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TO TAP OR NOT TO TAP? THAT IS THE UGANDAN PHONE QUESTION. By KADUULI STEPHEN

Fri, 9 Jun 2007 20:22:11 GMT

posted by kigowa

The proposal by the Ugandan Government to introduce official telephone tapping has generated intense social, political and legislative heat. Obviously, no individual would feel comfortable if they knew that their phone was being monitored. Mobile telephony is about a decade old in Uganda and at present the country has five companies providing the service. This article explores the proposed phone tapping in Uganda, its definition, history and methods and looks at experiences and reactions in other countries. There is a lot of ignorance being expressed on the Ugandan Fm airwaves about phone tapping. Civil Rights organizations, the Opposition, journalists, business men, fornicators and all law breakers are up in arms against the proposed bill. All commentators are aware that Government has for some time been tapping phones albeit illegally. Some ‘political commentators’ see it as an entrenchment of a ‘dictatorship’. Whereas others think the proposed law is directed at a leading opposition personality whose treason case is before court. The personality was told in public by security officials that Government has recordings of telephone conversations he used to have with some active rebel leaders. One Ugandan MP was so furious with the proposed law that he was quoted by a local daily swearing that he would throw away his mobile phone and resort to face to face conversation. But one of the most oft quoted phrases among the Ugandan mobile phone users is ‘how did we survive in the past without mobile phones’? Business people are worried that their money talk can be intercepted by wrong elements who can then waylay them and rob them of their monies. They are also worried that the Uganda Revenue Authority can use this channel to get information so as to up their taxes. Some citizens are even talking of resorting to use a SIM card once and then discard it because they do not understand the technology of tapping mobile phones. Mobile phones can be used anonymously. This because most them use pre-paid mobile phones which are not associated with a name or address, and because cards are used there is no billing information. Unfortunately for them, once they have been identified as using a certain phone, they can be tracked with the unique built-in International Mobile Equipment Identification (IMEI) encoded into each mobile phone. The IMEI emitted by the phone does not change, regardless of the SIM in the phone. It is even transmitted when no SIM at all is present in the phone. If longer-term anonymity is required, it is necessary to replace the phone and SIM every few days. Sometimes, for complete anonymity it is not advisable to have a mobile phone on your person at all. Some phones may still transmit information to the network or be accessible from the network even though the user has switched them off. It is therefore strongly recommended to remove the batteries from the phone. Definition Wikipedia, the Free Encyclopedia defines Telephone tapping (or wiretapping in the US), as the monitoring of telephone and Internet conversations by a third party, often by covert means. The telephone tap or wire tap received its names because historically, the monitoring connection was applied to the wires of the telephone line of the person who was being monitored and drew off or tapped a small amount of the electrical signal carrying the conversation. Legalized wiretapping by police or other recognized governmental authority is otherwise known as lawful interception. History Communication interception has been around for more than a century because it was born during the Presidency of President Abraham Lincoln. It has been traced back to the period during the American Civil War where eavesdropping of telegraph conversations was the first recorded. Telephone wiretapping began in the 1890s, following the invention of the telephone recorder. Wiretapping has also been carried out under most Presidents, usually with a lawful warrant since the Supreme Court ruled it constitutional in 1928. Domestic wiretapping under the Clinton administration led to the capture of Aldrich Ames, a former Soviet spy in 1994. The Robert F. Kennedy administration monitored the activities of Martin Luther King Jr. by wiretapping. According to The Einstein File by Fred Jerome, from the time Einstein arrived in the US in 1933 to the time of his death, in 1955, the FBI files reveal that his phone was tapped, his mail was opened and even his garbage searched. Legal status Amidst protest, legalize phone tapping is what Uganda is attempting to do. In many developed democratic countries, telephone tapping is officially strictly controlled to safeguard individuals’ privacy. In theory, telephone tapping often needs to be authorized by a court, and is, again in theory, normally only approved when evidence shows it is not possible to detect criminal or subversive activity in less intrusive ways; often the law and regulations require that the crime investigated must be at least of a certain severity. In many jurisdictions however, permission for telephone tapping is easily obtained on a routine basis without further investigation by the court or other entity granting such permission. Illegal or unauthorized telephone tapping is often a criminal offence. However, in certain jurisdictions such as Germany, courts will accept illegally recorded phone calls without the other party's consent as evidence. Experiences and Reactions in some Countries The Dutch and the Germans are considered to be among the world's most prolific telephone tappers (over 10,000+ phone numbers in both countries in 2003). Phone tapping is a common occurrence the whole world over, although some Ugandans tend to think it is only practiced under dictatorships. A BBC report says that, in the UK, police can only use phone taps for intelligence purposes and the each tapping to be authorized by the Home Secretary. Although it is being reconsidered, evidence from phone taps is not permissible in courts of law. But, as the law stands, it is not illegal for police to tap phones. Compared to other democracies, Britain is almost alone in the world in this respect. In the United States, Germany, Japan, Australia and most other European countries evidence from phone taps is widely used. In the United States, federal agencies may, in certain circumstances, be authorized to engage in wiretaps by the United States Foreign Intelligence Surveillance Court, a court with secret proceedings. In 2005, President George Bush was accused of violating the US Constitution because of the NSA warrantless surveillance controversy. The President argued his authorization was consistent with other federal statutes and other provisions of the Constitution, was necessary to keep America safe from terrorism, and could lead to the capture of notorious terrorists responsible for 9/11. Under United States federal law and most state laws there is nothing illegal about one of the parties to a telephone call recording the conversation, or giving permission for calls to be recorded or permitting their telephone line to be tapped. However the Telephone recording laws in some U.S. states require only one party to be aware of the recording, while other states require both parties to be aware. It is considered better practice to announce at the beginning of a call that the conversation is being recorded. There is nothing illegal about one of the parties to a telephone call recording the conversation, or giving permission for calls to be recorded or permitting their telephone line to be tapped. Many businesses record their telephone calls for legal reasons, so that they can prove what was said, train their staff, or monitor performance. This activity is not normally considered telephone tapping because it is done with the knowledge of at least one of the parties to the telephone conversation. Some advise or even ask if a conversation can be recorded. In Greece, between more than 100 mobile phone numbers belonging mostly to government officials, including that of the Prime Minister and top-ranking civil servants, were found to have been illegally tapped by a foreign intelligence body for a period of at least a year. The Greek government concluded this had been done for security reasons related to the 2004 Olympic Games, by unlawfully activating the lawful interception subsystem of the Vodafone Greece mobile network. In nearby Italy, the state listens in to its citizens' phone calls which is considered acceptable and just the way things are supposed to be. Looking at Asia, in 1999, Japan's Parliament passed the controversial law on telephone wire tapping amidst physical disagreements in the chamber. In 2005, the Thai cabinet approved a decree giving the Prime Minister sweeping powers of censorship and phone tapping. In 2006, Hong Kong's legislature has passed the controversial new law on the use of covert surveillance and phone tapping, which critics fear will harm liberties. In India, it is illegal to tap telephones unless the tapping has to be approved by a designated authority. Additionally, as nationals of various countries protest and at the introduction of tapping at a micro-level, at the macro-level, according to a Statewatch Report (1997), "The EU, in cooperation with the FBI of the USA, is launching a system of global surveillance of communications to combat "serious crime" and to protect "national security", but to do this they are creating a system which can monitor everyone and everything. The EU will be able to trawl the airwaves for "subversive" thoughts and "dissident" views and, with its partners, across the globe." The U.S. Department of State Country Reports on Human Rights Practices for 1995, states that the ‘majority of the countries of Africa have poor records on privacy. While 31 countries had constitutional, and another 12 had legal protections of privacy, illegal wiretapping was reported in thirty out of the 49 countries in that region’. South Africa introduced the Regulations of Interception and Provision of the Communication Related Information Bill, which provides for state monitoring of all telecommunications systems for criminal investigations, including cellular telephones, the Internet, and e mail, although, it had not been operationalised by the end of 2006. The law was introduced in Zimbabwe in 2006 and it also caused outrage. There, the Minister of Transport and Communications was given authority to issue warrants for interception of communication; Police, security and revenue service bosses (this is what is scaring Uganda business people) were given authority to apply to the minister to issue warrant; Extendable warrants, valid for 3 months, to be issued in case of perceived crime or security threats; Right of appeal to minister, not to courts and ISPs must install monitoring hardware and software. The Zimbabwean Government was believed to monitor some private correspondence and telephones, particularly international communications; The law permits the government to monitor and intercept e mails entering and leaving the country. Security services reportedly continued to monitor e mail and Internet activity and acquired new technology to do so; however, the extent of monitoring was unknown. In Egypt in 2002, the upper house of Parliament, the Shura Council, approved a draft bill that permits security agencies and the Interior Ministry to conduct telephone and Internet wiretaps in the interest of national security. A draft article that permitted such tapping without court approval faced resistance among members and was withdrawn from the bill. In Rwanda, there were some reports that the government monitors homes and telephone calls. Methods Land Lines It is possible to tap land line telephones through conversation recordings, direct line tapping and radio tapping. These are methods which are used by other free-lance illegal tappers and not Government because the latter has access to the telephone exchange. Recording the conversation - the person making/receiving the call records the conversation using a coil tap or telephone pickup coil attached to the ear-piece, or they fit an in-line tap with a recording output. A more modern alternative is to use telephone recording devices connected to computers, such as call recording software. Direct line tap - this is what the state used to do via the telephone exchange. But unofficial tapping, where the user's line is physically tapped near the house, is also possible. The tap can involve a direct electrical connection to the line using an induction coil. An induction coil is usually placed underneath the base of a telephone or on the back of a telephone handset to pick up the signal inductively. With a direct connection, there will be some drop in signal levels because of the loss of power from the line, and it may also generate noise on the line. Radio tap - this is like a bug that fits on the telephone line and can be fitted to one phone inside the house, or outside on the phone line. It only transmits when a call is in progress. Mobile Telephones In terms of surveillance, mobile phones are real liabilities. And the liability will get worse with the introduction of the new third-generation (3G) phones. This is because the base stations will be located closer together. For mobile phones the major threat is the collection of communications data. This data not only includes information about the time, duration, originator and recipient of the call, but also the identification of the base station where the call was made from, which equals its approximate geographical location. This data is stored with the details of the call and has utmost importance for traffic analysis. The contracts or licenses by which the state controls telephone companies often require that the companies must provide access for tapping lines to the intelligence services police. In the U.S, telecommunications carriers are required by law to cooperate in the interception of communications for law enforcement purposes. During the days of mechanical telephone exchanges, technicians would install a tap by linking circuits together to route the audio signal from a call. These days, with most exchanges converted to digital technology tapping is far simpler and can even remotely be ordered by computer. When the tap is implemented at a digital switch, the switching computer simply copies the digitized bits that represent the phone conversation to a second line and it is impossible to tell whether a line is being tapped. A well-designed tap installed on a phone wire can be difficult to detect. The noises that some people believe to be telephone taps are simply crosstalk created by the coupling of signals from other phone lines. Phone companies routinely and automatically collect data on the calling and called number, time of call and duration and then store the data for billing purposes. This data can be accessed by security services, often with fewer legal restrictions than for a tap. This information used to be collected using special equipment known as pen registers and trap and trace devices and U.S. law still refers to it under those names. Today, a list of all calls to a specific number can be obtained by sorting billing records. A telephone tap, during which only the call information is recorded but not the contents of the phone calls themselves, is called a Pen Register tap. It is also possible to get greater resolution of a phone's location by combining information from a number of cells surrounding the location, which cells routinely communicate and measuring the timing advance, a correction for the speed of light in the GSM standard. This additional precision must be specifically enabled by the telephone company - it is not part of ordinary operation. There is no countermeasure against the state/telephone companies doing this, perhaps with an exception of locking the phone to only one distant base station and accessing it from a distance using a high-gain antenna, limiting the location data disclosed to the network to a quite large distant arc. The second generation analogue mobile phones (circa 1978 through 1990) could be easily monitored by anyone with a 'scanning all-band receiver' because the system used an analog transmission system-like an ordinary radio transmitter. This is around the time (1989) when Prince Charles was a victim of an embarrassing eavesdropping episode in which he and his present wife Camilla were recorded having a sexually explicit tête-à-tête when the late Princess Diana was still the official Princess. The third generation digital phones are harder to monitor because they use digitally encoded and compressed transmission. However the government can tap mobile phones with the cooperation of the phone company. It is also possible for organizations with the correct technical equipment, such as large corporations, to monitor mobile phone communications and decrypt the audio. A special device called an "IMSI-catcher" pretends to the mobile phones in its vicinity to be a legitimate base station of the mobile phone network, subjecting the communication between the phone and the network to a man in the middle attack. This is possible because while the mobile phone has to authenticate itself to the mobile telephone network, the network does not authenticate itself to the phone. This blatant flaw in GSM security was intentionally introduced to facilitate eavesdropping without the knowledge or cooperation of the mobile phone network. Once the mobile phone has accepted the IMSI-catcher as its base station the IMSI-catcher can deactivate GSM encryption using a special flag. All calls made from the tapped mobile phone go through the IMSI-catcher and are then passed on to the mobile network. Up to now no phone is known which actively alerts the user when a base station or an IMSI-catcher deactivates GSM encryption. But no matter whether GSM encryption is active or not, users should not trust the encryption to be secure enough to foil an eavesdropper. There is no defense against IMSI-catcher based eavesdropping, except using end-to-end call encryption and more modern but expensive secure telephone sets. Internet There is not much information available about internet wiretapping. However, in 2006, it was reported that the FBI had drafted sweeping legislation that would require Internet service providers to create wiretapping hubs for police surveillance and force makers of networking gear to build in backdoors for eavesdropping. CONCLUSION Phone tapping should not be used by any Government as a carte blanche to interfere in the civil liberties of its citizens. All in all tapping phones should be used for the common good of any society and not for selfish motives. SOURCES Wikipedia, the Free Encyclopedia. US Department of State Country Reports on Human Rights Practices for 1995, 2002 & 2006. Released by the Bureau of Democracy, Human Rights, and Labor Statewatch, February 1997.

INFANT AND CHILD MORTALITY IN EASTERN AFRICA: CAUSES AND DIFFERENTIALS.

Wed, 29 Mar 2007 05:59:40 GMT

posted by kigowa

BY KADUULI STEPHEN

kaduuli@yahoo.com

Graduate Program in Demography

NATIONAL CENTRE FOR DEVELOPMENT STUDIES

AUSTRALIAN NATIONAL UNIVERSITY.

NOVEMBER 1988

Key Words

Infant mortality, Child mortality, Eastern Africa, Maternal education, Diarrhea,

Disease

Bio-sketch

I am a Demographer (M.A) and Social Worker (B.A) by academic profession and a Civil Servant by occupation. My area of interest has always been infant and child survival but now I have developed a passion for the family area. Since I left academics in 1990, I have always yearned to be back. After my first degree, I was a Teaching Assistant at Makerere University Kampala. In 1988, I got a meritorious Australian government (AIDAB) scholarship to go and pursue the Masters.

ABSTRACT

Infant mortality refers to the death of a child born alive before its first birthday and child mortality is the death of a child aged between one and five years.

Demographers have for a long time been interested in the study of mortality which is one of the components of population change. Infant and child mortality are among the best indicators of socio-economic development because a society’s life expectancy at birth is determined by the survival chances of infants and children.

This paper reviews the literature of infant and child mortality in Ethiopia, Kenya, Sudan, and Tanzania, countries, which, for purposes of this discussion, constitute Eastern Africa. In this part of the world, as many as 200 of every a thousand live born infants die before their first birthdays. Apart from Kenya, all the above mentioned countries have infant mortalities ranging between 100 and 200 deaths per thousand live births. Even though infant and child mortality have declined in the region since the 1960’s, they are still unquestionably high and have for various reasons stagnated in their decline.

INTRODUCTION

Infant mortality refers to the death of a child born alive before its first birthday and child mortality is the death of a child aged between one and five years.

DATA LIMITATIONS

Lack of quantitative and qualitative data makes the task of analyzing demographic trends in the region an arduous one. This is due to the absence of accurate vital registration systems and other high quality sources of information (Gaisie, 1979; Mott, 1982). Newman (1979: 513) believes that it is difficult to have confidence in the estimated mortality levels.

CAUSES OF DEATH

In tropical Africa, the main causes of infant and child deaths are more or less the same in most countries. These have been identified as infections, protein-calorie malnutrition, and birth trauma (Page and Coale, 1972; Newman, 1979; Newland, 1982). Most of the causes, especially of child mortality, are preventable.

The infections include neonatal tetanus, diarrhea, respiratory infections, measles, and malaria (Page and Coale, 1972; Chen, 1983). In Kenya it has been found that respiratory infections, especially pneumonia, are the main cause of death among infants and children (Ewbank et. al., 1986). Rotavirus has been isolated in at least 30% of young children admitted to the paediatric ward of Kenyatta National Hospital for acute diarrhea (Leeuwenburg et al., 1984). In the Machakos longtitudinal study in Kenya, it has been found that diarrhea plays a role in the measles syndrome. Diarrhea has been found to be a concomitant symptom in 50% of the measles cases (Leeuwenburg et al., 1984).

Protein-calorie malnutrition has been identified as the major secondary or underlying cause of death (Newman, 1979; Page and Coale, 1972; Newland, 1982). This is supported by the fact that in Kenya, respiratory deaths among children are frequently associated with malnutrition and with other infectious diseases (Ewbank et al., 1986). Mondot-Bernard (1977) has found that in this part of the world, children suffer from kwashiorkor (malnutrition in children due to diets lacking adequate proteins) between 18 months and 3 years, the time when they are weaned and given more solid food.

Neonatal deaths (deaths to children under one month of age) tend to be dominated by factors related to the birth process or congenital phenomena, but as the child grows older, exogenous factors take over and play a bigger role (Gaisie, 1979; Mott, 1982). Conditions which exacerbate the above causes of death include low birth weight, poor sanitation and water supply, poverty, inadequate food supplies, lack of education and information and inadequate health care (Newman, 1979; Newland, 1982).

Children in the third world, especially in sub-Saharan Africa, usually suffer from more than one disease at a time. There appears to be a ‘synergism of infection’ whereby children tend to suffer from several diseases at the same time on top of protein-calorie malnutrition, which appears to be largely responsible for the infant and child mortality (United Nations Economic Commission for Africa, 1979:22; Newman, 1979). An ad-hoc survey in Sudan has found that nutritional deficiencies are an associated cause in 61% of all childhood deaths with infectious disease and the contributory or preexisting cause in 59% of deaths due to measles (World Health Organization, 1981).

INFANT AND CHILD MORTALITY DIFFERENTIALS

There are considerable variations in the levels of infant and child mortality according to the child’s age and sex, the mother’s educational attainment, age at birth, nature and duration of marriage, parity, and place of residence.

Mother’s Educational Attainment

It has been found that maternal education is the single most significant determinant of infant and child mortality differentials. Increasing educational attainment of the mother has been associated with declines in infant and child mortality (Anker and Knowles, 1977; Caldwell, 1979b; Mott, 1982). Monsted and Walji (1978: 73) have found that in Tanzania, parents with no school education have an infant mortality of 155 per thousand births, and those with five or more school years had a rate of 82 per thousand births. Gebretu (1977) cited in Gaisie (1979: 455) has found that in Ethiopia, education has a depressing effect on infant and child mortality. Similar observations have been made in Sudan (WHO, 1981).

Reasons given for this inverse association include breaks with traditional methods of, and attitudes to, child care and the resort to medical alternatives, better nutritional use of available foods, intensive child care and a greater share of the family resources spent on the child (Caldwell, 1979a; Mott, 1982). However, Mwaniki (1983) cited in Ewbank et al., (1986: 49) has found that according to the Kenya Fertility Survey data, for both parents, one to three years of education is not sufficient to affect infant and child mortality significantly. Maina-Ahlberg (1979) cited in Ewbank et al., (1986: 49) has found that in Kenya, education has little effect on the likelihood that a child with measles or acute diarrhea will be treated using modern medicine. In other words, education does not rule out the fact that parents may resort to traditional medicine to cure the child’s measles or diarrhea. These findings seem to point to the fact that little education viz. three years or less, is not enough to positively affect infant and child mortality.

In Sudan, comparing childhood mortality by both education and rural/urban residence, it has been found that the mother’s education is associated with a lower level of childhood mortality in urban and rural areas (World Health Organization, 1981 :56).

Differentials by Religion

According to the UN (1985) cited in Mengistu (1987: 47), “Moslem women usually experience higher infant and child mortality than Christian women.” In Ethiopia and Kenya, data has shown that this statement is true. However, Gaisie (1979: 457) explains that religion per se does not greatly affect infant and child mortality but lower levels of infant and child mortality may be a reflection of the fact that the Christian group may contain more educated mothers than the group consisting of traditional or other worshippers.

Differentials by Type of Union

According to Caldwell (1979a), polygamy in some instances has been found to be associated with above average levels of infant and child mortality. However, Mott (1982) doubts the strength of this association and says this issue should be looked at in a multivariate context. He goes on to argue that infants and children in polygamous unions may receive less attention than those in monogamous ones. He adds that polygamous marriages are associated with more traditional childbearing practices because the women may, on the average, have less education than their counterparts in monogamous marriages. In the final analysis, he concedes that it is clear for uncertain reasons that there are significant differentials in infant and child mortality between women in different types of marriages, even after controlling for educational differences. Using data from the Kenya Fertility Survey he finds that polygamous women under 30 who have no education have infant mortality rates of 128 compared with 95 for their counterparts in monogamous unions.

Child’s Age and Sex

According to figures compiled by the United Nations, it has been found that child mortality is higher than infant mortality (Page, 1971; Gaisie, 1979; Adegbola, 1985). This is clearly a pointer to the environmental hazards and the accompanying diseases. It has also cast some doubt on the efficacy of infant mortality as an indicator of community health standards since child mortality tends to be higher (Gaisie, 1979). This seems to suggest that child mortality (0q2) may be a better indicator of the level of wellbeing of a society.

It has also been found that there are significantly higher numbers of infant deaths among male than female births (Anker and Knowles, 1977; Page, 1971). The Kenya Fertility Survey data suggests that infant mortality for males is 89 while the rate for females is 81 (Ewbank et al., 1986). Among the reasons given are those by Mott (1982: 15) who explains that ‘….physiological differences in the capability of male and female infants to survive early infancy largely account for this pattern. Boys have higher risk of birth injury, breathing difficulties and jaundice.’ He, however, explains further that for cultural reasons, female neonatal deaths are more likely to be underreported than male deaths.

On the other hand, male child mortality appears to be lower than female child mortality. Mengistu (1987: 49)suggests that this reversal is due to ‘…the unequal distribution of food between male and female children is supposed to be responsible for excess female child mortality.’ Seetharam and Mekki (1970) explain that excess female child mortality may be a reflection of the preference of male children over female children. According to Mengistu (1987: 50-51) in rural Ethiopia, it was found that mortality for male children was 133, and 138 for female children.

Differentials by Mother’s Parity/Child Spacing and Age at Birth

High infant and child mortality is usually accompanied by a high birth rate (Monsted and Walji, 1978). This is because when an infant dies, there is a discontinuation of breastfeeding (leading to the early return of ovulation) and the parents would like to replace the deceased child by another – ‘replacement effect’ (Lucas and McDonald, 1980: 141; Mondot-Bernard, 1977). Alternatively, some parents give birth to as many children as they can so that in case some die, a sizable number remains – ‘insurance effect’ (Lucas and McDonald, 1980: 141-2). A high birth rate results in closely spaced births which seem to lead to higher levels of infant and child mortality.

The occurrence of a second birth while the first child is still being breastfed may lead to abrupt weaning and higher child mortality and that is why mortality tends to rise at the age of six months and remains high throughout most of the second and third years of life (Page, 1971; Gaisie, 1979). Frequent births create a strain on the woman’s health and this, coupled with poor nutritional conditions, is bound to have an impact on the child’s health too (Monsted and Walji, 1978).

High parity risk is also exacerbated if the births are spaced closely together. Births of parity one and high parity births are associated with above average deaths (Mott, 1982; Caldwell, 1979; Mondot-Bernard, 1977).

The mother’s age at birth also impinges on her health and that of her child. According to Chen (1983: 208), evidence shows that childbearing at very young (under 17) and very old (over 35) ages jeopardizes the infant’s and the mother’s survival chances.

Regional and Rural/Urban Differentials

Mortality differentials exist between regions such as drought stricken areas, monocultural crop areas, rich and poor regions and rural and urban areas. In Kenya, high mortality is estimated for high density populations near the lake and on the coast, while districts to the north of Nairobi have very low levels (Ewbank, 1986). In Sudan, Teklu (1976) cited in Gaisie (1979: 452), has found that mortality is lower in the Central and Northern provinces and higher in the South and South-Eastern ones.

Cities and towns tend to have lower mortality than rural areas (Monsted and Walji, 1978; Page, 1971; Gaisie, 1979). Although there is enough evidence to support this inverse association, the rural-urban differential does not reflect rural or urban residence per se but other factors like education, marital status and family size which are associated with them (Mott, 1982; Monsted and Walji, 1978). Olusola (1985) advances the reasons that Africans living in rural areas are less educated than their urban counterparts and that the distribution of amenities is lopsided in favor of the urban areas.

Occupational Differentials

In Sudan, farmer’s children have been found to have higher incidence of diarrhea and thus mortality than children of people in other occupations (El Fatih et al., 1988). In Tanzania, it was found that among the urban top-level white collar people, infant mortality was in the region of 62 deaths per thousand (1967 figures), while among farmers, it was 155 per thousand births (Monsted and Walji, 1978).

CONCLUSION

This paper has reviewed the literature on the causes of infant and child mortality and differentials by age, sex and the socio-economic characteristics of the parents. Infection, malnutrition and diarrhea seem to be the major killers of infants and children. In all this, the mother’s level of education or lack of it, appears to be the central variable.

REFERENCES

ADEGBOLA, Okulunle

1985 ‘Mortality in Africa.’ In International Population Conference. Florence

1985, Vol. 2, pp. 257-59. Liege: IUSSP.

ANKER, Richard and J.C Knowles

1977 An Empirical Analysis of Mortality Differentials in Kenya at the Macro and Micro Levels. Population and Employment. Working Paper No. 60, Geneva: International Labor Office.

CHEN, C. Lincoln

1983 ‘Child Survival: Levels, Trends and Determinants.’ In Determinants of

Fertility in Developing Countries. Vol. 1 Supply and Demand for Children. (eds) A.R Bulatao and R.D Lee pp. 199-220. New York: Academic Press.

CALDWELL, John. C

1979a ‘Education as a factor in Mortality Decline: An Examination of Nigerian Data.’ In Population Studies, Vol. 33, No. 3.

CALDWELL, John. C

1979b ‘Background to Fertility and Mortality in Africa: An Overview’, in Population Dynamics: Fertility and Mortality in Africa. Proceedings of the Expert Group Meeting on Fertility and Mortality Levels and Trends in Africa and their Policy Implications. pp. 32-48 Liberia: UNECA.

EL FATIH, El Samani, W.C Willet and J.H Ware

1988 ‘Association of Malnutrition and Diarrhea in children under 5 years: A prospective follow up study in a rural Sudanese community.’ American Journal of Epidemiology. Vol. 128, No. 1. pp 93-105 John Hopkins University School of Hygiene and Public Health.

EWBANK, D., R Henin and J Kekovole

1986 ‘An Integration of Demographic and Epidemiologic Research on Mortality in Determinants of Mortality Change and Differentials in Developing Countries: The Five Country Case Study Project. pp. 33-85. New York: United Nations.

GAISIE, S.K

1979 ‘Mortality, Socio-Economic Differentials and Modernisation in Africa’ in Population Dynamics: Fertility and Mortality in Africa Proceedings of the Expert Group Meeting on Fertility and Mortality Levels and Trends in Africa and their Policy Implications. pp. 441-63 Monrovia: UNECA.

LEEUWENBURG, J., W.Gemert, A. Muller and S. Patel

1984 ‘The incidence of diarrhea disease.’ In Maternal and Child Health in Rural Kenya: An Epidemiological Study. (eds.) J.K van Ginneken and A.S Muller. Great Britain: Biddles Ltd.

LUCAS, David and Peter McDonald

1980 ‘Interrelations between the Demographic Variables’, in Beginning Population Studies (eds.) David Lucas et al., pp. 133-54. Canberra: Australian National University.

MENGISTU, Genet

1987 Fertility and Child Mortality in Rural Ethiopia, M.A Thesis, Department of Demography Canberra: Australian National University.

MONDOT-BERNARD, M. Jacqueline

1977 Relationships between Fertility, Child Mortality and Nutrition in Africa: A Tentative Analysis. Technical Papers. Paris: Development Centre of the Organization for Economic Cooperation and Development.

MONSTED, Mette and Parveen Walji

1978 A Demographic Analysis of East Africa: A sociological Interpretation. Uppsala: Scandinavian Institute of African Studies.

MOTT, L. Frank

1982 ‘Infant Mortality in Kenya: Evidence from the Kenya Fertility Survey.’ World Fertility Survey. Scientific Report No. 32. Voorburg: International Statistical Institute.

NEWLAND, Kathleen

1982 ‘Infant Mortality and the Health of Societies.’ In Worldwatch Paper 47. Washington D.C: Worldwatch Institute.

NEWMAN, Jeanne

1979 ‘Nutrition, Disease and Mortality in Young Children’, in Population Dynamics: Fertility and Mortality in Africa. Proceedings of the Expert Group Meeting on Fertility and Mortality Levels and Trends in Africa and their Policy Implications. pp. 513-26. Liberia: UNECA.

OLUSOLA, Ayeni

1985 ‘Geographical and Socio-Economic Differentials of Infant and Child Mortality in Africa’, in International Population Conference. Florence 1985. Vol. 2, pp. 261-73. Liege: IUSSP.

PAGE, H

1971 ‘Infant and Child Mortality’, in Population in African Development. Vol. 1. (eds.) Cantrelle Pierre et al., Liege: Ordina Editions.

PAGE, H.J and Coale A.J

1972 ‘Fertility and Child Mortality South of the Sahara’, Population Growth and Economic Development in Africa. (eds.) S.H Ominde and E.N Ejiogu. London: Heinemann.

SEETHARAM, K.S and M.A Mekki

1970 ‘Estimates of Mortality for Rural Ethiopia’, in Mortality Trends and Differentials in some African and Asian Countries. Research Monograph Series, No. 8. pp. 665-692 Cairo: Cairo Demographic Centre.

WORLD HEALTH ORGANISATION

1981 Infant and early childhood Mortality in relation to Fertility Patterns: Report on an Ad-Hoc Survey in Greater Khartoum and in Blue Nile, Kassala and Kordofan Provinces. Geneva: WHO.

UGANDAN ENTERS DOWN UNDER

Fri, 21 Apr 2007 16:32:29 GMT

posted by kigowa
By KADUULI STEPHEN
On 2nd February 1988, I got a call from the Secretary Uganda Central Scholarship Committee, telling me to, at long last, prepare for a journey to Australia to pursue my Masters’ Degree in Demography. I had been admitted to the then 42 year old Australian National University (ANU). The struggle for a scholarship had taken a seemingly endless five years. On receiving the news, my excitement was immeasurable.
Before proceeding to Australia, I had to formalize my union with his fiancé, Susan. This I did by being enjoined to her in the Special District Administrator’s Office in Wandegeya-Kampala on 5th February 1988. We were united by the then District Executive Secretary, a Mr. Byabagambi-Katuku. In Ugandaspeak, I had never ‘climbed the metal sheet ‘ (or precisely, olubaati) that flies. That may explain why I was the last passenger to board that Ethiopian Airways flight that 16th afternoon of February 1988. I was very excited but at the same time very worried for my wallet contained only $25 American dollars in the name of pocket money.
The flight left Entebbe International and headed southward over Tanzania until it landed at Harare International Airport. When we got to Harare, I linked up with my Ugandan scholarship mates in the hotel we were booked into. They included Dr. Mbuza, Kyamuhangire and Kapsanduy. These are the guys who made my stay in Harare comfortable because they had had enough notice to look around for pocket money for the journey. So, they ended up clearing all my lager bills. We received our visas from the Harare Australian High Commission on the 18th of February 1988.
At Harare Airport the same evening, we mounted the enormous Boeing 747. This was my first time to see such a massive aircraft. While in flight I made friends with some Australian mate whose name I do not recall since that was the last time I saw him. He was a very friendly chap. He tried to teach me how to drink Guinness beer but I failed to learn how to drink the bitter. I could not handle more than two swallows. So I stuck to the traditional beer, I think, Australian Foster’s it was.
Australia, at that time, had a population of approximately 15 million inhabitants, with over 80% of them residing mainly on the south-eastern part of the continent. It has a climate which ranges from the tropical to the temperate. We landed on the Western Australian soil at Perth on 19th February 1988.
We thought the flight would proceed after an hour or so but, fortunately or unfortunately, we were informed that we had to spend a night in Perth because an airline strike had been declared at Sydney Airport paralyzing all Australian air operations. Qantas Airline got us transport and accommodation in some good hotel. To me, this was a blessing in disguise because I was very tired and this was a chance to storm a city I would never have had a chance to come back to, probably for the rest of my life. At the Hotel, I got what I considered to be a very good room. I relaxed for some good time while watching TV. The room had a bar with lagers, spirits, wines and nuts of all ‘tribes’ but I, at first, feared to touch anything until I found out what the situation was. Later, I went down to the reception and there, I found a young lady who appeared to be a student on part-time employ, who told me that she ‘thought’ the drinks and snacks in the room were on the house. I proceeded to my room ‘like wind’ and immediately started imbibing and masticating as I flipped through the TV channels as if the following day would not come. Later, I linked up with the other Ugandan scholars and we spent virtually the whole night in the hotel’s discotheque downstairs.
The following morning, to my utter shock, as we were checking out of the Hotel, I was asked to clear the bills for my room bar. My Australian Guinness ‘tutor’ came to my rescue and I promised to send him a check when I settled down in Canberra. On landing at the Canberra Airport, I met a lady who had a message for me which left me whistling all the way up to Canberra city centre. She welcomed me and handed over an envelope which contained briefing material and a whole A$664! At that time, I had never held and owned such money as my own. I looked around for a cab whilst whistling. The cab man took the longest route to town and ate into the new found wealth, as I was to find out later. I was deposited at a little hotel or hostel on Northbourne Avenue in Canberra city centre, where I spent a few days alone until my Department contacted me. I registered at the University and was allocated the then $52 a week Toad Hall (opened March 1974) as my hall of residence. It is described in the overseas students’ orientation manual as ‘a modern residence comprising 231 rooms, located in Kingsley Street close to the civic shopping centre. This is a self catering establishment, with several rooms arranged around a central common-room and kitchen. Some of the kitchen-blocks are crowded at times, but most students enjoy the freedom and companionship at Toad Hall.’ Later, I came to learn from the late Honorable James Wapakhabulo, the former Speaker of the Ugandan Parliament, that he too had been a resident of Toad Hall. I made friends with my Australian neighbors because we used to cook in the same kitchen on our block. One day we went out shopping with them and bought a beer making kit. We brewed our beer and made some steak. That night we slept the following day, so to speak. I was taken to National Bank of Australia to open a bank account and this is when I first handled an ATM card. I was also given Medicare card issued by the national health system. Australians are informal people, both in speech and dressing, and possess a very high sense of humor. Their English accent is mid way between the American accent and the British one. They call the Britons Poms or simply Pommy, which a very derogatory form of address. One of the first things that intrigued me about Australians during my first days in Canberra was the way they greeted. One day I attended a party where he was greeted thus: ‘How’re you going mate?’ His answer in ignorance was ‘Going where? It caused raucous laughter. I also came to learn that food is called tucker. When an Aussie wants to complement you for something, they simply say ‘Good on you mate.’ I was amazed to meet an illiterate white grandmother in a supermarket. I had to assist her by reading what was written on the shelves. In Toad Hall, I had a neighbor and an Aussie friend called Nerida. One day I went to visit her and did not find her there and so I decided to leave her a note on her door. I wrote ‘Nerida, I had come to visit you but I bounced.’ Before she could read the note, however, her mother got to it first. She could not conceptualize what Uganda-speak ‘bouncing’ meant and so she asked her daughter ‘Nerida, are you sleeping with this man?’ I nearly died of laughter as I explained to my friend what bouncing entailed in Ugandese. When we, Africans, from the developing countries go to the developed world, our love for electronics is well known. On 26th March 1988, I bought my first asset from Triffets store in Belconen. I bought a good 21” Phillips television which lasted up to 2002. I was so mesmerized with full time variety television that I used not to switch it the whole night. I was accustomed to the lone Uganda Television which used to go on air at 6pm and was off air by mid night. As soon as I left Uganda, some people started plotting how to kick my wife out of the so called government house (it was more like a dungeon to me because it was a go-down beneath the main house) where we had been staying. This put her under so much stress and yet she was pregnant at the time and so I had to find a way out. I contacted my sponsors and narrated what the situation was to them. They understood it and explained to me that it was my entitlement to bring my spouse into Australia. So I made the necessary arrangements and on 27th May 1988 she landed in Australia, heavily pregnant with Sandra. A few days after her arrival in Canberra, Susan fell seriously ill. She had imported malaria from Uganda and yet she was pregnant! I rushed her to the Royal Canberra Hospital where it was confirmed that she indeed had malaria. Then it became sort of a national crisis because there are very few specialists in tropical medicine in Australia. The National Infectious Diseases Institute in far-away Sydney had to be notified immediately. The doctors were on phone to Sydney the whole night till a probable solution was found. If it had not been found, they were determined to induce a premature (six months) birth of Sandra in order to save her life.
Sandra Yvonne, who is sitting for her A’ Levels in 2007, was born at the Royal Canberra Hospital on 11th August 1988. Our gynecologist was a Canberra doctor called Dr. Hehir. She was baptized on 23rd July 1989 at St. Philips Church, 26 MacPherson Street, O’Connor and her God parents were family friends Christine McPaul and Mark Sawyers. Sandra’s ‘so called’ best friend was called Yin Yin because, although, she was older, Sandra was loved by her and was the only one she could play with, being a couple of months older. Her mother was a good neighbor and friend to Susan. Christine and Mark were like family to us. They took us to Tamworth, an Australian ‘village’ for the Christmas of 1988 to visit the McPaul farm. It was quite an experience! We went for the Christmas church service and what a stir we caused! It was as if we were the first Africans to go to that village. They were surprised that we could sing the Christmas carols because at all chorus times the congregation would all peer at where we were seated to see how we were singing. At the end of the service they all converged on us to marvel at baby Sandra. This is the one time I had a chance to learn how to ride a horse but I politely declined. We got a University flat at 8/6 Moorhouse Street, O’Connor A.C.T. In our first few months there, we had an African sub-tenant who used to assist us with our exorbitant rent payments. Horst-Posselt, a Germanic Australian friend and classmate of mine used to give me lifts to school because he resided nearby. He also became my driving instructor enabling me to get a three months provisional driving permit license on 12th January 1989. On Sundays, I would buy a four liter cask of Fruity Lexia wine and enjoy it with Susan accompanied by roasted meats made by ourselves. I also made friends with the few other African students namely Alec Upindi (died around 1991) from Malawi, Nandipha Ngcongco (pronounced with the famous Xhosa clicking sound) from Botswana, Duduzile from Swaziland, Muganda from Tanzania, the very academic (he was pursuing his second master’s degree) Jacob Adetunji from Nigeria and T.J Makatjane from Lesotho. We also had a black revolutionary friend from Irianjaya Indonesia. He was as black as any other musoga. Socially, however, Upindi was my closest friend and ally. He would tell me stories about life in his country and I would do likewise about Uganda. I do not know how many times he told me about a fish called the Lake Malawi Chambo. To him, it was like the Malawi National Emblem. I also told him about our famous Lake Victoria Tilapia fish. Our favorite pub was a bistro/discotheque called the Private Bin located on 50 Northbourne Ave. However, if we chose to drink on campus, we would go to University Union bar or University House. Others pubs/bistros in the city were The Stockade, the Old Canberra Inn, Jamison Inn, the Pot Belly, and Blind Beggars. Here we used to ‘shout’ schooners (one liter beer glasses) of our favorite draught bitters. The Australian custom of ‘shouting’ means that if someone buys you a drink, you are expected to ‘shout’ back by buying him a drink. I had by now ended up zeroing on Victoria Bitter (shortened to VB) as my favorite Australian beer. One day, we ran a white South African out of the Bin because he was making racist innuendos at us. Whenever we were low, in terms of Aussie dollars, we would buy chilled cans, six packs, preferably, with brown paper bags, then we would sit on the benches in the middle of Canberra and swallow the bitter camouflaged by the brown paper bags. We got to know two Ugandan families resident in Canberra: the Geria’s and the Kibuuka-Musoke’s. Mrs. Kibuuka-Musoke, wife of Uganda’s former High Commissioner to Australia, is the one who introduced me to Chinese cuisine. She invited Ugandan and other African students to the Lotus Chinese Restaurant on 100 Northbourne Ave. for a memorable luncheon. The Geria family used to invite us for parties and barbeques all the time we were there. There being very few Africans in Canberra, it was a pleasure to be invited and be in attendance at a party where almost all the Canberra Africans were in attendance. One such occasion we were invited to was to celebrate the 26th Anniversary of the Independence of the Republic of Kenya. We were invited by the exuberant High Commissioner, Mr. J M Musomba and his wife to the High Commission which was located at 9 Melbourne Avenue, Forrest on 12th December 1989. It was a very memorable Kenyan Independence Day because he was a very welcoming and gregarious host. We one time traveled to Melbourne with Christine and Mark. It was another experience! That’s when we first ate and relished the famous Latin American delicacy called ‘Tacos’. Very delicious! But in some of the Ugandan dialects, that word sounds rather obscene and we shall leave it there although the stuff was superb. I first tasted the delicious Mexican tacos although they were amazed that we have similar a sounding word in Uganda which is not delicious to ththey were amazed that we have similar a sounding word in Uganda which is not delicious to the ear or to the mouth. Towards the end of our course, we, as a class went to Brisbane Queensland with an overnight train for a conference. It was quite adventurous going as a group. Unfortunately, that was the first and only time I saw racism made in Aussieland. We met some skinheads on a street and one of them yelled at us that ‘Yous’ blacks go back to Africa’. We were shocked! We were about to end our course and this was the first time we were being discriminated against, if one discounts the attempted insults by the Boer in the Private Bin, in Canberra. Susan had relatives in Sydney, namely Mr. James Lukabyo (the current Ugandan High Commissioner in Canberra) and Mr. Kakaire and families. There was also a fellow student called Tampa-Kakaire (now deceased) who was pursuing a PhD in Sydney. We visited these relatives a few times. Before we left for Uganda, we spent our last weeks with the Kakaire’s in the Parramatta suburb. We spent the Christmas of 1989, our last in Australia, in Parramatta. Back HomeOn 19th December 1989, Sandra was issued with a blue Australian Certificate of Identity to enable her travel back to Uganda with us. The Uganda High Commission had been closed a few years back and we thus had no representation in Australia.In January 1990, we started the journey back to a which was to see us traverse half way around the world via Philippines, Malaysia and Germany. While over flying the Philippines, our aircraft had an engine failure! We were forced to land in the rebel infested Cebu area of the country. It was more or less like the Kony-like Northern Uganda. The little airport had many gun-totting government soldiers. The airline provided us transport to and accommodation in the capital Manila. We sighed with relief on leaving the rebel area. We spent two memorable days in Manila. The most interesting thing was in Manila Village Hotel where we spent two nights. On the first night some pimp who also happened to be a hotel worker approached me and started asking ‘You want…. you want’. At first I did not understand until he pointed to his chest. Then I clicked, laughed and shook my head! He was not aware that I was a married man who was traveling with a spouse.We left Philippines for Europe and landed at Frankfurt just in time to catch a Nairobi bound Lufthansa plane. It was over booked in the economy class and so we were lucky to fluke seats in the business class. Very comfortable, especially if you have traveled in economy class for over ten hours and have not paid an extra coin for the luxury. We spent that night in Nairobi-Kenya. The following day, when we arrived in Uganda, we found that our luggage had been ransacked at Jomo Kenyatta International Airport and several items were missing.

THE MAIN TYPES AND SOURCES OF HEALTH DATA IN DEVELOPING COUNTRIES AND THEIR LIMITATIONS AS A BASIS FOR EFFECTIVE HEALTH PLANNING

Thu, 13 Apr 2007 16:13:08 GMT

posted by kigowa

By KADUULI STEPHEN

Kaduuli@yahoo.com

GRADUATE PROGRAM IN DEMOGRAPHY

NATIONAL CENTRE FOR DEVELOPMENT STUDIES

AUSTRALIAN NATIONAL UNIVERSITY

HUMAN RESOURCES – HEALTH UNIT (1988)

ABSTRACT
This essay was a course work to analyse and contextualize Research Note No. 62) by Ruzicka and Kane (1986). It looks at the sources,types,limitations and general issues of health data for developing countries. Health data is found to be scarce and where existent, it is unreliable.

INTRODUCTION
Health refers to a state of physical, mental and social well-being that allows the individual to achieve their full potential. Alternatively, health can be seen as the absence of sickness. Health data in the developing countries is non-existent because no one collects it. In its place is data on sickness which is erroneously referred to as health data.    Perceptions about, and definitions of illness, sickness and disease are usually subjective. There tends to be a discrepancy between the medical concepts of disease and cure and the lay man's understanding of illness and healing. Not all people who are ill may be suffering from a medically recognized disease. Getting medically cured is not necessarily the same as being healed.

SOURCES OF HEALTH DATA
Two main sources of data are used as a basis for health planning in the developing countries. These are census and survey data and data obtained directly from the health system.     Censuses are periodic and comprehensive head counts which usually elicit general demographic data such as the age-sex composition and spatial distribution of a population. Health data is merely one by-product. Surveys are used to collect census-like information from a sample of the population. They are often engineered to collect specific information such health data or family planning information. Both censuses and surveys yield data based on the everyday understanding of the word sickness or illness because they are based on self reporting of illness.    The second source of data is data obtained directly from the health system. This takes the form of regular administrative reports from hospitals, doctors, clinics and other health staff. In this source of data, the medical concept of disease is what is reported. The data is used as a basis for resource allocation, planning and management purposes.

TYPES OF HEALTH DATA
Five main types of data are extracted from the above sources of health data. They are, demographic, morbidity and mortality data and data on the utilisation of and supply of health services.         Demographic data, which is obtained from censuses and surveys, includes information on the number of births, deaths, migrants and the age-sex composition and spatial distribution of the population. These statistics are customarily collected and reported by region or province of residence within the country.    Morbidity and mortality data is generated from both sources of information. Morbidity data takes the form of incidence and prevalence rates of disease. The prevalence rate of a disease refers to the number of cases occurring in a population at a particular point in time, regardless of the time of onset. On the other hand, the incidence rate of a disease refers to the frequency with which it occurs during a defined reference period.     Mortality data refer to the number of deaths from various causes. It includes the causes of death from which morbidity data is often extracted. It is usually presented by age and sex.    Data on the utilisation of health services is determined by the pattern of illness in a population and the size, age-sex composition and spatial distribution of the population. It includes the numbers of people who utilise health facilities like hospitals, clinics and the medical personnel for preventing or curing disease and other services.    Data on the supply of health services normally takes the form of the numbers of doctors, nurses and hospitals available, manpower and staffing requirements, data on costs of providing services and the demand for resources to construct physical facilities. It is the responsibility of the health system to provide this data.

LIMITATIONS OF THE SOURCES AND TYPES OF DATA
All the sources and types of data have similar limitations in that they are normally incomplete and unreliable. Data from the two sources is not likely to be compatible with each other because of the conceptual issues involved in the definitions of disease/illness.

Limitations of the Sources of Data.
Apart from the demographic data they yield, censuses and national surveys tend to be of limited value for detailed health planning because of the difficulties of obtaining valid and reliable data on the pattern of illness.     As already mentioned, self-reported illness tends to be different from the medically defined concept of disease. Data from censuses and surveys is, therefore, likely to be unreliable in the medical sense because self reported illness is what is elicited. For instance, a person may contract typhoid fever and yet think they have malaria because they feel feverish.     Both censuses and surveys frequently collect only prevalence and not incidence data. This is a major limitation because incidence data is more useful as a basis for health planning due to its depiction of the trends and patterns of disease. It is not possible for all respondents to be healthy or sick at the same time. Seasonality of disease cannot be taken into account if only prevalence data exists.    Data obtained directly from the health systems is also normally of poor quality. It only yields data on medically disease and none data based on the everyday understanding of illness. Masses of information are collected without any thought of what it will be used for. The people who collect it have an incentive to manipulate it because it is the basis on which resources are allocated. As a result, data gathering becomes an end in itself. Data on private and traditional health care is not normally included here.

Limitations of the Types of Data.(i) Demographic Data.
In developing countries, demographic data is characterised by inaccuracy and incompleteness which affect its use as a basis for planning. For example, most age data is frequently faulty because most respondents misstate or cannot state their age.      Furthermore, demographic data often provides only macro-level data and not detailed age and sex data at the local level. It does not, for instance, show the age and sex and the distribution of people at village level. Due to the lack of small scale area data, health systems have to use arbitrary "rules of thumb" to estimate, for example the numbers of children requiring immunization and, following an immunization program, coverage rates.

(ii) Epidemiological and Mortality Data.
There are very few developing countries which collect data on sickness. Most of the so-called morbidity data is derived either from causes of death data or from information on reasons for hospital admittance. These are often incomplete and unreliable. In Uganda, for instance, thousands of people get malaria every day but none of them show up in morbidity data because most of them do not go to hospitals for treatment. Only when the disease leads to someone's death, will the case appear in the data - both the sickness and the death. Thus, only those illnesses which cause death which appear in the morbidity data. However, many deaths appear in official statistics because not all people die in hospitals. Furthermore, causes of death are always open to debate because some people appear to have died from more than one cause. Children in developing countries often die from a synergism of protein-calorie malnutrition, infection and diarrhea, so it is difficult to tell the real cause of death.    Morbidity or epidemiological data is supposed to depict the incidence and prevalence of disease. Most of the available data does not take seasonality into account. During the rainy seasons, for instance, many people may contract cholera but this may not be taken into account by planners because they only have prevalence data and which may have been collected during the dry season. Prevalence data is much easier to get than incidence data. This implies that it is easier to get a cross-sectional view of disease occurrence than data on patterns and trends of diseases.

(iii) Information on the utilization of health services
This information is used in the place of data on demand for health services because the collection of the latter is neglected in the developing countries. Data on the willingness and ability of patients to pay for particular medical services would be more useful for planning purposes than data on the use of health services. Additionally, the information is mainly available only for government sponsored health services and not for private clinics and the traditional healers.

(iv) Data on supply of health services
Data on the supply of health services is not readily available. It customarily includes only data on the supply of public health services, excluding the private sector.

GENERAL ISSUES ON HEALTH DATA AND PLANNING.
Health planning in the developing countries, like else where, is dependent on broad policy decisions about the kinds of health services required and the available resources. The problem is that it tends to be over centralized in most countries leading to the misallocation of resources. As a result of proximity to planners, most health services are found principally in the urban areas.    There is also the problem of lack of resources which makes both data collection and planning difficult. Most of the available data is about disease prevalence because it is easier and cheaper to collect. Most of the health plans are therefore based on this data and the system is too rigid to adjust to seasonality of disease.

CONCLUSION
The sources and types of health data in the developing world exhibit inadequacies which make them unsuitable for planning purposes. The over centralization of health planning and the lack of adequate resources coupled with the poor data makes health planning, in these countries, an up-hill task.

Welcome to our blog about Yekoz Rekord

Wed, 29 Mar 2007 05:49:44 GMT

posted by kigowa
This is our group blog, which is unique because any Zimbio member can post an entry to it. Some members blog about recent news and trends related to the portal topic, others recount relevant personal stories. You can also comment on and rate existing blog entries, to voice your opinion and to help the community identify which members and entries on the portal are must-reads. Got an interesting idea or story to share with other members of this portal? Well, then put on your journalist's cap and add your own blog entry!