| Theme leader: Sam Clark with Mark Collinson; Theme officer: Victor Odera Demographic and epidemiological changes taking place in rural populations need to be understood for health and development planning at district, provincial and national levels. We need to identify the forces driving population change in mortality, morbidity, fertility, migration and socio-economics. The HDSS updates annually individual?s residence dynamics including dates of entering or leaving the population (births, deaths, in and out-migrations), pregnancy outcomes, maternity history, relationship to household head, links to parents, marital status, identity document status and national identity number. Research clusters represent collaborations of scientists who use the HDSS to compute and publish trends in mortality, morbidity, fertility, migration, and livelihoods. - Mortality
Collaborators: Univ Washington, USA; Wits Population Studies; Pasteur Institute, France; Ume?niv, Sweden
a. Trends in age, sex and cause-specific mortality, including spatio-temporal analyses using GIS data
b. Strengthening verbal autopsy assessment (VA): validation of InterVA, a deterministic model to assess probable cause of death using VA. Model produces standardised assessments compared to physician diagnoses, costs less and produces more timely outputs. Work will contribute to WHO efforts to improve cause-of-death ascertainment and make tools available.
- Morbidity
Collaborators: Kilifi HDSS, Kenya; Warwick and Edinburgh Universities, UK
The HDSS has supported prevalence studies in child and adult health (stroke, TB, IMCI, physical and cognitive function of adults 50 ). In 2009, surveillance of active convulsive epilepsy was conducted to establish the burden of disease. This involved a screening question in the HDSS census, followed up by clinical assessment of positive cases.
- Fertility and reproductive health
Collaborators: Wits Population Studies; Pasteur Institute, France; Univ Colorado Boulder, USA; London School of Hygiene and Tropical Medicine, UK
a. INDEPTH - multi-site fertility monograph (Agincourt chapter is authored by Mildred Shabangu, Chodziwadziwa Kabudula, Jill Williams and Michel Garenne)
b. Unit is a member of the Alpha Network, an international scientific network studying HIV in remote populations using HDSS and embedded HIV surveillance data. Emphasis is on adolescent fertility, sexual networks and reproductive health with an aim of strengthening policy in these areas.
- Migration
Collaborators: Wits Public Health and Population Studies; Brown, Washington & Colorado Universities, USA
Examines impacts of migration trends on livelihoods and health; includes INDEPTH multi-country study.
- Livelihoods
Collaborators: Univ Cape Town; Wits Population Studies; Wits School of Accountancy; Univ Missouri and Maryland, USA
Socioeconomic status indicators are collected during census update rounds. Repeat cross-sectional modules are done and used for longitudinal analyses of livelihood strategies, their outcomes, and how these change in time. In 2009,
modules included: asset status, food security, education and labour status.
- Indirect methods validation study
Collaborators: University of Cape Town; Wits Public Health; University of Washington
Every household had data collected as if a national survey. HDSS was used to provide a comparable dataset for evaluation of the indirect estimates obtained from project data. This will enable a better understanding of the errors and biases that arise in census-type data collection exercises. Results may lead to changes in how single-round census surveys are conducted, and indirect methods of demographic estimation. |
