International Journal of Epidemiology, Vol 22, S15-S19, Copyright © 1993 by International Epidemiological Association
WR Taylor, A Chahnazarian, J Weinman, M Wernette, J Roy, AR Pebley, O Bele and M Ma- Disu
The Combatting Childhood Communicable Disease (CCCD) project is a
comprehensive public health programme designed to reduce child mortality by
25% through the use of the following strategies: vaccination, oral
rehydration therapy, and prompt treatment for malaria. To evaluate this
programme, cross-sectional surveys were conducted in neighbouring health
zones in Zaire in 1984 to determine the use of selected medical services by
the population and to estimate the child mortality rate before the CCCD
programme began. A reinterview survey was conducted on a subsample of women
previously interviewed to determine the reliability of the mortality
estimates. In both health zones 84-85% of women used antenatal services,
45% of children under age 6 who had had fewer were treated with an
anti-malarial drug, 19-22% of children age 12-23 months had been vaccinated
against measles, and virtually no children who had had diarrhoea were
treated with oral rehydration therapy. Women's underreporting of births and
deaths resulted in low estimates of mortality in both surveys. The
reinterview survey provided more accurate estimates of mortality and led to
a better understanding of the factors influencing underreporting. The
estimated infant mortality rate was 74 deaths per 1000 livebirths; and the
probability of dying before age 5 was 191 per 1000. Because births and
deaths reported with incomplete dates were excluded from analysis, the
mortality rates from the reinterview survey are underestimates. Given the
difficulty in obtaining accurate estimates of mortality, primary importance
should be given to developing and improving routine health information
systems that measure changes in health status and provide information to
evaluate programmes.
ARTICLES
Mortality and use of health services surveys in rural Zaire
Office of Program Planning and Evaluation, Centers for Disease Control, Atlanta, GA 30333.
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