New approaches to the collection and analysis of data on mortality and cause-of-death

Among military officers higher rank associates with life expectancy. This may be causation: benefits of higher rank may cause life to last longer - or selection: robust health helps making it to top ranks. We investigate graduates of 1949, 1950, 1951 of the US Naval Academy (n=2206) and US Military Academy (n=1719), with 42%, 49%, 49% equally distributed survivors, focussing on men with 20+ years service, when men could retire with benefits.Variation in major intervening variables in this sample is minimal. Beyond the expected positive association between final rank and life span we find mortality differentials by rank peaking around age 75 then decreasing. This pattern supports selection hypothesis. Modelling unobserved heterogeneity by a frailty variable suggests that levelling off of differential mortality at higher ages is caused by differential loss rate by final rank. Trajectories to different final ranks and different lifespans start drifting apart early.

A single summery index of mortality can never replace the set of age-specific death rates, it has been found to be extremely useful for a wide variety of purposes. The choice of index depends upon the purposes for which it is to be used, and is important as different indexes can produce very different results. This study examines the variation in mortality and mortality trends in India and its major states from the 1970-75 to 2002-2006 using data from the Sample Registration System (SRS). Several indicators were developed to study mortality .The most basic indicators are: CDR, IMR, ASDR, and LEB and several other indicators were also existed. Arithmetic mean of the Age Specific Death Rates and Geometric Mean of the Age Specific Death Rates (or the Del Index) are examples. Input data used in deriving the DI and OMI Age Specific Death Rates (ASDRs) of the 16 age groups: 0-1, 1-4, 5-9, 10-14, -----65-69, and 70+ “Age Structure of Mortality in India and Its Bigger States“ Del Index refers to the geometric mean of the age-specific death rates as a summery index of mortality, which was postulated by the versatile Demographer Robert Schoen in the year of 1970.

At present maternal mortality in Bangladesh are 194 per 100,000 live births. Unavailability of human resources especially skilled provider, shortage of logistics/supplies and delay of clients to come to the facility, are the major causes of deaths at the health facility. Under pay-for-performance (P4P) at the facility based operation research, maternal and perinatal death review was introduced in the two intervention districts to contain deaths and take appropriate preventive measures. In order to carry out death reviews, facility-based death review teams formed and data was collected through death notification slip, death review form and agreed standard procedure. Findings shows that, 3 maternal deaths and 102 perinatal deaths occurs at the selected health facilities during the intervention period in these two districts. Most of the client admitted at the facility with unconsciousness and shock. Majority of neonatal deaths were due to perinatal asphyxia, sepsis, and birth trauma. Delay in decision making of client’s family, shortage of manpower and logistics at facilities, delay to refer are the major causes of maternal and perinatal death. Data collection on death and analysis of causes of death at the facility will contribute to take appropriate action to reduce maternal and perinatal death.

Road Traffic Accidents (RTA) is increasingly being recognized as a growing public health problem in the world. Nevertheless, little attention has been paid by the social scientists, including demographers, and policy makers to mitigate the problem. Therefore, there is an urgent need to explore the issue in detail to have a comprehensive understanding. The paper aims to assess various dimensions and magnitudes of RTA in India. At the same time, the study also explores the trends and patterns of RTA in India. The study uses data from the National Crime Record Bureau; Ministry of Home Affairs; and the Department of Road Transport and Highways, Govt. of India. The analysis shows that there is a persistent increase in the number of motor vehicle crashes, injuries and fatalities. RTA by the two wheelers is disproportionaly high and so are the fatalities. One of the most dangerous aspects of RTA is that it has been affecting the most productive young working population. Heavy vehicles accounts for about 35% of total deaths in India. Furthermore, with the growing rate of urbanization in India, and its expected increase in the decades to come, there is steep increase in RTA in the last two decades.

Commonly, methods such as rate-ratios and rate-differentials are applied to assess inter-temporal, inter-regional and inter-group progress. However, an indiscriminate application of these methods is identified as an area for concern. In particular, rate-ratios are sensitive to the adopted definition of an indicator (achievement or failure) and tend to be larger (smaller) at lower (higher) overall levels. Clearly, they are effective only when considered along with overall levels and the adopted definition of the indicator. Also, it is critical that the progress is assessed both in terms of achievement and the effort toward achievement. Given such intricacies, this paper reviews the existing methods for progress assessment and discusses an alternative level-sensitive approach that informs regarding effort and offers similar conclusions irrespective of the adopted definition of the indicator. Data from the official MDG monitoring database is analysed to present an international comparison of achievements in reducing child and infant mortality rates.

• El objetivo de esta investigación es fortalecer el Sistema Interinstitucional de Vigilancia de la Mortalidad Materna del Ecuador , y el estudio identificó que uno de los problemas históricos del cálculo de la razón de mortalidad materna (RMM) ha sido el subregistro de muertes maternas y para esto este estudio documentó, a través de los informes provinciales de muerte materna en los años 2010 y 2011, los aproximadamente 500 casos y reclasificó la causa básica de muerte mejorando el subregistro de los datos, a la vez analizó los factores causales de la diferencia en la prestación de la atención en salud que condujeron a la muerte materna, a través de las tres demoras definidas.
• También homologa metodológicamente para que, en el futuro, la RMM del Ecuador sea un solo dato a nivel país.
• Igualmente el estudio sugiere utilizar como denominador de la RMM, a la estimación de nacidos vivos, a partir de las nuevas proyecciones poblacionales calculadas de acuerdo al Censo de Población efectuado en el año 2010.
Palabras claves: Razón de mortalidad Materna, estimación de nacidos vivos.

Traditional health statistics are derived from civil/vital registration. In low- to middle-income countries civil registration varies from partial coverage to nothing. We propose a new statistical framework for gathering health and population data - HYAK - that leverages the benefits of sampling and longitudinal, prospective surveillance to create a cheap, accurate, sustainable monitoring platform. HYAK has three fundamental components:

1. DATA MELDING: a sampling and surveillance component that organizes two data collection systems to work together: (1) data from health and demographic surveillance systems (HDSS) with frequent, intense, linked, prospective follow-up and (2) data from linked sample surveys conducted in large areas surrounding the HDSS sites using informed sampling so as to capture as many events as possible;

2. CAUSE OF DEATH: verbal autopsy to characterize the distribution of deaths by cause at the population level; and

3. SES: measurement of socioeconomic status in order to characterize poverty and wealth.

We conduct a simulation study of the informed sampling component of HYAK. Compared to traditionally cluster sampling, HYAK's informed sampling captures more deaths and produces estimates of both death counts and mortality rates that have lower variance and small bias.

To assess excess deaths linked to the 1998-2004 armed conflicts in the Democratic Republic of Congo, the International Rescue Committee conducted a series of five surveys over a seven years period (2000–2007). IRC estimated excess deaths of 5.4 million between 1998 and 2007. Using an alternative method this study combines four different data sources – 1984 DRC Population Census; 1995 and 2001 Multiple Indicator Cluster Surveys and the 2007 Demographic and Health Survey – to assess excess population loss. Indirect techniques are used to derive estimates and cohort component projections conducted for factual and counter-factual scenarios using varying assumptions to estimate excess population loss. This study’s excess population loss is estimated at: 2.4 million for a closed population; 1.7 million when migration data in incorporated. We also find that the choice of mortality baseline determines the level of excess population loss. Mortality is exceptionally high in the DRC regardless of baseline or assumptions used. Further works are on-going to refine assumptions and assess competing causes of mortality as well as the extent of uncertainty linked to both this study’s model and components of population change.

In spite of an increasing demand for reliable information of cause and distribution of mortality, civil registration systems in most developing countries still do not yield the complete and accurate data required for the direct estimation of mortality rates. In India, where civil registration system and SRS lacks sufficient power to produce reliable estimates of mortality across life stages. Our knowledge of age-pattern of mortality depends largely on cross-sectional data from censuses /surveys providing us information on recent deaths in the households. Most of the household surveys are not designed to derive mortality estimates over all ages. This paper aims to fill this gap by analyzing large scale household survey (DLHS-III) conducted in 2007-2008 in India. We have computed age specific mortality rates for all age groups after adjusting infants/child exposure period by “Date by Year cohort” method. Brass two parameter logit model has been used to graduate non-linearity of estimated age specific mortality rates. This study clearly suggests that mortality estimates derived from “Recent household death" approach using district level data yield comparable results with official Sample registration system Death rates.

United Nations Millennium Development Goals(MDGs) has set the target of reducing high rates of infant (and child) mortality (IMR) by two thirds to be reached by 2015 using 1990 as the benchmark year. The availability of time series data on Infant Mortality rate from Inter- Agency Group for Child Mortality Estimation(IGME) led by UNICEF and WHO, it has become possible to track the rate of progress towards this goal. Using the IGME 2012 data for all the South Asian Countries, I have considered three specific issues in this article. (1). How does the South Asian Countries fair in reducing the IMR towards this MDG target? Although the time series data exhibit declining trends for all the countries in South Asia, to what extent such trends are attributed by their average annual progress trajectory over the period for which data are available? (2). Whether deterministic or stochastic trend can attribute the IMR decline in South Asian countries and what alternative time series models be used to forecast the decline in Infant Mortality? Can we find a serviceable representative model for the entire region? (3) In case, a satisfactory representative model for the entire region exists, how do we assess the forecast accuracy using the model and quantify the propagation of forecast error?