Lene Mikkelsen

The University of Queensland | UQ

Objective To evaluate the utility and quality of death registration data across countries. Methods We compiled routine death and cause of death statistics data from 2015–2019 from national authorities. We estimated completeness of death registration using the Adair-Lopez empirical method. The quality of cause of death data was assessed by evaluati...

Objective To assess civil registration and vital statistics completeness for births in World Health Organization’s Member States and identify data completeness gaps. Methods For the 194 Member States, we sourced birth registration data from the United Nations Children’s Fund database of national surveys, and, where available, vital registration re...

Objective To assess the current state of the world’s civil registration and vital statistics systems based on publicly available data and to propose strategic development pathways, including priority interventions, for countries at different levels of civil registration and vital statistics performance. Methods We applied a performance assessment...

Garbage codes, such as external causes with no specific information, indicate poor quality cause of death data. Investigation of garbage codes via an effective instrument is necessary to convert them into useful data for public health. This study analyzed the performance and suitability of the new investigation of deaths from external causes (IDEC)...

Background Correct certification of causes of death by physicians according to International Classification of Diseases (ICD) rules is essential to generate mortality statistics of the quality needed to guide public health policy debates and reliably monitor the impact of health interventions. Several efforts to train doctors have been undertaken i...

Background Correct certification of cause of death by physicians (i.e. completing the medical certificate of cause of death or MCCOD) and correct coding according to International Classification of Diseases (ICD) rules are essential to produce quality mortality statistics to inform health policy. Despite clear guidelines, errors in medical certific...

This paper describes the lessons from scaling up a verbal autopsy (VA) intervention to improve data about causes of death according to a nine-domain framework: governance, design, operations, human resources, financing, infrastructure, logistics, information technologies and data quality assurance. We use experiences from China, Myanmar, Papua New...

Introduction: Recent studies suggest that more male than female deaths are registered and a higher proportion of female deaths are certified as 'garbage' causes (ie, vague or ill-defined causes of limited policy value). This can reduce the utility of sex-specific mortality statistics for governments to address health problems. To assess whether th...

The civil registration and vital statistics system is the most comprehensive source of data on mortality used to inform health policy in Maldives. The objective of this study is to assess the quality of the civil registration and vital statistics data and recommend improvements. The electronic tool ANACONDA was used to evaluate completeness of deat...

Background: Setting public health policies and effectively monitoring the impact of health interventions requires accurate, timely and complete cause of death (CoD) data for populations. In Sri Lanka, almost half of all deaths occur outside hospitals, with questionable diagnostic accuracy, thus limiting their information content for policy. Objecti...

Background The majority of deaths in the Philippines occur out-of-facility and require a medical certificate of cause of death by Municipal Health Officers (MHOs) for burial. MHOs lack a standardised certification process for out-of-facility deaths and when no medical records are available, certify a high proportion of ill-defined causes of death....

Background Valid cause of death data are essential for health policy formation. The quality of medical certification of cause of death (MCCOD) by physicians directly affects the utility of cause of death data for public policy and hospital management. Whilst training in correct certification has been provided for physicians and medical students, th...

Background: Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. Accurate completion of the medical certificate of cause of...

Background: The need to monitor the Sustainable Development Goals (SDGs) and to have access to reliable and timely mortality data has created a strong demand in countries for tools that can assist them in this. ANACONDA (Analysis of National Causes of Death for Action) is a new tool developed for this purpose which allows countries to assess how a...

In this Series paper, we examine whether well functioning civil registration and vital statistics (CRVS) systems are associated with improved population health outcomes. We present a conceptual model connecting CRVS to wellbeing, and describe an ecological association between CRVS and health outcomes. The conceptual model posits that the legal iden...

New momentum for civil registration and vital statistics (CRVS) is building, driven by the confluence of growing demands for accountability and results in health, improved equity, and rights-based approaches to development challenges, and by the immense potential of innovation and new technologies to accelerate CRVS improvement. Examples of country...

The health and development challenges of the coming decades cannot be tackled effectively without reliable data for births, deaths, and causes of death, which only a comprehensive civil registration and vital statistics (CRVS) system can deliver. Alternative methods such as surveys, censuses, or surveillance are not adequate substitutes from a stat...

Increasing demand for better quality data and more investment to strengthen civil registration and vital statistics (CRVS) systems will require increased emphasis on objective, comparable, cost-effective monitoring and assessment methods to measure progress. We apply a composite index (the vital statistics performance index [VSPI]) to assess the pe...

Objective To systematically review the reliability of hospital data on cause of death and encourage periodic reviews of these data using a standard method. Methods We searched Google Scholar, Pubmed and Biblioteca Virtual de la Salud for articles in English, Spanish and Portuguese that reported validation studies of data on cause of death. We anal...

Background Timely and reliable data on causes of death are fundamental for informed decision-making in the health sector as well as public health research. An in-depth understanding of the quality of data from vital statistics (VS) is therefore indispensable for health policymakers and researchers. We propose a summary index to objectively measure...

is the preferred standard for generating cause-of-death statistics. Most deaths whose cause is certified occur in hospitals. Although not all hospitals have the same diagnos -tic tools, it seems reasonable to expect hospital-based certifying physicians to correctly identify patients’ underlying causes of death, since hospitals usually have establis...

A rapid assessment (RA) tool was developed to rapidly and inexpensively identify key areas of weakness and to yield an overall performance score for vital registration (VR) systems. This standardised tool has now been applied in more than 70 countries, but there has been no formal evaluation of its validity or relationship with measures of socioeco...

This article has presented the key elements of the advocacy process and the steps to consider in developing an advocacy campaign. There are compelling reasons for engaging in advocacy, particularly as civil registration systems in many countries have progressed very little over the past 50 years. Lack of awareness of the benefits for individuals an...

Good public-health decisionmaking is dependent on reliable and timely statistics on births and deaths (including the medical causes of death). All high-income countries, without exception, have national civil registration systems that record these events and generate regular, frequent, and timely vital statistics. By contrast, these statistics are...

Most people in Africa and Asia are born and die without leaving a trace in any legal record or official statistic. Absence of reliable data for births, deaths, and causes of death are at the root of this scandal of invisibility, which renders most of the world's poor as unseen, uncountable, and hence uncounted. This situation has arisen because, in...

This article is based on information from Trends in Europe, the statistical yearbook of the Economic Commission for Europe. It highlights some of the key population and health statistics for member countries, using the most recent data available--generally for 1995--collected from a wide range of national and international sources.