10 May 2012
A Monash University academic has conducted a world-first evaluation of Vietnam's 20-year-old mortality reporting system.
The A6 system records and reports causes of death in the Vietnamese population. Statistics from the system inform government and health care professionals in the development of health intervention policies and funding allocation and needs.
The system was implemented in 1992, replacing the country's original civil registration and vital statistics system, which suffered from a range of flaws, including missing and inaccurate data which failed to cover pockets of the Vietnamese population.
Today, it collects demographics at all commune levels, which are then recorded in the official A6 book, collated by the district level health service, and forwarded to the provincial and central governments.
Director of the Monash University Accident Research Centre (MUARC), Professor Mark Stevenson, said that it is crucial for mortality reporting systems to be accurate and comprehensive.
“A common problem in low and middle income countries is that national mortality reporting systems either do not exist or, if they exist, have significant limitations,” Professor Stevenson said.
“Despite the A6 system's novel approach to collecting the data, until this study, there have been no systematic evaluations of the system to ensure completeness and accuracy,” Professor Stevenson said.
To evaluate the system, Professor Stevenson looked at cause-of-death reports in three provinces in Vietnam, covering the northern, central highlands and southern regions. Within each province, three districts were randomly selected to represent rural, suburban and city areas, with 140 communes participating.
Official cause-of-death reports over a two-year period were compared with reports from the relevant commune health officer, justice officer and population family planning officer, as well as information from a follow-up questionnaire answered by the deceased’s household.
“We found the A6 system to be a very cost-effective and efficient way of collecting cause-of-death statistics in relation to injury. Nevertheless, improvements can be made," Professor Stevenson said.
"These include implementing the World Health Organisation ICD-10 coding protocols to better record cause of death due to injuries, particularly in relation to falls and poisoning. Further training of staff recording the data would also help considerably in improving accuracy.”
The study was led by Professor Stevenson, together with Hanoi Medical University, the Vietnam Ministry of Health and The George Institute for Global Health.
Professor Stevenson will present his findings to the Vietnam Government at the third Mekong Sante Symposium to be held from 10-12 May 2012 at Hanoi Medical University, Vietnam.