HOSPITAL OF THE DEAD REGISTRATION

HOSPITAL OF THE DEAD REGISTRATION

The United Nations goal 16 of the sustainable development goals contains a target related to civil registration and vital statistics (CRVS) in order to promote human security. In this context, strengthening death registration has attracted international attention as an important issue in the global public health field. However, according to the World Health Statistics in 2015, most low- and middle-income countries (LMIC) have a low death registration rate and inaccurate vital statistics. Ideally, all deaths should be registered and the CoD data should be obtained from accurate medical certification. The causes of death (CoD) information is especially significant for guiding health policy for the prioritization of health issues. Information about deaths is essential for effective policy-making in order to address local demands in relation to various public health issues. In order to strengthen the death registration system with accurate CoD, it will be useful to embed the SmartVA in ZambiaвЂ™s health information system. Since the information on the death notification form is reflected in the national vital statistics, more accurate and complete CoD data are required. While there many erroneous descriptions on the death notification form, the SmartVA could determine the CoD among more BiD cases. The CoD of the BiD cases were successfully analyzed using the SmartVA for the first time in Zambia. A proportion (42.7% for Adult and 46% for Child) of the CoD-determined cases matched in both sources, with a low concordance rate for Adult (kappa coefficientвЂ‰=вЂ‰0.1385) and a good for Child(kappa coefficientвЂ‰=вЂ‰0.635). The proportion of cases with a determined CoD was significantly higher when using the SmartVA (75% for Adult and 67% for Child) than the death notification form (61%). The top CoD for Adults were infectious diseases followed by non-communicable diseases and that for Child were infectious diseases, followed by accidents. One thousand three hundred seventy-eight and 209 cases were included for persons aged 13вЂ‰years and older (Adult) and those aged 1вЂ‰month to 13вЂ‰years old (Child), respectively. The CoD were compared with description on the death notification forms by using t-test and CohenвЂ™s kappa coefficient. The deceasedвЂ™s closest relatives were interviewed using a structured VA questionnaire and the data were analyzed using the SmartVA to determine the CoD at the individual and population level. All BiD cases who reached the target health facility from January to August 2017 were included. The target site was one third-level hospital in the Republic of ZambiaвЂ™s capital city.

Therefore, this study was designed to evaluate the function of automated VA based on the Tariff Method 2.0 to identify the CoD among the BiD cases and the usefulness by comparing the data on the death notification form. Over one third of deaths in Zambian health facilities involve someone who has already died before arrival (i.e., Brough in Dead), and in most BiD cases, the CoD have not been fully analyzed.

Hospital of the dead