Yokobori Yuta, Matsuura Jun, Obara Hiromi, Sugiura Yasuo, Kitamura Tomomi, Moyo Crispin, Mwango Chomba, Yuasa Motoyuki
National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan.
Department of Public Health, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Heliyon. 2021 Nov 11;7(11):e08367. doi: 10.1016/j.heliyon.2021.e08367. eCollection 2021 Nov.
Civil registration and vital statistics (CRVS) are essential administrative tools for accurate statistical data on vital events. However, civil registration coverage is particularly poor in low- and middle-income countries. Currently, CRVS are attracting global attention, as their improvement is considered a priority. While health facility is one of the important actors involved in the management of quality CRVS, its function in CRVS remains unclear. Therefore, this work aims to investigate the CRVS performance of the health facility in Zambia, a low-income country, and identify the gaps for effective policy-making.
To assess the health facilities' CRVS performance, a questionnaire was developed based on existing assessment tools for the whole CRVS; this comprised 21 multiple-choice questions in 10 areas with four choices awarded between 0 and 3 points according to performance. These questionnaire-based interviews were conducted by information officers in all health facilities per first, secondary, and tertiary-level in five target districts of Zambia, selected via socioeconomic and geographic features. The average points were calculated in each area by each level of healthcare system and summarized in a single chart.
The results indicated low scores in the following areas: staff compliance with standard reporting procedures, infrastructure, capacity of coding based on International Classification of Diseases among health personnel, documentation of the cause of death in medical records, and absence of a system to identify the cause of death of brought-in-dead cases.
The tool developed in this work to evaluate the CRVS performance of health facilities was useful for identifying the gaps that need to be overcome to ensure the quality of CRVS in Zambia. However, its validity should be further investigated in other areas in Zambia as well as in other countries.
民事登记和人口动态统计（CRVS）是获取生命事件准确统计数据的重要行政工具。然而，低收入和中等收入国家的民事登记覆盖率特别低。目前，CRVS正吸引着全球关注，因为其改进被视为一项优先事项。虽然卫生设施是参与高质量CRVS管理的重要行为主体之一，但其在CRVS中的作用仍不明确。因此，这项工作旨在调查低收入国家赞比亚卫生设施的CRVS表现，并确定有效决策的差距。
为评估卫生设施的CRVS表现，基于现有的整个CRVS评估工具制定了一份问卷；该问卷包括10个领域的21个多项选择题，根据表现给予四个选项，分数在0到3分之间。这些基于问卷的访谈由信息官员在赞比亚五个目标地区的所有一级、二级和三级卫生设施中进行，这些地区是根据社会经济和地理特征选定的。每个医疗系统级别在每个领域计算平均分，并汇总在一张图表中。
结果表明在以下方面得分较低：工作人员对标准报告程序的遵守情况、基础设施、卫生人员基于国际疾病分类的编码能力、医疗记录中死亡原因的记录以及缺乏识别死亡病例死亡原因的系统。
本研究中开发的评估卫生设施CRVS表现的工具，有助于识别赞比亚为确保CRVS质量需要克服的差距。然而，其有效性应在赞比亚的其他地区以及其他国家进一步调查。
