Registering Ebola Virus Disease (EVD) Both as a Multiple Cause of Death and as a Notifiable Disease in Africa: Comparison Between the Ideal and the Reality

The chapter explores the possibility of registering Ebola virus disease (EVD) as a multiple cause of death (part of the civil registration/vital statistics (CR/VS) system) in addition to being a notifiable disease (part of the disease surveillance system). The linkage between the two systems is established, followed by a framework showing how each of the systems would work in the ideal situation. A scoring system is developed and used to score each dimension of this ideal system, giving a total score of 23. This tool can be used to assess the extent to which the EVD is registered both as a multiple cause of death and as a notifiable disease in Africa. The application of the tool requires that the Ebola virus disease is coded at the fourth digit ICD-10 level and that multiple causes of death are routinely collected in the first place. The country that is closest to satisfying these criteria is South Africa. The application of the tool to South Africa data showed that South African system was “fair” (between “poor” and “good”). The results are shown, discussed and recommendations are made for improving two systems in Africa

Multiple Causes-of-death Statistics in South Africa: Their Utility and Changing Profile over the Period 1997 to 2001

Abstract not availabl

Diagnostic Tests on Assessing the Quality of Maternal Orphanhood Data from the 1996 South African Census and Implications for the Indirect Estimation of Adult Mortality

The maternal orphanhood technique is one of the oldest indirect demographic techniques used for the estimation of adult mortality in populations with inadequate vital statistics. One of the pioneers of the technique had cautioned for the careful assessment of the maternal orphanhood data. All researchers have not heeded this caution and as a result, improbable adult mortality estimates could not be adequately explained. In this paper, the maternal orphanhood data from the 1996 census have been subjected to a battery of diagnostic tests. The diagnostics attempted in the paper have shown that among the factors that affect the estimates of maternal orphanhood, the one with the least effect on the mortality estimates is age misreporting. The age analyses show very good age reporting for all population groups and all provinces. The next factor with less effect on the mortality estimates is that of ‘adoption effect’. In this case it is hard to distinguish ‘adoption effect’ from ‘AIDS orphans’ effect. This adoption/AIDS orphans effect is more pronounced in Eastern Cape and Northern Cape. The two factors which show large effect in the trend in mortality estimates is the age distribution of maternal orphans and the proportion of those who do not know or did not state their maternal orphanhood status (DK and NS). The paper has shown that while the maternal orphanhood data is good, unique factors related to South African history have contributed to raising the proportion of DK and NS in the data. It is concluded that more research is needed on the role of the maternal orphanhood technique in an era of increasing deaths due to AIDS in some population subgroups and in cases of increasing ageing and low mortality in other population subgroups. It is hoped that the incomplete gamma function would be found useful in the modelling efforts in this direction

A Supplementary Review of Existing HIV/AIDS Models with the View of Adopting/Adapting One or More Models for National and Provincial Population Projections in South Africa

Abstract not availabl

The Improvement of Marriages and Divorces Statistics in South Africa: Relevance, Registration Issues and Challenges

With the recent passing by parliament of the Recognition of Customary Marriages Act, 1998 (Act 120 of 1998), it is now possible to increase the coverage of registered marriages and divorces in South Africa. In the past, since certain unions were legally not recognised, the marriage statistics collected by the Department of Home Affairs excluded a large proportion of marriages, for example customary marriages among Africans. However, the passing of legislation on its own is a necessary but not sufficient condition to ensure that customary marriages are indeed registered. The aim of the paper is to explore ways of making sure that these marriages in particular and marriages in general, are adequately registered. The paper starts by outlining the relevance of statistics on marriages and divorces, drawing from published literature. This is followed by a discussion on registration issues and the challenges to be faced in trying to improve the registration of marriages and divorces. The paper ends with a discussion followed by a conclusion

Dynamics Of Morbidity And Mortality In Africa And Implications For Health Care Planning

The dissertation aims to tie together the empirical, theoretical and policy oriented aspects dealing with the dynamics of morbidity and mortality in Africa. On the theoretical aspect, scholars are arguing that the epidemiologic transition theory which provided the framework for understanding African mortality in the past, is actually part of a broader health transition theory which also includes a health care transition. In this theory, the overemphasis on biomedical interventions is down-played. To understand African mortality, it is argued, we have to consider the social and cultural determinants. Also we have to consider morbidity and its relationship to mortality. This thesis is only considering two aspects of these concerns of health transition theory, namely health care planning and the dynamic relationship between morbidity and mortality.;In order to study the dynamics of morbidity and mortality, a multistate demographic model is used. As data availability in Africa is poor, a straight-forward application of the model is not possible because of its high data requirements. The adopted solution is to construct separate submodels for the indirect estimation of morbidity and of mortality. In the mortality submodel, the relevant age-cause-specific death rates are obtained by synthesizing Preston\u27s cause of death model and an extension of the Brass logit model. In the morbidity submodel, the relevant morbidity rates are obtained by modifying Klementiev\u27s degenerative model to handle lethal infectious disease for which limited recovery is possible.;With the data obtained from these submodels, the multistate (dynamic) model is used to investigate the mechanism of the health transition; that is, the effect of changes in risk factors (affecting incidence rates) and that of health care technology (affecting case fatality rates). With changes in the incidence rates, case fatality rates or recovery rates, the model can then be used to obtain estimates of life expectancies in either the illness states or the well state.;A specific application of the dynamic model is in health care planning. In two hypothetical examples given in the thesis, scenarios are constructed and the application of the dynamic model in aiding in decision making is outlined

The Making, Unmaking and Remaking of a National but Stratified Vital Statistics System in the Republic of South Africa

The political history of South Africa had direct effect on the development of vital statistics in that country. The paper looks at the dynamics of the making, unmaking and remaking of a national but stratified vital statistics system in South Africa. The paper also outlines the crucial roles played by key players in the process. This historical context of vital statistics has implications for demographic teaching and research

A Critical Analytical and Historical Review of South African Published Life Tables

The paper gives a critical review of South African life tables published since the 1920s. The life tables were constructed on the assumption that vital registration was complete among whites, coloureds and Asians. Over time, robust measures of the life tables such as under-five mortality rate and life expectancy at birth have to show internal and external consistency. In addition, derived measures such as entropy, E, which summarises the degree of convexity of the life table survivorship function, l(x), and Anson’s U also have to display such consistency. Against these criteria, the paper sets out to assess the validity of South African life tables published since the 1920s