Socioeconomic status and elderly adult mortality in rural Ghana: evidence from the Navrongo DSS.

Elderly adult health and issues affecting them in Africa have not been adequately addressed by research. This study explored the relationship between socioeconomic status and elderly adult mortality in the Kassena-Nnakana District (KND) of northern Ghana using data from the Navrongo Health and Demographic Surveillance System (HDSS) in 2005-2006. 15,030 adults aged 60 years and over were included in the study, of whom 1315 died. Using Cox proportional hazards regression, we found that socioeconomic status (SES) was not a determinant of elderly mortality. Compared to the lowest SES quintile, the adjusted hazards ratios were: 0.94 (95%CI: 0.79–1.12) for second quintile, 0.91 (95%CI: 0.76– 1.08) for third quintile, 0.89 (95%CI: 0.75–1.07) for fourth quintile and 1.02 (95%CI: 0.86–1.21) for the highest income quintile. However, living without a spouse [HR=1.98, 95%CI: 1.74–2.25], being male [HR=1.80, 95%CI: 1.59– 2.04] and age [HR=1.05, 95%CI: 1.04–1.05] were significant factors for elderly adult mortality. This shows that companionship and social/family ties are of more importance than household socioeconomic status in determining elderly adult mortality. Efforts should therefore be made to introduce programs and policies to support the elderly, especially those living alone

Assessing levels and trends of adult mortality in Sub Saharan Africa using INDEPTH health and demographic surveillance systems

International audienceThere is still a considerable dearth of knowledge regarding adult mortality and premature deaths in Sub-Saharan Africa (SSA). Attempts to measure adult mortality using censuses and cross-sectional surveys rely mainly on indirect techniques that are affected by common biases. The growing number of Health and Demographic Surveillance Systems (HDSSs) offer a mediumterm solution to the dearth of knowledge regarding adult mortality and the main causes in Africa. This paper compares adult mortality estimates from 16 HDSSs in nine countries in SSA based on publicly available data on INDEPTHStats. We use Life Table techniques to examine differences in adult mortality trends and to identify mortality clusters and sex differentials. Results reveal distinctive mortality trends for the three regions of Africa with the Southern and Eastern African regions having relatively higher mortality than the West African region

Road traffic fatalities - a neglected epidemic in rural northern Ghana: evidence from the navrongo demographic surveillance system

Globally, road traffic fatalities have been on the increase, particularly in low-and-middle income countries. Much of this is attributed to increases in the acquisition, and use of motorized vehicles. However, there is very little empirical research to understand the causes and determinants of this threat. This paper investigates time trends and determinants of road traffic accidents in the Kasena-Nankana district of northern Ghana. First, we utilized causes of death data gathered by the Health and Demographic Surveillance System in Navrongo, to examine trends in deaths due to injury, particularly those related to road traffic crashes. Subsequently, we employed multivariate logistic regression to examine factors associated with deaths due to all injuries and road traffic crashes among adults 15–59 years of age. Results show a three-fold increase in mortality (18%) due to injuries in the Kasena-Nankana district in about a decade. Fatalities resulting from road traffic crashes constitute the greatest share of the burden of mortality resulting from injuries. Increases in road traffic fatalities have coincided with recent increases in motor and vehicular traffic in the region. Several factors are associated with the increased risk of deaths from road traffic accidents, principal among which include urban residence (OR = 1.74 95% CI 1.09-2.78), being male and in the prime adult ages of between 20–29 years old (OR = 4.85 95% CI 2.65-8.89), as well as people with higher levels of education (OR = 3.21 95% CI 1.75-5.87) and those in higher socioeconomic status categories (OR = 2.43 95% CI 1.21-4.88). Results suggest that road traffic fatalities have become a major cause of morbidity and mortality and brings into focus the need for measures to curb this looming crisis. There is need for strategic interventions to be adopted to avert what is sure to become one of the leading causes of death in this impoverished locality

Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Background: Under-five mortality is a major public health problem and one of the health indicators of health care in sub-Saharan Africa. In order to address inefficient health systems, there is a need to identify the spatial distribution of under-five mortality, especially areas of high mortality clustering. This study aimed to explore spatial and temporal clustering in under-five mortality in the Kassena-Nankana District of the Upper East region. Methods: We used data from the Navrongo Health and Demographic Surveillance System in the Kassena- Nankana District of northern Ghana, which had an average population of 140,000 of which about 18,400 were under five years of age. We analysed under-five mortality in 49 villages during the period 1997–2006. We calculated total under-five mortality rates and investigated their geographical distributions. A spatial scan statistic was used to test for clustering of the mortality in both space and time. Results: Under-five mortality has been declining during the period. However, the data show a persistently higher than average clustering of mortality over the period among villages mainly in the north-eastern parts of the district. Conclusion: There is a higher than average under-five mortality clustering in the villages in the north-east of the district and this may suggest a relatively poor health care system despite the many health interventions that took place over time in the district, including the Community Health and Family Planning Project, whose impact may not have been felt in these parts of the district between 1995 and 2004

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

Background: Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective: To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. Methods: The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results: The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion: The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people

Socioeconomic status and elderly adult mortality in rural Ghana: evidence from the Navrongo Dss.

Elderly adult health and issues affecting them in Africa have not been adequately addressed by research. This study explored the relationship between socioeconomic status and elderly adult mortality in the Kassena-Nnakana District (KND) of northern Ghana using data from the Navrongo Health and Demographic Surveillance System (HDSS) in 2005-2006. 15,030 adults aged 60 years and over were included in the study, of whom 1315 died. Using Cox proportional hazards regression, we found that socioeconomic status (SES) was not a determinant of elderly mortality. Compared to the lowest SES quintile, the adjusted hazards ratios were: 0.94 (95%CI: 0.79-1.12) for second quintile, 0.91 (95%CI: 0.76-1.08) for third quintile, 0.89 (95%CI: 0.75-1.07) for fourth quintile and 1.02 (95%CI: 0.86-1.21) for the highest income quintile. However, living without a spouse [HR=1.98, 95%CI: 1.74-2.25], being male [HR=1.80, 95%CI: 1.59-2.04] and age [HR=1.05, 95%CI: 1.04-1.05] were significant factors for elderly adult mortality. This shows that companionship and social/family ties are of more importance than household socioeconomic status in determining elderly adult mortality. Efforts should therefore be made to introduce programs and policies to support the elderly, especially those living alone

Assessing levels and trends of adult mortality in Sub Saharan Africa using INDEPTH health and demographic surveillance systems

There is still a considerable dearth of knowledge regarding adult mortality and premature deaths in Sub-Saharan Africa (SSA). Attempts to measure adult mortality using censuses and cross-sectional surveys rely mainly on indirect techniques that are affected by common biases. The growing number of Health and Demographic Surveillance Systems (HDSSs) offer a mediumterm solution to the dearth of knowledge regarding adult mortality and the main causes in Africa. This paper compares adult mortality estimates from 16 HDSSs in nine countries in SSA based on publicly available data on INDEPTHStats. We use Life Table techniques to examine differences in adult mortality trends and to identify mortality clusters and sex differentials. Results reveal distinctive mortality trends for the three regions of Africa with the Southern and Eastern African regions having relatively higher mortality than the West African region

Assessing levels and trends of adult mortality in Sub Saharan Africa using INDEPTH health and demographic surveillance systems

International audienceThere is still a considerable dearth of knowledge regarding adult mortality and premature deaths in Sub-Saharan Africa (SSA). Attempts to measure adult mortality using censuses and cross-sectional surveys rely mainly on indirect techniques that are affected by common biases. The growing number of Health and Demographic Surveillance Systems (HDSSs) offer a mediumterm solution to the dearth of knowledge regarding adult mortality and the main causes in Africa. This paper compares adult mortality estimates from 16 HDSSs in nine countries in SSA based on publicly available data on INDEPTHStats. We use Life Table techniques to examine differences in adult mortality trends and to identify mortality clusters and sex differentials. Results reveal distinctive mortality trends for the three regions of Africa with the Southern and Eastern African regions having relatively higher mortality than the West African region

Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites.

BACKGROUND: Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The INDEPTH Network maintains longitudinal surveillance, including cause of death, at population sites across Africa and Asia, which offers important opportunities to document external cause mortality at the population level across a range of settings. OBJECTIVE: To describe patterns of mortality from external causes at INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories. DESIGN: All deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates. RESULTS: A total of 5,884 deaths due to external causes were documented over 11,828,253 person-years. Approximately one-quarter of those deaths were to children younger than 15 years. Causes of death were dominated by childhood drowning in Bangladesh, and by transport-related deaths and intentional injuries elsewhere. Detailed mortality rates are presented by cause of death, age group, and sex. CONCLUSIONS: The patterns of external cause mortality found here generally corresponded with expectations and other sources of information, but they fill some important gaps in population-based mortality data. They provide an important source of information to inform potentially preventive intervention designs