Vital registration in rural Africa: is there a way forward to report on health targets of the Millennium Development Goals?

Zachariah, Rony; Mwagomba, Beatrice; Misinde, D; Mandere, Bester C.; Bemeyani, A.; Ginindza, Themba G.; Cortier, Hilde; Bissel, K.; Jahn, Andreas; Harries, Anthony

doi:10.1016/j.trstmh.2011.03.002

Cited by 10 publications

(13 citation statements)

References 15 publications

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“…For mortality, the long-term goal for all countries should be to achieve complete and accurate vital registration, classifying causes of death with the International Coding of Deaths system version 10 (ICD-10) [34]. Where nation-wide vital registration is not feasible, sample vital registration or demographic surveillance using verbal autopsy to establish causes of death can be a cost-effective interim approach [35,36]. …”

Section: Discussionmentioning

confidence: 99%

Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

Korenromp

2012

Malar J

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Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST), extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs) in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor.As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent.Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination.Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy makers and programme planners use planning tools such as LiST - even when predictions are less certain than often understood. The ultimate success of LiST for supporting malaria prevention may be to prove its linear predictions less and less relevant.

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Section: Discussionmentioning

confidence: 99%

Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

Korenromp

2012

Malar J

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“…; Zachariah et al . ). In developed countries, this registration system is electronic, and for many years, the collection of vital statistics has been a core component of public health.…”

Section: Introductionmentioning

confidence: 97%

“…; Zachariah et al . ). In Malawi, population censuses carried out every 10 years and demographic health surveys (DHS) every 4 years are the major sources of birth and mortality data.…”

Section: Introductionmentioning

confidence: 97%

“…Between these surveys, birth rates and death rates are estimated and may be inaccurate (Zachariah et al . ). Other sources of population data are disease‐specific surveys such as the Malaria Indicator Survey (MIS) and other such surveillances.…”

Section: Introductionmentioning

confidence: 97%

“…The systematic recording of births and deaths, referred to as vital registration (VR), is an important routine activity to help in tracing and assessing the progress countries are making towards reaching the targets in the 2015 healthrelated United Nations Millennium Development Goals (MDG) (Mwagomba et al 2010;Zachariah et al 2011). In developed countries, this registration system is electronic, and for many years, the collection of vital statistics has been a core component of public health.…”

Section: Introductionmentioning

confidence: 99%

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Village registers for vital registration in rural Malawi

Singogo

Kanike

Lettow

et al. 2013

Tropical Med Int Health

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Paper-based village registers were introduced 5 years ago in Malawi as a tool to measure vital statistics of births and deaths at the population level. However, usage, completeness and accuracy of their content have never been formally evaluated. In Traditional Authority Mwambo, Zomba district, Malawi, we assessed 280 of the 325 village registers with respect to (i) characteristics of village headmen who used village registers, (ii) use and content of village registers, and (iii) whether village registers provided accurate information on births and deaths. All village headpersons used registers. There were 185 (66%) registers that were regarded as 95% completed, and according to the registers, there were 115 840 people living in the villages in the catchment area. In 2011, there were 1753 births recorded in village registers, while 6397 births were recorded in health centre registers in the same catchment area. For the same year, 199 deaths were recorded in village registers, giving crude death rates per 100 000 population of 189 for males and 153 for females. These could not be compared with death rates in health centre registers due to poor and inconsistent recording in these registers, but they were compared with death rates obtained from the 2010 Malawi Demographic Health Survey that reported 880 and 840 per 100 000 for males and females, respectively. In conclusion, this study shows that village registers are a potential source for vital statistics. However, considerable inputs are needed to improve accuracy of births and deaths, and there are no functional systems for the collation and analysis of data at the traditional authority level. Innovative ways to address these challenges are discussed, including the use of solar-powered electronic village registers and mobile phones, connected with each other and the health facilities and the District Commissioner's office through the cellular network and wireless coverage.keywords operational research, vital statistics, village registers, Malawi

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Effect of the 2014/2015 Ebola outbreak on reproductive health services in a rural district of Guinea: an ecological study

Camara

Délamou

Diro

et al. 2017

Transactions of the Royal Society of Tropical Medicine and Hygiene

118

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BackgroundThe 2014/2015 Ebola outbreak was the most sustained in history. In Guinea, we compared trends in family planning, antenatal care, and institutional deliveries over the period before, during and after the outbreak.MethodsWe carried out an ecological study involving all the health facilities during pre-Ebola (1 March 2013 to 28 February 2014), intra-Ebola (1 March 2014 to 28 February 2015) and post-Ebola (1 March to 31 July 2016) periods in Macenta district.ResultsUtilization of family planning declined from a monthly average of 531 visits during the pre-Ebola period to 242 visits in the peak month of the Ebola outbreak (51% decline) but recovered in the post-Ebola period. From a monthly average of 2053 visits pre-Ebola, antenatal care visits declined by 41% during Ebola and then recovered to only 63% of the pre-Ebola level (recovery gap of 37%, p<0.001). From a monthly average of 1223 deliveries pre-Ebola, institutional deliveries also declined during Ebola and then recovered to only 66% of the pre-Ebola level (p<0.001).ConclusionsAll services assessed were affected by Ebola. Family planning recovered post-Ebola; however, shortfalls were observed in recovery of antenatal care and institutional deliveries. We call for stronger political will, international support and generous funding to change the current state of affairs.

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Vital registration in rural Africa: is there a way forward to report on health targets of the Millennium Development Goals?

Cited by 10 publications

References 15 publications

Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

Village registers for vital registration in rural Malawi

Effect of the 2014/2015 Ebola outbreak on reproductive health services in a rural district of Guinea: an ecological study

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