Interim measures to obtain vital data for developing countries

October 28, 2007

Most developing countries do not have fully functional civil registration systems (FFCRS). They have instead had to use interim measures to obtain vital data. These methods, though effective in the short term, should not be regarded as substitutes for complete civil registration, and international organisations, governments and academia all have responsibilities to ensure that civil registration systems are improved. These are the conclusions of Professor Kenneth Hill, Harvard Centre for Population and Development Studies, MA, USA, and colleagues, authors of this third paper in the Who Counts? Series in The Lancet.

Over the past four decades, innovative strategies for collection of data, and development of methods for evaluation of or estimation from these data - have been used to fill information gaps in countries lacking accurate civil registration system (CRS) data on births, deaths, and causes of death. These strategies include population censuses, sample vital registration systems, demographic surveillance sites, and sample survey programmes. Ascertainment of cause of death through verbal autopsy has been attempted, as has disease modelling.

The authors say that census and survey data can complement FFCRS, and thus provide a range of useful data to developed countries which already have FFCRS. Such combined efforts would represent a state-of-the-art health information system. As such, the authors are not calling for these interim measures to be 'abandoned and replaced' by FFCRS. They say: "On the contrary, the technical capacity built in the past several decades to create and refine these alternative systems will be crucial for establishing, improving, continually monitoring, and adding value to civil registration systems in poor countries."

They conclude by saying that International agencies should maintain their support for coordinated data collection and sharing activities and for specialised training, while increasing efforts to achieve a FFCRS. They say: "More intensive and better funded research programmes than we have at present are urgently needed to improve and refine the methods of analysis for converting incomplete or indirect information about mortality and causes of death into valid measures of population health for policymaking and planning."


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