All available estimates of rates of infant mortality, vaccination coverage (for BCG, DPT 3, polio 3, measles, and tetanus toxoid), and ORS use in Guatemala in the 1980s were identified and investigated. A large number of sources and estimates were found. Large discrepancies were also found between the estimates for a given indicator, even when the estimates were reported for the same year by the same source. For instance, reports for 1985 yielded 10 different infant mortality estimates ranging from 56.0 to 79.8 deaths per 1,000 live births; vaccination coverage estimates ranging from 30% to 60.5% for BCG, 3.5% to 34.2% for DPT 3, 3.5% to 33.5% for polio 3, 11% to 58.2% for measles, and 1% to 8.2% for tetanus toxoid; and estimated use rates of oral rehydration solution ranging from 3.5% to 7.2%. In this same vein, three Guatemalan Ministry of Health estimates of infant deaths per 1,000 live births in 1984 ranged from 52.4 to 79.8; four UNICEF estimates for 1985 ranged from 65 to 79.8; and three USAID estimates for 1987 ranged from 59 to 72. The many reasons found for this diversity point to significant problems influencing the reliability of current data.
PIP: During 1987-1988 and 1990-1992, the Center for International Health Information investigated all available data on infant mortality, vaccination coverage, and oral rehydration solution (ORS) use in Guatemala from various sources. It found 16 different sources for infant mortality; 13 sources for BCG vaccination, 14 sources for DPT (diphtheria, pertussis, tetanus), polio, and measles coverage; eight sources for tetanus toxoid coverage; and eight sources for ORS use. Infant mortality tended to decrease steadily during the 1980s. All vaccination coverages and ORS use stayed rather low (no greater than 50%) during the 1980s. DPT 3, polio 3, and measles coverages were more or less the same during the first half of the 1980s and then fluctuated during the last half of the decade. They were all higher at the end of the decade than at the beginning, but BCG coverage in 1989 was higher according to WHO but lower according to USAID. All sources showed steady rising trends for tetanus toxoid coverage and ORS use. 1985 data generated 10 different infant mortality estimates with the difference between the highest and lowest estimates being 23.8 deaths (56-79.8/1000 live births). BCG coverage ranged from 30% to 60.5%. DPT 3 coverage ranged from 3.5% to 34.2%. Polio 3 coverage ranged from 3.5% to 33.5%. Measles vaccine coverage ranged from 11% to 58.2%. Tetanus toxoid coverage ranged from 1% to 8.2%. ORS use ranged from 3.5% to 7.2% in 1985, from 8.7% to 17% in 1987, and 38.3% to 69.5% in 1989. Guatemalan Ministry of Health estimates for 1984 infant mortality varied from 52.4 to 79.9. UNICEF estimates for 1985 infant mortality ranged from 65 to 79.8. USAID 1987 infant mortality estimates ranged from 59 to 72. Different definitions, data sources, estimation methods, and reporting methods contributed to the differences in estimates. These problems influenced the reliability of current data. Policy makers need to consider these problems when making decisions based on one or a few estimates of child survival indicators.