, Volume 41, Issue 4, pp 757–772 | Cite as

Adult mortality in sub-Saharan Africa: Evidence from demographic and health surveys

  • Ian M. Timæus
  • Momodou Jasseh


This article reports levels, trends, and age patterns of adult mortality in 23 sub-Saharan Africa countries, based on the sibling histories and orphanhood data collected by the countries’ Demographic and Health Surveys. Adult mortality has risen sharply since HIV became prevalent, but the size and speed of the mortality increase varies greatly among countries. Excess mortality is concentrated among women aged 25–39 and among men aged 30–44. These data suggest that the increase in the number of men who die each year has exceeded somewhat the increase for women. It is time for a systematic attempt to reconcile the demographic and epidemiological evidence concerning AIDS in Africa.


Adult Mortality Model Life Table United Nations Joint Programme Paternal Orphanhood National Population Commission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Brass, W. 1975. Methods for Estimating Fertility and Mortality From Limited and Defective Data. Chapel Hill, NC: International Program of Laboratories for Population Statistics.Google Scholar
  2. Coale, A.J., P. Demeny, and B. Vaughan. 1983. Regional Model Life Tables and Stable Populations. London: Academic Press.Google Scholar
  3. Dorrington, R., D. Bourne, D. Bradshaw, R. Laubscher, and I.M. Timæus. 2001. The Impact of HIV/AIDS on Adult Mortality in South Africa. Tygerberg: South African Medical Research Council.Google Scholar
  4. Feeney, G. 2001. “The Impact of HIV/AIDS on Adult Mortality in Zimbabwe.” Population and Development Review 27:771–80.CrossRefGoogle Scholar
  5. Garenne, M., M. Madison, D. Tarantola, B. Zanou, J. Aka, and R. Dogore. 1996. “Mortality Impact of AIDS in Abidjan, 1986–1992.” AIDS 10:1279–86.CrossRefGoogle Scholar
  6. Grassly, N.C. and I.M. Timæus. 2003. “Methods to Estimate the Number of Orphans Due to AIDS and Other Causes in Sub-Saharan Africa.” Manuscript submitted for publication.Google Scholar
  7. Gregson, S. and G.P. Garnett. 2000. “Contrasting Gender Differentials in HIV-1 Prevalence and Associated Mortality Increase in Eastern and Southern Africa: Artefact of Data or Natural Course of Epidemics.” AIDS 14(Suppl. 3):S85-S99.Google Scholar
  8. Heuveline, P. 2003. “HIV and Population Dynamics: A General Model and Maximum Likelihood Standards for Africa.” Demography 40:217–45.CrossRefGoogle Scholar
  9. Hill, K. 1987. “Estimating Census and Death Registration Completeness.” Asian and Pacific Population Forum 1(3):8–13, 23–24.Google Scholar
  10. INDEPTH Network. 2002. Population and Health in Developing Countries. Volume 1: Population, Health and Survival at INDEPTH Sites. Ottawa: International Development Research Centre.Google Scholar
  11. Lopez, A.D., O. Ahmad, M. Guillot, B.D. Ferguson, J.A. Salomon, C.J.L. Murray, and K.H. Hill. 2002. World Mortality in 2000: Life Tables for 191 Countries. Geneva: World Health Organization.Google Scholar
  12. National Population Commission. 2000. Nigeria Demographic and Health Survey 1999. Calverton, MD: National Population Commission and ORC/Macro.Google Scholar
  13. Notkola, V., I.M. Timæus, and H. Siiskonen. 2004. “Impact on Mortality of the AIDS Epidemic in Northern Namibia Assessed Using Parish Registers.” AIDS 18:1061–65.CrossRefGoogle Scholar
  14. Pison, G., K.H. Hill, B. Cohen, and K.A. Foote. 1995. Population Dynamics of Senegal. Washington, DC: National Academy Press.Google Scholar
  15. Preston, S.H., A.J. Coale, J. Trussell, and M. Weinstein. 1980. “Estimating the Completeness of Reporting of Adult Deaths in Populations That Are Approximately Stable.” Population Index 46:179–202.CrossRefGoogle Scholar
  16. Rutenberg, N. and J.M. Sullivan. 1991. “Direct and Indirect Estimates of Maternal Mortality From the Sisterhood Method.” Paper presented at the Demographic and Health Surveys World Conference, August 5–7, Washington, DC.Google Scholar
  17. Stanecki, K.A. 2004. The AIDS Pandemic in the 21st Century. Washington, DC: U.S. Census Bureau.Google Scholar
  18. Stanton, C., N. Abderrahim, and K. Hill. 1997. DHS Maternal Mortality Indicators: An Assessment of Data Quality and Implications for Data Use. Calverton, MD: Macro International.Google Scholar
  19. Timæus, I.M. 1992. “Estimation of Adult Mortality From Paternal Orphanhood: A Reassessment and a New Approach.” Population Bulletin of the United Nations 33:47–63.Google Scholar
  20. —. 1993. “Adult Mortality.” Pp. 218–55 in Demographic Change in Sub-Saharan Africa, edited by K.A. Foote, K.H. Hill, and L.G. Martin. Washington, DC: National Academy Press.Google Scholar
  21. —. 1998. “Impact of the HIV Epidemic on Mortality in sub-Saharan Africa: Evidence From National Surveys and Censuses.” AIDS 12(Suppl 1):S15-S27.Google Scholar
  22. —. 1999. “Mortality in Sub-Saharan Africa.” Pp. 110–31 in Health and Mortality: Issues of lobal Concern, edited by J. Chamie and R.L. Cliquet. New York and Brussels: Population Division, United Nations, and Population and Family Study Centre (CBGS).Google Scholar
  23. Timæus, I.M., R. Dorrington, D. Bradshaw, N. Nannan, and D. Bourne. 2001. “Adult Mortality in South Africa, 1980–2000: From Apartheid to AIDS.” Paper presented at the annual meeting of the Population Association of America, March 29–31, Washington, DC.Google Scholar
  24. Timæus, I.M. and A.J. Nunn. 1997. “Measurement of Adult Mortality in Populations Affected by AIDS: An Assessment of the Orphanhood Method.” Health Transition Review 7(Suppl 2):23–43.Google Scholar
  25. UNAIDS Reference Group on Estimates Modelling and Projections. 2002. “Improved Methods and Assumptions for Estimation of the HIV/AIDS Epidemic and Its Impact: Recommendations of the UNAIDS Reference Group on Estimates, Modelling and Projections.” AIDS 16(9):W1-W16.CrossRefGoogle Scholar
  26. United Nations. 2002. World Population Prospects the 2000 Revision: Volume 3. Analytical Report. New York: United Nations.Google Scholar
  27. United Nations Joint Programme on HIV/AIDS. 2002. Report on the Global HIV/AIDS Epidemic, July 2002. Geneva: UNAIDS.Google Scholar

Copyright information

© Population Association of America 2004

Authors and Affiliations

  • Ian M. Timæus
    • 1
  • Momodou Jasseh
    • 2
  1. 1.Centre for Population StudiesLondon School of Hygiene and Tropical Medicine (LSHTM)LondonUK
  2. 2.Farafenni Field StationMedical Research Council LaboratoriesThe Gambia

Personalised recommendations