Estimating the completeness of under-5 death registration in Egypt

To evaluate the completeness of registration of infant and child deaths in Egypt, reinterviews were conducted with families who had reported a death of a child under age 5 in the five years before the survey for two national surveys recently conducted in Egypt: the United Nations PAPCHILD survey of1990-1991 and the Egyptian Demographic and Health Survey (EDHS) of 1992. The survey instrument included questions regarding notification of the death at the local health bureau. If the family said the death had been notified, separate employees searched the health bureau records for the registration. Overall 57% of infant deaths were reported as notified and 68% of those death reports were found; the corresponding figuresfor child deaths were 89% and 74%. Using the percentage reported as notified as an estimate for completeness of registration, we adjusted upward the national infant and child mortality rates from registration data, giving values of 73 per 1,000 for infant mortality and 99 for ₅q₀ for the period 1987-1990. These values are approximately 20% above the corresponding direct estimates from the PAPCHILD and EDHS surveys.     

Estimates of vital rates for the Canadian Indians, 1960–1970

The present paper is an attempt to evaluate the registered data on Canadian Indians collected by the Department of Indian Affairs and Northern Development and to prepare vital rates for 1960–1970 using the adjusted data. A cursory examination of registered data for the purpose of developing various demographic indices and for making future estimates of population indicates certain anomalies that call for a careful appraisal of the data. The main problem is the inconsistency in the reporting of births, due largely to the late registration of births. One plausible reason for late registration may be the increased outward movement of Indians from their reserves. Indirect methods are used to adjust the number of births and infant deaths reported annually since 1960. On the basis of the adjusted data, vital rates for the Canadian Indians are calculated for the period 1960–1970. The crude death rate decreased from 10.9 in 1960 to 7.5 in 1970. The infant mortality rate registered a drastic decline, from 81.5 deaths per 1,000 births in 1960 to 34.9 in 1970. During this same time period the birth rate also declined, from 46.5 to 37.2.     

Factors associated with child mortality in Pakistan and implications for the national health programs

"This study attempts to establish the levels of infant and child mortality in Pakistan using an indirect estimation technique to analyze data from the 1984-85 Pakistan Contraceptive Prevalence Survey....[Results indicate] that children's survival chances have hardly improved in recent years.... Suggestions are offered on ways to improve the effectiveness of rural health programs."     

Socioeconomic Inequalities in Infant Mortality in Egypt: Analyzing Trends Between 1995 and 2014

This paper analyses the trend of the socioeconomic inequalities in infant mortality rates in Egypt over the period 1995–2014, using repeated cross-sectional data from the National Demographic and Health Survey. A multivariate logistic regression and concentration indices are used to examine the demographic and socioeconomic correlates of infant mortality, and how the degree of socioeconomic disparities in child mortality rates has evolved over time. We find a significant drop in infant mortality rates from 63 deaths per 1000 live births in 1995 to 22 deaths per 1000 live births in 2014. However, analyzing trends over the study period reveals no corresponding progress in narrowing the socioeconomic disparities in childhood mortality. Infant mortality rates remain higher in rural areas and among low-income families than the national average. Results show an inverse association between infant mortality rates and living standard measures, with the poor bearing the largest burden of early child mortality. Though the estimated concentration indices show a decline in the degree of socioeconomic inequality in child mortality rates over time, infant mortality rate among the poor remains twice the rate of the richest wealth quintile. Nonetheless, this decline in the degree of socioeconomic inequality in child mortality is not supported by the results of the multivariate logistic regression model. Results of the logistic model show higher odds of infant mortality among rural households, children who are twins, households with risky birth intervals. We find no statistically significant association between infant mortality and child’s sex, access to safe water, mothers’ work, and mothers’ nutritional status. Infant mortality is negatively associated with household wealth and regular health care during pregnancy. Concerted effort and targeting intervention measures are still needed to reduce the degree of socioeconomic and regional inequalities in child health, including infant mortality, in Egypt.     

Demographic consequences of the 1984–1985 Ethiopian famine

This article analyzes demographic responses to the 1984-1985 Ethiopian famine and compares them with Bongaarts and Cain's (1982) hypothesized responses. After briefly describing the data collection, I estimate the age distribution and the age-specific mortality and fertility rates of Ethiopian famine victims in a resettlement area and compare these with mortality estimates for the 1972-1973 Bangladesh famine and with fertility estimates from the 1981 Ethiopian demographic survey. The results show that the mortality rate among Ethiopian famine victims was about seven times higher than the rate among the Bangladesh victims and that the Ethiopian famine-related mortality was general and not a function of household socioeconomic variables. The data also show a 26 percent lower total fertility rate among famine victims.     

Estimating the completeness of death registration

Summary Death registration statistics, even when incomplete, can provide valuable information about mortality. In particular, the age structure of deaths can be used to estimate the completeness of registration, provided that this completeness does not vary substantially with age. Two methods of estimating the completeness of death registration from the distribution of deaths by age are described. The first is derived from stable population theory and requires an estimate of the rate of natural increase of the population, as well as assuming stability. However, the technique can also be used to generate simultaneously estimates of the rate of natural increase and of death registration completeness. The second method which requires two census age distributions and intercensal deaths by age, estimates the relative enumeration completeness of the two censuses as well as the completeness of death registration and requires only that the population be closed. Results are sensitive to overstatement of age. The methods are illustrated by being applied to figures from Thailand for the period 1960-70 and are found to work satisfactorily.     

Revising Infant Mortality Rates for the Early Twentieth Century United States

Accurate vital statistics are required to understand the evolution of racial disparities in infant health and the causes of rapid secular decline in infant mortality during the early twentieth century. Unfortunately, U.S. infant mortality rates prior to 1950 suffer from an upward bias stemming from a severe underregistration of births. At one extreme, African American births in southern states went unregistered at the rate of 15 % to 25 %. In this study, we construct improved estimates of births and infant mortality in the United States for 1915–1940 using recently released complete count decennial census microdata combined with the counts of infant deaths from published sources. We check the veracity of our estimates with a major birth registration study completed in conjunction with the 1940 decennial census and find that the largest adjustments occur in states with less-complete birth registration systems. An additional advantage of our census-based estimation method is the extension backward of the birth and infant mortality series for years prior to published estimates of registered births, enabling previously impossible comparisons and estimations. Finally, we show that underregistration can bias effect estimates even in a panel setting with specifications that include location fixed effects and place-specific linear time trends.     

Estimation of vital rates by means of monte carlo simulation

Monte Carlo simulation has been used to estimate age-specific fertility and mortality rates for a small population,the French-derived isolate of Northside on St. Thomas, U. S. Virgin Islands. Estimates were based on data collected in a household census and genealogical survey and on birth, death, and marriage records for the years 1916to 1966. During this 50-year period (in which the population size increased from 202 to 657), the numbers of births and deaths were too, small to estimate age-specific rates directly, and in addition, death registration was incomplete. Mortality rates were estimated using a simulation program in which mortality was the only stochastic variable. A model mortality schedule was chosen which most accurately reproduced the growth pattern of the population over the 50-year period. To estimate fertility rates, a more complex simulation model was used in which fertility, nuptiality, and mortality were random variables with probability distributions. Preliminary estimates of fertility were made from the birth records and used as input to this simulation program. Birth probabilities were adjusted empirically from one set of simulation runs to the next, until population growth rates, as well as other demographic characteristics, were similar in the real and simulated populations. The birth rates which produced the best fit to the real population data were taken as the estimated age-specific fertility schedule. To reproduce the real population age structure more closely, secular changes in birth probabilities were applied.     

Effect of Conflict on Age at Marriage and Age at First Birth in Rwanda

Using Rwanda Demographic and Health Survey 2005 data, we estimate a Cox proportional hazard model to identify the determinants of age at marriage and age at first birth and whether these decisions were affected by conflict. We find that women living in clusters accounting for a larger proportion of sibling deaths in 1994, the year of the genocide, were more likely to marry later and have children later compared with those living in clusters accounting for a lower proportion of sibling deaths. Women living in regions with higher levels of under-five mortality were more likely to have their first child earlier compared with women living in regions with lower infant mortality. The age at marriage was probably affected by two reasons: the change in age structure and sex ratio of the population following the genocide, and the breakdown of kinship in the case of women who lost their siblings.     

Adult Mortality From Sibling Survival Data: A Reappraisal of Selection Biases

Because of incomplete registration of deaths in most countries in sub-Saharan Africa, data on the survival of close relatives constitute the cornerstone of estimates of adult mortality. Since 1990, sibling histories have been widely collected in Demographic and Health Surveys and are increasingly being relied upon to estimate both general and maternal mortality. Until recently, the use of sibling histories was thought to lead to underestimates of mortality, but a more optimistic view in the literature emerged with the development by Gakidou and King (Demography 43:569–585, 2006) of corrections for selection biases. Based on microsimulations, this article shows that Gakidou and King’s weighting scheme has been incorrectly applied to survey data, leading to overestimates of mortality, especially for males. The evidence for an association between mortality and sibship size in adulthood is reviewed. Female mortality appears to decline slightly with the number of surviving sisters, although this could be an artifact of severe recall errors in larger sibships or familial clustering of deaths. Under most circumstances, corrections for selection biases should have only a modest effect on sibling estimates.     

Estimation of vital rates for Ghana

Abstract A complete and efficient registration system, of the type which would provide good data on births and deaths, does not exist in Ghana. However, registration of vital events is supposed to be compulsory in 39 towns in the country but the data collected in these areas are too inadequate and defective to provide a sound basis for the analysis of the dynamics of population growth. The results of the censuses conducted by the colonial governments are so defective and unreliable that they do not allow scientific research in the field of population analysis. Before 1960, therefore, when the national census and the post-enumeration survey (based on a 5% sample of the population) were carried out, estimates of fertility and mortality levels were little more than guesses. In this study an attempt has been made to utilize the information on the age-sex composition provided by the 1960 census and post-enumeration survey data on births and deaths to determine, as far as possible, the levels of fertility and mortality and the rates of population growth in Ghana. The fertility estimates-i.e. a crude birth rate of 50, total fertility rate of 6.9 and a gross reproduction rate of 3.4-show that Ghana's fertility is one of the highest in the world. An expectation of life at birth of 40 years, an infant mortality of 160 and a crude death rate of 23 appear to be the most plausible estimates. These estimates yield a rate of natural increase of 2.7% and a growth rate of 3.0% per annum.     

Estimating infant mortality trends from child survivorship data

Summary Brass's procedure for estimating mortality from census or survey data on numbers of children born to women by age group and numbers of children surviving is generalized to allow the estimation of mortality trends. The new procedure is applied to data for Costa Rica and peninsular Malaysia. The resulting infant mortality rate estimates are compared with rates calculated from vital registration figures. The comparisons suggest, surprisingly, that the estimates derived from statistics for women aged 30-50 are not noticeably inferior to those derived from those for women aged 20-30. This suggests that the common practice of disregarding statistics for women aged over 30 or 35 years may be a mistake. Figures are presented which suggest that estimates based on women aged less than 20 are likely to be very seriously biased because of differential infant mortality by age of mother at birth.     

'Between one and three million': towards the demographic reconstruction of a decade of Cambodian history (1970-79)

Estimates of mortality in Camabodia during the Khmer Rouge regime (1975-79) range from 20,000 deaths according to former Khmer Rouge sources, to over three million victims according to Vietnamese government sources. This paper uses an unusual data source - the 1992 electoral lists registered by the United Nations - to estimate the population size after the Khmer Rouge regime and the extent of "excess" mortality in the 1970s. These data also provide the first breakdown of population by single year of age, which allows analysis of the age structure of "excess" mortality and inference of the relative importance of violence as a cause of death in that period. The estimates derived here are more comparable with the higher estimates made in the past. In addition, the analysis of likely causes of death that could have generated the age pattern of "excess" mortality clearly shows a larger contribution of direct or violent mortality than has been previously recognized.     

The completeness of enumeration in the 1973 census of the population of Colombia

The effort is made to determine the true size and distribution by age and sex of the population of the Republic of Colombia in October 1973. After initially arriving at estimates of the levels of fertility and mortality during the intercensal period and then correcting the 1964 census population for age misreporting and selective undernumeration of males, a hypothetical populaiton corresponding to October 1973 is constructed. Comparing the constructed population with the population observed in the census yelds an estimate of completeness of enumeration in 1973 that is relative to the enumeration of females in 1964. This estimate is obtained under the assumption that net international migration during the period was of negligible importance. As there is reason to believe that this is not a valid assumption and upon examining the limited amount of evidence available, speculaitons are made concerning the amount of net out-migration to have occurred during the 1964-1973 period and the size of the coresponding modificaiton in the estimate of completeness of enumeration. After adjusting for underenumeration of males in 1964 and neglecting the impact of international migration, a theoretical 1973 census population of 23,201,000 was estimated. Apart from the total number of people enumerated, the information that was analyzed from the advance sample appears to be of good quality, at least in relation to prior censuses. The estimates of fertility and mortality reveal an important decline in Colombian fertility. By coming up with separate estimates of infant and childhood and adult mortality, it has been possible to shed new light on the shape and the level of mortality in Colombia. The new Brass method for estimating adult mortality provides reliable results even when mortality has been declining, and there are recognizable distortions in the distribution of the population by age.     

Population research and education in Vietnam

Population research and education in Vietnam have expanded in their functions since the early 1980s. There are currently 5 departments conducting demographic studies: the National Committee for Population and Family Planning within the Ministry of Health, the Ministry of Education, and the Institute of Pedagogical Sciences, the Ministry of Labor Fore, the Vietnam Women's Union, and the Youth Union. An overview is provided of each department and its research and educational activities as well as the General Statistics Office (GSO) and the Institute of Sociology. GSO provides statistics on population annually from a variety of sources including the decennial census. The last census was conducted in 1989 and is useful for understanding general demographic trends. Vital rate data are considered too low. The Institute of Sociology uses the sample survey and focus groups to examine social and economic conditions and their effects on norms and values about reproduction. The Institute conducted a knowledge, attitudes, and prevalence (KAP) survey in 1984. Studies have focused on the commune level and the role of government in population regulation. Findings have supported a position that the goal of a 2-child family is not attainable without social and economic change as well as family planning. Migration studies have also been undertaken with the Ministry of Labor. The National Committee for Population and Family Planning is concerned with studies on the biotechnology of contraceptive methods and abortion. A study in 1987 examined health workers attitudes toward and knowledge of a variety of contraceptive methods. In 1988 the Demographic and Health Survey was conducted and data were comparable internationally. Studies have been helpful in designing training programs and in informing decision makers. Forecast data in 1990 were useful in setting targets for the coming decade. The Ministry of Education targets the general public and students. Materials aim to create positive attitudes to family planning and to inform about general population issues. Special groups such as the Women's Union have conducted KAP studies and the Center for Women's Studies has focused on the problems of women in development.     

The effect of compulsory schooling on health—evidence from biomarkers

Using data from the Health Survey for England and the English Longitudinal Study on Ageing, we estimate causal effects of schooling on health. Our study complements earlier studies exploiting two nationwide increases in British compulsory school leaving age in 1947 and 1973, respectively, by using biological stress markers as measures of health outcomes in addition to self-reported measures. We find a strong positive correlation between education and health, both self-rated and measured by blood fibrinogen and C-reactive protein levels. However, causal effects estimates based on compulsory schooling changes are ambiguous and remain statistically insignificant.     

Measures and effectiveness in controlling omission of reports on infant deaths in Shanghai metropolitan areas]

The infant mortality rate is a sensitive indicator of a country's or area's economic, cultural, and health care conditions, and in particular, it reflects the quality of health care for women and young children. Since liberation, great progress has been achieved in Shanghai's health and medical care in general as well as in health care for women and young children, and the infant mortality rate has dropped notably. However, the omission of reports on infant deaths is still a very serious problem. In order to control such omissions in reporting, the Shanghai municipal government and Department for Public Health have improved the methods of reporting deaths. Health care units are required to fill out a report on births and deaths, and census registers in the city government are responsible for registering all new births and deaths and preparing complete statistics on new births and deaths. At the end of each year, special investigators are sent to various hospitals to check on omissions of reports on infant deaths and they also help households to report infant deaths to census registers. The new measures have proved to be very effective. According to a new report released in 1980, the omission of reports on infant deaths has been reduced by 94.01% as compared with the 1972 statistics.     

The Philippines: country statement prepared for the International Conference on Population,Mexico City,August 1984

This statement, prepared for the 1984 International Conference on Population, summarizes the demographic situation in the Philippines, the Philippine position regarding implementation of the World Population Plan of Action, and current population policies. In 1980, the population of the Philippines stood at 48.1 million. The country's current population growth rate reflects the interplay between decreasing mortality and still high but declining fertility. The 1984-87 Philippine Development Plan aims to achieve sustainable economic growth, equitable distribution of the gains of development, and personal development. A net reproduction rate of unity by the year 2000 is sought, and preschool-age children, youth, premarriage-age groups, and married couples of reproductive age have been targeted for special outreach efforts. The national population program will concentrate on developing a network of public and private community-based organizations, strengthening the capacity of local government and community organizations to plan and manage the population program, developing community capacity to finance family planning services, upgrading the quality of natural family planning practice, continuing the promotion of effective contraceptive methods, developing a population data bank, and upgrading the technical and management capabilities of population program personnel. Increasing attention is being paid to regional development and spatial distribution. The average annual population growth rate is expected to decline from 2.8% in 1970-75 to 2.2% by 1987. The crude birth rate is expected to drop from 34/1000 in 1980 to 31/1000 in 1987. To help achieve this goal, the contraceptive prevalence rate should increase from 34% in 1983 to 41% in 1987 and 50% by 1993. In addition, attempts will be made to reduce the proportion of women marrying below the age of 20 years and to improve women's access to educational and employment opportunities.     

The impact of breast feeding patterns on the biometric analysis of infant mortality

A major assumption of the biometric analysis of infant mortality as developed by Bourgeois-Pichat is that the age structure of infant deaths after the first month of life is virtually constant across time and cultures. Reanalysis of results from studies which compare the mortality of infants according to the type of feeding indicated that the relationship between mortality and age within the first year of life followed different patterns for breast fed and artificially fed infants. Historical data for populations with different breast feeding customs reveal similar differences in the age pattern of infant mortality. In populations where breast feeding was uncommon or of very short duration, infant mortality rises particularly steeply during the early months of the first year of life. The age structure of infant mortality in less developed countries where breast feeding is decreasing rapidly may be similarly affected. When substantial deviations from the linear relationship are evident, particular caution is required in applying the biometric technique, since in such situations the estimated endogenous mortality is very much affected by the particular set of data points within the first year of life which are chosen for the basis of the estimates.     

Maternal mortality in South Africa: lessons from a case study in the use of deaths reported by households in censuses and surveys

South Africa is unique in being a developing country which has asked questions on pregnancy-related deaths in both its 2001 census and 2007 household survey, and monitors maternal and pregnancy-related mortality through vital registration and a confidential enquiry into maternal deaths. These sources of data provide a wide range of estimates of maternal mortality for the country. This paper examines these estimates to assess to what extent the differences between them are due to data deficiencies, methodological deficiencies or definitional differences. The results show that since maternal deaths are relatively rare it is fairly difficult to establish the maternal mortality rate with a great degree of accuracy in a setting where data are less than perfect. They also show that to some extent the differences are due to differences and errors in processing of data but that pregnancy-related mortality should not be treated as synonymous with maternal mortality. However, after adjustment, pregnancy-related mortality from vital registration was comparable with the level that may be expected using several alternative approaches, while the rate reported by households in census and surveys was about double that from vital registration. Nonetheless, all the data indicate an upward trend in maternal mortality that is in keeping with the impact of the HIV/AIDS epidemic, which is likely to have contributed to the discrepancies.