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Coding causes of death to statistical categories

Standardise training programs and certify trainers and coders

To ensure consistency in the level of skills, training curricula and courses should be standardised both nationally and internationally. At present, both training opportunities and training curricula are often inadequate in developing countries. As part of efforts to address this, an international core curriculum for certifiers of UCOD has been developed through a collaborative effort involving the WHO-FIC network and IFHIMA. This core curriculum offers a standard basis for education across the world, in the form of a nine-module training course with standard objectives. However, since the core curriculum is currently only available in English, countries will need to make their own national language versions of the course.

Institutions that provide training on mortality and morbidity coding can also apply to have their curriculum assessed by the WHO-FIC network. Approval will give coders confidence that their education and training program meets international standards for high-quality teaching and learning.

As an example, following evaluation by the WHO-FIC Education and Implementation Committee, the mortality coder training material used by the National Institute of Health Sciences (NIHS) in Sri Lanka for its ICD-10 training course was found to be compliant with the international core curriculum. Instructors from the NIHS now conduct ICD training for several countries in the region.

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Greenberg MS (2008). WHO-FIC Education Committee: A Status Report 2007–2008. WHO-FIC 2008/00-3. Geneva: World Health Organization. 

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Developed through a collaborative effort involving the WHO-FIC network and IFHIMA, this international core curriculum describes the minimum content requirements for training courses in certifying underlying causes of death. Its purpose is to provide a basis for such training in all countries. The curriculum and further information on the WHI-FIC IFHIMA Collaboration are available at:

WHO-FIC network core curriculum for training mortality coders

Module: 1 Knowledge of basic medical science
Objective: To develop an understanding of the medical terminology used in COD statements, given an understanding of the structure and function of the human body and an understanding of the nature of disease.

Module 2: Legal and ethical issues relevant to the country in which coding is being conducted
Objective: To introduce the legal and ethical issues applicable to health information and its collection and release.

Module 3: General use of underlying cause of death data
Objective: To explain the purpose of collecting and using COD data.

Module 4: Specific use of underlying cause of death data
Objective: To introduce the specific use of coded mortality data.

Module 5: Users of mortality data
Objective: To explain the different groups and stakeholders who use mortality data.

Module 6: Sources of mortality data
Objective: To explain the roles of those responsible for reporting data on the deceased, and the sources of that data.

Module 7: The ICD
Objective: To develop and understanding of the ICD and to develop the knowledge and skills necessary to assign valid codes for COD.

Module 8: How to code
Objective: To provide detailed instructions on how to apply the coding rules and assign codes.

Module 9: Quality assurance
Objective: To raise awareness of the various factors that influence the quality of coded data, and to describe techniques for ensuring the highest-possible data quality.

International Federation of Health Information Managers Association (IFHIMA).

Increase career opportunities and training for coders

In countries with good-quality coding, mortality coders are generally highly qualified professionals who work in a statistical office or the ministry of health. These coders usually have university or community college qualifications and are employed specifically to code. They know how to extract the relevant data, use the coding rules and guidelines to determine a UCOD and assign an accurate ICD code. Coders must understand medical terminology and medical science to ensure that the correct UCOD is selected.

A number of WHO-FIC Collaborating Centres regularly offer training courses in ICD coding. These training courses can be particularly valuable for trainers who provide national ICD training or when new versions of the ICD are being applied. Upon completion of national training programs, coders should receive certificates in recognition of their skills and have access to structured career paths in medical coding to help avoid a high turnover of coders and subsequent loss of valuable coding experience in a profession where consistency and expertise matter.

Interactive face-to-face training from a specialist in coding training is considered to be the best approach. However, because not all coders will have the opportunity to undergo such training, an online ICD-10 training tool has been developed by WHO as an alternative way of preventing major errors when using the classification.

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