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Welcome to our sixth edition of More than Numbers,
the e-newsletter that keeps you up to date on what is happening in the civil registration and vital statistics arm of the
Bloomberg Philanthropies Data for Health Initiative
by the University of Melbourne
Colleagues, we have all achieved so much over the past four years of the Data for Health (D4H) Initiative.
We are excited to move onto the second phase of this system-changing, data-enriching initiative that will put more reliable mortality data into the hands of decision makers.
We integrated verbal autopsy into civil registration and vital statistics (CRVS) systems and replaced paper forms with digital notification in many countries. Thousands of people who were trained and involved in the collection, analysis and dissemination of CRVS information now have a greater skillset and understanding of the importance of accurate cause of death information.
It is without saying that we couldn't have done it alone and we are buoyed by the enthusiasm we have seen along this journey. We are confident that the design of our CRVS interventions will allow countries to sustainably integrate these new processes into their health systems. Our mission is to make people's lives healthier and longer because of better mortality information on which to base their decision-making and plans.
The photo above features a ward recorder in the Alotau District of the Miline Bay Province in Papua New Guinea. I think his face says it all — empowered with training on notifying birth and deaths to the health centres — and a new record book! — to do his important work.
We will continue to mark our successes and findings in this newsletter throughout the next phase of the initiative.
In this edition, you will find links to the latest journals, resources and tools, including many new course materials; we have insights into D4H verbal autopsy implementation from a stalwart in the field, Professor Ian Riley; and many countries share their experiences using verbal autopsy methods. We have in-country video interviews and documentation of our work in Brazil, Colombia and Myanmar, as well as profiles of our five most recent Fellows at the University of Melbourne. Enjoy!
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)
New resources
Want to take a deeper dive into strengthening CRVS? Our new and updated resources are a good place to start.
You can take a look at all of our resources at: https://crvsgateway.info/library.
Academic journals/summaries:
- How useful are registered birth statistics for health and social policy? A global systematic assessment of the availability and quality of birth registration data / Summary
- How can we accelerate progress on civil registration and vital statistics?
- Preliminary results of strengthening the national death registry information system of Peru
Country experiences and knowledge/fellowship profiles and reports:
- Assessing the quality of medical certification in Bangladesh – findings from introducing the International Form of medical certificate of cause of death in four pilot hospitals
- Country-specific adaptation of a SmartVA DHIS2 integration module for Sri Lanka
- Implementing verbal autopsy in Ghana
- Improving the quality of birth and death data in Brazil
- Summary: Innovative approaches to strengthen the capture and quality of mortality data in Brazil
Handbooks/technical outcomes/guidance documents/action guides:
- ANACONDA mortality and cause of death assessment report template (note: clicking this link downloads document automatically)
- Assessing the quality of death certificates (update, guidance to rapid tool) / Rapid tool
- Developing a verbal autopsy costing and budgeting tool / Summary
- Medical certification of cause of death: Facilitator’s guide
- Medical certification of cause of death: Undergraduate curriculum
- The past, present and future of three sample registration systems in Asia
We want your feedback!
Are we providing you with all the CRVS information you need for your in-country work? Can you easily find what you are looking for on this website? Take our 5 minute survey to help us improve (closes 27 March):
Elevating the role of verbal autopsy into CRVS systems
Pioneer of the verbal autopsy method for determining the underlying cause of death in people who die outside of health settings, Professorial Fellow at the University of Melbourne and Technical Advisor for the D4H Initiative, Dr Ian Riley, describes how the method has evolved from his work in the 1970s examining the efficacy of the pneumococcal vaccine in Papua New Guinea into large-scale implementation to improve CRVS in Bangladesh, China, Papua New Guinea and the Solomon Islands.
Working together to find Bangladesh's top causes of death
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
Creating accurate mortality information across China
Assistant Professor Xin Ying Zeng, China CDC; Dr Hang Li, Technical Advisor, University of Melbourne
Transforming cause of death data in the Solomon Islands
Dr Matt Reeve, Technical Advisor, University of Melbourne; Seraphina Elisha, Principal Medical Statistician; Rodley Ruskin, CRVS Country Coordinator
Sri Lankan app puts death certification in doctors' hands; Improving the quality of mortality information in Sri Lanka
Lene Mikkelsen, Technical Advisor, University of Melbourne; Dr Lakshmi Somatunga, Additional Secretary, Public Health Services, Ministry of Health; Sathasivam Sridharan, Deputy Director-General of Health Services, Management Development and Planning Unit of the Ministry of Health; Dr Vindya Kumarapeli, Research Fellow, University of Melbourne
Verbal autopsy's evolution in Tanzania
Gregory Kabadi, Country Coordinator, D4H Initiative
Zambia's CRVS system to improve using Japan's lessons
Dr Yuta Yokobori, Medical Offier, Division of Partnership Development, Department of Global Network and Partnership, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
Zambia's death coverage climbs with Data for Health
Brian Munkombwe, Health Scientist, US CDC; Chomba Mwango, Country Coordinator, D4H Initiative; Lisuba Kabanda, Senior Registrar, National Registration Passport and Citizenship
Myanmar has made great progress in strengthening CRVS. In order to maximise the impact of CRVS on improved population health and the prevention of premature death and disability, the government requires accurate, reliable, timely, and complete information on birth and death registration, including data on cause of death.
Read more about Myanmar's interventions on the CRVS Knowledge Gateway: https://crvsgateway.info/file/7601/140. All videos were filmed in July 2018 in Nay Pyi Taw, Myanmar.
Short overview
Overview of CRVS in the country, highlighting videos that provide a more in-depth understanding of their system and improvements as part of D4H
Myanmar's CRVS political commitments
Address by Dr Myint Htwe, Union Minister, Ministry of Health and Sports
A short history of CRVS in Myanmar
Presentation by Dr Wah Wah Maung, Director-General, Central Statistical Organization
Myanmar's five-year CRVS strengthening strategy
Dr Wah Wah Maung, Director, General, Central Statistical Organization
Myanmar's story of change
Khin Sandar Bo, Country Coordinator, D4H Initiative
Measuring completeness of death registration in Myanmar
Tint Pa Pa Phyo, Statistical Officer, Central Statistical Organization and University of Melbourne Fellow
Verbal autopsy: Myanmar's perspective
Interview with Dr Thuzar Chit Tin, Deputy Director General, Shan State Health Department
Bringing verbal autopsy methods to Myanmar
Interview with Sonja Firth, Technical Manager, Verbal autopsy, Myanmar, University of Melbourne D4H Initiative
Implementing verbal autopsy in Myanmar
Daw Zin Mar Oo, Ma Ei Ei Thae, D. Than Than Aye, Kalaw MCH;
Dr. Han Thi Tin Oo, Southern Shan State Public Health Department;
Daw Su Mon Oo and Daw Khin Aye Hlaing, Nan Taing RHC
Colombia has demonstrated its political commitment towards improving its CRVS system, as well as an understanding of the critical value of vital statistics for effective planning and health policy decisions.
The main issues affecting quality and completeness of vital statistics in Colombia are the lack of a strategy to detect and register vital events in rural, ethnic, and dispersed communities; management and normative guidance in the health sector to account for vital events that go unreported; and a siloed CRVS system with poor interoperability of information systems.
As part of the D4H, Colombia has identified three interventions to improve system performance, with a focus on improving the capture of vital events and quality of vital statistics data. Read more on the CRVS Knowledge Gateway: https://crvsgateway.info/file/7598/137
These interviews with CRVS stakeholders and experts were filmed in September 2017 in Bogota, Colombia. Videos are in Spanish with English subtitles.
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. Ver en Español
Building strong statistics in Colombia
Mauricio Perfetti del Corral, Director, National Administrative Department of Statistics (DANE)
The state of civil registration in Colombia
Dr Luis Fernando Criales, Deputy Registrar, National Civil Registry Office
Improving usable mortality information in Colombia
Duban Quintero, Monitoring Coordinator Public Health, Department Secretary of Cauca and Margarita Ronderos, Technical Advisor, D4H Initiative
Improving vital event records: Santander, Colombia
Alexander Torres, Vital Statistics Officer, Department of Health, Department of Santander, Colombia
Finding lost mortality data in Magdalena, Colombia
Bertha Lucia Bolano Piñedo, Vital Statistics Officer, Department of Health, Department of Magdalena
Reporting mortality data for indigenous communities and violent deaths in Arauca, Colombia
Fabio Leonardo Bello Saavedra, Vital Statistics Technician, Department of Health, Department of Arauca
Brazil has implemented a number of measures to improve the registration of vital events, and completeness of births and deaths registered by the Civil Registrar and Ministry of Health is very high (over 95%). Although national completeness estimates are high, completeness varies by region, with the North and Northeast reporting the lowest levels. Further, the quality of cause of death data needs improvement, with 33% of all deaths in 2013 attributed to an ill-defined or unusable codes. As a result, continued improvement in the quality of cause of death data is a top priority of the Ministry of Health. Read more about the D4H Interventions to improve data on the CRVS Knowledge Gateway: https://crvsgateway.info/file/7596/135
These interviews with CRVS stakeholders and experts were filmed in October 2017 in Recife, Brazil. Videos are in Portuguese with English subtitles.
Working together for better health information
Dr Fatima Marinho, Ministry of Health
Measuring completeness: Brazilian Institute of Geography and Statistics
Dr Antonio Tadeu Ribeiro de Oliveira, Researcher, Brazilian Institute of Geography and Statistics (IBGE)
Arriving at a cause of death: Death Investigation Service
Professor Luiz Fernando Ferraz da Silva, University of Sao Paolo
Development and implementation of an e-learning module on death certification
Dr Rangana Wadugedara, Medical Officer, Health Informatics, Office of Additional Secretary, Public Health Services, Ministry of Health, Sri Lanka
Estimating coverage and omission of the births and deaths register at national and subnational levels in Perú
José Llanos Solórzano, Data Analyst, National Institute of Statistics and Informatics
Analysis of the quality of cause of death data in Shanghai
Dr Chen Jun, Department of Vital Statistics, Shanghai Putuo District Center for Disease Control and Prevention
SmartVA and ANACONDA improvement in China’s CRVS system
Dr Jinlei Qi, Death Surveillance Vital Registration Chinese Center of Disease Control and Prevention
Analysis of medical records review and verbal autopsy data in Shanghai
Dr Chen Lei, Department of Vital Statistics, Shanghai Shanghai Municipal Center of Disease Control and Prevention
