multiple indicator cluster surveys data dissemination - further analysis workshop
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Multiple Indicator Cluster Surveys Data Dissemination - Further Analysis Workshop. Mortality. Background. Child mortality: Probabilities of dying during the first 5 years of life, usually broken down by conventional age segments - PowerPoint PPT PresentationTRANSCRIPT
Multiple Indicator Cluster Surveys Data Dissemination - Further Analysis Workshop
Mortality
MICS4 Data Dissemination and Further Analysis Workshop
Background• Child mortality: Probabilities of dying during the first 5 years of life,
usually broken down by conventional age segments
• Infant (first one year) and under-5 mortality rates (first 5 years) are the most commonly calculated probabilities
Periods for Under-5 Mortality Measurement
Neonatal Mortality
(First month)
Post-Neonatal Mortality (1-11 months) Child Mortality (1 to 4 years)
Infant Mortality (Birth to One Year)
Under-5 Mortality (0-4 Years)
Birth 1 5
Background• MDG 4: reduce under-5 mortality by two-thirds, between
1990 and 2015– Indicator 1.3 – Under-5 Mortality Rate– Indicator 1.4 – Infant Mortality Rate
• Both indicators are measured in MICS surveys
• Child mortality indicators are broad indicators of social development/health status
• Used to evaluate impact of interventions based on trends
Measurement of child mortality
Data Sources
• Vital registration• Population censuses• Surveillance systems, sample registration systems• Household surveys
– Direct: Data from full birth histories, as in DHS and some MICS surveys
– Indirect: Data from summary birth histories, to use “Brass methods”
– Note that surveys that include birth histories can be used both for direct and indirect estimation
Methods: Direct method
•Based on birth histories
•Required data:– Data of birth for each child (month and year)– Survival status– Date or age at death for each child who has died
•Typically, synthetic cohort life table approach used to estimate rates
Methods: Direct method
• Rely heavily on the quality of information collected – work best in populations where dates and durations are well-known
• Sources of errors:– Omission of births and deaths– Misreporting of age at death (age heaping at 12 months is
common)– Birth misplacement
Age heaping: child’s death at 12 months
Niger DHS06 - Age at death in months
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
0 2 4 6 8 10 12 14 16 18 20 22 24 26
Months
Per
cent
of d
eath
s 1-
23 m
onth
s
Linear trendline
Niger: Births by year, DHS06
0
500
1000
1500
2000
2500
3000
1996 1998 2000 2002 2004 2006
Year
Num
bers
LivingDeadTotal
Questions on under-5s for all births after January 2001
Age shifting: common issue in DHS
Check denominators for:Less than 250 cases *250-499 cases ( )
0-4 5-9 10-14 15-19 20-24Mean Mean Mean Mean Mean
0 620.26 504.88 445.41 348.55 201.481-2 63.04 110.23 77.51 73.39 87.223-5 89.22 82.81 71.63 46.55 26.916-11 99.64 166.7 151.27 121.36 33.9412-23 208.61 242.33 169.82 175.52 98.3524-35 244.79 209.71 208.98 164.71 90.1836-47 144.69 133.63 107.73 69.09 30.9348-59 84.05 74.16 49.9 34.12 18.010 13920.14 11978.53 9302.7 6793.22 3910.571-2 13237.43 11624.09 8735.32 6359.38 3549.133-5 12969.53 11611.1 8495.96 6170.02 3277.486-11 12610.69 11262.74 8346.37 5903.85 3176.5812-23 12296.12 10425.94 7958.39 5335.74 2964.9724-35 11917.43 9526.55 7284.85 4659.14 2480.2536-47 11361.23 8756.18 6587.17 4033.44 1997.6348-59 10698 8153.75 6035.32 3489.87 1671.450 44.56 42.15 47.88 51.31 51.521-2 4.76 9.48 8.87 11.54 24.583-5 6.88 7.13 8.43 7.54 8.216-11 7.9 14.8 18.12 20.56 10.6912-23 16.97 23.24 21.34 32.89 33.1724-35 20.54 22.01 28.69 35.35 36.3636-47 12.73 15.26 16.35 17.13 15.4848-59 7.86 9.1 8.27 9.78 10.77
Exposure Age in months
Probability Age in months
Table CM.0: Early childhood mortality ratesNeonatal, post-neonatal, Infant, child and under-five mortality rates for five year periods preceding the
survey, (Total), 2010
Periods of analysis of 5 years
Deaths Age in months
Neonatal mortality
0-4 5-9 10-14 15-19 20-24Mean Mean Mean Mean Mean
0 620.26 504.88 445.41 348.55 201.481-2 63.04 110.23 77.51 73.39 87.223-5 89.22 82.81 71.63 46.55 26.916-11 99.64 166.7 151.27 121.36 33.9412-23 208.61 242.33 169.82 175.52 98.3524-35 244.79 209.71 208.98 164.71 90.1836-47 144.69 133.63 107.73 69.09 30.9348-59 84.05 74.16 49.9 34.12 18.010 13920.14 11978.53 9302.7 6793.22 3910.571-2 13237.43 11624.09 8735.32 6359.38 3549.133-5 12969.53 11611.1 8495.96 6170.02 3277.486-11 12610.69 11262.74 8346.37 5903.85 3176.5812-23 12296.12 10425.94 7958.39 5335.74 2964.9724-35 11917.43 9526.55 7284.85 4659.14 2480.2536-47 11361.23 8756.18 6587.17 4033.44 1997.6348-59 10698 8153.75 6035.32 3489.87 1671.450 44.56 42.15 47.88 51.31 51.521-2 4.76 9.48 8.87 11.54 24.583-5 6.88 7.13 8.43 7.54 8.216-11 7.9 14.8 18.12 20.56 10.6912-23 16.97 23.24 21.34 32.89 33.1724-35 20.54 22.01 28.69 35.35 36.3636-47 12.73 15.26 16.35 17.13 15.4848-59 7.86 9.1 8.27 9.78 10.77
Exposure Age in months
Probability Age in months
Table CM.0: Early childhood mortality ratesNeonatal, post-neonatal, Infant, child and under-five mortality rates for five year periods preceding the
survey, (Total), 2010
Periods of analysis of 5 years
Deaths Age in months
0-4 5-9 10-14 15-19 20-24Mean Mean Mean Mean Mean
0 620.26 504.88 445.41 348.55 201.481-2 63.04 110.23 77.51 73.39 87.223-5 89.22 82.81 71.63 46.55 26.916-11 99.64 166.7 151.27 121.36 33.9412-23 208.61 242.33 169.82 175.52 98.3524-35 244.79 209.71 208.98 164.71 90.1836-47 144.69 133.63 107.73 69.09 30.9348-59 84.05 74.16 49.9 34.12 18.010 13920.14 11978.53 9302.7 6793.22 3910.571-2 13237.43 11624.09 8735.32 6359.38 3549.133-5 12969.53 11611.1 8495.96 6170.02 3277.486-11 12610.69 11262.74 8346.37 5903.85 3176.5812-23 12296.12 10425.94 7958.39 5335.74 2964.9724-35 11917.43 9526.55 7284.85 4659.14 2480.2536-47 11361.23 8756.18 6587.17 4033.44 1997.6348-59 10698 8153.75 6035.32 3489.87 1671.450 44.56 42.15 47.88 51.31 51.521-2 4.76 9.48 8.87 11.54 24.583-5 6.88 7.13 8.43 7.54 8.216-11 7.9 14.8 18.12 20.56 10.6912-23 16.97 23.24 21.34 32.89 33.1724-35 20.54 22.01 28.69 35.35 36.3636-47 12.73 15.26 16.35 17.13 15.4848-59 7.86 9.1 8.27 9.78 10.77
Exposure Age in months
Probability Age in months
Table CM.0: Early childhood mortality ratesNeonatal, post-neonatal, Infant, child and under-five mortality rates for five year periods preceding the
survey, (Total), 2010
Periods of analysis of 5 years
Deaths Age in months
Post-neonatal mortalityInfant mortality
0-4 5-9 10-14 15-19 20-24Mean Mean Mean Mean Mean
0 620.26 504.88 445.41 348.55 201.481-2 63.04 110.23 77.51 73.39 87.223-5 89.22 82.81 71.63 46.55 26.916-11 99.64 166.7 151.27 121.36 33.9412-23 208.61 242.33 169.82 175.52 98.3524-35 244.79 209.71 208.98 164.71 90.1836-47 144.69 133.63 107.73 69.09 30.9348-59 84.05 74.16 49.9 34.12 18.010 13920.14 11978.53 9302.7 6793.22 3910.571-2 13237.43 11624.09 8735.32 6359.38 3549.133-5 12969.53 11611.1 8495.96 6170.02 3277.486-11 12610.69 11262.74 8346.37 5903.85 3176.5812-23 12296.12 10425.94 7958.39 5335.74 2964.9724-35 11917.43 9526.55 7284.85 4659.14 2480.2536-47 11361.23 8756.18 6587.17 4033.44 1997.6348-59 10698 8153.75 6035.32 3489.87 1671.450 44.56 42.15 47.88 51.31 51.521-2 4.76 9.48 8.87 11.54 24.583-5 6.88 7.13 8.43 7.54 8.216-11 7.9 14.8 18.12 20.56 10.6912-23 16.97 23.24 21.34 32.89 33.1724-35 20.54 22.01 28.69 35.35 36.3636-47 12.73 15.26 16.35 17.13 15.4848-59 7.86 9.1 8.27 9.78 10.77
Exposure Age in months
Probability Age in months
Table CM.0: Early childhood mortality ratesNeonatal, post-neonatal, Infant, child and under-five mortality rates for five year periods preceding the
survey, (Total), 2010
Periods of analysis of 5 years
Deaths Age in months
Child mortality
0-4 5-9 10-14 15-19 20-24Mean Mean Mean Mean Mean
0 620.26 504.88 445.41 348.55 201.481-2 63.04 110.23 77.51 73.39 87.223-5 89.22 82.81 71.63 46.55 26.916-11 99.64 166.7 151.27 121.36 33.9412-23 208.61 242.33 169.82 175.52 98.3524-35 244.79 209.71 208.98 164.71 90.1836-47 144.69 133.63 107.73 69.09 30.9348-59 84.05 74.16 49.9 34.12 18.010 13920.14 11978.53 9302.7 6793.22 3910.571-2 13237.43 11624.09 8735.32 6359.38 3549.133-5 12969.53 11611.1 8495.96 6170.02 3277.486-11 12610.69 11262.74 8346.37 5903.85 3176.5812-23 12296.12 10425.94 7958.39 5335.74 2964.9724-35 11917.43 9526.55 7284.85 4659.14 2480.2536-47 11361.23 8756.18 6587.17 4033.44 1997.6348-59 10698 8153.75 6035.32 3489.87 1671.450 44.56 42.15 47.88 51.31 51.521-2 4.76 9.48 8.87 11.54 24.583-5 6.88 7.13 8.43 7.54 8.216-11 7.9 14.8 18.12 20.56 10.6912-23 16.97 23.24 21.34 32.89 33.1724-35 20.54 22.01 28.69 35.35 36.3636-47 12.73 15.26 16.35 17.13 15.4848-59 7.86 9.1 8.27 9.78 10.77
Exposure Age in months
Probability Age in months
Table CM.0: Early childhood mortality ratesNeonatal, post-neonatal, Infant, child and under-five mortality rates for five year periods preceding the
survey, (Total), 2010
Periods of analysis of 5 years
Deaths Age in months
Under-5 mortality
Estimates from direct methodTable CM.1: Early childhood mortality rates
Neonatal, post-neonatal, Infant, child and under-five mortality rates for five year periods preceding the survey, (Total)
Neonatal mortality rate [1]
Post-neonatal mortality rate [2]
Infant mortality rate [3]
Child mortality rate [4]
Under five mortality rate [5]
Periods of analysis of 5 years
0-4 44.56 18.55 63.11 56.89 116.41
5-9 42.15 29.79 71.94 67.88 134.94
10-14 47.88 33.36 81.24 72.69 148.03
15-19 51.31 37.15 88.46 92.03 172.35
20-24 51.52 40.71 92.23 92.63 176.32
C1 MICS Survey
1985.00 1990.00 1995.00 2000.00 2005.00 2010.000
50
100
150
200
250
Direct estimates of U5MR
Methods: Indirect method•Required data
– Age of women– The total number of children she has ever borne, and– The number of those children who have died (or, the
number who are still alive)
•Require relatively fewer information than direct method
Indirect methodTable CM.1: Children ever born, children surviving and proportion dead
Mean and total numbers of children ever born, children surviving and proportion dead by age of women, Country, 2010
Mean number
of children
ever born
Total number
of children
ever born
Mean number children surviving
Total number
of children surviving
Proportion dead
Number of
womenAge 15-19 .286 1316 .267 1229 .082 4601
20-24 1.255 4732 1.107 4175 .123 3770
25-29 2.522 8287 2.160 7100 .149 3286
30-34 3.743 8339 3.202 7132 .145 2228
35-39 5.026 10654 4.105 8703 .185 2120
40-44 5.772 8421 4.669 6812 .192 1459
45-49 6.407 8138 5.016 6372 .217 1270
Total 2.663 49887 2.216 41523 .170 18734
Methods: Indirect method
• Distributes children ever born to women retrospectively over time using models
• Assumes– Little or no change in fertility levels and age patterns– No change or a linear decline in mortality– A pattern of mortality by age that conforms to known model life table
“families” which basically derived from European experience
Methods: Indirect method (3)
Converts proportion dead of children ever born (D(i)) reported by women in age groups 15-19, 20-24, etc. into estimates of probability of dying before attaining certain exact childhood ages, q(x):
q(x) = K(i)*D(i)
where the multiplier K(i) is meant to adjust for non mortality factors determining the value of D(i)
MICS4 Workshop
Methods: Indirect method•The age pattern of child mortality --- select the right model life table
– Coale-Demeny patterns by region: • East, North, South, and West
– United Nations patterns by region: • Latin America, Chilean, South Asian, Far Eastern, and General
Select the right model life table: India
Indirect method
Check denominators
Table CM.1: Children ever born, children surviving and proportion dead Mean and total numbers of children ever born, children surviving and
proportion dead by age of women, Country, 2010
Mean number
of children
ever born
Total number
of children
ever born
Mean number children surviving
Total number
of children surviving
Proportion dead
Number of
womenAge 15-19 .286 1316 .267 1229 .082 4601
20-24 1.255 4732 1.107 4175 .123 377025-29 2.522 8287 2.160 7100 .149 328630-34 3.743 8339 3.202 7132 .145 222835-39 5.026 10654 4.105 8703 .185 212040-44 5.772 8421 4.669 6812 .192 145945-49 6.407 8138 5.016 6372 .217 1270Total 2.663 49887 2.216 41523 .170 18734
Indirect method
Coale-Demeny Models (Trussel equations)
Mean
children ever born
Proportion children dead of
born Age iQ(i)
Northt(i)
NorthQ(i)
Southt(i)
SouthAge group
15-19 .286 .082 1 .071 1.4 .068 1.3
20-24 1.255 .123 2 .116 2.7 .122 2.7
25-29 2.522 .149 3 .140 4.4 .150 4.5
30-34 3.743 .145 5 .144 6.4 .149 6.6
35-39 5.026 .185 10 .196 8.5 .194 8.9
40-44 5.772 .192 15 .201 10.9 .197 11.5
45-49 6.407 .217 20 .223 13.7 .220 14.5
Indirect method
Under-five Mortality Rate(Male)
Reference date North
Under-five
Mortality Rate North
Reference date South
Under-five
Mortality Rate South
Reference date East
Under-five
Mortality Rate East
Reference date West
Age group
15-19 2009.0 .111 2009.0 .087 2009.0 .097 2009.0
20-24 2007.7 .150 2007.7 .142 2007.6 .140 2007.7
25-29 2006.0 .161 2005.9 .161 2005.8 .158 2005.8
30-34 2004.0 .144 2003.8 .149 2003.6 .147 2003.7
35-39 2001.8 .169 2001.5 .181 2001.3 .178 2001.5
40-44 1999.4 .162 1998.9 .178 1998.7 .175 1999.0
45-49 1996.6 .166 1995.9 .187 1995.5 .186 1996.1
MICS Survey
1985.00 1990.00 1995.00 2000.00 2005.00 2010.000
20
40
60
80
100
120
140
160
180
Indirect estimates
Final estimates
• As the “final” or “most recent” estimate, we use an average of estimates based on women age 25-29 and 30-34
• Ignore estimates based on women age 15-19 and 20-24: selection bias
C1: “Final” estimates
Infant
Mortality Rate [1]
Under-five Mortality Rate
[2]Sexo Masculin
o111 162
Feminino
98 146
Region SAB 87 119Leste 130 207Northe 104 153Sul 83 112
Area de residência
Urbano 93 131Rural 110 167
Quintil de riqueza
Mais rico 114 174Segundo 116 179Meio 104 154Quarto 102 149Mais pobre
69 89
Total 105 155
Data quality issues• Main errors in data on children ever born and children
dead/surviving– Omission of deaths– Misreporting of women’s age
• Other drawbacks– Violation of assumptions– Use model life tables to adjust the data for the age pattern of
mortality in the general population --- Inappropriate model life table may results in mis-estimation of trends.
Checking quality of mortality estimates
• Compare child mortality across sub-groups• Expected patterns by sex, background characteristics
• Check estimates from successive data sources
Compare CEB, CS, CD data
Age in 2000
Mean Number of Children Ever Born
Mean Number of Children Surviving
Mean Number of Children Deceased
2000 2006 2010 2000 2006 2010 2000 2006 20105-9 0.2860 0.2671 0.0189
10-14 0.6542 1.2551 0.5396 1.1073 0.1145 0.1478
15-19 0.5028 1.7176 2.5216 0.4255 1.4191 2.1605 0.0773 0.2985 0.3612
20-24 1.7158 3.3253 3.7432 1.4058 2.6190 3.2016 0.3100 0.7063 0.5416
25-29 3.3431 4.6799 5.0258 2.6323 3.6527 4.1055 0.7108 1.0272 0.9203
30-34 4.9895 5.8593 5.7723 3.8199 4.3312 4.6691 1.1696 1.5281 1.1032
35-39 6.1893 6.4765 6.4072 4.5381 4.7859 5.0164 1.6512 1.6906 1.3907
40-44 6.9033 6.7208 4.9685 4.6518 1.9349 2.0690
45-49 7.2666 5.1520 2.1146
Quality check: sample size
• Sample size needs to be sufficiently large to produce statistically reliable estimates of infant and under-five mortality
• Mortality data may carry wide confidence intervals
• Number of births and deaths for children of women aged 15-19 is often very small, thus have effects on the parity ratio and on the regression used to derive estimation equations, therefore may bias the indirect estimates
For further analysis
• Compare estimates from different sources• Analyze mortality by coverage indicators• Check age patterns of mortality (from direct
method), compare with model patterns• Multivariate analyses
The IGME Work
Members of the IGME
• UN Inter-agency Group for Child Mortality Estimation (IGME) was formed in 2004, led by UNICEF, WHO, and includes members of UN Population Division and The World Bank
• Technical Advisory Group (TAG) of the IGME– Independent– Composed of leading experts in demography and
biostatistics– Provide technical guidance on estimation methods,
technical issues and strategies for data analysis and data quality assessment
Objectives of the IGME
• Objectives of the IGME– Harmonize estimates within the UN system– Improve methods for child mortality estimation– Produce consistent estimates of child mortality
worldwide for reporting on progress towards MDG 4
– Enhance the capacity of countries to produce timely estimates of child mortality: regional workshops and country visits
The IGME method to estimate child mortality
• Update estimates annually– Compile all nationally representative data for each country– Check data quality– Fit a regression line to all data points that meet data quality standards
established by the IGME and extrapolate to a common reference year– Additional adjustment applied to countries with high HIV/AIDS
prevalence
• The IGME Estimates are based on national data from surveys, census, vital registrations, etc, but may differ from these data
Why is it necessary to produce interagency child mortality estimates
• No single, high quality source in most countries• Multiple data sources often inconsistent• Project estimates• Important to estimate since 1990• Consistent methodology
Example: Data rich and consistency countries
Mali
The available data sources cluster over a narrow band
and show considerable consistency
The estimate line is fitted to all the data
Example: Data rich countries with wide variations in mortality level from different sources
Nigeria
Has one of the widest spreads of source data,
with a range from 120 to 240 deaths per 1,000 live
birth
In driving the estimate line, all sources with
dotted lines are rated of lower quality and are
not used.
Discrepancies between national and interagency estimates
• National estimates: often use data directly from censuses, surveys, or vital registration systems
• IGME estimates: use national data from censuses, surveys, or vital registration systems as underlying data to generate estimates by fitting a tend line to these data
• For countries with consistent data, national estimates and interagency estimates are similar.
• For countries with inconsistent or messy data, differences might be large
Direct and indirect estimates
1985.00 1990.00 1995.00 2000.00 2005.00 2010.000
50
100
150
200
250
300
MICS2000 (Indirect)
MICS2006 (Indirect)
RHS/MICS2010 (Direct)
RHS/MICS2010 (Indirect)
CMEInfoThe IGME’s Child Mortality Database:
www.childmortality.org