The absence of adult mortality data for sub-Saharan Africa: a practical solution.

In the absence of accurate and comprehensive registries of vital events for the majority of the region's inhabitants, longitudinal studies of defined population-based cohorts represent the only realistic strategy to fill this void in basic public health information. [...] There are clear policy applications many cases the total absence, of national vital regis- for demographic and vital statistics in the structuring tration in some developing countries has made it of public health interventions and health systems, necessary to seek other sources of information on which makes the absence of such data all the more adult mortality. [...] Also, the able to visit hospitals or clinics, community-based assumptions and empirical foundations of such mod- surveys remain the only means of gathering data els are rarely stated, and the choice of parameters suitable for determining the rate and causes of adult can lead to very large differences in the final esti- mortality. [...] NIDDM prevalences in Africa for purposes of mak- Although there are other examples of longitudi- ing international comparisons, examination of the nal studies and surveillance systems at the com- sources reveals that the levels for the continent as a munity level in sub-Saharan Africa, the general whole are based on hospital surveys or on single situation is much the same as with the six studies p [...] Third, since the essential data The use of verbal autopsies to collect reliable are responses to questions by members of a cohort, adult mortality data at the community level assumes the community must cooperate with the survey pro- that it is possible to classify deaths into useful catego- cedures and be sufficiently stable to provide long- ries based on the results of retrospective interviews.