BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

•6 Pattern of Mortalityin,Childhood
degree of malnutrition, based on body
weight and clinical and pathological observations,
would be classified by the scale
proposed by G6mez et al. (1955) and used
by co-workers Ramos-GalvAn et al. (1958),
and the weight standards from Harvard
published by Nelson et al. (1969). The
Assessment of the NutritionalStatus of the
Community by Jelliffe (1966) was furnished
to each collaborator as a reference.
Medical interviewers from six of the projects
attended the Planning Conference in
Cali, and those from five other projects,
along with three principal collaborators,
participated in a meeting on interviewing
held at the Department of Preventive Medicine
of Sio Paulo University in Ribeirfio
Pr~to, Brazil, from 3 to 9 April 1968. Both
meetings proved very useful for establishing
the standard interviewing procedures.
One of the Investigation's objectives was
to develop procedures for the classification
of multiple causes of death. To ensure uniformity
and comparability, it was decided
that the assignments would be made in the
central office of PAHO in Washington, D.C.,
although important contributions would be
made by the principal collaborators in providing
complete diagnostic information for
such assignments. The collaborators would
have important roles also in the development
of statistics on multiple causes, not
only for the Investigation itself but also for
subsequent application in the participating
cities and countries. A second Planning
Conference of the principal collaborators
was convened from 6 to 10 October 1968 in
Caracas, Venezuela, to discuss the provisional
rules for classification and coding
of multiple causes according to a new
Manual specifically covering these procedures.
In addition to the collaborators
from the 13 Latin American projects, the
director and the former director of the Latin
American Center for Classification of Diseases
participated in this meeting, at which
additional principles and recommendations
were formulated. Through these discussions
the importance of complete diagnostic information
became clear.
In the original plans a timetable for the
research program was established. During
1968 agreements for the 13 field projects of
the Investigation were signed by the Ministers
of Health of the participating countries,
the deans of the participating medical
schools, and the Director of the Pan American
Sanitary Bureau. The field work was
started in all the Latin American projects
during 1968, with the first month of recorded
deaths varying from June to September.
The timetable called for completion
of all field work in 1970 and analyses
in 1971. Because of difficulties in obtaining
information on deaths in early life, the field
work was completed somewhat later in
nearly all projects, so that processing of the
entire data was not completed until 1972.
The problems encountered in this regard, as
well as the solutions applied, are explained
in Chapter II. The delay in preparation of
this report until 1972 made it possible to
include the two Northern American projects,
which vere late in starting the field
work.
T xeoikn
he exrien aed the planning
phase clearly demonstrated the key importance
of this phase to the achievement of
high standards of operation and highquality
results. The problems that arose in
this Investigation indicate that future research
of this type should have an even
longer preparatory phase and more extensive
pilot testing in each area. Such preparatory
work would be highly useful in
providing solutions for the many and varied
difficulties encountered.