Population and Development for health.pptx

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1. Population and Development by Wubegzier Mekonnen, PhD School of Public Health Addis Ababa University

2. Course outline Definition of demography and population studies; and sources of demographic data Demographic ratios, rates and probabilities Population composition Components of population change Population and Development relations Population Policy

3. Demography Demography originates from 2 Greek words(demos=people; graphein=to write) Demography is the scientific study of human populations, primarily with respect to their size, their distribution, their structure, and their change (UN Multilingual demographic dictionary) Demography—The study of a population in its static and dynamic aspects

4. Demography Static aspects include characteristics at a point in time such as composition by: Age Sex Race Marital status Economic characteristics

5. Demography Dynamic aspects are:the movement of population Fertility Mortality Nuptiality Migration Growth

6. Demographic Analysis Demographic Analysis—The study of components of variation and change in demographic variables and the relationships between them This is also called formal demography or demographic methods or technical demography

7. Population studies The definition of demography can be extended to include and to cover the social, economic, historical and political characteristics of the population and related processes This broader aspect of the study of demography is known as population studies

8. Population Studies Population Studies—The study of the relationships between demographic variables and other variables such as social and economic variables Population studies = Technical demography + Substantive demography Population studies is at least as broad as interest in the determinants and consequences of population trends

9. Sources of demographic data Conventional sources Civil registration system Censuses Surveys Non-conventional sources Population registers: records the movement of people Administrative records includes such as school records Parish registers includes records of burials and christenings

10. Civil Registration It is the continuous registration of vital events such as birth, death, marriage and death as they happen. Relatively a modern concept in its present format Churches have long maintained baptism and burial registries Provided insight on the demographic situation since the late Middle Ages

11. Civil Registration Data collection procedures in civil registration system Active: registrars visit every household Passive: informants report to registrars Informants can be health facilities or family members There are two main activities in the system The vital registration, which focuses on administrative and legal issues The Statistical system focusing on rates

12. Civil Registration Purpose Primarily administrative, but has legal and statistical use To collect data on the vital events happening in a population (generally concerned with live births, deaths, marriages and divorces) Help understand demographic characteristics of different populations at different points in time

13. Civil Registration Essential characteristics Event registration Universality Continuity Definitions and content Live birth Death Marriage Divorce

14. Live Birth Live birth—Complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which after such separation, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn Source: WHO

15. Live Birth All live-born infants should be registered and counted as such irrespective of gestational age or whether alive or dead at time of registration, and if they die at any time following birth they should also be registered and counted as deaths Source: WHO

16. Live Birth Registration The United Nations recommends that the following be collected at a minimum for live birth registration: Data on event Date of occurrence Date of registration Place of occurrence Type of birth/delivery Attendance at birth

17. Live Birth Registration Data on infant: Sex Legitimacy status Weight at birth

18. Live Birth Registration Data on mother: Age or date of birth Number of previous children born alive Date of marriage or duration of marriage Place of usual residence

19. Death Registration Death—Permanent disappearance of all evidence of life at any time after live birth has taken place (post-natal cessation of vital functions without capability of resuscitation) This definition excludes fetal deaths

20. Fetal Death Fetal Death—Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy The death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles

21. Fetal Death Categories Three major categories of fetal deaths recommended by WHO: Early fetal death: < 20 completed weeks of gestation Intermediate fetal death: > 20 but <28 weeks Late fetal death: > 28 weeks Stillbirth Stillbirth—Late fetal death To be used only if essential for national purposes

22. Death Registration The United Nations recommends that the following be collected at the minimum for death registration Data on event: • Date of occurrence • Date of registration • Place of occurrence • Cause of death • Certifier

23. Death Registration Data on deceased: Age or date of birth Sex Marital status Occupation Place of usual residence

24. Problems with Cause of Death Data Knowledge of certifier Certifier may never see deceased “Garbage codes”: missing, senility, etc . Heart versus brain function loss in the definition of death

25. Problems with Cause of Death Data Multiple and contributory causes of death Medical classification changes over time – François de la Croix – John Graunt WHO and the International Classification of Diseases (ICD); now at version 10

26. Marriage Registration Marriage—An act, ceremony or process by which the legal relationship of husband and wife is constituted The legality of the union may be established by civil, religious, or other means as recognized by the laws of each country There are civil, religious and traditional marriages in Ethiopia Source: United Nations

27. Marriage Registration The United Nations recommends that the following be collected at a minimum for marriage registration: Data on event: • Date of occurrence • Date of registration • Place of occurrence • Type of marriage—civil, religious, customary

28. Marriage Registration Data on bride and groom: – Age or date of birth – Previous marital status – Place of usual residence

29. Divorce Registration Divorce—Final legal dissolution of a marriage, that is, that separation of husband and wife which confers on the parties the right to remarriage under civil, religious and/or other provisions, according to the laws of each country

30. Civil Registration Evaluation of coverage and content – Matching studies – Aggregate demographic analysis Cost – High

31. Civil Registration Advantages – Continuous monitoring of vital rates – May provide both numerator and denominator for some rates (e.g., Infant Mortality Rate—IMR) – Small area data available – Base for testing the accuracy of censuses and surveys

32. Civil Registration Disadvantages – Uncertain coverage: Difficult to ensure registration of all the events – Limited background information – Time reference often inconsistent with denominator definition – Information may come from third party

33. Civil Registration Disadvantages – Easily disrupted by political/economic events – Literacy/numeracy – Costly

34. Points to Watch in using vital registration Data Always evaluate coverage for developing countries Look into how delayed registration was handled Check whether classification was done by place of residence or place of occurrence Consider how treatment of non-response has been handled

35. Personal Identification Number (PIN) Method used in Israel, South Africa, Sweden, and Thailand Each individual is assigned a unique number used for the rest of his/her life on all pertinent documents in the national data system System acts as a census because it is continuously updated by births, deaths, immigrants, and emigrants

36. Censuses Census—The total process of collecting, compiling, analyzing, and publishing or otherwise disseminating demographic, economic, and social data pertaining to all persons in a country or in a well-delineated part of a country at a specified time: United Nations Essential Characteristics Individual enumeration Universality Simultaneity

37. Content and Types A census contains: –Demographic data (at least age and sex) –Economic data (e.g., occupation and income) –Social (e.g., education and housing)

38. Content and Types 100-percent component – Household relationship – Sex – Age – Marital status – Religion Ethnic group

39. Content and Types Sample component Social characteristics – Education (enrollment and attainment) Marital status Occupation Industry Housing condition etc.

40. Content and Types A census can be conducted: – De jure: Legal or customary attachment to an area (you are registered where you usually reside) – De facto: Physical residence (you are registered where you are currently staying/residing at the time of the census)

41. Data Collection Procedures Establish administrative tree Develop questionnaire(s) Cartography (Define enumeration areas) Pretest enumeration processes Design data processing system Enumeration Publications Dissemination of results

42. Evaluation Estimation of undercounts – Post-enumeration survey – Demographic evaluation P t =P +B-D+I-O Cost Estimates for 1990 – $10 per head in the U.S. – $1 per head in most developing countries

43. Advantages Universal, hence small area data available National effort Provides frame for later sample surveys Provides population denominators Disadvantages Size limits content and quality control efforts Cost limits frequency Delay between field work and results Sometimes politicized

44. Imputation Technique To assign values to “Unknowns” – Cold deck: use the frequency distribution of known cases e.g known sex , age, m.status Occup =house wife – Hot deck: take values from previous case with same other characteristics (computer algorithm) Points to Watch in Data Population definition Coverage change between censuses Treatment of non-response Imputation technique

45. Surveys Purpose – Obtain information from a sample representative of some population Limited in scope Content – Varies widely – e.g., fertility, child mortality, migration, DHS, etc

46. Essential Characteristics Representative sample of certain population Smaller size than census allows collection of more in-depth information that can then be generalized

47. Types of Surveys Single-round retrospective/Cross-sectional – Census-type household surveys – Focused, (e.g., Contraceptive Prevalence Survey (CPS)) – Birth/Maternity history (World Fertility Survey (WFS), Demographic and Health Survey (DHS)) – Health monitoring

48. Types of Surveys Multi-round follow-up (prospective) e.g Surveys in Demographic Surveillance Sites (DSS) Butajira Rural Health Program Dabat Kersa Gilgel Gibe Kilte Awulalo Arbaminch

49. Sampling Methods Sampling frame, generally from census Usually separate strata are often defined for sampling – The provinces of a country could be strata or urban and rural areas – There may be multiple strata

50. Sampling Methods Census enumeration areas or sections of them may constitute a cluster from which households are sampled (clusters are typically sampled within strata and then households within clusters) Cost In the 1990s, ranged approximately from $10 to $150 per capita (in USA) Least expensive method

51. Advantages Single-round retrospective – Can be quick – Relatively inexpensive – Flexible – Can include detailed data (maternity history in DHS) – Needs little continuity effort Multi-round prospective – Some control on coverage and content errors e.g if age is missing in one round can be estimated later – Follow-up allows control for sampling distortion

52. Disadvantages Single-round retrospective – Coverage and content errors – Misses certain types of events e.g illegal abortion Multi-round prospective – Slow – Needs continuity effort over extended time – High cost

53. Demographic Ratio, Rate, and Probability

54. Ratio Value obtained by dividing one quantity by another Indicates the relative magnitude of a numerator and a denominator Ratios tend to be descriptive statistics A proportion is a special type of ratio in which the denominator includes the numerator A percentage is a special type of proportion, whereby the proportion is multiplied by 100

55. Examples of Ratio Sex ratio at birth (male births per 100 female births) Child-woman ratio (number of children aged 0 to 4 years divided by the number of women aged 15 to 44 years) Dependency ratio (population aged under 15 or over 64 divided by the population aged 15 to 64 and multiplied by 100)

56. Advantages of Ratios Ratios are very easy to calculate Provide quick and concise comparisons between many corresponding sets of numbers

57. Rate Measure of the frequency with which an event occurs in a defined population during a given length of time Rates are special cases of a ratio Rates tend to be associated with population change Numerator: Count of events that occur during a period Denominator: Midpoint population, or person-years, or other person-time units of exposure for the same period as the numerator – Persons exposed to the event are included in the denominator, but others can also be included

58. Types of rates Observed rates Standardized rates Observed rates may be classified as Central rates Probabilities Central rates can be categorized as Crude Specific rates

59. Limitations of central rates Unreliability-if some strata of the population consist of small number of people Unavailability-e.g deaths and not their division by segment Incomparability-due to variations in compositions by age, sex, etc. Non-probability-do not describe precisely the risk of dying for any cohort

60. Crude Rate The number of events is divided by the total population – Problems: Denominator contains some individuals not susceptible to the event Is affected by age structure of the population; makes comparison between populations difficult

61. Crude Rates

62. Specific Rate Specific rate—The number of events is divided by some homogeneous sub-group of the total population Age-specific death rate—Deaths in a specific age group divided by the mid-point population of that age group

63. Probability In demography, indicates the likelihood that some event will occur to some group of exposed persons during the course of some period of time Similar to rates except that they consider the number of people exposed to risk at the start of a time interval instead of the average number exposed (midpoint population) Probabilities are special cases of a ratio

64. Probability In general it expresses the chance that an event will occur during a particular period to a person in a particular population at risk at the beginning of a period Examples Probability of dying between birth and age five—Probability that a child will die between birth and exact age five Probability of surviving from age 20 to age 25—Probability that a person of exact age 20 will survive to exact age 25

65. Rates For an open population there is no much difference between probability and central rates for short period of time Probabilities does not consider seasonal or monthly variations on the comparability of rates

66. An outlier index

67. An outlier index Infant mortality rate – Is not a rate in the technical sense since the denominator is not in terms of midyear population or person-years of exposure – Is not a probability since the numerator includes events to births not included in the denominator – Should thus be regarded as a ratio, though it is called a rate

68. Population Composition/Structure

69. Sex Variable is of prime importance Separate data for males and females are important: In themselves For the analysis of other types of data For the evaluation of the completeness and accuracy of population counts

70. Sex Ratio Pattern by age Higher at very young ages Gap narrows with increasing age Goes below 100 by middle age Other characteristics Varies from one population to another Desirable to consider separately the sex ratio of important component subgroups (e.g. by race, by ethnicity)

71. Sex Ratio of Births

72. Sex Ratio of Births In human populations, there are more male births than female births, with ratio generally between 104 and 107 Important characteristics which distinguish births with respect to their sex ratio are age of mother, order of birth, or race

73. Sex Ratio of Deaths

74. Sex Ratio of Migrants

75. Age Demographers’ definition of age—age in completed full years, i.e. age of an individual at last birthday Most important variable in demographic analyses Data Collection on Age Data on age may be secured by – Asking a direct question on age – Asking a question on date of birth, or month and year of birth – Or a combination of these

76. Age-Reporting Errors Content – Centenarians • Those close to 100 years tend to overestimate their age – Understatement Women tend to understate their age – Overstatement Mothers tend to round up the age of their children Young persons up to age 21 Persons aged over 55

77. Age-Reporting Errors – Heaping/Digit preference People tend to report certain ages at the expense of others Can occur at any digit but happens most often with ages ending in 0 and 5 Distributing unknown and/or unreported age – Needs to be imputed with care

78. Age-Reporting Errors Coverage—Missed or counted twice – There is a tendency to miss the people in certain age groups (e.g. neonates, infants, young men) – Some people are counted twice e.g. Children living with grand parents Causes of age misreporting Unknown birth date (oneself or proxy reporting) Digit preference Deliberate under/over estimation

79. Method for Detecting the Extent of Age Errors

80. Correction of Age Errors Grouping – Generally by 5 or 10 years – Avoid problem of fluctuations in single year data Interpolation (many variants) Analysis When working with several populations, comparison of age distributions is a classic demographic analysis

81. Density and Distribution Functions

82. Mean Age

83. Median Age

84. Median Age

85. Median

86. Median The median is preferred to the mean because of: – The marked skewness of the age distribution – The calculation of mean is often complicated by open-ended age groups (e.g. 80+)

87. Age P 0-14 = The number of children under 15 P 65+ = The number of persons aged 65 + P 15-64 = The number of persons of “working age”

88. Age-Dependency Ratios

89. Child-Dependency Ratio

90. Old-Age Dependency Ratio

91. Age/Population Pyramid Gives a detailed picture of the age-sex structure of a population Consists of bars representing age groups in ascending order from lowest to highest pyramided on one another Bars are generally by single or 5-year age groups

92. Age Pyramid Number (or percentage) of persons in an age group is indicated by length of its bar from central axis Males on left side; females on right side Pyramids with absolute numbers show differences in overall sizes of total populations and in number at each age Percent pyramids show relative differences in population size at each age-sex group

93. Age Pyramid

94. Three Patterns of Population Change

95. Uses of Age pyramid Conveys at a glance the entire shape of the age-sex structure Shows gross irregularities due to: Widespread omissions of people of some age group by the census enumeration, Special past events (e.g war, epidemic and age-selective migration), fluctuations of fertility, inaccurate reporting of age

96. Race and Ethnic Group Race There are no standard definitions of race and ethnicity Ethnic Group Ethnic Group—Sub-Race Covers racial, national, cultural, or linguistic groups To varying extents, each such group will have a common descent, history, and habitat

97. Nationality Nationality—Country of present citizenship, or Country or other area of origin, sometimes an extinct country or a country that once had very different boundaries Country of Birth Inclusion in censuses recommended by United Nations Ask for country of birth for foreign born Used to identify and describe immigrant minorities and throw light on ethnic composition

98. United States Practices Native—Persons born in the U.S., the Commonwealth of Puerto Rico, or a possession of the U.S. Also includes persons born in a foreign country or at sea who have at least one native American parent Foreign Born—Persons not classified as native i.e. persons who report a foreign country as place of birth

99. Citizenship Citizenship—Legal nationality Alien—Person included in census, register, etc... of a country but non-citizen thereof –An alien, however, is usually citizen of another country; that country is his/her legal nationality May be acquired by birth or naturalization Almost all people born in some countries are automatically citizens, or at least have that option; this is not so in some other countries

100. Citizenship Useful in connection with problems of legal status and civil rights of immigrants, and for studies of naturalization and assimilation of alien populations Limitations – Confusion in definition with country of birth – Also sensitive where minorities are insecure in their status Language One of the most sensitive indices of ethnic origin because linguistic differences tend to persist until complete assimilation

101. Types of Language Data Recommended by UN Language spoken at home in early childhood or language of parents (mother tongue) – Is an indicator of ethnic origin Language currently spoken, or most often spoken in present home (usual language) – Is an indicator of ethnic origin – Can also be used to see degree of assimilation and integration of foreign stock or of specific ethnic minorities

102. Types of Language Data Recommended by UN Ability to speak various languages (designated languages) – Indicates linguistic skills of population, both native and foreign born

103. Religion Item mentioned by the United Nations in its consideration of ethnic origin If race or country of origin is also known, religion can be used to make further distinctions among ethnic groups Useful personal characteristic because it is associated with a variety of differences in attitudes, statuses, and behavior

104. Religion Of great interest for its hypothesized relationship with fertility, mortality, nuptiality , and migration For the benefit of users of the data who may not be familiar with all the religions or sects within a country, as well as for purposes of international comparability, the classifications of the data should show each sect as a sub-category of the religion of which it forms a part

105. Marital Status Standard categories of marital status Single Currently married Separated Widowed Divorced

106. Marital Status Note that: Ever married = married + widowed + divorced + separated Additional options to take into account when appropriate: – Consensual unions—Common-law, extra-legal or de facto unions – Practices such as polygamy, concubinage and inherited widows – Same sex

107. Singulate Mean Age at Marriage (SMAM)

108. Singulate Mean Age at Marriage (SMAM) SMAM—Mean age at marriage of women marrying before they reach 50 More stable estimate from retrospective data

109. Singulate Mean Age at Marriage (SMAM) Assumptions – The risk of marriage has remained constant (otherwise we estimate the mean for some average cohort) – The change in the proportion single from age x to age x+1 is a measure of the proportion of a birth cohort who married at that age, i.e. no woman dies between her 15 th and 55 th birthday

110. Singulate Mean Age at Marriage (SMAM) Steps for calculation—data in 5-year age groups Sum the percentages single through age group 15-49 and multiply the sum by 5 (because 5-year age groups) Add 1500 (i.e. years lived by the cohort before the 15 th birthday Average the percentage single for age groups 45-49 and 50-54

111. Singulate Mean Age at Marriage (SMAM) Multiply the result of (3) by 50 (Equals number of years lived by those who did not marry before age 50) Subtract result of (4) from (2) (Equals number of years lived by those who marry by age 50) Subtract result of (3) from 100 (Equals average percentage married by age 50) Divide result of (5) by result of (6) (Equals singulate mean age at marriage)

112. Singulate Mean Age at Marriage (SMAM)

113. Proportion of those single by age, Uganda 1969 Age group Single females (%) 15-19 50.1 20-24 13.1 25-29 6.8 30-34 5.7 35-39 5.3 40-44 6.0 45-49 5.8 50-54 6.5 Total 99.3

114. SMAM Calculation for Ugandan female population 1969 99.3*5=496.5 1500+496.5=1996.5 0.5(5.8+6.5)=6.2 6.2*50=310 1996.5-310=1686.5 100-6.2=93.8 1686.5/93.8=18.0 years

115. Order of Marriage The variables most often used in demographic analysis of marriage and of the marital factor in fertility are: Order of Marriage—Number of times married, or whether married more than once

116. Duration of Marriage Also of interest are age at and date of marriage Can be asked for first marriage or most recent marriage Date of first marriage is used to identify 1 st marriage cohorts, i.e. persons who entered marriage for the 1 st time in a specified period such as a calendar year

117. Importance for Fertility Age at first marriage is probably the most useful fact about women’s marital history for the study of their fertility Data on spacing of children in relation to date of first marriage, or number of years since first marriage, are highly useful for analysis of fertility

118. Education and Economic status Education Important variable in accounting for demographic behavior School Enrollment Measures of school enrollment usually relate to a point in time or a very short period of time

119. School Enrollment Data used to measure extent of the participation in the school systems of an area: – By persons of school age – The potential future participation of such persons – The relative participation of different segments of the population

120. School Enrollment School Enrollment—Enrollment at any regular educational institution, public or private, for systematic instruction at any level of education during a well-defined and recent time period (United Nations) School Attendance School Attendance—While enrollment data are available at yearly intervals, attendance data may be collected daily in school classrooms

121. School Enrollment Rates

122. Crude Enrollment Rate

123. General Enrollment Rate

124. Age-Specific Enrollment Rate

125. Sex-Specific Enrollment Rate

126. Age-Sex-Specific Enrollment Rate

127. Level-Specific Enrollment Rate

128. Literacy Literacy—Ability of a person to both read and write, with understanding, a short statement on his everyday life (UN) An illiterate person may not read and write at all, or may read and write only figures and his/her own name, or may only read and write a ritual phrase which has been memorized The language or languages in which a person can read and write are not a factor in determining literacy

129. Crude Literacy Rate

130. Age-Specific Literacy Rate

131. Sex-Specific Literacy Rate

132. Age-Sex-Specific Literacy Rate

133. Economic Participation – Many demographic characteristics are cross-tabulated with the economic characteristics of the individuals – Although all persons consume goods and services, only a part of the entire population of a country is engaged in producing such goods and services Labor Force Labor Force—Involves the carrying on of an activity from which the person derives, or attempts to derive, pay or profit In censuses and surveys, the entire population can be subdivided into the employed and the unemployed

134. Employed Employed—Persons who worked for pay or profit during the time-reference period or who had a job or business that period but were absent from it because of vacation, illness, etc. Six months in rural and 7 days in urban areas Unemployed Unemployed—Persons who, during the reference period, were not working but who were seeking work for pay or profit, including those who never worked before

135. Not in Labor Force Not in Labor Force—All persons who are neither employed nor unemployed Note that the difference between the amount of work performed by persons in employment and the amount of work they would normally be able or willing to perform is a measure of underemployment

136. Status in Labor Force Status in Labor Force—Refers to the status of a person in the labor force with respect to his/her employment, that is, whether s/he is (or was, if unemployed) an employer, own-account worker, employee, unpaid family worker, or a member of a producers’ cooperative (United Nations)

137. Status in Labor Force Employer—A person who operates his/her own economic enterprise or engages independently in a profession or trade and hires one or more employees Own-Account Worker—A person who operates his/her own economic enterprise or engages independently in a profession or trade and hires no employees Employee—A person who works for a public or private employer and receives remuneration in wages, salary, commission, tips, piece-rates, or pay in kind

138. Status in Labor Force Unpaid Family Worker—A person who works a specified minimum amount of time (at least 1/3 of normal working hours), without pay, in an economic enterprise operated by a related person living in the same household Member of Producers’ Co-operative—A person who is an active member of a producer’s co-operative, regardless of the industry in which it is established

139. Status in Labor Force Persons Not Classified by Status—Experienced workers with status unknown or inadequately described and unemployed persons not previously employed Note that categories can be combined or further subdivided to better reflect a country’s reality

140. Problems of Labor Force Concept Formal vs. informal sector Mismatch of skills and work – PhDs driving taxis Persons move in and out of labor force Persons working part-time who want fulltime employment

141. Occupation Refers to the kind of work done during the time-reference period established for data on economic characteristics by the person employed (or performed previously by the unemployed) irrespective of the industry or the status in which the person should be classified (United Nations) – Examples: Nurse, Doctor, Teacher, sales clerk, farmer, car washer, etc.

142. Personal Income Personal Income—One of the best measures of economic well-being; vie s with educational attainment and occupation as a measure of socio-economic status No international standard definition and sometimes difficult to collect In principle, income from all sources should be counted, both cash income and income in kind Reference period = usually one year

143. Household Income Household Income—Income data collected for each person in the household may be added to produce total for the household Wealth Wealth—All goods and resources having value in terms of exchange or use – Land holdings, stocks, and bonds – Jewelry and other possessions, livestock

144. Measures of Labor Force Participation Crude Activity Rate—Percentage of total population in the labor force – Equals crude labor force participation rate – Is greatly influenced by the age composition of the population

145. Crude Activity Rate

146. General Activity Rate

147. Age-Sex Specific Activity Rate Labor force participation rates – Far more widely used measure of economic activity – Basic rates studied and projected in analyses of population in the labor force

148. Age-Sex Specific Activity Rate

149. Basic Concepts on Fertility Fecundity—Physiological capacity to conceive Infecundity (sterility)—Lack of the capacity to conceive – Primary sterility—Never able to produce a child – Secondary sterility—Sterility after one or more children have been born Fecundability —Probability that a woman will conceive during a menstrual cycle Fertility ( natality )—Manifestation of fecundity Infertility—Inability to bear a live birth Natural fertility—Fertility in the absence of deliberate parity-specific control

150. Basic Concepts on Fertility Reproductivity —Extent to which a group is replacing its own numbers by natural processes Gravidity—Number of pregnancies a woman has had Parity—Number of children born alive to a woman Birth interval—Time between successive live births Pregnancy interval—Time between successive pregnancies of a woman

151. Basic Indices in Fertility

152. Age specific fertility rate

153. Total Fertility rate Total Fertility Rate—Number of children a woman will have if she lives through all the reproductive ages and follows the age specific fertility rates of a given time period (usually one year)

154. Other fertility rates We may also calculate marital fertility rates, order specific fertility rates and duration specific fertility rates The analogy of calculation is the same as calculating age specific fertility rates

155. Birth Probability May be age-specific as well Birth probabilities are the most sensitive indicators of temporal change in the pace of childbearing

156. Basic Concepts in Mortality

157. Egypt ASDR Graph 1990

158. Infant Mortality “Rate”

159. Exercise Infant Mortality “Rate”

160. Exercise Answer Infant Mortality “Rate”

161. Infant Mortality “Rate” Good index of child mortality in low mortality populations; less good in high mortality populations Because of the very high level of mortality in the first hours, days, and weeks of life, IMR is broken down into even more specific rates Not a true rate

162. Adjusted Infant Mortality Rate To be used when the number of births fluctuates sharply between years and within a year Infant deaths in a year occur to births of that year and also to births of the previous year

163. Adjusted Infant Mortality Rate

164. Three Techniques for Adjusting Infant Mortality Rate Cohort probability Data by year and cohort Separation factors

165. Adjusted Infant Mortality Rate Cohort Probability

166. Exercise Cohort Probability

167. Concepts in Migration Mover—A person who changes residence Migrant—A person who moves from one political area to another Non-migrant—Non-movers and local movers Migration—Geographic or spatial mobility involving a relatively permanent change in usual residence between clearly defined political or statistical units; has dimensions of time and space

168. Concepts on Migration In-migrant—A person who moves in a political area within the same country Immigrant—An international migrant who enters the area from a place outside the country Out-migrant—A person who moves out of a political area within the same country Emigrant—An international migrant departing to another country by crossing the international boundary

169. Concepts on Migration Net Migration—In-migrants - Out-migrants Net Immigration—Immigrants - Emigrants – Note: Net migration for an area often includes both international and internal migration Gross Migration—In-migrants + Out-migrants = Migration turnover

170. Concepts on Migration Migration stream—A group of migrants having a common origin and destination in a given migration period Migration counterstream —In opposite direction of stream

171. Estimating Migration Net migration can be estimated using The residual method Cohort component method We can also calculate various migration rates the using the same way we used in calculating mortality and fertility rates

172. R/ship b/n components of population Change High fertility is associated with high migration and mortality High fertility depletes households’ and country’s economy Rapid population deters economic growth and have negative effect on the environment High mortality induces the replacement norm in communities with no social security

173. R/ship b/n components of population Change High mortality forces many people to move out from their areas of usual abode High out migration deters economic development in case out-migrants are the youth and educated High out migration might assist country’s development if migrants send skill and capital remittance to the source population

174. How do population dynamics affect the health sector High fertility and mortality puts unnecessary pressure to the health systems The health manpower would have fatigue The quality of training of health professionals might be compromised to address the huge demand to cope the challenge (accelerated trainings) High out migration of health professionals might affect the health sector