Étude de la mortalité aux grands âges à l’aide du Registre des décès d’Antananarivo (Madagascar)
For 60 years now, mortality has been declining sharply in Madagascar, mainly at young ages. Fertility has also decreased significantly in the last two decades. Individuals aged 65 and over, which currently accounts for 3% of the total population, are to represent an increasing share of the population in future years. Given that around 60% of the workforce labors in the informal economy and as a consequence will not have access to a pension system, it becomes crucial to better understand old age mortality in order to determine the extent of the coming phenomenon. In this context, this research examines the evolution of the modal (i.e. most frequent) age at death (M), a suitable indicator for monitoring improvements in old-age survival. Our paper focuses on Antananarivo, the capital and a city for which detailed and virtually complete data on deaths since 1976 are available. From a nonparametric P-spline smoothing approach, and estimates of the population exposed to the risk of death for each year, we obtain relatively accurate estimates of M and the standard deviation of ages at death above the mode for both sexes. Our results show that great progress in longevity has been made in Antananarivo since the mid-1980’s, especially for men. This increase in modal age at death came with a mortality compression above the mode. In other words, inequalities in old age mortality noticeably narrowed. These positive developments are due primarily to a continued strong reduction in infectious-related mortality. However, further progress will now require efficient measures aimed at fighting circulatory system diseases (cardiovascular and cerebrovascular diseases).
Madagascar Modal age at death Old-age causes of death Sub-Saharan Africa Lifespan dispersion P-spline smoothing Mortality compression