Sources of vital statistics Experiences from Ethiopia and

Sources of vital statistics Experiences from Ethiopia and Mexico 1| June 6, 2021

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 2| June 6, 2021

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 3| June 6, 2021

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 4| June 6, 2021

Demographic and health surveillance systems § 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 5| June 6, 2021

Sample registration with verbal autopsy § 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 6| June 6, 2021

7| June 6, 2021

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. 8| June 6, 2021

Under five mortality Burkina Faso 9| June 6, 2021

Under five mortality Burkina Faso 10 | June 6, 2021 http: //www. childmortality. org/cme. Main. html

Maternal mortality Burkina Faso 11 | June 6, 2021

12 | June 6, 2021