Estimation of district-level under-5 mortality in Zambia using birth history data, 1980–2010

https://doi.org/10.1016/j.sste.2014.09.002Get rights and content
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Highlights

  • We develop methods to estimate under-5 mortality subnationally based on survey and census data.

  • We compared different combinations of small area and demographic methods using simulation.

  • Performance, in terms of bias, efficiency, and coverage, varies widely among different models.

  • We used the best model to estimate district-level under-5 mortality from 1980 to 2010 in Zambia.

  • District-level estimates reveal large inequalities in levels of under-5 mortality in Zambia.

Abstract

Birth history data—the primary source of data on under-5 mortality in developing countries—are infrequently used for subnational estimates due to concerns over small sample sizes. In this study we consider different methods for analyzing birth history data in combination with various small area models. We construct a simulation environment to assess the performance of different combinations of birth history methods and small area models in terms of bias, efficiency, and coverage. We find that performance is highly dependent on the birth history method applied and how temporal trends are accounted for. We estimated trends in district-level under-5 mortality in Zambia from 1980 to 2010 using the best-performing model. We find that under-5 mortality is highly variable within Zambia: there was a 1.8-fold difference between the lowest and highest levels in 2010, and declines over the period 1980 to 2010 ranged from less than 5% to more than 50%.

Keywords

Small area estimation
Geospatial analysis
Spatial–temporal smoothing
Birth history methods
Under-5 mortality
Child mortality

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