scholarly journals Investigation of ill-defined causes of death: assessment of a program's performance in a State from the Northeastern region of Brazil

2014 ◽  
Vol 17 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Elisabeth Barboza França ◽  
Carolina Cândida da Cunha ◽  
Ana Maria Nogales Vasconcelos ◽  
Juan José Cortez Escalante ◽  
Daisy Xavier de Abreu ◽  
...  
Keyword(s):  
Health Professionals ◽  
Causes Of Death ◽  
Family Health ◽  
Completion Rate ◽  
Epidemiological Surveillance ◽  
Mortality Data ◽  
Hospital Records ◽  
Brazilian Government ◽  
Probabilistic Sample

OBJECTIVE: The proportion of ill-defined causes of death (IDCD) was persistently high in some regions of Brazil in 2004. In 2005, the Brazilian government implemented a project in order to decrease this proportion, especially in higher priority states and municipalities. This study aimed to evaluate the performance of this project in Alagoas - a state from the Northeast region of Brazil. METHOD: We selected a probabilistic sample of 18 municipalities. For all IDCD identified in 2010, we collected the verbal autopsy (VA) questionnaires used for home investigation, and the Ministry of Health (MoH) form, which contains information about the final disease and cause of death taken from hospital records, autopsies, family health teams, and civil registry office records. The completion rate of the MoH form and VA was calculated using the number of deaths with specific causes assigned among investigated deaths. RESULTS: A total of 681 IDCD were recorded in 2010 in the sample, of which 26% had a MoH and/or VA3 forms completed. Although the majority of cases were attended by health professionals during the terminal disease, the completion rate was 45% using the MoH form and 80% when VA was performed. CONCLUSIONS: Our findings provide evidence that the training of the epidemiological surveillance teams in the investigation and certification of causes of death could contribute to improve the quality of mortality data.

scholarly journals Perception of health professionals about neonatal palliative care

2019 ◽  
Vol 72 (6) ◽  
pp. 1707-1714
Author(s):  
Ernestina Maria Batoca Silva ◽  
Maria José Machado Silva ◽  
Daniel Marques Silva
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Neonatal Intensive Care ◽  
Ethical Decisions ◽  
Palliative Care Teams ◽  
Pain And Suffering ◽  
Probabilistic Sample ◽  
Perception Of Health ◽  
Relational Difficulties

ABSTRACT Objective: To identify the perception of health professionals about neonatal palliative care. Method: A phenomenological qualitative study, a non-probabilistic sample, of 15 health professionals from a neonatal intensive care unit in northern Portugal. Content analysis was performed. Results: Despite their lack of training in palliative care, the health professionals showed concern for the dignity, quality of life and comfort of the newborn and family. They expressed emotional and relational difficulties in following the trajectories of serious illness and death and in the ethical decisions regarding the end-of-life. Conclusion: It is emphasized that professionals are sensitive to pain and suffering and reveal dedicated and committed in the care of the newborn and family. They are available to train and embrace the current challenges posed by the constitution of pediatric palliative care teams and to help achieve an organizational culture that advances in such care.

scholarly journals Improving the usefulness of mortality data in Brazil: reclassification of ill-defined causes of death

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E França ◽  
L Ishitani ◽  
R Teixeira ◽  
C Cunha ◽  
F Marinho
Keyword(s):  
Interpersonal Violence ◽  
Large Scale ◽  
Causes Of Death ◽  
Age Groups ◽  
Family Health ◽  
Routine Data ◽  
Population Level ◽  
Mortality Data ◽  
Access To Health Services ◽  
Underlying Causes

Abstract Background Garbage codes (GC) among registered causes of death can bias mortality analysis. In Brazil, more than one million deaths occurred annually in 2006-2017 and around 100,000 deaths per year were originally attributed to GC ill-defined causes of death (IDCD) in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade). To provide more accurate cause-of-death analysis, routine investigations of IDCD in the health surveillance system have been implemented in the country since 2005. The objective of this study was to analyze specific underlying causes for deaths originally assigned as IDCD in the SIM in 2006-2017. Methods For all IDCD (ICD codes from chapter 18, or R-codes) identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Proportions of reclassified deaths by cause-specific mortality fractions (CSMF) derived from the reclassified IDCD by age and four calendar periods were analyzed to assess specific causes detected after investigation. Results A high proportion of deaths due to IDCD was investigated in 2006-2017 (32%). From a total of 257,367 IDCD reclassified, chronic diseases (56.6%), injuries (7.2%), and infectious (5.2%) or neonatal, maternal, malnutrition (1.7%) were the underlying causes detected among IDCD. Neonatal-related conditions, interpersonal violence, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively. Conclusions High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement. Key messages Investigation of IDCD as part of routine data collection on a large scale as had occurred in Brazil in 2006-2017 is an innovative approach to strengthen population-level mortality statistics. In addition to reducing the proportions of IDCD by their reclassification into specific causes, this initiative opens up the prospect of using these results for redistributing remaining cases of IDCD.

scholarly journals Improving quality of medical certification of causes of death in health facilities in Tanzania 2014–2019

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Trust Nyondo ◽  
Gisbert Msigwa ◽  
Daniel Cobos ◽  
Gregory Kabadi ◽  
Tumaniel Macha ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Policy ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Health Facilities ◽  
Mortality Data ◽  
Medical Certification ◽  
Specific Mortality ◽  
Icd 10

Abstract Background Monitoring medically certified causes of death is essential to shape national health policies, track progress to Sustainable Development Goals, and gauge responses to epidemic and pandemic disease. The combination of electronic health information systems with new methods for data quality monitoring can facilitate quality assessments and help target quality improvement. Since 2015, Tanzania has been upgrading its Civil Registration and Vital Statistics system including efforts to improve the availability and quality of mortality data. Methods We used a computer application (ANACONDA v4.01) to assess the quality of medical certification of cause of death (MCCD) and ICD-10 coding for the underlying cause of death for 155,461 deaths from health facilities from 2014 to 2018. From 2018 to 2019, we continued quality analysis for 2690 deaths in one large administrative region 9 months before, and 9 months following MCCD quality improvement interventions. Interventions addressed governance, training, process, and practice. We assessed changes in the levels, distributions, and nature of unusable and insufficiently specified codes, and how these influenced estimates of the leading causes of death. Results 9.7% of expected annual deaths in Tanzania obtained a medically certified cause of death. Of these, 52% of MCCD ICD-10 codes were usable for health policy and planning, with no significant improvement over 5 years. Of certified deaths, 25% had unusable codes, 17% had insufficiently specified codes, and 6% were undetermined causes. Comparing the before and after intervention periods in one Region, codes usable for public health policy purposes improved from 48 to 65% within 1 year and the resulting distortions in the top twenty cause-specific mortality fractions due to unusable causes reduced from 27.4 to 13.5%. Conclusion Data from less than 5% of annual deaths in Tanzania are usable for informing policy. For deaths with medical certification, errors were prevalent in almost half. This constrains capacity to monitor the 15 SDG indicators that require cause-specific mortality. Sustainable quality assurance mechanisms and interventions can result in rapid improvements in the quality of medically certified causes of death. ANACONDA provides an effective means for evaluation of such changes and helps target interventions to remaining weaknesses.

scholarly journals Barriers to Implementation of Perinatal Death Audit in Maternity and Pediatric Hospitals in Jordan: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Yousef Khader ◽  
Mohammad Alyahya ◽  
Anwar Batieha
Keyword(s):  
Health Care ◽  
Health Information ◽  
Patient Information ◽  
Health Professionals ◽  
Perinatal Death ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Records

BACKGROUND Perinatal death audit is a feasible and cost-effective quality improvement tool that helps to improve the quality of health care and reduce perinatal deaths. Perinatal death audit is not implemented in almost all hospitals in Jordan. OBJECTIVE This study aimed to assess health professionals’ attitude toward perinatal death auditing and determine the main barriers for effective implementation of perinatal death auditing as perceived by health professionals in Jordanian hospitals. METHODS A cross-sectional study was conducted among health professionals in 4 hospitals in Jordan. All physicians (pediatricians and obstetricians) and nurses working in these hospitals were invited to participate in the study. The study questionnaire assessed the attitude of health professionals toward perinatal death audit and assessed barriers for implementation of perinatal death audit in their hospitals. RESULTS This study included a total of 84 physicians and 218 nurses working in the 4 selected maternity hospitals. Only 35% (29/84) of physicians and 36.2% (79/218) of nurses reported that perinatal death audit would help to improve the quality of prenatal health care services to a great or very great extent. Lack of time was the first-mentioned barrier for implementing perinatal death audit by both physicians (35/84, 42%) and nurses (80/218, 36.7%). Almost the same proportions of health professionals reported inadequate patient information being documented in hospital records as a barrier. Lack of a health information system was the third-mentioned barrier by health professionals. Fear of having conflicts with the family of the dead baby was reported by almost one-third of physicians and nurses. Only 28% (23/83) of physicians and 16.9% (36/213) of nurses reported that they would like to be involved in perinatal death audit in their health facilities. CONCLUSIONS Health professionals in Jordan had poor attitude toward perinatal death audit. The main barriers for implementing perinatal death audit in Jordanian hospitals were lack of time, inadequate patient information being documented in hospital records, and lack of health information systems.

scholarly journals Investigation of hospital deaths declared as garbage codes in Belo Horizonte, Brazil, in 2017

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Corrêa ◽  
L Ishitani ◽  
S Lansky ◽  
M Santos ◽  
R Teixeira ◽  
...  
Keyword(s):  
Public Health ◽  
Causes Of Death ◽  
Heart Diseases ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
Mortality Statistics ◽  
Obstructive Pulmonary Disease ◽  
Belo Horizonte ◽  
The Impact

Abstract Background Improving the quality of causes of death (COD) is vital for defining adequate public policies. In Brazil, one third of deaths are reported as having a cause that is not useful for public health analysis of cause-of-death data, the so-called garbage codes (GC). The investigation of these deaths is one of the strategies that could improve the quality of mortality statistics in the country. Methods For all GCs identified in 2017 in the routine mortality information system from Belo Horizonte city, Brazil, municipal health professionals collected information about the final disease obtained from hospital records or autopsies in a standardized form. A trained physician analyzed this information and filled in a new death certificate (DC). The DC that originally showed a GC as an underlying COD was categorized into GC reclassified when the garbage cause changed to a specific cause after investigation. Causes of death derived from the reclassified GCs were analyzed to assess the impact on the mortality profile before and after the investigation. Results In Belo Horizonte, 1,395 deaths out of 3,038 registered as garbage codes were investigated, with a 35% reduction in deaths due to these causes. There was an increase in deaths from ischemic heart diseases, Alzheimer's disease, chronic obstructive pulmonary disease, hemorrhagic and ischemic stroke, and violence. Conclusions The investigation of deaths from garbage codes modified the mortality profile and improved its quality, providing direction for more assertive public health policies. Strategies for training physicians to report specific causes of death is another strategy that could improve the quality of mortality data. Key messages This study proved to be a feasible strategy in improving the quality of causes of death in mortality statistics and should be incorporated into the surveillance routine activities in Brazil. The evaluation of the GC investigation is an important instrument in helping management of health interventions aiming at better quality of information and more qualified health services.

scholarly journals Family Planning in a Family Health Unit

2010 ◽  
Vol 18 (6) ◽  
pp. 1161-1168 ◽  
Author(s):  
Luzia Aparecida dos Santos Pierre ◽  
Maria José Clapis
Keyword(s):  
Family Planning ◽  
Health Professionals ◽  
Family Health ◽  
Study Data ◽  
Health Unit ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
The Family ◽  
Sexual And Reproductive Rights

The aim of this study was to identify the care provided by health professionals who work in family planning, in a Family Health Unit in the municipality of Ribeirao Preto, São Paulo. This was a descriptive, cross-sectional and quali-quantitative study. Data were collected through interviews with 11 health professionals. The results revealed that most professionals had not received training in family planning, and that information about contraceptive methods is transmitted in an individual way, having women as the target-public. The contraceptive methods which the professionals suggest and offer more are those considered most effective. These findings indicate that family planning care at the Family Health Unit needs to be adjusted not only to ensure quality of service, but also to ensure sexual and reproductive rights.

scholarly journals Intersectoral collaboration to promote child development: mapping the relationships

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A P G Chiari ◽  
A R S Soares ◽  
G C Cury ◽  
C R L Alves ◽  
M I B Senna ◽  
...  
Keyword(s):  
Child Development ◽  
Health Services ◽  
Health Professionals ◽  
Social Protection ◽  
Health Sector ◽  
Family Health ◽  
Minas Gerais ◽  
Central Position ◽  
Intersectoral Collaboration

Abstract Integrated and intersectoral interventions early in life have the greatest potential to address social inequities, ensuring better opportunities for access to child development support services. The “Projeto Nascente” (Universidade Federal de Minas Gerais and Ministry of Health, Brazil) sought to qualify health and other sectors professionals in actions to promote and monitor early child development, in primary health care. One of its focuses was to stimulate the intersectoral actions to promote child development. The research analyzed the intersectoral network in 31 municipalities in the State of Minas Gerais, Brazil, participating in the 'Projeto Nascente'. A case study with a qualitative approach was developed using document research on the professionals' perception regarding intersectoral networking. The material was ecomaps elaborated by professionals during the training of the “Projeto Nascente”. The ecomaps represented the local intersectoral networks. Initially, 29 ecomaps from eleven municipalities were analyzed. Social Protection, Education, Sports, Culture, churches and non-governmental organizations were cited. Other health services were also included. All ecomaps were represented with the family health team in a central position with the other services around them. In municipalities with more than one ecomap, there was no uniformity neither in the services nor in the quality of the relationships represented. A closer relationship between Education and Social Protection was noticed. However, the quality of the relationships often seemed stressful. Health professionals reported that they invest more energy in relationships than other sectors. Sport and Culture, although less mentioned, seem to be potential partners for new collaborations. The emergence of other health services seems to reflect the fragmentation of the health sector, as well as evidence of the conceptual confusion surrounding intersectoral collaboration. Key messages The identification and mapping of the services networking aimed at promoting child development are essential steps in the process of stimulating and reflecting on intersectoral collaboration. The centrality and self-perceived protagonism of the health professionals may not be the best way to involve and count on the participation of other sectors in intersectoral collaboration.

Evaluation of civil registration and vital statistics system in the Maldives: Focus on mortality statistics

2020 ◽  
Vol 36 (4) ◽  
pp. 933-941
Author(s):  
Sofoora Kawsar Usman ◽  
Sheena Moosa
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Time Lag ◽  
International Classification Of Diseases ◽  
Vital Statistics ◽  
Mortality Data ◽  
Death Registration ◽  
Quality Of Data ◽  
Civil Registration

An efficient Civil Registration and Vital Statistics (CRVS) system is a development imperative. Data on death registration and causes of death are important for measuring health outcomes. This paper evaluates the completeness and quality of data on death registration and causes of death (CoD) based on analysis of the registration records on death and causes of death for the period 2009–2018. Using established methods and approaches, we observed that CRVS system performed well on death registration completeness, quality of age and sex reporting. However, the quality of cause of death data was poor with 50% of the International Classification of Diseases (ICD) codes classified as “major garbage codes” and significant time lag was observed in the transmission and production of vital statistics. The CRVS system in Maldives is complete with all deaths occurring within its territory registered and causes of death recorded. The two areas that require attention are the time taken for publication of vital statistics and quality of cause of death reporting. Appropriate re-engineering of the existing business process can build real-time mortality data, and regular quality assessment of death certificates with feedback to health facilities can bring sustained improvements in quality of vital statistics.

scholarly journals Risk factors for the ill-defined causes of death in the Brazilian states: a multilevel analysis

2018 ◽  
Vol 23 (11) ◽  
pp. 3979-3988 ◽  
Author(s):  
Nádia Cristina Pinheiro Rodrigues ◽  
Regina Paiva Daumas ◽  
Andréa Sobral de Almeida ◽  
Gisele O’Dwyer ◽  
Mônica Kramer de Noronha Andrade ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Age Groups ◽  
Poisson Model ◽  
Mortality Data ◽  
Age Group ◽  
Socioeconomic Conditions ◽  
The Past ◽  
The North ◽  
Socioeconomic Data

Abstract This study describes the spatial-temporal changes of the proportion of ill-defined causes of death in Brazil (1998-2012) and investigates which demographic and socioeconomic factors affect this proportion. We collected information of the proportion of ill-defined causes of death by age (15-59 years), sex, period, locality, and socioeconomic data. We used a multilevel Poisson model to investigate which factors affect the risk of ill-defined causes of death. Unlike states located in the South and Midwest, we detected clusters with high proportional levels of these deaths in states in the North and Northeast regions. A greater proportion occurred in 1998-2002 (0.09), in the North and Northeast (0.14 and 0.12, respectively), in older age groups (0.09), and in places with poor socioeconomic conditions. The adjusted analysis showed differences in proportion according to the region, age, period, schooling, social inequality, and income. The results indicate that the lower the age group and the better the socioeconomic situation, the lower the risk to register the cause of death as ill-defined. Although over the past years, the quality of Brazil’s mortality data has gradually increased, investments towards improving mortality registries cannot be discontinued.

scholarly journals O PAPEL DA INTERPROFISSIONALIDADE NO CUIDADO DA PESSOA IDOSA: UM RELATO DE EXPERIÊNCIA

2020 ◽  
Vol 7 (1) ◽  
pp. 71-77
Author(s):  
Guilherme Parreira Vaz ◽  
Evandro Leite Bitencourt
Keyword(s):  
Health Professionals ◽  
Health Workers ◽  
Family Health ◽  
The Elderly ◽  
Descriptive Study ◽  
Unified Health System ◽  
Care For The Elderly ◽  
De Medicina

RESUMO Qual o papel da interprofissionalidade no cuidado da pessoa idosa? Partindo desse questionamento, o objetivo deste artigo é descrever e discutir as funções desempenhadas pelo trabalho interprofissional em saúde para o cuidado do público idoso. Para tal, foram descritas e interpretadas experiências vivenciadas por um grupo de estudantes da disciplina de Saúde da Família I, do curso de Medicina da Universidade Federal do Tocantins, Câmpus Palmas-TO. Na metodologia foi utilizado um estudo descritivo do tipo relato de experiência a partir das aulas práticas realizadas no Parque Municipal da Pessoa Idosa Francisco Xavier do município de Palmas. Os resultados apontam para a necessidade de aprimoramento da interprofisionalidade nas equipes de saúde pelos seguintes motivos: a existência de especificidades para o cuidado do idoso dependentes da atuação interprofissional; a melhoria da humanização na saúde ser potencializada pelo trabalho integrado, assim como o papel formativo e socializador da interdisciplinaridade para se garantir a autonomia e qualidade de vida na terceira idade. O trabalho permitiu ainda a reflexão sobre a formação dos profissionais de saúde, sendo importante por ressaltar necessidade de capacitação dos servidores da saúde para a execução eficaz dos princípios defendidos pelo Sistema Único de Saúde (SUS). Palavras- Chave: Interprofissionalidade.  Saúde.  Idoso. ABSTRACT What is the role of interprofessionalism in the care of the elderly? Based on this questioning, the purpose of this article is to describe and discuss the functions performed by interprofessional work in health care for the elderly public. For that, experiences were experienced and interpreted by a group of students of the discipline of Family Health I, of the Medicine course of the Federal University of Tocantins, Palmas-TO campus. In the methodology was used a descriptive study of the type of experience report from the practical classes held in the Municipal Park of the Elderly Francisco Xavier of the municipality of Palmas. The results point to the need to improve interprofisionality in health teams for the following reasons: the existence of specifics for the care of the elderly dependent on interprofessional work; the improvement of humanization in health will be enhanced by integrated work, as well as the formative and socializing role of interdisciplinarity to guarantee autonomy and quality of life in the elderly. The work also allowed for reflection on the training of health professionals, and it is important to emphasize the need for training of health workers for the effective execution of the principles defended by the Unified Health System (SUS). Keywords: Interprofessionality. Health. Elderly.

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