Kabwama Steven Ndugwa, Bulafu Douglas, Ndejjo Rawlance, Nampeera Rose, Kihembo Christine, Umeokonkwo Chukwuma David, Antara Simon, Gitta Sheba Nakacubo, Kyozira Caroline, Muruta Allan, Nguessan Jean-Edgard, Wanyenze Rhoda K
Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Solna, Stockholm, 17177, Sweden, 46 7 075 780 93, 46 8 524 800 00.
Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda.
JMIR Public Health Surveill. 2025 Aug 13;11:e77135. doi: 10.2196/77135.
Mortality data are critical for planning and prioritization of public health interventions and are generated through civil registration and vital statistics systems like mortality surveillance systems. However, frameworks for strengthening mortality surveillance systems do not acknowledge the cultural relativism surrounding death and how it influences strategies to improve mortality surveillance systems.
This paper aims to describe the experiences and perceptions about death reporting and notification among rural dwellers on the islands of Lake Victoria in Central Uganda.
The study was conducted in Buvuma and Kalangala Districts on Lake Victoria using a phenomenological qualitative research design. We conducted 12 in-depth interviews with community members who were purposively identified by village leaders and had experienced the death of a next of kin and reported and notified, and 8 in-depth interviews with those who had experienced the loss of a next of kin but did not notify and report the death. Key informant interviews were also conducted with 2 police officers and 2 cultural leaders. A total of 4 focus group discussions were conducted among village leaders. Interviews were abductively analyzed to generate grand narratives.
The findings revealed 6 grand narratives of the perceptions and experiences of the process of death reporting and notification among the rural dwellers. These include (1) death reporting and notification are preceded by a tragic event that affects how, when, and if it is conducted; (2) a long and cumbersome process; (3) a process that involves multiple stakeholders with official and unofficial roles and responsibilities; (4) a process with little perceived individual or societal value; (5) a process with several mandatory but unofficial costs; and (6) a process preceded by events with deep cultural undertones.
Death reporting and notification are perceived to be tedious and cumbersome, which discourages community members from conducting them. There is a need to evaluate the process to remove any perceived or actual barriers through strategies such as decentralization of the process to lower levels of political administration. Death reporting and notification are also part of a broader social context that includes cultural beliefs, norms, and traditions. Efforts to strengthen mortality surveillance systems would profit from acknowledging the broader sociocultural issues around death and grieving and the role that cultural and religious institutions can contribute to addressing misconceptions and articulating the benefit of the process to society.
死亡率数据对于公共卫生干预措施的规划和优先排序至关重要，是通过民事登记和诸如死亡率监测系统等人口动态统计系统生成的。然而，加强死亡率监测系统的框架并未认识到围绕死亡的文化相对主义以及它如何影响改善死亡率监测系统的策略。
本文旨在描述乌干达中部维多利亚湖岛屿上农村居民关于死亡报告和通知的经历与看法。
该研究在维多利亚湖的布武马区和卡兰加拉区采用现象学定性研究设计进行。我们对由村长特意选定的、经历过近亲死亡并进行了报告和通知的12名社区成员进行了深入访谈，对经历过近亲死亡但未报告和通知死亡情况的8名社区成员进行了深入访谈。还对2名警察和2名文化领袖进行了关键信息人访谈。在村长中总共进行了4次焦点小组讨论。对访谈进行归纳分析以生成宏大叙事。
研究结果揭示了农村居民在死亡报告和通知过程中的看法和经历的6个宏大叙事。这些包括：（1）死亡报告和通知之前有一个影响报告方式、时间和是否报告的悲剧事件；（2）一个漫长而繁琐的过程；（3）一个涉及多个具有官方和非官方角色及责任的利益相关者的过程；（4）一个几乎没有被感知到的个人或社会价值的过程；（5）一个有若干强制性但非官方成本的过程；（6）一个之前有具有深刻文化底蕴事件的过程。
死亡报告和通知被认为是乏味和繁琐的，这使得社区成员不愿进行此类报告。有必要对该过程进行评估，通过诸如将该过程下放到较低政治行政层面等策略消除任何被感知到的或实际存在的障碍。死亡报告和通知也是更广泛社会背景的一部分，其中包括文化信仰、规范和传统。加强死亡率监测系统的努力将受益于认识到围绕死亡和悲伤的更广泛社会文化问题，以及文化和宗教机构在解决误解和阐明该过程对社会的益处方面可以发挥的作用。
