Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-07-21T13:33:08Z No. of bitstreams: 1 Dissertação Maria Cristina Camargo. 2000.pdf: 8022402 bytes, checksum: 296a0873d8b8c457742e9945fb83eb7c (MD5) / Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-07-21T13:55:22Z (GMT) No. of bitstreams: 1 Dissertação Maria Cristina Camargo. 2000.pdf: 8022402 bytes, checksum: 296a0873d8b8c457742e9945fb83eb7c (MD5) / Made available in DSpace on 2014-07-21T13:55:22Z (GMT). No. of bitstreams: 1 Dissertação Maria Cristina Camargo. 2000.pdf: 8022402 bytes, checksum: 296a0873d8b8c457742e9945fb83eb7c (MD5) / Este estudo teve como objetivos identificar, descrever e analisar as principais causas da morte materna, do sub-registro e da sub-informação, no período de janeiro a dezembro de 1998. Trata-se de um estudo descritivo e de validação. O método utilizado neste estudo, conhecido por ―RAMOS‖, utiliza todas as possíveis fontes de informações, no rastreamento dos óbitos maternos. Foram estudados 128 casos de óbitos de mulheres em idade fértil, sendo que oito foram óbitos maternos dos quais apenas 3 haviam sido declarados no sistema oficial. O sub-registro encontrado foi de 12,5% e a classificação incorreta das causas maternas respondeu por 50%, totalizando 62,5% de sub-informação. Calcularam-se os coeficientes de mortalidade geral, específicos e proporcionais segundo grupo de causas, idade e município de residência. A análise da composição da mortalidade revelou uma heterogeneidade dos padrões de mortalidade entre os municípios selecionados. A taxa de mortalidade materna oficial foi de 61,6/100.000 nascidos vivos, e a taxa corrigida foi de 164,3/100.000 nascidos vivos, 2,7 vezes maior que a primeira. Os resultados indicam que 3/4 das mortes maternas ocorreram no puerpério precoce, e 1/4 durante a gravidez. As principais causas responsáveis foram às obstétricas diretas (62,5%). / The purpose of this study were as follows: to identify, describe and analyze the main causes for maternal mortality and the related under-recording and under-information from January through December 1998. A descriptive and validation-type study was conducted. The methodology used, known as ―RAMOS‖, utilizes any possible source of information for tracking the maternal deaths. One hundred twenty-eight cases of female deaths occurred during reproductive age; a total number of eight deaths were maternal ones, however just three of them had been recorded accordingly on the official information system. The under-recording rate was 12.5%, while the incorrect classification for maternal deaths was equivalent to fifty percent, thus totalizing an under-information rate equivalent to 62.5%. The specific and proportional coefficients for general mortality were calculated based on mortality cause, age and municipality of residence. The analysis of the composition of mortality revealed a heterogeneous pattern for mortality rates among the selected municipalities. The official maternal mortality rate was equivalent to 61.6/100.000 live birth, while the adjusted rate was equivalent to 164.3/100.000 live birth, which is 2.7 times higher than the former one. The results indicate that ¾ of maternal deaths occurred during early puerperium, while ¼ took place during pregnancy. The main causes were directly related to the obstetrical condition (62.5%).

Under the modern mortality pattern females die at all ages at a lower rate than males. However, this was not always the case. For much of the nineteenth century in the United States and parts of Europe it appears that females died at a higher rate with respect to at least one disease, pulmonary tuberculosis. The purpose of this research is to investigate this question in four towns of the Connecticut River Valley, Massachusetts. First, it is necessary to establish age- and sex-specific mortality rates in the four rural towns in the Connecticut River Valley during the latter half of the 19th century and beginning of the 20th. Secondly, it is necessary to identify those cases in which tuberculosis was the main disease and cause of death. This research seeks to discuss and contribute to the topic of excess female mortality. The four Massachusetts towns of Greenfield, Deerfield, Shelburne, and Montague constitute my research sites. These towns are appropriate for the anthropological pursuit of historical epidemiology due first to the towns’ rural nature at a time when the majority of Americans lived in rural towns, not large urban cities where studies are often focused. Secondly, these towns are of interest because of the extensive data collection that has been conducted previously. Tuberculosis (TB) is an interesting and instructive disease to focus research on. TB has re-emerged in recent decades, and research on the disease may have applied implications and value. TB was the number one killer during the study period, and the nature of the disease is such that it is very sensitive to the social environment. The combination of a rural setting and tuberculosis may give insight into the etiology of a disease that shares a long yet uneven history with humans, and has both biological and cultural significance. Under the traditional mortality pattern females of particular age ranges have greater mortality rates than males. This research discovered that females exceeded males in mortality rates at ages ten to 19 and 30 to 39 and that TB was the root cause of greater female mortality. Interestingly, the sex-specific gap in TB mortality rates was much wider than the gap in overall mortality rates. Thus, while females were dying of one cause, evidence shows that males were dying of another, which may have offset male TB mortality rates.

This thesis examines demographic manifestations of son preference in three parts. Part I develops a simulation model that formalises the decision to practice prenatal sex selection through a "ready, willing and able" framework. The model is calibrated to South Korean and Indian sex ratio at birth (SRB) trajectories. Simulations reveal how SRB distortions in both countries have emerged despite declining son preference due to the rapid diusion of ultrasound combined with growing propensities to abort as a result of weakening norms for large families. Part II examines the potential role of big data to indirectly estimate the SRB at the subnational level in India. States with distorted SRBs tend to display a relatively high Google search activity for ultrasound. SRB "now-casts" generated using search volumes perform better than lagged variable models in high birth registration states. Part III examines the relationship between prenatal sex selection and postnatal excess female child mortality in two studies. The first applies lifetable techniques to decompose population changes in child sex ratios into a fertility component attributable to prenatal sex selection and a mortality component attributable to sex-differentials in postnatal survival. This study finds that although reductions in numbers of excess female deaths have accompanied increases in "missing" female births in all countries experiencing SRB distortions, excess female mortality has persisted in some but not in others. The second study uses birth histories of the Demographic and Health Surveys for six countries that have witnessed SRB distortions - India, Nepal, Pakistan, Azerbaijan, Armenia and Albania - to examine if differential mortality change by sex can be explained by the uptake of prenatal sex selection. This study finds that changes in prenatal sex selection only explain mortality change in India. Across all countries, although patterns of mortality disadvantage are concentrated amongst less educated mothers, prenatal sex selection is strongest among the better educated. Differential sorting into the two behaviours offers an explanation for why the effect for prenatal sex selection is generally weak.