Improving the measurement of adolescent and adult mortality in low-income countries

改进低收入国家青少年和成人死亡率的测量

基本信息

批准号：
9754205
负责人：
Stephane Helleringer
金额：
$ 57.08万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-15 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9754205
关键词：
15 year old AIDS/HIV problem Adolescent Adopted Adult Affect Age Bangladesh Bayesian Method Bayesian Modeling Birth Calendar Cause of Death Cessation of life Child Mortality Country Cues Data Data Analyses Data Collection Data Quality Data Set Data Sources Date of birth Demographic and Health Surveys Effectiveness Event Fertility Future Goals Government Guinea-Bissau Health Household Institution International Intervention Interview Investments Malawi Maternal Mortality Measurement Measures Modeling Pilot Projects Population Pregnancy Questionnaires Randomized Recording of previous events Reporting Respondent Risk Sample Size Sampling Selection Bias Sensitivity and Specificity Series Siblings Site Statistical Models Suicide Surveys Sustainable Development System Techniques Testing Time Traffic accidents Uganda Uncertainty United Nations Visit Work age group arm base burden of illness data modeling flexibility global health improved innovation low and middle-income countries low income country mortality operation premature prevent primary outcome programs prospective secondary outcome simulation tool trend validation studies

项目摘要

With child mortality rapidly declining, an increasing proportion of all deaths in low and middle-income countries (LMICs) will occur at adolescent and adult ages in the next decades. The forthcoming Sustainable Development Goals (SDGs) set out by the United Nations reflect this shift: over the next 15 years (2015-2030), several SDG targets will focus on reducing deaths from causes that affect primarily those age groups (e.g., maternal mortality, road traffic accidents, suicides). Investments in adolescent and adult health from US federal institutions, international organizations and governments of LMICs are thus expected to increase significantly. The mortality impact of such investments may however remain unknown because few LMICs have vital registration systems that allow measuring mortality precisely. Despite current efforts to improve such systems, household-based surveys (e.g., the Demographic and Health Surveys, DHS) will remain the primary data source on adolescent an adult mortality in LMICs. These surveys entail asking a random sample of respondents to report their siblings' survival history (SSH), i.e., whether each of their siblings 1) is alive, 2) how old s/he is, and 3) if deceased, how old s/he was at the time of death and the time since death. SSH permit directly estimating mortality rates at ages 15 and older, and also include basic assessments of the causes of siblings' deaths. They are however still affected by pervasive reporting errors. For example, respondents may omit some deaths, whereas other deaths may be added, or displaced in time. The net effects of these reporting errors on mortality indicators are large and hard to predict, but existing analytical corrections are based on very limited validation studies and do not capture this complexity. They risk accentuating bias and/or misrepresenting uncertainty in mortality estimates. In this project, we propose to improve the accuracy of survey-based estimates of adolescent and adult mortality through a) innovative data collection techniques (e.g., event history calendars, recall cues) and b) integrated Bayesian methods that account for sampling and non-sampling errors. Results from this study will help develop and target adolescent and adult health interventions in low and middle-income countries, and evaluate the effectiveness of global health initiatives.

随着儿童死亡率迅速下降，低收入和中等收入国家的所有死亡人数所占比例不断增加（中低收入国家）将在未来几十年内发生在青少年和成人阶段。即将到来的可持续发展联合国制定的发展目标（SDG）反映了这一转变：在未来15年（2015-2030），一些可持续发展目标的具体目标将侧重于减少主要影响这些年龄组的原因造成的死亡（例如，孕产妇死亡率、道路交通事故、自杀）。美国联邦对青少年和成人健康的投资因此，预计中低收入国家的机构、国际组织和政府将大幅增加。然而，此类投资对死亡率的影响可能仍然未知，因为很少有中低收入国家拥有至关重要的技术。允许精确测量死亡率的登记系统。尽管目前正在努力改进此类系统，以家庭为基础的调查（例如人口统计和健康调查，DHS）仍将是主要数据中低收入国家青少年和成人死亡率的来源。这些调查需要随机抽样询问受访者报告其兄弟姐妹的生存历史 (SSH)，即他们的每个兄弟姐妹是否 1) 还活着，2) 怎样他/她的年龄，以及 3) 如果已故，他/她死亡时的年龄以及死亡后的年龄。 SSH 许可直接估算 15 岁及以上的死亡率，还包括对死亡原因的基本评估兄弟姐妹的死亡。然而，他们仍然受到普遍存在的报告错误的影响。例如，受访者可能忽略一些死亡，而其他死亡可能会被添加或及时转移。这些报告的净影响死亡率指标的误差很大且难以预测，但现有的分析修正是基于非常有限的验证研究并没有捕捉到这种复杂性。他们可能会加剧偏见和/或歪曲死亡率估计的不确定性。在这个项目中，我们建议提高通过 a) 创新数据收集技术对青少年和成人死亡率进行基于调查的估计（例如，事件历史日历、回忆线索）和 b) 考虑采样和分析的综合贝叶斯方法非抽样误差。这项研究的结果将有助于发展和瞄准青少年和成人的健康低收入和中等收入国家的干预措施，并评估全球卫生举措的有效性。