Accurate mortality statistics, needed for population health assessment, health policy and research, are best derived from data in vital registration systems. However, mortality statistics from vital registration systems are not available for several countries including Viet Nam. We used a mixed methods case study approach to assess vital registration operations in 2006 in three provinces in Viet Nam (Hòa Bình, Thùa Thiên-Hué and Bình Duong), and provide recommendations to strengthen vital registration systems in the country. For each province we developed life tables from population and mortality data compiled by sex and age group. Demographic methods were used to estimate completeness of death registration as an indicator of vital registration performance. Qualitative methods (document review, key informant interviews and focus group discussions) were used to assess administrative, technical and societal aspects of vital registration systems. Completeness of death registration was low in all three provinces. Problems were identified with the legal framework for registration of early neonatal deaths and deaths of temporary residents or migrants. The system does not conform to international standards for reporting cause of death or for recording detailed statistics by age, sex and cause of death. Capacity-building along with an intersectoral coordination committee involving the Ministries of Justice and Health and the General Statistics Office would improve the vital registration system, especially with regard to procedures for death registration. There appears to be strong political support for sentinel surveillance systems to generate reliable mortality statistics in Viet Nam.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

Defining a behavior as a medical problem can change both its moral and legal consequences. Responses to suicide were secularized in the late seventeenth and eighteenth centuries as coroners' juries increasingly adopted the medical explanation for self-destruction and excused suicides as innocent lunatics who were not criminally responsible for their act. It was medical laymen, however, not physicians, who were the principal champions of the medical explanation as they sought to alleviate the effects of the suicide laws on survivors. The change in societal attitudes and responses to suicide illustrates both the negotiated quality of disease definition and the way in which formal medical thinking constituted only one factor in a diverse political, religious, and cultural context.

SynopsisThis essay traces the shifting perception of the nature and prevalence of suicide in early modern England. Suicide is presented as one form of deviance contemporaries recognized and is used to illuminate the history of mental disorder in its social and intellectual context.Daft Meg [an idiot and suicide] was a sort of household familiar among us, and there was much like the inner side of wisdom in the pattern of her sayings, many of which are still preserved as proverbs.John Galt, Annals of the Parish, p. 126.

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Not since 1945 has the UN enjoyed such support across the East-West divide as today. Cold War standards to evaluate UN performance are now of little value, but there is little general and theoretical discussion of alternative criteria. In an effort to clarify the issues at stake in what is sure to be a lively debate, the authors derive four distinct performance criteria extant in the literature on UN performance. These criteria include (1) declarations found in organic documents (charter-based), (2) medium and short-term objectives established by agency officials (operational), (3) past performance (trend-based), and (4) a scenario following elimination of the agency (absence-based). The strengths and weaknesses of each criteria are discussed theoretically and concretely through use of the four criteria to assess UN peace-keeping operations. The authors conclude that a blending of the operational and trend-based approach offers the most promising avenue for UN evaluation.