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  • Title: [Estimating child mortality using the previous child technique, with data from health centers and household surveys: methodological aspects].
    Author: Aguirre A, Hill AG.
    Journal: Notas Poblacion; 1988; 16(46-47):9-39. PubMed ID: 12282542.
    Abstract:
    2 trials of the previous child or preceding birth technique in Bamako, Mali, and Lima, Peru, gave very promising results for measurement of infant and early child mortality using data on survivorship of the 2 most recent births. In the Peruvian study, another technique was tested in which each woman was asked about her last 3 births. The preceding birth technique described by Brass and Macrae has rapidly been adopted as a simple means of estimating recent trends in early childhood mortality. The questions formulated and the analysis of results are direct when the mothers are visited at the time of birth or soon after. Several technical aspects of the method believed to introduce unforeseen biases have now been studied and found to be relatively unimportant. But the problems arising when the data come from a nonrepresentative fraction of the total fertile-aged population have not been resolved. The analysis based on data from 5 maternity centers including 1 hospital in Bamako, Mali, indicated some practical problems and the information obtained showed the kinds of subtle biases that can result from the effects of selection. The study in Lima tested 2 abbreviated methods for obtaining recent early childhood mortality estimates in countries with deficient vital registration. The basic idea was that a few simple questions added to household surveys on immunization or diarrheal disease control for example could produce improved child mortality estimates. The mortality estimates in Peru were based on 2 distinct sources of information in the questionnaire. All women were asked their total number of live born children and the number still alive at the time of the interview. The proportion of deaths was converted into a measure of child survival using a life table. Then each woman was asked for a brief history of the 3 most recent live births. Dates of birth and death were noted in month and year of occurrence. The interviews took only slightly longer than the basic survey of coverage for the expanded program of immunization to which the questions were added. Information from the trial clarified some important problems that should be taken into account in future surveys to measure recent early mortality trends in countries with incomplete registration. Collection of data on early childhood mortality in brief household interviews has been proven feasible . All women able to bear children should be interviewed if possible. The minimum questions on child mortality include the Brass questions on live born and surviving children and dates of birth and death of the 2 most recent births. The data should be analyzed based on each birth rather than each women. Use of the previous child method applied to regularly collected data offers a potentially rewarding method of discovering recent mortality trends.
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