1,721,083 research outputs found
The measurement of neonatal mortality: how reliable is Demographic and Household Survey Data?
No full textIt is estimated that, on a global scale, neonatal deaths now contribute to nearly 40% of all mortality in children under the age of five. However, as most neonatal deaths occur at home in countries with no vital registration, estimates of mortality are normally based on large national surveys such as the Demographic and Household Surveys (DHS). However, these have major limitations which restrict their accuracy.This study explores the potential contribution of DHS data in improving knowledge of trends in neonatal mortality in developing countries. It analyses the potential causes and extent of both sampling and non-sampling errors using review of existing literature as well as original analysis. The study suggests that one of the greatest limitations for DHS data is the wide confidence intervals. This makes it impossible to use DHS data to detect relatively small changes over time. While analysis suggests that in most countries data on neonatal mortality conform to expected patterns, there is also some evidence of age-heaping and back-dating of death
How reliable are reports of early adolescent reproductive and sexual health events in demographic and health surveys?
No full textCONTEXT: Age at sexual debut, age at first marriage or first union and age at first birth are among the most widely used indicators of health and well-being for female adolescents. However, the accuracy of estimates for these indicators, particularly for younger adolescents, is poorly understood.METHODS: For each of nine countries in Africa and Latin America, Demographic and Health Survey (DHS) data from two surveys conducted five years apart were used to examine women’s reports of age at sexual debut, marriage or first union, and first birth. The consistency of estimates between surveys and across birth cohorts is described, focusing particularly on the reporting of events occurring before age 15 and age 16.RESULTS: Marked differences in estimates for very early first births and marriage were found. Women aged 15–19 were much less likely to report marriages and first births before age 15 than were women from the same birth cohort when asked five years later at ages 20–24. Early sexual debut was reported more consistently in consecutive surveys than early marriages or births. CONCLUSIONS: Caution should be exercised when inferring changes in early adolescent sexual and reproductive health on the basis of estimates from the DHS. Greater effort should be made to develop data collection instruments that reduce misreporting of self-reported data from women sampled in household surveys
Neonatal death and national income in developing countries: will economic growth reduce deaths in the first month of life?
No full textThe relationship between national income and child mortality has been understood for many years. However, what is less well known is whether the association differs for neonatal mortality compared to postneonatal and early childhood deaths. Our study extends knowledge by analysing the relationship between gross national income (GNI) and neonatal, postneonatal, and early child mortality. The study draws on mortality estimates from Demographic and Household Surveys and World Bank data for GNI. It uses multivariate multiple regression analysis to examine the relationship between GNI and neonatal, postneonatal, and early child mortality rates (NMR, PNMR, and ECMR) using cross-sectional data from 65 countries and trend data from 49 countries. No significant relationship can be found between NMR and GNI for cross-sectional data once adjusted for region. The trend data confirms that increases over time in GNI are associated with lower reductions in NMR than other component rates. Thus, economic growth alone may have a weaker effect on reducing neonatal deaths than for older age groups; achieving improvements in neonatal mortality requires investment in maternal and new born health services alongside growth
The measurement of early adolescent fertility: evidence of differential under-reporting by women 15-19 years in Demographic Household Surveys
No full textNeonatal mortality in developing countries: an analysis of trends and determinants
No full textThere is limited understanding of how both trends and determinants of neonatal mortality vary from post-neonatal mortality, and more specifically how health care variables are associated with deaths in the first month of life. In particular the association between care at delivery and neonatal mortality is difficult to determine: in developing countries many women only seek skilled care once complications arise, making poor outcomes more probable. It is therefore inappropriate to directly compare outcomes from those who did and did not receive care at delivery due to this heterogeneity between the groups.This three-paper PHD thesis attempts to address some of these issues. Chapter 1 provides an overview of what is known about the determinants of neonatal and child mortality, before developing a conceptual framework for the analysis of neonatal and post-neonatal deaths.Chapter 2 (paper 1) provides a comprehensive analysis of the quality of Demographic & Household Surveys (DHS) data, before describing how trends in neonatal mortality differ from post-neonatal mortality over the short- and medium- term. It then examines how the associations between gross domestic product and neonatal, post-neonatal and early childhood mortality at national level differ using both cross-sectional and longitudinal data.Chapter 3 (paper 2) uses DHS data from Bangladesh to carry out bivariate and multivariate analysis to determine how the determinants of neonatal mortality vary from those of postneonatal mortality. It also tries to identify groups of women who are at ‘high’ or ‘low’ risk from institutional deliveries and compares rates of neonatal mortality. The risk categories are based on socio-economic, maternal health and health care utilisation factors that influence whether or not they are likely to have planned their delivery care or sought hospital care only in the event of complications.Chapter 4 (paper 3) furthers this work using Indian DHS data by examining how the association between health care determinants and neonatal mortality differ by asset quintile, mother’s education and state-level access to professional attendant at delivery. In this chapter I also use instrumental variable methodology to overcome the problem of endogeneity between delivery care variables and neonatal mortality. This technique enables me to examine the association between professional assistance at delivery while adjusting for the heterogeneity between women who do and do not seek such care. Chapter 5 concludes with a summary of key findings, as well as outlining areas for further research in this area
Misrepresenting the multi-cultural nation: the policy making process, news media management and the Parekh Report
No full textThe Commission for the Future of Multi-Ethnic Britain was launched by Jack Straw in January 1998 to provide a blueprint for a progressive, multi-culturally constituted ‘post nation’. The long awaited Commission report – the Parekh report – was published two years later and was met by a torrent of negative news media coverage and government handwashing. Academics and policy makers working on sensitive issues of race, ethnicity, culture and national identity are still attempting to learn the lessons from the failure of the Parekh report to capture the national-popular imagination. A series of important research questions are raised in this article about the role of the media in public policy agenda-setting; the most significant being whether the negative news coverage and political response to the report signalled the end of New Labour's ‘post Lawrence’ attempts to re-imagine Britain as a twenty-first century multiethnic nation. In its account of the report's production to publication narrative, the article considers the continued power of the news media to confound and unsettle the plans of policy makers, academics, public relations companies and government ministers working on race matters. In the broader context in which the nature of the relationship between policy networks, social policy documents and the news media remains relatively under-scrutinised in both policy and media debates, the article explores how, and on what terms, policy makers can and do engage with the process of making race-related policy documents ‘known about’. Drawing on data collected through a qualitative study of the journey of the Parekh report into the public domain, this article analyses the news media strategy developed to launch and promote the report and reveals the limits of attempts to manage the news media. It argues that the report was destabilised not only by the news media and its political reception but by competing sets of demands that mystified the purpose of the Commission and its beneficiaries
Climbing the ladder to equitable access for mothers and children: health system transitions to universal coverage in urban and rural settings
No full textRemaking English ruralities: Processes of belonging and becoming, continuity and change in racialised spaces
No full textThis chapter argues that while the geographical space of the English countryside has been particularly filled with a sense of nation of an ‘old England’, it has also been a space which has always been fiercely contested. It uses the concept of ‘rural citizenship’ to examine the changing contours of the rural, as well as to map a racialised landscape where questions of legitimacy, inclusion, exclusion, and authenticity have been particularly struggled over. The chapter also uses the story of the Black Environment Network and empirical data from a recent research project to view what happens when certain claims to rural citizenship are made in multicultural Britain
Researching up? Interviews, emotionality and policy-making elites
Full text linkThis article recounts the methodological story of a qualitative research project that investigated the work of the Commission on the Future of Multi-Ethnic Britain and the news media’s deconstruction of the Commission’s report – the Parekh Report – which was published on 11 October 2000. Our project used a multi-method fieldwork approach, combining textual analysis of news media coverage and the extensive documentary archives of the Commission, along with semi-structured interviews with Commissioners and other figures involved in the publication of the Report. The article attempts to offer a reflexive account of the experiences of interviewing a particular public policy-making elite and examines how a particular ‘public trauma’ – that is, the damaging political fall-out of extremely negative news media coverage of the Parekh Report – inflected our research encounters. We argue that the openness with which many of the participants spoke about this traumatic experience suggests that the production of policy documents can constitute highly emotional labour for participants. We extend this argument by examining how this openness also reveals the instabilities and uncertainties of power within the research interviewee/interviewer relationship. In this way the article seeks to contribute to debates about the problems of defining the category ‘elites’ in both public policy and social research worlds
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