New method quantifies uncertainty in estimates of child mortality rates

Measures of uncertainty should be taken into account when estimating progress towards Millennium Development Goal 4 (to reduce the mortality rate of children under 5 years by two thirds from the 1990 level by 2015) in order to give more accurate assessments of countries' progress, according to a study published in this week's PLOS Medicine.

Leontine Alkema and Jin Rou New from the National University of Singapore used a called bootstrapping to calculate uncertainty intervals for the estimates of mortality rates in children aged under 5 years and the yearly reduction in these rates for 174 countries.

Factoring in uncertainty is necessary because many do not have well-functioning vital registration systems to record the number of . When analysing trends in under-5 mortality rates, researchers typically focus on the "best" estimates, but this practice can lead to misleading results and comparisons when such estimates are highly uncertain.

The authors found that in 86 high child mortality countries (with more than 40 deaths per 1,000 in 1990), there was much uncertainty about the levels and trends, especially more recently because of the limited availability of data. In 2011, the median width of the uncertainty intervals of the , relative to their level, was 48% among the high mortality countries compared with 19% in 1990. Furthermore, for 8 countries, the uncertainty level was high enough to not exclude the possibility that no progress had been made in reducing child mortality, whereas for 13 countries, progress is likely to have exceeded the Millennium Development Goal 4 of a 4.4% annual rate of reduction since 1990.

The authors say: "The new uncertainty assessments provide more insights into countries' progress in reducing child mortality because they enable a categorization of countries based on the evidence for the progress that has been made (as supposed to focusing on potentially highly uncertain point estimates)".

The authors add: "Uncertainty assessments can and should be used to complement point estimates to avoid unwarranted conclusions about levels or trends in child mortality and to reduce confusion about differences in estimates, such as estimates from different groups such as the [United Nations Inter-agency Group for Child Mortality Estimation] and the [Institute for Health Metrics Evaluation], or after updating point estimates in light of new data."

More information: Alkema L, New JR (2012) Progress toward Global Reduction in Under-Five Mortality: A Bootstrap Analysis of Uncertainty in Millennium Development Goal 4 Estimates. PLoS Med 9(12): e1001355. doi:10.1371/journal.pmed.1001355

Related Stories

New PLOS collection: Child mortality estimation methods

date Aug 28, 2012

Child mortality is a key indicator not only of child health and nutrition but also of the implementation of child survival interventions and, more broadly, of social and economic development. Millennium Development Goal 4 ...

Adult death rates lowest in Iceland, Cyprus

date Apr 30, 2010

The most comprehensive assessment to date of global adult mortality appears today, April 30, in The Lancet . The study, "Worldwide mortality in men and women aged 15-59 years from 1970 to 2010: a systematic analysis", shows ...

Recommended for you

Breastfeeding protects against environmental pollution

date May 22, 2015

Living in a city with a high level of vehicle traffic or close to a steel works means living with two intense sources of environmental pollution. However, a study conducted by the UPV/EHU researcher Aitana ...

When it comes to hearing, diet may trump noise exposure

date May 22, 2015

Although the old wives' tale about carrots being good for your eyesight has been debunked, University of Florida researchers have found a link between healthy eating and another of your five senses: hearing.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.