Needs in vital and health statistics in underdeveloped countries.

The author discusses the types of health and vital statistics that would be of the greatest practical value to countries with only slightly developed public-health and vital registration systems and the ways by which these statistics may be obtained.While a regular census is necessary for proper mortality and natality statistics, population estimates may be successfully used until a census can be taken. Natality statistics should include live-births, stillbirths, legitimacy, and age of mother. For morbidity measurement, four sources of information or types of inquiry can be used before complete registration systems are available: sickness surveys by home visits of families; records of notifiable communicable diseases; medical records of sickness in schools; and records of health welfare centres and health visitors, when these exist. The use of infant mortality figures in underdeveloped countries is subject to considerable error, and great effort will be needed to get every living child in the birth register. A useful local index of health is the recording in selected areas of deaths during the first three years of life. Death-rates at higher ages can only be assessed where death registration is fairly complete.It is suggested that reliable information on population changes, child mortality and sickness, and the incidence of disease can be obtained by a continuous study programme in carefully selected model survey and registration districts. Apart from the immediate results from such a programme, it would prepare the ground for the subsequent establishment of a full vital registration system.