Abstract
In countries with limited vital registration, adult mortality is frequently estimated using siblings' survival histories (SSHs) collected during Demographic and Health Surveys (DHS). These data are affected by reporting errors. We developed a new SSH questionnaire, the siblings' survival calendar (SSC). It incorporates supplementary interviewing techniques to limit omissions of siblings and uses an event history calendar to improve reports of dates and ages. We hypothesized that the SSC would improve the quality of adult mortality data. We conducted a retrospective validation study among the population of the Niakhar Health and Demographic Surveillance System in Senegal. We randomly assigned men and women aged 15-59 y to an interview with either the DHS questionnaire or the SSC. We compared SSHs collected in each group to prospective data on adult mortality collected in Niakhar. The SSC reduced respondents' tendency to round reports of dates and ages to the nearest multiple of five or ten ("heaping"). The SSC also had higher sensitivity in recording adult female deaths: among respondents whose sister(s) had died at an adult age in the past 15 y, 89.6% reported an adult female death during SSC interviews versus 75.6% in DHS interviews (p = 0.027). The specificity of the SSC was similar to that of the DHS questionnaire, i.e., it did not increase the number of false reports of deaths. However, the SSC did not improve the reporting of adult deaths among the brothers of respondents. Study limitations include sample selectivity, limited external validity, and multiple testing. The SSC has the potential to collect more accurate SSHs than the questionnaire used in DHS. Further research is needed to assess the effects of the SSC on estimates of adult mortality rates. Additional validation studies should be conducted in different social and epidemiological settings. Controlled-Trials.com ISRCTN06849961
Highlights
In countries with limited vital registration, demographers increasingly rely on ‘‘unconventional techniques’’ to estimate mortality levels and trends [1]
The siblings’ survival calendar (SSC) has the potential to collect more accurate siblings’ survival history (SSH) than the questionnaire used in Demographic and Health Surveys (DHS)
In a study we conducted in Bandafassi, Senegal, we found that even some deaths that occurred within 2–3 y of the survey were omitted during SSHs [11,19]
Summary
In countries with limited vital registration, demographers increasingly rely on ‘‘unconventional techniques’’ to estimate mortality levels and trends [1] Such techniques utilize information collected during censuses or surveys about the survival of the close relatives of a respondent (e.g., her parents or the members of her household). In countries with limited vital registration, adult mortality is frequently estimated using siblings’ survival histories (SSHs) collected during Demographic and Health Surveys (DHS) These data are affected by reporting errors. In low-to-middleincome countries that have limited resources to devote to such a system, unconventional techniques are often used to estimate mortality levels and trends One such method is siblings’ survival histories collected while conducting a health or other type of public survey. Reporting errors occur when an individual fails to report a sibling’s death, misreports the age of a sibling, or does not recall the exact date when a sibling died
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