5
Trends in Childhood Mortality

Althea Hill

INTRODUCTION

A broad, comparative outline of levels, patterns, and trends in childhood mortality across the African continent was presented in a paper written in 1987 and published recently (Hill, 1989, 1991, 1992). That paper covered sub-Saharan mainland Africa between roughly the late 1940s and the late 1970s and made use of all the data on child survival available at the time of writing. The overall findings are summarized in Figures 5–1 and 5–2, which display summary estimates over time for all countries possessing usable data.

Four major features, all clearly visible in the figures, emerged from the findings of that paper. These were

  1. declines in childhood mortality since World War II in almost all countries for which data were available;

  2. much variation among countries in the type of decline;

  3. much variation among countries in the level of childhood mortality in all periods; and

  4. a marked overall difference in mortality levels between countries in western and middle Africa and countries in eastern and southern Africa,

Althea Hill is at the India Country Department, Population and Human Resources Division, The World Bank.



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Demographic Change in Sub-Saharan Africa 5 Trends in Childhood Mortality Althea Hill INTRODUCTION A broad, comparative outline of levels, patterns, and trends in childhood mortality across the African continent was presented in a paper written in 1987 and published recently (Hill, 1989, 1991, 1992). That paper covered sub-Saharan mainland Africa between roughly the late 1940s and the late 1970s and made use of all the data on child survival available at the time of writing. The overall findings are summarized in Figures 5–1 and 5–2, which display summary estimates over time for all countries possessing usable data. Four major features, all clearly visible in the figures, emerged from the findings of that paper. These were declines in childhood mortality since World War II in almost all countries for which data were available; much variation among countries in the type of decline; much variation among countries in the level of childhood mortality in all periods; and a marked overall difference in mortality levels between countries in western and middle Africa and countries in eastern and southern Africa, Althea Hill is at the India Country Department, Population and Human Resources Division, The World Bank.

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Demographic Change in Sub-Saharan Africa FIGURE 5–1 Risk of dying before age 5, western and middle Africa, 1926–1980. SOURCE: Hill (1991: Figure 3–2). with a rough gradient running from higher mortality in the northwest to lower mortality in the southeast of the continent. With regard to this last point, there were indications that this gradient, having been very distinct at the start of the period of study, was becoming progressively blurred as more and more western and middle African countries reduced their mortality levels to near or within the eastern and southern range. However, the picture was still too indefinite for firm conclusions at that time. The paper also noted three exceptions to these general patterns: Some countries had experienced periods of static or rising mortality, almost all against a background of civil war and disruption of normal socioeconomic development (e.g., Ethiopia, Mozambique, Rwanda, and Sudan). The mortality of a few western and middle African countries (notably Ghana, Congo, and Cameroon) had fallen to well within the eastern and southern range. One eastern African country, Malawi, had a level of mortality toward the upper end of the western and middle African range.

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Demographic Change in Sub-Saharan Africa FIGURE 5–2 Risk of dying before age 5, eastern and southern Africa and Sudan, 1926–1980. SOURCE: Hill (1991: Figure 3–3). DATA DEVELOPMENTS SINCE 1987 In 1987, when the aforementioned review of levels and trends in childhood mortality in Africa was prepared, almost no data on developments in the 1980s were yet available. As shown in Table 5–1, several censuses and surveys had indeed been carried out between 1980 and 1987, but very few of them had yet yielded available results. Over the last five years, however, a considerable quantity—though by no means all—of new data collected during the 1980s has been released. This chapter reviews levels and trends in many of the countries for which fresh data are available for analysis, and examines whether the conclusions of the previous review still hold both at country and at continental levels. In total, new national-level data are available for 16 countries (about 40 percent of all mainland sub-Saharan countries); these are Botswana, Burkina Faso, Burundi, Côte d’Ivoire, The Gambia, Ghana, Kenya, Liberia, Malawi, Mali, Nigeria, Senegal, Sudan, Togo, Zaire, and Zimbabwe. Data are also available for a large part of Uganda. In addition, data from small-

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Demographic Change in Sub-Saharan Africa TABLE 5–1 African Censuses and Surveys Since 1980 Country Type of Operationa Date Status of Mortality Data Western   Benin WFS 1981 Published Burkina Faso Censusb 1985 Available Côte d’Ivoire WFSb 1980–1981 Published   LSMS 1985–1986 Partly available Censusb 1988 Available The Gambia Censusb 1983 Published Ghana Census 1984 Not collected   LSMS 1987–1988 Not yet available DHSb 1988 Published Guinea Census 1983 Abandoned Guinea-Bissau Census 1979 Not yet available Liberia Census 1984 Partly available   DHSb 1986 Published Mali Censusb 1987 Available   DHSb 1987 Published Niger Census 1988 Available Nigeria Demographic survey 1980–1981 Unavailable   WFSb 1981–1982 Published DHS (Ondo State) 1987 Published DHS (national)b 1990 Available Senegal DHSb 1986 Published   Census 1988 Partly available Sierra Leone Census 1985 Not yet available Togo Census 1981 Not collected   DHSb 1988 Published Middle   Angola Census (Luanda only) 1983–1984 Available   Southeast region surveyb 1988 Available Cameroon Census 1987 Partly available   DHS 1991 Available Congo Census 1984 Partly available Zaire CPS (small area) 1984 Published   Censusb 1984 Partly available Eastern   Burundi DHSb 1987 Published   Census 1990 Not yet available Ethiopia Demographic survey 1980–1981 Published   Census 1984 Not yet available   National demographic survey 1990 Partly available Kenya National demographic surveyb 1983 Partly available   CPS 1984 Published DHSb 1989 Published Census 1989 Not yet available Malawi National demographic surveyb 1982 Published

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Demographic Change in Sub-Saharan Africa Country Type of Operationa Date Status of Mortality Data   WFS typeb,c 1984 Published Census 1987 Partly available Mozambique Censusb 1980 Available   WFS typeb,c,e 1987 Partly available Rwanda WFS typec 1983 Published Somalia Demographic survey 1980 Published   Census 1986–1987 Possibly lost Tanzania Census 1988 Partly available Uganda Census 1980 Mostly lost   DHS (south only)b 1988–1989 Published Zambia Census 1980 Not published   DHS 1992 Partly available Zimbabwe Censusb 1982 Partly published   CPSb 1984 Published Demographic surveyb 1987 Partly published DHSb 1988 Published Southern   Botswana Censusb 1981 Published   CPSb 1984 Published Demographic survey 1987 Not yet available DHSb 1988 Published Lesotho Census 1986 Not yet available Swaziland Census 1986 Not yet available   DHS typed 1986 Not yet available Northern   Sudan Censusb 1983 Available   DHS (northern only)b 1989–1990 Published aWFS: World Fertility Survey; LSMS: Living Standards Measurement Survey; DHS: Demographic and Health Survey; CPS: Contraceptive Prevalence Survey. bData set used in this chapter. cSurvey modeled after WFS, but not part of the WFS series. dSurvey modeled after DHS, but not part of the DHS series. eData from Maputo, the capital city, are used here. scale surveys in Mozambique and Angola are examined, because of the particular interest and data scarcity in those two countries. The methodology employed is the same as for the previous review (see appendix A to this chapter). The mainstay of the analysis is information on child survival, collected from mothers in censuses and surveys and analyzed by using the Trussell variant of the Brass child survival method (Trussell, 1975); estimates based on Coale-Demeny North and South families of life tables (Coale and Demeny, 1983) are compared, and those that appear to fit

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Demographic Change in Sub-Saharan Africa Summary estimates of dying before age 5 (per 1,000), selected African countries between 1979 and 1985. the data best are selected.1 Direct data on child deaths from maternity histories are used for evaluation but not for the final estimates. More methodological details are given in Hill (1989, 1991, 1992). 1   Coale and Demeny developed four model life table families (East, West, North, and South) to reflect the different age and sex patterns of mortality derived from historical data from eastern-central, northwestern, Scandinavian, and southern countries of Europe, respectively. The North and South models provide the best fit for the African age pattern of mortality in childhood (see the appendix to this chapter for details). Estimates based on these two models are given in the appendix B tables for each country discussed. In some cases, the estimates from both models are also presented in the figures; however, because of space limitation, only one of the models is usually presented in a figure.

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Demographic Change in Sub-Saharan Africa Every stage of the analysis and estimation for each country is standardized as much as possible in order to put individual country results into a framework of continental levels, patterns, and trends. Inevitably, estimation from large quantities of imperfect data is a subjective process in which individual judgment must play a large part. (See map for summary of continental levels of child mortality.) NEW COUNTRY DATA AND RESULTS Botswana and Zimbabwe These two countries are examined together because they are neighbors, their levels of overall development are very similar, their mortality levels and trends were also very similar up to 1980 (see Figure 5–2), and their data collection schedules in the 1980s were almost identical. They each had a census at the beginning of the decade, a Contraceptive Prevalence Survey (CPS) in 1984, an intercensal demographic survey (ICDS) in 1987 (unfortunately not yet available for Botswana), and a Demographic and Health Survey (DHS) in 1988. The results of the analysis of all available mortality data for both countries are presented in Tables 5–B.1 and 5–B.2 of appendix B, and are shown graphically in Figures 5–3, 5–4, and 5–5. In both, there is a marked contrast between the smoothness and regularity of the census results and the irregular, seesaw, and often rather wild results from various surveys; no doubt the much larger numbers available for analysis from the census are largely responsible. However, the consistency and plausibility of the results from the 1980s survey data differ sharply between the two countries. For Botswana, provided the South model is used, all the data except the direct DHS reports are highly consistent. They show a continued decline in childhood mortality from 1955 to 1985, with the decline possibly accelerating during the late 1970s and early 1980s. Because Botswana enjoyed rapid economic growth and fast-developing infrastructure and social services throughout the 1970s and 1980s, such a trend is not at all surprising. The very low level of mortality achieved by the mid-1980s—a probability of dying by age 5 of not much more than .050, which implies an infant mortality rate between 30 and 40 deaths per 1,000 live births—should also be acceptable because the DHS shows that child health and nutrition are excellent. Botswana appears now to have perhaps the lowest mortality in sub-Saharan Africa. By contrast, the 1980s survey data for Zimbabwe are confused and inconsistent, with the exception of the larger-scale 1987 demographic survey of the traditional type, which fits well with the two sets of census data. The 1984 CPS results not only are highly irregular in trend—first steeply up

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Demographic Change in Sub-Saharan Africa FIGURE 5–3 Risk of dying before age 5, Botswana, 1955–1990, South model. SOURCES: 1971 census (Botswana, 1972); 1981 census (Botswana, 1983); 1984 Contraceptive Prevalence Survey (CPS) (Botswana, 1985); 1988 Demographic and Health Survey (DHS) (Lesetedi et al., 1989). FIGURE 5–4 Risk of dying before age 5, Zimbabwe, 1950–1990, North model. SOURCES: 1969 census (Rhodesia, n.d.); 1982 census (Zimbabwe, 1985a); 1984 Contraceptive Prevalence Survey (CPS) (Zimbabwe, 1985b); 1987 Intercensal Demographic Survey (ICDS) (Zimbabwe, 1991); 1988 Demographic and Health Survey (DHS) (Zimbabwe, 1989).

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Demographic Change in Sub-Saharan Africa FIGURE 5–5 Risk of dying before age 5, Zimbabwe, 1950–1990, South model. SOURCES: 1969 census (Rhodesia, n.d.); 1982 census (Zimbabwe, 1985a); 1984 Contraceptive Prevalence Survey (CPS) (Zimbabwe, 1985b); 1987 Intercensal Demographic Survey (ICDS) (Zimbabwe, 1991); 1988 Demographic and Health Survey (DHS) (Zimbabwe, 1989). and then even more steeply down, all in the space of less than 15 years—but appear quite at odds with all the other data. The 1988 DHS mortality levels are much too low compared with the other data sources, except perhaps in the most recent few years. The best choice seems to be a combination of the 1987 demographic survey results with those of the two censuses, which would also yield mortality levels similar to those from the DHS around the mid-1980s. North appears the better-fitting model for the two censuses, but South gives better consistency thereafter; there seems no clear-cut reason to prefer one over the other. The resulting trend is again of a continued mortality decline from the early 1970s to the mid-1980s, gentle at first, then with perhaps an acceleration of decline in the 1980s; there is also a hint in the data of some temporary stagnation or rise in mortality during the late 1970s, the period of the war for independence. The relatively low overall level of childhood mortality achieved by the mid-1980s—a probability of dying by age 5 of about .080 to .090—is again consistent with Zimbabwe’s good general level of income and development and the excellent child health and nutrition noted in the DHS. Such a level would place Zimbabwe behind Botswana, but still among the very lowest-mortality countries in Africa.

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Demographic Change in Sub-Saharan Africa Middle and Eastern Africa Mozambique and Angola, the two major former Portuguese colonies, have enjoyed neither stability nor solid economic growth for many years. In both, a long and painful war for independence was followed by a short period of relative peace before internal conflicts resumed. No new national-level data for the 1980s are yet available for Mozambique, and none were collected in Angola. Survey data from two small areas in the southern parts of these countries are, however, available and are presented in this chapter. These are Maputo, the capital city of Mozambique (data from a 1987 national World Fertility Survey (WFS) type of survey), and rural parts of the southwest region of Angola bordering on Namibia (data from a local socioeconomic-demographic survey in 1988). The results from these new data sets, combined with the latest available national data, are shown in Tables 5–B.3 and 5–B.4, and summarized graphically in Figures 5–6 and 5–7. The trend in childhood mortality in Maputo between the early 1970s and the mid-1980s is broadly consistent with the picture already evident in the national census results. There was possibly a mortality decline through the earlier 1970s (when the Portuguese were still developing Maputo as a modern city headquarters containing a major concentration of the Portuguese settler population), followed by stagnation from the mid-1970s through FIGURE 5–6 Risk of dying before age 5, Mozambique and Maputo, 1960–1990, North and South models. SOURCES: 1980 census (Mozambique, n.d.); 1987 Maputo Fertility Survey (MFS) (WFS-type survey) (Mozambique, 1987).

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Demographic Change in Sub-Saharan Africa FIGURE 5–7 Risk of dying before age 5, Angola and southwestern Angola, North and South models. SOURCES: 1940 census (Heisel, 1968); 1988 rural survey (Angola, 1990). the mid-1980s, during which the Portuguese withdrawal was followed by the onset of a crippling civil war. The overall level of childhood mortality in Maputo during the late 1970s and 1980s was, however, relatively low, with a probability of dying by age 5 of .120 to .140—much lower than the corresponding level of .270 to .280 for Mozambique as a whole. The picture in southwestern Angola is even worse. Rural pastoral and agricultural populations appear to have experienced stagnating or rising childhood mortality from 1970 to the mid-1980s, even though this area was relatively prosperous and least affected by the postindependence civil war. According to the analysis of the 1940 census reported in Brass et al. (1968), the region, then called Huila, enjoyed by far the lowest childhood mortality in Angola at that time. The childhood mortality estimates emerging from the 1988 rural survey, with probabilities of dying by age 5 of .200 to .250, represent an improvement over the levels found in the 1940 census data, but are still very high given the area’s location in the lowest-mortality part of Africa. Full results from the Malawi census of 1987 are not yet available. However, given Malawi’s extraordinarily severe childhood mortality in earlier periods—probabilities of dying by age 5 of .330 to .370, which are high for any part of sub-Saharan Africa (see Figures 5–1 and 5–2) —it is of interest to examine the additional data on trends from the mid-1960s to the beginning of the 1980s that emerge from the two surveys carried out in

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Demographic Change in Sub-Saharan Africa TABLE 5–B.15 Child Survival Analysis Results, Ghana   Coale-Demeny North Model Coale-Demeny South Model Data Set Reference Date Probability of Dying Before Age 5 Reference Date Probability of Dying Before Age 5 1948 census 1934.00 .3555 1933.21 .3800   1936.64 .3432 1936.10 .3624 1938.84 .3543 1938.45 .3700 1940.86 .3321 1940.58 .3467 1942.80 .2915 1942.63 .3004 1944.61 .2483 1944.56 .2460 1960 census 1945.99 .2632 1945.14 .2876 PESa 1948.75 .3242 1948.16 .3446   1951.22 .2541 1950.80 .2693 1953.52 .2453 1953.24 .2555 1955.63 .2391 1955.49 .2426 1957.50 .2310 1957.47 .2247 1970 census 1957.02 .2196 1956.14 .2436 PESa 1959.91 .2141 1959.28 .2333   1962.61 .2076 1962.17 .2219 1965.13 .2082 1964.86 .2162 1967.38 .1981 1967.26 .1982 1969.27 .1918 1969.26 .1826 1979–1980 WFS 1964.98 .1488 1964.09 .1702   1967.87 .1369 1967.22 .1524 1970.58 .1232 1970.13 .1341 1973.11 .1280 1972.84 .1331 1975.38 .1254 1975.27 .1242 1977.30 .1507 1977.29 .1417 1988 DHS 1974.34 .1679 1973.52 .1895   1977.20 .1513 1976.63 .1668 1979.75 .1499 1979.36 .1611 1982.07 .1613 1981.83 .1668 1984.15 .1613 1984.04 .1605 1985.90 .1751 1985.89 .1662   Reference Date Equivalent Value of q5 1988 DHS 1973–1977   .1872   Direct data 1978–1982 .1524   1983–1987b .1547

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Demographic Change in Sub-Saharan Africa   Coale-Demeny North Model Coale-Demeny South Model Data Set Reference Date Probability of Dying Before Age 5 Reference Date Probability of Dying Before Age 5 1979–1980 WFS 1949–1953   .213   Direct data 1954–1958 .172   1959–1963 .145 1964–1968 .148 1969–1973 .118 1974–1978 – aPostenumeration survey. bIncludes exposure during 1988 up to the month preceding the interview. SOURCES: 1948 census (Ghana, 1948); 1960 census postenumeration survey (PES) (Gaisie, 1969); 1970 census postenumeration survey (PES) (Ramachandran, 1979); 1979–1980 World Fertility Survey (WFS) (Owusu, 1984); 1988 Demographic and Health Survey (DHS) (Ghana, 1989).

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Demographic Change in Sub-Saharan Africa TABLE 5–B.16 Child Survival Analysis Results, Togo   Coale-Demeny North Model Coale-Demeny South Model Data Set Reference Date Probability of Dying Before Age 5 Reference Date Probability of Dying Before Age 5 1961 census 1947.82 .3334 1947.01 .3582 PESa 1950.64 .3188 1950.08 .3383   1953.12 .3282 1952.73 .3431 1955.37 .3249 1955.13 .3365 1957.42 .3271 1957.30 .3325 1959.18 .3171 1959.16 .3150 1971 census 1957.18 .2759 1956.34 .3003 PESa 1960.04 .2636 1959.45 .2832   1962.64 .2596 1962.23 .2743 1965.02 .2414 1964.77 .2501 1967.16 .2423 1967.05 .2433 1968.96 .2190 1968.95 .2101 1988 DHS 1974.72 .1781 1973.90 .2001   1977.57 .1875 1977.00 .2047 1980.09 .1717 1979.70 .1837 1982.39 .1808 1982.15 .1870 1984.46 .1558 1984.36 .1551 1986.22 .1560 1986.21 .1473   Reference Date Equivalent Value of q5 1988 DHS 1973–1977   .2056   Direct data 1978–1982 .1590   1983–1988 .1582 aPostenumeration survey. SOURCES: 1961 census postenumeration survey (PES) (United Nations, 1978); 1971 census postenumeration survey (PES) (Adognon, 1980); 1988 Demographic and Health Survey (DHS) (Agounké et al., 1989).

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Demographic Change in Sub-Saharan Africa TABLE 5–B.17 Child Survival Analysis Results, Côte d’Ivoire   Coale-Demeny North Model Coale-Demeny South Model Data Set Reference Date Probability of Dying Before Age 5 Reference Date Probability of Dying Before Age 5 1978–1979 multiround NDS 1964.50 .2557 1963.70 .2790 1967.19 .2513 1966.65 .2696 1969.47 .2390 1969.09 .2531   1971.55 .2773 1971.29 .2885 1973.51 .2158 1973.36 .2187 1975.28 .2016 1975.25 .1954 1980–1981 WFS 1966.21 .2433 1965.33 .2677   1968.99 .2248 1968.37 .2441 1971.53 .2127 1971.08 .2275 1973.91 .2018 1973.62 .2107 1976.10 .2018 1975.96 .2040 1978.03 .1919 1978.00 .1843 1988 census 1973.75 .1859 1972.91 .2085   1976.48 .1792 1975.89 .1963 1978.91 .1612 1978.48 .1735 1981.16 .1481 1980.87 .1545 1983.26 .1394 1983.11 .1402 1985.14 .1428 1985.11 .1355   Reference Date Equivalent Value of q5 1980–1981 WFS 1960–1964   .287   Direct data 1965–1969 .255   1970–1974 .243 1975–1979 .176   SOURCES: 1978–1979 National Demographic Survey (NDS) (Côte d’Ivoire, n.d.); 1980–1981 World Fertility Survey (WFS) (Côte d’Ivoire, 1984); 1988 census (unpublished data).

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Demographic Change in Sub-Saharan Africa TABLE 5–B.18 Child Survival Analysis Results, Liberia   Coale-Demeny North Model Coale-Demeny South Model Data Set Reference Date Probability of Dying Before Age 5 Reference Date Probability of Dying Before Age 5 1970 1953.72 .3089 1952.66 .3384 NDS, round one 1956.57 .2915 1955.75 .3169 1959.56 .2622 1958.95 .2829   1962.52 .2509 1962.12 .2660 1965.23 .2638 1965.05 .2715 1967.60 .2840 1967.57 .2809 1971 1956.70 .3289 1955.81 .3550 NDS, round two 1959.46 .3029 1958.83 .3238 1961.99 .2919 1961.54 .3085   1964.37 .2953 1964.07 .3086 1966.58 .2775 1966.42 .2839 1968.53 .2802 1968.50 .2776 1974 census 1959.79 .2376 1958.91 .2620   1962.48 .2400 1961.85 .2600 1964.92 .2240 1964.45 .2397 1967.23 .2234 1966.91 .2345 1969.41 .2081 1969.23 .2127 1971.41 .1777 1971.37 .1719 1986 DHS 1972.01 .2372 1971.17 .2610   1974.76 .2211 1974.17 .2397 1977.20 .2344 1976.78 .2491 1979.45 .2194 1979.18 .2285 1981.54 .2486 1981.40 .2526 1983.40 .2501 1983.36 .2451   Reference Date Equivalent Value of q5 1986 DHS 1971–1975   .275   Direct data 1976–1980 .243   1981–1986 .220   SOURCES: 1970–1971 National Demographic Survey (NDS) (Massalee, 1974; United Nations, 1978); 1974 census (Liberia, 1977); 1986 Demographic and Health Survey (DHS) (Cheih-Johnson et al., 1988).

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Demographic Change in Sub-Saharan Africa TABLE 5–B.19 Child Survival Analysis Results, Nigeria   Coale-Demeny North Model Coale-Demeny South Model Data Set Reference Date Probability of Dying Before Age 5 Reference Date Probability of Dying Before Age 5 1981–1982   WFS 1966.92 .1729 1965.97 .1961   1969.81 .1778 1969.10 .1964 1972.63 .1570 1972.12 .1703 1975.31 .1427 1975.00 .1492 1977.74 .1596 1977.60 .1601 1979.80 .1876 1979.78 .1787 1990 DHS 1976.83 .1974 1976.04 .2197   1979.64 .1972 1979.10 .2143 1982.05 .1979 1981.68 .2105 1984.23 .1862 1981.00 .1926 1986.21 .1937 1986.10 .1939 1987.92 .2228 1987.89 .2149   Reference Date Equivalent Value of q5 1990 DHS 1975.5–1980.5   .2009   Direct data 1980.5–1985.5 .1891   1985.5–1990.5 .1924   SOURCES: 1981–1982 World Fertility Survey (WFS) (unpublished data); 1990 Demographic and Health Survey (DHS) (Nigeria, 1992).

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Demographic Change in Sub-Saharan Africa REFERENCES Adognon, K. 1980 L’evolution de la fécondité dans les années soixante (1961–1971) au Togo. In Actes du Colloque de Démographic d’Abidjan (22–26 janvier 1979), Tome 1, Fécondité. Abidjan: Institut de Formation et de Recherche Démographiques. Agounké, A., M.Assogba, and K.Anipah 1989 Enquête Démographique et de Santé au Togo, 1988. Lomé: Unité de Recherche Démographique, Direction de la Statistique, Direction Générale de la Santé; Columbia, Md.: Institute for Resource Development/Macro Systems, Inc. Angola 1990 Famílias e aldeias do sul de Angola: análise dum inquérito socio-económico e demográfico nas Zonas rurais da regiao Sal-Sudoeste. Institute Nacional de Estatistica Unidade de Analise demografica. República Popular de Angola. Botswana 1972 Report on the Population Census, 1971. Gabarone: Central Statistical Office. 1983 1981 Population and Housing Census: Administrative/Technical Report and National Statistics Tables. Gabarone: Central Statistical Office. 1985 Botswana Family Health Survey 1984. Gabarone: Ministry of Health; Columbia, Md.: Westinghouse Public Applied Systems. Brass, W., A.J.Coale, P.Demeny, D.F.Heisel, F.Lorimer, A.Romaniuk, and E.van de Walle 1968 The Demography of Tropical Africa. Princeton, N.J.: Princeton University Press. Burkina Faso No date Recensement Démographique, Ouagadougou, 1961–62. Resultats Définitifs. Paris: INSEE. 1981 Morbidité et Mortalité en Haute-Volta: 1960–76. Dossier Technique, no. 4. Ouagadougou: Institut National de la Statistique et de la Demographic. Burundi 1974 Enquête Démographique, 1970–71. Bujumbura: Département de Statistiques/République Française. Chieh-Johnson, D., A.R.Cross, A.A.Way, and J.M.Sullivan 1988 Liberia Demographic and Health Survey, 1986. Monrovia: Bureau of Statistics, Ministry of Planning and Economic Affairs; Columbia, Md.: Institute for Resource Development/Westinghouse. Coale, P., and D.F.Demeny 1983 Regional Model Life Tables and Stable Populations, 2nd ed. San Diego: Academic Press. Côte d’Ivoire No date Enquête Démographique à Passages Répétés 1978–1979: Resultats Définitifs. Abidjan: Ministère du plan et de l’industrie, Direction de la Statistique. 1984 Enquête Ivoirienne sur la Fécondité 1980–81: Rapport Principal, Tome II, Tableaux Statistiques. Abidjan: Ministère de l’economie et des finances, Direction de la Statistique. Ewbank, D.C. 1985 Senegal population sector report. Unpublished paper commissioned by the World Bank. Population Studies Center, University of Pennsylvania, Philadelphia . Gaisie, S.K. 1969 Dynamics of Population Growth in Ghana. Accra-Tema: Ghana Publishing Corporation. The Gambia 1976 Population Census, 1973, Vol. III, General Report. Banjul: Central Statistics Division, Ministry of Economic Planning and Industrial Development.

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