1. Sources of vital statistics
Experiences from
Ethiopia and Mexico

2. 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

3. 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

4. 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

5. 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Sustainability concerns when research funding withdrawn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

6. 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

8. 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.

9. Under five mortality
Burkina Faso

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

11. Maternal mortality
Burkina Faso