Measuring adult mortality in developing countries : a review and assessment of methods

In most developing countries, data collection methods in the civil registration system and health services are woefully inadequate and methods for adjusting them apply only at the national level. The authors argue that the best way to collect data on adult mortality is probably to combine sample community based health reporting systems and singleround surveys in which respondents are asked about the survival of various relatives. The method's main limitation is that it provides rather broad, nonspecific measures of mortality - but these are adequate for allocation of resources, which is likely to be affected only by large differences.Health Monitoring&Evaluation,Demographics,Health Systems Development&Reform,Health Economics&Finance,Adolescent Health

Objectives and methods of a world health survey

Many developing countries are trying to improve the routine collection of health information by strengthening surveys, censuses, and registration systems. At the international level, too, efforts are underway to provide information on health and health interventions, including statistical reporting programs of the U.N. and the World Bank. In view of the limited financial resources in the developing countries, would a world health survey complement these health information systems and contribute to long-term health care? This paper finds that although a series of coordinated country health studies could be valuable, there are many tradeoffs. Considering the variety of health problems and priorities in developing countries, it is probably more important to develop the expertise to conduct and analyze health studies than to devise a standard questionnaire to collect health data. As for the cost effectiveness of health programs, a world health survey is not the appropriate vehicle for such evaluations, but it could address such concerns as access, coverage, patient costs, and financing systems.Health Monitoring&Evaluation,Health Systems Development&Reform,Agricultural Knowledge&Information Systems,Housing&Human Habitats,Gender and Health

Biokultursysteme und ihre Evolution

Here I present the general concept of biocultural systems. Biocultural systems are an alternative to related concepts such as bioeconomy, ecosystem services or agroecosystems. Biocultural systems consist of (1) culture habitats cultivated by humans for cultivated biodiversity (2) cultivated biological diversity that is shaped through domestication and breeding by humans and their values, (3) humans and their values and (4) technology and knowledge needed for cultivation. Some key insights from the perspective of biocultural systems are: (1) humans and cultivated biodiversity are mutually dependend, (2) biocultural systems evolve in a process intertwining the evolution of biological organisms and human values, (3) the evolution of biocultural systems is a dialect of innovation and tradition

Contraceptive use and lengthening birth intervals in rural and urban Eastern Africa

BACKGROUND The transition towards low fertility has been slow in sub-Saharan Africa. Although increasing numbers of women are now using contraception, levels of unmet need for contraception remain high. And yet the dynamics of fertility are changing: national estimates have documented significant lengthening of birth intervals across the region. OBJECTIVE The aim of this paper is to explore trends in birth interval length by residence in Ethiopia, Kenya, Tanzania, and Zimbabwe, and the role of contraception in these changes. METHODS We conducted a birth interval analysis of fertility using up to six Demographic and Health Surveys from each country. We modelled age-order duration-specific period fertility using Poisson regression and calculated median birth interval lengths from the fitted rates using life-table techniques. RESULTS Birth intervals have lengthened in all four countries, most notably Zimbabwe. Urban populations now have median intervals that exceed 35 months in all four countries. The lengthening of birth intervals is associated with, although not limited to, the use of contraception. In urban areas the median birth interval among ever-users of contraception ranges between 52 and 86 months. CONCLUSIONS The increase in the length of birth intervals in Eastern Africa has been concentrated in urban areas. The trend is most pronounced among contraceptive users, but also results from unreported forms of birth control. It might become even more pronounced if access to contraception were improved. CONTRIBUTION We show that lengthening of birth intervals in Eastern Africa has resulted largely from dramatic increases among urban women and women who have ever used contraception

Measurement of adult mortality in populations affected by AIDS: an assessment of the orphanhood method

This paper demonstrates that orphanhood data can be used to estimate adult women’s mortality in populations experiencing an epidemic of AIDS. It develops both a correction for selection bias in reports of orphanhood and a revised procedure for estimating life table survivorship for use in populations with significant AIDS mortality. These new methods yield mortality estimates for a Ugandan population that are consistent with those obtained by prospective surveillance. Countries that lack effective death registration systems should ask about the survival of mothers in the census and surveys in order to monitor the effect of the AIDS epidemic on mortality

Teenage Childbearing and Educational Attainment in South Africa.

The relationship between teenage childbearing and school attainment is investigated using nationally representative longitudinal data drawn from South Africa's National Income Dynamics Study. The analysis focuses on the outcomes by 2010 of a panel of 673 young women who were aged 15-18 and childless in 2008. Controlling for other factors, girls who went on to give birth had twice the odds of dropping out of school by 2010 and nearly five times the odds of failing to matriculate. Few girls from households in the highest-income quintile gave birth. Girls who attended schools in higher-income areas and were behind at school were much more likely to give birth than those who were in the appropriate grade for their age or were in no-fee schools. New mothers were much more likely to have re-enrolled in school by 2010 if they were rural residents, they belonged to relatively well-off households, or their own mother had attended secondary school. These findings suggest that, in South Africa, interventions that address poor school attainment would also reduce teenage childbearing

Faktoren für die Integration von Mischkulturen in die landwirtschaftliche Praxis

In diesem Beitrag präsentieren wir die ersten empirisch fundierten Hypothesen über die Faktoren, die den Einsatz von landwirtschaftlichen Mischkulturen (Gemengen) in der Praxis bedingen. Die wichtigsten ermittelten Faktoren sind: (1) psychosoziale Faktoren, (2) argrar-systemische Faktoren, ernährungs-systemische Faktoren, (3) technologische Faktoren und (4) bio-ökologische Faktoren. In geplanten zukünftigen Interview-Studien werden diese Faktoren validiert und weiter differenziert

Obligation to family during times of transition: care, support and the response to HIV and AIDS in rural South Africa

In rural South Africa, high HIV prevalence has the potential to affect the care and support that kin are able to provide to those living with HIV. Despite this, families seem to be largely resilient and a key source of care and support to family affected by HIV. In this article, we explore the motivations for the provision of care and support by kin. We use the results of a small-scale in-depth qualitative study conducted in 10 households over 6 months in rural KwaZulu-Natal, South Africa, to show that family obligation and conditional reciprocity operate in varying degrees and build social capital. We highlight the complexity of kin relations where obligation is not guaranteed or is limited, requiring the consideration of policy measures that provide means of social support that are not reliant on the family