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INDEPTH Workshop Report
Report prepared by Ms. Samuelina Arthur (INDEPTH), Ernest Obed Nettey (Kintampo HDSS) and
Martin Bangha (INDEPTH)
Workshop Title Page: MADIMAH 3 AND MORTALITY DATA ANALYSIS WORKSHOP:
Data Preparation for All-Cause and Cause-Specific Mortality Analysis
a) From 30th
May to 6th
June, 2012
b) At Miklin Hotel, East Legon, Accra, Ghana
c) Hosted by INDEPTH Secretariat
d) Under the leadership of Philippe Bocquier (Université Catholique de
Louvain), Peter Byass (Umea University), Samuel Clark (University
of Washington ), Steve Tollman (Wits University)
e) Funded by INDEPTH (with support from IDRC Asia)
Names of INDEPTH
Member HDSSs that
participated
The first part which ran from 30th June to 2 July 2012 brought together participants
who attended the MADIMAH 2 workshop that was held in Maputo, Mozambique
28-30 Oct 2011 as well as participants from the Burkina specific data preparation
workshop held in April 2012. A total of about 32 participants from 15 HDSS
attended this first part. These were joined on 2 July by the participants from the
member HDSSs that had not participated in the previous data preparation workshops
(MADIMAH 1 & 2) that were held in Accra and Maputo. Taken together, well over
80 participants including representative from 31 member HDSSs in 14 countries
attended the two workshops. The INDEPTH secretariat was also represented along
with partners from several other collaborating institutions. The list of participating
HDSSs and collaborating institutions is provided below. For detailed list of
participants see Appendix A
HDSS/Collaborating
Institution
Country Number of
participants
Agincourt South Africa 5
Africa Centre (ACDIS) South Africa 1
Bandim Guinea-Bissau 1
Bandafassi Senegal 1
Ballabgarh India 2
Butajira Ethiopia 2
ChiliLab Vietnam 2
DodaLab Vietnam 1
FilaBavi Vietnam 2
Dikgale South Africa 3
Dodowa Ghana 3
Farafenni Gambia 1
Ifakara Tanzania 1
Iganga/Mayuge Uganda 2
Kaya Burkina Faso 2
Kilifi Kenya 2
Kintampo Ghana 4
2
Kisumu Kenya 2
Manhica Mozambique 2
Magu Tanzania 2
Mlomp/Niakhar Senegal 1
Nanoro Burkina Faso 2
Nairobi Kenya 2
Navrongo Ghana 4
Nouna Burkina Faso 2
Ouagadougou Burkina Faso 2
Rakai Uganda 2
Rufiji Tanzania 1
Taabo Cote D‟Ivoire 2
Sapone Burkina Faso 2
Vadu India 3
INDEPTH Secretariat Ghana 4
31 INDEPTH member
HDSSs
14 Countries 69 Participants
Names of INDEPTH
Partners that participated
Collaborating Institution Country Number of
participants
Ghana Health Services (GHS) Ghana 1
Ghana Statistical Services
(GSS)
Ghana 1
Ministry of Health (MOH) Ghana 1
School of Public Health (UG) Ghana 1
Université Catholique de
Louvain
Belgium 1
Umea University Sweden 1
Swiss TPH Switzerland 1
University of Washington USA 1
The two workshops were facilitated by experts from different institutions namely:
PHILIPPE BOCQUIER, Université Catholique de Louvain, Belgium
PETER BYASS, Umea University, Sweden
SAM CLARK, University of Washington, Seatle, USA
STEVE TOLLMAN, Agincourt/Wits University, South Africa
With the assistance of the following: Afolabi Sulaiman and Cho Kabudula
(Agincourt); Kazienga Adama and Karim Derra (Nanoro); Ovalho Augusto
(Manhica); Ernest Nettey and Charles Zandoh (Kintampo), Frank Odhiambo
and Amek Nyaguara (Kisumu); Patricia Elung\„ata and Marilyn Wamukoya
(Nairobi); Martin Bangha (INDEPTH Secretariat)
Background a) The rationale/justification for the two stage workshop
The first NDEPTH mortality data analysis was held in July 2000 at the Hotel
Splendide, Ouagadougou hosted by Nouna HDSS. At that meeting, 18 HDSSs
presented their data. Two years later, the first INDEPTH book title Population and
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Health in Developing Countries was published out of this meeting. Since then,
INDEPTH members HDSSs have increased substantially with more data
accumulated over the years. However, attempts to update this first INDEPTH book
alongside other efforts to publish a comprehensive compendium on fertility and/or
migration using data from most member centers have been unsuccessful.
The reasons were to be found in the need to ensured data quality as well as
harmonization of the various datasets for comparability. Indeed, efforts have been
invested in data quality by different working groups (WG) with considerable success
(e.g. Migration and Urbanization WG and the Mortality Analysis WG). All these
efforts have underscored data management issues and differences in formats as
major obstacle to all cross-HDSS analysis. These led to the recognition that event
history analysis format was the best way to go. In 2011, the Migration and
Urbanization Working Group (MUWG) was supported to launch the 2nd
phase of
work under the theme: “Multi-centre Analysis of Dynamics in Migration and Health
(MADIMAH). The official launch of MADIMAH was marked by the holding of its
first data preparation workshop in Accra in April 2011, during which event-history
files were created for the 15 or so participating HDSSs. INDEPTH later supported a
second data preparation workshop for the same group in Maputo during which
training in event history analyses (micro-data longitudinal analysis) for migration,
mortality and fertility studies was undertaken.
Following the MADIMAH 2 workshop, the facilitator approached INDEPTH for a
3rd
workshop on grounds that this was necessary to come up with the full event
history that will enable the computation of migration, mortality and fertility
indicators before they can proceed with analysis. In March 2012, during the
INDEPTHStats data quality meeting, it was unanimously agreed that the
comprehensive approach of ensuring the harmonization and standardization of data
for cross-HDSSs analysis is best by the event history format. This recommendation
was adopted by the Board.
In line with the foregoing a mortality analysis workshop was scheduled to bring all
the member centres to speed on the data preparation and management format. As
such, this workshop target all centres (all leaders were expected to attend) so as to
discussed these and other strategic decision. Since the previous MADIMAH (1&2)
workshop had targeted only a few centres, it was agreed that MADIMAH 3 should
be held as a training of trainers‟ workshop just before the main mortality analysis
workshop. The MADIMAH 3 workshop targeted previous workshop participants.
b) Workshop announcement
The workshop was announced through the regular INDEPTH information channels:
via the INDEPTH Network web site and email to all the HDSS member centre
leaders (see Appendix b for the detailed announcement).
c) Participants’ selection and application process
Participants for the MADIMAH 3 (training of trainers‟) workshop were mainly
members of the Migration and Urbanization WG who had participated at the two
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preceding workshops (MADIMAH 1 & 2) together with the Burkina participants
who had benefited from a data preparation workshop in April 2012. For the
Mortality analysis workshop, all member HDSSs (centre leaders) were requested to
nominate the appropriate participants who registered online. The centre leaders were
also requested to attend since strategic decisions had to be taken on the mortality
datasets.
Objectives MADIMAH 3 Data Preparation Workshop
The Objectives of the MADIMAH
To finalise consistency checks and complete data preparation as well as
introduce participants to time merging procedure
To include fertility variables (in particular delivery events) and observation dates
in the event history data preparation and to generate fertility outputs in Events
History analysis
To train facilitators (trainers) for the general mortality analysis workshop
MORTALITY Analysis Workshop
As indicated in the foregoing background, following the recommendations of the
INDEPTHStats data quality meeting in Accra March 2012, there were strategic
deliberations at the levels of the Secretariat, Board and SAC. These deliberations
reached a unanimous conclusion that the event history format is the best way to go
for all INDEPTH member HDSSs. Hence the decision to bring the data analysts and
centre leaders from all member HDSSs to Accra for the crucial mortality analysis
workshop. The overall aim of mortality workshop was the harmonization of
datasets by jointly adopting the event history analysis format for INDEPTH
members‟ data on mortality, migration, fertility and cause of death data as well as
agreeing on datasets specifications for online repository (iSHARE), indicators for
INDEPTHStats (display) and more importantly the strategy to increase the scientific
productivity and relevance of the INDEPTH Network ( detailed analysis plan for
cross-centre, cross-national and cross-continental scientific papers).
Specific objectives of the workshop include:
To understand and agree on strategic issues (regarding iSHARE,
INDEPTHStats, INDEPTH Data Specification, INDEPTH data access
and sharing policy, Annual core minimum datasets, confidentiality
issues, etc)
To understand, agree and finalize the events history format for
longitudinal HDSS data, i.e. mortality, fertility and cause of death.
Bring the rest of the member HDSSs to speed with the data preparation
(MADIMAH 1-3 procedures)
To work on cause of death, all-cause and cause-specific mortality
To agree on analysis plan for papers in scientific journals on cross-
centre, cross-national and cross-continental all-cause and cause-specific
mortality, levels, patterns and trends.
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Activities carried out: MADIMAH 3 Workshop
Saturday 30th
June 2012
In the opening remarks by the Executive Director of INDEPTH, Dr. Osman
Sankoh stressed the workshop objectives: that MADIMAH 3 is the last of the
series of data preparation and also meant as a trainer of tutors. The latter will
have to share the knowledge with the wider INDEPTH scientific family during
the mortality analysis session. He expressed gratitude to Philippe for his
availability and willingness to share the knowledge and to those making
themselves available to be tutors. He also expressed pleasure at the presence of
two female scientists in the room from Nairobi HDSS.
Finalization of mortality analysis and preparation of fertility data
To kick off the workshop, Prof. Philippe Bocquier (Universite Catholique de
Louvain) gave some background information about the MADIMAH project. He
stressed on the need for harmonization of data from each HDSS to come out
with a common data structure so that all member HDSSs can produce
comparable data using the same data structure and analytical technique. He
stressed on the idea of analysis-oriented data management which has become a
standard for INDEPTH members expected to adhere to the core minimum data
requirements. This approach in the long run will benefit all member HDSSs to
be able to produce the minimum data requirement. He also acknowledged the
fact that the participants were not all at the same level since not all participants
were part of MADIMAH 1 and 2. In particular, he made allusion of HDSSs from
Burkina who were not part of the initial group but had benefitted from a country-
specific data preparation workshop in April and are now catching up.
Once we have a standardized data across HDSSs, then comparative analysis can
be done as well as data can be shared easily on the iSHARE platform.
Checking of various consistencies and acceptable level of error: Programs on
preparing the data for the workshop were sent to participants ahead of the
workshop. Phillippe pointed out that it is very important to run the consistencies
matrices before analyzing the data. The recommendation for observations with
errors is to be dropped during analysis if they are not much, after which these
errors can be resolved. However, it is important to try as much as possible to
identify and resolved such inconsistencies. Discussions and recommendations
from previous workshops indicate an error level of 1% may be acceptable.
The participants were taken through the event matrix table with emphasis on
some of the important errors that are generated by the matrix. Participants were
made to understand that after identifying and solving the errors in the data, there
is the need to run the matrix again to see the number of errors that still remain in
the data. The final solution in the event matrix is to drop records that still have
problems. This is not recommended if the numbers are still high, however effort
should be made to resolve them. Deleted records should be coded in a way that
the time they contributed is not discarded even though there may be problem of
how they entered or exited. If this is not done, a bias may be introduced into the
analysis.
The most important problem is where a person enters twice at different dates.
This affects both the numerator and the denominator. (Double events are
problems because they can bias the estimates: indeed reconciliation are the most
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difficult cases to resolve). After checking of data, various demographic rates are
now computed which should at least follow the gold standard pattern
(plausibility). The matrix of errors is very effective in identifying problems in
the sequencing of events. It also serves as a monitoring system. It provides an
indication of the quality of data and the areas where more efforts are needed to
improve data quality.
In sum day 1 consisted of going through the mortality and migration (in and out)
output as well as the INDEPTH core minimum data specification, identifying
inconsistencies and how to define/resolve them.
Sunday 1st July 2012
Data preparation for fertility analysis
Taking into account fertility: Unlike migration and mortality, fertility is not
related to residential status of the individual, but fertility is very crucial for
knowledge on the growth of the population. Besides, it can be a consequence of
migration and mortality. While not directly linked to residency, fertility like
migration (possibility of several residency episodes) is a renewable event
(possibility of several delivery episodes per individual). The preceding data
preparation workshops (MADIMAH 1 & 2) did not have time to tackle fertility.
Consequently, day 2 of the workshop focused on how to include into the EHA
data events that are not directly linked to residency.
The main event considered here being the delivery (DLV). The group was taken
through steps required to bring data structure and variables to proposed
INDEPTH data structure and variable naming conventions. Again, participants
were taken through the TMERGE routines which are a user generated ado
program for STATA. Here, it is assumed that all inconsistencies have been
checked regarding the ordering of events in the residency file before merging
with the delivery file. Merging the individual or residency file and the DLV file
is not easy since the latter is not based on the individual Ids. Hence a special
kind of merge is required that matches according to time.
Harmonization was not also considered during the previous data preparation
workshops (MADIMAH 1 & 2) since the aim at first was just to ensure that all
the centers have consistent files. However, henceforth, there is need to
harmonize all datasets to ensure that all the members are speaking the same
language and that data files/variables names are same across different datasets.
Using exactly the same datafiles that they had used to produce mortality and in-
/out-migration rates, the participants were requested to harmonize all the
variables according to the INDEPTH data specification standards.
Monday 2nd
July 2012
Work on data preparation for fertility analysis continued. In particular, the focus
was on how to handle the likely case where the delivery events occur at the same
time or date as the change of residency status. The logic here is that, in such
cases where two different events occur exactly the same day for the same
person, there is often a likelihood that one event will disappear from the file in
favour of the first recorded or given priority in the analysis. The strategy adopted
in order to capture all possible events as close to the date/time of occurrence as
possible was to record such events with a fraction of time difference in timing
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(event time).
In sum, participants were taken through the updated procedure for merging
residency episodes and delivery events by time and generated preliminary
fertility indicators. At the end, most participants were able to produce the first
smoothed curve/graph of ASFR directly in STATA and others could generate
the table of ASFRs from their data.
The group adjourned after lunch break to reconvene the next day for Mortality
analysis. Before the adjournment, facilitators for the mortality workshop were
identified. Participants were actually requested to volunteer and we had in all 11
who volunteered to assist as facilitators during the mortality analysis.
MORTALITY ANALYSIS WORKSHOP
With the arrival of participants from the remaining HDSSs, the mortality workshop
picked up the next day. As noted, it aimed at the creation of event history analysis
format for INDEPTH‟s longitudinal data on mortality, fertility, migration and cause
of death, agreeing on data specifications for iSHARE (online repository for HDSS
data) and INDEPTHStats (displaying HDSS indicators). Another major goal was to
have a detailed analysis plan for cross-centre, cross-national and cross-continental
scientific papers to increase the Network‟s productivity.
Day 1: July 3rd
Tuesday
Prof. Marcel Tanner, Chair of the INDEPTH Board, presided over the opening
session. In a welcome address to the participants the Executive Director of
INDEPTH, Dr. Osman Sankoh, reiterated the main goal of the workshop which, he
said, was to increase the scientific productivity and relevance of INDEPTH. Among
the expected outputs he mentioned include: agreed data specifications; a detailed
analysis plan; a plan for the launch of INDEPTHStats; clarity on iSHARE; and an
understanding of the Secretariat‟s mandate to expedite INDEPTH publications. He
also mentioned that the activities of the workshop would also facilitate the revision
of the first INDEPTH publication entitled: “Population and Health in Developing
Countries” which was published exactly ten years ago.
In his opening address, the INDEPTH Board Chair, Prof. Marcel Tanner urged the
participants to raise the scientific productivity of the Network and provide the global
research society with credible scientific information. “Do not compromise on
science, the Network is about science,” “this is a low level meeting with high
content”, he said. He further encouraged the participants and INDEPTH in particular
to steer away from the usual talk of “high-level meetings with low content”. That
INDEPTH and its members centre should adopt new approaches to make their work
more efficient. In particular he stressed on data quality. In essence, we need to
ensure that what we share is of good quality, which makes impact. What the
INDEPTH needs to do is to ensure good data for the network, and aim at lots of
impact/input for the benefit of the people we are working. There is the need for the
update of cause specific determination of mortality. Prof Marcel Tanner ended with
the assuring participant to focus on their work seriously, no compromise on science,
as good science equal good products and good impact. With this we should achieved
a status for INDEPTH „Too dangerous to be ignored” by other institutions and
organizations.
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Following the opening session, were a series of presentations or updates on various
activities that are critical to the data harmonization and mortality data analysis.
In one of the presentations, Dr. Martin Bangha, the Capacity Strengthening and
Training Manager of INDEPTH, presented the INDEPTH Data Access &
Sharing Policy (iDASP). In particular, he recounted the process involved in the
development, revision and adoption of the policy. He highlighted the levels of
access and data processes distinguished in the policy and acknowledge the
committee that led the development of the policy that is now published and
available on the INDEPTH website.
Dr. Abraham Kobus provided an update on iShare (the online INDEPTH data
repository); the Wellcome Trust funded initiative aimed to assist INDEPTH
scientific working groups and the network scientific activities to develop
documents, extract, harmonise and maintain quality assurance of the analytical
datasets required from centres operational databases. The data repository is
important because it license access to INDEPTH data. More importantly will be
a place for the working group to share data with each other.
Prof. Philippe Bocquier (a member INDEPTH SAC) presented the updated
INDEPTH data specification and minimum core datasets with highlights on
issues that came up during the MADIMAH 3 workshop.
Mr. Somnath Sambhudas presented the INDEPTHStats (online display of
indicators from HDSSs) and Mr. Eliezer Odai-Lartey presented the electronic
VA data capture being developed to help speed up the diagnosis of completed
VAs by physicians.
Dr. Martin Bangha made an update on current status of the data plausibility
checks on mortality and fertility that have been conducted on the datasets
submitted to the INDEPTH Secretariat by the member HDSSs. In effect,
member centres submitted disaggregated HDSS datasets to the Secretariat and a
team of demographers/scientists had been applying plausibility checks based on
life table values and graphs. Reports were written on the checks and forwarded
to the member HDSSs. The update show that there are currently 27 mortality
dataset confirmed as plausible while there are 26 fertility datasets confirmed as
plausible.
After the lunch break, work continued in plenary with Philippe Bocquier
presenting on analysis-oriented longitudinal data management. He went through
a few myths concerning event history analysis (e.g. used for survey data or right-
censored data, etc) and the various terminologies used (e.g. Survival Analysis,
Panel analysis etc). Issues raised and discussed include:
o How to separate and take into account events that occurred on same
day/time to same individual (e.g. multiple DLV)? Concern was expressed
about the potential of artificially separating events that happened on the
same day by adding a day to one of the dates and the fact that this option
could cause dates to be extended beyond censor dates. In response, this
problem could be solved by adding a percentage of a day. Going forward,
this could be decided on by INDEPTH to develop a standard for all.
o How does EHA account for enumeration polygamous men who spend a lot
of time within surveillance area but move often from compound to
compound? How does EHA account for their short multiple residential stays
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in compound?
o How are the HDSSs working to identify real time emergencies in
populations? EHA, particularly if data was captured electronically should be
able to move toward data outputs in real time. It means the HDSSs to be
relevant at national level should become more a surveillance and response
platform than just a monitoring and evaluation platform.
o Currently, HDSSs does not update vagrant homeless populations because of
residency definitions.
Day 2: July 4th
Wednesday
The first day plenary updates and lectures on EHA gave way to the second day
organized in break out sessions of 3 working groups with the facilitators from the
MADIMAH 3 helping their other colleagues through the practical exercises of data
preparation for events history format: Converting episode files into Event History
Analysis files and checking the structure of these files.
Each group consisted of the MADIMAH facilitators and non-MADIMAH HDSSs.
The Non-MADIMAH HDSSs were guided through to construct the consistency
matrices and reported on percentage of inconsistencies. This exercise on how to
create the consistency matrix was facilitated by Prof Philippe Bocquier.
Towards the close of day 2, there was a scheduled presentation in plenary by Prof
Peter Byass who Chairs the INDEPTH SAC. He introduced the group to issues
concerning Cause of Death determination as a context to a later presentation on the
use of InterVA (a probabilistic approach to analysing cause of death). He took the
participant through the WHO/HMN/INDEPTH/UQ short standard verbal autopsy
(VA) tool, which was about to be released.
Finally to wrap up for the day, the Board Chair (Prof Marcel Tanner who was taking
off that evening) was given the floor to share his impressions with the participants.
Expressing his happiness at working with the various centres and appreciation of the
ongoing workshop, he said he has learnt something. He again stressed that we must
all aim at growing INDEPTH to the level of “Too dangerous to be ignored”. In his
comments, he suggested that this could be well achieved if we focus on the
following interrelated points for the years to come:
Build on assets: As he sees it, the best is yet to come. A lot of the basic work has
been done at the sites as well as at the secretariat. Bringing VA and iSHARE2 is
very important. We have to adapt to the technical possibility and realities of
trying to study population dynamics in LMICs.
Data quality: To influence policy and make an impact, we must have better data
The VA story in particular: We have generated a lot of wonderful
data/information. However we do not want to continue with the long delays.
InterVA provides the platform for us to be able to compare/make comparative
cross-site analysis. If we want to be listened to, contribute country-specific data,
and to be recognized in the global arena, we need the synthetic comparative
analysis. We do not want to make wide comparisons rather, there is need to
adapt to situations and move on.
In conclusion, he expressed the hope that by the time INDEPTH celebrates the
next 10 years, it should have achieved this comparative synthetic analysis,
whereby member HDSSs should not only report deaths but have moved beyond
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to explaining why they die of as well as explaining the difference from one area
to another. In this way, INDEPTH would acquire the desirable status of “Too
dangerous to be ignored”. The key remains scientific performance with no
compromise on science. While thanking all the participants for the commitment
and efforts he urge them on with the words: “iSHARE 3 Joys: Joy to discover;
Joy to share and comparing more; Joy to translate to action!”
Day 3: July 5thth
Thursday
The computation for residency status and censoring variables ended in a discussion
led by Kobus Herbst with respect to how the date variables was to be formatted
(handling simultaneous events). The suggestion was that dates should be formatted
by second so that simultaneous events can be separated by a few hours so that dates
of events are not unduly changed. By implication, quite substantial changes had to
be made to previous do-files so as to reformat dates to the lowest denominator.
In a plenary that wrapped up activities for day 3, Peter Byass introduced the group to
the use of InterVA-4 package that will be used to analyse cause of death. He spoke
about the evolution of the software through the years, and demonstrated its utility to
generate causes of death in a short time. InterVA-4 is a probabilistic model that
determines cause of the death on the basis of responses to VA questions and finally
determines cause of death with likelihood estimates. He mentioned an electronic
version of InterVA-4, currently in preparation, which will be field tested in August
for data capture and processing cause of death. Peter made clear that it should still
be possible to use longer VA forms and extract the indicators needed for the new
WHO short standard and InterVA-4. He informed participants that WHO, however,
recommends that any research settings seeking more complex forms should include
all the items in the new WHO standard as a minimum core. The main problems
expressed by participants concerned the lack of narrative towards the determination
of cause of death.
Planning Group Sessions:
Simultaneously to the breakout sessions on 4th and 5th
July, a planning group of
SAC, Board, Centres and Secretariat representatives met under the chairmanship of
Prof. Sam Clark (member of INDEPTH SAC) to deliberate on various issues:
including the launch of INDEPTHStats, and propose an INDEPTH analysis plan,
considering potential themes for cross-centre papers.
A. Agreed indicators for display in INDEPTHStats:
Mortality:
1-CDR
2-Child mortality rate (4q1)
3-IMR (1q0), deaths/live births (do both)
4-U5MR (5q0)
5-ASDR
6-Adult mortality (45q15)
7-Life expectancy
8-Neonatal mortality
9- ASCDR (using INDEPTH, Segi, WHO)
Fertility:
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1-CBR
2-ASFR
3-TFR
4-Mean age of childbearing (maternity, a point measure)
5-Sex ratio at birth
Population
1. Standard Age/Sex groups Pys
2. Standard Age/Sex groups counts of deaths and births
3. Counts of in-/out- migration (standard age / sex)
4. Proportion Under15
5. Proportion 15-59
6. Proportion 60+
7. Overall sex ratio
Migration:
1. Crude In-Migration rate
2. Crude Out-Migration Rate
3. Crude Net-Migration rate (IM-OM)
4. Crude Gross -Migration rate (IM+OM)
5. Age-Specific In-Migration Rates
6. Age-Specific Out-Migration Rates
Cause of Death
Broad categories
B. Publications plans, for the next six months: papers expected on
• Demographic and Health Transitions
• Vaccination and child survival
C. Beyond the six months, papers expected in the following areas:
• Mortality and Fertility
• Migration Dynamics
• Sahelian pattern of childhood mortality
D. With CAUSE OF DEATH information, papers are expected in the
following areas:
• Child mortality
• Adult mortality
• Maternal mortality
• Seasonal mortality
• Aging and NCDs
• Social Determinants of Health (Poverty, Social Inequality, Urban Poverty)
E. Other agreed potential themes for cross-centre papers:
• Newborns
• Health Systems
• Adolescent cohort studies (SRH and Metabolic diseases)
• Epilepsy/VA validation
• HIV/AIDS - ALPHA collaboration
• TB
• Hypertension
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• Family and household dynamics
• HDSS Methods (Analytical methods, HDSS management methods, VAs, SES,
Well-being, Data management/capture/OpenHDS, Expanding the HDSS
footprint (HDSS light), Measurement, Data linkage, Morbidity and health,
Triangulation of HDSS, DHS and census data)
• Malaria
• INESS
• Indoor Air Pollution
• Capacity strengthening / academic experience
• Social Autopsy
• H3Africa
Day 4: July 6th
Friday
Being the last day, the main highlights was the stock taking on the achievements of
the workshop. Philippe Bocquier facilitated the final stock taking session where the
each HDSS reported on the extent of work accomplished on the creation of events
history data structures. Except for Farafenni HDSS (the Gambia), most HDSSs had
completed the data consistency matrices. As might be expected, MADIMAH sites
had completed most of the required outputs for mortality, out-migration, in-
migration and fertility. Non-MADIMAH sites also completed the mortality and out-
migration outputs (see summary report on the centres in Appendix D).
Workshop Achievements
At the end of the workshop, the accomplishments include but not limited to the
following:
Understanding and agreement on Events History Format for HDSS data for
analysis of mortality, fertility, migration and cause of death
Training of trainers on event history data preparation and consistency checks
Regarding INDEPTHStats, the main indicators were agreed for its launch
Merging and extraction of files and identifications of common errors that occurs
during this process.
Understanding and agreement on INDEPTH core minimum dataset
specifications for iSHARE as well as the way forward for iSHARE
Analysis plan for papers in scientific journals on cross-centre, cross-national and
cross-continental all-cause and cause-specific mortality
Conclusion /
Recommendations
Some of the main Recommendations include but not limited to:
Data currently on iSHARE are not in line with the new INDEPTH data
specification. Suspend all current access to data on the repository. As a transition
to iSHARE 2, consider only centre data that have gone through the plausibility
checks of INDEPTH and that are in line with data specification
Cause of death coding: Use the new WHO/INDEPTH classification and for level
of details, use the chapter headings with selection of important diseases
(Malaria, TB, HIV, Pneumonia, Neonatal)
Cause of death determination: For comparative INDEPTH or cross-centre
studies, InterVA 4 is the method of choice. Other methods like physician coding
can be used for centre-specific analysis/studies
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INDEPTHStats: Ensure that everything on display is consistent with the data on
iSHARE 2 and to use only datasets that have gone through checks and certified
as plausible
To customize INDEPTHStats, then subject indicators/uploaded information to
internal review (centre leaders) and external review by international experts (UN
group) before making this public. Meanwhile, the list of indicators will be
reviewed every two years
To enhance the scientific productivity of the Network, focus on cross-centre
publications while simultaneously support centre-specific papers.
The workshop also considered the important issue of whether member centres
should acknowledge INDEPTH‟s contribution to their work and agreed that
centres should acknowledge INDEPTH in all their publications, especially those
that make use of the HDSS platform.
By way of conclusion: INDEPTH “Too Dangerous to be Ignored” or “Too
Shiny to be Missed”
The closing remark was made by Prof. Osman Sankoh. He expressed his gratitude to
the board chair, board members, SAC members and all participants who were
attended for their participations, contributions and their support for the Network.
During the stocktaking exercise that was done regarding the quality of the data
achieved by the various HDSSs present, the participants cheered at the revelation
that 50% of the HDSSs had fewer than 0.8% errors, and 90% had fewer than 3.5%
errors even BEFORE corrections! This meant that the Network‟s efforts to support
the member centres over time had paid off. The Board chair, Marcel Tanner, in his
excitement had coined the slogan: "It's too dangerous to ignore INDEPTH." In
response to this achievement, Evasius Bauni of Kilifi HDSS coined his: "INDEPTH
is too shiny to be missed."
Appendices
(See below)
a) List of participants
b) Workshop announcement
c) Workshop programme
d) Summary table on completed event history outputs by HDSS
e) Presentation and other workshop documents (see attached files)
14
Appendix A: List of participants
Name of Participant HDSS Contact
1 Chodziwadziwa Kabudula Agincourt, South Africa [email protected]
2 Sulaimon Afolabi Agincourt, South Africa [email protected]
3 Fikre Gashe Butajira, Ethiopia [email protected]
4 Negussie Kabeta Butajira, Ethiopia [email protected]
5 Solomon Choma Dikgale, South Africa [email protected]
6 Nguyen Linh Filabavi, Vietnam [email protected]
7 Obed Nettey Kintampo, Ghana [email protected]
8 Charles zandoh Kintampo, Ghana [email protected]
9 Frank Odhiambo Kisumu, Kenya [email protected]
10 Nyaguara Amek Kisumu, Kenya [email protected]
11 Orvalho Augusto Manhica, Mozambique [email protected]
12 Charfudin Sacoor Manhica, Mozambique [email protected]
13 Kazienga Adama Nanoro, Burkina Faso [email protected]
14 Karim Derra Nanoro, Burkina Faso [email protected]
15 Patricia elung'ata Nairobi, Kenya [email protected]
16 Marilyn Wamukoya Nairobi, Kenya [email protected]
17 Niamba Louis Nouna, Burkina Faso [email protected]
18 Ali Sie Nouna, Burkina Faso [email protected]
19 George Wak Navrongo, Ghana [email protected]
20 Abraham Oduro Navrongo, Ghana [email protected]
21 Paul welaga Navrongo, Ghana [email protected]
22 Cornelius Debpuur Navrongo, Ghana [email protected]
23 Bruno Lankoande Ouagadougou, Burkina Faso [email protected]
24 Roch Millogo Ouagadougou, Burkina Faso [email protected]
25 Lankoande Malik Sapone, Burkina Faso [email protected]
26 Sombie Seydou Sapone, Burkina Faso [email protected]
27 Bhushan Girase Vadu, India [email protected]
28 Somnath Sambhudas Vadu, India [email protected]
29 Philippe Bocquier SAC/UCL Belgium [email protected]
30 Stephen Tollman Agincourt, South Africa [email protected]
31 Kathleen Kahn Board/Agincourt, South Africa [email protected]
32 Samuel Clark SAC/U. Washington, USA [email protected]
33 Seth Owusu-Agyei Kintampo, Ghana [email protected]
34 Abraham Herbst Africa Centre, South Africa [email protected]
35 Amabelia Rodrigues Bandim, Guinea-Bissau [email protected]
36 Ousmane Ndiaye Bandafassi, Senegal [email protected]
37 Sanjay Rai Ballabgarh, India [email protected]
38 Shashi Kant Ballabgarh, India [email protected]
39 QuyenEN Bui Chililab, Vietnam [email protected]
40 Bich Tran Chililab, Vietnam [email protected]
41 Marianne Alberts Dikgale, South Africa [email protected]
42 Timotheus Darikwa Dikgale, South Africa [email protected]
43 Tran Thanh Dodalab, Vietnam [email protected]
44 Doris Sarpong Dodowa, Ghana [email protected]
45 Elizabeth Awini Dodowa, Ghana [email protected]
46 Margaret Gyapong Board/Dodowa, Ghana [email protected];
47 Momodou Jasseh Farafenni, Gambia [email protected]
48 Phuc Ho Dang Filabavi, Vietnam [email protected]
49 Amri Zomboko Ifakara, Tanzania [email protected]
50 Dorean Nabukalu Iganga/Mayuge, Uganda [email protected]
15
51 Aristide BADO Kaya, Burkina Faso [email protected]
52 Simon Tiendrebeogo Kaya, Burkina Faso [email protected]
53 Evasius Bauni Kilifi, Kenya [email protected]
54 Carolyne Ndila Kilifi, Kenya [email protected]
55 Coleman Kishamawe Magu, Tanzania [email protected]
56 Laetitia Douillot Mlomp, Senegal [email protected]
57 Tom Lutalo Rakai, Uganda [email protected]
58 Joseph Ssekasanvu Rakai, Uganda [email protected]
59 Sigilbert Mrema Rufiji, Tanzania [email protected]
60 Siaka KONE Taabo, Côte d'Ivoire [email protected]
61 Nahoua Baikoro Taabo, Côte d'Ivoire [email protected]
62 Peter Byass SAC/Umea University, Sweden [email protected]
63 Sanjay Juvekar Board/Vadu, India [email protected]
64 Tola Heng FilaBavi, Vietnam [email protected]
65 Marcel Tanner Board/Swiss TPH [email protected]
66 Jacques Emina Indep. Consultant, Belgium [email protected]
67 Peter waiswa Iganga/Mayuge, Uganda [email protected]
68 Eliezer Odei-Lamptey Kintampo, Ghana [email protected];
69 Cynthia Bannerman Ghana Health Services (GHS)
70 Reginald Odai Ministry of Health (MOH)
71 Richmond Ayeteey School of Public Health (SPH)
72 Representative?? Ghana Statistical Services
73 Osman Sankoh INDEPTH Secretariat [email protected]
74 Martin Bangha INDEPTH Secretariat [email protected]
75 Titus Tei INDEPTH Secretariat [email protected]
76 Samuelina Arthur INDEPTH Secretariat Samuelina.arthur@indepth-
network.org
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Appendix B: Workshop announcement
Related Workshops
Titles: 1) MADIMAH 3
2) Analysis of All-Cause and Cause-Specific Mortality at
INDEPTH member HDSSs Dates: MADIMAH 3
a) Arrival: b) Workshop: c) Departure:
Mortality Analysis d) Arrival: e) Workshop: f) Departure:
29 June 2012 30 June – 2 July 2012 6 July 2011 2 July 2012 3 July – 6 July 2012 6 July 2011
Venue: a) Hotel: b) City/Country:
Same venue for both workshops Miklin Hotel, East Legon, Accra, Ghana Accommodation at: Miklin Hotel and MJ Grand Hotel, East Legon
Facilitators Overall responsibility:
Prof. Peter Byass (INDEPTH SAC Chair)
Prof. Steve Tollman (INDEPTH Principal Scientist)
Prof. Sam Clark (INDEPTH SAC) MADIMAH
Prof. Philippe Bocquier (INDEPTH SAC)
Dr. Mark Collinson (INDEPTH Migration and Urbanisation WG)
A group of new tutors to be trained
Objectives: A. MADIMAH 3 1. Include FERTILITY in the events history preparation 2. Finalise checks and complete data preparation 3. Train tutors for the general mortality analysis group
B. Mortality Analysis 1. Deal with strategic issues (iSHARE, INDEPTHStats, INDEPTH Data
Specification, INDEPTH data access and sharing policy, Annual minimum data, confidentiality issues, etc)
2. Bring the rest of HDSSs to speed with MADIMAH 1-3 3. Finalise Events History Format. Agree final data sets 4. Work on Cause of Death 5. Analysis all-cause and cause-specific mortality 6. Agree cross-site and centre-specific papers for international journals
on mortality levels, patterns and trends
Expected Outcomes: A. MADIMAH 3 1. Mortality datasets prepared for analysis based on events history
format. 2. A group of INDEPTH scientists trained to train others.
B. Mortality Analysis 1. Final datasets for mortality analysis – INDEPTH stamped 2. Agreement on Cause of Death analysis 3. Preliminary analysis results obtained
17
4. Further analysis plan for multisite and centre-specific publications agreed
5. Responsibilities for further analysis and writing agreed 6. Agreement on the launch of INDEPTHStats
Proposed topics for discussion
a) Events History Analysis b) Cause of Death c) Life Tables d) Mortality Levels, Patterns and Trends e) Maternal Mortality f) Infant and Child Mortality g) Adult Mortality h) Old-age Mortality i) Seasonal Trends in Mortality j) Model Life Tables k) INDEPTH Population Standard l) Cross-site and centre-specific publications
Expected Participants: 1. ALL INDEPTH Member HDSSs (Data Analyst plus HDSS leader are expected to attend.
2. Centres with multiple HDSSs may send one analyst for each HDSS)
Deadline for Nomination of Participants to the Secretariat
Reasonable tickets to workshops can be obtained if booking for participants is done early enough. Hence, centre leaders are kindly urged to nominate participants on or before the deadline stated below. (Friday, 25 May 2012)
Hosts:
INDEPTH Secretariat
Requirements: a) Nominations must be made by centre leaders only to ensure that the right people attend the workshop
b) Centre leaders are kindly requested to attend this workshop as strategic decisions on mortality datasets will be taken.
c) All participants are required to bring along laptops to the workshop.
Travel advisory: a) Visas:
b) Overnight stays
a) We will issue out invitation letters to confirmed participants to apply
for visas, where applicable. Please inform the Secretariat if you require any assistance.
b) For overnight stays, please see travel support below.
Travel Support: a) The Secretariat will cover the cost of a return economy class ticket from home country to the city where the workshop will be held.
b) Reasonably priced non-refundable tickets will be purchased. When you receive a booking you must check to ensure that everything is fine. Once confirmed by you, any changes that will lead to extra cost must be covered by the member centre.
c) Travel insurance cannot be covered by INDEPTH d) In-country travel from centres to the airport will be covered. Please
inform the Secretariat of the cost. Evidence of payment for the travel must be produced.
e) Should overnight stay both in-country and while in transit be necessary, please inform the Secretariat before starting the journey so that adequate preparation can be done for reimbursements. Original receipts will be requested by the Secretariat.
f) The Secretariat will usually cover accommodation for the workshop
18
days plus half boarding. A per diem will be paid for dinner and incidentals. All other services at the hotel (mini bar, telephones, etc) must be paid for directly by the participants.
Reimbursements a) Please bring along to the workshop originals of all expenses incurred for your travel to the workshop.
b) To avoid delays, you may scan the receipts and email before starting your journey to the Secretariat.
c) We prefer to transfer funds to institutions’ bank accounts. However, if you have pre-financed the trip privately, we will refund to your personal bank account.
INDEPTH Staff responsible for these workshops
Dr. Martin Bangha (Capacity Strengthening and Training Manager) Email: [email protected] Supported by:
1. Caroline Tekyi-Mensah: [email protected] 2. Peter Asiedu: [email protected]
Other issues: Participants may be asked kindly by the Secretariat to bring along information materials from their centres. These may include strategic plans, annual reports, publications and brochures and financial reports on sub-grants.
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Appendix C: Workshop programme
MADIMAH 3 and Mortality Analysis Workshop Miklin Hotel, East Legon: 30th June – 6th July 2012
Date/Time Activities
Fri June 29 Arrivals in Accra
Sat 30 June Finalization of mortality analysis and preparation of fertility data
09:00-10:30 Completing data checks for migration/mortality: conformity to
INDEPTH “Core minimum micro-data set specifications”
10:30-11:00 Health Break
11:00-13:00 Producing life-table indicators for mortality workshop using Excel
13:00-14:00 Lunch
14:00-16:00 Sites updates on their fertility files
16:00-16:00 Health Break
16:30-17:30 Preparing data: adding fertility events to residency file
Sun 01 July Finalization of fertility data and first fertility analysis
09:00-13:00 Organizing data for fertility analysis
11:00-11:30 Health Break
11:30-13:00 Organizing data for fertility analysis
13:00-14:00 Lunch
14:00-16:00 Producing fertility indicators
16:00-16:30 Health Break
16:30-17:30 Producing fertility indicators
Mon 02 July Way forward
09:00-11:00 Reporting on fertility analysis and MADIMAH next steps
11:00-11:30 Health Break
11:30-13:00 Deliberations: identifying trainers and leaders for mortality workshop
13:00-14:00 Lunch
14:00-16:00 Meeting of leaders and trainers for mortality workshop
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Appendix D: Summary Table on completion of expected outputs by various members HDSSs
HDSS Site
Percent Complete (30 sites)
MADIMAH Group (15)
Mortality Group
(15)
Consistency matrices (order of events)
Matrix before corrections (with % errors) 96.7% 15 14
Initial mean percentage errors 1.8%
Initial median percentage errors 0.8%
Initial 9th decile percentage errors 3.5%
Matrix after desk corrections (with % errors) 93.3% 15 13
Mortality indicators
Mortality nMx table 86.7% 14 12
Mortality lx table 86.7% 14 12
Table of nax 86.7% 14 12
Graph of age-specific mortality rates (log-scale)
90.0% 15 12
Excel Life-Table using Stata output* 30.0% 6 3
Out-Migration indicators
Out-Migration Rates table (5-year age groups) 53.3% 13 3
Graph of out-migration age-specific rates 56.7% 14 3
In-Migration indicators
In-Migration Rates table (5-year age groups) 40.0% 12 0
Graph of in-migration age-specific rates 46.7% 14 0
Fertility indicators
Age-specific fertility rates (ASFR) table 33.3% 10 0
Graph of age-specific fertility rates 33.3% 10 0
Mean age at childbearing 30.0% 9 0
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Appendix E: List of presentations