Indicator 3.2.1 Under‐5 mortality rate

Goal 3: Ensure healthy lives and promote well-being for all at all ages 

Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.

Indicator 3.2.1: Under-five Mortality Rate

November 2021

3.2.2 Neonatal mortality rate

Uganda Bureau of Statistics (UBOS)

Uganda Bureau of Statistics (UBOS)

Johnstone Galande

Department of Demography and Social Statistics

Senior Demographer

+256 782 789787

P.O Box 7186, Kampala

galandej1@gmail.com

Definition:

Under-five mortality is the probability of a child born in a specific year or period dying before reaching the age of 5 years.

Concepts:

The under-five mortality rate as defined here is, strictly speaking, not a rate (i.e. the number of deaths divided by the number of population at risk during a certain period of time), but a probability of death derived from synthetic cohort life table and expressed as a rate per 1000 live births. There are two principal categories of estimation methods for calculating infant and child mortality rates: direct and indirect. Direct methods of calculation use data on the date of birth of children, their survival status, and the dates of death or ages at death of deceased children. Indirect methods use information on survival status of children to specific cohorts of mothers, typically age cohorts or time since first birth cohorts. DHS uses the direct method and National Population and Housing Censuses use indirect method.

Number of deaths per 1000 live births

Not applicable

The Uganda Demography and Health Survey (UDHS)

Sample Design:

The sample design for the 2016 UDHS used the sampling frame from the Uganda National Population and Housing Census (NPHC 2014).The census frame is a complete list of all census Enumeration Areas (EAs) created for the 2014 NPHC. In Uganda, an EA is a geographic area that covers an average of about 130 households. At the time of the NPHC, Uganda was divided administratively into 112 districts, which were grouped for this survey into 15 regions. The sample for the 2016 UDHS was designed to provide estimates of key indicators for the country as a whole, for urban and rural areas separately, and for each of the 15 sub regions. Estimates are also presented for three special areas: the Lake Victoria islands, the mountainousdistricts, and greater Kampala. The 2016 UDHS sample was stratified and selected in two stages. In the first stage, 697 EAs were selected from the 2014 NPHC, 162 EAs in urban areas and 535 in rural areas. Households constituted the second stage of sampling. A listing of households was compiled in each of the 696 accessible selected EAs from April to October 2016. To minimize the task of household listing, each large EA (that is to say more than 300 households) selected for the 2016 UDHS was segmented. Only one segment was selected for the survey with probability proportional to segment size, and the household listing was conducted only in the selected segment. Out of the 20,880 selected households (30 households per EA), 18,506 women aged 15-49 were successfully interviewed. All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. In one-third of the sampled households, all men age 15-54, including both usual residents and visitors who stayed in the household the night before the interview, were eligible for individual interviews.

Recruitment and Training:

UBOS recruited and trained field staff to serve as supervisors, CAPI managers, interviewers, health technicians, and reserve interviewers for the main fieldwork. Health technicians were trained separately from interviewers. A two-day f ield practice was organized to provide trainees with additional hands on practice before the actual fieldwork. Prior to the main field work, a pre-test was conducted and best practices were adopted.

Questionnaires:

Four questionnaires were used for the 2016 UDHS: The Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to Uganda. Input was solicited from all stakeholders such as; Government Ministries and Agencies, Non-governmental Organizations, and Development partners. After the finalization of the questionnaires in English, they were then translated into eight major local languages. The Household, Woman’s, and Man’s Questionnaires were programmed into a computer-assisted personal interviewing (CAPI) application for data collection purposes.

Data collection:

Data collection was conducted by 21 field teams, each consisting of one team leader, one field data Manager, three female interviewers, one male interviewer, one health technician, and a driver. The health technicians were responsible for anthropometric measurements, blood sample collection for Hemoglobin and malaria testing, and DBS specimen collection for vitamin A testing. The, interviewers used tablets to record all questionnaire responses during the interviews. The tablets were equipped with Bluetooth technology to enable remote electronic transfer of files, such as assignments from the team supervisor to the interviewers, individual questionnaires among survey team members, and completed questionnaires from interviewers to team supervisors. The field supervisors transferred data to the central data processing office via Internet File Streaming System (IFSS). Senior staff from the Makerere University School of Public Health, the Ministry of Health, and UBOS and a survey technical specialist from the DHS Program coordinated and supervised fieldwork activities. Data collection took place over a 6-month period from June 2016 through December 2016.

Every 5 years

2022

Uganda Bureau of Statistics

Uganda Bureau of Statistics and ICF

The Uganda Bureau of Statistics (UBOS) Act, 1998 provides for the development and maintenance of a National Statistical System (NSS) to ensure collection, analysis and publication of integrated, relevant, reliable and timely statistical information. It established the Bureau as the coordinating, monitoring and supervisory body for the National Statistical System.

Mortality rates among young children are a key output indicator for child health and well-being, and, more broadly, for social and economic development. It is a closely watched public health indicator because it reflects the access of children and communities to basic health interventions such as vaccination, medical treatment of infectious diseases and adequate nutrition.

Miss-reporting of the child’s age at death may distort the age or pattern of mortality especially if the net effect of the age miss-reporting is to transfer death from one age bracket to another.

A full birth history is a complete list of all children the woman has ever given birth to including their date of birth, sex, survival status, age (if alive), and age at death (if died). This is the form of birth history found in the majority of DHS surveys. Birth histories include all live births, including children who later died, but omit stillbirths, miscarriages or abortions. Birth histories are collected in chronological order from first to last.

It is calculated from the component survival probabilities by subtracting each component death probability from 1.  Then product of the component survival probabilities for 0, 1-2, 3-5, 6-11, 12-23, 24-35, 36-47, and 48-59 months of age and    subtract the product from 1 and multiply by 1000 to get the under-five mortality rate.

A wide consultative process is undertaken to compile, assess and validate data on the indicator. The consultation process solicited feedback directly from other Government Agencies responsible for official statistics, on the compilation of the indicators, including the data sources used, and the application of internationally agreed definitions, classification and methodologies to the data from that source. The results of this Indicator consultation are reviewed by Ministry of Health and UNICEF.

None

1. The survey implementation is overseen by a Steering Committee which is constituted using a multi sectorial approach.

2. The survey report is reviewed by an experienced team at Management level who are in most cases Directors or Heads of departments and key stakeholders from Makerere School of Public Health, Molecular Laboratory of Makerere University School of Health Sciences, Ministry of Health and later reviewed by consultants

The UDHS goes through several stages before production and sharing of the final findings. During the Survey implementation. i. Consultative user needs assessment meetings are held with all key stakeholders.

ii. ICF International provided consultants to oversee the UDHS

iii. The survey and sampling design generated using scientific methods as recommended by the Census and Survey Rules and Regulations.

iv. The questionnaire development for different categories of the Target respondents were adapted to reflect the population and health issues relevant to Uganda. (Man’s Questionnaire, Woman’s questionnaire, Biomarker questionnaire and Field worker questionnaire. This follows a multi-stakeholder approach and pretesting helps to establish the relevancy and adequacy of the questions to be used.

v. Comprehensive training is organized for all survey staff before field work.

vi. Senior Supervision is conducted during data collection to ensure that quality data is collected.

vii. Debriefing meetings are organized for field staff at agreed intervals during field work to discuss the field challenges.

viii. Field Data editing, Secondary data cleaning and coding is undertaken before analysis and report writing

Before dissemination, the report is reviewed and quality assured by a professional team of the National Statistical System. Quality Control is addressed at all levels during Survey implementation.

Data Availability:

Data available Every 5 years

Time Series:

Indicator is available for from 1998 to 2016.

Disaggregation: The disaggregation for under-five mortality indicator is sex, Residence (Urban and Rural), Region, Mother’s education, Wealth quintile.

Not applicable

Uganda Demographic and Health Survey 2016 [FR333] (ubos.org) https://dhsprogram.com