Sources of vital statistics

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Presentation transcript:

Sources of vital statistics Experiences from Ethiopia and Mexico

Census Meets requirements of universal coverage, confidentiality and regular dissemination But cannot produce data with sufficient frequency to be useful for monitoring Cannot be used to generate cause-specific mortality data (experiences with maternal mortality ambiguous) No sampling errors but a number of non-sampling errors that are difficult to quantify Census data on vital events require evaluation and adjustment using demographic techniques

Household surveys Generate more detailed information than possible in the census. This helps improve accuracy Easier to ensure quality control; sampling errors can be quantified Enable cross-national analyses of associations between child mortality risks and socio-economic/ biodemographic variables Problems of quality of responses due to memory lapses, omission of events. Concerns about continuity and regular dissemination, especially as surveys are often reliant on external donors. Not suitable for generating data for small areas so do not meet criteria of universality. Can generate data to assess the performance of CR systems

Health facility records Vital events (births, deaths and foetal deaths) should be certified by a medical authority but this does not always happen in practice. Facility data biased and incomplete. Use of medical records my improve with increasing computerization and data transmission so that data can be rapidly available Essential to ensure standardization of concepts and classifications Issues of confidentiality and privacy of individual data Need coordination between health, registration and statistical authorities Important role of health sector in vital events notification/declaration

Demographic and health surveillance systems World Health Organization Demographic and health surveillance systems 1 January 2019 INDEPTH Network: 37 sites, 26 in Africa, in 19 countries. Population 50,000 to 200,000. All vital events recorded. Mainly established for research e.g. intervention trials. Sites cover small geographic areas; small, non random populations of limited generalizability. Sites become less representative over time Active surveillance : regular visits to each household Individuals gain from improved health services. Sites build capacities for surveillance, data compilation and analysis. Sustainability concerns when research funding withdrawn Individuals do not benefit from certification

Sample registration with verbal autopsy World Health Organization Sample registration with verbal autopsy 1 January 2019 Used in large populations: Bangladesh, China, India, Tanzania Random sample of surveillance sites, nationally representative Active follow-up of families to detect events. For mortality use verbal autopsy, not always WHO standard (India) Cost, sustainability. Existence of parallel sample and civil registration systems, e.g. India Individuals do not benefit, either from health services or from certification

Linking across data sources Shortcoming of civil registration data is the absence of good socioeconomic information. Linking death records to survey information, as in the National Death Index in the USA provides data on characteristics of individuals for several years before their death, thus converting cross-sectional data into prospective data. Missing from civil registration data is information about risk factors and the health status of living people, such as is provided by health examination surveys.

Under five mortality Burkina Faso

http://www.childmortality.org/cmeMain.html Under five mortality Burkina Faso http://www.childmortality.org/cmeMain.html

Maternal mortality Burkina Faso