Neo-natal and post-neo-natal mortality in a rural area of Bangladesh

Abstract An analysis of neo-natal and post-neo-natal mortality in 132 villages (population of 117,000) of Matlab thana indicates the following: (i) Neo-natal deaths accounted for 60% of the infant mortality rate of 125. This proportion was unexpectedly high since previous research had maintained that in countries with infant mortality rates over 100, neo-natal deaths account for less than one-third of all infant deaths. Since the present findings on the proportions of neo-natal deaths correspond exactly with results from an earlier registration system in East Pakistan, it is suggested that the long-accepted proposition, 'less developed' areas are characterized by lower proportions of neo-natal deaths than 'more developed' areas, be re-examined. (2) The infant death rate accounts for 36% of all deaths in the population. If the infant death rate were reduced by half the result would be a decrease in the current crude death rate from 16 to 13. Although this reduction would appear to be small, in the context of a current high growth rate of 3% (from 1966-67 to 1968-69) it exerts a sizeable impact. For example, it would take a reduction of eight points in the crude birth rate of 46 just to achieve a growth rate 2·5% under these circumstances. Obviously, continued efforts in death control without an effective birth control programme will perpetuate high rates of growth. (3) Neo-natal and post-neo-natal mortality exhibited the -expected 'U' shaped pattern with parity, and generally varied as expected with age and family size, except in the oldest age group and largest family size where the risk was smaller than in the preceding groups. An explanation for these findings is presented, based on the effect that births to high-parity women with low child mortality have upon the total neo-natal and post-neo-natal mortality rates. It was found that these births exhibit a much lower mortality risk than births to women of comparable parities and higher child mortality, and that their numbers account for the lower risk to the births in the oldest age group and largest family size. It was concluded that women with a combination of high parity and low child mortality most probably represent a group with superior socio-economic and or health conditions which contribute to the lower risk of neo-natal and post-neo-natal death.     

Levels and patterns of infant and child mortality in ghana

This paper attempts to measure infant and child mortality levels and also to determine their structure by utilizing the results of the 1968–1969 National Demographic Sample Survey which was conducted under the directorship of the author. Among the major problems encountered in the exercise are the adjustment of the current raw mortality data and the estimation of infant and child mortality from independent source material. The estimated infant mortality rates range from 56 per 1,000 live births in the Accra Capital District to 192 in the Upper Region during the late 1960’s. The urban rate is lower than the rural rate, 98 as against 161 per 1,000 live births. A large proportion of the deaths among children aged 0–4 occur in the second year of life, and deaths in this age group account for the bulk of the deaths within the age group 1–4 years.     

A note on some vital statistics of a primitive peasant community in Sierra Leone

In the course of some work in which a community of 1400 primitive Sierra Leone peasants were being re-examined at two-monthly intervals over a period of a year opportunity was taken to record births, deaths and pregnancies. A birth-rate of 32·9 (P.E. ± 3·27), and a death-rate of 38·4 (P.E. ± 3·52) per thousand per annum were obtained. The infant mortality rate was found to be 417 (P.E. · 48) per thousand live births, and the ratio of miscarriages and stillbirths to live births to be 22·9: 100. Since the community was small the figures are subject to a high statistical error, but they are offered because the data are believed to be accurate, and accurate vital statistics of primitive West African communities are practically non-existent.

The most interesting features in regard to deaths were that deaths in children aged 3 years or under accounted for almost half the total deaths at all ages, and that of these deaths in young children 38·5 % were attributed to an acute febrile illness.     

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.     

Consistent correction of data for aboriginal populations

A consistent correction procedure is used to determine improved, consistent estimates by sex of census age distributions, intercensal births, intercensal deaths and net migration by age for the Aboriginal populations of the Northern Territory, South Australia and Western Australia during the period 1986–91. Undercount estimates and life tables show the Aboriginal populations to have lower coverage in statistical collections and much higher death risks than the total Australian population. Inter-regional net migration estimates show that component of change can no longer be ignored.     

Sample registration in India

Abstract The Sample Registration Project in India is designed to obtain current estimates of birth and death rates for the whole country. It is being implemented quite rapidly. Rural and urban areas in all states and Union Territories in India will be covered before the close of 1969. Bigger states have 150 sample units in rural areas and 60 to 100 units in urban areas. Essential elements of the project for each unit are: (1) continuous enumeration of births and deaths in respect of usual resident population by a paid part-time local enumerator; (2) a six-month household survey to detect births and deaths which occurred to the usual resident population during the previous six months; and (3) manual matching of all event from enumeration and surveys and field re-check of unmatched events to obtain the 'best' count of real number of events. The results of a full-scale sample in four states and pilot sample in ten states indicate that the crude birth and death rates are around 40 and 18 per 1,000, respectively, for India's rural population. Most of the problems of implementation are operational or administrative rather than statistical. The main problem in the whole project is to maintain control of field operations well enough at each stage to ensure that prescribed instructions and methodology are being followed; particularly in the six-month survey. Experience in India indicates that sample registration techniques are capable of providing reliable birth and death rates in similar conditions in developing countries. However, there are still a number of methodological problems which must be tested as the sample registration evolves.     

High foetal mortality and birth intervals

Abstract Studies of birth intervals have generally separated the process into: (1) the period of infertility following a pregnancy termination; (2) the length ofthe interval from the end of the infertile period to the next conception (which reflects the probability of conception), and (3) the average duration of pregnancy for both live births and foetal deaths.(1) Empirically derived intervals between successive live births average from 19 to 30 lunar months(2) (Table 1), depending upon the population studied and the birth order.(3) Estimates of conception rates using birth intervals data require some estimate of the extent to which foetal wastage increases the birth interval.     

Reply to Wachter

Although twins constitute only about 2.4 per cent of total births in less developed countries, they account for about 12 per cent of neonatal deaths and about nine per cent of infant deaths. Twin mortality in less developed countries has almost never been analysed systematically. We examine survival among twins as contrasted with that among singleton births by using 2692 twin observations pooled from 26 standardized Demographic and Health Surveys. Weakened by gestational and other biological complications, twins seem to be more vulnerable to detrimental demographic and household socio-economic influences than singletons. Twinning tends to amplify, or at least retain, whatever group differences exist among singleton births.     

Coverage of the population in Census 2000: Results from Demographic Analysis

Since the 1960 Census, Demographic Analysis (DA) has been used by the Census Bureau to evaluate the coverage of the population. Administrative statistics on births, deaths, immigration and Medicare enrollments as well as estimates of legal emigration and net undocumented immigration are used to produce demographic analysis estimates of the population for the census date. These estimates are compared to the Census 2000 data to evaluate coverage in the census. The results are also compared to measures of undercount obtained from dual system estimation. The DA measures substantial reduction in net undercount in Census 2000 compared to 1990. The reductions occur among all demographic categories: all broad age groups, males and females, Blacks and Non-Blacks.     

Estimating census and death registration completeness

This article presents a new method for estimating the relative completeness of 2 census enumerations and of intercensal registered deaths. The Growth Balance Equation was developed by Brass (1975) to estimate the completeness of death registration relative to the completeness of census enumeration. The method presented here can be seen either as an extension of Martin's formulation to allow explicitly for changes in census coverage or as a modification of Brass's method to use deaths by age group rather than deaths by cohort, preferable on the grounds that age group comparisons will be less distorted by age misreporting than cohort comparisons if the patterns of age misreporting are similar for 2 successive censuses. This simple method estimates simultaneously the relative coverage of the 2 censuses and the completeness of registration of intercensal deaths. The key assumptions of the method are that the population is closed to migration and that all the coverage factors involved are invariant with age, at least for the age range studied. Analysis of the sensitivity of the estimates to the assumptions and further work on extending the method to open populations would be useful.     

Review of educational interventions to increase traditional birth attendants’ neonatal resuscitation self-efficacy

Background

Annually, up to 2.7 million neonatal deaths occur worldwide, and 25% of these deaths are caused by birth asphyxia. Infants born in rural areas of low-and-middle-income countries are often delivered by traditional birth attendants and have a greater risk of birth asphyxia-related mortality.

Annual mortality rates and excess deaths of children under five in Iraq, 1991-98

Data from two parallel household surveys conducted in Iraq by UNICEF in 1999 show that under-5 mortality declined steadily from 1974 to 1990, reaching about 63 per 1,000 live births in the period 1986-90. It then rose dramatically to 118 per 1,000 in 1991, the year of the Gulf War. The number of 'excess' under-5 deaths (i.e., the number in excess of the number predicted from past trends) in Iraq between 1991 and 1998 was calculated assuming that, instead of the rates measured by the 1999 survey for this period, either (a) average mortality rates for the period 1986-90 had been maintained, or (b) mortality had continued to decline at the rate observed between 1974 and 1990. According to these calculations, the estimated number of excess deaths resulting from the Gulf War and its aftermath up to 1998 was between 400,000 (assumption a) and 500,000 (assumption b).     

A comparison of different survey techniques for obtaining vital data in A developing country

This article presents estimates of the sources and the extent of observation errors in different questionnaires and methods used to collect birth and death data in the 1961-63 multi-purpose sample survey of Morocco.The questionnaires used in the analysis of the three survey rounds were a list of household members (Rounds1 and 2) and a roll-call (Round3); retrospective death (Rounds1, 2, and 3) and birth (Round 3) queries; a date-of-birth tabulation (Round 2); and a household check-sheet to explain differences between Rounds 1 and 2. All available questionnaires for a given household were brought together and collated to provide several sources of information on births and deaths and a basis for assessing errors.From this analysis, the survey attempted to define the nature and to estimate the frequency of the errors which would have occurred if more restricted types of survey design had been used. Results, based on the period between Rounds 1 and 2, led to three major conclusions.First, if vital data had been collected with a single-round retrospective procedure, gross error (over enumeration plus underenumeration) would have been 17 percent for births and 36 percent for deaths. There is a net error of overenumeration of 3 percent for births (1.4 per1,000population) and 9 percent for deaths (2.3 per1,000population).Second, if two rounds were available to permit a combination of household composition follow-up and a retrospective mortality questionnaire, overenumeration would be almost entirely eliminated and underenumeration would be noticeably reduced. Third, most of the remaining errors of underestimation may be attributed to (1) an estimated number of infants born and deceased between two rounds and missed by all questionnaires, (2) matching failures caused by the absence of adults at Round 1, and (3) matching errors.     

Aggregate population and economic growth correlations: The role of the components of demographic change

The results of recent correlations showing a negative impact of population growth on economic development in cross-country data for the 1980s, versus “nonsignificant” correlations widely found for the 1960s and 1970s, are examined with contemporaneous and lagged components of demographic change, convergence-type economic modeling, and several statistical frameworks. The separate impacts of births and deaths are found to be notable but offsetting in the earlier periods. In contrast, the short-run costs (benefits) of births (mortality reduction) increase (decrease) significantly in the 1980s, and the favorable labor-force impacts of past births are not fully offsetting.     

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.     

Natural population decrease in Iowa counties

As a follow-up on the studies by Dorn and Beale, this paper examines differences between Iowa counties with natural decrease and those with natural increase and analyzes the part that migration and fertility played in bringing about an excess of deaths over births in Iowa counties. The county groups are distinctly different in demographic and socioeconomic characteristics. Out-migration as a mode of response adopted by the rural population in Iowa is by far the most dominant factor leading to natural decrease. Sustained net out-migration is more likely to touch off natural decrease in counties of comparatively low fertility than in those with higher fertility. Low fertility is, therefore, a contributing factor to the imbalance between births and deaths, but the amount of influence of fertility adjustment over the fertility differentials among county groups cannot be ascertained in this study because of the correlation between fertility and Catholic Church membership in counties. The data of this study were obtained from the population censuses and vital statistics.     

How many children? – Fixing total annual births as a population control policy

Traditional family planning's emphasis on manipulating the total fertility rate often results in erratic number of births which disrupts school enrollment and labor supply. Fixing total annual births to a permanently lower level will avoid such repeated disruptions and can eventually lead to a lower stationary population with annual deaths equal to the fixed annual births. If allocation of the fixed birth quotas is conditional upon deaths, each death can be converted to a variable number of inheritable and tradable birth quotas. Tradable birth coupons allow families to have the number of children they want and can afford within the overall fixed birth quotas. Inheritable birth quotas provide incentive for higher old-age mortality and consequently less aging in a declining population.     

The forecast accuracy of Australian Bureau of Statistics national population projections

This paper examines the forecast accuracy of Australian Bureau of Statistics national population projections produced from the 1960s to the early 2000s. As well as total populations, the accuracy of the following is assessed: age-sex-specific populations, the Total Fertility Rate, life expectancy at birth and net international migration. It is shown that forecasts of the 1960s and 70s were the most inaccurate; forecasts of the 1980s and later proved to be much more reliable. The paper goes on to take an alternative perspective on population forecast error through the use of an adapted percentage error measure which accounts for offsetting errors in births, deaths, net migration and the jump-off population. This measure also permits an assessment of the relative contributions of the components of demographic change to overall inaccuracy. It is shown that errors in forecasting net international migration have generally contributed most to inaccuracy followed by births and then deaths and jump-off error. ABS projections of total population are also compared to those produced using a simple naïve model. The paper concludes by arguing that the new error measure could prove valuable in other studies of population forecast accuracy.     

The cocos-keeling islands: A demographic laboratory

The Cocos Islands, which are situated in the Indian Ocean approximately halfway between Colombo and Fremantle, were first peopled early in the nineteenth century and were gradually developed as a very isolated coconut plantation with a labour force consisting partly of persons of Malay stock descended from the original group of settlers and partly of Bantamese contract labourers from Java. As the Cocos-born population increased in size, the dependence on contract labour decreased and, before the end of the century, all immigration ceased. The 1947 Malay population of the islands was about 1,800.

The islands are fascinating from a demographer's point of view because there was a virtually complete registration of live births, deaths and marriages and a partial registration of stillbirths. With these registration records it was possible to construct the life history of every individual from birth, through infancy and childhood to marriage, and thence through fatherhood or motherhood to death.

The picture revealed by an analysis of these records is that of a population with very high fertility and with mortality at a high level before the first World war and at a medium level after that war. Crude birth rates varied between 50 and 60 per thousand population during the period 1888 to 1947. Crude death rates were between 30 and 40 per thousand population until 1912 but under 2.0 per thousand population after 1918.

Most Cocos girls married before reaching the age of 20 and there were an average of between eight and nine live births per woman living through the childbearing period. There was a steady decline in the average number of live births with advancing age at marriage from age 16 onwards. A significantly high proportion of those dying in the middle of the childbearing period had never married, but the fertility of those marrying at an early age (14, 15 and 16) and dying before reaching the age of 36 was slightly higher than that of those who married at a similar age and survived. Women who survived to the age of 55 were of higher fertility than those who died between the ages of 40 and 55. An analysis of birth intervals revealed significant differences (a) between birth intervals after a stillbirth or after a live birth in which the child died in early infancy, and birth intervals after a live birth in which the offspring survived for longer than 0.4 years, and (b) between the interval from first to second birth and the subsequent birth intervals. There was a difference of almost exactly a year between the average birth interval after a stillbirth or live birth ending in a neo-natal death and the average birth interval after the birth of a child surviving to age 2; there was a similar difference of a year between corresponding median birth intervals.

From 1888 to 1912 infant mortality was well above 300 per thousand. After 1918 infant mortality averaged rather under 100 infant deaths per 1,000 live births. The reduction in infant mortality rates was accompanied by an increase in the mortality of children aged 1 to 4, and the heavy incidence of mortality at these ages after 1918 is the most striking feature of the analysis of mortality by age. Whilst mortality in infancy fell much more heavily on males than on females, early childhood mortality was much higher in Cocos for girls than for boys. The life table computed for the period 1918 to 1947 indicated a life expectancy of about 50 years for males and 47 years for females.