scholarly journals The civil registration system is a potentially viable data source for reliable subnational mortality measurement in India

2020 ◽  
Vol 5 (8) ◽  
pp. e002586 ◽  
Author(s):  
Chalapati Rao ◽  
Mamta Gupta

IntroductionThe Indian national Civil Registration System (CRS) is the optimal data source for subnational mortality measurement, but is yet under development. As an alternative, data from the Sample Registration System (SRS), which covers less than 1% of the national population, is used. This article presents a comparison of mortality measures from the SRS and CRS in 2017, and explores the potential of the CRS to meet these subnational data needs.MethodsData on population and deaths by age and sex for 2017 from each source were used to compute national-level and state-level life tables. Sex-specific ratios of death probabilities in five age categories (0–4, 5–14, 15–29, 30–69, 70–84) were used to evaluate CRS data completeness using SRS probabilities as reference values. The quality of medically certified causes of death was assessed through hospital reporting coverage and proportions of deaths registered with ill-defined causes from each state.ResultsThe CRS operates through an extensive infrastructure with high reporting coverage, but child deaths are uniformly under-reported, as are female deaths in many states. However, at ages 30–69 years, CRS death probabilities are higher than the SRS values in 15 states for males and 10 states for females. SRS death probabilities are of limited precision for measuring mortality trends and differentials. Data on medically certified causes of death are of limited use due to low hospital reporting coverage.ConclusionsThe Indian CRS is more reliable than the SRS for measuring adult mortality in several states. Targeted initiatives to improve the recording of child and female deaths, to strengthen the reporting and quality of medically certified causes of death, and to promote use of verbal autopsy methods can establish the CRS as a reliable source of subnational mortality statistics in the near future.

2020 ◽  
Author(s):  
Chalapati Rao ◽  
Mamta Kansal

ABSTRACTIntroductionThe Indian national Civil Registration System (CRS) is the optimal data source for mortality measurement, but is yet under development. As an alternative, data from the Sample Registration System (SRS) which covers less than 1% of the national population is used. This article presents a comparative analysis of mortality measures from the SRS and CRS in 2017, and explores the potential of the CRS to meet these subnational data needs.MethodsData on population and deaths by age and sex for 2017 from each source were used to compute national and state level life tables. Sex specific ratios of death probabilities in five age categories (0-4, 5-14, 15-29, 30-69, 70 -84, 85+) were used to evaluate CRS data completeness, using SRS probabilities as reference values. The quality of medically certified causes of death was assessed through hospital reporting coverage and proportions of deaths registered with ill-defined causes from each state.ResultsThe CRS operates through an extensive infrastructure with high reporting coverage, but child deaths are uniformly under reported, as well as female deaths in some states. However, at ages 30 to 69 years, CRS death probabilities are higher than the SRS values in 15 states in males and 10 states in females. SRS death probabilities are of limited precision for measuring mortality trends and differentials. Medical certification of cause of death is affected by low hospital reporting coverage.ConclusionsThe Indian CRS is more reliable than the SRS for measuring adult mortality in several states. Targeted initiatives to improve the recording of child and female deaths, to strengthen the quality of medical certification of cause of death, and to promote use of verbal autopsy methods are necessary to establish the CRS as a reliable source of sub national mortality statistics in the near future.KEY MESSAGESThe Sample Registration System (SRS) is currently the main source of mortality statistics in India, since the Civil Registration System (CRS) is yet under developmentLimitations in sample size as well as problems with quality of causes of death result in considerable uncertainty in population level mortality estimates from the SRSThis research evaluated the quality of the sex and age specific mortality risks from the CRS, using the SRS values in each state as reference valuesThe CRS has high levels of reporting coverage for death registration, and also measures higher levels of mortality at ages 30 to 69 years in several states, with high precisionInterventions are required to improve child death registration, strengthen medical certification of cause of death in hospitals, and introduce verbal autopsy for home deathsThese interventions will establish the CRS as a routine and reliable source for national and subnational mortality measurement in India in the near future


Author(s):  
Jan Mainz ◽  
Mikkel Hagen Hess ◽  
Søren Paaske Johnsen

Abstract All countries want to improve the health of their populations and to improve the quality of care and patient safety. Consequently, there is an ongoing need to assess and document population health, the quality of care and patient safety using valid and reliable data. This requires the ability to monitor the same individuals over time as they receive prevention, diagnostics, treatments, care and rehabilitation and experience improvements or deteriorations in their health or healthcare. This is, however, a challenge for most healthcare systems. A prerequisite to such data is the unique personal identifier. This perspective on quality paper describes the experience with the unique personal identifier in Denmark, based on the Danish Civil Registration System (DCRS) as a tool for research in epidemiology, health services research, quality improvement and patient safety. DCRS has been celebrating its 50 years anniversary.


2021 ◽  
Author(s):  
Anuj Kumar Pandey ◽  
Diksha Gautam ◽  
Benson Thomas M ◽  
Yogita Kharakwal

AbstractBackgroundThe medical certification of cause of death (MCCD) under Civil Registration System (CRS) has been implemented in the States/UTs in a phased manner to provide data on cause of death but due to incomplete coverage and inadequate quality of civil registration data and medically certified data system, use of this data has been compromised. The completeness of registration of death (CoRD) and completeness of medically certified deaths were assessed from 2010 to 2019 at state level to understand their current status and trend over time and also to identify gaps in data to improve data quality.MethodsCoRD and CoMeRD for each year for each state was calculated from the CRS reports and MCCD reports respectively for the period 2010-2019. Data were analyzed nationally as per geographical region and individual state. Union Territories excluding Delhi and Telangana have not been considered in this analysis.ResultsThe CoRD in India have increased in the CRS from 66.9% in 2010 to 92 percent in 2019, a significant increase of 37.7% over 9 years (P<0.001) whereas India has not witnessed a substantial increase in the CoMeRD in MCCD which has increased from 17.1% in 2010 to only 20.6% in 2019. Among the 29 States, 18 (62%) had CoRD >95 percent in 2019, with 15 states recording 100 percent of CoRD however just 3 states (10.3%) have CoMeRD more than 50% namely Goa (100%), Manipur (67.3%) and Delhi (61.7%).Interpretation & conclusionsDespite the significant progress made in CoRD in India, importance of medical certification cannot be undermined; critical differences between the States within the CRS and MCCD remain a cause of concern. Concentrated efforts to assess the strengths and weaknesses at the State level of the MCCD and CRS processes, quality of data and plausibility of information generated are needed in India.


2017 ◽  
Vol 7 (3) ◽  
pp. 410-425
Author(s):  
Manoj Kumar Rau ◽  
Ananta Basudev Sahub

In India, Civil registration was initiated under the registration of births and deaths act,1969 to give reliable estimates of fertility and mortality situation for the nation up to the lowest administrative levels, but due to its inadequate and underreporting, still the Sample Registration System is used to generate reliable indicators of fertility and mortality. In this paper, an attempt is made to compute certain indicators from the civil registration system for the period of 2001-14 in the State of Rajasthan, India. The major SDG indicators of goal 3 of ensuring healthy lives and promoting well-being for all at all ages; targets 3.1 (By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births) and 3.2 (By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births) with indicators of Under-five Mortality Rate (indicator 3.2.1) and Maternal Mortality Ratio (indicator 3.1.1) and other fertility and mortality indicators can be computed, if certain denominator bases are available every year. As the civil registration data has not been classified by the place of residence, it is not strictly comparable to SRS figures. But it has been presented here so as to serve as an indication and for the improvement of the system for generation of reliable vital rates at subnational levels using civil registration data, which is the need of the day for planning purposes for programme managers and policy makers.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. Chabila Mapoma ◽  
Brian Munkombwe ◽  
Chomba Mwango ◽  
Bupe Bwalya Bwalya ◽  
Audrey Kalindi ◽  
...  

Abstract Background Ascertaining the causes for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are not well developed or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution to determine the cause of death. We conducted a demonstration project in Lusaka District of Zambia where verbal autopsy (VA) method was implemented in routine civil registration system. Methods About 3400 VA interviews were conducted for bodies “brought-in-dead” at Lusaka’s two major teaching hospital mortuaries using a SmartVA questionnaire between October 2017 and September 2018. Probable underlying causes of deaths using VA and cause-specific mortality fractions were determined.. Demographic characteristics were analyzed for each VA-ascertained cause of death. Results Opportunistic infections (OIs) associated with HIV/AIDS such as pneumonia and tuberculosis, and malaria were among leading causes of deaths among bodies “brought-in-dead”. Over 21.6 and 26.9% of deaths were attributable to external causes and non-communicable diseases (NCDs), respectively. The VA-ascertained causes of death varied by age-group and sex. External causes were more prevalent among males in middle ages (put an age range like 30–54 years old) and NCDs highly prevalent among those aged 55 years and older. Conclusions VA application in civil registration system can provide the much-needed cause of death information for non-facility deaths in countries with under-developed or non-functional civil registration systems.


2020 ◽  
Author(s):  
Niloofar Peykari ◽  
Sahar Saeedi Moghaddam ◽  
Nazila Rezaei ◽  
Anita Mansouri ◽  
Shohreh Naderimagham ◽  
...  

Abstract Background Following global commitments to prevent and control non-communicable diseases, we sought to estimate national and sub-national trends in diabetes mortality in Iran and to assess its association with socioeconomic factors.Methods To assess the correlation between diabetes mortality and socioeconomic factors we used data obtained from the Death Registration System (DRS), the spatio-temporal model and Gaussian Process Regression (GPR) levels and the diabetes mortality trends, which were estimated by sex, age and year at national and sub-national levels from 1990 to 2015.Results Between the years 1990 and 2015, the age-standardized diabetes mortality rate (per 100,000) increased from 3.40 (95% UI: 2.33 to 4.99) to 7.72 (95% UI: 5.51 to 10.78) in males and from 4.66 (95% UI: 3.23 to 6.76) to 10.38 (95% UI: 7.54 to 14.23) in females. In 1990, the difference between the highest age-standardized diabetes mortality rate among males was 3.88 times greater than the lowest (5.97 vs. 1.54) and in 2015 this difference was 3.96 times greater (14.65 vs. 3.70). This provincial difference was higher among females and was 5.13 times greater in 1990 (8.41 vs. 1.64) and 5.04 times greater in 2015 (19.87 vs. 3.94). The rate of diabetes mortality rose with urbanization, yet declined with an increase in wealth and years of schooling as the main socio-economic factors.Conclusion The rising trend of diabetes mortality rate at national level and the sub-national disparities associated with socioeconomic status in Iran warrant the implementation of specific interventions recommended by the ‘25 by 25’ goal.


2020 ◽  
Vol 8 (1) ◽  
pp. 117-122
Author(s):  
Tushar Manohar Rane ◽  
Tulika Goswami Mahanta ◽  
Safikul Islam ◽  
Pranjal Pratim Gogoi ◽  
Bivash Gogoi

2018 ◽  
Vol 3 (4) ◽  
pp. 336-366 ◽  
Author(s):  
Rollin F Tusalem

Migrant remittances have been linked to improving the quality of government and political accountability in the developing world. The argument is that migrants have the capacity to withhold remittances to their families when they deem that their local governments are blighted with corruption and bureaucratic inefficiency. Relatedly, migrants also empower citizens in sub-national regions by providing funds to family members who become less beholden to clientistic ties with political parties which concomitantly foster state-level corruption. Thus, relatives of migrants also become social agents who will increasingly expect better governmental performance and demand higher levels of political accountability at the sub-national level. Using data provided by the Philippine National Statistics Office and the National Statistical Coordinating Board of the Philippines (NSCB hereafter), the study provides empirical evidence that the number of migrants (by province) and the amount of remittances sent by migrants are positively associated with governmental effectiveness and higher levels of human development at the provincial level. It is also found that opportunistic shirking on the part of the sub-national governments is also not occurring, as remittances also induce provincial governments to spend more on their citizens, which will likely lead to better public goods provision. The overall findings imply that just like their counterparts from other developing countries, Filipino migrants are agents of democratic accountability.


2019 ◽  
pp. 088626051988386
Author(s):  
Man Amanat ◽  
Khatereh Naghdi ◽  
Sahar Saeedi Moghaddam ◽  
Naser Ahmadi ◽  
Nazila Rezaei ◽  
...  

Interpersonal violence (IPV) is a major public health concern with a significant impact on physical and mental health. This study was designed to evaluate age–sex-specific IPV mortality trends and the assault mechanisms (firearm, sharp objects, and other means), at national and provincial levels, in Iran. We used the Iranian Death Registration System (DRS) and the population and housing censuses in this analysis. Spatio-temporal and Gaussian Process Regression methods were used to adjust for inconsistencies at the provincial level and to integrate data from various sources. After assessing their validity, all records were reclassified according to the International Classification of Diseases, 10th Revision (ICD-10). All ICD-10 codes were then mapped to Global Burden of Disease (GBD) 2013 coding. More than 700 individuals died due to IPV in 1990 and more than twice this number in 2015. The IPV mortality age-standardized rate, per 100,000, increased from 1.62 (95% Uncertainty Interval [UI] = [0.96, 2.75]) in 1990 to 1.81 [1.15, 2.89] in 2015. Among females, the age-standardized mortality rate at national level per 100,000 due to IPV was 1.27 [0.66, 2.43] in 1990 and decreased to 1.08 [0.60, 1.96] in 2015. Among males, the age-standardized mortality rate was 1.96 [1.25, 3.09] in 1990 rising to 2.54 [1.70, 3.82] in 2015. Data from provinces revealed that during the period of our study, Hormozgan province had the largest increase of IPV among females, and Fars province had the largest increase of IPV among males. Conversely, the largest decrease was detected in West Azarbaijan and Qom provinces in females and males, respectively. This study showed a wide variation in the incidence and trends of IPV in Iran by age, sex, and location. The study has provided valuable information to reduce the burden of IPV in Iran and a means to monitor future progress through repeated analyses of the trends.


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