Health, well-being and mortality in Africa (Botswana, Lesotho, Zambia).

摘要

This dissertation is made up of three separate but related papers. The first two utilize verbal autopsy data to examine causes of death in a rural African setting while the third one employs census data to examine household socio-economic status and its relationship to childhood mortality in Africa. In the first paper, I evaluate the data using demographic and statistical techniques and examine the causes of death patterns resulting thereof, comparing these to standard patterns of mortality based on data from areas with similar socio-economic and ecological conditions. In the second paper, I estimate the impact of malaria mortality, the leading cause of death in this population by attempting to answer the question "how many person-years could be saved if malaria was eliminated from the population and how would that contribute to increases in human longevity?" Assuming that mortality conditions of the period prevailed, it is estimated that well over 22 percent of the total population may have been saved if malaria were eliminated as a major cause of death in the population. This could have resulted in extending life expectancy at birth by more than 6 years. The third paper explores the extent to which housing and household characteristics, including asset possessions could be used to proxy for income and consequently, socioeconomic status within households in Africa where direct measures of income are not usually available. Employing census data from Botswana, Lesotho and Zambia, we establish that these measures are useful for providing reliable information that can be used to differentiate populations within households by poverty groups. The results indicate clearly that there are persistent health inequities in the countries covered, with children from better-off households experiencing lower mortality levels than their counterparts from poorer households.