Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
BMJ Glob Health. 2020 Dec;5(12). doi: 10.1136/bmjgh-2020-003747.
Full notification of deaths and compilation of good quality cause of death data are core, sequential and essential components of a functional civil registration and vital statistics (CRVS) system. In collaboration with the Government of Papua New Guinea (PNG), trial mortality surveillance activities were established at sites in Alotau District in Milne Bay Province, Tambul-Nebilyer District in Western Highlands Province and Talasea District in West New Britain Province.Provincial Health Authorities trialled strategies to improve completeness of death notification and implement an automated verbal autopsy methodology, including use of different notification agents and paper or mobile phone methods. Completeness of death notification improved from virtually 0% to 20% in Talasea, 25% and 75% using mobile phone and paper notification strategies, respectively, in Alotau, and 69% in Tambul-Nebilyer. We discuss the challenges and lessons learnt with implementing these activities in PNG, including logistical considerations and incentives.Our experience indicates that strategies to maximise completeness of notification should be tailored to the local context, which in PNG includes significant geographical, cultural and political diversity. We report that health workers have great potential to improve the CRVS programme in PNG through managing the collection of notification and verbal autopsy data. In light of our findings, and in consultation with the main government CRVS stakeholders and the National CRVS Committee, we make recommendations regarding the requirements at each level of the health system to optimise mortality surveillance in order to generate the essential health intelligence required for policy and planning.
死亡通报的全面性和高质量死因数据的编制是功能完备的民事登记和生命统计系统的核心、连续和必要组成部分。在与巴布亚新几内亚政府（PNG）合作的过程中，在米尔恩湾省的阿洛陶区、西部高地省的坦布尔-内比利尔区和西新不列颠省的塔拉塞亚区建立了试点死亡率监测活动。省级卫生当局对提高死亡通报完整性和实施自动死因推断方法的策略进行了试验，包括使用不同的通报代理和纸质或移动电话方法。在塔拉塞亚，死亡通报的完整性从几乎为 0%提高到了 20%；在阿洛陶，使用移动电话和纸质通知策略分别提高到了 25%和 75%；在坦布尔-内比利尔提高到了 69%。我们讨论了在 PNG 实施这些活动所面临的挑战和经验教训，包括后勤方面的考虑因素和激励措施。我们的经验表明，应根据当地情况制定最大程度提高通知完整性的策略，在 PNG，当地情况包括显著的地理、文化和政治多样性。我们报告称，卫生工作者通过管理通知和死因推断数据的收集，有很大潜力改善 PNG 的民事登记和生命统计方案。根据我们的发现，并与主要政府民事登记和生命统计利益攸关方和国家民事登记和生命统计委员会协商，我们就卫生系统各级的要求提出建议，以优化死亡率监测，从而生成政策和规划所需的基本健康情报。
