Using the INDEPTH model life tables to. mortality rates for. projections. John Gordon INDEPTH AGM DSM 2008

Transcription

1 Using the INDEPTH model life tables to estimate baseline e mortality rates for HIV/AIDS demographic projections John Gordon INDEPTH AGM DSM 2008

2 Background The approach taken is a combination of applied economics/information technology. Required a computerized application to make year national population projections under different scenarios of the HIV/AIDS epidemic in SSA for economic policy analysis. The projections were required to estimate the costs of ART, the impact of prevention and medical staff requirements. No suitable model was publicly available. Borrowed components/data from different sources. Component modules Life table, ASFR, 5 year cohort survival model, ART costing and medical staff requirements. For this presentation concentration is on the life table module.

3 Background II For life tables I required a system which: Was based on African data Used easily available inputs IMR, U5MR Was easy to computerize Provided dcredible estimates. t The INDEPTH Model Life Tables for Sub Saharan Africa were the only option that seemed feasible.

4 Meeting Requirements Looking at the first three criteria: Indepth model based on data from 17 SSA sites for 1995 to Provides full life tables using readily available infant mortality and under 5 mortality rates as inputs. It is designed to estimate mortality tables under scenarios of low and high levels of HIV prevalence. I was hoping to use the low level scenario as a baseline mortality estimate for a two decrement five year cohort survival model. The Indepth tables are based on a Brass logit model and were easy to computerize.

5 Testing the System The INDEPTH tables meet the first three requirements, but it was necessary to test tthe model with available data to see if the model provides credible results. Historical and projected IMR, U5MR and Life Expectancy data is available from the World Bank, UN, USCB. The IMR and U5MR data was used to calculate life tables and the generated life expectancy was compared to the published life expectancy. First tested the system with historical World Bank WDI data WDI does not include male/female estimates Tested with USCB data, estimates of IMR, U5MR and life expectancy with and without an HIV epidemic. Most tests were for Eastern and Southern Africa but also some for West Africa

6 Sample Tests Ghana

7 Source:WDI Sample Tests Sudan

8 Source: WDI Sample Tests Zambia

9 Source: WDI Sample Tests Lesotho

10 Life Expectancy Projections Baseline The first results discouraging. g Model does not provide credible estimates of life expectancy after in countries with serious HIV/AIDS epidemics. Reviewed dthe Indepthsite dt data and estimates: t Different patterns of U5MR for East and West Africa. The modeldid did provide credible estimatesfor , 1985, before the significant drops in life expectancy were evident Used USCB provided estimates of IMR, U5MR and Life Expectancies developed dfor a no epidemic i scenario to test the model for providing baseline mortality data.

11 Kenya HIV and HIV+

12 Malawi HIV and HIV+

13 Tanzania HIV and HIV+

14 Lesotho HIV and HIV+

15 Swaziland HIV and HIV+

16 Botswana HIV and HIV+

17 Projection Issues Botswana, Swaziland and Lesotho IMR and Botswana, Swaziland and Lesotho IMR and U5MR projections by USCB very low, outside range of the INDEPTH model data and out of range of correction coefficients. Also ratio of U5MR to IMR much lower than in INDEPTH input data. In most cases tested INDEPTH high HIV model fits USCB Eastern and Southern African and the low HIV model fits West Africa.

18 Conclusions Computerized ed module eprovides desan opportunity ty to test INDEPTH model under many scenarios. For the countries tested the model is suitable for single decrement models in very low HIV prevalence countries in SSA, but not for high HIV prevalence countries. ti Model suitable for generating baseline mortality estimates for multi decrement models. Computerized module is still a prototype further development needs input from a demographer.

19 THANK YOU ASANTE SANA

20 The Application

21 The Application II

22 The Application III