Small number issues in mortality statistics

Robustness of data for publication

Data limitations and transparency

Why CRVS systems matter

CRVS systems – notably for birth and death registration, With the aim of identifying and reducing inequities across populations and ‘leaving no-one behind’.

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 Glossary

Sustainable Development Goals (SDGs)

<p class="p1">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.&nbsp;</p> <p class="p2">&nbsp;</p> <p class="p1">The 2030 Agenda for Sustainable Development is applicable to all countries until the year 2030. It aims to ensure &lsquo;No One is Left Behind&rsquo; in global sustainable development efforts, regardless of who they are and where they live.</p>

Iris

<p>Iris is an automated, interactive mortality coding system, which codes multiple&nbsp;causes of death&nbsp;and selects the&nbsp;underlying cause of death&nbsp;for statistical tabulation.</p>

Medindo a integralidade: Instituto Brasileiro de Geografia e Estatística / Measuring completeness: Brazilian Institute of Geography and Statistics

Deaths that occur outside of health facilities in Brazil are not necessarily recorded in all the databases that they should be, which makes the development of health policies and plans difficult. Dr Antonio Tadeu Ribeiro de Oliveira, Researcher at the Brazilian Institute of Geography and Statistics (IBGE) shares how linking systems will improve the country's understanding of mortality patterns. Filmed at the meeting on strengthening the quality of information on causes of death in Brazil in October 2017.

La historia de cambio del Perú (conferencia)

Conferencia con el Profesor Alan Lopez, Director de la Iniciativa Datos para la Salud. Filmado en Lima, Perú, en Septiembre de 2018.

Standardise training programs and certify trainers and coders

WHO online ICD training tool

CRVS and the SDGs

SDGs have been agreed to by the global development community as representing the direction of global development efforts between 2015 and 2030.

Improve medical certification of cause of death

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.

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.

How enterprise architecture has improved CRVS in Bangladesh

Anir Chowdhury, Policy Advisor for the Access to Information Programme (a2i) at the Prime Minister's Office in Bangladesh, and National Advisor to the CRVS Steering Committee, Cabinet Division explains how the country improved registration through enterprise architecture.

Why do we need data?

Why Data for Health? For more information on the initiative visit: www.crvsgateway.info/aboutus Interviews with Bloomberg Philanthropies Data for Health staff: -Laureate Professor Alan Lopez, Technical Director, University of Melbourne -Carla AbouZahr, Senior Technical Adviser, University of Melbourne -Dr Lene Mikkelsen, Senior Technical Adviser, University of Melbourne -Professor Don deSavigny, Chief Technical Collaborator, Swiss Tropical and Public Health Institute

Process mapping: Phase 4 (improved processes)

Health sector

Verbal autopsy diagnostic algorithms

Innovation collaboration with Swiss TPH

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.”

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 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 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.

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.

The implementation of verbal autopsy

Comprehensive assessment

Overview of verbal autopsy

Outputs of verbal autopsy

Conclusions and key actions for improvement

Using tabulation and analysis to check the data

SmartVA

What verbal autopsy is and what it is not

The benefits and beneficiaries of CRVS systems

InSilicoVA

WHO ICD online training tool

Automated VA

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

Legal review tools

WHO 2016 automated verbal autopsy questionnaire

IT systems for automated verbal autopsy

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.

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.

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.

Building momentum

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.

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.

Emerging challenges in IT for verbal autopsy

Systems prerequisites for introducing verbal autopsy

Stages and steps for implementing verbal autopsy in country

What are people dying of in Greenland and why?

Greenland is considered a high-income country that has almost doubled its life expectancy since the 1950s, yet the life expectancy of the country is that of low-income countries - so what are people dying of and why?

What are people dying of in Greenland and why?

Greenland's cause of death data have only recently been separated from Denmark in the Global Burden of Disease Study. University of Melbourne Data for Health Initiative visiting academic Kim Moesgaard Iburg is Associate Professor at Aarhus University in Denmark, he is studying how the quality of these data can be improved to further benefit the direction of health policy in the country.

University of Virginia Fellow Visits Data for Health

“Estimating and analysing the distribution of causes of death in rural areas of the world may not sound as sexy as ground-breaking surgery techniques, but it has the potential to save millions of lives. Our research will help inform health policy in underdeveloped regions of the world,” Riley said.

Tools to assist in correctly identifying the underlying COD

Challenges and barriers to CRVS

Rapid assessment of national CRVS systems

Objectives and definitions

Storage and archiving

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

Summary: Redefining 'garbage codes' for public health policy

Describes the alternative classification of garbage codes used in ANACONDA that better aligns with public health priorities.

Outcomes of improving death data in Solomon Islands

Strengthening CRVS in Solomon Islands is a challenge because data, especially death data, have never been collected before in an organised manner. Only two percent of all estimated deaths are registered in the country. Dilip Hensman, Technical Officer, World Health Organization explains. Watch Dilip describe the barriers to death notification in the Solomon Islands: https://youtu.be/9F4ntk7xtCk

Saving lives by counting deaths

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

Volume 1: Tabular list

What will it cost?

Conclusion

Automated classification of medical entities (ACME)

<p>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.</p>

Act

<p>In some legal systems, an item of &#39;primary legislation&#39; (law passed in parliament) is known as an act after enactment.</p>

Age

<p>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.</p>

Attendant at birth

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

Bill

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

Birth

<p>See &#39;live birth&#39;</p>

Birth parity

<p>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.</p>

Birth rate

<p>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.</p>

Born in wedlock

<p>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.</p>

Born out of wedlock

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

Burial permit

<p>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.</p>

Capture - recapture

<p>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).</p>

Quality control of vital statistics

Communication channels

Common issues and challenges: microdata

Legislation or regulation?

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.

What is the purpose of civil registration?

Cause of death

Conclusion

Conclusion

Conclusion

Conclusion

Conclusion

Delays in the production of vital statistics

Principles for data tabulation

CRVS and digital technologies

Increasing awareness, engagement, and participation

Addressing human resource constraints

FAQ

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

CRVS Fellowship report: Developing a CRVS-VA management dashboard

This summary 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. The dashboard is a user-friendly tool that provides real-time monitoring of summary statistics from VA interviews.

Electronic data management and generation

Data management and capacities and skills of staff involved

What is a process?

Safeguarding data and confidentiality

Getting the message across with words

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.

Strengthening CRVS design

In May, the Bloomberg Philanthropies Data for Health (BD4H) Initiative joined with several countries in Bangkok to develop country-specific process models for the registration of births and deaths, both inside and outside health facilities.

Building mortality coding expertise in Bangladesh and Myanmar

Both Bangladesh and Myanmar have prioritised coding in their Civil Registration and Vital Statistics (CRVS) Country Work Plans. The country does not have a team of coders so the training has helped build the expertise in-country.

Nonstandard death certificates

The concept of underlying cause of death

Roles and responsibilities for civil registration

Centralised mortality coding

Minimal essential tabulations

Defining the target audiences

Situations in which verbal autopsy can be used

Coordination

InterVA

How do I use findings from the assessment tools?

What are the components of good CRVS laws?

Ten CRVS milestones framework

Avances de RCEV en el Perú

Mire videos con las partes interesadas de RCEV de Perú sobre cómo está trabajando el país para fortalecer su sistema de RCEV y mejorar sus datos de causa de muerte.

Developing a verbal autopsy costing and budgeting tool

This paper describes the Verbal Autopsy Costing and Budgeting Tool that has been developed by the Swiss Tropical and Public Health Institute and the University of Melbourne. The tool estimates the resources needed to implement verbal autopsy (VA) as part of a routine civil registration and vital statistics (CRVS) system. The tool has been piloted in four different countries, representing different stages of implementation of VA activities, and the tool was able to demonstrate the relatively low ongoing cost of conducting routine VA when integrated within a CRVS system.

CRVS strengthening in Peru

Watch videos with Peru's CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

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.

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.

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.

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.

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.

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.

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.

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.

CRVS strengthening in Papua New Guinea

Watch videos with Papua New Guinea CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

ANACONDA mortality and cause of death assessment report template - Portuguese version (Relatório de avaliação da qualidade dos dados sobre mortalidade)

Este modelo foi desenvolvido para ajudar os países a escrever um relatório de avaliação da qualidade dos dados sobre mortalidade, utilizando ANACONDA. Podem ser incluídas todas as seções, tabelas e gráficos indicados, ou selecionar um subconjunto menor para trabalhar.

A template for a national CRVS birth and death statistics report

Challenges in accurate medical certification of cause of death

IT requirements for automated verbal autopsy

Demonstrating the value of vital statistics for policy, planning, monitoring and evaluation

Supply-side challenges

Approaches to measure the quality of reporting of birth characteristics

Classification of the main types of unusable diagnoses

Policy and institutional challenges

Recommended principles for the reporting and registration of births and deaths

Overcoming policy and institutional challenges

High-level political commitment

Process mapping for CRVS

Process mapping forces CRVS stakeholders to look at the whole system, considering not only the activities in which they are involved but also those implemented by other CRVS stakeholders and the relationships among them.

Process mapping and enterprise architecture

Legislation and regulations

Bar charts

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.

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.

News All

Additional references

Elements of automated verbal autopsy

Process mapping: Phase 3 (analysis)

Zambia's death coverage climbs with Data for Health

Zambia's rate of death registration coverage has been low as a result of the law that requires all deaths that are registered to have a cause. The Bloomberg Philanthropies Data for Health Initiative in Zambia is using verbal autopsy methods to count deaths that occur outside of health settings, in order to get a better understanding of who is dying of what in the country, which will better inform preventative health policies and plans. Interview with Brian Munkombwe, Health Scientist, US CDC; Chomba Mwango, Country Coordinator, Data for Health Initiative; Lisuba Kabanda, Senior Registrar, National Registration Passport and Citizenship in Melbourne, Australia in December 2018.

Myanmar's five year CRVS strengthening strategy

"To improve the CRVS system, we need to cooperate, coordinate and collaborate," says Dr Wah Wah Maung, Director-General, Central Statistical Organization of Myanmar. Civil registration and vital statistics data will be very beneficial to the country she says, for evidence-based health planning, resource allocation, as well as monitoring and evaluation.

Guidelines for good charts

Age heaping

New article

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.

CRVS Fellowship profile: Investigating garbage codes to improve mortality statistics in Brazil

Between January and February 2018, Raquel Barbosa de Lima, from the Department of Health Situation Analysis, Ministry of Health, Brazil, came to the University of Melbourne to receive support in analysing data from a pilot study that investigated key attributes of deaths with ‘garbage codes’.

Summary: SDG achievement depends on CRVS systems

Well-functioning civil registration and vital statistics (CRVS) systems will play an important role in assisting countries and regions to measure, monitor and meet their Sustainable Development Goal (SDG) targets. Strengthening of CRVS systems is an SDG outcome in and of itself; therefore, to fully achieve the SDG agenda, CRVS systems must be robust with near-complete registration of births and deaths.

Summary: Monitoring CRVS data quality and progress

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.

The quality of medical death certification of cause of death in hospitals in rural Bangladesh

Accurate and timely data on cause of death are critically important for guiding health programs and policies. Physicians in Bangladeshi hospitals had difficulties in completing the MCCD correctly. Physicians routinely made errors in death certification practices and medical record quality was poor. There is an urgent need to improve death certification practices and the quality of hospital data in Bangladesh if these data are to be useful for policy.

From death notification to registration (Bangladesh)

Mohamad Ashfaque Mukut, Deputy Secretary Cabinet Division (Bangladesh) and Deputy Project Director of the CRVS Technical Project, shares his fellowship work at the University of Melbourne that looks at a recent pilot in Kaliganj, Bangladesh that encourages health staff to notify community deaths.

Filling the gaps in Bangladesh's mortality data

University of Melbourne Fellow Dr Muhammad Adnan Khan, who is Assistant Chief Medical in the Director General (Health) in Bangladesh discusses the data quality of the medical certification of cause of death in Bangladesh.

What are the preliminary findings of using HBCPs as verbal autopsy interviewers in Rwanda?

Marc Hagenimana from the Rwanda Biomedical Center, Ministry of Health and University of Melbourne Data for Health Fellow discusses the findings of Rwanda's use of Health-Based Care Practitioners as verbal autopsy interviewers in the country.

Implementing MCCOD in all public hospitals in Rwanda

How did Rwanda implement standardised MCCOD training across all public hospitals? Godfrey Ngoboka, Rwanda Country Coordinator, and James Mwanza, Rwanda Project Officer from Vital Strategies, explain the approach.

Fellowship profile with Xavier Ngomituje

Interview with Xavier Ngomituje, Statistician at the National Institute of Statistics Rwanda on what he is working on during his fellowship at the University of Melbourne as part of the Bloomberg Philanthropies Data for Health Initiative. Read Xavier's fellowship report: https://crvsgateway.info/file/5452/1977

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.

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.

Short overview of CRVS in Ghana

This short video is an overview of CRVS in Ghana, 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.

Inside Ghana's Birth and Death Registry archives

The University of Melbourne Data for Health CRVS technical team visit the Ghana Birth and Death Registry archives, that have been kept since 1910. With Ghana Birth and Death Registry's Sowada Abordo and Emmanuel Nortey Botchway.

Birth registration digitisation in Ghana

Vital event registration in Ghana is low, with birth registration at 57%. Nevertheless the country is moving to implement digitisation for birth registration records. Benjamin Clapham, Ghana's Project Officer, explains.

Process of death registration in Ghana's 37 Military Hospital

Joyce Djama Ampini-Tetteh, Chief Registration Officer from the 37 Military Hospital Registry in Accra, Ghana describes the process of death registration in hospitals.

Ghana Birth and Death Registry's commitment to improvement

The University of Melbourne Data for Health CRVS technical team visit Ghana's Birth and Death Registry's Reverend Kingsley Asare Addo (Principal Assistant Registrar) and Registrar John Yao Agbeko.

Ghana Statistical Service: Improving systems, registration and sustainability

Anthony Amuzu and Stephen K. Amoah from the Ghana Statistical Service outline recent efforts to mobilise birth and death registration, digitisation, the issues with population registers and their commitment to integrated systems.

Barriers to death notification (Ghana)

Interview with Francis Yeji, Research Officer at the Ghana Health Service and Fellow at the University of Melbourne's Bloomberg Philanthropies Data for Health Initiative.

Increasing verbal autopsy supervision from afar

Patrick Larbi-Debrah, Health Information Officer from Ghana Health Service and University of Melbourne Data for Health Fellow describes how the new verbal autopsy dashboard for supervisors allows for greater visibility to monitor rural verbal autopsy work from central offices. Read more about the dashboard in our resource: https://crvsgateway.info/file/5171/1829

How Ghana revolutionised their CRVS system using process mapping

Interview with Professor Don de Savigny from the Data for Health Innovations Hub and the Swiss Tropical and Public Health Institute about how Ghana has been able to undertake process mapping to document the entire 'as is' and 'as desired' civil registration and vital statistics processes and the effect process mapping has had.

Tanzania's commitment to improved civil registration and vital statistics

This short video is an overview of CRVS in Tanzania, 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.

Tanzanian Ministry of Health perspective: How is Data for Health doing?

Edward Mbanga, Ag. Director for Policy and Planning at Tanzania's Ministry of Health, Community Development, Elderly and Children agency describes the successes so far of improving health information and its use as a result of the Bloomberg Philanthropies Data for Health Initiative.

Improving our understanding of births and deaths in Tanzania

RITA, the agency responsible for birth and death registration in Tanzania shares their progress on their legal and regulatory review, decentralisation of birth and death registration, system sustainability and use of technology.

Challenges to timely and sensitive death certification in Tanzania

Godfrey M Semu, Health Record and Information Officer at the Muhimbili National Hospital describes the challenges to timely death certification in Tanzania.

Educating Tanzanian physicians on the value of accurate assignments for underlying cause of death

Godfrey M Semu, Health Record and Information Officer at the Muhimbili National Hospital explains how the hospital is rolling out medical certification of death training.

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.

Volume 2: Instructions and guideline manual

Legal and practical support to physicians

How to successfully conduct a CRVS process mapping exercise

Volume 3: Alphabetical index

CRVS characteristics

What is a process map?

Sri Lanka: Strengthening the quality and availability of mortality statistics

This paper outlines the strategy for improving the quality and availability of mortality statistics in Sri Lanka, which is built on two main pillars: improving the quality of medical certification of cause of death for facility deaths; and implementing automated verbal autopsy to ascertain probable cause of death for community deaths.

Background

Inadequate number of coders, qualifications and training

The certifier

What is the vital statistics system?

Prioritisation and planning

Conduct regular coding quality assessments

Correct – that is, reliable

Structure of the ICD-10

CRVS systems are passive

Developing an enterprise architecture and business process mapping for CRVS systems

Completeness

What can process mapping do for you and your CRVS system?

Methods to assess the completeness of birth registration

CRVS and governance

The CRVS system benefits individuals and communities, national administrative systems and statistical systems.

Common issues and challenges in mortality coding

Governance

<p>A way to describe the processes for making and implementing decisions.</p>

The health sector as an active notification agent in CRVS systems

An analysis of cause of death data from PNG

Ila Rouka and Elizabeth Mathias from the National Department of Health, Papua New Guinea (PNG), came to the University of Melbourne for a fellowship to analyse medical certificates of cause of death.

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.

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.

SmartVA DHIS2 Integration | Sri Lanka (e-SmartVA)

Video by Dr Chamika Senanayake (Sri Lanka). More info: https://crvsgateway.info/SmartVA-DHIS2-Integration-Sri-Lanka-e-SmartVA-~2402

Importing WHO 2016 aggregate data into SmartVA

If you collect data using WHO 2016, this video will show you how to use SmartVA to analyse and assign the probable cause of death. It's easy, Roger Ward, Data Systems Analyst from the University of Melbourne's Data for Health Initiative explains.

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

How can we accelerate progress on civil registration and vital statistics?

The first in a series of papers published by the WHO Bulletin looking at how the health sector can contribute towards strengthening CRVS systems and increasing birth and death registration coverage.

New release: SmartVA 2.0

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

Civil registration and vital statistics in health systems

Over the past decades, the health sector has forged a widespread network of health facilities and community health workers who carry out key public health interventions, aiming to reach the most marginalized populations with life-saving interventions. In many countries, health networks offer untapped potential to leverage health services for the notification and registration of births and deaths.

Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú

Mortality statistics derived from cause of death data are an important source of information for population health monitoring, priority setting and planning. However, the quality of cause of death data is poor. In August 2016, the Ministry of Health of Perú decided to make two specific interventions to improve cause of death data: to introduce an online death certification system and to train doctors in standard death certification practices. This study demonstrates how the two interventions improved the correctness of death certificates. The study also provides evidence on necessary changes to the training program to address the poor certification practices that have remained after implementation of the online system.

CRVS Fellowship profile: Assessing the impact of death certification interventions in Peru

Between November 2017 and January 2018, Janet Miki from the Ministry of Health in Perú, came to the University of Melbourne to receive support in conducting a study assessing the impact of two death certification interventions to improve cause of death data in Perú. This fellowship profile documents Janet’s experiences whilst at Melbourne, including what she worked on, what she learned, and what impact this might have on improving the quality of mortality data in Perú.

Process mapping: Phase 1 (preparation)

The importance of legal and regulatory frameworks

Fragmented storage systems and parallel channels

Pie charts

Methods to measure death registration completeness

Background

Civil registry

Tariff 2.0

Timeliness of data

Using fertility rates to assess birth data quality

Operations and innovations

Conducting a legal review

Common issues and challenges with CRVS legislation

Background

Ill-defined causes of deaths

Scatter plots

Population_pyramid

Population_pyramid

CRVS strengthening in the Philippines

Watch videos with Filipino CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

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.

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.

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.

CRVS strengthening in Ecuador

Watch videos with Ecuador's CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

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.

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.

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.

Melhorando os códigos do 'lixo' do Brasil / Improving Brazil's 'garbage' codes

Raquel Barbosa from the Ministry of Health in Brazil, and Fellow at the Bloomberg Philanthropies Data for Health Initiative in University of Melbourne, explains how the country is working to improve the 33% percent of 'garbage', or unusable, for the purposes of public health planning. Video in Portuguese with English subtitles.

Creating accurate mortality information across China

Since 2017, the China CDC has cooperated with Bloomberg Philanthropies Data for Health to conduct a SmartVA (Smart Verbal Autopsy) pre-test in order to test whether the intervention was suitable for implementation in China. Assistant Professor Xin Ying Zeng from China CDC and Dr Hang Li, Technical Advisor at the University of Melbourne discuss how well SmartVA captures underlying cause of death for people who died at home.

Important CRVS laws

Verbal autopsy costing and budgeting tool

From cause of death certification to statistical coding

Protecting individual privacy rights

Considerations for the use of IT

Roles and responsibilities for individuals

Process mapping

A stepwise process

Case study: Understanding the underlying cause of death

It is very important that the underlying cause of death (UCOD) is correctly determined and accurately recorded for each death to get an understanding of the real causes of death

Roles and responsibilities

Summary: Understanding the VA costing and budgeting tool

A VA costing and budgeting tool has been developed to help determine the financial and economic costs of implementing routine VA, based on six activity groups: start-up activities, governance activities, program management, supervision, refresher training, VA delivery and analysis.

Summary: Innovative approaches to strengthen the capture and quality of mortality data in Brazil

Brazil has implemented several measures to improve the registration of vital events including: developing a new 'garbage code' study protocol to evaluate death certificates; training doctors on how to correctly complete death certificates, and assessing the accuracy of mortality data from forensic institutes

CRVS Fellowship report: Implementing verbal autopsy in Ghana

Between January and March 2018, Mr Francis Yeji, from the Policy, Monitoring and Evaluation Division of the Ghana Health Service, spent time at the Universities of Basel and Melbourne to analyse results from the verbal autopsy pre-test conducted in Ghana in 2017. This CRVS fellowship report describes the approach to verbal autopsy implementation used by Ghana, results from the pre-test in the Bongo District and implications this has for future phases, and how the results were used to inform the sampling strategy for Ghana, as part of national scale-up.

Zambia's death coverage climbs with Data for Health

Zambia's rate of death registration coverage has been low as a result of the law that requires all deaths that are registered to have a cause. The Bloomberg Philanthropies Data for Health Initiative in Zambia is using verbal autopsy methods to count deaths that occur outside of health settings, in order to get a better understanding of who is dying of what in the country, which will better inform preventative health policies and plans.

Validation

Dissemination of vital statistics

Introduction to mortality coding tools

Start up mortality list (SMoL)

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

Insufficient information

Imputation of missing values

Principles for integrating different data sources

Poor certification practices

Linking civil registration and vital statistics data in Brazil to estimate completeness

Luiz Fernando from the IBGE (Brazilian Federal Institute of Geography and Statistics) and Fellow at the University of Melbourne Data for Health Initiative explains his work to link civil registration and vital statistics data in Brazil to estimate completeness.

Ecuador: Estimating completeness of death registration at the national and subnational level

Jose Andrade from the National Statistical Office in Ecuador and Fellow at the University of Melbourne Data for Health Initiative explains his work to estimate the completeness of death registration at the national and subnational levels.

SmartVA/DHIS2 Integration in Sri Lanka

Dr Chamika Senanyake from the Ministry of Health, Nutrition and Indigenous Medicine in Sri Lanka and Fellow at the University of Melbourne Data for Health Initiative explains his work integrating Smart Verbal Autopsy (SmartVA) and DHIS-2 in Sri Lanka. Dr Senanyake has created a tutorial video about integration that you can view here: https://youtu.be/E66tnNV2rko

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.

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.

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.

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: Video demostrativo completo

Video subido con permiso del Ministerio de Salud, Perú.

SINADEF: Video tutorial

Video subido con permiso del Ministerio de Salud, Perú.

SINADEF: Introducción

Video subido con permiso del Ministerio de Salud, Perú.

CRVS Fellowship profile: Assessing the quality of vital statistics in the Philippines

Between July and October 2018, Majorie “Joy” Villaver, a supervising statistical specialist of the Philippine Statistics Authority, came to the University of Melbourne to assess the quality and completeness of birth and death registration, as well as the quality of cause of death data using the ANACONDA tool. This fellowship profile documents Joy’s experiences while at Melbourne, including what she worked on, what she found, and what impacts this might have on improving the civil registration and vital statistics system in the Philippines.

CRVS Fellowship profile: Estimating the completeness of birth and death registration in Ecuador

Between August and October 2018, José Andrade, from the Vital Statistics Department of the National Institute of Statistics and Census (INEC) in Ecuador, came to the University of Melbourne to receive support in calculating the completeness of birth and death registration in Ecuador. His fellowship involved using surveys, censuses, and population projections to do so, and these methods are described here, along with implications for the CRVS system of Ecuador.

Summary: Maximising synergies between health observatories and CRVS systems

Outlines six different areas of potential collaboration between health and demographic observatories and CRVS systems, including challenges and successes.

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

The Philippines: A story of CRVS change

What was the civil registration and vital statistics system in the Philippines like before the Bloomberg Philanthropies Data for Health Initiative started, and what impact has the initiative had? Interview with Lene Mikkelsen, Senior Technical Advisor to the Philippines from the University of Melbourne, Bloomberg Philanthropies Data for Health Initiative.

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

Comprehensive assessment tool

Demand-side challenges

Poor linkage between notification and registration for events occurring in the community

Conclusions and key actions

Limited access to resources

Sampling strategies for verbal autopsy in national CRVS systems

Summary: 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.

Key consideration for developing data visualisations

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.

Progresos de RCEV en Ecuador

Mire videos con las partes interesadas de CRVS de Ecuador sobre cómo está trabajando el país para fortalecer su sistema de RCEV y mejorar sus datos de causa de muerte.

What is civil registration?

Civil registration is the system by which a government records vital events such as births, deaths and marriages.

Medical certification of cause of death: Undergraduate curriculum - Portuguese version (Certificação médica da causa da morte: currículo de graduação)

This resource was developed to help medical schools incorporate medical certification of cause of death into their undergraduate medical curriculum.

Medical certification of cause of death: Facilitator's guide

This course has been developed to help physicians and medical students to correctly certify COD using standard death certification practices that comply with the international statistical classification of diseases and related health problems. It forms part of a package of resources that includes case studies and references for self-directed learning, a number of practical resources (including guidance on how to assess the quality of death certificates), and this facilitator’s manual for running workshops.

Trabalhando juntos para melhor informação em saúde / Working together for better health information

Dr Fatimo Marinho from Brazil's Ministry of Health explains why countries need to help one another to improve health systems and information. Filmed at the meeting on strengthening the quality of information on causes of death in Brazil in October 2017. Filmed in Portuguese with English subtitles. O Dr. Fatimo Marinho, do Ministério da Saúde do Brasil, explica por que os países precisam se ajudar mutuamente para melhorar os sistemas e informações de saúde. Filmado na reunião sobre fortalecimento da qualidade das informações sobre causas de morte no Brasil em Outubro de 2017.

Preliminary results of strengthening the national death registry information system of Peru

Peru has low coverage of deaths with a cause (54%) and about 30% of causes of death are classified as poorly-defined or not very useful for the formulation of public policies. In response to these problems, the Ministry of Health together with other government agencies, with the support of D4H, is implementing the National Death Registry Information System (SINADEF). The objective of this article is to describe the process of strengthening the mortality information system in Peru, focused on the implementation of SINADEF. Since the implementation of SINADEF in August 2016 until July 2018, 28,407 users of the SINADEF application have been created and a total of 122,411 deaths have been registered. The quality of data recording, including the cause of death, has been improved, while low coverage of deaths with a cause of death still persists.

Guidance for assessing and interpreting the quality of mortality data using ANACONDA - Russian version

For users of ANACONDA (statisticians and/or analysts in health and statistics departments, researchers, or other experts working with mortality data).

CRVS strengthening in Bangladesh

Before Bloomberg Philanthropies Data for Health Initiative launched in Bangladesh, there was very little information on who was dying of what, which is needed to guide public health policies and plans. Watch videos with Bangladesh's CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

Working together to find Bangladesh's top causes of death

Before Bloomberg Philanthropies Data for Health Initiative launched in Bangladesh, there was very little information on who was dying of what, which is needed to guide public health policies and plans. Interview with Dr Toufiq Shawon, Resident Medical Officer, Ministry of Health and Family Welfare; Dr Hafiz Chowdhury, Technical Advisor, Sri Lanka, University of Melbourne; Dr Razi Uddin, Assistant Chief Statistical Officer; Management Information System; Directorate General of Health Services. Filmed in Melbourne Australia in December 2018.

CRVS strengthening in Ghana

Watch videos with Ghana's CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

CRVS strengthening in Tanzania

Tanzania has demonstrated an increased commitment to civil registration and vital statistics (CRVS) system improvement, as reflected in its five-year country CRVS strategy (2015 to 2020). However, key stakeholders and governance mechanisms for CRVS are poorly linked, resulting in incomplete and inadequate data sources for informing policy-making. Watch videos with Tanzania's CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.

CRVS strengthening in Rwanda

Watch videos with Rwanda's CRVS stakeholders on how the country is working to strengthen their CRVS system and improve their cause of death data.