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Decennial Census

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Decennial Census: BACKGROUND

A national population census involves collecting, evaluating, analysing and disseminating demographic and socio-economic data on all persons in a country (or in a well-delimited part of a country) at a specified time. Most countries do a national census every 10 years.

Where countries already ask about deaths in the household in the year before the census (or some other reference period), adding questions on whether the deaths were pregnancy-related can be an efficient way to get national and subnational estimates of maternal mortality, including the proportion of maternal deaths among female deaths (PMDF), the maternal mortality ratio (MMR), the maternal mortality rate (MMRate) and the lifetime risk of maternal death (LTR).

However, if the census is used for the measurement of maternal mortality, it is essential that these data be evaluated and adjusted, if necessary. Demographic techniques have been developed to adjust for under/over reporting of births (reverse projection techniques or parity to cumulated fertility ratios) and deaths (growth balance).

Data requirements include:

Identification of death:

Adult household members retrospectively report to the enumerator the age and sex of all household members who have died within a specified period, usually 1 or 2 years prior to the census. These are referred to as the Direct Mortality Questions.

Ascertainment of maternal/pregnancy related status:

For all female deaths to women aged 15-49 identified in the household, an adult respondent reports if the death occurred during pregnancy, childbirth or within the six weeks following the termination of the pregnancy. This series of questions is referred to as Pregnancy-related Questions.

Advantages:

Limitations:

Census Questions

When information is collected on household deaths (by age and sex) in the past 12 months (or some other reference period), the following question is asked for any woman who died between the ages of 15 and 49:

The ideal response is “yes/no”, however the only available answer may be “unknown” or “not sure”. *

Alternatively, this question can be broken into parts, which may be easier to understand:

*UN (2007) Principles and recommendations for population and housing censuses, Rev 2, Draft. Page 131-2. New York: United Nations

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Measure Evaluation Hill K, Stanton C, Gupta N (2001) Measuring maternal mortality from a census: Guidelines for potential users. Chapel Hill: MEASURE Evaluation

World Health Organisation Stanton C, Hobcraft J, Hill K, Kodjogbe N, Mapeta WT, Munene F, Naghavi M, Rabeza V, Sisouphanthong B, Campbell O (2001) Every death counts: measurement of maternal mortality via a census. Bulletin of the World Health Organization, 79(7): 657-64.

The Lancet Hill K, on behalf of participants at the Expert Panel on Capturing Maternal Mortality in the 2010 Census Round (2006) Measuring maternal mortality. Lancet, December 368(9553): 2121

Immpact Immpact/Health Metrics Network meeting Census meeting (September 2006)

United Nations United Nations Statistics Division

US Census and Survey Processing Free downloadable software, US Census

Emerging Themes in Epidemiology Special topic: Health Surveys in Difficult settings