published_or_final_version / Medicine / Master / Master of Medical Sciences

published_or_final_version / Urban Studies / Master / Master of Social Sciences

published_or_final_version / Statistics / Master / Master of Social Sciences

The introduction outlines the reasons for the priority of maternal and child health emphasizing the relatively simple resources required. The aims of such programmes must be identified and the results measured so that services can be monitored and evaluated. Categories of measurement are defined and indicators of maternal child health identified within these categories. A chapter is devoted to an outline of the principal non-medical determinants based on material from the Inter-American Investigation of Childhood Mortality. The significance of the principal indicators viz. the perinatal mortality rate, the infant mortality rate, the maternal mortality rate and growth and development data are compared. Chapter lV presents a report of a questionnaire study into local indices viz. Stillbirth rates, Caesarean Section rates and Maternal Mortality rates. The uptake of certain clinic services was also determined. Differences between groups and possible reasons for these are discussed. The final chapter points out the need for accurate birth and death registration and a reliable health information system and suggests methods for achieving this. Recommendations are made for upgrading the collection of data and for improving maternal and child health by research and peripheralization of services. / Thesis (M.Med.)-University of Natal, Durban, 1981.

Infant mortality rates are used as indicators of a group or population's well being. A high rate indicates poor access to social services such as health care provision, and other socioeconomic factors. Sub-Saharan Africa has the highest infant mortality rates in tne world. Compared to the region as a whole, South Africa's rates are lower. However, a sudden increase in rates was noted from early 1990s (Department of Health, Medical Research Council, Macro International, 1998). Since household is the first environment that infants are exposed to, it is thus the environment that strongly influences development and survival chances of this group. The study aims at taking a closer look at several aspects of the structure of the household and how they impact on infant mortality. The study is based on data from the South African Demographic and Health Survey (SADHS) administered by the Department of Health in 1998. Aspects of household structure that are viewed as affecting infant mortality are: sex of the household head, his/her age, number of household members, and number of children under 5 years old in a household. Estimating infant mortality rate and its probability by using ordinary life tables and multiple logistic regression modeling respectively, the study found that sex of the household head does no have an impact as a determinant of infant mortality in South Africa. However, other aspects of the household structure (number of household members and number of younger children under 5 years of age) were found to determine the survival of infants. Larger households are better off in securing infant survival than smaller households. / Thesis (M.A.)-University of Natal, Durban, 2002.

Background Recent gains in child survival are being threatened by the RN epidemic. Monitoring child mortality rates is essential to understanding the impact of the epidemic, but is constrained by a lack of data. A community-based survey was used to determine child mortality rates in a rural area with high RN prevalence, located in the Rlabisa subdistrict of the KwaZulu-Natal Province, South Africa. ii. Methods The study was conducted between 1 January 2000 and 31 December 2002 on deaths in children under the age of 15 years. Children were followed up through 4-monthly home visits. Cause of death was ascertained by verbal autopsy. Rates were calculated using Poisson methods. iii. Results Infant and under-5 mortality ratios were respectively, 59.6 and 97.1 deaths per 1000 live births. Infant and under-5 mortality rates were, respectively, 67.5 and 21.1 deaths per 1000 child-years. RN/AIDS was attributed to 41% of deaths in the under-5 age group, with a mortality rate of 8.6 per 1000 person years. Lower respiratory infections caused an estimated 24.9 deaths per 1000 person years in children under 1 year of age. iv. Discussion In rural South Africa, infant and child mortality levels are high, with RN/AIDS estimated as the single largest cause ofdeath. Improving the coverage of interventions known to impact on child mortality is required urgently. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2007.

No description available.

Life re-insurers are exposed to mortality catastrophe risk. Mortality CAT bonds are a tool that can mitigate this risk. However, a key disadvantage of this tool is the existence of population basis risk, which occurs whenever there are differences between reference and insured populations. In this thesis, we propose a method to measure population basis risk of mortality CAT bonds. We consider a fictitious mortality CAT bond based on the mortality rates of two regional populations. We first obtain mortality change indexes by calibrating the MBMM model on these two regional populations. Then we use copula-based semi-parametric models to simulate the serial dependence and interdependence structure simultaneously between two regional mortality change indexes. Finally, we analyze the hedge effectiveness of the bond, from which we are able to quantify the population basis risk. We find that population basis risk decreases under certain circumstances.

This study investigates the use of five broad accountability mechanisms by gathering the perceptions of charities involved in the Canadian effort to reduce under-5 mortality abroad. While annual deaths in children under the age of 5 declined from an estimate of over 24.0 million in 1960 to under 8.0 million in 2010, mortality reduction goals have been established and missed for decades. As worldwide economies worsen, the amount of funds available for development assistance can be expected to decrease. This study seeks to determine if having accountability mechanisms is perceived to improve organizational behaviour, results and/or reduce costs. It uses a mixed methods approach including: a literature review to gain an understanding of accountability, effectiveness, development and under-5 mortality; key informant interviews to gain an understanding of funders, charities and development; a survey to gather the information required to answer the research questions; and a multiple-case study to gain a better appreciation of how accountability is used and to gather evidence of survey responses. The study investigates: which accountability mechanisms charities have, why they have them and the associated accountability holders; standards body memberships; the relationship between accountability mechanisms and various organizational characteristics; and the perceived effects of accountability mechanisms on organizational behaviour, results and costs. The survey finds that: charities say that they adopt accountability mechanisms because it is a good management practice that is perceived to improve organizational behaviour and results while not incurring costs in excess of the benefits; charities are more likely to adopt accountability mechanisms due to internal pressures than external pressures; the use of accountability mechanisms increases with organization size; and there is a greater difference in use of accountability mechanisms between small and large charities than there is between medium and large charities. The multiple-case study confirms the survey results. This study fills a gap in the literature by providing a Canadian perspective on the use of accountability mechanisms and the relationships amongst them and their perceived effects on organizational behaviour, results and costs. As economic burdens increase, increased accountability may lead to improved results even with fewer dollars.

This study investigates the use of five broad accountability mechanisms by gathering the perceptions of charities involved in the Canadian effort to reduce under-5 mortality abroad. While annual deaths in children under the age of 5 declined from an estimate of over 24.0 million in 1960 to under 8.0 million in 2010, mortality reduction goals have been established and missed for decades. As worldwide economies worsen, the amount of funds available for development assistance can be expected to decrease. This study seeks to determine if having accountability mechanisms is perceived to improve organizational behaviour, results and/or reduce costs. It uses a mixed methods approach including: a literature review to gain an understanding of accountability, effectiveness, development and under-5 mortality; key informant interviews to gain an understanding of funders, charities and development; a survey to gather the information required to answer the research questions; and a multiple-case study to gain a better appreciation of how accountability is used and to gather evidence of survey responses. The study investigates: which accountability mechanisms charities have, why they have them and the associated accountability holders; standards body memberships; the relationship between accountability mechanisms and various organizational characteristics; and the perceived effects of accountability mechanisms on organizational behaviour, results and costs. The survey finds that: charities say that they adopt accountability mechanisms because it is a good management practice that is perceived to improve organizational behaviour and results while not incurring costs in excess of the benefits; charities are more likely to adopt accountability mechanisms due to internal pressures than external pressures; the use of accountability mechanisms increases with organization size; and there is a greater difference in use of accountability mechanisms between small and large charities than there is between medium and large charities. The multiple-case study confirms the survey results. This study fills a gap in the literature by providing a Canadian perspective on the use of accountability mechanisms and the relationships amongst them and their perceived effects on organizational behaviour, results and costs. As economic burdens increase, increased accountability may lead to improved results even with fewer dollars.