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Structure of the ICD-10

Action guide on training and education on medical certification of cause of death

Outlines an approach to training and education on medical certification of cause of death based on three key stages in a physician's career: during medical school, as an intern or junior physician, and as senior practicing clinicians.

Course prospectus: ANACONDA

Course prospectus: Verbal autopsy costing and budgeting tool

Course prospectus: Enterprise architecture and process mapping for strengthening CRVS design

Course prospectus: SmartVA

Course prospectus: Iris automated mortality coding training

Course prospectus: Estimating completeness of birth and death registration

CRVS birth and death statistics template

This template has been designed to ensure that useful data on birth and death will become available for policy through annual reporting.

CRVS birth and death statistics report template

This template has been designed to ensure that useful data on birth and death will become available for policy through annual reporting.

How do I translate the SmartVA instrument?

This SmartVA IT action guide describes how to translate the SmartVA instrument (Excel questionnaire and media files) into a different language for use through the Open Data Kit (ODK) platform.

How do I download and install ODK Collect?

This action guide describes how to install ODK Collect onto a tablet in two ways: directly onto a tablet via the ‘Play Store’ or Internet browser, or from a computer via the Internet and copying it across to the tablet for installation

How do I install and use SmartVA?

This SmartVA IT action guide describes how to install and use the SmartVA Analyze software ('Tariff') for automated analysis of verbal autopsy data.

Automated classification of medical entities (ACME)

Program which automates the underlying cause of death coding rules. The inputs to ACME are the multiple ICD cause of death codes assigned to each entity (eg disease condition, accident or injury) listed on cause of death certifications, preserving the location and order as reported by the certifier. ACME then applies WHO rules to the ICD codes and selects an underlying cause of death. ACME has become the de facto international standard for the automated selection of underlying cause of death.

Accuracy of register-based vital statistics

The degree to which data items on the statistical report have been correctly and completely filled out with no errors introduced during transcription of vital records data into the statistical report, or during the processing stages (including coding, editing, input and tabulation).

Age

The interval of time between birth and the present, expressed in completed units of solar time. For adults and children, age is usually measured in completed years, while for infants or very young children, in completed months, weeks, days, hours or minutes of life as appropriate.

As-desired process

This step in business process mapping involves outlining your plan for change after identifying existing gaps in your as-is process.

ANACONDA

Analysis of causes of (national) death for action (ANACONDA) is an electronic tool that assesses the accuracy and completeness of mortality and cause of death data.

Attendant at birth

The person who assisted the mother in giving birth; eg a physician, midwife, nurse, paramedic or lay person.

Act

In some legal systems, an item of 'primary legislation' (law passed in parliament) is known as an act after enactment.

Capture - recapture

A type of method that can be used to assess the completeness of registration. Two independent sources of data are used to identify births or deaths, with subsequent determination made of the proportion of cases identified by the second method that were also identified by the first. From this information, the total number of cases can be estimated using mathematical models. Although capture-recapture methods can be used to help monitor trends over time, this assumes closed populations (that is, low rates of migration).

Causes of death

All diseases, morbid conditions or injuries that either resulted in or contributed to death, and the circumstances of the accident or violence that produced any such injuries. Symptoms or modes of dying (such as heart failure or asthenia) are not considered to be causes of death for vital statistics purposes (see 'underlying cause of death').

Born in wedlock

A characteristic of a live born infant or dead fetus whose mother and father were legally married (any recognised union according to the laws or customs of the country) at the time of delivery.

Burial permit

An official document, usually issued only for a legally registered death, authorising the removal of the dead body (corpse) to a cemetery or other final site.

Birth parity

The number of times that a woman has given birth to a fetus with a gestational age of 24 weeks or more, regardless of whether the child was born alive or was stillborn.

Born out of wedlock

A characteristic of a live born infant or dead fetus whose mother and father were not legally married at the time of delivery.

Birth rate

The crude birth rate is the number of birth over a given period divided by the person years lived by the population over that period. It is expressed as the number of births per 1000 population.

Bill

Before an item of legislation becomes law, it may be known as a bill.

Birth

See 'live birth'

Certifier (of cause of death)

A person authorised by law to issue a medical certificate in a prescribed format, stating the underlying and contributory causes of death and other facts related to the event submission to the local registrar or other appropriate authority. The certifier is usually the physician who attended the deceased in their final illness or, in the case of individuals who were not attended by a physician during their final illness or who may have died due to violence or injury, the medical-legal officer (eg coroner or medical examiner).

Civil registration

The continuous, permanent, compulsory and universal recording of the of the occurrence and characteristics of vital events (live births, deaths, fetal deaths, marriages and divorces) and other civil is events pertaining to the population as provided by decree, law or regulation, in accordance with legal requirements of each country. It establishes and provides legal documentation of such events. These records are also the best source of vital statistics.

Civil register

A loose-leaf file, ledger book, electronic file or any other official file for the permanent recording in accordance with established procedures, of each type of vital event and its associated data occurring in the population of a well-defined area (eg an entire country, county, district, municipality or parish).

Civil registration system

The institutional, legal and technical settings established by government to conduct civil registration in a technical, sound, coordinated and standardised manner throughout country, taking into account cultural and social circumstances particular to the country (see 'civil registration and vital statistics system').

Civil registrar

The official charged with the responsibility for civil registration of vital events in well-defined area (eg an entire country, county, district, municipality or parish) and for recording reporting information on those vital events for legal and statistical purposes.

Citizen

A person who holds the legal nationality of the country they are living in and, as such, benefits from all the constitutional rights of that country, but who is also subject to the obligations and regulations that apply to its citizens.

Certification of cause of death

The completion by a medically trained person of a death certificate including the cause of death (according to ICD certification standards) .

Certification

The issuance by the civil registrar of a legal document certifying a birth or death.

Citizenship

The legal nationality of a person.

Completeness of civil registration

A measure of the extent to which the births and deaths that occur in a given year are registered by the civil registration system. Several demographic techniques have been developed to assess and adjust the information on births and deaths derived from civil registration. Some methods compare data from independent sources (direct capture-recapture approaches), whereas others are indirect analytical methods based on assumptions about the population age distribution. There are various indirect demographic techniques for estimating the completeness of death registration; eg the Bennett-Horiuchi, Chanrasekaran-Deming and Brass-Growth Balance methods. These methods are often used by a national statistics office or academic institution to estimate registration completeness.

Crude death rate

A vital statistics summary rate based on the number of deaths occurring in a population during a given period of time. Typically expressed as the number of deaths occurring among the populationduring a given geographical area during a given calendar year per 1000 mid-year total population of the given geographical area during the same year.

Crude birth rate

A vital statistics summary rate based on the number of live births occurring in a population during a given period of time. Typically expressed as the number of live births occurring among the population of a given geographical area during a given calendar year per 1000 mid-year total population of the given geographical area during the same year.

Coroner

An officer of a county, district, municipality, parish, etc., authorised by law to hold an inquest into deaths that may have involved violence, injury or suspicious circumstances to determine if the death was due to non-natural causes, such as accident, suicide or homicide.

Cohort

A group of people sharing a common temporal demographic experience who are observed through time. For example, the birth cohort of the year 2000 comprises the people born in that year.

Civil society

The voluntary participation of citizens in the civic and social bodies that form the basis of functioning society, as opposed to state and commercial institutions.

Completed fertility rate

The number of children born per woman to a cohort of women by the end of childbearing years.

Coalition

A group of organisations working together in a coordinated fashion towards a common goal.

Confidentiality

A guarantee that information provided by respondents will not be revealed to others.

Data repository

A means of providing storage and access to datasets and their documentation.The repository can comprise multiple networked data-storage technologies running on diverse operating systems, where data that no longer need to be in primary storage are protected and classified according to captured metadata, processed, de-duplicated and then purged automatically, based on data service level objectives and requirements. In information repositories, data-storage resources are virtualised as composite storage sets and operate as a federated environment.

Death

The permanent disappearance of all evidence of life at any time after live birth has taken place (postnatal cessation of vital functions without capability of resuscitation). This definition excludes fetal death.

Data documentation

Facilitates the effective checking and preservation of a data set and ensures that the research community will be able to use the data. For more information, please see the Data Documentation Initiative at: ddialliance.org

Data dashboard

A means of providing at-a-glance views of key performance indicators. Data dashboards are typically limited to showing summaries, key trends, comparisons and exceptions.

Data dictionary

A centralised repository of information on data such as meuning, relationships to other data, origin, usage and format. Also known as a metadata repository.

Date of occurrence

The day, month and year of occurrence of a vital event; and hours and minutes in the case of births, and infants dying in the first week of life.

Date of birth

The day, month and year of birth (and hours and minutes, if required) used to determine age in completed units of time.

Date of registration

The day, month and year when an entry of registration of a vital event is made in the civil register.

Decision-maker

A person with the authority to create or change communal, organisational or governmental policies, programs and/or laws.

Fetal death

The death prior to the complete expulsion or extraction from its mother of a product of inception, irrespective of the duration of the gestation period; following separation, the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord or define movement of voluntary muscles.

Delayed registration

The registration of a vital event after hte period prescribed in existing laws, rules or regulations (including any specified grace period). A late registration is the registration of a vital event after the prescribed period but within a specified grace period. Since the grace period is usually considered to be one year following the vital event, delayed registration is usually considered to be the registration of a vital event one year or more after its occurence.

Demographic surveillance system

The longitudinal enumeration of all demographic events, including cause of death via verbal autopsy, in a geographically defined population; usually established with the primary purpose of health and development intervention research.

Geographic information systems (GIS)

A system designed to capture, store, manipulate, analyse, manage and present all types of geographically referenced data. In simple terms, the GIS is the merging cartography, statistical analysis and database technology.

Fertility rate

The total fertility rate is the average number of children born to each woman over the course of her life. In general, total fertility rate is a better indicator of (current) fertility rates than crude birth rate as it is unaffected by the age distribution of the population.

Enumeration

The means by which the presence of individuals in a household or other group is recorded; normally used in reference to a census or survey. Distinct from registration, enumeration is anonymous and does not provide any direct benefit to the individual.

Evaluation of a civil registration (or vital statistics) system

An appraisal of the value, worth and importance of individual elements in the operation of the system.

Episodes

The meaningful and identifiable segments of time associated with life events such as pregnancies, conjugal relationships and residencies.

Epidemiology

The study of the distribution and determinants of health-related states and events in populations.

Household surveys

Generally unreliable sources of data on adult and cause-specific mortality due to relatively rarity of such deaths and the limitations of sample size. Due to the sample size limitations, reliable estimates are usually only possible at national level and for major subregions. Population-based surveys include more-detailed questions on mortality and fertility that can be asked during a census, and can thus be used to generate estimates of fertility, and of child and adult mortality. DHS, PAPCHILD and MICS are examples of survey programs that have yielded useful estimates of vital statistics rates, particularly fertility and child mortality.

International Statistical Classification of Diseasee and Related Health Problems, tenth revision (ICD-10)

Sometimes shortened to the 'International Classification of Diseases', this classification systems is maintained by WHO for coding diseases, signs, symptoms ansd other factors causing mobidity and mortality. Used worldwide for morbidity and morality statistics and designed to promoted international comparability in the collection, processing, classification and presentation of statistics.

Household

An arrangement in which one or more people make common provisions for their own food ('eat from the same pot') or other life essentials. A household may have a common budget, be related, unrelated or a combination of both, and there may be more than one household in a housing unit.

Gestational period

The interval in completed weeks between the first day of the last menstrual period of the mother and the day, month and year of delivery, irrespective of whether the product of conception is a live birth or stillbirth.

Ill-defined cause of death

A collection of vague diagnoses that should not be used as the underlying cause of death, and consisting of 'symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified'.

Informant

An individual responsible by law for reporting the occurrence of a vital event to the local registrar and for providing all the information and characteristics related to the event. On the basis of such a report, the event may be legally registered by the local registrar.

Intercensal projection

Estimates of population size between official census dates.

Infant deaths

The deaths of liveborn children under one year of age.

Governance

A way to describe the processes for making and implementing decisions.

Maternal mortality ratio

A vital statistics rate based on the number of deaths due to maternal causes relative to the number of live births occurring during a given period of time, usually a calendar year. Typically expressed as the number of deaths of women resulting from (a) direct obstetric complications of pregnancy, labour and the puerperium; (b) from interventions, omissions or incorrect treatments or their results; or (c) from indirect obstetric causes resulting from previously existing disease or disease arising during pregnancy and which was not due to direct obstetric causes but which was aggravated by the physiological effects of the pregnancy, occurring in a given geographical area during a given calendar year per 100,000 (or 10,000) live births occurring in the given geographical area during the same year.

Live birth

The result of the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which after such separation breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered to be liveborn.

Legal framework for civil registration and vital statistics

The system of regulations and guidelines that govern the civil registration system and the vital statistics derived. This includes regulations on the medical certification process and burials, as well as on the dissemination and tion of vital statistics, with these different aspects potentially coming under different jurisdictions and acts.

Life table

A tabular display of life expectancy and the probability of dying at each age (or age group) for a given population, according to the age-specific death rates prevailing at that time. The life table provides an organised and complete picture of a population' s mortality.

Maternal death

The death of a woman while pregnant or within 42 days after the termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Life expectancy

The average number of additional years a person could expect to live should current mortality trends continue for the rest of their life. Most commonly cited as life expectancy at birth.

Iris

Iris is an automated, interactive mortality coding system, which codes multiple causes of death and selects the underlying cause of death for statistical tabulation.

Message

A statement that aims to inform, persuade or motivate an audience.

Medical certification

See 'certification of cause of death'.

Notification

The issuance by an appropriate authority (such as a health careworker) of a form confirming a vital event (birth or death). Often this notification form is used by the family to report the event to the civil registration office. It can also be required to obtain a burial permit in the case of a death. This form does not have the legal status of a birth or death certificate.

Migration

The movement of people across a specified boundary for the purpose of establishing a semi-permanent residence. External migration is a move from a residential unit in the demographic surveillance area to one outside it, and internal migration is a move from one residential unit to another the same demographic surveillance area.

Monitoring of a civil registration system (or a vital statistics system)

Checking the operation of civil registration (or vital statistics) system in order to control its efficiency, accuracy, timeliness and coverage on an ongoing basis.

Metadata

'Descriptive metadata' is information about data, such as data sources, purpose of the data, standards, definitions, statistical methods and possible sources of bias. 'Structural metadata' relates to the design and specification of data structures and databases.

Mode of death

The way a person died; for example, 'respiratory failure'. To write this on a death certificate is not sufficient because it does not indicate what disease or condition caused the death.

Millennium Development Goals (MDGs)

Eight social, health and economic development goals endorsed by the United Nations General Assembly in 2000.

Neonatal deaths

Deaths of liveborn infants during the first 28 completed days of life.

Morbidity rate

The frequency of disease, illness, injuries and disabilities in a population.

Mortality rate

The frequency of deaths as a component of population change.

Population register

A mechanism for the continuous recording of selected information pertaining to each member of the resident population of a country or area, resulting in up-to-date information on the size and characteristics of the population at selected points in time. Because of the nature of the population register, both its organisation and operation should have a legal basis. Population registers start with a base consisting of an inventory of the inhabitants of an area and their characteristics (such as date of birth, sex, marital status, place of birth, place of residence, citizenship and language). To help in locating a record for a particular person, household or family in a population register, rare unique identification number is provided for each entity.

The population register can contain other socioeconomic data, such as occupation or educational level. The population register should be updated with the births, deaths, marriages and divorces recorded by the civil registration system of the country. The population register is also updated using migration records. Thus, notifications of certain events, which may have been recorded originally in different administrative systems, are automatically linked to a population register on an ongoing basis. The method and sources of updating should cover all changes to ensure that the characteristics of individuals in the register remain current.

Population census

The total process of collecting, compiling, evaluating, analysing and publishing or otherwise disseminating demographic, economic and social data pertaining (at a specified time) to all the people in a country or in a well-delimited part of a country. Data from population censuses can be used to estimate birth and death rates. Also, population censuses can provide the best source of data on at-risk populations (numerators and denominators) in small geographical or administrative areas, and baseline for sample vital registration.

Population

(1) All of the inhabitants of a given country or area (province, city, metropolitan area etc.) considered together; or the number of such inhabitants. (2) In sampling, the whole collection of units has people, households, institutions or events) from which a sample may be drawn.

Policy analysis

Usually the first step in planning an advocacy initiative. Policy analysis examines plans regulations set by governments, business or other institutions, and how policies (or lack of policies ii lure to implement them) affect specific population groups.

Personal identification number (PIN)

The number or other code used to uniquely identify a person in population database or any other administrative register. The use of a unique identifier for each person IDs, duplicate entries and errors in respect to a person's identity.

Population-at-risk

(1) for vital statistics purposes, the population that is subject to the occurrence of vital event, such as the total population in the case of deaths, or the legally married population in the case of divorces. (2) for the calculation of specified vital statistics rates, the number (denominator) by which the number of vital events (numerator) is divided.

Perinatal mortality rate

The number of fetal deaths after 28 weeks of pregnancy (late fetal deaths) is the number of deaths of infants under 7 days of age per 1000 live births.

Perinatal period

The perinatal period commences at 22 weeks (154 days) of gestation (the time when weight is normally 500 grams) and ends 7 completed days after birth.

Policy

A plan, course of action or set of regulations adopted by government, business or other institutions and designed to influence and determine decisions or procedures.

Record linkage

A process (usually computer-based) that brings together information from two or more data files into a new combined file containing selected information on individuals or events that were not available in the separate records.

Registration

The formal act of reporting a birth or death, and obtaining a birth or death certificate issued by the civil registration authority. At this stage, details of the event are written into the official civil register by the registrar. Registration is the essential step prior to obtaining a certificate.

Poverty mapping

The plotting of information on income, education, health etc. on maps in order to display the spatial distribution of welfare and its determinants. It is also used to simultaneously display different dimensions of poverty and/or its determinants.

Sample registration system

Longitudinal enumeration of demographic events (including cause of death via verbal autopsy) in a nationally representative sample of clusters, such as that used in China and India.

Regulation

A law that has been passed not by the parliament but by an executive body of the government (eg an administration or a ministry). Regulations are as compulsory as laws, and deal with the details of how law sare to be executed.

Quality of data

In civil registration or vital statistics system, the quality of data is measured in terms of the degree of data completeness, correctness (accuracy), timeliness and availability.

Registrar-general

The head of the civil registration office or department, with jurisdiction usually extending over the entire national territory.

Probability of dying

The probability that an individual of exact age x will die before exact age x+n, represented by the symbol nqx.

Resident

See 'usual residence'.

Sustainable Development Goals (SDGs)

The Sustainable Development Goal (SDG) agenda is an Action Agenda unanimously agreed by the UN Member States at a high-level UN summit in September 2015. The 17 SDGs considerably expand the scope and ambition of their precursor, the Millennium Development Goals (MDGs) of 2001. 

The 2030 Agenda for Sustainable Development is applicable to all countries until the year 2030. It aims to ensure ‘No One is Left Behind’ in global sustainable development efforts, regardless of who they are and where they live.

Stillbirth

A baby that shows no signs of life when born. Stillbirths may be due to injuries, illness, infections or catastrophic events happening to the mother or to the child while in the womb or during birth. To distinguish this from abortion or miscarriage (for which a verbal autopsy is not conducted), the verbal autopsy system includes only births that occur after 28 weeks of pregnancy.

Timeliness in register-based vital statistics

For every vital event registered within the interval specified by legislation, a statistical report form must be forwarded to the agency responsible for the compilation of vital statistics within the established time schedule of the vital statistics system. In addition, the production, publication and dissemination of the vital statistics must be prompt enough to serve the needs of users.

Sample vital registration with verbal autopsy (SAVVY)

The MEASURE Evaluation project based at the University of North Carolina at Chapel Hill and the United States Census Bureau has produced a series of SAVVY manuals for mortality surveillance (available here).

Start up mortality list (SMoL)

SMoL was developed by WHO in collaboration with the University of Oslo for collecting cause of death  (COD) information. SMoL contains a simplified list of 106 CODs that physicians can use to certify the COD. 

Small-area data estimation

Any of several statistical techniques involving the estimation of parameters for small sub-populations. Generally used when the sub-population of interest is included in a larger survey.

Survey

A canvassing of selected individuals or households in a population usually used to infer demographic characteristics or trends for a larger segment or for all of the population (see 'census').

Statistical reporting of vital event data

The transmission of statistical reports on legally recorded vital events to the agency responsible for the compilation of statistics on such events.

Stakeholders

People or institutions with a shared interest (financial or otherwise) in a given event process or outcome.

Vital statistics

Summary measures of the frequency of occurrence and relevant characteristics of specified and defined vital events derived from civil registration, enumeration and other sources of vital events data. In settings where civil registration functions poorly or not at all, the United Nations acknowledges that a variety of data sources and systems are used to derive vital statistics.

Verbal autopsy (VA)

A structured interview administered to caregivers or family members of households following a death. The VA is used to determine the probable cause(s) of death in settings where most deaths occur outside of health facilities and were direct medical certification is rare.

Usual place of residence

Although no standard definition exists, most countries agree that a person can only have one 'usual' (or 'primary') residence, which is typically defined as the place where they spend most time and where they are registered for voting in elections.

Underlying cause of death

The disease or injury that initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury. The underlying cause of death is used as the basis for the tabulation of mortality statistics.

Timeliness in registration

This element of a vital event report is determined by the time difference between the date of the event and the date of its registration when compared to the interval specified by legislation.

Vital event

The occurrence of a live birth, death, fetal death, marriage, divorce, adoption, legitimation, recognition of parenthood, annulment of marriage or legal separation.

Vital statistical record

A document or record containing the items of information on an individual vital event needed to compile vital statistics.

Vital event record

A legal document entered in the civil register which attests to the occurrence and characteristics of a vital event.

Vital registration

All sanctioned modes of registering individuals and reporting on vital events.

Vital statistics system

The entire system for (1) collecting summary vital events data. (2) compiling, processing, analysing, evaluating, presenting and disseminating this data in the form of vital statistics.

Additional references

Objectives and definitions

Privacy

Video

News

Library

Discover more about strengthening and innovating CRVS systems, plus learn from other countries’ challenges, experiences and successes.

Glossary

Find definitions to the words you need to comprehend the complexities of CRVS systems in our Glossary.

WHO 2016 automated verbal autopsy questionnaire

What verbal autopsy is and what it is not

WHO online ICD training tool

WHO ICD online training tool

What will it cost?

Error 404

FAQ

Don't know where to begin? start with our Frequently Asked Questions

What is CRVS?

Civil registration and vital statistics (CRVS) is the act of recording of vital events in people's life including births, deaths, adoptions

Verbal autopsy diagnostic algorithms

Verbal autopsy within the civil registration and vital statistics sequence of events

Verbal autopsy questionnaires

Visualisation of data

Volume 3: Alphabetical index

Volume 1: Tabular list

Volume 2: Instructions and guideline manual

Using tabulation and analysis to check the data

Training and skills development

Using fertility rates to assess birth data quality

Tools to assist in correctly identifying the underlying COD

Users of vital statistics

The International Classification of Diseases

Timeliness of data

The importance of data quality

The implementation of verbal autopsy

The decedent

The cause of death: social norms and legal issues

Tabulation and generation of vital statistics for national policy

Tariff 2.0

Systems prerequisites for introducing verbal autopsy

Strategies to improve certification of cause of death

Stages and steps for implementing verbal autopsy in country

Standardise training programs and certify trainers and coders

Sampling strategies for verbal autopsy in national CRVS systems

SmartVA

Situations in which verbal autopsy can be used

Small number issues in mortality statistics

Scatter plots

Safeguarding data and confidentiality

Robustness of data for publication

Quality assurance

Principles for integrating different data sources

Principles for data tabulation

Presentation of vital statistics

Principles for reference period and place

Other direct methods to measure completeness of birth registration

Overview of verbal autopsy

Periodic validation studies

Outputs of verbal autopsy

Poor certification practices

Pie charts

Methods to assess the completeness of birth registration

Methods to measure death registration completeness

Minimal essential tabulations

Minimum characteristics to collect for mortality statistics

Mortality coding using the ICD-10

Nonstandard death certificates

New article

Map advice

Limited access to resources

Medical certificate of cause of death and assessment tool

Methods and tools to evaluate the quality of vital statistics

Line charts

Legal and practical support to physicians

IT systems for automated verbal autopsy

Introduction to verbal autopsy

Key consideration for developing data visualisations

IT requirements for automated verbal autopsy

Key steps in improving mortality coding

Introduction to mortality coding tools

Insufficient information

InSilicoVA

InterVA

Introduction

Importance of age, sex and cause of death in mortality statistics

Implications for the generation and use of vital statistics

Inadequate number of coders, qualifications and training

Ill-defined causes of deaths

Improving quality and presentation of civil registration and vital statistics data

Improve medical certification of cause of death

Imputation of missing values

Guidelines for good charts

Getting the message across with words

Guidelines for good tables

Examples of strategies to improve the quality of vital events records

Electronic data management and generation

External causes of death

From cause of death certification to statistical coding

Elements of automated verbal autopsy

Emerging challenges in IT for verbal autopsy

Defining the target audiences

Dissemination and accessibility

Data limitations and transparency

Data management and capacities and skills of staff involved

Dead-on-arrival cases

CRVS and the population register

Coverage

Criteria for introducing automated verbal autopsy into civil registration and vital statistics systems

Conduct regular coding quality assessments

Conclusions and key actions

Conclusions and key actions for improvement

Conclusions and key actions

Conclusion

Conclusion

Conclusion

Conclusion

Common issues and challenges of birth statistics

Common issues and challenges: microdata

Communication channels

Completeness

Classification of the main types of unusable diagnoses

Checking the accuracy of vital events records

Common issues and challenges in mortality coding

Check your knowledge

Check your knowledge

Check your knowledge

Check your knowledge

CRVS helps us understand the value of data for births and deaths

Check your knowledge

Check your knowledge

Check your knowledge

Check your knowledge

Check your knowledge

Check your knowledge

Basic roadmap for improving mortality coding practices

Cause of death: where there is no physician

Centralised mortality coding

Bar charts

Cancer-related deaths

Avoiding ill-defined and unusable underlying causes

A common error is to report the ‘mode of dying’ as the COD, not the underlying condition responsible for the failure should also be reported. For example, ‘acute renal failure due to diabetes mellitus’ or ‘liver failure due to hepatitis B infection’.

Approaches to measure the quality of reporting of birth characteristics

Automated VA

Automated verbal autopsy (VA), Data collection on handheld devices will help automate algorithms to generate probable cause of death (COD)

A stepwise process

Filipino Ministry of Health: Ways to improve death certification

Dr Ferchito L Avelino, Officer in Charge at the Philippine Department of Health, Epidemiology Bureau shares his previous experience as a Rural Health Physician and the challenges he experienced certifying deaths, at the Smart Verbal Autopsy Evaluation Workshop in Manila, February 2018.

Elevating the role of verbal autopsy into CRVS systems

Pioneer of the verbal autopsy method for determining the underlying cause of death in people who die outside of health settings, Professorial Fellow at the University of Melbourne and Technical Advisor for the Bloomberg Philanthropies Data for Health Initiative, Dr Ian Riley, describes how the method has evolved from his work in the 1970s examining the efficacy of the pneumococcal vaccine in Papua New Guinea into large-scale implementation to improve civil registration and vital statistics in Bangladesh, China, Papua New Guinea and the Solomon Islands.

Mejora de los registros de evento vital: Santander, Colombia / Improving vital event records: Santander, Colombia

Entrevista con Alexander Torres, Téchnico de Estadísticas Vitales, Secretaría de Salud, Departamento del Santander. Filmado en Septiembre de 2017 en Bogotá, Colombia. Interview with Alexander Torres, Vital Statistics Officer, Department of Health, Department of Santander, Colombia. Filmed in September 2017 in Bogota, Colombia. Video in Spanish with English subtitles.

Application of SmartVA in the Philippines

Historically, determining the underlying cause of death for people who die in community has been “pretty hard,” says Dr Clemencia Dilag Bondol, President of the Municipal Association of Municipal Health Officers. But now that municipal health officers and physicians in community settings are using SmartVA as part of the Bloomberg Philanthropies Data for Health Initiative to diagnose deaths, the process has become much more simple.

Better data = Better health for Papua New Guineans

Charlotte Polly, Statistician for Hospitals, National Department of Health and Ila Rouka, Technical Advisor, National Health Information Systems describe why about 85 percent of Papua New Guinean deaths are unreported and how the country is working to change that.

Construyendo estadísticas sólidas en Colombia / Building strong statistics in Colombia

Entrevista con Mauricio Perfetti del Corral, Director, Departamento Administrativo Nacional de Estadística (DANE). Filmado en Septiembre de 2017 en Bogotá, Colombia. Interview with Mauricio Perfetti del Corral, Director, National Administrative Department of Statistics (DANE). Filmed in September 2017 in Bogota, Colombia. Video in Spanish with English subtitles.

Avances de RECV en el Perú

Perú ha demostrado su compromiso con la mejora de los registros civil y de las estadísticas vitales (RCEV) a pesar de tener recursos limitados y esfuerzos duplicados en la producción de estadísticas vitales. Este breve video es una descripción general de CRVS en el país, y destaca los videos que proporcionan una comprensión más profunda de su sistema y mejoras como parte de la Iniciativa de Datos para la Salud de Bloomberg Philanthropies.

Completeness of birth and death registration

Completeness of birth and death registration course introduction. Presenter: Principal Research Fellow, Dr Tim Adair

CRVS progress in Colombia

This short video is an overview of CRVS in the country, and highlights videos that provide a more in-depth understanding of their system and improvements as part of the Bloomberg Philanthropies Data for Health Initiative.

El rol del Instituto de Medicina Legal y Ciencias Forenses en la certificación de muerte / Institute of Legal Medicine and Forensic Science's role in death certification

Reunirse con with Dr Andres Eduardo Castro Flores, Médico legista, Instituto de Medicina Legal de Lima, Ministerio Público; Javier Vargas, Coordinador de País, Iniciativa de Datos para la Salud; Dr Judith Angelica Maguiña Romero, Médico legista, Instituto de Medicina Legal de Lima, Ministerio Público. Filmado en Lima, Perú, en Septiembre de 2018. Meeting with Dr Andres Eduardo Castro Flores, Medical Examiner, Institute of Legal Medicine of Lima, Public Ministry; Javier Vargas, Country Coordinator, Data for Health Initiative, Dr Judith Angelica Maguiña Romero, Medical Examiner, Institute of Legal Medicine of Lima Public Ministry. Filmed in Lima, Peru in September 2018. Spanish video with English subtitles.

Encontrar datos de mortalidad perdidos en Magdalena, Colombia / Finding lost mortality data in Magdalena, Colombia

Entrevista con Bertha Lucia Bolano Piñedo, Oficial de Estadísticas Vitales, Secretaría de Salud, Departamento del Magdalena. Filmado en Septiembre de 2017 en Bogotá, Colombia. Interview with Bertha Lucia Bolano Piñedo, Vital Statistics Officer. Department of Health, Department of Magdalena. Filmed in September 2017 in Bogota, Colombia. Video in Spanish with English subtitles.

El uso de la tecnología en el monitoreo de tendencias de mortalidad / How Peru uses technology to track mortality trends

Entrevista con Dr Rosario Kiyohara Okamoto, Directora General Hospital Nacional Dos de Mayo, Ministerio de Salud CEO. Filmado en Septiembre de 2018 en Lima, Perú. Interview with Dr Rosario Kiyohara Okamoto, CEO, National Hospital Dos de Mayo, Ministry of Health. Filmed in September 2018 in Lima, Peru. Video in Spanish with English subtitles.

CRVS progress in the Philippines

The Philippines has shown ongoing commitment to strengthening its civil registration and vital statistics (CRVS) system. It is a relatively mature and functioning system, but there are many aspects that could function better if they were strengthened. In-depth videos at:https://www.youtube.com/playlist?list=PLQfUxrZQ_vdgiO2kaiSlOi2XvaoIcVe7u

Enterprise architecture/business process mapping

Enterprise architecture/business process mapping course introduction. Presenter: Senior Technical Advisor, Dr Carla AbouZahr

CRVS progress in Peru

Peru has demonstrated its commitment to civil registration and vital statistics (CRVS) improvement in spite of the country’s limited resources and duplicative efforts in the production of vital statistics. This short video is an overview of CRVS in the country, and highlights videos that provide a more in-depth understanding of their system and improvements as part of the Bloomberg Philanthropies Data for Health Initiative.

Haciendo visibles las poblaciones invisibles / Making ‘invisible’ populations visible

Entrevista con Soledad Carrera, Instituto Nacional de Estadística y Censos (INEC) y Juan Cortez-Escalante, Asesor Técnico en RCEV por la Universidad de Melbourne. Interview with Soledad Carrera, National Institute of Statistics and Census (Ecuador) and Juan Cortez-Escalante, CRVS Technical Advisor, University of Melbourne. Video in Spanish with English subtitles.

Estimating completeness of death registration and assessing quality of cause of death data

Marjorie Villaver from the Philippine Statistics Authority explains her work to estimate completeness of death registration and assess the quality of cause of death data at the national and subnational levels.

Implementación de autopsias verbales en Ecuador / Verbal autopsy intervention in Ecuador

Entrevista con Mónica García-Pérez, Coordinadora de Campo Proyecto de Autopsias Verbales, Iniciativa de Datos para la Salud. Interview with Mónica García-Pérez, Field Coordinator, Verbal Autopsy Project, Data for Health Initiative. Video in Spanish with English subtitles.

Indonesia's path to identify the country's leading causes of death

How will Indonesia's verbal autopsy work evolve during the Data for Health Initiative, how important are mortality statistics and what are and what do we already know about mortality trends in the country? An interview with Soewarta Kosen from the National Institute of Health Research and Development in Indonesia, filmed in February 2018.

ICD-10

ICD-10 course introduction. Presenter: Research Fellow, Dr Vindya Kumarapeli

Instituto Nacional de Estadística y Censos (INEC)

Reunirse con Mr Mgs Roberto Castillo Añazco, Director Ejecutivo, Instituto Nacional de Estadística y Censo; Juan Cortez-Escalante, Coordinador de Pais, Datos para la Iniciativa de Salud; Profesor Alan Lopez, Director, Iniciativa de Datos para la Salud, Universidad de Melbourne; Profesor Deirdre McLaughlin, Subdirector, Iniciativa de Datos para la Salud, Universidad de Melbourne. Filmado en Septiembre de 2018 en Quito, Ecuador. Meeting with Mr Mgs Roberto Castillo Añazco, Executive Director, National Institute of Statistics and Census (INEC); Juan Cortez-Escalante, Country Coordinator, Data for Health Initiative; Professor Alan Lopez, Director, Data for Health Initiative, University of Melbourne; Professor Deirdre McLaughlin, Deputy Director, Data for Health Initiative, University of Melbourne. Filmed in September 2018 in Quito, Ecuador. Video in Spanish with English subtitles.

Launch of the Bloomberg Philanthropies Data for Health Initiative in Colombia

Laureate Professor Alan Lopez AC, CRVS Technical Director of the Bloomberg Philanthropies Data for Health Initiative from the University of Melbourne describes interventions that Colombia will use to improve their cause of death data.

Innovation collaboration with Swiss TPH

Mejora de la información de mortalidad útil en Colombia / Improving usable mortality information in Colombia

Entrevista con Duban Quintero, Coordinador Vigilancia Salud Publica, Secretaria Departamento de Salud del Cauca, Colombia y Margarita Ronderos, Asesor Tecnico, Datos para Iniciativa de Salud. Filmado en Diciembre de 2018 en Melbourne, Australia. Interview with Duban Quintero, Monitoring Coordinator Public Health, Department Secretary of Cauca and Margarita Ronderos, Technical Advisor, Data for Health Initiative. Filmed in September 2017 in Bogota, Colombia. Video in Spanish with English subtitles.

Mejora de la información de mortalidad útil en Ecuador / Improving usable mortality information in Ecuador

Entrevista con Dr. Caterina Yepes, Coordinadora de Campo Proyecto de Causas de Mortalidad Poco Útiles, Iniciativa de Datos para la Salud. Interview with Dr Caterina Yepes, Field Coordinator of the Garbage Codes Project, Data for Health Initiative. Filmed in September 2018. Video in Spanish with English subtitles.

Estimating coverage and omission of the births and deaths register at national and subnational levels in Peru

Despite Peru's efforts to improve birth and death registrations with online systems, registration rates are still not improving. José Llanos Solórzano, Data Analyst, National Institute of Statistics and Informatics and Fellow at the University of Melbourne explains why his work to estimate the coverage and omission of the births and deaths register at the national and subnational levels are important to monitor and control health outcomes.

Reportes de datos de mortalidad en comunidades indígenas y muertes violentas en Arauca, Colombia / Reporting mortality data for indigenous communities and violent deaths in Arauca, Colombia

Entrevista con Fabio Leonardo Bello Saavedra, Téchnico de Estadísticas Vitales, Secretaría de Salud, Departamento del Arauca. Filmado en Septiembre de 2017 en Bogotá, Colombia. Interview with Fabio Leonardo Bello Saavedra-Vital Statistics Technician, Department of Health, Department of Arauca. Filmed in September 2017 in Bogota, Colombia. Video in Spanish with English subtitles.

Progresos de RCEV en Ecuador (visión general)

Ecuador ha demostrado su compromiso con la mejora de los registros civil y de las estadísticas vitales (RCEV) a pesar de tener recursos limitados y esfuerzos duplicados en la producción de estadísticas vitales. Este breve video es una descripción general de CRVS en el país, y destaca los videos que proporcionan una comprensión más profunda de su sistema y mejoras como parte de la Iniciativa de Datos para la Salud de Bloomberg Philanthropies.

Resultados de la iniciativa / Results of the initiative

Entrevista con Lic Gladys Garro, Directora de la Oficina Ejecutiva de Gestión de la Información, Oficina General de Tecnologías de la Información (OGTI), Ministerio de Salud. Filmado en Septiembre de 2018 en Lima, Perú. Interview with Lic Gladys Garro, Director of the Executive Office of Information Management, General Office of Information Technologies (OGTI), Ministry of Health. Filmed in September 2018 in Lima, Peru. Video in Spanish with English subtitles.

Peru's story of CRVS change (lecture)

Lecture with Professor Alan Lopez, Director of the Data for Health Initiative. Filmed in Lima, Peru in September 2018.

Short overview of CRVS progress in Ecuador

Ecuador has demonstrated its commitment to civil registration and vital statistics (CRVS) improvement in spite of the country’s limited resources and duplicative efforts in the production of vital statistics. This short video is an overview of CRVS in the country, and highlights videos that provide a more in-depth understanding of their system and improvements as part of the Bloomberg Philanthropies Data for Health Initiative.

SINADEF: Video demostrativo completo

Video subido con permiso del Ministerio de Salud, Perú.

SmartVA rollout in the Philippines

For the first time, SmartVA is being used by physicians, to diagnose the underlying cause of death in community settings. Verbal autopsy expert, Associate Professor Rohina Joshi from the University of Melbourne explains.

SINADEF: Introducción

Video subido con permiso del Ministerio de Salud, Perú.

SINADEF: Video tutorial

Video subido con permiso del Ministerio de Salud, Perú.

Understanding patterns of mortality in Papua New Guinea

Since 2014, there have been substantial investments in strengthening Papua New Guinea’s civil registration and vital statistics system. However challenges still remain, especially around the integration of mortality surveillance systems. Interview with John Hart, Technical Advisor, University of Melbourne, Dr Viola Kwa, Country Coordinator, filmed in Melbourne, Australia on December 2018.

Up-skilling Filipino physicians in underlying cause of death diagnoses

There are many challenges to death registration and certification in the Philippines including a gap in training physicians to correctly certify the underlying cause of death in medical school. Three doctors in the Philippines share how their organisations are working to improve the quality of death certification through the Bloomberg Philanthropies Data for Health Initiative.

Timelier death data in the Philippines

Edith Ramos Orcilla, Assistant National Statistician and Aurora T Reolalas, Chief Statistical Specialist at the Philippine Statistical Authority share how the has been able to drastically improve the speed of which they report their cause of death data, which is vital for health policymaking and planning.

Usando Telesalud para cubrir areas de dificil acceso en Peru / Using Telehealth to cover Peru's hard-to-reach areas

Entrevista con Dr Leonardo Rojas Mezarina, Asesor Técnico Unidad de Telesalud, Universidad Nacional Mayor. Filmado en Septiembre de 2018 en Lima, Perú. Interview with Dr Leonardo Rojas Mezarina, Mayor Technical Advisor Telehealth Unit, National University of San Marcos. Filmed in September 2018 in Lima, Peru. Video in Spanish with English subtitles.

The state of civil registration in Colombia / El estado del registro civil en Colombia

Entrevista con Dr Luis Fernando Criales, Secretario Adjunto, Oficina Nacional del Registro Civil, Colombia. Filmado en Septiembre de 2017 en Bogotá, Colombia. Interview with Dr Luis Fernando Criales, Deputy Registrar, National Civil Registry Office, Colombia. Filmed in September 2017 in Bogota, Colombia. Video in Spanish with English subtitles.

Verbal autopsy: from research to field

How did verbal autopsy (VA) work evolve from research settings? Riley Hazard, University of Melbourne Research Assistant, shares a brief overview of how verbal autopsy has continued to evolve as a result of the Bloomberg Philanthropies Data for Health Initiative. More on SmartVA: crvsgateway.info/SmartVA~547

Welcome to the CRVS Knowledge Gateway

ANACONDA

ANACONDA course introduction. Presenter: Senior Technical Advisor, Dr Lene Mikkelsen

Analysis of the quality of cause of death data in Shanghai

How can China optimise their health services to serve such a dense population? Cause of death data is key to allocating resources to prevent, manage and treat the country's top causes of disease burden, but it's important that that data is of quality. Dr Chen Jun, Department of Vital Statistics, Shanghai Putuo District Center for Disease Control and Prevention, University of Melbourne Data for Health Initiative Fellow explains.

Lessons learned from the Beijing verbal autopsy (VA) pilot

Dr Peng Yin from the Chinese Center for Disease Control and Prevention discusses the barriers to verbal autopsy in Beijing, VA data quality and next steps for implementation. Filmed in February 2018.

SmartVA and ANACONDA improvement in China’s CRVS system

China has around 7.3 million people, yet almost 75% of deaths are in community settings and far less (2.5%) are actually coded for mortality statistics. Dr Jinlei Qi, Death Surveillance Vital Registration Chinese Center of Disease Control and Prevention, University of Melbourne Data for Health Initiative Fellow explains how her fellowship work on SmartVA and ANACONDA will work to fill these gaps in mortality data.

Building skills in data quality assessments in the Philippines

Access to reliable and timely mortality and cause of death statistics is essential for monitoring trends in diseases, injuries and risk factors, and critically important to guide good public health policy and prevention. Training in ANACONDA will build this capacity in the Philippines, enabling them to identify inconsistencies and errors in their mortality datasets and subsequently improve the quality of their mortality statistics.

Building momentum

With the increasing capabilities of technology to bring together scientists who were once separated geographically or by different disciplines, we now have the ability to track and estimate disease, injuries and risk factors down to the specifics, and with a level of accuracy that we couldn’t have imagined before.

Fellowship profile – from Shanghai to Melbourne

In order to build capacity to strengthen CRVS systems in countries involved in the BD4H, six to eight fellows from the project's countries are trained a year on CRVS systems and work on a project with direct application to BD4H activities in their country.

Innovation collaboration with Swiss TPH

The Swiss Tropical and Public Health Institute at the University of Basel is the University of Melbourne’s collaborator for the BD4H Initiative, developing CRVS tools and filling knowledge and methods gaps in order to provide technical assistance to countries.

Fellow wins Commonwealth Digital Health Award

Congratulations to University of Melbourne Data for Health Fellow Dr Chamika Senanayake for winning a Commonwealth Digital Health Award in Colombo, Sri Lanka in the category of health promotion and health education for his work on SmartVA DHIS2 integration.

How enterprise architecture has improved CRVS in Bangladesh

Recently, the birth registration rate jumped to more than 40 percent after Bangladesh re-worked their CRVS system.

Ghana: Developing a CRVS-VA management dashboard

This fellowship report highlights key features of the CRVS-VA management dashboard that was developed by Patrick Larbi-Debrah from the Policy, Planning, Monitoring and Evaluation department of Ghana Health Service, as part of his time at the Universities of Melbourne and Basel.

Growing number of guides on SmartVA and ODK

New or existing users of SmartVA and ODK can benefit from short, step-by-step guides.

Melbourne boot camp to bolster world-wide vital statistics

Country coordinators from Bangladesh, Brazil, Ecuador, Ghana, Indonesia, Malawi, Myanmar, Peru, Philippines, Papua New Guinea, Solomon Islands, Tanzania and Zambia attended a CRVS boot camp organised by Bloomberg Data for Health partners, the University of Melbourne and Vital Strategies.

Establishing mortality surveillance in Papua New Guinea

Historically in Papua New Guinea (PNG), the two major health systems for capturing deaths and causes of death have not provided complete or timely information.

Myanmar: Strengthening data

Bloomberg Philanthropies Data for Health Initiative researchers Professor Alan Lopez, Dr Tim Adair, Sonja Firth and Nicola Richards travelled to Nay Pyi Taw, Myanmar, in early August to assist with strengthening the local civil registration and vital statistics (CRVS) system.

Implementing an electronic death notification system in Peru

In Peru, over one in five people who die are not being counted in either the Ministry of Health or in the National Registry of Identification and Marital Status.

Manuel sur la certification de la cause de décès à l’intention des médecins

Le présent manuel a été conçu de façon à servir de ressource que les médecins peuvent garder à portée de main et consulter rapidement et facilement.

Introducing ANACONDA Plus

Recently in Bangkok, representatives from 12 ESCAP countries gathered for the first capacity-building workshop using ANACONDA and the new ANACONDA Plus program.

Fellowship profile: Developing a qualitative study protocol on VA interviewer experiences in Myanmar

Between November 2016 and February 2017 Ms Tun Zin Mar, from the Central Statistical Office came to the University of Melbourne to develop a framework of analysis for a qualitative study to learn about the experiences of verbal autopsy interviewers during the initial phases of implementation.

Meeting on strengthening the quality of information on causes of death in Brazil

The objective of the meeting was to discuss the improvement of the quality of the information on causes of death in Brazil, with the participation of the three spheres of government, civil society, universities, and international institutions. This report summarises the main outcomes of the meeting, including each of the main sessions, comments from participants, and links to additional resources.

New web resource supports country improvement of critical health data

The CRVS Knowledge Gateway developed by the University of Melbourne, provides technical tools and information that countries can use to improve birth and death data, with the ultimate goal to support their citizens to live longer, healthier lives.

New release: SmartVA 2.0

An improved version of SmartVA Analyze (including full source code) has been released.

New Sri Lankan MCCOD app wins Commonwealth award

A new interactive mobile app that was created as part of Data for Health, won an award at the Commonwealth Digital Health Conference Awards in Colombo, Sri Lanka in October 2017.

New Peruvian reports

Three new reports have just been published on work undertaken as part of the Bloomberg Philanthropies Data for Health Initiative.

New method to estimate completeness of death registration

A new empirical method to estimate the completeness of death registration, has been developed and launched by the CRVS team at the University of Melbourne.

New- Colombia: A strategy to improve the registration and certification of vital events in rural and ethnic communities

This paper details Colombia’s strategy to increase the registration and certification of vital events in rural municipalities and ethnic communities. Key parts of this intervention involve developing a proactive search system to improve capture of vital events through mobile notification, and subsequently applying automated verbal autopsy to determine probable cause of community-based deaths.

New Frequently Asked Questions page

CRVS Knowledge Gateway users can find answers to their frequently asked questions more easily with a new FAQ page.

Saving lives by counting deaths

Professor Alan Lopez says the use of big data can revolutionise global health policy.

Patterns and trends in Rwandan hospital mortality data

Read the latest fellowship report: Patterns and trends in Rwandan hospital mortality data, 2017-2018, by Patrick Nshimiyimana from the National Institute of Statistics of Rwanda.

New- Summary: Monitoring CRVS data quality and progress

This new resource summarises key points from the Lancet series paper, which discussed results from a global assessment of CRVS systems, and the development of a composite index, the Vital Statistics Performance Index (VSPI) that can monitor data quality and progress over time.

New- Maximising synergies between Health Observatories and CRVS

This report provides practical guidance about how population and health observatories and CRVS systems can collaborate, to ultimately improve the registration and certification of births, deaths, and causes of death.

New- Summary: Improving the notification of community deaths

Notification of deaths, particularly deaths in the community, requires special attention and will likely need specific interventions tailored to each country. Two checklists have been developed for countries seeking to audit and improve internal notification of community deaths.

New- Developing a mobile app for doctors to improve the recording of cause of death in Sri Lanka

Describes the development, testing, and potential impact of a mobile application for doctors to improve the recording of cause of death in Sri Lanka.

New: Redefining ‘garbage codes’ for public health policy

Report on the expert group meeting, 27–28 February 2017

The road to registering more births in Tanzania

“The implications of not having your birth registered are huge,” says statistician and BD4H Tanzania CRVS Fellow Chris Sanga, “yet as little as 1 in 4 Tanzanian children under the age of 5 have had their birth registered.”