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Mortality and attrition processes in longitudinal studies in Africa: an appraisal of the IFORD surveys.
POPULATION STUDIES. 1992 Jul; 46(2):327-48.The Institute for Demographic Training and Research (Institute de Formation et de Recherche Demographiques--IFORD) is a UN institution in Yaounde, Cameroon, which has been conducting longitudinal surveys since 1978 in urban areas of Africa to determine levels and characteristics of infant and child mortality. Longitudinal studies, however, lose original participants through attrition. Some critics assert that failing to adjust for this participant dropout may seriously bias study results. This study examines dropout characteristics to assess the degree of validity IFORD surveys hold as alternatives to indirect measurement technics. Employing 1978-81 IFORD survey data, relationships are explored between the initial characteristics of children in maternity units and different statuses of children identified by the IFORD surveys. Study results show no evidence that mortality or observed mortality differentials are biased by attrition. No relation was found between mortality and attrition in the survey, thereby suggesting that dropouts would have mortality experiences similar to those who remained in the study. Ignoring attrition, IFORD surveys may be used instead of indirect techniques to find levels and determinants of mortality in countries where registration systems and vital statistics are inaccurate. There is no need for such countries to wait for censuses or large-scale surveys to begin looking at infant mortality patterns. Specifically for Cameroon, the study revealed substantial mortality differentials by birth weight, ethnicity, place of delivery, and area of residence.
In: Infant and childhood mortality and socio-economic factors in Africa. (Analysis of national World Fertility Survey data) / Mortalite infantile et juvenile et facteurs socio-economiques en Afrique. (Analyse des donnees nationales de l'Enquete Mondiale sur la Fecondite), [compiled by] United Nations. Economic Commission for Africa [ECA]. Addis Ababa, Ethiopia, United Nations, ECA, 1987. 7-26. (RAF/84/P07)Technical problems and methods associated with the analysis of differential child mortality data for a conference of representatives from 8 African countries, sponsored by the UN Economic Commission for Africa and the International Statistical Institute are described. The data being interpreted were from the World Fertility Surveys, conducted between 1977 and 1981, including complete birth histories of women up to 50 years of age. A core questionnaire contained 7 sections on woman's background, maternity history, contraceptive knowledge and marriage history, fertility regulation, work history and husband's background. Mortality was measured by Brass methods and the cohort approach with analysis of determining factors. No adjustment was made for omission of births and of dead children: since underreporting is more likely to occur in the past, current mortality estimates can be considered fairly accurate. Methods of correcting for misreporting are described. The extent of potential bias due to lack of data on children whose mothers were deceased at the time of survey is unknown. Another source of bias is truncation due to loss of data on older children born to older women. Generally the quality of the World Fertility Survey mortality data is reasonably good, compared to other studies.