Using survey data to assess neonatal tetanus mortality levels and trends in developing countries

Demographic and health surveys are a useful source of information on the levels and trends of neonatal mortality in developing countries. Such surveys provide data on mortality occurring at 4–14 days of life, which is a sensitive indicator of neonatal tetanus mortality. We analyze birth history data from 37 national surveys in developing countries to assess the quality of neonatal mortality data and to estimate levels and trends in mortality occurring at 4–14 days. It is shown that mortality at 4-14 days has declined considerably during the last decade in most developing countries, concomitant with development and expansion of programs to reduce neonatal tetanus. These declines show that reductions in neonatal tetanus mortality probably have been an important contributor to the decline of neonatal and infant mortality during the 1980s.     

Using remote sensing and census tract data to improve representation of population spatial distribution: case studies in the Brazilian Amazon

This work proposes a methodological approach to redistribute population data obtained from polygonal census tracts into population density surfaces (grids) based on a cell space database. The methodology was first developed for the municipality of Marabá, Pará state, in the Brazilian Amazon. We used a dasymetric method to eliminate areas of environmental restriction to human presence; then integrated environmental data indicative of human presence to generate a potential surface of population occurrence; and finally, census population count data were redistributed into cells. The methodology was subsequently adapted for 13 municipalities of the Sustainable Forests District (SFD) of BR-163, generating population distribution surfaces for 2000 and 2007. The evolution of the resident population over the SFD-BR163 showed spatial patterns compatible with the occupation process described in the literature and verified by fieldwork. To be applied over other areas, the proposed methodology must be adapted with local parameters but in this way, population density surfaces can be useful as an additional data source to study population and environment relationships.     

Human mobility and environmental change: a survey of perceptions and policy direction

Population and Environment - Research concerning human mobility in the context of environmental change is primarily focused on analyses of the nexus itself. We have taken a less-travelled route,...     

Improving response to an establishment survey through the use of web-push data collection methods

ABSTRACT

The web-push method has been shown to increase web response rates in general public surveys. Response rates from two waves of the Emergency Medical Services for Children Program’s Performance Measures Survey, a state-administered establishment survey, were compared to determine if the second wave's revised, centralized implementation strategy improved response rates and consistency across states. The centralized strategy included the web-push design; a carefully timed contacts; and a three-month timeline. The results of the centralized web-push method included a higher overall response rate for a three-month period (81.0% compared to 56.6%) as well as greater consistency in results across states.     

Family planning's benefits include improved child health and nutrition: new data from Bangladesh

2 recent studies from the Matlab in Bangladesh confirm that family planning promotes child survival. The 1st study is a longitudinal analysis of 3370 births in 1985 to women living in 70 villages who were served by the International Centre for Diarrhoeal Disease Research, Bangladesh's Matlab Family Planning and Health Services Project. The 2nd is a study of 12-26 month old children and 24-36 month old children, all of whom were born in the same 70 villages between July 1985 and June 1986. The 1st study demonstrates that family planning improves child survival by lengthening the birth interval. In fact, if women delay a subsequent birth by about 2 years, child survival improves at all ages up to 5 years. Longer birth intervals result in a reduction of very high order births. The same study also reveals that family planning improves child survival indirectly by granting mothers access to integrated maternal and child health services. The 2nd study indicates that a child is 3 times more likely to suffer malnutrition, even at age 3, than a child whose mother gives birth again at an interval greater than 24 months. Specifically, the mother removes the index child from the breast prematurely, thereby adversely affecting the index child's nutrition. The birth interval prior to the index child does not adversely affect the index child's nutritional status, however. The 2nd study's result suggest that birth spacing, as promoted by family planning programs, improves child health and nutrition. The findings from these studies show the importance of continued investments in family planning programs in developing countries.     

Combining registration-system and survey data to estimate birth probabilities

With the widespread availability of event-history data, demographers have increasingly eschewed registration-system data in favor of survey data. We propose instead using survey and registration-system data in combination, via a constrained maximum-likelihood framework for demographic hazard modeling. As an application, we combine panel survey data and birth registration data to estimate annual birth probabilities by parity. The general fertility rate obtained from registration-system data constrains the weighted sum of parity-specific birth probabilities. The variances about the parity-specific birth probabilities are halved when registration-system data are used to constrain the estimates. Other demographic applications are discussed.     

Family planning and reproductive health: the link to environmental preservation

This paper seeks to refocus the attention of environmentalists on the importance of population trends to environmental sustainability and identifies prevention of unintended pregnancy as potential common ground for environmentalists and family planning advocates. The health and other welfare benefits of preventing unintended pregnancy are felt most keenly by individual women, men, and their families. At the same time, however, preventing unwanted pregnancies usually results in smaller family size, an important factor in slowing population growth and, as a result, a source of broader benefits—including environmental benefits—to society.     

Using satellite imagery to measure the relationship between air quality and infant mortality: an empirical study for Mexico

This research uses a unique dataset that provides relatively inexpensive measures of air quality at detailed geography. The analytical focus is the relationship, in Mexico, between Aerosol Optical Depth (AOD, a measure of air quality obtained from satellite imagery) and infant mortality due to respiratory diseases from January, 2001 through December, 2006. The results contribute to existing literature on the relationship between air pollution and health outcomes by examining, for the first time, the relationship between these variables for the entire land area of Mexico, for most of which no ground measures of pollution concentrations exist. Substantive results suggest that changes in AOD have a significant impact on infant mortality due to respiratory diseases in municipalities in the three highest AOD quartiles in the country, providing evidence that air pollution’s adverse effects, although nonlinear, are not only present in large cities, but also in lower pollution settings which lack ground measures of pollution. Methodologically, it is argued that satellite-based imagery can be a valuable source of information for both researchers and policy makers when examining the consequences of pollution and/or the effectiveness of pollution-control mechanisms.     

A method for combining sample survey data and symptomatic indicators to obtain population estimates for local areas

Past efforts of statistical demographers to compute postcensal population estimates for local units have been hampered by the fact that they have had to rely completely on symptomatic information. In this paper, a new method of postcensal estimation is presented in which the symptomatic information is combined with sample data by means of a regression format. Combining symptomatic information on births, deaths, and school enrollment with sample data from the Current Population Survey, county estimates of population growth were computed by means of the new method for the postcensal period after 1960. These estimates were tested for accuracy by comparison with a set of special censuses which were conducted between 1964 and 1967 in 75 counties. The results of this test are promising, but not conclusive. A more conclusive test is currently underway using 1970 data. While the method has been tested as a means for estimating population growth, it is to be emphasized that it can be used to compute postcensal estimates for any variable for which the necessary symptomatic information and sample data are available.     

Using epidemiological and health economic measures to inform maternity staffing decisions: A guide

BackgroundThere is growing concern around unnecessary intervention (particularly caesarean section) at birth in high-income countries. Caseload midwifery care aims to offset this, but is perceived to be costly to health services.AimTo use epidemiological and health economic techniques to estimate health outcomes and cost-savings of different levels of equivalent full time (EFT) midwives working in caseload midwifery care.MethodsTwo simulations were conducted — one assuming 10 EFT midwives working in a caseload model, with 35 women per caseload, and one assuming 50 EFT midwives working in a caseload model, with 45 women per caseload. Both were based on a sample of 5000 women. The main model inputs included rates of health outcomes for women (caesarean section, epidural anaesthesia, and episiotomy) and infants (low birthweight and admissions to special care nursery (SCN) or neonatal intensive care unit (NICU)), and the cost savings associated with health outcome avoidance.FindingsThe first simulation estimated 27 fewer caesarean sections, 12 fewer epidurals, 12 fewer episiotomies, 10 fewer low birthweight births, and 23 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$1,874,715. The second simulation estimated 173 fewer caesarean sections, 76 fewer epidurals, 76 fewer episiotomies, 65 fewer low birthweight births, and 150 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$12,051,741.ConclusionThis study provides local-level decision-makers with a decision-tool to calculate the potentially avoidable health outcomes and cost savings associated with implementing caseload midwifery care in their own service.     

Understanding staff views and experiences of a clinical practice change to reduce stillbirth in South Asian women: A cross-sectional survey

BackgroundIn July 2017, Victoria’s largest maternity service implemented a new clinical practice guideline to reduce the rates of term stillbirth in women of South Asian background.AimTo capture the views and experiences of clinical staff following the implementation of the new clinical guideline.MethodsCross sectional survey of clinical staff providing maternity care in August 2018, 12 months post implementation. Staff were asked to provide their agreement with ten statements assessing: perceived need for the guideline, implementation processes, guideline clarity, and clinical application. Open-ended questions provided opportunities to express concerns and offer suggestions for improvement. The frequency of responses to each question were tabulated. Open ended responses were grouped together to identify themes.FindingsA total of 120 staff completed the survey, most (n = 89, 74%) of whom were midwives. Most staff thought the rationale (n = 95, 79%), the criteria for whom they applied (83%, n = 99), and the procedures and instructions within the guideline were clear (74%, n = 89). Staff reported an increase in workload (72%, n = 86) and expressed concerns related to rationale and evaluation of the guidelines, lack of education for both staff and pregnant South Asian women, increased workload and insufficient resources, patient safety and access to care. Challenges relating to shared decision making and communicating with women whose first language is not English were also identified.DiscussionThis study has identified key barriers to and opportunities for improving implementation and highlighted additional challenges relating to new clinical guidelines which focus on culturally and linguistically diverse women.     

Using administrative data to estimate population displacement and resettlement following a catastrophic U.S. disaster

After a large scale evacuation, authorities need to know the new and frequently changing population distributions in order to meet needs for housing, schools, health care, and other services. This paper reviews literature from the fields of demography and other disciplines to identify available administrative data sets that can form the basis of sound, relevant, and timely county-level population estimates following a catastrophic U.S. event. The most appropriate data to estimate population in damaged counties will be disaster-specific data such as housing damage estimates and FEMA applicant counts initially, and later electric accounts and USPS active residences. In heavily damaged counties, data on electric accounts and USPS active residences may not be consistently collected for many months, during which time sample surveys may be needed. For counties that receive an influx of population, school enrollment data provide the most appropriate basis for population estimates. Population estimates for large, heavily damaged counties are highly uncertain. Sensitivity analysis when using estimates for planning in these areas is recommended. The Census Bureau can build on this research by codifying recommendations to local authorities for developing frequent post-disaster population estimates.     

Estimating the emigration rates of legal immigrants using administrative and survey data: The 1971 cohort of immigrants to the United States

Based on administrative and survey data as well as data-based assumptions about the bounds on alien address reporting, this study provides estimates of the lower and upper bounds for the cumulative net emigration rates, by country and area of origin, of the FY1971 cohort of legal immigrants to the United States as of January 1979. The merged data indicate that the cumulative net emigration rate for the entire cohort could have been as high as 50 percent. Canadian emigration was probably between 51 and 55 percent. Emigration rates for legal immigrants from Central America, the Caribbean (excluding Cuba), and South America were at least as high as 50 percent, and could have been as high as 70 percent. Emigration rates for Koreans and Chinese could not have exceeded 22 percent over the same period.