Table 3.

Key Regional Priorities for Action

Assessment Category	Recommendations
Societal Issues	Recognise the importance of community nurses in the reporting process (including links and influence with the local community) and provide support for increased training and feedback on how their data is used in health planning. [Long term]
Administrative Environment	Conduct operational research to validate reporting completeness and quality in functioning systems to build internal management support and confidence to use results. [Short Term]
	Formalise MOU or similar between health departments and civil registration offices on data sharing and cause of death information. [Short Term]
System Issues – Administration	Identify and minimise duplication between parallel systems (particularly within health departments), through data sharing agreements. [Short Term]
	Assign staff (and adequate resources) to analysis role. [Short Term]
	Investigate ways of better engaging provincial governments (island councils, municipal governments etc.) with civil registration, and support this with feedback at a provincial level. [Long Term]
System Issues – Technical	Support countries to identify staff responsible for each process and provide in-country training to support them to meet minimum skill and knowledge level. [Short Term]
	Encourage tabulation and use of medical certificates as a source of information rather than relying solely on hospital discharge data. [Short Term]
	Design databases to capture medical certificates as written. Create an additional field for selection of underlying cause to avoid changes to recorded sequence. [Short Term]
	Encourage use of standard statistical measures (confidence intervals, and rolling averages) and reporting of system limitations to aid in appropriate data interpretation. [Short Term]
	Assess and build staff capacity, particularly in data analysis and certification practices. [Short Term]
System Issues –Ownership	Build supportive relationships between data managers, senior management and doctors that will allow data managers to develop sufficient authority to question data as needed. [Long Term]

Source data: [16].