1. Strengthening data collection on
TB Deaths/Mortality

2. Types of HIS in WPR
Strong HIS supplemented by non-routine data collection system
Relatively advanced HIS with limited non-routine information
Weak routine HIS, heavily dependent on survey information

3. ESTIMATED DEATHS AND DALYs BY SELECTED DISEASES IN 2002, WPRO
Estimated Deaths
DALYs in Millions
Rank
Total Deaths
Deaths Per day
Tuberculosis 5
986
5.95 9
HIV/AIDS 12
46 000
126
1.97 13
Diarrhoeal diseases 10
408
6.53 8
Childhood diseases* 11
53 000
145
2.26
Hepatitis
40 000
110
0.70 14
Malaria 15
11 000 30
0.43
Respiratory infections 4
1 400
8.54 6
Perinatal conditions
959
14.44
Nutritional deficiencies
26 000 71
4.36
Malignant neoplasms 2
6 342
24.82 3
Diabetes mellitus
5230
3.26
Cardiovascular diseases 1
10 458
32.34
Respiratory diseases**
4 408
15.50
Mental disorders (suicides) 7
912
6.82
Neuro-psychiatric disorders
452
46.52
* Pertussis, poliomyelitis, diphtheria, measles, tetanus Source: The WHR 2003
** Chronic obstructive pulmonary diseases and asthma.
Updated 22 April 2004

4. TB deaths reported Mongolia 598 (2000) Philippines 28038 (1998)
China (1999) selected areas
PNG 211 (1980)

5. TB deaths in Malaysia
Year Hospital TB Program Statistics Dept NA NA NA

8. Health information dept
Ministry of Health
Health information dept
Health related ministries
National statistics office
Private health care
NGO etc
Other components of HIS
Hospital information system
RPH TB
Malaria
Environmental health
Oral health
Communicable disease etc

11. Issues of concern
Underreporting (not reported or not reported correctly)
Data discrepancy from various data systems (communication problem/data sources)
Diagnostic & coding problem (skill-related)

12. What need to be done Set up one if there is none
Streamline the various systems for better estimates thro’ constant dialogue
Periodical study (e.g.cross-matching on death documentation) to assess extent of underreporting, where are the gaps of reporting
Institutionalize better coordinating mechanism between depts

13. By contrast, the WHO “requirements” for TB data have viewed by many as an obstacle to use of data by nurses and district managers in the TB program because there are so many indicators and data elements that local users get lost.
Brainstorming with TB nurses on their requirements, the Eastern Cape Department of Health developed a 12-item data list for TB to replace the 160 items that “WHO required,” but this was not acceptable due to WHO requirements. While many of these data may be useful for international comparisons (over half of the items had to do with race and age breakdowns and unusual types of TB) they confuse the user and obscure the important information on which management decisions at the clinic should be made. WHO does not clearly distinguish between its own needs and data that are recorded for local use and decision making.
More recently, an electronic, computerized TB register has been introduced to capture all the information on each patient — some 40,000 new cases in
Eastern Cape and 150,000 in South Africa annually. This will provide all the detailed information national and international managers could want, leaving space for a few simple indicators to drive case finding,
sputum exams, and early identification of dropouts in the monthly routine data set.
Source:2nd international RHINO workshop on: enhancing quality & use ofr routine health information at district level OCT 2003, Eastern Cape, South African

14. Thank You