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Illustrative Analysis: Infant and {~ ild Mortality in Colombia JORGE L. SOMOZA

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NUMBER 10, MAY 1980 JORGE L. SOMOZA llustrative Analysis: nfant and {~ ild Mortality in Colombia Nl ['.RNATJONA L ST AT ST CAL NST!Tl TE 1'L mrn11ent Office. Director: E_ Lunenberg 428 Pri11Scs lkalrixlua11
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NUMBER 10, MAY 1980 JORGE L. SOMOZA llustrative Analysis: nfant and {~ ild Mortality in Colombia Nl ['.RNATJONA L ST AT ST CAL NST!Tl TE 1'L mrn11ent Office. Director: E_ Lunenberg 428 Pri11Scs lkalrixlua11 Vu11rb1n!'., T'he 1 lngue Net hcrla11ds WOl .UJ FEPTLl!'Y Sl'RVL:Y l'rojcc\ Oircctor: Sir Mauricl' K.e11d.dl, Sc. D.. F.13.A. b 3 7 Grnsvcuo1 Cardc11s Lundnn SWWOBS, U.K. The World Fertility Survey is an international research programme whose purpose is to assess the current state of human fertility throughout the world. This is being done principally through promoting and supporting nationally representative, internationally comparable, and scientifically designed and conducted sample surveys of fertility behaviour in as many countries as possible. The WFS is being undertaken, with the collaboration of the United Nations, by the nternational Statistical nstitute in cooperation with the nternational Union for the Scientific Study of Population. Financial support is provided principally by the United Nations Fund for Population Activities and the United States Agency for nternational Development. This publication is part of the WFS Publications Programme which includes the WFS Basic Documentation, Occasional Papers and auxiliary publications. For further information on the WFS, write to the nformation Office, nternational Statistical nstitute, 428 Prinses Beatrixlaan, Voorburg, The Hague, Netherlands. L'Enquete Mondiale sur la Fecondite (EMF) est un programme international de recherche dont le but est d'evaluer l'etat actuel de la fecondite humaine dans le monde. Afin d'atteindre cet objectif, des enquetes par sondage sur la recondite sont mises en oeuvre et financees dans le plus grand nombre de pays possible, Ces etudes, elaborees et realisees de fai;on scientifique, fournissent des donnees representatives au niveau national et comparables au niveau international. L'lnstitut nternational de Statistique avec l'appui des Nations Unies, a ete charge de la realisation de ce projet en collaboration avec l'union nternationale pour l'etude Scientifique de la Population. Le financement est principalement assure par le Fonds des Nations Unies pour Jes Activites en matiere de Population et l'agence pour le Developpement nternational des Etats-Unis. Cette publication fait partie du programme de publications de!'emf, qui comprend la Documentation de base, Jes Documents Non-Periodiques et des publications auxiliaires. Pour tout renseignement complementaire, s'adresser au Bureau d'nformation, lnstitut nternational de Statistique, 428 Prinses Beatrixlaan, Voorburg, La Haye, Pays-Bas. La Encuesta Mundial de Fecundidad (EMF) es un programa internacional de investigaci6n cuyo prop6sito es determinar el estado actual de la fecundidad humana en el mundo. Para lograr este objetivo, se est{m promoviendo y financiando encuestas de fecundidad por muestreo en el mayor numero posible de paises. Estas encuestas son disefiadas y realizadas cientificamente, nacionalmente representativas y comparables a nivel internacional. El proyecto esta a cargo de! nstituto nternacional de Estadistica en cooperaci6n con la Union nternacional para el Estudio Cientifico de la Poblaci6n y con la colaboraci6n de las Naciones Unidas. Es financiado principalmente por el Fondo de las Naciones Unidas para Actividades de Poblaci6n y por la Agenda para el Desarrollo nternacional de los Estados Unidos. Esta publicaci6n ha sido editada por el Programa de Publicaciones de la EMF, el que incluye Documentaci6n Basica, Publicaciones Ocasionales y publicaciones auxiliares. Puede obtenerse mayor informaci6n sobre la EMF escribiendo a la Oficina de nformaci6n, nstituto nternacional de Estadistica, 428 Prinses Beatrixlaan, Voorburg-La Haya, Paises Bajos. cientific ep rts llustrative Analysis: nfant and Child Mortality in Colombia JORGE L. SOMOZA Centro Latino Americano de Demografia Contents PREFACE ACKNOWLEDGEMENTS 1. NTRODUCTON REMARKS ON THE DATA AND METHODOLOGY The Data The Methods EVALUATON OF THE QUALTY OF THEDATA The Age Pattern of Mortality is Plausible nfant Mortality ncreases with Age of Mother at Time of the Survey nfant Mortality is Higher Among the Children of Women with Lower Education as Compared with Those of Women with Higher Education, within Age Groups of Women nfant Mortality Varies with Age of the Mother at the Time of Birth of the Child, as it is Known to Occur in Populations for Which Reliable Data Are Available Mortality Declines Over Time The Sex Ratio at Birth is Normal nfant Mortality is Higher for Males than for Females The Age Distribution of the Sample of Women is Acceptable DRECT ESTMATES OF MORTALTY Mortality Between Ages 0 and 10 by Birth Cohorts nfant Mortality by 5-Year Cohorts nfant Mortality by Age of Mother at the Time of Birth of the Child nfant Mortality by Birth Order nfant Mortality by Birth Order and Age of Mother at Time of Birth of the Child Mortality Between Birth and Age Two by 5-Year Calendar Periods Mortality by Sex Urban and Rural Mortality Child Mortality by Educational Level of Mother Mortality by Regions Summary NDRECT METHODS FOR ESTMATNG MORTALTY The Data The Methods The Brass Method The Feeney Method The Trussel Method CONCLUSONS 50 TABLES 3.1 The function l(x) for (a) The Colombian Survey; (b) the United States, Total of 'Other Races', ; and (c) Scotland, nfant Mortality by Mother's Age in Direct and ndirect Estimates Probability of Dying Before Age x (q(x)) for Children Born to Women Classified by Age and by Level of Education 12 3 nfant Mortality by Mother's Age at the Time of Birth of the Child nfant Mortality by 5-Year Calendar Periods Between and 1971 Sex Ratios at Birth nfant Mortality by Sex for Different Cohorts Age Distribution of the Female Population (a) Surveyed and (b) or Two Model Populations Life Table for Children from Between 1941 and 1959 Life Table for Children Born Between 1960 and 1967 Life Table for Children Born Between 1968 and 1976 Neonatal, Post-Neonatal and nfant Mortality by 5-Year Birth Cohorts, from to Mortality during the First Year of Life by Mother's Age at the Time of Birth of the Child Mortality during the First Year of Life by Birth Order nfant Mortality by Birth Order and by Age of Mother at Time of Birth of the Child Births and Deaths in the First Year of Life by Birth Order and by Age of Mother at the Time of Birth of the Child Mortality Between 0 and 2 Years by 5-Year Calendar Periods from to Mortality Between 0 and 2 Years by 5-Years Calendar Periods from to Restricted to Women Aged Under 35 at the Time of Birth of the Child Mortality by Birth Cohorts and by Sex Probability of Dying Between Ages 0 and 1 and Between 1 and 5 in Various Latin American Countries Mortality by Type of Place of Residence: Urban and Rural Mortality of Children by Mother's Level of Education Mortality by Region of Residence Number of Dead Children, Number of Births and Proportions of Children Dead, by Age of Mothers and by Region of Residence Women, Children Ever Born, Children Who Have Died, Average Number of Children Ever Born and the Proportion Who Have Died, by Age of Mother Mortality Estimates Obtained by Applying Brass's ndirect Method (Assuming an Annual 2 Per cent Decrease in Mortality) to nformation Collected in the ndividual Survey; Compared With Estimates Obtained Directly from Selected Two-Year Cohorts of Births Direct Mortality Estimation at Selected Ages for Two-Year Cohorts of Births Estimates of nfant Mortality Through the Years Obtained by Applying Feeney's Method to nformation Collected in the ndividual Survey Mortality Estimates Obtained by Direct Calculation and by Applying Trussell's Methods to nformation on Proportion of Children Dead (a) Assuming Constant Fertility and (b) Assuming Changing Fertility in the Last Five Years Trussell Regression Equations for Child Mortality Estimates (Family West, Coale Demeny Life Tables, Fertility Constant) Trussell Regression Equations for Child Mortality Estimates (Family West, Coale Demeny Life Tables, Changing Fertility), nter-survey nterval: 5 Years FGURES 3.1 Age Distribution of the Female Population Between Ages 15 and 50, Observed and from Two Models 4.1 Mortality Rate nmx Between 0 and 10 Years by Birth Cohorts 4.2 Mortality Rate q(x) Between 0 and 10 Years by Birth Cohorts 4.3 Neonatal, Post-Neonatal and nfant Mortality, to Birth Cohorts 4.4 Mortality Rate q(x) during the First Year of Life by Mother's Age at Time of Birth of the Child 4.5 Mortality Rate q(x) during the First Year of Life by Birth Order 4.6 nfant Mortality by Birth Order and by Age of Mother at Time of the Birth of the Child 4. 7 Mortality Rate q(x) Between 0 and 2 Years by Calendar Periods 4.8 Mortality Rate q(x) by Sex 4.9 Mortality Rate nmx by Sex 4.10 Mortality Rate nmx by Birth Cohorts and by Sex 4.11 Mortality Rate nmx by Type of Place of Residence 4.12 Mortality Rate nmx by Mother's Level of Education 4.13 Mortality Rate nmx by Region of Residence 5.1 Proportion of Children Dead by Age of Mother in Household and ndividual Surveys 5.2 Mortality Estimates - Brass's ndirect Method (2 Percent Annual Decrease) and Direct Calculations for Two-Year Cohorts 5.3 nfant Mortality through the Years. Feeney's ndirect Method and the Direct Calculation 5.4 Mortality Estimates by Direct Calculations and Trussell's Method Assuming (a) Constant Fertility and (b) Changing Fertility in the Last Five Years APPENDCES V CALCULATON OF LFE TABLES FROM DATA ON CHLDREN CLASSFED BY AGE AT THE TME OF THE SURVEY OR AGEATDEATH DRECT ESTMATON OF MORTALTY BY 5-YEAR CALENDAR PERODS LFE TABLES BY AGE OF MOTHER DATA USED FOR DRECT ESTMATON Preface One of the main concerns of the World Fertility Survey has been the analysis of the data collected by the participating countries. t was decided at the outset that, in order to obtain quickly some basic results on a comparable basis, each country would produce soon after the field work a 'First Country Report', consisting of a large number of cross-tabulations with a short accompanying text. Precise guidelines for the prepation of the tables were produced and made available to the participating countries. t was also recognised, however, that at later stages many countries would wish to study in greater depth some of the topics covered in their first reports, or indeed new but related subjects, using more refined analytic techniques. n order to assist the countries at this stage a general 'Strategy for the Analysis of WFS Data' was outlined, a series of 'Technical Bulletins' was started, dealing with specific methodological issues arising in the analysis, and a list of 'Selected Topics for Further Analysis of WFS Data' was prepared, to serve as a basis for selecting research topics and assigning priorities. t soon became evident that many of the participating countries would require assistance and more detailed guidelines for further analysis of their data. Acting upon a recommendation of its Programme Steering Committee, the WFS then launched the present series of 'llustrative Analyses' of selected topics. The main purpose of the series is to illustrate the application of certain demographic and statistical techniques in the analysis of WFS data, thereby encouraging other researchers and other countries to undertake similar work. n view of the potentially large number of research topics which could be undertaken, some selection was necessary. After consultation with the participating countries, 12 subjects which are believed to be of top priority and of considerable interest to the countries themselves were selected. The topics chosen for the series span the areas of fertility estimation, levels, trend and determinants, marital formation and dissolution, breastfeeding, sterilization, contraceptive use, fertility preferences, family structure, and infant and child mortality. t was envisaged that each study would include a brief literature review summarizing important developments in the subject studied, a clear statement of the substantive and methodological approach adopted in the analysis, and a detailed illustration of the application of such an approach to the data from one of the participating countries, but with emphasis on the general applicability of the analysis. These studies have been conducted in close collaboration with the country concerned, where possible with the active participation of national staff. t should perhaps be emphasised that the studies in the 'llustrative Analyses' series are meant to be didactic examples rather than prescriptive models of research, and should therefore not be viewed as cookbook recipes to be followed indiscriminately. n many cases the investigators have had to choose a particular course of action from several possible, sometimes equally sound, approaches. n some instances this choice has been made more difficult by the fact that demographers or statisticians disagree among themselves as to the approach most appropriate for a particular problem. n the present series we have, quite intentionally, resisted the temptation to enter the ongoing debates on all such issues. nstead, and in view of the urgency with which countries require guidelines for analysis, an attempt has been made to present what we believe to be a basically sound approach to each problem, spelling out clearly its drawbacks and limitations. n this difficult task the WFS has been aided by an ad hoc advisory committee established in consultation with the nternational Union for the Scientific Study of Population (USSP) and consisting of Ansley Coale (Chairman), Mercedes Concepcion, Gwendolyn Johnson-Ascadi and Henri Leridon, to whom we express our gratitude. Thanks are also due to the referees who have generously donated their time to review the manuscripts and to the consultants who have contributed to the series. Many members of the WFS staff made valuable contributions to this project, which was co-ordinated by V. C. Chidambaram and German Rodriguez. Sir Maurice Kendall WFS Project Director 5 Acknowledgements wish to express my appreciation to the several persons, particularly in the WFS central staff, who made comments on the first draft of this document. n particular, wish to thank Ken Hill, who made valuable suggestions to improve the manuscript, and German Rodriguez, who in addition contributed to the analysis of mortality by calendar periods controlling age of mother and had the difficult task of translating the manuscript into English. 7 1. ntroduction n this study we illustrate the application of direct and indirect methods for estimating infant and child mortality to data from the Colombian National Fertility Survey conducted in mid-1976 as part of the World Fertility Survey. The study has two objectives: (1) to show how the data collected in the World Fertility Survey may be used to estimate infant and child mortality; and (2) to produce such estimates for Colombia, a country which - like many other developing countries - lacks satisfactory information on mortality. This document is organised in six chapters, including this brief introduction. Chapter 2 provides some background material which will prepare the reader for subsequent chapters. t provides information on the data available, and points out some of their limitations - particularly regarding sample size - for a study of infant and child mortality. t also includes a discussion of the direct methods used to estimate infant and child mortality. t should be noted that the methods themselves are not original; what is unusual is their application to data from a country like Colombia, where the quality of the demographic data usually available does not permit applying direct methods. As we shall see, the data collected in the Colombian survey do not appear to be affected by serious errors. Chapter 3 deals with the plausibility of mortality estimates derived from the available data and, more generally, with the study of possible deficiencies in the data, specially regarding the omission of children who have died. Chapter 4 presents the results obtained using direct methods. t includes mortality estimates by 5-year periods, by cohorts of children born in a given period, and by age of mother, as well as estimates for several breakdowns of the population which lead to mortality differentials by sex, urban or rural residence, level of education of the mother, and regions within the country. Chapter 5 considers the estimation of mortality by applying indirect techniques to data on children ever born and children dead by age of mother (in 5-year groups) at the time of the interview. The Colombian survey included an individual interview, which collected directly from each woman a birth history, and a household survey, where the information on mortality is limited to children ever born and children dead. The results of both interviews are quite similar. The indirect estimates are compared with those obtained from the individual survey using direct methods. The document ends with a brief Chapter 6, where the more important conclusions of the study are noted. 9 20 Remarks on the Data and Methodology Before considering mortality estimates we shall describe briefly the data available from the survey and the analysis procedures to be utilised. 2.1 THEDATA The Colombian National Fertility Survey was conducted in 1976 jointly by the Corporaci6n Centro Regional de Poblaci6n (CCRP), a non-profit private institution devoted to research in population, and the Departamento Administrativo Nacional de Estadfstica (DANE), the state agency responsible for the collection, processing and. publication of statistical data, with the collaboration of the Division of nformation Systems of the Ministry of Health in the design and implementation of the sample. The mortality to be measured is that experienced by the children reported by the women interviewed. The following are some basic statistics from the individual survey: - The sample comprises 5378 women between the ages of 15 and 49; - of these women, 3225 reported having had at least one child. - The total number of children ever born to these women is 14432; - of these children, there are 17 for whom the survival status at the time of the interview is unknown; - thus, there are 14,415 children for whom the basic information required, survival status at the time of the survey (mid-1976), is known. - The total number of deaths among these children is 1830, classified by age at death in the following groups, with numbers indicated in parentheses: 1 - less than 1 month (560) 2 - between 1 and less than 3 months (151) 3 - between land less than 6 months (183) 4 - between 6 months and less than a year (255) 5 - between 1 and less than 2 years (286) 6 - between 2 and less than 5 years (254) 7 - between 5 and less than 10 years (89) 8-10 years or more (52) - The groupings cannot be altered because the information on date of death or exact age at death was not recorded (unlike date of birth, which is available). - Among the deaths there are 1149 to children less than a year old, and 629 to children aged between 1 and less than 10 years, making a total of 1778 deaths to children under 10 years of age. Thus, we may study the mortality experienced between. the ages of 0 and 10 years (a total of 1778 deaths), by 14,415 children observed from birth, with the degree of detail by age just noted. The number of cases seems appropriate for measuring mortality in the first 10 years of life for the whole sample. However, the number of cases may not be sufficient to establish reliable measures of mortality for subgroups of the sample. n dealing with subgroups throughout this study we have used coarser age groups as the number of cases was reduced, in order to control sampling errors. t is important to keep in mind the limitations imposed by the reduced number of cases in the analysis of data for subgroups. To emphasize this point we have generally indicated the number of cases
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