From 9-11 October the Pacific Community (SPC) will be hosting a review/“train the trainers” meeting in Fiji on cause of death certification.
The purpose of this report is to review the available data, both quantitative and qualitative, on the type and magnitude of gender-related under-registration of vital events and non-possession of adult identity documents in Asian and Pacific (AP) countries, and their possible consequences, and the availability and dissemination of sex-disaggregated vital statistics by country or groups of AP countries.
The event is organized by the Organization of American States, UNICEF, the Inter-American Development Bank, Plan International and Mexico’s National Register of Population and Personal Identification. Global experts, civil registry authorities from 26 countries, as well as members of the civil society will participate in the event and analyze strategies to achieve universal birth registration in the Americas by 2030, innovations in births registration, and the link between birth registration and access to social services among other subjects.
In this Series paper, the authors examine whether well functioning civil registration and vital statistics (CRVS) systems are associated with improved population health outcomes. They present a conceptual model connecting CRVS to wellbeing, and describe an ecological association between CRVS and health outcomes. The conceptual model posits that the legal identity that civil registration provides to individuals is key to access entitlements and services. Vital statistics produced by CRVS systems provide essential information for public health policy and prevention.
This study aims to assess the quality of mortality data from the registration system of Thailand. The study takes advantage of the Kanchanaburi Project by comparing the deaths found in the annual censuses to those recorded in the civil registration system in order to measure the level of under-registration. The age and sex pattern of death registration found in this study might be useful information in adjusting the data from this source.
An effective Civil Registration and Vital Statistics (CRVS) system helps secure a person’s legal identity, tracks the major events of an individual’s life such as; birth, adoption, marriage, divorce, death, and cause of death, and is essential for planning, measuring and monitoring progress of development. In the past few years, several initiatives have been underway to harness the potential of Information and Communication Technology (ICT) to strengthen CRVS.
UNICEF, UNHCR, UNESCAP, Plan International, and WHO, in collaboration the CRVS Regional Steering Group and other partners, hosted the Asia-Pacific Civil Registrars Meeting. The main objectives of the meeting were to:
• Agree on the formulation of the proposed Asia-Pacific Civil Registrars’ Network and the objectives, principals, roles, modalities and structure
• Present good practices, pilots and promising innovations at national level, and provide guidance on how to most effectively manage and scale up innovations to strengthen CRVS systems
This document was the meeting document of the First session, Committee on Statistics, organized in Bangkok from 15 to 17 December 2008.
It was contributed by Dr. Yawarat Porapakkham, Dr. Melanie Bertram SPICE project, Ministry of Public Health, Dr. Pramote Prasartkul, Institute for Population and Social Research, Mahidol University, Dr. Lene Mikkelsen, Health Metrics Network and Dr. Alan D. Lopez, School of Population Health, The University of Queensland.
CRVS data on mortality and cause of death is essential for improving health in the Pacific islands.
Please see the poster on Monitoring the Pacific non-communicable disease (NDC) crisis for more details.
In order to facilitate country-level access to technical expertise and assistance for strengthening CRVS systems, the Centre of Excellence launched a call for expressions of interest to invite professionals to apply for inclusion in a directory of experts. They are looking for mid-level and senior professionals with expertise and experience in one/several of the following fields: civil registration and vital statistics, public health, social and behavior change, law, digitization, statistics.
Many Pacific Island countries and territories are unable to get accurate counts of birth, death and causes of death information. This lack of information affects local health and community planning, funding and priority planning and ability to access aid investment. Many people are born in one country but die in another place. The original birth and death certificates are generally issued in the country of occurrence, so the records are often not registered in their home island, country or territory.
The Start-Up Mortality List (SMoL) has been designed to be in line with the International Classification of Diseases version 10 (ICD-10), and informs setting public health priorities and tracking progress towards national and international targets and goals such as the post-2015 health and development agenda. This list is designed to be a first step towards standardized reporting of causes of death. Countries lacking the capacities to code to ICD-10 3- or 4-digits should use the SMoL.
WHO, in collaboration with Canada, UNICEF, USAID and the World Bank, organized a technical meeting in Geneva from 17 to 18 December 2013 to share experiences and explore the potential of health sector innovation for strengthening CRVS systems. This paper describes key areas in which health innovations can contribute to CRVS systems strengthening and lays out good practices against which health sector activities should be assessed.
The workshop aimed to guide countries in developing a sustainable nation-wide strategy to implement ICD for causes of death. By the end of the workshop each country should have a sound strategy with set goals and timelines given their resources. Their strategy may also include using verbal autopsy as an approach to obtain causes of death in deaths occurring outside of health-facilities. This will include:
This document has been developed through a consultative process involving country representatives from the health, civil registration and statistics sectors, technical experts, researchers, and representatives of agencies, donors and development partners. As part of this process, a technical meeting, Improving Mortality Statistics as part of Strengthening Civil Registration and Vital Statistics Systems, World Health Organization, Technical Meeting, was convened by WHO from 4 to 5 November 2014 in Geneva, Switzerland.
Accurate cause of death (COD) information is fundamental to good public health practice. The principal sources of information are medical certificates of COD for deaths in hospitals and verbal autopsies for non-hospital deaths. A verbal autopsy (VA) is a process whereby relatives of the deceased respond to questions about the medical history and terminal illness of the decedent (i.e. the illness that led directly to death). These two sources of COD data are complementary.
The purpose of this technical user guide is to provide guidelines for the collection of verbal autopsy (VA) data using an electronic, shortened VA questionnaire; the use of tablets and the Open Data Kit (ODK) for data management; and for the ascertainment of cause of death (COD) using SmartVA Analyze (Tariff).
This manual provides guidance for training on all aspects of conducting verbal autopsy (VA) using electronic collection methods. It covers the importance of VA for assigning cause of death for community deaths, the roles and responsibilities of VA interviewers and supervisors, ethics and sensitivity in conducting a VA interview, detailed review of the questions included in the four modules of the SmartVA questionnaire, and how to collect information using a tablet.
This manual is intended to provide verbal autopsy (VA)1 interviewers with the information needed to conduct interviews systematically, to ensure the information collected is reliable and valid. It
provides a complete description of the roles and responsibilities of the interviewers for conducting VAs in routine surveillance. This manual is also designed to show how to conduct an interview with
As part of the CRVS D4H Initiative, Sri Lanka is focused on improving the quality of mortality statistics. Through four prioritised interventions, CRVSsystem performance will be enhanced, leading to a significant shift in the quality of vital statistics.
Six interventions have been developed in the Solomon Islands to advance system performance by focusing on unmet objectives from the National CRVS Improvement Plan. These interventions will help advance a system that operates according to international best practice.
As part of their commitment to introduce systemic improvements in a phased and scalable manner, Rwanda will implement two interventions as part of the CRVS D4H Initiative: improving notification and registration, and implementing verbal autopsy for community deaths. These interventions will contribute to the achievement of key objectives for the government.
In line with their strong commitment to improving civil registration and vital statistics, the Philippines has identified six interventions to improve system performance, with a focus on improving mortality statistics and strengthening staff capacity.
As part of the CRVS D4H Initiative, Myanmar aims to increase the registration of deaths, improve the quality of cause of death data, and enhance understanding of the importance of civil registration. Combined, these activities will help to produce high-quality evidence for policy and planning.
Mortality coding involves transforming information on death certificates into alpha-numeric codes. This allows for the tabulation and aggregation of mortality statistics for monitoring population health.
As part of the Bloomberg Philanthropies Data for Health (D4H) Initiative, countries will be provided with guidance and advice on how to implement or improve mortality coding according to ICD-10 coding rules.
Certification is the process doctors use to determine underlying cause of death. Improved certification practices ensure that decision-makers have accurate information on what people are dying from. Activities to improve certification include: establishing national mortality committees; introducing the international form of medical certificate of cause of death; training courses and curriculum.
When people die at home or in areas without doctors, it is difficult to know what they died from. Verbal autopsy provides a systematic way of collecting information from close friends or family on the signs and symptoms of someone before they died to determine a probable cause of death.
This tool is designed to assess the quality of death certification practices through checking for the presence of common errors in death certificates. This can be used to assess the quality of death certification as part of routine assessment, or to assess the training needs of doctors in designing cause of death certification training. This tool can also be used to evaluate the effectiveness of death certification training.
This document provides guidance on how to improve the quality of cause of death data in hospitals, and will be useful for Ministry of Health staff, hospital administrators and managers, medical society officers, medical education leaders, and physicians. It will also be of interest to stakeholders involved in planning and strengthening civil registration and vital statistics systems, as it provides overall guidance on the steps required in improving hospital data.
This handbook aims to guide doctors in filling out death certificates. Death certification forms an important part of a doctor’s duties because the information recorded in death certificates helps decision-makers determine health priorities for prevention of deaths due to similar causes in the future.
This tool is designed to quickly assess the quality of death certification practices through checking for the presence of common errors in death certificates. This can be used to assess the quality of death certification as part of routine assessment, or to assess the training needs of doctors in designing cause of death certification training. This tool can also be used to evaluate the effect of death certification training.
The Civil Registration and Vital Statistics (CRVS), Data for Health Initiative (D4H), at The University of Melbourne has developed an assessment tool to assess the quality of death certification practices through checking for the presence of common errors in death certificates. This can be used to assess the quality of death certification as part of routine assessment, or to assess the training needs of doctors in designing cause of death certification training.
Iris is an automatic system for coding multiple causes of death and for the selection of the underlying cause of death. It can be used in batch or interactively. The aim of Iris is twofold:
Report of the 2nd national steering and coordination committee meeting for civil registration and vital statistics, held april 03, 2015; at p block planning commission, Pak secretariat islamabad.
The meeting objectives:
- To review the implementation status of decisions made during the 1ST National Steering AND Coordination Committee Meeting held 18th Nov. 2014
This is the report of the first meeting of National CRVS Steering and Coordination Committee held in Hotel Marriot- Islamabad and supported through WHO under its COIA initiative. Following were the main workshop objectives;
– To discuss the progress made for CRVS improvement and implementation of CRVS Strategic Plan.
– To urge the provincial and special area governments to notify their provincial steering and coordination committees so that national strategic direction could be translated.
During the Ministerial Conference on Civil Registration and Vital Statistics 24 – 28 November 2014, APO discussed ways of producing high quality evidence on health systems to inform policy makers, Knowledge Broker between researchers, development agencies and governments, Building capacity for health policy analyses and evidence based policy formation.
This material was presented at the Ministerial Conference on Civil Registration and Vital Statistics 24 – 28 November 2014, by Mr. Mark Landry, Coordinator, Health Intelligence and Innovation Division of Health Systems, WHO Regional Office for the Western Pacific
This report presents final 2012 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and post neonatal death are also presented. This report supplements ‘‘Deaths: Final Data for 2012,’’ the National Center for Health Statistics’ annual report of final mortality statistics.
This global health and life sciences course enables learners to investigate health problems affecting large populations – the whole world in fact! By understanding the big numbers in global mortality and their causes and distributions you will learn how to think numerically about global health. We will use real data from real people to ask the questions: What are the major causes of death in the world? Why do we need cause of death statistics? How does counting the dead help the living?
As part of the reporting structure of the Regional Action Framework on Civil Registration and Vital Statistics (CRVS) in Asia and the Pacific, by the end of 2015, members and associate members are required to submit a baseline report to the ESCAP Secretariat through their designated national focal point. This report is the report submitted by Armenia.
This is a non-official document, for information only, prepared by the Working group of co-organizers of the Ministerial Conference on Civil Registration and Vital Statistics in Asia and the Pacific to be held in Bangkok, 24 November to 28 November 2014. It provides additional background information to delegations attending the Regional Preparatory Meeting for the Ministerial Conference on 28 and 29 August 2014.
This policy brief proposes a framework with options for countries to rapidly improve information about cause of death (COD) in their populations, which includes a series of actions that are based on the literature and national experiences with intervention strategies according to the level of statistical development of a country.
Review of the state of civil registration and vital statistics systems in Asia and the Pacific
The 2016 version of the WHO verbal autopsy instrument is suitable for routine use. The instrument is designed for all age groups, including maternal and perinatal deaths, and also deaths caused by injuries. Based on the 2012 instrument, and the 2014 version, questions have been added or edited to facilitate the use of publicly available analytical software for assigning the cause of death (SmartVA, InterVA, InSilicoVA).
This rapid assessment tool has been developed to accompany the comprehensive guide, and countries are advised to apply it before undertaking a full review of their systems. The rapid assessment tool is not a replacement for the detailed procedures described in the comprehensive guide; instead, it provides a quick overview of how well or how poorly a country’s overall system is functioning. The rapid assessment tool consists of 25 questions, grouped into 11 areas, about how the civil registration and vital statistics systems function.
This volume of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) contains guidelines for recording and coding, together with much new material on practical aspects of the classification’s use, as well as an outline of the historical background to the classification. This manual provides a basic description of the ICD, together with practical instructions for mortality and morbidity coders, and guidelines for the presentation and interpretation of data. It is not intended to provide detailed training in the use of the ICD.
The detailed assessment tool reviews the main aspects of the civil registration and vital statistics systems. These include the legal and regulatory framework; registration, certification and coding practices; and the compilation, tabulation and use of the resulting data. The tool comprises both a roadmap, which outlines the main steps in conducting the review, starting with the formation of a review committee of key stakeholders, and an assessment framework, which serves as a template for the detailed review.
The SMoL has been designed to be in line with the ICD, and informs setting public health priorities and tracking progress towards national and international targets and goals such as the post-2015 health and development agenda. This list is designed to be a first step towards standardized reporting of causes of death. Countries lacking the capacities to code to ICD 3- or 4-digits should use the Simple Mortality List. Wherever capacity exists or completeness of reporting is sufficient, the full ICD should be used, ideally in combination with electronic coding tools.
The Asian and Pacific Civil Registration and Vital Statistics Decade 2015- 2024 was proclaimed at the Ministerial Conference on Civil Registration and Vital Statistics in Asia and Pacific, held in Bangkok in November 2014. This poster illustrates the three goals and 15 targets of the Regional Action Framework on Civil Registration and Vital Statistics in Asia and the Pacific, which was one of the key outcomes of the Conference. (Poster: © UN ESCAP 2014)
The ANACoD electronic tool provides a step-by-step approach to enable users to quickly conduct a comprehensive analysis of data on mortality levels and causes of death. The tool is an Excel-based application and offers a wider range of analyses and includes a special module for analysing external causes of injury deaths.
The objective of the Mortality Forum and the Mortality Reference Group (MRG) is to improve international comparability of mortality data by establishing standardized application of the International Classification of Diseases, 10th edition (ICD-10).
The Asian and Pacific Civil Registration and Vital Statistics Decade 2015- 2024 was proclaimed at the Ministerial Conference on Civil Registration and Vital Statistics in Asia and Pacific, held in Bangkok in November 2014. This publication contains the Ministerial Declaration to "Get Every One in the Picture" and the Regional Action Framework on Civil Registration and Vital Statistics in Asia and the Pacific, which were two key outcomes of the Conference.
As Members and associate members prepare to set their own national targets for the CRVS Decade, ESCAP and partners have developed a set of guidelines to assist countries in this process.
This handbook contains instructions for physicians on cause-of-death certification. It was prepared by the Department of Health and Human Services’ Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). These instructions pertain to the 2003 revision of the U.S. Standard Certificate of Death and the 1992 revision of the Model StateVital Statistics Act and Regulations. This handbook serves as a model that can be adapted by any vital statistics registration area.
The VAI was initially designed to be used by field reporters with minimal schooling and had only 18 symptom questions. It also allowed for the recording of a brief open-ended narrative, the place of death, any treatment by health services, and the type of treatment. The disease classification was based on Lay reporting of health information (WHO 1978) and COD was entered into the international form of the death certificate. Verbal autopsies (VAs) were physician-coded with reference to diagnostic algorithms.
These basic guidelines are a tool for countries and regions that have not yet introduced correct cause-of-death certification according to the ICD, or established ICD morbidity and mortality coding practices for their data, and therefore cannot compare the health situation of their population to that of other countries. The tool is organised for easy reference and explains in a stepwise way how to go about establishing ICD certification and coding practices in a country or region.
This manual provides instructions to mortality medical coders and nosologists for coding the underlying cause of death from death certificates filed in the states. These mortality coding instructions are used by both the State vital statistics programs and the National Center for Health Statistics (NCHS), which is the Federal agency responsible for the compilation of U.S. statistics on causes of death. NCHS is part of the Centers for Disease Control and Prevention.
This is an online module on “Improving Cause of Death Reporting” for training physicians. It covers topics such as importance of cause of death, completing a death certificate, and the medical examiner or coroner physician overview. This module can be used with or without audio.
This capacity-building tool has been produced by the Health Information Systems Knowledge Hub of the School of Population Health at the University of Queensland. This handbook aims to guide doctors in filling out death certificates. This handbook is designed to be a readily accessible resource that doctors can consult rapidly and easily. These are generic guidelines about how to certify the cause of death, written for doctors and medical students, particularly in developing countries.
This document highlights the importance of death registration in Africa and presents the status of death registration, what is currently being done and recommendations for improvement.
This international curriculum describes minimum requirements for the content of training in certifying causes of death. Its purpose is to provide a basis for education for all countries.
The CoDEdit tool is intended to help producers of cause-of-death statistics to strengthen their capacity in performing routine checks on their data in order to minimize errors. While the CoDEdit tool is applied at data compilation stage, its primary purpose is to warn and flag basic gross errors, alert about possible misuse of codes and finally provide a summary of the data set.
The value of good-quality mortality data for public health is widely acknowledged. While effective civil registration systems remains the ‘gold standard’ source for continuous mortality measurement, less than 25% of deaths are registered in most African countries. Alternative data collection systems can provide mortality data to complement those from civil registration, given an understanding of data source characteristics and data quality.
The section on the cause of death on the death certificate is identical worldwide. It has two parts - called Part I and Part II, and a section to record the time interval between the onset of each condition and the date of death.
Part I - is used for diseases or conditions that form part of the sequence of events leading directly to death.
Part II - is used for conditions which have no direct connection with the events leading to death but whose presence contributed to death.
The objective of this study is to synthesise the findings from a large number of studies that have used medical record reviews to validate the COD reported on the death certificate or through the vital registration system. Based on an analysis of a core set of these studies, we developed a methodological framework for medical record reviews for countries to follow for routinely validating their CODs.
This working paper provides practical information on the preparation and use of a business case in support of a civil registration system. The paper outlines a six-step approach to building the business case and comprises – assessing the current system; conducting research and formulating the arguments; identifying, analysing and engaging with stakeholders; and, presenting the case to the relevant decision-makers. The paper describes ideas for mobilising support for implementing civil registration systems. It includes a cost–benefit analysis to help decision-makers understand the short-term and long-term costs, benefits and impacts of a registration system.
In this series of articles, the role of universal civil registration and vital statistics (CRVS) systems is examined as an essential tool for good governance and inclusive development. In the first article in the series, the case is made for investing in CRVS systems; the current situation in countries in the region is described, and the emergence and development of regional collaboration on CRVS is summarized. In the second article, the actions taken in specific countries to strengthen their CRVS systems are highlighted, and the lessons learned are described, with several innovative approaches being showcased. The third article contains a description of the relationships between CRVS systems (civil registration and population databases in particular), legal identity, the realization of human rights and access to basic social protection, using country examples from the Asia-Pacific region for these purposes. In the fourth and final article, the importance of building a sound evidence base for efforts to improve CRVS is highlighted, and a framework for prioritizing research activities is proposed.
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