Morojele, M.

Sembajwe, Israel

English

IDS OpenDocs

70-74
88-88•0-04BM*
80-5448-4840-44
80-8428-2810-24
18-111fr-14
08-84 WALES FEMALES
' C T O ? )  J
WORKING PAPERS 
DEMOGRAPHY
44(7
PRELIMINARY MORTALITY' ESTIMATES FOR LESOTHO BASED ON DATA PROM 
THE N A T IO N A L  H EALTH  AMD N U T R IT IO N  SU R VEY
by
M. M o r o j e l e  
and
I s r a e l  Sembajwe
W o rk in g  P ape r  Mo. 1 
J u l y  
I 990
DEMOGRAPHY UNIT  
DEPARTMENT OF STATIST ICS  
NATIONAL UNIVERSITY' OF LESOTHO
ro -7 *
80-94
49-49
40-44
36-9930-94
10-94
19-19
10-14
00-04
MALES FEMALES
WORKING PAPERS 
DEMOGRAPHY
by
M. Mo roj e !e 
and
I s rae l  Sembajwe
Working Paper No. 17 
Jul y  
I 990
DEMOGRAPHY UNIT  
DEPARTMENT Or STAT IST ICS  
NATIONAL UNIVERSITY OF LESOTHO
0
Preliminary Mortality Estimates for Lesotho 
Based on Data from the National Health and 
Nutrition Survey.
by
M. Morojele 
and 
I. Sembajwe
Working Papers in Demography 
Paper No. 17 
July 
1990
Demography Unit 
Department of Statistics 
National University of Lesotho.
1Foreword
Most of the indicators for mortality in the country 
available up to date are from old data sets of 1976 and 1977 
(of over ten years ago). This is largely due to the fact 
that relatively recent data sets, such as the 1986 
population census, have experienced some technical problems 
related to data processing. It is not yet possible,
therefore, to get current indicators for mortality from 
those sources.
It is with great relief that some limited information has 
been acquired from the Health and Nutrition Survey 
(1988/89). Since the data set is still being processed, the 
results presented in this paper which deals with the 
analysis of the information should be regarded as 
pre1iminary.
We invite analytical reports of data on population, however,
small they may be, as well as research papers and reports
dealing with issues related to population from any member of
training insititutions or Government departments for
consideration for publication under this series of Working
Papers in Demography. The papers are published under the
0
auspices of UNFPA Project No. LES/88/P01: Demographic
. *
ii
Training at the National University of Lesotho. The views 
expressed in the papers are, however, entirely those of the 
authors and not those of the United Nations.
I. Sembaj we
Chief Technical Advisor 
Project LES/88/P01
rTABLES OF CONTENTS
Foreword    i
Introduction  .........................................  1
Mortality Estimation ...............    . 3
Conclusion        7
References    8
Annex I      10
i i i
#
11 * Introduction
Technical problems related to the processing of the 1986 
population census of Lesotho have prevented the release of 
most of the detailed information from that census up to now. 
Consequently, there are no current estimates of demographic 
parameters. When questions are raised regarding the 
magnitude of infant or child mortality, or the general level 
of mortality in the country, the nearest point of reference 
for such measures, is the 1976 population census which is 
over fourteen years old now or the 1977 Lesotho fertility 
survey which is thirteen years old ( Kingdom of Lesotho 
1981a and 1981b; Sembajwe, 1984). Therefore, we all feel 
somewhat unhappy when, whenever infant or child mortality or 
general mortality indicators for Lesotho are referred to, we 
refer to the 1976 or 1977 results of between 110 to 130 
deaths per thousand for infant mortality. Results which do 
not reflect the current situatioh.
It is, therefore, not surprising that both analysers and 
users were very happy when they were assured by the Bureau
of Statistics late last year that the detailed results of
the 1986 population census would be released in early 1990
since most of the technical problems were nearly overcome.
But as it has already been stated, some of the detailed
0
data are still not available.
Consequently, out of eagerness to have some curent estimates 
of at least one of the demographic parameters, an attempt is 
made in this brief paper to estimate a relatively recent 
level of mortality for Lesotho. The analysis in this paper, 
utilizes information collected during the fourth round of 
the 1988/89 National Health and Nutrition Survey (NHNS). 
As stated by one observer, this survey "is an impressive 
investigation which will give important results not only for 
Lesotho but also from an internationa1 perspective" (Taube, 
1989). The data from the survey are still being processed 
and not yet ready for final presentation. Our estimates are 
therefore preliminary.
0
Mortality Estimation
I he information used to estimate the mortality parameters 
was collected during the fourth round of the NHNS when the 
following questions were added to section D of the 
questionnaire:-
Have you had a live birth in the past 12 
months (in other words after March 1988) ?
What was the date of birth of the most recent 
child (even if that child died) ?
Have you had a previous live birth ?
Is this previous child now alive ?
— _
(see Annex 1: Form D of the questionnaire).
By incorporating these simple questions into the 
questionnaire especially "Is this previous child now 
alive?", some information which can be analysed using a 
recently developed estimation method was acquired.
Althouqh this type of question was originally adopted for 
use during the completion of registration or notification
forms at various branches of the national health facilities 
and services by health personnel, it was deemed useful for 
incorporation into an ordinary survey by assuming that all 
mothers who had had a live birth in the 12 months preceding 
the survey would constitute a group of women at maternity 
during the notification period. What follows is the 
analysis and interpretation of data yielded by this 
questionnare. It should be reiterated that the analysis is 
preliminary since the data utilized has not been fully 
edited and processed.
. IT
4
The method for analysing this type of information, was 
developed at the Centre for Population Studies, London
Preceding Preceding Births Proportion Surviving
Births Surviving at Age 2 years
368 336 .913
School of Hygiene and Tropical Medicine ( Brass and Macrae, 
198b ). It is proved that the proportion surviving out of
the preceding births reported approximates the probability 
of surviving from birth to age two ( conversely, the
proportion dead approximates the probability of dyinq 
between birth and age 2 ). It is thus a simple straight 
forward method. This method is recommended both for 
collecting and analysing data for monitoring trends and 
evaluating intervention programmes. For further discussion 
of the method and applications, see Aguirre and Hill (1987) 
and Hill and Macrae (1885).
The proportion surviving to age 2 of 913 per thousand 
yielded an infant mortality rate for Lesotho within the 
range of 70 to 75 per 1000 births and an expectation of life 
at birth within the range 59 to 60 years. Given the 
problems still prevailing in the data (further editing is 
necessary before final estimates can be made), these 
estimates should be regarded as (i) lower limits, of the 
infant mortality rate that may have prevailed in Lesotho in 
1989, and (ii) upper limits of the expectation of life at 
birth that may have represented the average length of life 
in the country during the same period.
These estimates are, however, more plausible than those 
acquired from other investigations but which are localized 
in nature. For example, the Mohale's Hoek Demographic 
study of four selected villages yielded an infant mortality 
rate of 51 per thousand (Sembajwe and Makatjane, 1990) and 
a small investigation of the problems facing the civil
5
registration system in Lesotho carried out in Mantsebo, a 
village on the way from Maseru to Mafeteng (about 25 kms 
from Maseru Urban centre), in 1989, yielded an infant 
mortality rate of 32 per thousand (Sembajwe, forthcoming). 
As already stated, these studies were extremely localized. 
They do not reflect the national situation.
Assuming a Gross Reproduction Rate (GRR) for Lesotho of 2.5 
to 3.0 children, the level of mortality reflected by the 
above estimates suggests a Death Rate for Lesotho of 10 to 
11 per 1000, and a Birth Rate of 36 to 43 per 1000. 
Therefore, the rate of natural increase for the country 
falls within a passible range of 2.6 to 3.3 per 1000. 
Hence the likelihood of a growth rate for Lesotho in excess 
of 2.6 per cent as reflected by the 1986 population census 
is very high.
Among the implications of even a faster population growth 
rate for the country, are increased population pressure on 
available meagre resources and limited ability for the 
government to provide the basic needs to its people.
6
7Cone 1usion
A relatively recent and simple method of estimating
mortality in childhood has been utilized in this brief
paper. Data from the NHNS has facilitated the application
of this method.
The estimates indicate a mortality level with an expectation 
of life at birth falling within the range 59 to 60 years. 
But given the nature of the data that have been used, these 
results should be regarded as preliminary. Indeed, the need 
for a current more reliable national indicator for mortality 
in Lesotho is still very prevalent.
Nevertheless, the prospect of a gradual but steady decline 
in mortality in the country and the likelihood of a constant 
and high fertility level portends a high population growth 
rate. The implications of this 6igh growth rate are
unfavourable to improved welfare of Lesotho's population and 
this calls for sharpened and concerted government effort to 
curb the high rate of population growth.
«•
4 . N e T 0 r 0 n c
f-i □ u i r I-" 0 , A a n ci H i 1 ]. , A » G . .19 3 ~7 . " C h .11 d h o o d M o r t0.1 i. t y
Estimates Using the Preceding Birth 
70 chniqu0 s S0m0 A p pIi cat i on s an d Extensions." 
C0n t r0 f or Popu. 1 a t1 on 31udies, London Sc hoo 1 
of Hygi.0n0 and Tropica.1 Medicme, Univers 1 1y 
of London„
Br ass , W . and S „ Mac rae . 1c?85 . "Child hood Mor ta 1 i ty
Estimated from Reports on Previous Births 
Given by Mothers at the Time of a Maternity: 
I„ Pr0ceding-Births Techniqu0 ." Asian and 
Pacific Census Forum. Volume 11. No. 4, pp 
1—9 .
H 1 1 1 , A „ G „ and S . Macrae „ .1985. "Monitoring the Chi 1 d and 
Deve1opment Revolution„" Unic0 f Socia1 
Statistics Bu 1 leti.n . A Pu.b 1 ication of the 
Eastern and Southern Africa Regional Office
Vol S. No.2.
Kingdom of Lesotho,. 1981 a. I he 19 76 Population Census, 'Vol
IV , B u r 0 a u o f S t a t
Kingdom of Lesotho. 1981 b . The 1977 Lesotho Ferti1itv
Survey. B ureau of S ta ti sti cs.
9
Sembajwe, I. 1984. "Lesotho Demographic Profile and
Research Agenda", Working Papers
DemoqrapIty , Wo. 1 . Demoqraphy Unit. 
National University of Lesotho.
l n
Sembajwe (forthcoming). Problems Facing the Civil 
Registration System in Lesotho. Demography 
Unit, National University of Lesotho.
Sembaiwe, I an(j T . Makatjane. 1990 . A_ Demographic Study of
Sec ted Rural Communities in Lesotho.
Monog raph Series No . 1 . Demograptry Un i t ,
National University of Lesotho.
au.be , A. 19 8( "Analysis arts Presentation of Data from 
the Hea1th and Mut r i t ion Survey." Report
from a shiort-term Mission, March 13 - Apri 1
7, 1989. Burean of S'
T i m a e u. s , I . 198 4 . ' M o r t a 1 i t y i n L. e s o t h o : A S t u d y o f
Levels, Trends and Differentials Based
#
on Retrospective Data",1.S.I. Paper No.59
10
Annex i; Form D of the Questionnaire 
* TO BE ASKED OF ALL WOMEN BETWEEN 15 AND 49 YEARS OF AGE
1. Name ___________________________
2. * LINE NUMBER (fron form A) ______
3. Na u lebeletse ngoa? (* circle one answer)
No Don't knew Yes
1 ________________________
4. U nako e kae u le mokhachane? 
(* Write number of months 
or DK if don't knew) _____
V
*SKIP TO QUESTION 8
V
5. Na u kile oa ba le ngoana ea hlahileng a phela likhoeli tse 
leshame le metso e 'meli tse fetileng? Ka mantsoe a mang 
kamor'a hlakubele selemong sa 1988. (*Circle one answer)
Yes No1
7.
N/
What was the date of birth of the most recent child 
(even if that child died)?
Day_ Month Year J__ J I
8a. Have you had a previous live birth?
No Yes1
8b. Is this previous child new alive?
Yes No
8c. How many live births have you had altogether? 
(*Write number)
i l i
V
9. During the most recent pregnancy, (" i.e. the present pregnancy 
if pregnant, the most recent live birth if not pregnant), did you 
receive any special care for the pregnancy (ante-natal care or ANC)?
No Yes
>1_______________________________________
10. Where did you receive this care? (* circle one no.only)
Clinic (health centre, dispensary) or hospital------
Private doctor, private nurse.
Traditional (Mopostola, ngaka ea Sesotho, Mopepisi 
Trained VHW, trained traditional birth attendant i.e. 
Hopepisi who has been trained at the clinic 
Self care, family 
Other (specify)___
11. There are many reasons why people do not 
go to a clinic during pregnancy. Why did 
you not go? ("Maximum 2 answers)
a. Clinic too far
b. No money to go to clinic
c. Sickness needs ngaka ea sesotho
d. Other (specify):
12. How many times 
did you go for ANC?
I I I
13. IF PREGNANT  } l^iere do you intend to have the baby delivered?
IF NOT PREGNANT ------ > Where was the child delivered?
(* circle one no. only)
C 1 Hospital
----------------- « 2 Clinic (health centre, dispensary)
/3 Private doctor's/nurse's surgery 1---
_______[4 Home
1.5 Other (specify).....................
v
14 Who assisted (will assist) in the delivery? ("circle one no.)
1 Mopepisi who has trained at the clinic (Trained TBA) or VHW
2 Relative
3 Fr i end
4 Other (specify)............
i'
15. There are many reasons Uiy women do not deliver in a health 
facility? Why did/will you not? ("Circle maxinun 3 answers)
a. Lack of money b. Facilities too far
c. The birth came unexpectedly d. Clinic was closed
e. Prefer to deliver at home
f. Do not find it necessary to deliver at clinic
g. Attitude of clinic/hospital staff
h. Tradition is to deliver at home to learn how to deliver others
i. Delivered at home so that could bury placenta
j. Other (specify):
V
16. Did/will you and the child visit any clinic or hospital during the 
2 months after the child's birth?
Yes No
4
Don't know
i
v
17. There are many reasons why women do not go to the clinic 
during the period after the baby is born?
Why did/will you not visit the clinic? ("Max. 3 answers)
a. Did not feel sick/ mother & baby were fine
b. No money
c. Chi Id passed away
d. Child had already received first immunisation
e. Too young to visit clinic
f. Mother was i11
g. No reason
h. Other (specify):
* NEXT FORM j
This work is licensed under a 
Creative Commons
Attribution -  Noncommercial - NoDerivs 3.0 License.
To view a copy of the license please see: 
http://creativecommons.Org/licenses/bv-nc-nd/3.0/
This is a download from the BLDS Digital Library on OpenDocs
http://opendocs.ids.ac.uk/opendocs/
i
® * V |n s t itu te  o f
Development Studies


Preliminary Mortality Estimates for Lesotho Based on Data from The National Health and Nutrition Survey

https://opendocs.ids.ac.uk/opendocs/bitstream/20.500.12413/6719/1/WP17-M.Morojele%20%26%20I%20Sembajwe.pdf

Preliminary Mortality Estimates for Lesotho Based on Data from The National Health and Nutrition Survey

Abstract

Similar works

Full text

Available Versions

IDS OpenDocs