Improving Age- and Cause-specific Under-five Mortality Rates (ACSU5MR) by Systematically Accounting Measurement Errors to Inform Child Survival Decision Making in Low Income Countries

An estimated 5.2 million children died before age 5 years globally in 2019 (IGME 2018 report). To further improve child survival, the US government and international community invest substantially in the development, evaluation and implementation of age-targeted, disease-specific life-saving childhood interventions, such as a malaria vaccine or distribution of azithromycin. Routine and timely estimates of age-and cause-specific under-five mortality (ACSU5M) are critical for understanding heterogeneity in cause within the under-five window and evaluating policy and program effectiveness, and mandates precision in ACSU5M estimates well beyond what’s required to effectively target policies and programs in adults. In this proposal, we leverage a team with extensive experience in both cause-specific and under-five mortality estimation and data collection to propose a series of Aims targeted specifically at improving data collection, analysis and modeling for ACSU5M in low-resource settings.