Civil Registration And Vital Statistics Research Articles

A Review of the Processes and Procedures of Road Traffic Accident Mortality Data Collection in Zambia

Road traffic crashes (RTCs) pose significant public health challenges globally, leading to millions of deaths, injuries and disabilities each year. Low- and middle-income countries, including Zambia, bear a disproportionate burden of RTC fatalities and injuries. However, the collection and accuracy of RTC data in Zambia are hampered by various challenges, including underreporting and inadequate data collection procedures. Strengthening RTC data collection systems is crucial to accurately understand the magnitude of the problem and implement effective measures to reduce RTC fatalities and injuries. This article presents a review of RTC mortality data collection processes and procedures in Zambia, focusing on the key stakeholders involved, namely the Zambia Police Service, Health Care Facilities, and the Department of National Registration, Passports and Citizenship. The study identifies key challenges such as paper-based records, inadequate training, resource limitations, varying case definitions, and low death registration rates. The research emphasizes the need to strengthen data systems and improve coordination among stakeholders. Recommendations include establishing a multidisciplinary road crash data analysis team, utilizing technology for data collection and analysis, providing training and capacity building, conducting public awareness campaigns, and enhancing collaboration between the police, hospitals and Civil Registration and Vital Statistics (CRVS). Implementing these recommendations is crucial to improve the accuracy and completeness of RTC mortality data, leading to evidence-based road safety interventions and policies. This research contributes to the understanding of RTC data collection practices in Zambia and provides valuable insights for policymakers, researchers, and practitioners in addressing the challenges in RTC mortality data collection.

A Review of the Processes and Procedures of Road Traffic Accident Mortality Data Collection in Zambia

Road traffic crashes (RTCs) pose significant public health challenges globally, leading to millions of deaths, injuries and disabilities each year. Low- and middle-income countries, including Zambia, bear a disproportionate burden of RTC fatalities and injuries. However, the collection and accuracy of RTC data in Zambia are hampered by various challenges, including underreporting and inadequate data collection procedures. Strengthening RTC data collection systems is crucial to accurately understand the magnitude of the problem and implement effective measures to reduce RTC fatalities and injuries. This article presents a review of RTC mortality data collection processes and procedures in Zambia, focusing on the key stakeholders involved, namely the Zambia Police Service, Health Care Facilities, and the Department of National Registration, Passports and Citizenship. The study identifies key challenges such as paper-based records, inadequate training, resource limitations, varying case definitions, and low death registration rates. The research emphasizes the need to strengthen data systems and improve coordination among stakeholders. Recommendations include establishing a multidisciplinary road crash data analysis team, utilizing technology for data collection and analysis, providing training and capacity building, conducting public awareness campaigns, and enhancing collaboration between the police, hospitals and Civil Registration and Vital Statistics (CRVS). Implementing these recommendations is crucial to improve the accuracy and completeness of RTC mortality data, leading to evidence-based road safety interventions and policies. This research contributes to the understanding of RTC data collection practices in Zambia and provides valuable insights for policymakers, researchers, and practitioners in addressing the challenges in RTC mortality data collection.

Exploring challenges and recommendations for verbal autopsy implementation in low-/middle-income countries: a cross-sectional study of Iringa Region—Tanzania

BackgroundVerbal autopsy (VA) plays a vital role in providing cause-of-death information in places where such information is not available. Many low-/middle-income countries (LMICs) including Tanzania are still struggling to yield...

The Implementation of Bantu Warga Apps and Metabase for Spatial Data Processing In Surabaya

Civil registration and vital statistics (CRVS) is known as an essential supporting system for effective policy-making and service delivery. Its primary purpose is establishing an individual's legal identity and vital events to ensure all citizens get their rights well. Furthermore, an advanced level of CRVS is equipped with a forecasting system to serve more useful data. This paper discusses the potential benefits and challenges of using Metabase and Bantu Warga as civil ministry support systems. The spatial data visualization system using open-source Metabase ran well and resulted in many visualization geospatial maps like birth, marriage and divorce, education, and employment. The forecasting autoregression model configuration and cumulative sum dataset reach the best error result in 1056618. The other aspects, like the self-isolation management system, civil documents classification system, and OCR system, have a good result.

Estimation of the completeness of road traffic mortality data in Zambia using a three source capture recapture method

BackgroundAccurate and reliable data are essential for tracking progress and evaluating the effectiveness of road safety intervention measures. However, in many low- and medium-income countries, good quality data on road traffic crashes are often difficult to obtain. This situation has led to an underestimation of the severity of the problem and distortions in trends when the reporting changes over time. This study estimates the completeness of road traffic crash fatality data in Zambia. MethodsData from the police, hospitals, and the civil registration and vital statistics (CRVS) databases was collected for the period 1st January to 31st December 2020 and analyzed using a three-source capture-recapture technique. ResultsA total of 666 unique records on mortalities as a result of road traffic crashes were collected from the three data sources during the period under review. The capture-recapture technique estimated the completeness of police, hospital, and CRVS databases to be 19%, 11% and 14% respectively. The combination of the three data sets was found to increase completeness to 37%. Based on this completion rate, we estimate that the actual number of people who died as a result of road traffic crashes in Lusaka Province in the year 2020 was approximately 1,786 (95% CI [1,448–2,274]). This corresponds to an estimated mortality rate of around 53 deaths per 100,000 population. ConclusionsThere is no single database contains complete data to provide a comprehensive picture of Lusaka province and by extension the country’s road traffic injury burden. This study has shown how capture and recapture method can address this problem. It shows the need for the continuous review of the data collection processes and procedures in order to identify gaps and bottlenecks, improve efficiency, and increase the quality and completeness of road traffic data on injuries and fatalities. Based on the findings of this study, it is recommended that the city of Lusaka province and Zambia as a whole utilize more than one database for official reporting of road traffic fatalities to increase completeness.

Estimation of national and subnational all-cause mortality indicators in Nepal, 2017

BackgroundDespite the civil registration and vital statistics (CRVS) system in Nepal operating for several decades, it has not been used to produce routine mortality statistics. Instead, mortality statistics rely on irregular surveys and censuses that primarily focus on child mortality. To fill this knowledge gap, this study estimates levels and subnational differentials in mortality across all ages in Nepal, primarily using CRVS data adjusted for incompleteness.MethodsWe analyzed death registration data (offline or paper-based) and CRVS survey reported death data, estimating the true crude death rate (CDR) and number of deaths by sex and year for each province and ecological belt. The estimated true number of deaths for 2017 was used with an extension of the empirical completeness method to estimate the adult mortality (45q15) and life expectancy at birth by sex and subnational level. Plausibility of subnational mortality estimates was assessed against poverty head count rates.ResultsAdult mortality in Nepal for 2017 is estimated to be 159 per 1000 for males and 116 for females, while life expectancy was estimated as 69.7 years for males and 73.9 years for females. Subnationally, male adult mortality ranges from 129 per 1000 in Madhesh to 224 in Karnali and female adult mortality from 89 per 1000 in Province 1 to 159 in Sudurpashchim. Similarly, male life expectancy is between 64.9 years in Karnali and 71.8 years in Madhesh and female male life expectancy between 69.6 years in Sudurpashchim and 77.0 years in Province 1. Mountain ecological belt and Sudurpashchim and Karnali provinces have high mortality and high poverty levels, whereas Terai and Hill ecological belts and Province 1, Madhesh, and Bagmati and Gandaki provinces have low mortality and poverty levels.ConclusionsThis is the first use of CRVS system data in Nepal to estimate national and subnational mortality levels and differentials. The national results are plausible when compared with Global Burden of Disease and United Nations World Population Prospects estimates. Understanding of the reasons for inequalities in mortality in Nepal should focus on improving cause of death data and further strengthening CRVS data.

Strengthening causes of death identification through community-based verbal autopsy during the COVID-19 pandemic

IntroductionIndonesia has not optimally provided complete and reliable civil registration and vital statistics (CRVS). Death certification is one of the elements of the CRVS system. Reliable data on death rates and causes serve as the basis for building a strong evidence base for public health policy, planning, monitoring, and evaluation. This study aims to implement an approach to identifying the cause of death through verbal autopsy by empowering community health workers during the pandemic.MethodThis study is implementation research with the empowerment of the community, in this case, health cadres and health facilitators/workers, to identify the cause of death through a mobile-based verbal autopsy. This implementation research consisted of four main activities: community-based verbal autopsy, mobile-based verbal autopsy development, data collection, and analysis of the suspected causes of death using InterVA-5.ResultFrom October to November 2020, a total of 143 respondents were willing to do a verbal autopsy interview (response rate of 58%). Of 143 respondents, most of them were women (112 or 78.3%), was the child of the deceased (61 or 42.7%) and lived with the deceased until before he/she died (120 or 83.9%). Based on the characteristics of the deceased, of 143 deceased, 78 (54.5%) were male, 134 (93.7%) were adults, 100 (69.9%) died at home, and 119 (83.2%) did not have a death certificate stating the cause of death. The cause of death of 143 deceased mainly was infectious disease (92 or 64.3%), followed by non-communicable disease (39 or 27.3%), external factors (5 or 3.5%), and unknown factors (4 or 2.8%). In sequence, the top five suspected causes of death are acute respiratory infection, including pneumonia (72 or 50.3%), other and unspecified infectious disease (18 or 12.6%), other and unspecified cardiac disease (17 or 11.9%), acute cardiac disease (4 or 2.8%), and Digestive neoplasms (4 or 2.8%).ConclusionThe findings showed that the mobile-based verbal autopsy using a community-based mechanism was feasible during the COVID-19 pandemic.

A Novel Block Chain Method for Urban Digitization Governance in Birth Registration Field: A Case Study.

Even though digitization is widely recognized as one of the most imperative trends in achieving effective urban governance, digital infrastructure remains far from the global trend in many African countries. This paper proposes a novel, resilient data manipulation architecture model called the Birth Notification Verification Model (BNVM) using blockchain and smart contracts. The proposed solution was evaluated in a real-world use case scenario in Ghana. The model, which is based on the Ten Civil Registration and Vital Statistics (CRVS) Framework, focuses on the initial inputs for birth registration at the birth notification level. The approach presented in this study paves the way for the creation of decentralized, secure, transparent, and automated systems for civil registration. The application of a smart contract architecture that blends a centralized design with an on-chain and off-chain architecture is further supported by this, providing more evidence of its viability. It offers a safe verification framework for the Ghana Birth and Death Registry based on smart contract technology and can guarantee a birth notification as proof of birth certificate registration in accordance with international standards. The findings provide insight into the use of blockchain technology in public registry institutions. Furthermore, exploring its adoption and implementation in Sub-Saharan Africa contributes to the growing field of blockchain technology research and demonstrates how the concept will address long-standing issues with corruption and security in developing countries.

Assessment of the national and subnational completeness of death registration in Nepal

BackgroundReliable and timely mortality data from a civil registration and vital statistics (CRVS) system are of crucial importance for generating evidence for policy and monitoring the progress towards national and global development goals. In Nepal, however, the death registration system is not used to produce mortality statistics, because it does not providing data on age at death and only reporting deaths by year of registration. This study assesses the completeness of death registration in Nepal – both the existing offline system and the newer online system – as well as the completeness of death reporting from a CRVS Survey, and assesses differences by year, sex, ecological belt, and province.MethodsThe empirical completeness method is used to estimate completeness at all ages from the offline (paper-based) registration system (2013-17), the online registration system (2017-19) and the CRVS Survey (2014-15).ResultsCompleteness of the offline death registration system was 69% in 2017, not increasing since 2013 and being higher for males (73%) than females (65%). Completeness of online registration was only 32% in 2019, but almost double the 2017 figure. Completeness of death reporting in the CRVS Survey was 75% in 2015. The largest subnational differentials in completeness exist for the offline registration system, ranging from 90% in Gandaki to just 39% in Karnali.ConclusionsImprovement in the utility of the Nepalese death registration system for mortality statistics is dependent on continued roll-out of the online death registration system (which reports age at death and deaths by year of occurrence) throughout the country, focusing on areas with low registration, building a strong coordination mechanism among CRVS stakeholders and implementing public awareness programs about death registration.

Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records

ObjectivesTo assess the quality of cause of death reporting in Shanghai for both hospital and home deaths.Design and settingMedical records review (MRR) to independently establish a reference data set against...

How has COVID-19 impacted the civil registration and vital statistics system in Loreto, Perú? Evidence using process mapping and qualitative analysis

ObjectivesAccurate civil registration and vital statistics (CRVS) systems are the primary data source to measure the impact of the COVID-19 pandemic on mortality. This study assesses how the pandemic impacted...

Have inequalities in completeness of death registration between states in India narrowed during two decades of civil registration system strengthening?

BackgroundIn India the number of registered deaths increased substantially in recent years, improving the potential of the civil registration and vital statistics (CRVS) system to be the primary source of mortality data and providing more families of decedents with the benefits of possessing a death certificate. This study aims to identify whether inequalities in the completeness of death registration between states in India, including by sex, have narrowed during this period of CRVS system strengthening.MethodsData used in this study are registered deaths by state and year from 2000 to 2018 (and by sex from 2009 to 2018) reported in the Civil Registration Reports published by the Office of Registrar General of India. Completeness of death registration is calculated using the empirical completeness method. Levels and trends inequalities in completeness are measured in each state a socio-economic indicator – the Socio-Demographic Index (SDI).ResultsEstimated completeness of death registration in India increased from 58% in 2000 to 81% in 2018. Male completeness rose from 60% in 2009 to 85% in 2018 and was much higher than female completeness, which increased from 54 to 74% in the same period. Completeness remained very low in some states, particularly from the eastern (e.g. Bihar) and north-eastern regions. However, in states from the northern region (e.g. Uttar Pradesh) completeness increased significantly from a low level. There was a narrowing of inequalities in completeness according to the SDI during the period, however large inequalities between states remain.ConclusionsThe increase in completeness of death registration in India is a substantial achievement and increases the potential of the death registration system as a routine source of mortality data. Although narrowing of inequalities in completeness demonstrates that the benefits of higher levels of death registration have spread to relatively poorer states of India in recent years, the continued low completeness in some states and for females are concerning. The Indian CRVS system also needs to increase the number of registered deaths with age at death reported to improve their usability for mortality statistics.

Estimation of all-cause excess mortality by age-specific mortality patterns for countries with incomplete vital statistics: a population-based study of the case of Peru during the first wave of the COVID-19 pandemic

SummaryBackgroundAll-cause excess mortality is a comprehensive measure of the combined direct and indirect effects of COVID-19 on mortality. Estimates are usually derived from Civil Registration and Vital Statistics (CRVS) systems, but these do not include non-registered deaths, which may be affected by changes in vital registration coverage over time.MethodsOur analytical framework and empirical strategy account for registered mortality and under-registration. This provides a better estimate of the actual mortality impact of the first wave of the COVID-19 pandemic in Peru. We use population and crude mortality rate projections from Peru's National Institute of Statistics and Information (INEI, in Spanish), individual-level registered COVID-19 deaths from the Ministry of Health (MoH), and individual-level registered deaths by region and age since 2017 from the National Electronic Deaths Register (SINADEF, in Spanish).We develop a novel framework combining different estimates and using quasi-Poisson models to estimate total excess mortality across regions and age groups. Also, we use logistic mixed-effects models to estimate the coverage of the new SINADEF system.FindingsWe estimate that registered mortality underestimates national mortality by 37•1% (95% CI 23% - 48•5%) across 26 regions and nine age groups. We estimate total all-cause excess mortality during the period of analysis at 173,099 (95% CI 153,669 - 187,488) of which 108,943 (95% CI 96,507 - 118,261) were captured by the vital registration system. Deaths at age 60 and over accounted for 74•1% (95% CI 73•9% - 74•7%) of total excess deaths, and there were fewer deaths than expected in younger age groups. Lima region, on the Pacific coast and including the national capital, accounts for the highest share of excess deaths, 87,781 (95% CI 82,294 - 92,504), while in the opposite side regions of Apurimac and Huancavelica account for less than 300 excess deaths.InterpretationEstimating excess mortality in low- and middle-income countries (LMICs) such as Peru must take under-registration of mortality into account. Combining demographic trends with data from administrative registries reduces uncertainty and measurement errors. In countries like Peru, this is likely to produce significantly higher estimates of excess mortality than studies that do not take these effects into account.FundingNone.

Adult death registration in Matlab, rural Bangladesh: completeness, correlates, and obstacles

Civil registration of vital events such as deaths and births is a key part of the process of securing rights and benefits for individuals worldwide. It also enables the production of vital statistics for local planning of social services. In many low- and lower-middle-income countries, however, civil registration and vital statistics (CRVS) systems do not adequately register significant numbers of births and, especially, deaths. In this study, we aim to estimate the completeness of adult death registration (for age 15 and older) in the Matlab health and demographic surveillance system (HDSS) area in Bangladesh and to identify reasons for (not) registering deaths in the national CRVS system. We conducted a sample survey of 2538 households and recorded 571 adult deaths that had occurred in the 3 years preceding the survey. Only 17% of these deaths were registered in the national CRVS system, with large gender differences in registration rates (male = 26% vs. female = 5%). Respondents who reported that a recent death in the household was registered indicated that the primary reasons for registration were to secure an inheritance and to access social services. The main reasons cited for not registering a death were lack of knowledge about CRVS and not perceiving the benefits of death registration. Information campaigns to raise awareness of death registration, as well as stronger incentives to register deaths, may be needed to improve the completeness of death registration in Bangladesh.

Lessons Learnt and Pathways forward for National Civil Registration and Vital Statistics Systems after the COVID-19 Pandemic

The COVID-19 pandemic has had a substantial impact on government services in many areas, including Civil Registration and Vital Statistics (CRVS). However, the pandemic has also highlighted the importance of recording of mortality and causes of death, with some potentially positive impacts for longer term CRVS strengthening, including: (1) increasing online provision of registration services (2) reporting of mortality statistics from settings which had not previously done so (3) improved intersectoral cooperation, particularly with the health sector, improving the ability to record deaths and (4) increased awareness among governments and public of the importance of mortality statistics. Now, it is pressing for national governments, and international organizations working to strengthen CRVS systems, to evaluate the effectiveness of strategies adopted over the last year, and use lessons learnt to catalyse broader sustainable CRVS improvement strategies, providing governments with essential data on mortality and causes of death into the future.

Protocol for analysing the epidemiology of maternal mortality in Zimbabwe: A civil registration and vital statistics trend study.

Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe-an SSA country. In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007-2008 and 2018-2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe. This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007-2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

Gaps in the civil registration and vital statistics systems of low- and middle-income countries and the health sector's role in improving the situation.

Civil Registration and Vital Statistics (CRVS) is an essential administrative system that provides legal identification to all individuals and accurate statistical data of vital events, such as birth and death rates within the population. Globally, CRVS has been considered a priority issue, especially for low- and middle-income countries where the coverage of this system is poor. This may be attributed to factors such as inefficiency of laws, poor inter-ministerial cooperation, and a lack of awareness among people. To address these issues and improve coverage of the CRVS, the health sector could play a key role by acting as an entry point, collecting accurate vital data, and utilizing information from CRVS. However, the function of the health sector in implementing CRVS has not been fully analyzed in most countries. Further investigation is necessary to develop effective measures to strengthen CRVS.

Approaches, achievements, challenges, and lessons learned in setting up an urban-based Health and Demographic Surveillance System in South Africa

ABSTRACT Reliable civil registration and vital statistics (CRVSs) are essential for estimating mortality rates and population changes, and are critical for public health and socio-economic planning. CRVSs are largely incomplete in Africa, thus Health and Demographic Surveillance Systems (HDSSs) fill gaps in CRVSs, albeit existing HDSSs in South Africa are in rural areas. This limits the generalisability of such data in a country such as South Africa where over 60% live in urban areas, and where there are limitations to access health and social services. We describe the approaches, achievements, challenges and lessons learned in setting up a HDSS site in Soweto and Thembelihle (SaT-HDSS), Johannesburg; which is the first urban-based HDSS in Southern Africa. We also highlight a number of studies being implemented in the HDSS. In 2017–2020, the HDSS has enrolled 124,169 individuals and followed up 95% of this population through 3 rounds of data collection. Several challenges were encountered during the initiation of the HDSS, including difficulties in community mobilisation and entry, stakeholders’ engagement and participation, inaccessibility problems and concerns about safety of fieldworkers, and difficulty in getting/recruiting technical staff with requisite experience. Nevertheless, the SaT-HDSS was successfully established through application of several strategies, including continuous community engagement and stakeholders’ mobilisation; in-depth training and retraining of all study staff; technical support from well-established HDSS sites across Africa, and international academic collaborations. Despite the challenges of undertaking routine surveillance of a hard-to-reach and highly mobile population, the SaT-HDSS was successfully established with a high-retention rate. The HDSS offers an important lens on morbidity and mortality and serves as a platform for pilots of interventions and programmes aimed at improving health and well-being of an urban population.

Civil registration and vital statistics (CRVS): Trends in low- and middle-income countries and international cooperation

Civil registration and vital statistics (CRVS): Trends in low- and middle-income countries and international cooperation

Estimation of All-Cause Excess Mortality by Age-Specific Mortality Patterns of COVID-19 Pandemic in Peru in 2020

Background: All-cause excess mortality is a comprehensive measure of the combined direct and indirect effects of COVID-19 on mortality. Estimates are usually derived from Civil Registration and Vital Statistics (CRVS) systems, but these do not include non-registered deaths, which may be affected by changes in vital registration coverage over time.Methods: We use quasi-Poisson models to estimate excess registered mortality in Peru during the first wave of the COVID-19 pandemic during 2020. We use logistic mixed-effects models to estimate the completeness of the new online registration system (SINADEF) at this time.Findings: We estimate that registered mortality nationally underestimates mortality by 30·1% (95% CI 28·9% - 32·7%). We estimate total all-cause excess mortality during the period of analysis at 142,875 (95% CI 127,163 - 155,739) of which 99,814 (95% CI 85,605 - 110,738) were captured by the vital registration system. Deaths at age 60 and over accounted for 74·9% (95% CI 74·9% - 75·0%) of total excess deaths, while there were fewer deaths than expected in younger age groups. Lima region, on the Pacific coast and including the national capital, accounts for 76,158 (95% CI 72,740 - 79,212) excess deaths, while the regions of Apurimac and Pasco account for less than 300 excess deaths.Interpretation: Estimating excess mortality in low- and middle-income countries (LMICs) such as Peru must take under-registration of mortality into account. Combining demographic trends with data from administrative registries reduces uncertainty and measurement errors. In countries like Peru, this is likely to produce significantly higher estimates of excess mortality than studies that do not take these effects into account.Funding Statement: None.Declaration of Interests: RM is a staff member of the Pan American Health Organization. The author alone is responsible for the views expressed in this publication, and they do not necessarily represent the decisions or policies of the Pan American Health Organization. All other authors declare no competing interests.