Ph.D., MSPH, MHA
Kristiania University College
Oslo | Norway
Main Specialties: Public Health
Additional Specialties: Health economics, health policy, health services administration, public health, cost effectiveness of health interventions, global health issuues, burden of disease
Prof.Dr. Adnan Kisa received his B.S. from Hacettepe University, masters from Meharry Medical College, USA and Istanbul University, and doctorate from Tulane University, USA, health policy and economics.
Dr. Kisa administered many scientific projects and worked as consultant; Health Economics and Policy Manager of Wyeth Pharmaceuticals((conducted the economic evaluation of Pneumococcal 7-valent Conjugate Vaccine for the national Immunization List for Turkey), PI of the WHO WHS-Turkey, Principal Investigator of the National Burden of Disease and Cost-Effectiveness of Essential Health Services in Turkey ($1.6 million grant from the World Bank), consultant in WHO-ICC, PM of the Strengthening Management in Reproductive Health Services Project, Member of The Network of Innovators of the Chronic Conditions of the WHO, PE Team Member of INFINITY Project-Tulane, Perinatal Outcome Study MMC.
Dr. Kisa has more than 90 peer reviewed published articles, books, book chapters, research reports in English, Russian, Spanish and French and Turkish and member of many national and international health institutions, scientific boards, and editorial boards. He is the author/scientific writer/editor of “Social Determinants of Healthcare Utilization in Dubai”, LAP Lambert Academic Publishing. 2016, “Innovative Care for Chronic Conditions: Building Blocks for Action”, World Health Organization, 2002, Geneva, “Adherence to Long-term Therapies: Evidence for Action Report”, World Health Organization, 2003,Geneva, “Health Care Management”, Anadolu University Publications 2007, “World Health Systems-Global Engagement in Creating Financially Viable Healthcare Systems” Proceedings Book, 2002, “Proceedings: Sixth International Conference on Healthcare Systems” 2010, Introduction to Health Economics, 1999
Primary Affiliation: Kristiania University College - Oslo , Norway
429PubMed Central Citations
Lancet 2018 11;392(10159):1859-1922
Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade.
Lancet 2018; 392: 1684–735
Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing
BACKGROUND: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. METHODS: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. FINDINGS: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week. INTERPRETATION: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
Lancet 2018 06 1;391(10136):2236-2271. Epub 2018 Jun 1.
J Int Med Res 2017 Dec 12;45(6):1739-1749. Epub 2017 Jan 12.
3 Department of Health Policy & Management, Global Health, Economics & Finance Concentrations, Jackson State University, Jackson, MS, USA.
Lancet 2017 Sep 12;390(10100):1423-1459. Epub 2017 Sep 12.
Lancet 2017 Sep;390(10100):1260-1344
Lancet 2017 Sep;390(10100):1345-1422
Lancet 2017 Sep;390(10100):1211-1259
Eval Program Plann 2016 06 21;56:64-8. Epub 2016 Mar 21.
Biomedical Sciences and Natural Sciences, Keiser University, Fort Myers, FL, USA. Electronic address:
Evaluation and Program Planning
BACKGROUND: In the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range. OBJECTIVE: This study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health. METHODS: A short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval. RESULTS: The participant's mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81±14.95kg (82.6kg for males and 79.5kg for females) that decreased to 78.9±14.33kg (81.1kg for males and 77.3kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65±71.45mg/dL before educational intervention that decreased to 177.7±66.11mg/dL after the educational intervention (p=0.049). The mean glycosylated hemoglobin was 8.57±1.21 before educational intervention that decreased to 7.95±1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27±37.74mg/dL that decreased to 169.57±34.23mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85±171.04mg/dL to 183.28±152.4mg/dL (p=0.025). The mean score of knowledge questionnaire before educational intervention was 60.6±20.65 that increased to 78.1±13.4 after conducting educational intervention. CONCLUSIONS: Diabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge. RECOMMENDATIONS: Diabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient's family, diabetes care team, community, and decision makers in the education process.
Inquiry 2015 8;52. Epub 2015 Dec 8.
Zirve University, Gaziantep, Turkey.
Inquiry 2015 11;52. Epub 2015 Mar 11.
Zirve University, Turkey.
Value Health 2013 Jul-Aug;16(5):755-9. Epub 2013 Jul 10.
Department of Pediatrics and Pediatric Infectious Diseases, Bezmialem Vakif University, Adnan Menderes Bulvan Vatan Caddessi, Fatih, Istanbul, Turkey.
J Health Care Finance 2009 ;35(3):35-43
School of Health Sciences, Jackson State University, Jackson, MS, USA.
Health Mark Q 2007 ;24(3-4):19-31
Faculty of Business and Tourism Education, Gazi University, Golbasi, Ankara, Turkey.
J Health Care Finance 2007 ;33(4):86-92
Gaziosmanpasa University Hospital, Tokat, Turkey.
Public Health Rep 2007 Sep-Oct;122(5):693-701
Baskent University School of Health Sciences, Department of Healthcare Administration, Ankara, Turkey.
J Health Soc Policy 2003 ;17(3):55-69
School of Allied Health, Gazi University, Ankara, Turkey.
Public Health Rep 2006 Nov-Dec;121(6):764-8
Baskent University School of Health Sciences, Ankara, Turkey.
Int J Technol Assess Health Care 2006 ;22(4):537-42
Baskent University, Ankara, Turkey.
Health Care Manag (Frederick) 2006 Jul-Sep;25(3):254-62
School of Nursing, Gazi University, Ankara, Turkey.
Health Care Manag (Frederick) 2006 Apr-Jun;25(2):122-9
School of Nursing, Gazi University, Ankara, Turkey.
Health Care Manag (Frederick) 2006 Jan-Mar;25(1):37-42
Department of Healthcare Administration, School of Health Sciences, Baskent University, Ankara, Turkey.
J Med Syst 2005 Oct;29(5):487-92
Department of Health Administration, School of Health Education, Ankara University, Kecioren, Ankara, Turkey.
Hosp Top 2005 ;83(1):13-9
Baskent University, Turkey.
Health Mark Q 2004 ;22(1):21-39
Gazi University, School of Business, Ankara, Turkey.
Health Care Manag (Frederick) 2005 Jan-Mar;24(1):55-60
Department of Office Management Education, Faculty of Commerce and Tourism Education, Golbasi, Ankara, Turkey.
J Med Syst 2004 Dec;28(6):653-63
Department of Health Administration, Gulhane Military Medical School, Etlik-Ankara, Turkey.
J Health Soc Policy 2002 ;15(1):77-94
Baskent University, School of Health Sciences, Department of Health Care Management, Turkey.
J Med Syst 2002 Apr;26(2):89-95
Department of Health Care Management, School of Health Sciences, Baskent University, Ankara, Turkey.
World Hosp Health Serv 2001 ;37(1):6-13, 33-4
School of Health Administration, Hacettepe University, Ankara, Turkey.
Health Serv Manage Res 2001 Feb;14(1):27-35
Gazi University, Ankara, Turkey.
J Health Soc Policy 2000 ;12(1):53-69
School of Allied Health, Gazi University, Teknikokullar, Ankara-Turkey.
J Med Syst 1999 Oct;23(5):363-75
School of Allied Health, Gazi University, Teknikokullar, Ankara, Turkey.
Health Serv Manage Res 1999 Aug;12(3):149-60
Baskent University, School of Health and Health Care Management, Ankara, Turkey.
J Community Health 1999 Feb;24(1):73-91
School of Allied Health, Gazi University Teknikokullar, Ankara-Turkey.
Health Serv Manage Res 1996 Nov;9(4):243-53
School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.