Trend and Gender Inequality in Non-Communicable Disease Burden in Ethiopia: evidence from GBD and EDHS 2000-2019

Abstract Background: The global noncommunicable disease burden is significantly increasing and has become a major reason for morbidity, productivity loss, higher healthcare costs, and sources of inequality. To mitigate the impact of these diseases among the vulnerable population, understanding the trends and gender disparities in the NCD burden is essential. We aimed to investigate the trends of NCD burden in Ethiopia, with a particular focus on examining gender-specific disparities. Methods: We analyzed data from the global burden of disease and five-round survey data from the Ethiopian demographic and health survey. The trend of NCD burden was measured in terms of death rate, DALY, YLL, and YLD from 1980 – 2021 using data from the global disease burden. Gender disparities concerning NCD death rate, DALY, and YLL were assessed using data from EDHS 2000,2005, 2011, 2016, and 2019 mini-EDHS. To measure inequality, difference, population attributable fraction, population attributable risk, and ratio were considered. Results: In Ethiopia, the NCD disease burden showed a decreasing trend between 1990 to 2021 with a greater reduction between the years 2000 and 2010. During this period greater change in death and DALY was seen among females. R and D measures revealed noticeable gender inequality favoring females, while PAR and PAF did not indicate inequality in NCD death rates. On the contrary, during the years 2000 and 2010, DALY concentrations were higher among females (D = -127.2 in 2000 and -106.7 in 2010), but in 2005, 2015, and 2019, the concentrations shifted to males. Across all years, YLL due to mortality was higher among females according to D and R measures, while PAF and PAR measures showed higher YLL due to disability among males. Conclusions: The study revealed the existence of significant gender inequalities in NCD burden