Table 3.
Summary of the recommendations suggested by the key informants. The potential of an electronic death registration system in South Africa: a feasibility and acceptability study (July—November 2022)
| Challenge/concern | Recommendations |
|---|---|
| Poor quality of cause of death (CoD) data |
· Digital tool, with features, such as skip-logic and quality checks, to ensure accurate capturing of cause of death · MCCD training of certifiers with emphasis on the importance of accurate CoD data, and CoD causal sequence |
| Reservations about a digital system |
· Use of an offline system which allows information to be automatically uploaded when the tool is connected to the internet · Computer literacy training for staff |
| Choice of device/platform |
· Web-based platform, with software that can be used across devices, so individuals with limited access to a computer can use their mobile device · Accessible on mobile devices, as this is the most easily accessible device. Issue of privacy and confidentiality can be addressed by ensuring individual access codes for each user, with additional protection, such as biometrics or face recognition (featured on most smartphones) |
| Desired features of the tool |
· In-built quality check features for data verification, for example · ID number and date of death to confirm age · Pop-ups that can prompt doctor to check ill-defined conditions and causal sequence · Drop-down boxes and tick-boxes where possible · Integration with DHA death registration system which could improve efficiency of operations · Integration with Department of Justice to enable update with inquest findings |
| Incorporating tool into routine practise |
· Adequate staff training, with access to IT personnel who would be able to assist with any real-time issues · Making the new digital tool compulsory, which requires buy in from decision-makers in management positions |
| Design of the electronic solution |
· In the design of the solution, several stakeholders should be involved: o Users (junior/senior doctors, as well as urban/rural, funeral homes) o Stakeholders (Department of Health, Statistics South Africa, forensic pathologists, Department of Home Affairs) o Data analysts and IT designers to advise on feasibility o International partners [for example, WHO or United Nations Children’s Fund (UNICEF)] o Traditional leaders and community representatives to engage with the community |