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Global, regional and national levels and trends of preterm birth rates for 1990 to 2014: protocol for development of World Health Organization estimates.
Reproductive Health. 2016 Jun 17; 13(1):76.BACKGROUND: The official WHO estimates of preterm birth are an essential global resource for assessing the burden of preterm birth and developing public health programmes and policies. This protocol describes the methods that will be used to identify, critically appraise and analyse all eligible preterm birth data, in order to develop global, regional and national level estimates of levels and trends in preterm birth rates for the period 1990 - 2014. METHODS: We will conduct a systematic review of civil registration and vital statistics (CRVS) data on preterm birth for all WHO Member States, via national Ministries of Health and Statistics Offices. For Member States with absent, limited or lower-quality CRVS data, a systematic review of surveys and/or research studies will be conducted. Modelling will be used to develop country, regional and global rates for 2014, with time trends for Member States where sufficient data are available. Member States will be invited to review the methodology and provide additional eligible data via a country consultation before final estimates are developed and disseminated. DISCUSSION: This research will be used to generate estimates on the burden of preterm birth globally for 1990 to 2014. We invite feedback on the methodology described, and call on the public health community to submit pertinent data for consideration. TRIAL REGISTRATION: Registered at PROSPERO CRD42015027439 CONTACT: firstname.lastname@example.org.
Trends in maternal mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.
Geneva, Switzerland, World Health Organization, 2015. 100 p.In 2000, the United Nations (UN) Member States pledged to work towards a series of Millennium Development Goals (MDGs), including the target of a three-quarters reduction in the 1990 maternal mortality ratio (MMR; maternal deaths per 100 000 live births), to be achieved by 2015. This target (MDG 5A) and that of achieving universal access to reproductive health (MDG 5B) together formed the two targets for MDG 5: Improve maternal health. In the five years counting down to the conclusion of the MDGs, a number of initiatives were established to galvanize efforts towards reducing maternal mortality. These included the UN Secretary-General’s Global Strategy for Women’s and Children’s Health, which mobilized efforts towards achieving MDG 4 (Improve child health) as well as MDG 5, and the high-level Commission on Information and Accountability (COIA), which promoted “global reporting, oversight, and accountability on women’s and children’s health”. Now, building on the momentum generated by MDG 5, the Sustainable Development Goals (SDGs) establish a transformative new agenda for maternal health towards ending preventable maternal mortality; target 3.1 of SDG 3 is to reduce the global MMR to less than 70 per 100 000 live births by 2030.
Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group.
Lancet. 2016 Jan 30; 387(10017):462-74.BACKGROUND: Millennium Development Goal 5 calls for a 75% reduction in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed projections to show the requirements for the Sustainable Development Goal (SDG) of less than 70 maternal deaths per 100,000 livebirths globally by 2030. METHODS: We updated the UN Maternal Mortality Estimation Inter-Agency Group (MMEIG) database with more than 200 additional records (vital statistics from civil registration systems, surveys, studies, or reports). We generated estimates of maternal mortality and related indicators with 80% uncertainty intervals (UIs) using a Bayesian model. The model combines the rate of change implied by a multilevel regression model with a time-series model to capture data-driven changes in country-specific MMRs, and includes a data model to adjust for systematic and random errors associated with different data sources. RESULTS: We had data for 171 of 183 countries. The global MMR fell from 385 deaths per 100,000 livebirths (80% UI 359-427) in 1990, to 216 (207-249) in 2015, corresponding to a relative decline of 43.9% (34.0-48.7), with 303,000 (291,000-349,000) maternal deaths worldwide in 2015. Regional progress in reducing the MMR since 1990 ranged from an annual rate of reduction of 1.8% (0.0-3.1) in the Caribbean to 5.0% (4.0-6.0) in eastern Asia. Regional MMRs for 2015 ranged from 12 deaths per 100,000 livebirths (11-14) for high-income regions to 546 (511-652) for sub-Saharan Africa. Accelerated progress will be needed to achieve the SDG goal; countries will need to reduce their MMRs at an annual rate of reduction of at least 7.5%. INTERPRETATION: Despite global progress in reducing maternal mortality, immediate action is needed to meet the ambitious SDG 2030 target, and ultimately eliminate preventable maternal mortality. Although the rates of reduction that are needed to achieve country-specific SDG targets are ambitious for most high mortality countries, countries that made a concerted effort to reduce maternal mortality between 2000 and 2010 provide inspiration and guidance on how to accomplish the acceleration necessary to substantially reduce preventable maternal deaths. FUNDING: National University of Singapore, National Institute of Child Health and Human Development, USAID, and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. Copyright (c) 2016 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.
Washington, D.C., Population Reference Bureau [PRB], 2016 Mar.  p.The "last missing piece" to complete the architecture of the 2030 sustainable development agenda is to adopt a comprehensive framework of progress indicators to guide countries’ efforts to reach the Goals by 2030. This article explains the challenges of collecting the indicator data.
[Washington, D,.C.], World Bank, 2015 Jun.  p.The Roadmap articulates a shared strategic approach to support effective measurement and accountability systems for a country’s health programs. The Roadmap outlines smart investments that countries can adopt to strengthen basic measurement systems and to align partners and donors around common priorities. It offers a platform for development partners, technical experts, implementers, civil society organizations, and decision makers to work together for health measurement in the post-2015 era. Using inputs and technical papers developed by experts from international and national institutions, the Roadmap was completed following a public consultation that received extensive contributions from a wide number of agencies and individuals from across the globe. (Excerpt)
Geneva, Switzerland, WHO, 2012.  p.The World Health Statistics series is WHO’s annual compilation of health-related data for its 194 Member States and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. This year, it also includes highlight summaries on the topics of noncommunicable diseases, universal health coverage and civil registration coverage.
PLOS Medicine. 2012 Aug; 9(8):e1001303.Monitoring development indicators has become a central interest of international agencies and countries for tracking progress towards the Millennium Development Goals. In this review, which also provides an introduction to a collection of articles, we describe the methodology used by the United Nations Inter-agency Group for Child Mortality Estimation to track country-specific changes in the key indicator for Millennium Development Goal 4 (MDG 4), the decline of the underfive mortality rate (the probability of dying between birth and age five, also denoted in the literature as U5MR and 5q0). We review how relevant data from civil registration, sample registration, population censuses, and household surveys are compiled and assessed for United Nations member states, and how time series regression models are fitted to all points of acceptable quality to establish the trends in U5MR from which infant and neonatal mortality rates are generally derived. The application of this methodology indicates that, between 1990 and 2010, the global U5MR fell from 88 to 57 deaths per 1,000 live births, and the annual number of under-five deaths fell from 12.0 to 7.6 million. Although the annual rate of reduction in the U5MR accelerated from 1.9% for the period 1990-2000 to 2.5% for the period 2000-2010, it remains well below the 4.4% annual rate of reduction required to achieve the MDG 4 goal of a two-thirds reduction in U5MR from its 1990 value by 2015. Thus, despite progress in reducing child mortality worldwide, and an encouraging increase in the pace of decline over the last two decades, MDG 4 will not be met without greatly increasing efforts to reduce child deaths.
Geneva, Switzerland, WHO, 2012.  p. (WHO/IER/HSI/12.1)WHO’s annual compilation of health-related data for its 194 Member States includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. This year, it also includes highlight summaries on the topics of noncommunicable diseases, universal health coverage and civil registration coverage.
Trends in maternal mortality: 1990 to 2008. Estimates developed by WHO, UNICEF, UNFPA and The World Bank.
Geneva, Switzerland, World Health Organization [WHO], 2010.  p.This report presents the global, regional, and country estimates of maternal mortality in 2008, and the findings of the assessment of trends of maternal mortality levels since 1990. It summarizes the challenges involved in measuring maternal mortality and the main approaches to measurement, and explains the methodology of the 2008 maternal mortality estimates. The final section discusses the use and limitations of the estimates, with an emphasis on the importance of improved data quality for estimating maternal mortality. The appendices present the sources of data for the country estimates as well as MMR estimates for the different regional groupings for WHO, UNICEF, UNFPA, The World Bank, and UNPD. (Excerpt)
Lancet. 2007 Nov 24; 370(9601):1744-1746.The four papers in this Series called Who Counts? describe the state of the world's vital statistics, and the fact that few countries derive these from routine compulsory measures through civil registration. However, every country in the world has the capacity to produce useful economic data. Because of its particular interest in, and requirements for, demographic and epidemiological data, the health sector should raise similar expectations of national capacity to produce vital statistics. Unrepresentative, biased, incomplete, and often out-of-date, the world's vital statistics compare poorly with the detailed information available on every country's economy. The effort and expense of gathering and interpreting data on national income and trade balances are accepted costs of monitoring economic prospects in an international market. Health is arguably as important as economics, and establishing their mutual interdependence has made a big difference to the funding and attention that health attracts.Sen proposes mortality as an indicator of economic success or failure, but many countries are still making patchy and incomplete efforts to count lives and deaths, and to document how their people die. (excerpt)
Lancet. 2007 Nov 10; 370(9599):1653-1663.Vital statistics generated through civil registration systems are the major source of continuous monitoring of births and deaths over time. The usefulness of vital statistics depends on their quality. In the second paper in this Series we propose a comprehensive and practical framework for assessment of the quality of vital statistics. With use of routine reports to the UN and cause-of-death data reported to WHO, we review the present situation and past trends of vital statistics in the world and note little improvement in worldwide availability of general vital statistics or cause-of-death statistics. Only a few developing countries have been able to improve their civil registration and vital statistics systems in the past 50 years. International efforts to improve comparability of vital statistics seem to be effective, and there is reasonable progress in collection and publication of data. However, worldwide efforts to improve data have been limited to sporadic and short-term measures. We conclude that countries and developmental partners have not recognised that civil registration systems are a priority. (author's)
Lancet. 2007 Oct 20; 370(9596):1413.Christopher Murray and colleagues publish the results of an analysis of under-5 mortality data. They note several issues they believe limit the quality and usefulness of evidence on child mortality estimates produced by the Inter-agency Child Mortality Estimation Group (IACMEG), which includes WHO, UNICEF, the World Bank, the UN Population Division, Harvard University, the US Bureau of the Census, and others. Developing the best possible method is important, and we repeat the invitation previously extended to Murray to join the Inter-agency group. However, we wish to note that many of the issues raised have already been recognised by the IACMEG and incorporated into its work plan. Additionally, we take issue with several of the technical arguments and conclusions of the article. First, UNICEF and members of the IACMEG have recognised the issue of the completeness of databases and significant work has already been completed in the development of a new and updated database, which will go live in thecoming months. This public-access database will allow ready access to the IACMEG child mortality estimates, in addition to information on how they are calculated and the data sources used. (excerpt)
Lancet. 2006 Jan 21; 367(9506):190-193.After decades of debate about the need to improve the quality of basic health statistics in developing countries, there is at last substantial progress on the horizon. The recently created Health Metrics Network and the Ellison Institute for World Health offer the potential for strengthened health information systems to inform better policy development. Both initiatives are backed by new funding. Both will lead to new secretariats and partnerships between academics, governments, and intergovernmental agencies. That is the promise. The magnitude of the need has been well documented. Many countries are still unable to count their dead, let alone produce accurate statistics for cause of death or disease. Most countries do not have the capacity to regularly assess the performance of their health systems and few use reliable information for decision-making. In recent years, some progress has been made in addressing the need for improved global and regional health data. For specific diseases, such as HIV, a solid empirical database has been established. (excerpt)
Health Policy. 2005 Sep; 73(3):339-351.This article argues that the health-related Millennium Development Goals do not appropriately address the challenges faced by the countries of Eastern Europe and Central Asia. By ignoring adult mortality, their achievement would result in relatively small gains in life expectancy. To achieve greater impact, policies in this region must supplement the classical Millennium Development Goals with indicators of adult health, in particular cardiovascular diseases and external causes of death. In addition, countries, with support from the international community, must improve the quality of vital registration data to enable more accurate estimation of the disease burden. (author's)
Lancet. 2004 Jan 3; 363:67-68.The UN Millennium Declaration has eight goals and 18 targets, including the reduction of maternal mortality by three-quarters by 2015. While this target helps to raise the profile of pregnancy-related deaths, it also has some drawbacks. One of these relates to the distinction between maternal health and maternal death; averting deaths will not alone reduce the burden of suffering caused by pregnancy-related complications, for women, their families, and their communities. Progress judged only in terms of maternal mortality will mask this fact and even distort programme priorities. But a further drawback to the target is that it assumes maternal mortality is indeed measured. Herein lies a problem for the Millennium Declaration and indeed for the many international charters linking human rights to health that presume the availability of outcome indicators for monitoring progress. Here we seek to argue the case of women who are not even statistics—for their right to count. 100 years ago, the case report in the panel might have come from the UK; today it is typical of the estimated half-a-million maternal deaths that occur every year in the developing world. But this figure—like many global indicators of public health—is really just a guess, and most national estimates are not much better. Under-reporting of maternal deaths ranges from 17% to 63% in the routine statistical systems of several developed countries. Similarly, the most recent enquiry into maternal deaths in the UK noted that 19% of direct deaths were initially missed. Addressing the difficulty of counting maternal deaths is, however, a very different prospect in these settings than in the world’s poorest countries. (excerpt)
Feasibility study on accelerating the improvement of civil registration and vital statistics systems of the Philippines.
New York, New York, United Nations, 1995. vii, 119,  p. (ST/ESA/STAT/110)This evaluation of the Philippines Vital Statistics and Civil Registration system was conducted by the International Institute for Vital Registration and Statistics. The aim is to ascertain whether system improvements are feasible. It is concluded that substantial financial assistance and external cooperation with the Filipino government will be required. The report is presented in three parts: 1) an analysis of the legal, administrative, and technical constraints on the civil registration and vital statistics systems; 2) nationwide strategies for improving quality and reliability; and 3) concrete recommendations for reforming the system within five years. Constraints to registration are identified. Filipinos perceive that the system pertains to Christians only. The central filing office is inaccessible from rural barangays. Ethnic minorities have different customs (naming, polygamy, divorce, burial) that do not fit the system. Civil registration is not an immediate requirement for living one's life. Births are not always registered under the name of the natural mother. Births should be registered by place of occurrence, but migrants may delay registration or register twice. There are civil and religious marriages and sometimes double registration. Civil registers are sometimes left with incomplete information or lost. It is recommended that government responsibilities for registration management be defined, all local chief executives be instructed in legal procedures for registration, and assessments be made of over and under staffing patterns. Incentives, taxpayer reporting requirements, and work registration were other suggestions. Long term solutions include the establishment of a National Civil Registration Office and the inclusion of minority reporting. Recommendations, which were made in the five year agenda (1992-96), were implemented in part during 1992-93.
New York, New York, United Nations. Department for Economic and Social Information and Policy Analysis. Statistical Division, 1995. x, 1,032 p. (No. ST/ESA/STAT/SER.R/24)This is a comprehensive collection of international demographic statistics published annually by the United Nations. "The tables in this issue of the Yearbook are presented in two parts, the basic tables followed by the tables devoted to population censuses, the special topic in this issue. The first part contains tables giving a world summary of basic demographic statistics, followed by tables presenting statistics on the size, distribution and trends in population, natality, foetal mortality, infant and maternal mortality, general mortality, nuptiality and divorce. In the second part, this issue of the Yearbook serves to update the census information featured in the 1988 issue. Census data on demographic and social characteristics include population by single years of age and sex, national and/or ethnic composition, language and religion. Tables showing data on geographical characteristics include information on major civil divisions and localities by size-class. Educational characteristics include population data on literacy, educational attainment and school attendance. In many of the tables, data are shown by urban/rural residence."
New York, New York, United Nations, Dept. for Economic and Social Information and Policy Analysis, 1995 Jan. , 19 p. (Statistical Papers Series A Vol. XLVII, No. 1; ST/ESA/STAT/SER.A/192)This paper presents 1993 and 1994 estimates of world and continental population size, as well as corresponding 1993 estimates for 234 countries and areas of the world listed separately in the report. Also shown for each country or area are the results of the latest nationwide census of population, the most recent official estimate of population, and, when available, nationally representative statistics of live births, deaths, and deaths to individuals younger than one year old for the most recent year available. Sample survey data are presented in cases where nationwide population censuses have never been conducted. It is noted that this issue of the Population and Vital Statistics Report supersedes all previous issues, with the data currently presented subject to future revision. Interested readers may find more detailed data and data relating to years not shown in the report in the Demographic Yearbook. Countries and areas are arranged in alphabetical order within continents.
New York, New York, United Nations, 1992. viii, 400 p. (ST/ESA/SER.A/128)Available child mortality data are provided since the 1960s for 82 developing countries, arranged alphabetically, with a population of >1 million. The scope and methodology of the data, the main findings, a guide to the notation and layout of the database, and country specific profiles are included. Available data are included from many different sources without adjustment; graphs are provided. There is a brief discussion of the nature of child mortality and the methods used to measure it such as the crude death rate, age specific death rates, the infant mortality rate, <5 mortality, mortality 1-5 years, and model life tables for age specific child mortality. There is also discussion of the various data sources and estimation methods: vital registration data, prospective surveys, household surveys, prospective sample surveys, surveillance systems, retrospective questions in censuses and surveys, questions on recent household deaths by age, Brass method questions to whom on aggregate number of children born or dead, questions on women's most recent birth and survival, and maternity histories. Commentary is provided on the common index approach and the intersurvey change approach to evaluation of child mortality estimates. There is not 1 best method for measuring mortality. Countries with the most complete reporting of vital registration data are Hong Kong, Israel, Mauritius, Puerto Rico, and Singapore. Countries with incomplete data which does not provide a good measure of child mortality are Egypt, El Salvador, Guatemala, Jamaica, and Trinidad and Tobago. Brass estimates which agree with vital registration data include the following countries: Costa Rica, Cuba, Kuwait, and Peninsular Malaysia. Indirect estimates which confirm vital registration data pertain to Chile and Uruguay. Brass questions provide satisfactory results in Costa Rica, Cuba, Egypt, El Salvador, Guatemala, Jamaica, Sri Lanka, and Trinidad and Tobago. Underestimates are expected for Argentina and Egypt. Indirect methods applied to census data provide good estimates for 23 countries, indirect methods applied to survey data yields good estimates for 21 countries, and direct calculations from maternity histories provide good estimates for 20 countries. 17 countries have poor results from maternity histories alone. Child mortality may have fallen by >50% in developing countries between 1960-85.
In: Improving civil registration, edited by Forrest E. Linder and Iwao M. Moriyama. Bethesda, Maryland, International Institute for Vital Registration and Statistics, . 235-42.Because agencies responsible for vital statistics collection vary substantially among nations, the International Conference for the 6th Decennial Revision of the Inernational Lists of Disease and Causes of Death (Paris, 1948) recommended that all governments establish National Committees on Vital and Health Statistics. To promote international cooperation the conference suggested that: 1) the World Health Assembly establish an Experts Committee on Health Statistics and 2) governments establish national committees for statistical activities coordination to serve as links with the World Health Organization. The 1st International Conference of National Committees on Vital and Health Statistics (London, 1953), with 28 nations attending, introduced 8 objectives to define needs and stimulate statistical studies and encouraged governments that had not yet set up national committees to establish them. 59 countries participated in the 2nd International Conference (Copenhagen, 1973) to evaluate objectives and emphasize the need for national committees in developing countries. This study briefly discusses recent developments and changes within national committees for the African, American, Eastern Mediterranean, European, Southeast Asian, and Western Pacific Regions. Usefulness and productivity of national committees depend on: 1) strong commitment by civil registration, national vital statistics, and national health programs administrators, 2) clear understandings of the National Committee's objectives and limitations, 3) careful selection of Committee members, and 4) the administrative ability of the chairman. National committees have demonstrated their potential for improving statistics collection and usage; each country must find the most effective organization and operation for success.
New York, New York, United Nations, 2001. 19 p. (Statistical Papers Series A Vol. LIII, No. 2; ST/ESA/STAT/SER.A/217)This issue of the "Population and Vital Statistics Report" presents 1999 and 2000 estimates of world and continental population, as well as corresponding 1999 estimates for 229 countries or areas of the world. It shows the results of the existing nationwide census of population (total, male, and female) for each country or area, and nationally representative statistics of live births, deaths, and infant deaths (deaths under 1 year of age) for the most recent year available. Countries or areas are arranged in alphabetical order within continents. The estimates, prepared by the Population Division of the UN Secretariat, are published in World Prospects 1998. The aggregates do not coincide exactly with the sum of the figures for individual countries or areas because they include adjustments for overenumeration and underenumeration, or overestimation and underestimation, and data for categories of population not regularly included in the official figures.
New York, New York, United Nations, 2000 Jul. 19 p. (Statistical Papers Series A Vol. LII, No. 3; ST/ESA/STAT/SER.A/214)This issue of the Population and Vital Statistics Report presents the 1999 and 2000 estimates of the global and continental population, as well as the corresponding 1999 estimates for 229 countries or areas around the world, which are listed separately in the Report. Also shown for each country or area are results of the latest nationwide census of population and, wherever possible, nationally representative statistics of live births, deaths and infant deaths (death under 1 year of age) for the most recent year available. If a nationwide population census has never been taken, but a sample survey has, the survey results are shown in the "Latest population census" column until census data become available. Countries or areas are arranged in alphabetical order within continents.
[Addis Ababa, Ethiopia], United Nations, Economic Commission for Africa, 1994 Dec. xvii, 77 p.This report provides socioeconomic statistical data for 53 African countries including totals by region, on vital statistics, demographic and socioeconomic indicators, and land use and food production. The data pertain to 1990 and 1993 on a regular basis and occasionally other decennial or quinquennial periods back to 1970. Demographic and social indicators include mid year population, female population, age and sex ratio, annual growth rates of total and urban population, age dependency ratio, total fertility and reproduction rates, crude birth and death rates, economic dependency ratio, economic activity by sex and sector, activity rates, survival indicators, infant mortality rate, health care indicators, access to social and health facilities, illiteracy, and school enrollment by level. Economic indicators include gross domestic product (GDP) by activity and expenditure; annual growth rates of GDP; land use and per capita land use; production of agriculture and forestry; agricultural products by broad groups; index number of food production; production and consumption of fertilizers; mineral sector production; value added in manufacturing; consumption of electricity; crude petroleum production; trade of solid fuels; imports and exports by structure, commodity group, and annual growth rates; balance of trade; share of value of world exports and imports; balance of payments; external debt; central government tax revenue; consumer price index; length of asphalt roads; motor vehicles; and shipping and air traffic.
New York, New York, United Nations, Dept. of Economic and Social Affairs, Statistics Division, 1998 Jul. , 19 p. (Statistical Papers Series A, Vol. L, No. 3; ST/ESA/STAT/SER.A/206)This statistical compendium provides the most recent (1989-97) data on population, births, deaths, and infant deaths for each of 229 countries in the world. Data are included that were available as of July 1, 1998. Statistics are provided by region and then alphabetically by country. Regional totals are not provided. Population data pertain to the most recent census figures by gender and mid-year estimates for mid-1997. Birth, death, and infant death data are given by number and rate as available and estimated rate.
In: Multilateral treaties, index and current status, Ninth Cumulative Supplement, compiled by M.J. Bowman and D.J. Harris. Nottingham, England, University of Nottingham Treaty Centre, 1992. 170.On 6 June 1991 Mongolia became a party to the Convention on Consent to Marriage, Minimum Age for Marriages and Registration of Marriages. The Convention reaffirms the consensual nature of marriages and requires the parties to establish a minimum age by law and to ensure the registration of marriages. On 14 October 1991, Saint Lucia succeeded to the Convention on the Nationality of Married Women. See Multilateral Treaties, Index and Current Status, p. 155. This Convention provides for the retention of nationality by women upon marriage or dissolution of marriage or when their husband changes his nationality. It also contains provisions on the naturalization of foreign wives.