scholarly journals Estimating the infant mortality rate from DHS birth histories in the presence of age heaping

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259304
Author(s):  
Julio Romero Prieto ◽  
Andrea Verhulst ◽  
Michel Guillot
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Life Table ◽  
Life Tables ◽  
Model Life Table ◽  
Infant Mortality Rate ◽  
Quadratic Model ◽  
Vital Registration ◽  
Age Patterns ◽  
Sub Saharan

Background The infant mortality rate (IMR) is a critical indicator of population health, but its measurement is subject to response bias in countries without complete vital registration systems who rely instead on birth histories collected via sample surveys. One of the most salient bias is the fact that child deaths in these birth histories tend to be reported with a large amount of heaping at age 12 months. Because of this issue, analysts and international agencies do not directly use IMR estimates based on surveys such as Demographic and Health Surveys (DHS); they rely instead on mortality models such as model life tables. The use of model life tables in this context, however, is arbitrary, and the extent to which this approach appropriately addresses bias in DHS-based IMR estimates remains unclear. This hinders our ability to monitor IMR levels and trends in low-and middle-income countries. The objective of this study is to evaluate age heaping bias in DHS-based IMR estimates and propose an improved method for adjusting this bias. Methods and findings Our method relies on a recently-developed log-quadratic model that can predict age-specific mortality by detailed age between 0 and 5. The model’s coefficients were derived from a newly constituted database, the Under-5 Mortality Database (U5MD), that represents the mortality experience of countries with high-quality vital registration data. We applied this model to 204 DHS surveys, and compared unadjusted IMR values to IMR values adjusted with the log-quadratic model as well as with the classic model life table approach. Results show that contrary to existing knowledge, age heaping at age 12 months rarely generates a large amount of bias in IMR estimates. In most cases, the unadjusted IMR values were not deviating by more than +/- 5% from the adjusted values. The model life table approach, by contrast, introduced an unwarranted, downward bias in adjusted IMR values. We also found that two regions, Sub-Saharan Africa and South Asia, present age patterns of under-5 mortality that strongly depart from the experience represented in the U5MD. For these countries, neither the existing model life tables nor the log-quadratic model can produce empirically-supported IMR adjustments. Conclusions Age heaping at age 12 months produces a smaller amount of bias in DHS-based IMR estimates than previously thought. If a large amount of age heaping is present in a survey, the log-quadratic model allows users to evaluate, and whenever necessary, adjust IMR estimates in a way that is more informed by the local mortality pattern than existing approaches. Future research should be devoted to understanding why Sub-Saharan African and South Asian countries have such distinct age patterns of under-five mortality.

scholarly journals The effect of the quality of institutions on the relationship between public health expenditure and the infant mortality rate: evidence from the PVAR (X) and PSTR approaches

2021 ◽  
Vol 1 (1) ◽  
pp. 16-35
Author(s):  
Arthur Evariste KOUASSI ◽  
Ya Assanhoun Guillaume KOUASSI ◽  
Nogbou Andetchi Aubin AMANZOU
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Important Indicator ◽  
Institutional Variables ◽  
Public Health Expenditure ◽  
Sub Saharan

Infant mortality is a major health problem in developing countries. It is an important indicator of a country's public health as it goes hand in hand with socio-economic conditions and many others. Public health spending has been committed to reducing this scourge. This has led to the completion of numerous studies which have yielded mixed results. The main objective of this study is to test the effect of public health expenditure (% GDP) on the infant mortality rate, taking into account the role that institutional quality can play. To achieve this, we use two approaches which are the autoregressive vector panel model with exogenous variables (PVAR (X)) and the smooth threshold regression model (PSTR) on annual data covering the period 2002-2016 and covering 37 African countries. Sub-Saharan. Our main results through the PVAR (X) reveal that in the absence of institutional variables, public health expenditure has a negative and significant effect on the infant mortality rate, whereas, in the presence of the various institutional variables, this effect is still negative but is no longer significant. Our results show that the presence of institutions halves the weight of public health expenditure in explaining the infant mortality rate. In addition, our results show through the PSTR that there is a certain level of institutional qualities that these countries must achieve for public health expenditure to positively affect infant mortality rates. These thresholds oscillate for all the institutional variables around 7%. Taking institutional variables into account will help reduce infant mortality in Sub-Saharan African countries.

scholarly journals Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa

2020 ◽  
Vol 117 (8) ◽  
pp. 4027-4033 ◽  
Author(s):  
Emily Smith-Greenaway ◽  
Jenny Trinitapoli
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Age Groups ◽  
Infant Mortality Rate ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Sub Saharan ◽  
Offspring Mortality ◽  
Cumulative Prevalence

We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics.

scholarly journals Transportation: Barrier to Maternal and Child Healthcare Service in Rural sub-Saharan Africa

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Aaron Kwasi Nartey
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Health Facility ◽  
Primary Healthcare ◽  
Health Planning ◽  
Maternal Mortality Ratio ◽  
Infant Mortality Rate ◽  
Sub Saharan Africa ◽  
Compound System ◽  
Sub Saharan

Maternal and infant mortality has reduced over the years in sub-Saharan African but it is still the highest globally. Maternal Mortality Ratio in this region was approximately 66% (201,000) with 45% decrease in Infant Mortality rate between the periods of 1990 and 2015. Women on this part of the world face 15 times the dangers of childbirth and pregnancy situations as compared to those in the developed countries, children on the other hand are more than 14 times more likely to die before attaining age 5 than children in the developed world. This is partly because of challenges of patient referral. Referral is when a health professional at a lower health facility requests that a patient should seek for healthcare services at a higher health facility. The key among other challenges in referring a patient to a higher health facility from rural communities in sub-Saharan is the means of transport. This significantly and negatively affected the achievement of Maternal and Child health outcome in spite of the good works ongoing in sub-Saharan Africa. Therefore, for countries in sub-Saharan Africa to achieve the targets of the goal 3 of the Sustainable Development Goal (SDG) which is to Ensure Healthy Lives and Wellbeing for all at all ages, the issue of geographic and physical barriers to healthcare facilities should be well looked into. Government and non-governmental organizations should help in the building of health facilities in rural and deprived communities, provide ambulance services, provide adequate health officers and drugs. All these coupled with good road network would help people in these communities. Also, primary healthcare should be placed within the cultural settings of these people, so that they can embrace and easily access it to save mothers and children from preventable deaths. Finally, other sub-Saharan African countries should adopt the Community-based Health Planning and Services (CHPS) compound system of primary healthcare provision introduced in Ghana to help reduce the maternal and infant mortality rate drastically by 2030.

scholarly journals Socioeconomic Performance in Sub-Saharan Africa with Reference to Southeast Asia: Natural Resources or Institutions?

2017 ◽  
Vol 32 (3) ◽  
pp. 1-28
Author(s):  
Katoka Ben ◽  
Kwon Huck-ju
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Natural Resources ◽  
Institutional Quality ◽  
Infant Mortality Rate ◽  
Sub Saharan Africa ◽  
Gdp Growth ◽  
Per Capita Gdp ◽  
Per Capita ◽  
Sub Saharan

This paper explores the relationship between institutional quality, dependence on natural resources, and socioeconomic performance in Sub-Saharan Africa (SSA) and Southeast Asia (SEA) in the period from 1995 to 2015. It uses three measures―per capita GDP growth; foreign direct investment inflows (FDI); and infant mortality rate―to capture socioeconomic performance. The World Bank’s Regulatory Quality (RQ) indicator and the share of natural resource exports in percentage of total merchandise exports are used to capture institutional quality and resource dependence, respectively. Using Pooled OLS with robust estimators that control for temporal and spatial dependence, the paper finds that (1) higher levels of natural resource exports in SSA were significantly associated with larger FDI flows, but had no significant correlation with per capita GDP growth and infant mortality rate. Additionally, (2) in both SSA and SEA, a higher RQ score was significantly associated with increased per capita GDP growth and decreased infant mortality. The paper concludes by highlighting a few key areas that need serious consideration for further research on institutions and development in SSA.

Health expenditure in sub-Saharan Africa: Is it mean reversion? A Fourier unit root test approach

2021 ◽  
Vol 66 (4) ◽  
pp. 25-44
Author(s):  
Gbenga A. Olalude ◽  
Hammed A. Olayinka ◽  
Oluwadare O. Ojo
Keyword(s):  
Health Outcome ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Unit Root ◽  
Health Expenditure ◽  
Unit Root Test ◽  
Mean Reversion ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Sub Saharan

The aim of the paper is to examine the mean reversion in health expenditure of 45 sub-Saharan African countries. The series on current health expenditure (percent of GDP in total), obtained from the World Development Indicators, each spanned the years 2000–2017. We employed the Fourier unit root test, which allows modelling structural breaks, to deal with any such breaks that could arise as a result of a small sample size (18 years) of data available on health expenditure of the selected countries. The results showed evidence of mean reversion in the health spending pattern of 27 sub-Saharan African countries. There is evidence of nonmean reversion in the health expenditure pattern of the remaining 18 countries considered. We further investigate the link between health expenditure and health outcome, using infant mortality rate and under-five mortality rate as health outcome variables. An inverse association could be observed between the infant mortality rate and health expenditure and between the under-five mortality rate and health expenditure in 24 sub-Saharan African countries. On the other hand, in 13 other sub-Saharan African countries we observed a positive association between the variables. The findings of this study could be of great importance to healthcare delivery programmes in the studied countries.

scholarly journals Can Aid Improve People Health in Sub-Saharan African Countries?

2018 ◽  
Vol 3 (2) ◽  
pp. 91
Author(s):  
W. Jean Marie Kébré
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Prevalence Rate ◽  
Health Indicators ◽  
Hiv Prevalence ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Crude Mortality ◽  
Sub Saharan ◽  
Hiv Aids

<p><em>This paper analyzes the effects of aid on health of people in Sub-Saharan African Countries. Used as health indicators for infant mortality rate, crude mortality rate and HIV/AIDS prevalence rate, this analysis uses panel data for a sample of 43 countries over the period of 1990 to 2014. Through assessing the effect of aid on reducing mortality and HIV prevalence, the article examines a central issue with regard to the new global development agenda: Can we still promote health through increased aid? The results tend to show that aid significantly reduces crude mortality and infant mortality rates and HIV/AIDS prevalence rate. They do not validate the presence of decreasing marginal returns. However, the impact of aid on health indicators is not linear. This non-linearity suggests that aid is more effective in reducing mortality and HIV prevalence in relatively poorest countries and in those with relatively lower health expenditure. Thus, health promotion in sub-Saharan African countries through increased aid is possible.</em><em></em></p>

Perbandingan Linieritas Dalam Pendeteksian Faktor-Faktor Yang Mempengaruhi Angka Kematian Bayi Di Provinsi Aceh

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Desfira Ahya ◽  
Inas Salsabila ◽  
Miftahuddin
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Linear Model ◽  
Health Workers ◽  
Additive Model ◽  
Infant Mortality Rate ◽  
Mortality Data ◽  
Important Indicator ◽  
Penalized Spline ◽  
Aceh Province

Angka Kematian Bayi/ Infant Mortality Rate (IMR) merupakan indikator penting dalam mengukur keberhasilan pengembangan kesehatan. Nilai IMR juga dapat digunakan untuk mengetahui tingkat kesehatan ibu, kondisi kesehatan lingkungan dan secara umum, tingkat pengembangan sosio-ekonomi masyarakat. Penelitian ini bertujuan untuk memperoleh model IMR terbaik menggunakan tiga pendekatan: Model Linear, Model Linear Tergeneralisir dan Model Aditif Tergeneralisir dengan basis P-spline. Sebagai tambahan, berdasarkan model tersebut akan terlihat variabel yang mempengaruhi tingkat kematian bayi di provinsi Aceh. Penelitian ini menggunakan data jumlah kematian bayi di tahun 2013-2015. Data dalam penelitian ini diperoleh dari Profil Kesehatan Aceh. Hasil menunjukkan bahwa model terbaik dalam menjelaskan angka kematian bayi di provinsi Aceh tahun 2013-2015 ialah Model Linear Tergeneralisir dengan basis P-spline menggunakan parameter penghalusan 100 dan titik knots 8. Faktor yang sangat mempengaruhi angka kematian ialah jumlah pekerja yang sehat.   Infant mortality rate (IMR) is an important indicator in measuring the success of health development. IMR also can be used to knowing the level of maternal health, environmental health conditions and generally the level of socio-economic development in community. This research aims to get the best model of infant mortality data using three approaches: Linear Model, Generalized Linear Model and Generalized Additive Model with Penalized Spline (P-spline) base. In addition, based on the model can be seen the variables that affect to infant mortality in Aceh Province. This research uses data number of infant mortality in Aceh Province period 2013-2015. The data in this research were obtained from Aceh’s Health Profile. The results show that the best model can be explain infant mortality rate in Aceh Province period 2013-2015 is GAM model with P-spline base using smoothing parameter 100 and knots 8. Factor that high effect to infant mortality is number of health workers.

Empirical analysis of factors influencing the public health expenditure in Malaysia

2018 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Kok Wooi Yap ◽  
Doris Padmini Selvaratnam
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Price Index ◽  
Infant Mortality Rate ◽  
Public Health Expenditure ◽  
The Public ◽  
Empirical Results ◽  
Per Capita

This study aims to investigate the determinants of public health expenditure in Malaysia. An Autoregressive Distributed Lag (ARDL) approach proposed by Pesaran & Shin (1999) and Pesaran et al. (2001) is applied to analyse annual time series data during the period from 1970 to 2017. The study focused on four explanatory variables, namely per capita gross domestic product (GDP), healthcare price index, population aged 65 years and above, as well as infant mortality rate. The bounds test results showed that the public health expenditure and its determinants are cointegrated. The empirical results revealed that the elasticity of government health expenditure with respect to national income is less than unity, indicating that public health expenditure in Malaysia is a necessity good and thus the Wagner’s law does not exist to explain the relationship between public health expenditure and economic growth in Malaysia. In the long run, per capita GDP, healthcare price index, population aged more than 65 years, and infant mortality rate are the important variables in explaining the behaviour of public health expenditure in Malaysia. The empirical results also prove that infant mortality rate is significant in influencing public health spending in the short run. It is noted that macroeconomic and health status factors assume an important role in determining the public health expenditure in Malaysia and thus government policies and strategies should be made by taking into account of these aspects.

Sign in / Sign up

Export Citation Format

Share Document