22/07/16

Measuring cause of deaths to help achieve SDGs

Children play in the cemetery in Jenrok village
Copyright: Vlad Sokhin/Panos

Speed read

  • More than 6-in-10 deaths in many countries go unrecorded, WHO says
  • Policymakers need data on deaths to fine-tune state health strategies
  • A verbal autopsy method is now being used to collect data on deaths

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[NEW YORK] The UN’s new Sustainable Development Goals (SDGs) require countries to measure a formidable 230 indicators, a considerable challenge given that many countries are yet to collect simple data such as cause of death.

The World Health Organization (WHO) estimates that 65 per cent of deaths globally go unrecorded. In the Solomon Islands, the figure is closer to 100 per cent.

“It is estimated that about 1,800 deaths occur every year [in the Solomon Islands]. However, we don’t have a single death certificate for any of these deaths,” Dilip Hensman, WHO technical officer in the Solomon Islands, tells SciDev.Net.

Collecting information about cause of death is an important way for governments to improve their health policies, says Hensman. “It is very important that we start collecting mortality statistics to inform policymakers on better health policies.”

With a unique and changing burden of diseases, the Solomon Islands stands particularly to benefit from improved knowledge about causes of death.

“Historically, communicable diseases were rampant here, such as malaria, tuberculosis. But now the country is in transition, we’re seeing more of non-communicable diseases and also the effects of climate change, disasters and outbreaks,” says Hensman.

The Solomon Islands is just one example of a developing country where there is insufficient data for the government to know what the main causes of death are.

“There is a vast uncertainty around who’s dying of what in many populations in the world,” Alan Lopez, director of the Bloomberg Initiative for Civil Registration and Vital Statistics, tells SciDev.Net.

Lopez, who is also a laureate professor at the University of Melbourne, Australia, says that a new verbal autopsy methodology being implemented by the Bloomberg Data for Health Initiative is helping to address the gaps in knowledge about cause of death.

The verbal autopsies involve simple interviews conducted by nurses and other health workers, which collect essential information from families after their family member has died.

“Using computer algorithms and recognised patterns of the data in the symptoms that are being reported, you can correctly assign the cause of death more often than a doctor looking at that information who didn’t know the patient,” says Lopez.

Increasing the information known about cause of deaths will also help countries to measure the new SDGs, which include several goals and targets related to health.
 
However, Hensman notes that measuring the 17 goals, which have a total of 230 indicators, will be a challenge for countries like the Solomon Islands.
 
Lopez adds, the issue is that many countries lack the data needed to report on the required indicators.
 
“The problem is not the indicators, it’s the sources of data that the countries have used to measure these indicators,” he says.
 
For the Solomon Islands, which has only recently begun collecting birth registrations and still has a way to go towards improving registrations of deaths, several challenges remain, including connectivity.

“The Solomon Islands consists of 900 islands spread across the [Pacific], ranging from Papua New Guinea all the way up to Vanuatu,” says Hensman.

A lack of internet connectivity on remote islands means that some records are still paper based, requiring additional data entry at headquarters level.

“Internet connectivity is expanding gradually and the government is also negotiating for undersea fibre optic cables which the government doesn’t have at present. It’s all satellite based and expensive,” says Hensman.
 
This piece was produced by SciDev.Net’s South-East Asia & Pacific desk.