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对乌干达死亡率监测的快速评估。

A rapid assessment of mortality surveillance in Uganda.

作者信息

Zalwango Marie Gorreti, Kyozira Caroline, Nambuya Mariam, Bulamu Martin, Muruta Allan

机构信息

Department of Integrated Epidemiology, Surveillance and Public Health Emergencies, Uganda Ministry of Health, Kampala, Uganda.

出版信息

PLOS Glob Public Health. 2025 Jul 15;5(7):e0003722. doi: 10.1371/journal.pgph.0003722. eCollection 2025.

Abstract

Mortality surveillance aids in identifying and addressing causes of death allowing health systems to adapt and respond effectively. An assessment of mortality surveillance in Uganda was conducted from November 2023 to June 2024 through data reviews and plenary discussions engaging various stakeholders in Uganda. Eight (8) workshops/meetings were conducted over a period of eight months to generate information on mortality data sources, processes of data generation and challenges affecting the system. Responses from the meetings and workshops were recorded and transcribed. Data were thematically analysed and presented as descriptive narratives. Quantitative data from district health information system version. 2 (DHIS2) was analyzed using excel and presented using charts and tables. The rapid assessment of mortality surveillance in Uganda highlighted opportunities for improved mortality surveillance through the existence of various sources of data. It was highlighted that 66.9% of the death occur in communities, however, there is a major data completeness gaps where suboptimal data from the community is feed into the national health statistics database (DHIS2) to enable stakeholder analysis and utilization. Furthermore, a number of data quality issues were identified in the health facility generated data where 33% of the deaths occur. These include: data completeness where the national referral specialized health institutes do not feed their data into the national data base, late reporting and the lack of coordination and standardisation of reporting among the various partners. The existence of structures to conduct mortality surveillance in Uganda presents an opportunity for improved mortality surveillance despite the highlighted gaps and challenges. Adoption of strategies aimed to enable the successful implementation of an efficient mortality surveillance program like: strengthening governance and operations of death reporting activities, establishing a clear definition of institutional roles and responsibilities, raising awareness and advocacy at all levels, building technical capacities, improving allocation of resources, and leveraging on shared interests by both implementing and development partners could improve mortality surveillance and the health of the population through utilisation of the generated data.

摘要

死亡率监测有助于识别和应对死亡原因,使卫生系统能够有效适应和做出反应。2023年11月至2024年6月,通过数据审查和全体讨论,让乌干达的各利益相关方参与,对乌干达的死亡率监测进行了评估。在八个月的时间里举办了八次研讨会/会议,以收集有关死亡率数据来源、数据生成过程以及影响该系统的挑战的信息。会议和研讨会的反馈被记录和转录。对数据进行了主题分析,并以描述性叙述的形式呈现。使用Excel对地区卫生信息系统2(DHIS2)的定量数据进行了分析,并以图表形式呈现。对乌干达死亡率监测的快速评估突出了通过各种数据来源改进死亡率监测的机会。据强调,66.9%的死亡发生在社区,然而,存在重大的数据完整性差距,即来自社区的次优数据被输入国家卫生统计数据库(DHIS2),以实现利益相关方的分析和利用。此外,在卫生机构生成的数据中发现了一些数据质量问题,33%的死亡发生在这些机构。这些问题包括:国家转诊专科医院未将其数据输入国家数据库导致的数据不完整、报告延迟以及各合作伙伴之间报告缺乏协调和标准化。尽管存在突出的差距和挑战,但乌干达开展死亡率监测的架构为改进死亡率监测提供了机会。采用旨在成功实施高效死亡率监测计划的战略,如:加强死亡报告活动的治理和运作、明确界定机构的角色和责任、在各级提高认识和开展宣传、建设技术能力、改善资源分配以及利用实施伙伴和发展伙伴的共同利益,可通过利用生成的数据改善死亡率监测和民众健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4089/12269044/8257e5765044/pgph.0003722.g001.jpg

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