The Spectrum projection package: improvements in estimating incidence by age and sex, mother-to-child transmission, HIV progression in children and double orphans

BACKGROUND: The Spectrum program is used to estimate key HIV indicators from the trends in incidence and prevalence estimated by the Estimation and Projection Package or the Workbook. These indicators include the number of people living with HIV, new infections, AIDS deaths, AIDS orphans, the number of adults and children needing treatment, the need for prevention of mother-to-child transmission and the impact of antiretroviral treatment on survival. The UNAIDS Reference Group on Estimates, Models and Projections regularly reviews new data and information needs, and recommends updates to the methodology and assumptions used in Spectrum. METHODS: The latest update to Spectrum was used in the 2009 round of global estimates. This update contains new procedures for estimating: the age and sex distribution of adult incidence, new child infections occurring around delivery or through breastfeeding, the survival of children by timing of infection and the number of double orphans

Mortality Measurement Matters: Improving Data Collection and Estimation Methods for Child and Adult Mortality

Colin Mathers and Ties Boerma discuss three research articles in PLoS Medicine that address the measurement and analysis of child and adult mortality data collected through death registration, censuses, and household surveys

The orphaning experience: descriptions from Ugandan youth who have lost parents to HIV/AIDS

The HIV/AIDS epidemic has continued to pose significant challenges to countries in Sub-Saharan Africa. Millions of African children and youth have lost parents to HIV/AIDS leaving a generation of orphans to be cared for within extended family systems and communities. The experiences of youth who have lost parents to the HIV/AIDS epidemic provide an important ingress into this complex, evolving, multi-dimensional phenomenon. A fundamental qualitative descriptive study was conducted to develop a culturally relevant and comprehensive description of the experiences of orphanhood from the perspectives of Ugandan youth. A purposeful sample of 13 youth who had lost one or both parents to HIV/AIDS and who were affiliated with a non-governmental organization providing support to orphans were interviewed. Youth orphaned by HIV/AIDS described the experience of orphanhood beginning with parental illness, not death. Several losses were associated with the death of a parent including lost social capitol, educational opportunities and monetary assets. Unique findings revealed that youth experienced culturally specific stigma and conflict which was distinctly related to their HIV/AIDS orphan status. Exploitation within extended cultural family systems was also reported. Results from this study suggest that there is a pressing need to identify and provide culturally appropriate services for these Ugandan youth prior to and after the loss of a parent(s)

Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions

Background and Objectives: Despite India’s substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI. Data and Methods: The present study used households with a pair of male-female siblings (aged 1–5 years) from two rounds of National Family Health Survey (NFHS, 1992–93 and 2005–06). The overall inequality in the immunization status (after controlling for age and birth order) of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992–93 and 2005–06). Household fixed-effects models for immunization status of children were also estimated. Results and Conclusions: Findings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992–93 to 0.023 in 2005–06. However, as a percentage o

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

Environment and health in developing countries An analysis of intra-urban differentials using existing data

SIGLEAvailable from British Library Document Supply Centre- DSC:q95/32354 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Household Surveys — Using Qualitative Data to Enhance Our Understanding of Household Dynamics over Time

Margo Russell suggested that the “household has become dangerously reified” (1993: 755). She had a point. As she and many commentators have explained, identifying “the household” in many African settings is not straightforward and, indeed, may be misleading because it fails to take account of linkages across a wider kinship or familial group (Guyer and Peters 1987; Martin and Beittel 1987; and, more recently, Müller 2004; McEwan and Samuels 2006; Hosegood et al. 2007). However, as Coast, et al. (2009: 1) have recently stated, “Household surveys are the mainstay of micro-level data for developing countries” and while the use of the household as a unit for data collection has well-documented limitations the important place of “the household” in research as well as for national health surveillance surveys suggests that developing a better understanding of how to define households, and distinguish among different types, is a worthwhile exercise. Demographers such as Sara Randall and Ernestina Coast have undertaken extensive research to understand the use of different definitions of the household in survey and census data, and whether they reflect the household and family structures in Europe and Africa (see, for example, Randall et al. 2011), and this chapter builds on this existing body of work