[Data, methods, and indirect techniques of estimating mortality].
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This paper is a critical assessment of techniques used for the estimation of cause of death structure in Africa in the light of contemporary theories of mortality. The technique mostly used for the indirect estimation of cause of death structure is based on the mortality experience in Western countries. With the marked differences in the epidemiologic transition experienced in Western countries and those being experienced in African countries, it is not very likely that an estimation of cause of death structure based on data from the former can accurately estimate cause of death structure in the latter. This argument is supported in the paper through a comparison of observed estimates of cause of death structure for some African populations with indirect estimates. It is proposed that a better approach is to use a residual method whereby one proceeds from nearly true estimates of cause of death rates to obtain estimates for unknown causes via the known general mortality.
"This paper provides some estimates of fertility level for different periods from 1974 and 1981 census data [for Bangladesh]. The fertility levels were estimated using some indirect methods of estimation. The birth rate during the 70's decade was observed to fall in the range of 45-48 per thousand.... During the last intercensal period no significant change was observed between the measures of fertility."
"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."
"This study attempts to estimate by indirect estimation technique the levels of infant and child mortality in Bangladesh using the 1989 Bangladesh Fertility Survey (BFS). The levels of infant and child mortality obtained from the 1989 BFS indicate substantial improvements in child survival, although the fall in infant mortality has been faster than the fall in child mortality."
"This paper describes a new general formula developed for the time location of mortality levels when the original indirect method is used, in the relation to the childhood survivorship data. The result of application of the method to data from two countries yielded plausible estimates and close agreement with variant methods. The childhood mortality estimates can be translated to their [equivalent] infant mortality rates...from which infant mortality trends can be estimated." The geographical focus is on developing countries. (SUMMARY IN FRE AND ITA)
"Data from various censuses and surveys covering the last two decades for six Arab countries (Bahrain, Egypt, Jordan, Kuwait, the Syrian Arab Republic, and the United Arab Emirates) are analysed using the Brass-Trussell methodology and the Coale-Demeny West model life tables. Overlapping levels and trends with respect to various infant and childhood mortality measurements since the mid-1950s are determined. The measurements show that these countries are not homogeneous with respect to mortality, as they reflect disparities in both health programmes, standards of living and quality of life."
Demographic estimation techniques suggest that worldwide about 50 million deaths occur each year, of which about 39 million are in the developing countries. In countries with adequate registration of vital statistics, the age at death and the cause can be reliably determined. Only about 30-35% of all deaths are captured by vital registration (excluding sample registration schemes); for the remainder, cause-of-death estimation procedures are required. Indirect methods which model the cause-of-death structure as a function of the level of mortality can provide reasonable estimates for broad cause-of-death groups. Such methods are generally unreliable for more specific causes. In this case, estimates can be constructed from community-level mortality surveillance systems or from epidemiological evidence on specific diseases. Some check on the plausibility of the estimates is possible in view of the hierarchical structure of cause-of-death lists and the well-known age-specific patterns of diseases and injuries. The results of applying these methods to estimate the cause of death for over 120 diseases or injuries, by age, sex and region, are described. The estimates have been derived in order to calculate the years of life lost due to premature death, one of the two components of overall disability-adjusted life years (DALYs) calculated for the 1993 World development report. Previous attempts at cause-of-death estimation have been limited to a few diseases only, with little age-specific detail. The estimates reported in detail here should serve as a useful reference for further public health research to support the determination of health sector priorities.
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"In the developing world, measures of child mortality are needed for a variety of purposes, and estimates of child mortality can be obtained by a variety of approaches. In this paper, the author reviews the characteristics that child mortality measures should have for particular purposes, and then examines the available measurement approaches to determine the extent to which they provide accurate measures with the required characteristics. Particular emphasis is put on the comparative performance of different approaches in different settings to produce estimates of recent levels and trends in child mortality. He concludes that no single approach can satisfy all measurement purposes and that all approaches are sensitive to the quality of data collection, but that many needs can be met by relatively inexpensive data collection and analysis methods."
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