Mortality in transitional Vietnam

-----------------------------------------------------------------------------------------------------------i ABBREVIATIONS --------------------------------------------------------------------------------------------------ii ORIGINAL PAPERS ----------------------------------------------------------------------------------------------iii CHAPTER I: INTRODUCTION--------------------------------------------------------------------------------1 1.1. The importance of mortality data in public health systems---------------------------------------1 1.2. The change in mortality patterns during epidemiological transition ----------------------------1 1.3. Certifying cause of death: an overview ---------------------------------------------------------------3 1.4. Verbal autopsy (VA): an alternative method for determining cause of death ------------------5 1.5. Collecting mortality data: the current situation in developing countries -----------------------6 1.6. Quantifying burdens of premature mortality -------------------------------------------------------9 1.7. Vietnam ------------------------------------------------------------------------------------------------11 1.8. Study objectives ---------------------------------------------------------------------------------------19 1.9. Outline of publications ------------------------------------------------------------------------------20 CHAPTER II: MATERIALS AND METHODS -----------------------------------------------------------21 2.1. Study setting-------------------------------------------------------------------------------------------21 2.2. Study base----------------------------------------------------------------------------------------------23 2.3. Collection of mortality data and the verbal autopsy performance ----------------------------26 2.4. Measuring premature mortality and calculating life expectancy ------------------------------31 2.5. Statistical methods------------------------------------------------------------------------------------31 2.6. Main definitions and variables----------------------------------------------------------------------32 2.7. Ethical considerations--------------------------------------------------------------------------------32 CHAPTER III. RESULTS---------------------------------------------------------------------------------------33 3.1. Verbal autopsy method application----------------------------------------------------------------33 3.2. The pattern of mortality in transitional Vietnam------------------------------------------------35 3.3. Measuring premature mortality --------------------------------------------------------------------39 3.4. The association between cause specific mortality and socio-economic status ---------------40 CHAPTER IV: DISCUSSIONS--------------------------------------------------------------------------------42 4.1. Methodological issues--------------------------------------------------------------------------------42 4.2. The double burden of mortality in transitional Vietnam --------------------------------------49 4.3. Premature mortality: a public health concern----------------------------------------------------52 4.4. Socio-economic situation inequality and mortality ---------------------------------------------54 CHAPTER V: CONCLUSIONS AND RECOMMENDATIONS -------------------------------------56 ACKNOWLEDGEMENTS-------------------------------------------------------------------------------------58 REFERENCES-----------------------------------------------------------------------------------------------------62