Laboratory

Demographic Data

Project

Monitoring Mortality in Developing Countries

Conducted by Dmitri A. Jdanov; Domantas Jasilionis, Vladimir M. Shkolnikov, László Németh, Yue Li (China Population and Development Research Center, Beijing, China); in Collaboration with Usha Ram (International Institute for Population Sciences, Mumbai, India), Danan Gu (United Nations, Population Division, New York, World), Rasul Afza (Lahore College for Women University, Pakistan)

Detailed Description

The majority of developing countries are currently undergoing substantial epidemiological transformations manifested by large declines in child mortality and the growing role of chronic noncommunicable diseases. However, the ongoing health transitions are highly uneven and complex. In many cases, the countries enter into a new stage of health transition in the conditions of a persisting high or even reemerging burden of communicable diseases. In addition, progress in sustainable health is threatened by new epidemics at the global, regional, and national levels.

In order to adequately monitor these global processes and challenges, internationally comparable data-driven mortality estimates are needed at the global, regional, national, and subnational levels. Currently, for the majority of developing countries the existing evidence is almost entirely based on surveys that primarily focus on child and maternal mortality. The international estimates available are based on heavy modeling assumptions and substantial adjustments, and they are hardly comparable and interpretable. The new epidemiological realities and emerging threats call for more reliable, real data-based, and transparent mortality estimates, especially for adult and older age groups.

This project focuses on producing internationally comparable mortality estimates at the national and subnational levels for a selected set of developing countries. It benefits from exploiting and sharing the experiences of the project Human Mortality Database (HMD, www.mortality.org) in the fields of data collection, harmonization, adjustments, and distribution. The extrapolation of the methodological advances and the main principles of the HMD toward countries with problematic data will be the major challenge. However, success in implementing at least some of the methodological solutions and principles has a strong potential to contribute to filling the data and knowledge gaps.

We first focus on national and subnational mortality estimates for India and China. In collaboration with the International Institute for Population Sciences (Mumbai, India), the project team performed the systematic quality assessment and harmonization of the Sample Registration System (SRS) data at national and major state levels. In addition, other data sources such as the National Family Health Survey and District Level Household and Facility Survey are exploited to test for the completeness of the SRS data and to produce mortality estimates by socioeconomic group in India. In cooperation with researchers from Beijing University, a thorough assessment of the population census data on retrospective mortality was performed to produce national and province-level mortality estimates for China. Special methodological solutions and alternative data sources were tested to adjust child and old age mortality. In collaboration with Afza Rasul from the Lahore College for Women University (Pakistan), we investigate age-heaping patterns in the DHS data for Pakistan and other developing countries.

One expected outcome of the first project phase is harmonized, well-documented, and internationally comparable mortality estimates for both India and China. The methodological principles used for producing these estimates will be used to expand the project to other countries that have problematic population data.

Research Keywords:

Aging, Mortality and Longevity, Data and Surveys, Health Care, Public Health, Medicine, and Epidemiology

Region keywords:

Africa, America, Asia