveys spanning multiple decades using our infertility definition. Generated the first-ever analysis of global, regional, and country trends of infertility prevalence.
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Expertise Convening
Managed a team of global disease experts to guide modeling assumptions for analyses of infertility and other cross-cutting conditions.
Key Discoveries
Measurement Gaps
Identified significant gaps and inconsistencies in how infertility was being measured worldwide.
Global Prevalence
Estimated that 1.9% of women who wanted a child were unable to have their first live birth (primary infertility).
Secondary Infertility
Discovered that 10.5% of women who had previously given birth were unable to have another child.
Translation Into Action
Our research findings had significant impacts on global health measurement and policy:
Definition Adoption
Our standardized demographic definition of infertility was incorporated into future health surveys and research protocols worldwide.
GBD Integration
Our estimates were directly incorporated into the Global Burden of Disease project, highlighting the need for prevention.
Policy Influence
Findings informed WHO policies on reproductive health resource allocation by providing the first reliable global picture of infertility.
Methodological Template
Created an approach that was subsequently applied to other health conditions with similar measurement challenges.
Research Impact
Our work on global infertility created the first reliable, standardized measure of this condition worldwide, revealing that nearly 50 million couples experience infertility globally. The methodology we developed addressed the challenge of measuring conditions in regions where clinical data is limited by leveraging demographic surveys in innovative ways.
With approximately 3,000 citations, these publications have become foundational references for understanding reproductive health burden globally. Beyond infertility specifically, the Global Burden of Disease research established approaches for measuring cross-cutting conditions and making estimates in the face of significant data gaps that are now standard practice in global health assessment, demonstrating how epidemiological rigor can transform our understanding of previously under-measured health challenges.