Ascertaining Cause of non-Facility Deaths and Associated Demographic Characteristics: An Application of Verbal Autopsy in Routine Civil Registration in Lusaka District of Zambia

Abstract BACKGROUND: Ascertaining the cause for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are poor or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution 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 the “brought-in-dead” cases at Lusaka’s two major 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 for each cause. Demographic characteristics associated with each cause were analyzed. RESULTS: Opportunistic infections associated with HIV/AIDS such as pneumonia, tuberculosis and malaria were among leading causes of deaths among cases of “brought-in-dead”. Over 21% and 27% of deaths were attributable to external causes and non-communicable diseases, 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 poor civil registration system.

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Application of verbal autopsy in routine civil registration in Lusaka District of Zambia

BMC Health Services Research ◽

10.1186/s12913-021-06427-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

C. Chabila Mapoma ◽

Brian Munkombwe ◽

Chomba Mwango ◽

Bupe Bwalya Bwalya ◽

Audrey Kalindi ◽

...

Keyword(s):

Middle Ages ◽

Cause Of Death ◽

Verbal Autopsy ◽

Opportunistic Infections ◽

Civil Registration System ◽

Registration System ◽

Civil Registration ◽

Major Teaching Hospital ◽

External Causes ◽

Causes Of Deaths

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.

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India’s Civil Registration System: a potentially viable data source for reliable subnational mortality measurement

10.1101/2020.04.03.20052894 ◽

2020 ◽

Author(s):

Chalapati Rao ◽

Mamta Kansal

Keyword(s):

Cause Of Death ◽

Civil Registration System ◽

Registration System ◽

Civil Registration ◽

Medical Certification ◽

Sample Registration System ◽

Reliable Source ◽

Data Source ◽

Near Future

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

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Addressing the rising cause of death due to diseases of the circulatory system geared towards achieving SDG 3: evidence from data on medical certification of cause of deaths in Rajasthan State, India: 1999-2015

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20175779 ◽

2017 ◽

Vol 5 (1) ◽

pp. 182 ◽

Cited By ~ 1

Author(s):

Manoj Kumar Raut ◽

Ananta Basudev Sahu

Keyword(s):

Cause Of Death ◽

Estimation Method ◽

Well Being ◽

Chronic Respiratory Disease ◽

Civil Registration System ◽

Registration System ◽

Civil Registration ◽

Medical Certification ◽

Cause Of Deaths ◽

Circulatory Diseases

Background: Medical certification of cause of death (MCCD) scheme is imperative tool to obtain scientific and reliable information in terms causes of mortality. The office of the registrar general of India (ORGI) initiated the scheme on MCCD under civil registration system (CRS), during the third five year plan. Methods: This paper analyzes the data for the last 16 years for MCCD in Rajasthan from 1999 to 2015. The findings are based on more than half a million deaths, for which cause of death data is reported. The per cent of cause of deaths have been computed and the curve estimation method has been used to project the cause of death due to circulatory diseases. Results: The data reveals that the percentage of medically certified deaths hovers around 10 to 13 percent during 1999 to 2015 of the total deaths registered under the civil registration system, which is about 5 million deaths. The highest percentage of deaths that has been medically certified is due to circulatory diseases as seen for the combined period of sixteen years (1999-2015) (21 percent) followed by deaths due to certain infectious and parasitic diseases (16 percent). This has increased from 13.8 per cent in 1999 to 20.2 per cent in 2015. This proportion has been projected upto 2030, the target year of achievement of Sustainable Development Goals (SDGs). Conclusions: Addressing this cause, could help in the achievement of indicator of 3.4.1, mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease under the target of reducing by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being by 2030 subsumed under the SDG 3 of ensuring healthy lives and promote well-being for all at all ages.

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Routine mortality surveillance to identify the cause of death pattern for out-of-hospital adult (aged 12+ years) deaths in Bangladesh: introduction of automated verbal autopsy

BMC Public Health ◽

10.1186/s12889-021-10468-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Md. Toufiq Hassan Shawon ◽

Shah Ali Akbar Ashrafi ◽

Abul Kalam Azad ◽

Sonja M. Firth ◽

Hafizur Chowdhury ◽

...

Keyword(s):

Verbal Autopsy ◽

Software Tool ◽

Relevant Information ◽

Chronic Respiratory Disease ◽

Death Registration ◽

Registration System ◽

Health Programming ◽

Performance And Evaluation ◽

Disease Study ◽

Causes Of Deaths

Abstract Background In Bangladesh, a poorly functioning national system of registering deaths and determining their causes leaves the country without important information on which to inform health programming, particularly for the 85% of deaths that occur in the community. In 2017, an improved death registration system and automated verbal autopsy (VA) were introduced to 13 upazilas to assess the utility of VA as a routine source of policy-relevant information and to identify leading causes of deaths (COD) in rural Bangladesh. Methods Data from 22,535 VAs, collected in 12 upazilas between October 2017 and August 2019, were assigned a COD using the SmartVA Analyze 2.0 computer algorithm. The plausibility of the VA results was assessed using a series of demographic and epidemiological checks in the Verbal Autopsy Interpretation, Performance and Evaluation Resource (VIPER) software tool. Results Completeness of community death reporting was 65%. The vast majority (85%) of adult deaths were due to non-communicable diseases, with ischemic heart disease, stroke and chronic respiratory disease comprising about 60% alone. Leading COD were broadly consistent with Global Burden of Disease study estimates. Conclusions Routine VA collection using automated methods is feasible, can produce plausible results and provides critical information on community COD in Bangladesh. Routine VA and VIPER have potential application to countries with weak death registration systems.

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The Danish Civil Registration System

Scandinavian Journal of Public Health ◽

10.1177/1403494810387965 ◽

2011 ◽

Vol 39 (7_suppl) ◽

pp. 22-25 ◽

Cited By ~ 1845

Author(s):

Carsten Bøcker Pedersen

Keyword(s):

Civil Registration System ◽

Registration System ◽

Civil Registration ◽

Danish Civil Registration System

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Civil registration system (CRS) for birth and death registration in Assam – A rapid assessment

Clinical Epidemiology and Global Health ◽

10.1016/j.cegh.2019.05.006 ◽

2020 ◽

Vol 8 (1) ◽

pp. 117-122

Author(s):

Tushar Manohar Rane ◽

Tulika Goswami Mahanta ◽

Safikul Islam ◽

Pranjal Pratim Gogoi ◽

Bivash Gogoi

Keyword(s):

Rapid Assessment ◽

Death Registration ◽

Civil Registration System ◽

Registration System ◽

Civil Registration

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Employment, disability pension and income for children with parental multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458516672016 ◽

2016 ◽

Vol 23 (8) ◽

pp. 1148-1156 ◽

Cited By ~ 6

Author(s):

Julie Yoon Moberg ◽

Bjarne Laursen ◽

Nils Koch-Henriksen ◽

Lau Caspar Thygesen ◽

Anne Brødsgaard ◽

...

Keyword(s):

Multiple Sclerosis ◽

Low Income ◽

Disability Pension ◽

Adult Life ◽

Offspring Cohort ◽

Civil Registration System ◽

Registration System ◽

Civil Registration ◽

Employment Disability ◽

The Mean

Background: Little is known about the consequences of parental multiple sclerosis (MS) on offspring’s socioeconomic circumstances. Objective: To investigate employment, disability pension and income in offspring of parents with MS compared with matched reference persons in a nationwide register-based cohort study. Methods: All Danish-born persons with onset of MS during 1950–1986 were retrieved from the Danish Multiple Sclerosis Registry. Their offspring were identified using the Civil Registration System. One random offspring from each sibship was matched by sex and year of birth with eight random reference persons. Results: We included 2456 MS offspring and 19,648 reference persons. At age 30, employment was lower among MS offspring than reference children (odds ratio (OR): 0.89; 95% confidence interval (CI): 0.84–0.95; p = 0.0003), and they more often received disability pension (OR: 1.31; 95% CI: 1.15–1.50; p < 0.0001) at ages 30 and 40 but not at age 50. Although the mean income was not significantly lower for the MS offspring cohort, most of them attained an annual personal income below 250,000 DKK (Danish krone), that is, ~33,650 EUR (OR: 0.91; 95% CI: 0.84–0.99; p = 0.04). Conclusion: Having had a parent with MS may affect employment and increase the risk of disability pension and low income in adult life.

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Strengthening Civil Registration System in AP, India: Lessons from a 4 Year Study

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v6i1.5170 ◽

2014 ◽

Vol 6 (1) ◽

Author(s):

Jayaram Madala ◽

Srikrishna Sulgodu Ramachandra

Keyword(s):

Civil Registration System ◽

Registration System ◽

Civil Registration ◽

Factors Influencing ◽

Inter State

Civil Registration System (CRS) in India has been in vogue for more than 100 years now. Even after 4 decades of the enactment of the Act, there are wide inter-state and intra-state variations. Objectives 1. To assess the district wise reporting and registrations of births and deaths in AP from 2007 - 2010. 2. To make an urban vs. rural comparison of proportions of these registrations. 3. To identify factors influencing civil registration in AP and steps for strengthening CRS. The article discusses, determinants of civil registration in India & strategies for strengthening reporting & registrations.

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