Abstract |
Published mortality indices for Fiji and causes of death for 1940-2008 were assessed for quality, and compared with those generated from recent Ministry of Health reporting1. Trends in credible estimates are compared with proportional mortality for cause of death, and life tables generated from recent Ministry of Health data (1996-2004). Infant mortality rate (IMR) declined to below 20 by 2000 (per 1000). Life expectancy (LE) increased, but has been stable at 64 and 69 years since the 1980’s for males and females respectively. Proportional mortality from cardiovascular disease has increased from around 20% in the 1960s to over 45%. Credible estimates indicate stagnation in life expectancy in the context of a declining and relatively low infant mortality rate. Proportional mortality trends suggest this is largely due to the emergence of chronic diseases (especially cardiovascular) in adults. Incompatible variations in published estimates of infant mortality rate and life expectancy were indentified. Difficulties encountered in assessment of published data were the lack of information in many publications concerning the primary data sources, methods used for calculation,and the assumptions made. In order to deal with this lack of information, exclusion criteria were specified and unreliable estimates censored from further analyses. The use of single input parameter models to estimate life expectancy from childhood mortality results in estimates that are similar to many of the published estimates that were censored from the final analysis, and overestimates life expectancy by 4-5 years. The most plausible estimates of mortality are derived from two local sources: census analyses from the Fiji Bureau of Statistics and routine death reporting from the Fiji Ministry of Health, with these data found to be mostly more than 95% complete by the Brass method. |