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Determination of Causes of Death by Using Verbal Autopsy VA Method
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At the initial census October 1998anuary 1999 all individuals who were intending to be resident in the DSA for at least 4 months were eligible for inclusion Verbal consent to participate in the census was sought from the head of every householdDefinitions of several characteristics such as household membership migration and head of household are set in order to correctly assign individuals or households to events or attributes A household in Rufiji HDSS is defined as a group of individuals sharing or who eat from the same cooking pot A member of the HDSS is defined as someone who has been resident in the DSA for the preceding 4 months New members qualify to be an inmigrant if she moves into the Rufiji HDSS and spends at least 4 months thereWomen married to men living in the Rufiji HDSS and children born to these women qualify to be members of the Rufiji HDSS In the case of multiple wives the husband will be registered as a permanent resident in only one household He will be linked to other wives by his husband identification number given to his wives After the census the study population is visited three times a year in cycles or updated rounds over FebruaryMay JuneSeptember and OctoberJanuary to update indicatorsFrom July 2013 onwards Rufiji HDSS switched to two data collection rounds per year which happen in JulyDecember and JanuaryJune Mapping of households and key structures such as schools health facilities markets churches and mosques was done by field interviewers using handheld global positioning systems GPS Updating of GPS coordinates has been an ongoing exercise especially for new structures and for demolished structuresIn 2012 the population size of the DSA was about 103 503 people residing in 19 315 households There are several ethnic groups in the DSA The largest is the Ndengereko other groups include the Matumbi Nyagatwa Ngindo Pogoro and Makonde The population comprises mainly Muslims with few Christians and followers of traditional religions The main language spoken is Kiswahili English is not commonly used in the areaAround 75 of the population aged 715 years have attended primary education 14 of those in age group 1565 years have secondary education and only 1 of the population has tertiary education Almost 50 of the adult population aged 1565 are selfemployed in agriculture 28 engage in other small economic activities 16 are selfemployed in smallscale business and 6 are unemployed Fuel wood is the main source of energy for cooking and shallow wells are the main source of water for domestic useThe household heads in Rufiji HDSS are considered as breadwinners and most 673 are male Active community engagement programmes are in place which include key informants KIs days where the HDSS team convenes meetings with KIs for presentations on recent findings to feed back to community and for distribution of newsletters to households Community sensitization events are held at the time of introducing new studies These initiatives have cemented good relationships with the community and eventually maintained high participation
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