A new method for estimating recent adult mortality from summary sibling histories.

Background: In low- and middle-income countries with limited death registration statistics, adult mortality rates are commonly estimated through sibling survival histories (SSH). In full SSH, respondents are asked about either the age, or the age and time of death, of each of their siblings in turn. Full SSH allow direct mortality estimation but can be time-consuming to collect. In this study, we introduce a new indirect estimation method using summary SSH, requiring only a limited set of questions to produce recent mortality estimates.

Methods: We developed a set of 192 microsimulations representing a wide range of fertility and mortality patterns, and reconstructed summary SSH within these simulations as if they had been collected from adults aged 15-49. For each age group of respondents, we calculated coefficients that convert the proportion of adult siblings who died in the previous 5 years into age-specific mortality rates. We then evaluated the performance of this new method with real data, using 154 Demographic and Health Surveys.

Results: The new indirect method provides mortality rates that are consistent with direct estimates from full SSH. Across all DHS, the mean absolute percentage error in the risk of dying in adulthood (ages 15-49) is 6% for both men and women. In all but one survey, 95% confidence intervals around the direct and indirect estimates overlap. As with direct estimates of adult mortality from SSH, the indirect estimates remain, however, lower than those of the Population Division of the United Nations.

Conclusions: Summary questions on sibling survival can be included in censuses and rapid turn-around surveys for the measurement of recent adult mortality.