The population-level impact of public-sector antiretroviral therapy rollout on adult mortality in rural Malawi

Demographic Research
Collin F Payne, Hans-Peter Kohler

Abstract

Recent evidence from health and demographic surveillance sites (HDSS) has shown that increasing access to antiretroviral therapy (ART) is reducing mortality rates in sub-Saharan Africa (SSA). However, due to limited vital statistics registration in many of the countries most affected by the HIV/AIDS epidemic, there is limited evidence of the magnitude of ART's effect outside of specific HDSS sites. This paper leverages longitudinal household/family roster data from the Malawi Longitudinal Survey of Families and Health (MLSFH) to estimate the effect of ART availability in public clinics on population-level mortality based on a geographically dispersed sample of individuals in rural Malawi. We seek to provide evidence on the population-level magnitude of the ART-associated mortality decline in rural Malawi and confirm that this population is experiencing similar declines in mortality as those seen in HDSS sites. We analyze longitudinal household/family-roster data from four waves of the MLSFH to estimate mortality change after the introduction of ART to study areas. We analyze life expectancy using the Kaplan-Meier estimator and examine how the mortality hazard changed over time by individual characteristics with Cox regression. ...Continue Reading

References

Nov 14, 2007·International Journal of Epidemiology·Frank TanserMarie-Louise Newell
Nov 29, 2007·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Mwita WamburaBasia Zaba
Nov 15, 2008·PloS One·John StoverGodfrey Musuka
Jul 31, 2012·International Journal of STD & AIDS·E Freeman, P Anglewicz
Aug 31, 2012·International Journal of Epidemiology·Frank O OdhiamboJohn M Vulule
Dec 20, 2013·International Journal of STD & AIDS·Elysia LarsonJeffrey D Klausner
Mar 19, 2014·International Journal of Epidemiology·Hans-Peter KohlerLinda Kalilani-Phiri
Oct 31, 2015·Journal of Health Economics·Victoria BaranovHans-Peter Kohler

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Citations

Nov 2, 2018·European Journal of Population = Revue Européenne De Démographie·Collin F PayneHans-Peter Kohler
Mar 1, 2019·Population and Development Review·Collin F PayneHans-Peter Kohler

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