Mortality registration and surveillance in China: History, current situation and challenges

Abstract

BACKGROUND: Mortality statistics are key inputs for evidence based health policy at national level. Little is known of the empirical basis for mortality statistics in China, which accounts for roughly one-fifth of the world's population. An adequate description of the evolution of mortality registration in China and its current situation is important to evaluate the usability of the statistics derived from it for international epidemiology and health policy. CURRENT SITUATION: The Chinese vital registration system currently covers 41 urban and 85 rural centres, accounting for roughly 8 % of the national population. Quality of registration is better in urban than in rural areas, and eastern than in western regions, resulting in significant biases in the overall statistics. The Ministry of Health introduced the Disease Surveillance Point System in 1980, to generate cause specific mortality statistics from a nationally representative sample of sites. Currently, the sample consists of 145 urban and rural sites, covering populations from 30,000 - 70,000, and a total of about 1 % of the national population. Causes of death are derived through a mix of medical certification and 'verbal autopsy' procedures, applied according to standard guidelines in all sites. Periodic evaluations for completeness of registration are conducted, with subsequent corrections for under reporting of deaths. CONCLUSION: Results from the DSP have been used to inform health policy at national, regional and global levels. There remains a need to critically validate the information on causes of death, and a detailed validation exercise on these aspects is currently underway. In general, such sample based mortality registration systems hold much promise as models for rapidly improving knowledge about levels and causes of mortality in other low-income populations.

Socio‐economic disparities in maternal mortality in China between 1996 and 2006

“…40 Our findings corroborate those of a recent assessment of the NMCHRS, which theoretically registers all births, and maternal and child deaths, in China. 7 business/htmlfiles/mohbgt/s3582/200902/39201.htm 41 ) On the other hand, the level of maternal mortality reported by the NMCHRS for the period 2000-05 (47.3 deaths per 100 000 livebirths) is lower than that reported by our analysis based on the MCMS for the same period (61.8 per 100 000 births for 2000-05), suggesting that the MCMS may be better at capturing maternal deaths.…”

“…40 Our findings corroborate those of a recent assessment of the NMCHRS, which theoretically registers all births, and maternal and child deaths, in China. 7 The recently released summary of China's 2008 fourth National Health Services Survey also verifies the rises in institutional delivery and ANC that we have observed.…”

Cervical Cancer Screening Among Adult Women in China, 2010

“…CCDRFS is a nationwide survey using face-to-face interviews and physical measurements. It is conducted once every 3 years using a random sampling design based on the China National Disease Surveillance Points (DSP) system [4][5][6]. Briefly, the 2010 CCDRFS covered all 31 provinces, autonomous regions, and municipalities and included 162 counties with surveillance points; 63 counties were in urban areas and 99 counties in rural areas (Fig.…”

Risk factors for noncommunicable chronic diseases in women in China: surveillance efforts

“…The establishment, history and degree of representativeness of the national disease surveillance points system are explained elsewhere. 21,22 The ethics committee of the Chinese Center for Disease Control and Prevention approved the 2010 CCDRFS and written informed consent was obtained from each participant before data collection.…”