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The Cebu Longitudinal Health and Nutrition Survey COVER PHOTOGRAPH A Hmong grandmother and her granddaughter in a village in the Lao People’s Democratic Republic (Photograph by Susan Hardman). The passage of time, sometimes over many decades and generations, is precisely at the core of this special issue of the Asia-Pacific Population Journal, dedicated entirely to the topic “Understanding Health and Population over Time”. Full text of articles available at: http://www.unescap.org/appj.asp ASIA-PACIFIC POPULATION JOURNAL Vol. 23, No. 3, December 2008 CONTENTS Foreword 2 Abstracts 4 Articles Longitudinal Research Designs and Utility 9 in the Asian and Pacific Region The Asia-Pacific Population By Bencha Yoddumnern-Attig, Philip Guest, Journal is published three times a year in English by the United Varachai Thongthai, Sureeporn Punpuing, Nations Economic and Social Chanya Sethaput, Aree Jampaklay, Rossarin Commission for Asia and the Gray and Yupin Vorasiriamorn Pacific (ESCAP). Produced by the Social Longitudinal Community Studies in Africa: 23 Development Division of ESCAP, APPJ provides a medium for the Challenges and Contributions to Health international exchange of Research knowledge, experience, ideas, technical information and data on By Cheikh S.M. Mbacké and James F. Phillips all aspects of the field of population, in order to help The Cebu Longitudinal Health and 39 developing countries in the region Nutrition Survey: Two Decades Later improve the utilization of data and information for policy and By A.B. Feranil, S.A. Gultiano and L.S. Adair programme purposes, among others. Vital Horoscope: Longitudinal Data 55 The designations employed Collection in the Iranian Primary Health and the presentation of the material in this periodical do not Care System imply the expression of any opinion By Amir H. Mehryar, Mohsen Naghavi, whatsoever on the part of the Secretariat of the United Nations Shirin Ahmad-Nia and Shahla Kazemipour concerning the legal status of any country, territory, city or area, or The Effects of Intergenerational Support on 75 of its authorities, or concerning the the Changes in Cognitive Functioning of the delimitation of its frontiers or Rural Elderly in China boundaries. Mention of firm names and By Ping Wang and Shuzhuo Li commercial products does not imply the endorsement of the Evaluation of the Thai Tobacco Control 91 United Nations. Policy ESCAP is not accountable for the accuracy or authenticity of any By Buppha Sirirassamee, Philip Guest, quotations from sources identified Warangkana Polprasert, Tawima Sirirassamee, in this publication. Questions concerning quoted materials Orapin Pitakmahaket and Pariya Gainroj should be addressed to the sources directly. Managing the Kanchanaburi Demographic 107 Surveillance System: Creation of a Relational Database Management System ST/ESCAP/2523 By Jongjit Rittirong ESCAP works towards reducing poverty and managing globalization Foreword Over the years, longitudinal studies in Asia and the Pacific have made a unique contribution to the understanding of health, demographic and social trends and the causal factors contributing to them. The knowledge and insight that such studies reveal are necessary to measure large-scale changes and their impact on policy, thus helping societies to better address the long-lasting and the emerging challenges confronting them. However, a persistent lack of capacity and resources, especially in resource-poor settings, has largely constrained the undertaking of such studies and analysis, as well as the utilization of the data generated. In order to highlight the scientific and policy relevance of longitudinal studies and advocate greater investment in this type of research, the Institute for Population and Social Research (IPSR), Mahidol University, Thailand, organized the International Conference on Understanding Health and Population over Time: Strengthening Capacity in Longitudinal Data Collection and Analysis in Asia and the Pacific in Bangkok on 24 and 25 May 2007. The event was a part of the Institute’s broader efforts to promote research into the health and demographic changes in the region that had been initiated in 2000. The conference, co-sponsored by the Welcome Trust under its Health Consequences of Population Change Programme and the Rockefeller Foundation, provided a forum to discuss the state of the art of longitudinal studies in Asia and the Pacific. The two-day meeting brought together a wide range of experts from various countries and institutions in the region and beyond. Papers presented during the conference assessed the role of longitudinal studies in monitoring and analysing population and health trends (including epidemiological concerns, ageing and lifestyle patterns), and the actual utilization of these studies. The papers also reflected on the specific contribution made by such studies to science and their potential for scientific as well as policy purposes. The need to develop strategies to strengthen human and technical capacity in longitudinal data collection and analysis was also highlighted. This special issue of the Asia-Pacific Population Journal on understanding health and population over time is aimed at conveying a sense of the discussions held at the conference to a wider public of interested key readers, planners, decision makers, policymakers and academics. The seven articles included herein present an overview of longitudinal studies in Asia and the Pacific, and one in comparison to similarly constrained settings such as in parts of Africa, providing evidence of their theoretical 2 Asia-Pacific Population Journal, Vol. 23, No. 3 and applied relevance. The challenges posed by their complex, labour-intensive and expensive nature are discussed and examples of cohort models and ongoing research efforts in Asia are provided. The contribution made by those research studies to action-oriented policies is also highlighted; a more technical aspect of longitudinal studies is also tackled, namely that of database management systems. The selection of articles published here, from more than 50 presentations made during the conference, and the peer review of the various drafts were entrusted to an editorial team led by Rosalia Sciortino and composed of Philip Guest, Sureeporn Punpuing and Amara Soonthorndhada - all associated at the time with IPSR. We are greatly indebted to them. Without their diligent efforts and the active cooperation of the authors throughout the peer-review and editing processes, the publication of this special issue would not have been possible. As essential research tools, longitudinal studies are key instruments for improving the understanding of ongoing population and health transformations and crafting more effective policies. It is our hope that this extrabudgetary issue of the Journal, focused upon a largely overlooked methodological issue, will help establish the potential of longitudinal studies for the advancement of health and population sciences and for improving the welfare of people in the region. Thelma Kay Rosalia Sciortino Director Chair of the Conference Social Development Division Institute for Population Economic and Social Commission and Social Research for Asia and the Pacific (ESCAP) Mahidol University (IPSR) Asia-Pacific Population Journal, December 2008 3 Special Issue Understanding Health and Population over Time Abstract Longitudinal Research Deesigns and Utility 9 in the Asian and Pacific Region Longitudinal studies in the Asian and Pacific region show a wide diversity of research designs and modes of utilization. In drawing on these experiences, the article discusses the relative advantages of different approaches and the multiple ways in which they have contributed to building demographic and health knowledge and to shaping related policies, interventions and services, thus contributing to the welfare of people in the region. Because of this theoretical and applied relevance, the authors conclude that the undertaking of longitudinal research should be encouraged, notwithstanding the challenges posed by their complex, labour-intensive and expensive nature, and the extra precautions needed to address ethical concerns. Longitudinal Community Studies in Africa: 23 Challenges and Contributions to Health Research The history of longitudinal community studies in Africa attests to their value for demographic and health research, policy and practice and their resilience in the face of multiple challenges. This collection provides a comparative parameter for 4 Asia-Pacific Population Journal, Vol. 23, No. 3 activities in the Asian and Pacific region. The article discusses the contributions of longitudinal community studies to demographic surveillance and health research in Africa and considers the many challenges faced when undertaking them in resource-poor settings. In Africa, where these studies are most needed, the shortage of technical, human and financial resources has required sites to collaborate, share technology and pursue common strategies, giving impetus to methodological and technical innovations. The Cebu Longitudinal Health and Nutrition Survey: 39 Two Decades Later The Cebu Longitudinal Health and Nutrition Survey (CLHNS) is the longest health and nutrition longitudinal study ever conducted in the Philippines and possibly one of the longest in Asia. It started in 1983 with 3,327 pregnant women who, together with their children born between May 1983 and April 1984, have been reinterviewed 18 times thereafter. This article discusses the origins and modalities of CLHNS, underscoring its value
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