Stan
Becker, Associate Professor, Department of
Population Dynamics, Johns Hopkins School of
Hygiene and Public Health;
Robert E. Black, Edgar Berman Professor and Chair,
Department of International Health, Johns Hopkins
School of Hygiene and Public Health.
The authors present a macro model of morbidity and mortality in children under five years of age. Monthly disease-specific incidence and case fatality rates form the basis of the model, and the efficacy and coverage of disease-specific interventions alter these values. In addition, frailty is modeled via relative risks of mortality based on five groups, determined for newborns by the birthweight distribution and, at ages after the first month, by the proportion of children surviving a given illness who become more frail and the proportion not ill and with adequate nutrition who become less frail. A validation of the model was carried out using data from the Demographic Surveillance System in Matlab, Bangladesh. The model very closely predicts the observed mortality level. Scenarios for improvements in coverage of specific interventions in settings in South Asia, West Africa, and South America are modeled and their effects on mortality gauged. The model provides a useful tool for those wishing to know the mortality impact of specified mixes of interventions in a given setting.
Population
and Development Review [22, no. 3 (Sep 96)
431-456]