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. 2019 Mar 29;19(1):356.
doi: 10.1186/s12889-019-6671-y.

Reliable mortality statistics in Myanmar: a qualitative assessment of challenges in two townships

Myitzu Tin Oung  1   2 , Kerry Richter  3 , Pramote Prasartkul  3 , Yadanar Aung  4 , Kyaw Thu Soe  4 , Thuzar Chit Tin  5 , Viroj Tangcharoensathien  6
Affiliations

Reliable mortality statistics in Myanmar: a qualitative assessment of challenges in two townships

Myitzu Tin Oung et al. BMC Public Health. .

Abstract

Background: The vital registration system is universally recognized as the main source of mortality data which is essential for policy formulation, proper interventions and resource allocation to address priority health challenges. To improve availability and quality of mortality statistics by strengthening the vital registration system, understanding the current vital registration system is essential. This study identified challenges in generating reliable mortality statistics in the vital registration system of Myanmar.

Methods: Qualitative methods were used to collect data in two selected townships of Mandalay Region. Grey literature related to the management of mortality registration was reviewed; in-depth interviews of sixteen key informants and fourteen focus group discussions were conducted with those involved in death registration at the local level, such as healthcare providers, local administrators and knowledgeable adults in households where deaths occurred during the past three years. Thematic analysis was performed to identify system barriers in the death registration process.

Results: Weaknesses in the death registration system are classified in three areas: a) administrative which includes the lack of enforcement of mandatory death registration, limited issuance of death certificates and no formal mandatory notification of death events by households and; b) technical which includes absence of proper and regular on-the-job trainings, ineffective cause-of-death certification practice for deaths in the communities and the absence of routine data plausibility checks at the local level; and c) societal which includes poor community awareness and inadequate participation in death registration.

Conclusion: The study highlighted challenges in the death registration system at the operational level, which undermines the achievement of a satisfactory level of completeness and accuracy of mortality data. We recommend establishing a strong legal framework, improving technical capacities and raising public awareness and cooperation to strengthen the system that can generate reliable mortality statistics.

Keywords: Mortality statistics; Myanmar; Vital registration system.

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Conflict of interest statement

Ethics approval and consent to participate

The Ethics Review Committee, Department of Medical Research, Myanmar and the Institutional Review Board, Institute for Population and Social Research, Mahidol University, Thailand approved the conduct of this study. Written informed consent was obtained from all respondents while personal attributes were kept confidential.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Formal reporting process of vital information in the VRS of Myanmar. MCH: Maternal and Child Health Center; DH/TH: District/Township Hospital; SH: Station Hospital; SHU: Station Health Unit; RHC: Rural Health Center; SC: Sub-Health Center
Fig. 2
Fig. 2
Number of Key Informant Interviews (KII) and Focus Group Discussions (FGD) in two townships. Note: LHV: Lady Health Visitors; MW: Midwives
Fig. 3
Fig. 3
Sources of information of deaths for Midwives (MW)
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Improving mortality statistics as part of strengthening Civil Registration and Vital Statistics Systems: Guidance for country strategies and partner support. Outcome Tech Meet. 2014:4–5.
    1. Central Statistical Organization (CSO) Improvement of Vital Registration and National Statistics System. Workshop report. Myanmar: Central Statistical Organization, Ministry of National Planning and Economic Development; 1998.
    1. Central Statistical Organization (CSO) Training Manual for Birth and Death Registration. Myanmar: Central Statistical Organization, Ministry of National Planning and Economic Development; 2009.
    1. Central Statistical Organization (CSO) Statistical Yearbook 2011, Myanmar. Myanmar: Central Statistical Organization, Ministry of National Planning and Economic Development; 2013.
    1. Ministry of National Planning and Economic Development (MNPED) National Statistical System: Problems, issues and prospects (Myanmar). ADB/PARIS 21 secretariat joint high level forum on statistical capacity building for ASEAN countries Manila, Philippines. 2002.