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. 2012 Jun 13;12:436. doi: 10.1186/1471-2458-12-436

Table 1.

Key Strengths and Weaknesses of Mortality Reporting Systems in the Pacific Islands

Category Strengths Weaknesses
Societal Issues
Social incentives for registration
Private land burials without official approval
Administrative Environment
Existing legal framework
Inadequate/inconsistent implementation of laws
 
Health systems involvement in Civil registration and vital statistics operations
Passive registration i.e. onus to report on citizen
 
 
Registration process for “off-island” deaths unclear
 
National statistics committees
Complex statistical reporting requirements
System Issues – Administration
Community nurses formally tasked to notify vital events
Improper emphasis on community nurses to report cause of death
 
Routine compilation of mortality data by different health departments
Need for better coordination to generate one reconciled mortality dataset from the health system
 
 
Private health intuitions rarely integrated adequately into reporting systems
 
 
No clear delineation of responsibility across institutions, leading to task duplication
 
 
Personnel lack authority to query/clarify data
System Issues – Technical
Standard international medical death certificate (except Nauru)
Lay reporting of cause for deaths outside facilities in some countries
 
 
Medical certificates of death not routinely tabulated in all countries
 
Trained ICD coders
High turnover of trained staff
 
Key personnel adequately skilled for data management at national level
Statistical analysis limited to ten leading causes of death
 
 
Insufficient data quality assessment and control
 
Initiatives to set data standards for health information
Dysfunctional/outdated software programs not amenable to modification or upgrade
System Issues – Ownership
Strong ownership of systems/interest at national levels that has contributed substantially to ongoing survival of the systems
Generally poor feedback to local level staff
    Many systems are highly dependent on one or two key individuals with a strong interest in providing health data

Source data: [16].