Abstract
BackgroundMillennium Development Goal 4 calls for a reduction in the under-five mortality rate by two-thirds between 1990 and 2015, which corresponds to an annual rate of decline of 4.4%. The United Nations Inter-Agency Group for Child Mortality Estimation estimates under-five mortality in every country to measure progress. For the majority of countries, the estimates within a country are based on the assumption of a piece-wise constant rate of decline.Methods and FindingsThis paper proposes an alternative method to estimate under-five mortality, such that the underlying rate of change is allowed to vary smoothly over time using a time series model. Information about the average rate of decline and changes therein is exchanged between countries using a Bayesian hierarchical model. Cross-validation exercises suggest that the proposed model provides credible bounds for the under-five mortality rate that are reasonably well calibrated during the observation period. The alternative estimates suggest smoother trends in under-five mortality and give new insights into changes in the rate of decline within countries.ConclusionsThe proposed model offers an alternative modeling approach for obtaining estimates of under-five mortality which removes the restriction of a piece-wise linear rate of decline and introduces hierarchy to exchange information between countries. The newly proposed estimates of the rate of decline in under-5 mortality and the uncertainty assessments would help to monitor progress towards Millennium Development Goal 4.
Highlights
Millennium Development Goal 4 (MDG4) calls for a reduction in the under-five mortality rate by two-thirds between 1990 and 2015
The parameters are changed individually in each plot to illustrate their influence on the rate of decline and corresponding U5MR trajectory
U5MR estimates The under-5 mortality rate was estimated with the Bayesian hierarchical time series model (BM) for 165 countries within their observation periods, and projected for an additional five years after the most recent observation year in each country
Summary
Millennium Development Goal 4 (MDG4) calls for a reduction in the under-five mortality rate by two-thirds between 1990 and 2015. The United Nations Inter-Agency Group for Child Mortality Estimation (IGME) estimates under-five mortality in every country to measure progress. A set of standard weights that quantify the relative accuracy of different types of observations has been developed [3,4]. In this weighting system, observations that are deemed to be of high quality are assigned a higher weight than observations of lesser quality. The United Nations Inter-Agency Group for Child Mortality Estimation estimates under-five mortality in every country to measure progress. For the majority of countries, the estimates within a country are based on the assumption of a piece-wise constant rate of decline
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