2016 Articles

The Evolving Demographic and Health Transition in Four Low- and Middle-Income Countries: Evidence from Four Sites in the INDEPTH Network of Longitudinal Health and Demographic Surveillance Systems

Bawah, Ayaga A.; Houle, Brian; Alam, Nurul; Razzaque, Abdur; Streatfield, Peter Kim; Debpuur, Cornelius; Welaga, Paul; Oduro, Abraham; Hodgson, Abraham; Tollman, Stephen; Collinson, Mark; Kahn, Kathleen; Toan, Tran Khan; Phuc, Ho Dang; Chuc, Nguyen Thi Kim; Sankoh, Osman; Clark, Samuel J.

This paper contributes evidence documenting the continued decline in all-cause mortality and changes in the cause of death distribution over time in four developing country populations in Africa and Asia. We present levels and trends in age-specific mortality (all-cause and cause-specific) from four demographic surveillance sites: Agincourt (South Africa), Navrongo (Ghana) in Africa; Filabavi (Vietnam), Matlab (Bangladesh) in Asia. We model mortality using discrete time event history analysis. This study illustrates how data from INDEPTH Network centers can provide a comparative, longitudinal examination of mortality patterns and the epidemiological transition. Health care systems need to be reconfigured to deal simultaneously with continuing challenges of communicable disease and increasing incidence of non-communicable diseases that require long-term care. In populations with endemic HIV, long-term care of HIV patients on ART will add to the chronic care needs of the community.