Welcome to our fifth edition of More than Numbers,
the e-newsletter that keeps you up to date
on the civil registration and vital statistics (CRVS) arm of the
Bloomberg Philanthropies Data for Health Initiative (D4H)
by the University of Melbourne.I hope you read this newsletter refreshed from your holiday break, as we race towards the finish line of the D4H initiative. In this edition: -A new data analysis and interpretation tool -How to use SmartVA with one device -Colombia's innovation to report community events -A new video with health information system change expert Professor Don de Savigny guides us on what it means to implement process mapping with countries. -Spotlight on the in-country
work in the Philippines, Papua New Guinea, Ecuador and Peru. -Four of the D4H fellows share how they will take the lessons learned from their time at the University of Melbourne back to their countries. As always, we highlight new resources developed by the University of Melbourne that document the work done as part of D4H, as well as improve understanding of the best-practice ways to implement CRVS strengthening activities in their country. Lastly, we have listened to your feedback and created a 'frequently asked questions' page to give visitors of the CRVS Knowledge Gateway a simple way to find the information they need. You can view the page here. Best wishes, Laureate Professor Alan Lopez AC, Director Have comments or suggestions for future content?
Email us at crvs-info@unimelb.edu.au The Data for Health Initiative is funded by Bloomberg Philanthropies and the Australian Government's Department of Foreign Affairs and Trade (DFAT)
VA data analysis and interpretation tool in the works University of Melbourne has developed a guidance framework and tool – VIPER – to assist countries to analyse and interpret the causes of death coming from their verbal autopsy data. The framework and tool are in the early stages of development and were trialled at the recent VA Interpretation Workshop in Melbourne. Following feedback and suggestions from countries, the team will release a second version of the guidance manual and tool before end of March 2019.
SmartVA now available for use on single device
After feedback from users of SmartVA, SmartVA Auto Analyse, now permits physicians to do a verbal autopsy interview and analyse the results on a single device. In this video, Roger Ward, Data Systems Analyst from the University of Melbourne explains how.
Colombia innovates with community event notifications
Colombia is trialling an innovative way to ensure that all vital events that occur (or are known) in rural hospitals are added to the online reporting system, to correct underreporting in these resource-poor areas. Now community members can simply text a number to report a birth or death in community. Read more about Colombia's strategy to improve the registration and certification of vital events in rural and ethnic communities.
Rural health care workers distribute these cards in remote villages to raise awareness of SMS notification
An exercise called 'process mapping' has enabled governments across the D4H Initiative to visualise what processes aren't working and effectively reshape their system. Professor Don de Savigny from the Swiss Tropical and Public Health Institute explains. View full video (9'25"): https://youtu.be/geMu3OaOZ-w
The Philippines has shown ongoing commitment to strengthening its civil registration and vital statistics system. It is a relatively mature and functioning system, but there are many aspects that could function better if they were strengthened. Every time the D4H Technical Advisory Group go into countries with DFAT country posts, we liaise with the nominated DFAT representative to update them on what we’re doing, challenges, and what we are experiencing. These videos from Manila in July 2018 with key CRVS experts detail the work happening in the Philippines. For full information on interventions, visit: https://crvsgateway.info/file/7604/142
CRVS progress in the Philippines (overview)
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.
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 SmartVA Evaluation Workshop.
The Philippines: A story of CRVS change
What was the CRVS system in the Philippines like before the D4H Initiative started and what impact has the initiative had? Interview with Lene Mikkelsen, Senior Technical Advisor to the Philippines. View full video (12'35"): https://youtu.be/p2KAcNPUX9w)
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. View full video (10'10"): https://youtu.be/gR7ho43VpXA
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 to diagnose deaths, the process has become much more simple.
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 country has been able to drastically improve the speed of which they report their cause of death data.
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 initiative. View full video (8"): https://youtu.be/NMH-qdY9HkU
CRVS in Papua New Guinea (PNG) is characterised by multiple and overlapping systems of vital events reporting. Since 2014, there have been substantial investments in strengthening PNG's civil registration and vital statistics system. However challenges still remain, especially around the integration of mortality surveillance systems. These videos were filmed in Melbourne, Australia in December 2018. For full information on PNG interventions visit: https://crvsgateway.info/file/7602/141
Understanding patterns of mortality in Papua New Guinea "I feel that we are doing something good," says Dr Viola Kwa, University of Melbourne, in a wide-ranging interview with John Hart, Technical Advisor, University of Melbourne. Full video (10:40): https://youtu.be/yNlkWPUd6LI
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 PNG deaths are unreported and how the country is working to change that.
Ecuador has identified five interventions to improve system performance, with a focus on building human capacity, increasing death registration completeness, and improving quality of mortality data. These videos provide a more in-depth understanding of their system and improvements as part of the Bloomberg Philanthropies Data for Health Initiative. All videos are in Spanish with English subtitles. Filmed in September 2018 in Quito, Ecuador. For full information on Ecuador interventions: https://crvsgateway.info/file/7599/138
Short overview
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 D4H.
Making ‘invisible’ populations visible
Interview with Soledad Carrera, National Institute of Statistics and Census and Juan Cortez-Escalante, CRVS Technical Advisor, University of Melbourne in Melbourne, Australia in December 2018.
Verbal autopsy
intervention in
Ecuador
Interview with Mónica García-Pérez, Field Coordinator, Verbal Autopsy Project, D4H Initiative.
Improving usable mortality information in Ecuador
Interview with Dr. Caterina Yepes, Field Coordinator, Garbage Codes Project, D4H Initiative.
National Institute of Statistics and Census
Discussion with Mr. Mgs. Roberto Castillo Añazco, Executive Director, National Institute; Juan Cortez, CRVS Technical Advisor, University of Melbourne; Professor Alan Lopez, Director, University of Melbourne; Professor Deirdre McLaughlin, Deputy Director, University of Melbourne. View full video (11'20"): https://youtu.be/lhLHho_9zGs
Peru has demonstrated its commitment to CRVS improvement in spite of the country’s limited resources and duplicative efforts in the production of vital statistics. These videos provide a more in-depth understanding of their system and improvements as part of the Bloomberg Philanthropies Data for Health Initiative. All videos are in Spanish with English subtitles. Filmed in September 2018 in Lima, Peru. For full information on Peru interventions, visit: https://crvsgateway.info/file/7603/1552
Short overview
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 D4H.
How Peru uses technology to track mortality trends
Interview with Dr Rosario Kiyohara Okamoto, CEO, National Hospital Dos de Mayo Ministry of Health.
Results of the Initiative
Interview with Lic Gladys Garro, Director of the Executive Office of Information Management, General Office of Information Technologies, Ministry of Health.
Peru's story of change
Lecture by Professor Alan Lopez, Director, D4H Initiative, University of Melbourne. In English, Spanish subtitled version available soon.
Institute of Legal Medicine and Forensic Science's role in death certification
Discussion with Dr Andres Eduardo Castro Flores, Medical Examiner, Institute of Legal Medicine of Lima; Javier Vargas, Country Coordinator; Dr Judith Angelica Maguiña Romero, Medical Examiner, Institute of Legal Medicine. View full video (13'34"): https://youtu.be/DJ__ySijyrQ
Using Telehealth to cover Peru's hard-to-reach areas
Interview with Dr Leonardo Rojas Mezarina, Telehealth Unit, National University of San Marcos.
With the view of creating sustainability of CRVS interventions in countries supported by the Data for Health Initiative, the University of Melbourne has committed to a fellowship program that has grown throughout the four-year project. Fellows spend three months on average at the University of Melbourne, supported by CRVS experts. The fellows' projects provide valuable information that will assist in creating upcoming health policies and plans in their countries. Below some of the recent fellows describe their work. Past fellow interviews can be found here.
Jose Andrade from the National Statistical Office in Ecuador explains his work to estimate the completeness of death registration at the national and subnational levels.
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.
Chamika Senanyake from the Ministry of Health, Nutrition and Indigenous Medicine in Sri Lanka explains his work integrating SmartVA and DHIS-2 in Sri Lanka.
Marli Montenegro,
health situation analyst at Brazil's Ministry of Health describes her University of Melbourne fellowship work to link the civil registry and vital statistics in Brazil to estimate completeness.
Luiz Fernando from the IBGE (Brazilian Federal Institute of Geography and Statistics) explains his work to link civil registration and vital statistics data in Brazil to estimate completeness.
Raquel Barbosa from the Ministry of Health in Brazil's fellowship work examines the country's 33% of deaths that are classified as 'garbage', or unusable, for the purposes of public health planning.
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