The Republic of the Union of Myanmar The 2014 Myanmar Population and Housing Census THEMATIC REPORT ON MORTALITY Census Report Volume 4-B Department of Population Ministry of Labour, Immigration and Population With technical assistance from UNFPA SEPTEMBER 2016 Revised second edition, February 2017. The 2014 Myanmar Population and Housing Census THEMATIC REPORT ON MORTALITY Census Report Volume 4-B For more information contact: Department of Population Ministry of Labour, Immigration and Population Office No. 48, Nay Pyi Taw, MYANMAR Tel: +95 67 431 062 www.dop.gov.mm SEPTEMBER 2016 Figure 1 Map of Myanmar by State/Region and District Census Report Volume 4-B – Mortality I Foreword The 2014 Myanmar Population and Housing Census (2014 Census) was conducted with midnight of 29 March 2014 as the reference point. This is the first Census in 30 years; the last was conducted in 1983. Planning and execution of this Census was spearheaded by the former Ministry of Immigration and Population, now the Ministry of Labour, Immigration and Population, on behalf of the Government in accordance with the Population and Housing Census Law, 2013. The main objective of the 2014 Census was to provide the Government and other stakeholders with essential information on the population, in regard to demographic, social and economic characteristics, housing conditions and household amenities. By generating information at all administrative levels, it was also intended to provide a sound basis for evidence-based decision-making and to evaluate the impact of social and economic policies and programmes in the country. The results of the 2014 Census have been published so far in a number of volumes. The first was the Provisional Results (Census Report Volume 1), released in August 2014. The Census Main Results were launched in May 2015. These included The Union Report (Census Report Volume 2), Highlights of the Main Results (Census Report Volume 2-A), and reports of each of the 15 States and Regions (Census Report Volume 3[A - O]). The reports on Occupation and Industry (Census Report Volume 2-B) and Religion (Census Report Volume 2-C) were launched in March 2016 and July 2016, respectively. The current set of the 2014 Census publications comprise thirteen thematic reports and a Census Atlas. They address issues on Fertility and Nuptiality; Mortality; Maternal Mortality; Migration and Urbanization; Population Projections; Population Dynamics; the Elderly; Children and Young People; Education; Labour Force Dynamics; Disability; Gender Dimensions; and Housing Conditions, Amenities and Household Assets. Their preparation involved collaborative efforts with both local and international experts as well as various Government Ministries, Departments and research institutions. Data capture was undertaken using scanning technology. The processes were highly integrated, with tight controls to guarantee accuracy of results. To achieve internal consistency and minimize errors, rigorous data editing, cleaning and validation were carried out to facilitate further analysis of the results. The information presented in these reports is therefore based on more cleaned data sets, and the reader should be aware that there may be some small differences from the results published in the earlier set of volumes. In such instances, the data in the thematic reports should be preferred. This thematic report presents the status of mortality based on the 2014 Census. The analysis shows that Myanmar has recorded declines in childhood mortality in the last three decades, but mortality rates in the country are still high compared with other countries in the ASEAN region. The decline in mortality rates could be attributed to programmes implemented by the ministry responsible for health. The declines are, however, not evenly distributed across the country. States and Regions such as Ayeyawady, Magway, and Chin, among others, still exhibit high levels of mortality both for children and adults. Life expectancy at birth has increased significantly both for males and females at the Union level, however again there are wide disparities at the subnational levels. There are some States and Regions especially Mon, Yangon and Nay Pyi Taw that have low early-age mortality rates as well as high life expectancy, but in Mon State other development indicators do not support this scenario. In II Census Report Volume 4-B – Mortality Foreword addition, the wide variation in mortality rates between male and female children is a matter that requires further investigation. There is a need for specialized mortality surveys in such States and Regions to validate findings from the Census. On behalf of the Government of Myanmar, I wish to thank the teams at the Department of Population, the United Nations Populations Fund (UNFPA) and the authors for their contribution towards the preparation of these thematic reports. I would also like to thank our development partners, namely; Australia, Finland, Germany, Italy, Norway, Sweden, Switzerland, and the United Kingdom for their support to undertake the Census, as well as the technical support provided by the United States of America. H.E U Thein Swe Minister of Labour, Immigration and Population The Republic of the Union of Myanmar Census Report Volume 4-B – Mortality III Table of Contents Foreword / II List of Tables / VI List of Figures / VI List of Appendices / VII List of Acronyms / VIII Executive Summary / IX 1. Introduction / 1 2. Early-age mortality / 4 3. Adult mortality and life tables / 18 4. Early-age mortality differentials / 32 5. Spatial distribution analysis of under-five mortality / 38 6. Policy implications / 46 7. Conclusions / 50 References / 52 Glossary of terms and definitions / 56 Appendices / 57 Appendix A. / 58 Ever born and non-surviving children by sex, by age of women: numbers and sex ratios, Union, urban and rural areas, State/Region, 2014 Census Appendix B. / 64 The selection of a model life table to estimate indicators of early-age mortality Appendix C. / 71 Infant, child and under-five mortality by Districts Appendix D. / 78 Adjustment of household deaths during the 12 months prior to the Census Appendix E. / 86 Life tables for urban and rural place of residence and for State/Region Appendix F. / 112 Life expectancy at birth by Districts LIst of Contributors / 115 Census Report Volume 4-B – Mortality V List of Tables 1.1 Mortality indicators, Myanmar (2014 Census), global areas and regions / 2 2.1 Infant, child, and under-five mortality rates, 2014 Census / 7 2.2 Infant and under-five mortality estimates according to different sources / 8 2.3 Infant and under-five mortality trends, 1968 to 2012 from several sources / 10 2.4 Infant, child and under-five mortality rates by urban/rural place of residence and State/ Region, 2014 Census / 12 2.5 Infant, child, and under-five mortality by sex, 2014 Census / 15 3.1 Age-sex specific mortality rates, unadjusted and adjusted and smoothed by the Growth Balance Equation method, 2014 Census / 21 3.2 Life table for Myanmar for the 12-month period prior to the 2014 Census / 22 3.3 Selected life table measures, Union, urban/rural areas and State/Region, 2012 / 26 4.1 Infant, child and under-five mortality differentials for selected variables, 2014 Census / 33 5.1 Correlation coefficients between early-age mortality and selected socio-demographic indicators / 41 5.2 Results of a stepwise regression analysis for early-age mortality and selected socio- demographic indicators / 43 List of Figures 1 Map of Myanmar by State/Region and District / I 2.1 Mortality questions in the 2014 Census / 5 2.2 Infant mortality trend / 11 2.3 Under-five mortality trend / 11 2.4 Under-five mortality rates by State/Region, 2014 Census / 13 2.5 Under-five mortality rates by State/Region, 2014 Census / 14 2.6 Infant, child and under-five mortality rates by sex, 2014 Census / 16 3.1 Number of survivors [l(x)] by sex in the 12-month period prior to the 2014 Census / 24 3.2 Probability of dying between ages 15 and 59 by State/Region, 2012 / 30 4.1 Infant mortality rate by selected differentials, 2014 Census / 34 5.1 Early-age mortality by Township, 2014 Census / 39 VI Census Report Volume 4-B – Mortality List of Appendices Appendix A. / 58 Ever born and non-surviving children by sex, by age of women: numbers and sex ratios, Union, urban and rural areas, State/Region, 2014 Census Appendix B. / 64 The selection of a model life table to estimate indicators of early-age mortality Figure B1 Relation between infant mortality (1q0) and child mortality (4q1) in the nine families of model life tables and estimates from three Fertility and Reproductive Health Surveys (FRHS, 1997, 2001, and 2007) / 65 Table B1 Infant and child mortality according to three Fertility and Reproductive Health Surveys (FRHS, 1997, 2001, and 2007) / 65 Figure B2 Infant and child mortality according to three Fertility and Reproductive Health Surveys (FRHS, 1997, 2001, and 2007) / 66 Table B2 Indirect estimates of infant, child and under-five mortality rates by sex according to different mortality models, 2014 Census / 68 Appendix C. /71 Infant, child and under-five mortality by Districts Table C Infant, child and under-five mortality by State/Region and District, 2014 Census / 73 Appendix D. /78 Adjustment of household deaths during the 12 months prior to the Census Table D1 Unadjusted deaths, death rates and probabilities of dying by sex, 2014 Census / 78 Table D2 Percentage under-enumeration of adult mortality according to the Brass Growth Balance Equation Method, 2014 Census / 80 Table D3 Unadjusted Life Tables based on deaths in the households within 12 months prior to the 2014 Census / 80 Table D4 Unadjusted Life Tables with q(0,1) and q(1,4) estimated indirectly using data on children ever born and non-surviving children, 2014 Census / 82 Table D5 Adjusted Life Tables, 2014 Census / 84 Appendix E.