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Home » DHS-8 Questionnaire Review » Module: Adult and Maternal Mortality » Death registration (Addition and extending coverage)
Death registration [message #16952] Thu, 14 March 2019 09:45 Go to next message
AMihnovits
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The request is submitted by HelpAge International.

Accurate data on mortality and causes of death across all ages is required to guide national policies in relation to demography, and provision of health and care services for current and future population. However, death registrations remain rare in low- and middle-income countries as only 9 per cent of deaths are registered, and only 34 countries have high-quality data on causes of deaths. [ref. WHO, 2012, World Health Statistics]
There is a need to improve availability and coverage of national data on mortality.

The module on Adult health and maternal mortality currently collects information about deaths of respondents' siblings. Therefore HelpAge International requests that the module collects information about:
i. Deaths of any member of the household, and
ii. Whether each death was registered


Re: Death registration [message #17142 is a reply to message #16952] Fri, 15 March 2019 15:00 Go to previous messageGo to next message
JohnMeara is currently offline  JohnMeara
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I would also strongly recommend that one more question be asked of all mortality:

Did this person have a surgical procedure (including c-section) within 30 days of death.

This is critical to track post-operative mortality and death after c-section
Re: Death registration [message #17223 is a reply to message #16952] Fri, 15 March 2019 16:18 Go to previous messageGo to next message
ptruche is currently offline  ptruche
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Knowing if a surgical procedure was performed within the last thirty days will provide key NCD data. This take an existing survey question and adds an important aspect that will help direct surgical systems strengthening efforts. I agree this should be added the the DHS survey. There would be many uses for this type of data within the DHS framework.
Re: Death registration [message #17229 is a reply to message #16952] Fri, 15 March 2019 16:19 Go to previous messageGo to next message
Scott Corlew is currently offline  Scott Corlew
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This appears to be a very appropriate addition to DHS. I would suggest that it also include the simple additional question, "Did this person undergo surgery within 30 days of death?"
This would facilitate the collection of peri-operative mortality.
Re: Death registration [message #17238 is a reply to message #16952] Fri, 15 March 2019 16:21 Go to previous messageGo to next message
RPatterson is currently offline  RPatterson
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A recent Lancet publication highlighted that an estimated 7.7% of all deaths occur in the post-operative period. However, we do not have a good understanding of what contributes to post-operative death due to the paucity of data on deaths as death registration is largely inadequate worldwide. This addition to the DHS would promote the ability to tailor surgical care expansion towards safe surgery and post-operative care.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6 736(18)33139-8/fulltext
Re: Death registration [message #17244 is a reply to message #17142] Fri, 15 March 2019 16:24 Go to previous messageGo to next message
blakealkire is currently offline  blakealkire
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I agree with user JohnMeara and Scott Corlew. These are crucial data, and incorporating a question with regard to recent surgical procedure would benefit identification of 30 day POMR, which has proven to be elusive.
Re: Death registration [message #17254 is a reply to message #16952] Fri, 15 March 2019 16:27 Go to previous messageGo to next message
taylorwurdeman is currently offline  taylorwurdeman
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We can no longer rely on modeled estimates for cause of death. In order to truly understand the global burden of disease, and thus understand how to address it, data on actual cause of deaths needs to be collected. This is an extremely important measure to include in the DHS survey as it is many researchers focus to understand and ameliorate premature death. Specific focus should be placed on death attributable or treatable by surgery, as this is an active and growing field of study with potential to decrease total death rates.
Re: Death registration [message #17255 is a reply to message #17142] Fri, 15 March 2019 16:28 Go to previous messageGo to next message
AlexPetersMD is currently offline  AlexPetersMD
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I would also recommend that we not only more effectively collect death notifications, but we strive to better understand the care they received around death. In particular, it would be helpful to know if a patient had surgery within 30 days of death.
Re: Death registration [message #17278 is a reply to message #16952] Fri, 15 March 2019 16:41 Go to previous messageGo to next message
leahmoody is currently offline  leahmoody
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I agree with Tayler Wurdeman that recording prompt, specific death certificates is essential to ascertain and alleviate the top causes of death. Relying on modeled data can fail to reflect recent population changes, whereas having recorded data with specific details of the care received surrounding time of death can allow potential deficiencies in care to be revealed and corrected swiftly.
Re: Death registration [message #17280 is a reply to message #17278] Fri, 15 March 2019 16:42 Go to previous messageGo to next message
gmenon is currently offline  gmenon
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Knowing cause-specific mortality rates is crucial to developing preventive strategies. I fully support the inclusion of these questions.
Re: Death registration [message #17297 is a reply to message #16952] Fri, 15 March 2019 16:59 Go to previous messageGo to next message
SebastianShu is currently offline  SebastianShu
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Agree with including a specific question if death is related to surgical care. It would complement with on going effort to estimate surgical mortality.

I belileve the question proposed by Scott Corlew is on point: "Did this person undergo surgery within 30 days of death?"
Re: Death registration [message #17310 is a reply to message #17142] Fri, 15 March 2019 17:24 Go to previous messageGo to next message
Aboatin is currently offline  Aboatin
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I fully agree with recording whether surgical care was received in the 30 days preceding a death. This is a critical component to understanding the perioperative mortality around surgery, unmet need for surgery and quality of health care provision.

[Updated on: Fri, 15 March 2019 17:24]

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Re: Death registration [message #17311 is a reply to message #16952] Fri, 15 March 2019 17:24 Go to previous messageGo to next message
CLReddy is currently offline  CLReddy
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If we are to truly build health systems that delivery safe and affordable care under UHC, we need to have a better understanding of why people are dying. Knowing if someone died due to a surgical intervention will be critical to reducing MMR (part of SDG 3) but also to improve the overall quality of health care systems. As both the demand and supply for surgical interventions increase, we need to make sure that the surgery people receive is actually benefitting them. Currently, we simply do not know this.
Re: Death registration [message #17322 is a reply to message #16952] Fri, 15 March 2019 17:35 Go to previous messageGo to next message
Rachel Koch is currently offline  Rachel Koch
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Peri-operative mortality is a difficult metric to track particularly once patients leave hospitals. Inclusion of whether the person had a surgical procedure (including c-section) within 30 days of death in all death registries would be a big step forward in collecting this data and understanding outcomes for surgical patients.
Re: Death registration [message #17341 is a reply to message #16952] Fri, 15 March 2019 17:53 Go to previous messageGo to next message
Kee Park is currently offline  Kee Park
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Collecting death registration data including recent surgeries is critical to understanding the causes of death and informs strategies to reduce preventable deaths. It also strengthens the data collection infrastructure in developing countries.
Re: Death registration [message #17346 is a reply to message #17142] Fri, 15 March 2019 18:03 Go to previous messageGo to next message
Dr. Ernest Barthélemy is currently offline  Dr. Ernest Barthélemy
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I fully support including questions that enable death registration, especially with regard to JohnMeara's recommendation to capture data on surgical procedures that may have been performed within 30 days of death, such as c-section, or surgery for trauma care such as fracture reduction, laparotomy or neurosurgical procedures for evacuating intracranial hematomas (epidural, subdural or intraparenchymal) after traumatic brain injury. These surveillance data will be a key aspect of improving health system performance as it relates to emergency and essential surgical care.

JohnMeara wrote on Fri, 15 March 2019 15:00
I would also strongly recommend that one more question be asked of all mortality:

Did this person have a surgical procedure (including c-section) within 30 days of death.

This is critical to track post-operative mortality and death after c-section
Re: Death registration [message #17378 is a reply to message #17322] Fri, 15 March 2019 21:16 Go to previous messageGo to next message
vsanthirapala is currently offline  vsanthirapala
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I would also support the addition of the questions proposed by John Meara and Scott Corlew, knowing if the patient died acutely following surgical intervention is key for accounting for the dead.
Re: Death registration [message #17392 is a reply to message #16952] Fri, 15 March 2019 21:49 Go to previous messageGo to next message
Jacob.Lepard is currently offline  Jacob.Lepard
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I support this module as a means to better track and understand causes of death - I stress here the importance of understanding whether the patient has undergone a surgical procedure or was diagnosed with a surgical condition 30 days prior to their death. This data would be highly useful in the tracking of surgical mortality worldwide. As a neurosurgeon this has high relevance to neurosurgical workforce expansion.
Re: Death registration [message #17404 is a reply to message #16952] Fri, 15 March 2019 22:30 Go to previous message
IsaacWasserman is currently offline  IsaacWasserman
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As powerful as modeling studies are, the only way to progress past the realm of the theoretical, and anchor ourselves in the realm of the real is to collect robust data. These data will inform not just our area of focus, but all area relevant to both global health and development work.
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