Mortality decline in developing countries and its theoretical implications

This paper investigates the variability of life span at retirement age in 28 developed and transition countries. We analyze trends in cohort mortality for selected OECD countries, Russia and Taiwan and predict life expectancy and inequality at age 60. We find that the average and the standard deviation of (remaining) life span are increasing in all countries but Russia. Average life span tends to increase more rapidly than the standard deviation, resulting in lower levels of relative inequality. We forecast that the life span distribution will continue to shift out and widen. Across birth cohorts 1930-1960, we predict increasing relative inequality in Russia and among Japanese women. In other countries, and among Japanese men, we predict lower relative inequality. The declines are expected to be particularly pronounced among men and in Western Europe. We discuss the findings in the context of the debate on limits to longevity and public pension reform.

This study examines the use of insecticide treated nets on under-five mortality in Uganda. The quantitative analysis of Uganda and Demographci Health Surveys data of 2011 utilises Cox proportional hazard model. It examines the extent to which insecticide treated nets affects under-five mortality. It also compares the strength of community effect of insecticide treated nets to individual protective effect in Uganda. It is anticipated that use of insecticide treated nets does not only reduce the risk of under-five mortality but also its use at community level explains under-five mortality differences.

Uganda has opted for immunisation for child survival strategy. Although under-five mortality has reduced, the rate remains higher in rural than urban areas. Mortality also differs by region. These follow the level of immunisation coverage. Besides, most children are not fully immunised. These existing conditions seem to be contributing to different levels of under-five mortality but the extent to which they contribute is not well known. Hence, the objectives of this study are to: Examine the extent to which partial and full immunisation contribute to under-five mortality in Uganda; and;Explore the effects of immunisation on under-five mortality by place of residence and region. This study will use Uganda Demographic and Health Survey data of 2011 and apply Cox proportional hazards model for the statistical analysis.

Demography of Saudi Arabia is little known and little explored. Aspects covered by researchers within the nation and elsewhere include size, growth, distribution and age structure. Detailed analyses on components of population growth namely fertility, mortality and migration are limited. While Saudi Arabian demography is characterized by higher levels of fertility and immigration, mortality has registered at lower level since long.
The current effort is concentrated on (i) tracking changes in death rates in the Kingdom (ii) linking death rates decline with social, economic, cultural and political transformation and (iii) tracing changes in causes of death along the transition. National level data from Government ministries will be utilized to carry out this analysis.
Mortality declined in the Kingdom at a faster pace since its formation in 1935, which has its base on changes in national per capita, GDP and natural wealth. National economic scenario influenced societal, family and individual life leading to modernized life style and health seeking behavior. Governmental efforts at building social and educational, health and public utilities paved way for improved health. The resultant increase in life expectancy replaced premature deaths with deaths caused due to senility related non-communicable disorders.

We provide a joint overview of trends in mortality under age 5 and between ages 15 and 60 in Sub-Saharan Africa using data on the survival of children and siblings collected in Demographic and Health Surveys. Disregarding conspicuous stalls in the 1990s, child mortality levels mostly declined and converged over the last 30–40 years. By contrast, many Eastern and Southern African countries have witnessed an enormous surge in adult mortality that echoed earlier increases in HIV incidence. In Eastern Africa, adult mortality levels have begun to decline again, in some instances before the large-scale expansion of antiretroviral therapy programs. More surprising is the lack of sustained improvements in adult survival in some countries without severe HIV epidemics. Because trends in child and adult mortality do not always evolve in concert, model-based estimates that are inferred from matching indices of child survival onto standard mortality schedules can be very misleading.

Distance to health facilities is often cited as a major barrier limiting access to care in sub-Saharan and other developing countries. There are however limited data on the causal effects of distance to facilities on child survival. This paper uses unique longitudinal data collected in a rural district of Tanzania to test whether enhanced proximity to health services arising from investment in dispensaries contributed to the rapid decline in under-five mortality recently observed in Tanzania. Data on births, deaths, migrations, SES and geographic data on households and facilities have been recorded every 120 days since 1999 (n≈85,000). We use multivariate analysis to measure the causal effects of distance to health facilities on child survival and to test interactions between distance to health facilities and maternal education and households’ SES. Initial results indicate that, from 2000 to 2010, child mortality declined close to 40% (from 115 to 70 per 1000). The distance to the closest health facility remained a strong determinant of child survival, even after adjusting for endogeneity biases. The development of community-based primary health care can improve health outcomes and can increase equity by offsetting the detrimental effects of low maternal education, household poverty and distance to health facilities.

Several estimates of maternal mortality ratio (MMR), expressed as the number of maternal deaths per 100,000 live births are available for Cambodia since 1995, which give a picture of inexplicable fluctuations. The first estimate is 473, from the KAP Survey on Fertility and Contraception 1995. The Cambodia Demographic and Health Survey 2000, Intercensal Population Survey 2004 and Cambodia Demographic and Health Survey 2005 yielded estimates of 437 during 1995-2000, 491 during 2003- 2004 and 472 during 2000-2005 respectively. The MMR estimated from the General Population Census of 2008 is 461 during 2007- 2008. These estimates are considered not significantly different implying no change in maternal mortality in Cambodia during 1995-2008. But the MMR estimated from the latest Demographic and Health Survey of 2010 shows a steep decline to 206 during 2005-2010. The aim of this paper is to critically review the estimates of MMR from 1995 to 2010, including the data, methods of estimation and trends in the immediate and distant determinants of maternal mortality, and examine the theoretical implications of such rapid decline in maternal mortality. The methodology will basically comprise reviews of data, methods of estimation and other relevant literature.

Ouagadougou, the capital of Burkina Faso, is currently experiencing rapid population growth. Since 2008, the Ouaga HDSS following 80,000 people living in five neighborhoods on the periphery of the city, half of them living in poor, informal settlements. First analyses of the mortality data collected show that the main causes of deaths among adults aged 15 to 59 are AIDS, cardiovascular diseases and accidents; adult mortality (15 to 59) is higher in formal neighborhoods. This excess mortality seems attributable to the relatively higher wealth of households in formal neighborhoods: affluent adults are indeed more often overweight and more likely to be HIV positive; better educated adults are more likely to have accidents. In this analysis, we test (using Cox regression and data on mortality from 2008 to 2012) whether wealthier adults are more often victim of premature death, controlling for a variety of factors at the individual and household level.

The study aims to examine the trends and patterns of infant and child mortality in India in the light of several programmes. In this paper, three data sources have been used namely, Sample Registration System (SRS) of India from 1971-2010; Inter-Agency Child Mortality Estimation, UNICEF, 2006; and the three rounds of the National Family Health Survey (NFHS I, II, III) conducted in the year 1992-93, 1997-98 and 2005-06 respectively. The study uses trend analysis to examine the trends and patterns and Cox-proportional hazard model to find out the determinants of infant and child mortality. The preliminary findings indicate that though there was zigzag pattern in IMR, U5MR and NMR in the beginning but from the decades of 1980s there is rapid decline in these mortalities. Various programmes have been implemented in this period of time which has profound influence on the reduction of the mortalities. It should also be noted that the reduction of mortality is not only because of the influence of one programme but, combined influence of all programmes. The Cox-proportional hazard model indicates that mother’s education and use of unsafe fuel, higher birth order and institutional delivery are significant predictors of infant mortality.

During the last century, India experienced drastic improvement in life expectancy. Did the extra years gained to the life expectancy have really improved the quality of life? Such question becomes prominent when one considers the changes in morbidity. So far, no study has been available by combining mortality and morbidity changes to a single index by representing health status in India. This paper is an exploration of quality of life by using Disability Free Life Expectancy (DFLE) rates in India. It followed methodology forwarded by Sullivan (1971). It used three levels of disability rates -perceived morbidity, restricted activity and also confined to bed by using the data from SRS and NSSO. It found that DFLE is declined in higher rates in advanced states indicating a considerable decline in the quality of life with the advancement in life expectancy, especially to the older ages. Females and urbanites have considerable decline in quality of life than that of males and rural people. The study also found that prominent role of chronic/degenerative diseases in losses in DFLE. All the three levels of disability for DFLE found similar pattern. It concludes that mere increase in longevity does not mean better life. It is high time for India to have effective interventions to improve the quality of life along with life expectancy.