Should Data from Demographic Surveillance Systems Be Made More Widely Available to Researchers?

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Abstract

Background to the debate: Demographic surveillance—the process of monitoring births, deaths, causes of deaths, and migration in a population over time—is one of the cornerstones of public health research, particularly in investigating and tackling health disparities. An international network of demographic surveillance systems (DSS) now operates, mostly in sub-Saharan Africa and Asia. Thirty-eight DSS sites are coordinated by the International Network for the Continuous Demographic Evaluation of Populations and Their Health (INDEPTH). In this debate, Daniel Chandramohan and colleagues argue that DSS data in the INDEPTH database should be made available to all researchers worldwide, not just to those within the INDEPTH Network. Basia Żaba and colleagues argue that the major obstacles to DSS sites sharing data are technical, managerial, and financial rather than proprietorial concerns about analysis and publication. This debate is further discussed in this month's Editorial.

Abstract

Chandramohan and colleagues argue that DSS data should be made available to all researchers worldwide, while Żaba and colleagues discuss the major obstacles to DSS sites sharing their data more widely.

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Mortality registration and surveillance in China: History, current situation and challenges

Gonghuan Yang, Jianping Hu, Ke Rao … (2005)

Background Mortality statistics are key inputs for evidence based health policy at national level. Little is known of the empirical basis for mortality statistics in China, which accounts for roughly one-fifth of the world's population. An adequate description of the evolution of mortality registration in China and its current situation is important to evaluate the usability of the statistics derived from it for international epidemiology and health policy. Current situation The Chinese vital registration system currently covers 41 urban and 85 rural centres, accounting for roughly 8 % of the national population. Quality of registration is better in urban than in rural areas, and eastern than in western regions, resulting in significant biases in the overall statistics. The Ministry of Health introduced the Disease Surveillance Point System in 1980, to generate cause specific mortality statistics from a nationally representative sample of sites. Currently, the sample consists of 145 urban and rural sites, covering populations from 30,000 – 70,000, and a total of about 1 % of the national population. Causes of death are derived through a mix of medical certification and 'verbal autopsy' procedures, applied according to standard guidelines in all sites. Periodic evaluations for completeness of registration are conducted, with subsequent corrections for under reporting of deaths. Conclusion Results from the DSP have been used to inform health policy at national, regional and global levels. There remains a need to critically validate the information on causes of death, and a detailed validation exercise on these aspects is currently underway. In general, such sample based mortality registration systems hold much promise as models for rapidly improving knowledge about levels and causes of mortality in other low-income populations.

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Co-coverage of preventive interventions and implications for child-survival strategies: evidence from national surveys.

Cesar Victora, Bridget Fenn, Jennifer Bryce … (2015)

In most low-income countries, several child-survival interventions are being implemented. We assessed how these interventions are clustered at the level of the individual child. We analysed data from Bangladesh, Benin, Brazil, Cambodia, Eritrea, Haiti, Malawi, Nepal, and Nicaragua. A co-coverage score was obtained by adding the number of interventions received by each child (including BCG, diphtheria-pertussis-tetanus, and measles vaccines), tetanus toxoid for the mother, vitamin A supplementation, antenatal care, skilled delivery, and safe water. Socioeconomic status was assessed through principal components analysis of household assets, and concentration indices were calculated. The percentage of children who did not receive a single intervention ranged from 0.3% (14/5495) in Nicaragua to 18.8% (1154/6144) in Cambodia. The proportions receiving all available interventions varied from 0.8% (48/6144) in Cambodia to 13.3% (733/5495) in Nicaragua. There were substantial inequities within all countries. In the poorest wealth quintile, 31% of Cambodian children received no interventions and 17% only one intervention; in Haiti, these figures were 15% and 17%, respectively. Inequities were inversely related to coverage levels. Countries with higher coverage rates tended to show bottom inequity patterns, with the poorest lagging behind all other groups, whereas low-coverage countries showed top inequities with the rich substantially above the rest. The inequitable clustering of interventions at the level of the child raises the possibility that the introduction of new technologies might primarily benefit children who are already covered by existing interventions. Packaging several interventions through a single delivery strategy, while making economic sense, could contribute to increased inequities unless population coverage is very high. Co-coverage analyses of child-health surveys provide a way to assess these issues.

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Cause-specific mortality rates in sub-Saharan Africa and Bangladesh.

Jahit Sacarlal, Kubaje Adazu, Adama Marra … (2006)

To provide internationally comparable data on the frequencies of different causes of death. We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2). Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases.

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Journal ID (nlm-ta): PLoS Med

Journal ID (publisher-id): pmed

Journal ID (publisher-id): plme

Journal ID (pmc): plosmed

Title: PLoS Medicine

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Print): 1549-1277

ISSN (Electronic): 1549-1676

Publication date (Print): February 2008

Publication date (Electronic): 26 February 2008

Volume: 5

Issue: 2

Electronic Location Identifier: e57

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Publisher ID: 07-PLME-PMD-0940R1

DOI: 10.1371/journal.pmed.0050057

PMC ID: 2253613

PubMed ID: 18303944

SO-VID: 134374be-b863-45a8-97c9-9bd264053e94

Copyright © Copyright: © 2008 Chandramohan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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citation Chandramohan D, Shibuya K, Setel P, Cairncross S, Lopez AD, et al. (2008) Should data from demographic surveillance systems be made more widely available to researchers? PLoS Med 5(2): e57. doi: 10.1371/journal.pmed.0050057

Should Data from Demographic Surveillance Systems Be Made More Widely Available to Researchers?

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Most cited references 13

Mortality registration and surveillance in China: History, current situation and challenges

Co-coverage of preventive interventions and implications for child-survival strategies: evidence from national surveys.

Cause-specific mortality rates in sub-Saharan Africa and Bangladesh.

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