Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative
Abstract Background Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. A...
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2020-03-01
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Online Access: | http://link.springer.com/article/10.1186/s12916-020-01519-8 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
John D. Hart Renee Sorchik Khin Sandar Bo Hafizur R. Chowdhury Saman Gamage Rohina Joshi Viola Kwa Hang Li Buddhika P. K. Mahesh Deirdre Mclaughlin Lene Mikkelsen Janet Miki Roderick Napulan Rasika Rampatige Matthew Reeve Carmina Sarmiento Nang Su War Nicola Richards Ian D. Riley Alan D. Lopez |
spellingShingle |
John D. Hart Renee Sorchik Khin Sandar Bo Hafizur R. Chowdhury Saman Gamage Rohina Joshi Viola Kwa Hang Li Buddhika P. K. Mahesh Deirdre Mclaughlin Lene Mikkelsen Janet Miki Roderick Napulan Rasika Rampatige Matthew Reeve Carmina Sarmiento Nang Su War Nicola Richards Ian D. Riley Alan D. Lopez Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative BMC Medicine Cause of death Certification Certificate Mortality Training |
author_facet |
John D. Hart Renee Sorchik Khin Sandar Bo Hafizur R. Chowdhury Saman Gamage Rohina Joshi Viola Kwa Hang Li Buddhika P. K. Mahesh Deirdre Mclaughlin Lene Mikkelsen Janet Miki Roderick Napulan Rasika Rampatige Matthew Reeve Carmina Sarmiento Nang Su War Nicola Richards Ian D. Riley Alan D. Lopez |
author_sort |
John D. Hart |
title |
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative |
title_short |
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative |
title_full |
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative |
title_fullStr |
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative |
title_full_unstemmed |
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative |
title_sort |
improving medical certification of cause of death: effective strategies and approaches based on experiences from the data for health initiative |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2020-03-01 |
description |
Abstract Background Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. Accurate completion of the medical certificate of cause of death (MCCOD) should be a relatively straightforward procedure for physicians, but mistakes are common. Here, we present three training strategies implemented in five countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne (UoM) and evaluate the impact on the quality of certification. Methods The three training strategies evaluated were (1) training of trainers (TOT) in the Philippines, Myanmar, and Sri Lanka; (2) direct training of physicians by the UoM D4H in Papua New Guinea (PNG); and (3) the implementation of an online and basic training strategy in Peru. The evaluation involved an assessment of MCCODs before and after training using an assessment tool developed by the University of Melbourne. Results The TOT strategy led to reductions in incorrectly completed certificates of between 28% in Sri Lanka and 40% in the Philippines. Following direct training of physicians in PNG, the reduction in incorrectly completed certificates was 30%. In Peru, the reduction in incorrect certificates was 30% after implementation and training on an online system only and 43% after training on both the online system and basic medical certification principles. Conclusions The results of this study indicate that a variety of training strategies can produce benefits in the quality of certification, but further improvements are possible. The experiences of D4H suggest several aspects of the strategies that should be further developed to improve outcomes, particularly key stakeholder engagement from early in the intervention and local committees to oversee activities and support an improved culture in hospitals to support better diagnostic skills and practices. |
topic |
Cause of death Certification Certificate Mortality Training |
url |
http://link.springer.com/article/10.1186/s12916-020-01519-8 |
work_keys_str_mv |
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doaj-b759e2ca39d44216813dd2332b7563802020-11-25T02:51:11ZengBMCBMC Medicine1741-70152020-03-0118111110.1186/s12916-020-01519-8Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health InitiativeJohn D. Hart0Renee Sorchik1Khin Sandar Bo2Hafizur R. Chowdhury3Saman Gamage4Rohina Joshi5Viola Kwa6Hang Li7Buddhika P. K. Mahesh8Deirdre Mclaughlin9Lene Mikkelsen10Janet Miki11Roderick Napulan12Rasika Rampatige13Matthew Reeve14Carmina Sarmiento15Nang Su War16Nicola Richards17Ian D. Riley18Alan D. Lopez19Melbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneThe George Institute for Global Health, UNSW SydneyMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneCivil Registration and Vital Statistics, Vital Strategies, Bloomberg Data for Health InitiativeHealth Facility Development Bureau, Department of HealthMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneJohn Snow, Inc. (JSI Research & Training Institute, Inc.)Melbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneAbstract Background Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. Accurate completion of the medical certificate of cause of death (MCCOD) should be a relatively straightforward procedure for physicians, but mistakes are common. Here, we present three training strategies implemented in five countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne (UoM) and evaluate the impact on the quality of certification. Methods The three training strategies evaluated were (1) training of trainers (TOT) in the Philippines, Myanmar, and Sri Lanka; (2) direct training of physicians by the UoM D4H in Papua New Guinea (PNG); and (3) the implementation of an online and basic training strategy in Peru. The evaluation involved an assessment of MCCODs before and after training using an assessment tool developed by the University of Melbourne. Results The TOT strategy led to reductions in incorrectly completed certificates of between 28% in Sri Lanka and 40% in the Philippines. Following direct training of physicians in PNG, the reduction in incorrectly completed certificates was 30%. In Peru, the reduction in incorrect certificates was 30% after implementation and training on an online system only and 43% after training on both the online system and basic medical certification principles. Conclusions The results of this study indicate that a variety of training strategies can produce benefits in the quality of certification, but further improvements are possible. The experiences of D4H suggest several aspects of the strategies that should be further developed to improve outcomes, particularly key stakeholder engagement from early in the intervention and local committees to oversee activities and support an improved culture in hospitals to support better diagnostic skills and practices.http://link.springer.com/article/10.1186/s12916-020-01519-8Cause of deathCertificationCertificateMortalityTraining |