Estimating Child Mortality at the Sub-national Level in Papua New Guinea: Evidence From the Integrated Health and Demographic Surveillance System

Abstract

BackgroundChild mortality is an important indication of an effective public health system. Data sources available for the estimation of child mortality in Papua New Guinea (PNG) are limited.ObjectiveThe objective of this study was to provide child mortality estimates at the sub-national level in PNG using new data from the integrated Health and Demographic Surveillance System (iHDSS).MethodUsing direct estimation and indirect estimation methods, household vital statistics and maternal birth history data were analysed to estimate three key child health indicators: Under 5 Mortality Rate (U5MR), Infant Mortality Rate (IMR) and Neonatal Mortality Rate (NMR) for the period 2014–2017. Differentials of estimates were evaluated by comparing the mean relative differences between the two methods.ResultsThe direct estimations showed U5MR of 93, IMR of 51 and NMR of 34 per 1000 live births for all the sites in the period 2014–2017. The indirect estimations reported an U5MR of 105 and IMR of 67 per 1000 live births for all the sites in 2014. The mean relative differences in U5MR and IMR estimates between the two methods were 3 and 24 percentage points, respectively. U5MR estimates varied across the surveillance sites, with the highest level observed in Hela Province (136), and followed by Eastern Highlands (122), Madang (105), and Central (42).DiscussionThe indirect estimations showed higher estimates for U5MR and IMR than the direct estimations. The differentials between IMR estimates were larger than between U5MR estimates, implying the U5MR estimates are more reliable than IMR estimates. The variations in child mortality estimates between provinces highlight the impact of contextual factors on child mortality. The high U5MR estimates were likely associated with inequality in socioeconomic development, limited access to healthcare services, and a result of the measles outbreaks that occurred in the highlands region from 2014-2017.ConclusionThe iHDSS has provided reliable data for the direct and indirect estimations of child mortality at the sub-national level. This data source is complementary to the existing national data sources for monitoring and reporting child mortality in PNG.

Prevalence and risk factors associated with under-five mortality in the Solomon Islands: an investigation from the 2015 Solomon Islands demographic and health survey data

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Social determinants of injury-attributed mortality in Papua New Guinea: new data from the Comprehensive Health and Epidemiological Surveillance System

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“…CHESS was designed as a population-based longitudinal follow-up cohort study, with an aim to provide up-to-date data series for monitoring and evaluation of the impact of socioeconomic development programmes and health interventions on the health of the population at the national and subnational levels. The design and methods of CHESS have been published elsewhere 16–18…”

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Editorial: Utilization of healthcare services for children in low and middle-income countries: Its determinants and child health outcomes

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