Global Age Patterns of Under-Five Mortality

项目摘要 5岁以下儿童死亡率是儿童健康的一个关键和广泛使用的指标，但它掩盖了 关于死亡率如何按年龄分布的重要信息。为了更好地了解和监测 在儿童健康方面，至关重要的是要研究0 - 5岁年龄范围内死亡风险的变化情况。这包括年龄 超过28天（新生儿死亡率）和1岁（婴儿死亡率）标准截止点的细目 死亡率）。然而，在许多人口中，5岁以下儿童死亡率的年龄模式并不为人所知。减去- 特别是发达国家缺乏高质量的详细的生命登记信息， 分析这种年龄模式。收集追溯出生史的抽样调查不能令人满意地填补 这一差距，因为他们受到系统性偏见，特别是对估计年龄的后果， 模式.这就更加需要关于5岁以下儿童死亡率年龄模式的高质量信息 关键的，因为在这些年龄模式中的学习可以作为评估和纠正的有力工具。 数据来源不足时。在这个竞争修订应用程序的父项目中，我们正在改进 我们通过以下方式了解5岁以下儿童死亡率的年龄模式：收集迄今为止最大的关于高死亡率的数据库， 从出生到死亡，按详细年龄（按日、周、月和岁）提供高质量的全球死亡率信息。 按性别分列的5岁以下儿童死亡率分布情况; 人口的详细年龄;使用这些模型评估和纠正5岁以下儿童死亡率 较不发达国家按详细年龄分列的资料;处理关于如何 以及为什么5岁以下儿童死亡率的年龄模式因性别、时间和地点而异， 影响本行政补充项目的目标是通过以下方式扩展母项目的目标： 跟踪和回顾性地获得妊娠和出生史（如DHS中所用）， 参与者（活产、死产和新生儿死亡）来自农村前瞻性妊娠队列研究 尼泊尔这将有助于我们确定DHS是否高估或低估了新生儿死亡率，以及是否 死产和新生儿早期死亡的错误分类起了一定作用。这些结果将补充到文献中， DHS生命事件估计的有效性。

Project Summary The Under-5 Mortality Rate (U5MR) is a key and widely-used indicator of child health, but it conceals important information about how this mortality is distributed by age. For better understanding and monitoring of child health, it is critical to examine how the risk of death varies within the 0-5 age range. This includes age breakdowns beyond the standard cut-off points of 28 days (for neonatal mortality) and 1 year (for infant mortality). In many populations, however, the age pattern of under-5 mortality is not well known. Less- developed countries, in particular, lack the high-quality detailed vital registration information necessary for the analysis of such age patterns. Sample surveys collecting retrospective birth histories do not satisfactorily fill this gap, because they are subject to systematic biases that are particularly consequential for estimating age patterns. This makes the need for high-quality information on age patterns of under-5 mortality even more critical, because regularities in these age patterns can be used as a powerful tool for evaluating and correcting data when sources are deficient. In the parent project of this competing revision application, we are improving our understanding of age patterns of under-5 mortality by: gathering the largest database to date on high- quality global mortality information by detailed age (by days, weeks, months, and years of age) from birth until age 5, by sex; developing models summarizing regularities about how under-5 mortality is distributed by detailed age in human populations; using these models for evaluating and correcting under-5 mortality information by detailed age in less-developed countries; addressing specific substantive questions about how and why age patterns of under-5 mortality vary by sex, time, and place, with important programmatic implications. The goal of this administrative supplement project is to expand the aims of the parent project by tracking and retrospectively obtaining a pregnancy and birth history (as used in the DHS) with selected participants (live births, stillbirths and neonatal deaths) from a prospective pregnancy cohort study in rural Nepal. This will help us determine if the DHS over or underestimates neonatal mortality and whether misclassification of stillbirths and early neonatal deaths plays a role. These results will add to the literature on the validity of DHS vital event estimation.