Abstract

BackgroundTwo World Health Organization comparative assessments rated the quality of South Africa’s 1996 mortality data as low. Since then, focussed initiatives were introduced to improve civil registration and vital statistics. Furthermore, South African cause-of-death data are widely used by research and international development agencies as the basis for making estimates of cause-specific mortality in many African countries. It is hence important to assess the quality of more recent South African data.MethodsWe employed nine criteria to evaluate the quality of civil registration mortality data. Four criteria were assessed by analysing 5.38 million deaths that occurred nationally from 1997–2007. For the remaining five criteria, we reviewed relevant legislation, data repositories, and reports to highlight developments which shaped the current status of these criteria.FindingsNational mortality statistics from civil registration were rated satisfactory for coverage and completeness of death registration, temporal consistency, age/sex classification, timeliness, and sub-national availability. Epidemiological consistency could not be assessed conclusively as the model lacks the discriminatory power to enable an assessment for South Africa. Selected studies and the extent of ill-defined/non-specific codes suggest substantial shortcomings with single-cause data. The latter criterion and content validity were rated unsatisfactory.ConclusionIn a region marred by mortality data absences and deficiencies, this analysis signifies optimism by revealing considerable progress from a dysfunctional mortality data system to one that offers all-cause mortality data that can be adjusted for demographic and health analysis. Additionally, timely and disaggregated single-cause data are available, certified and coded according to international standards. However, without skillfully estimating adjustments for biases, a considerable confidence gap remains for single-cause data to inform local health planning, or to fill gaps in sparse-data countries on the continent. Improving the accuracy of single-cause data will be a critical contribution to the epidemiologic and population health evidence base in Africa.

Highlights

  • In a region marred by mortality data absences and deficiencies, this analysis signifies optimism by revealing considerable progress from a dysfunctional mortality data system to one that offers all-cause mortality data that can be adjusted for demographic and health analysis

  • [10] Three key events played a major role to facilitate improvements in coverage and content of civil registration: (i) the passing of the Births and Deaths Registration Act of 1992, abolishing differential vital registration based on race and rural residence; (ii) the adoption of the Interim Constitution of South Africa in 1993, consolidating the geographically-segmented country into one geo-political unit which enabled the centralisation of the civil registration and vital statistics system; and (iii) a collaboration among strategic role players, i.e. the Department of Health, Department of Home Affairs, Statistics South Africa (StatsSA) and mortality researchers, focussing on enhancing the vital statistics system [8]

  • Criterion 1: Coverage Death registration, enacted since 1867, was effectively a partial process for most of the 1900s as coverage was constrained by differential registration practice based on geographical segmentation and population segregation imposed by various acts under ‘homeland’ and apartheid policies. [8,28] During the 1990s, the ‘homeland’ ideology was abolished under democratic rule, and the country was geographically unified under one government

Read more

Summary

Introduction

Based on 1996 data, two WHO assessments [1,3] rated South Africa in a group of countries with low quality mortality data, using as criteria completeness of death registration (,70%), use of ill-defined codes (.20% of registered deaths), timeliness and/or using an old revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) or alternate list to code causes of death. Under the Population Registration Act of 1950, South Africans were classified as ‘Black African’, ‘Coloured’, ‘Indian/Asian’ or ‘White’. This population group classification was associated with disparities in different spheres of life, including civil registration practice, mobility, and residential access, all constraining the coverage of civil registration and completeness of death reporting. It is important to assess the quality of more recent South African data

Methods
Results
Discussion
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.