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. 2020 Mar 9;18(1):65.
doi: 10.1186/s12916-020-01524-x.

Where there is no hospital: improving the notification of community deaths

Tim Adair  1 , Megha Rajasekhar  2 , Khin Sandar Bo  2 , John Hart  2 , Viola Kwa  2 , Md Ashfaqul Amin Mukut  3 , Matthew Reeve  2 , Nicola Richards  2 , Margarita Ronderos-Torres  2   4 , Don de Savigny  5   6 , Daniel Cobos Muñoz  5   6 , Alan D Lopez  2
Affiliations

Where there is no hospital: improving the notification of community deaths

Tim Adair et al. BMC Med. .

Abstract

Background: Globally, an estimated two-thirds of all deaths occur in the community, the majority of which are not attended by a physician and remain unregistered. Identifying and registering these deaths in civil registration and vital statistics (CRVS) systems, and ascertaining the cause of death, is thus a critical challenge to ensure that policy benefits from reliable evidence on mortality levels and patterns in populations. In contrast to traditional processes for registration, death notification can be faster and more efficient at informing responsible government agencies about the event and at triggering a verbal autopsy for ascertaining cause of death. Thus, innovative approaches to death notification, tailored to suit the setting, can improve the availability and quality of information on community deaths in CRVS systems.

Improving the notification of community deaths: Here, we present case studies in four countries (Bangladesh, Colombia, Myanmar and Papua New Guinea) that were part of the initial phases of the Bloomberg Data for Health Initiative at the University of Melbourne, each of which faces unique challenges to community death registration. The approaches taken promote improved notification of community deaths through a combination of interventions, including integration with the health sector, using various notifying agents and methods, and the application of information and communication technologies. One key factor for success has been the smoothing of processes linking notification, registration and initiation of a verbal autopsy interview. The processes implemented champion more active notification systems in relation to the passive systems commonly in place in these countries.

Conclusions: The case studies demonstrate the significant potential for improving death reporting through the implementation of notification practices tailored to a country's specific circumstances, including geography, cultural factors, structure of the existing CRVS system, and available human, information and communication technology resources. Strategic deployment of some, or all, of these innovations can result in rapid improvements to death notification systems and should be trialled in other settings.

Keywords: Cause of death; Civil registration and vital statistics; Community; Death notification; Death registration; Innovation; Mortality; Verbal autopsy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of completeness of death registration within 1 year for intervention (Kaliganj and Kapasia) and non-intervention (Savar) subdistricts, 2015–2017, Bangladesh
Fig. 2
Fig. 2
Percentage point change in completeness of death registration between 2016 and 2018 in 42 intervention townships, Myanmar
Fig. 3
Fig. 3
Percentage of estimated total deaths in the target districts notified to health centres, 2018, Papua New Guinea
See this image and copyright information in PMC

References

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