Hyak Mortality Monitoring System, Innovative Sampling and Estimation Methods - Proof of Concept by Simulation

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.