Monitoring adult mortality by type of residence in the absence of death registration: a perspective from Burkina Faso

Abstract

In the context of the post 2015 agenda, disaggregation of mortality indicators is needed to assess health inequalities within populations. However, producing sub-national estimates of adult mortality is notably difficult in the absence of death registration. Using Burkina Faso as a case study, this paper revisits the main avenues to quantify differences in adult mortality between the ages of 15 and 60 according to urban/rural residence. Estimates are based on reports on the survival of parents and siblings collected in surveys and in the 2006 census, and compared to levels inferred from recent household deaths or inferences based on child mortality. Results indicate that in Burkina Faso, adults living in urban areas still benefit from a health advantage compared to their rural counterparts. Thus, efforts made in reducing adult mortality in rural settings should be intensified. In terms of methods, this analysis shows the value of asking additional questions about the place of residence of close relatives to avoid misclassification errors. The approach adopted here could be implemented in other countries to facilitate the measurement of spatial inequalities in health indicators for all ages when monitoring Sustainable Development Goals (SDGs).