Improving the collection and dissemination of vital statistics at international level Dr Fatima Marinho, MD, PhD Coordinator of Health Information and Analysis United Nations Expert Group Meeting on International Standards for Civil Registration and Vital Statistics Systems. United Nations, New York, 27-30 June 2011 2011 Content • General aspects about the document for discussion • Collection of Vital Statistics • Dissemination of Vital Statistics • Recommendations Pan American Health Organization 2011 Content • General aspects about the document for discussion • Collection of Vital Statistics • Dissemination of Vital Statistics • Recommendations Pan American Health Organization 2011 General aspects about the document for discussion • It would be good if an evaluation of the progress of Vital Registration at national level overtime is included. – Tables 1 to 6 do not show progress on data collection and data quality over time. It is expected that the quantity and quality of data is improved over time. Is that happening? • The improvement on data collection and dissemination processes in UNSD should not be isolated from what is occurring on the Vital Registration & rest of NSO’s information systems – It is not presented in the document this interaction and vision Pan American Health Organization 2011 General aspects about the document for discussion • It is not included in the document if exist any continuous feedback mechanism to know about: – the impact of the UNSD’s efforts regarding data collection and dissemination in countries – What is the NSO perception about the added value of UNDS data collection and dissemination processes – What is the value of UNSD’s products – let say reports and data, to countries Pan American Health Organization 2011 Content • General aspects about the document for discussion • Collection of Vital Statistics • Dissemination of Vital Statistics • Recommendations Pan American Health Organization 2011 Collection of Vital Statistics • Current practice is mainly based on questionnaires (Excel format) – This is a common practice in many international institutions. It is acceptable but could be improved – Some drawbacks of this practice: • Introduction of errors while entering data manually from one source to other • Generate an extra work burden at national level (NSO) because of data should be entered in an questionnaire out of National VS system. • Low level of harmonization (high fragmentation) of the dimensions per measure and/or indicator. e.g Live births • Lost of valuable data and information as they are collected at a high level of aggregation. Pan American Health Organization 2011 Collection of Vital Statistics • Suggestions for improving the data collection process 1. Implementation of web-based applications for data collection from NSO 2. Implementation of Data Exchange Services in UNSD and NSO Information systems using data & metadata exchange standards Pan American Health Organization 2011 1.- Implementation of web-based applications for data collection from NSO • • • Intermediate solution It does not solve drawbacks of current practice (mentioned earlier) It improves the data collection, transformation and loading processes at international (global) level 1. Data can be checked & validated while being entered to the system 2. Almost instant data availability in a central data repository Pan American Health Organization 2.- Implementation of Data Exchange Services as part of VS Information Systems • • • • 2011 A most better solution that allow data exchange among heterogeneous information systems (IS). Use of data and metadata exchange standards e.g SDMX National data from a NSO IS can be extracted (pulled) from the UNSD IS and vice-versa Most of the drawbacks of the current practice can be solved with this solution as data is collected through automated processes Pan American Health Organization 2.- Implementation of Data Exchange Services as part of VS Information Systems • This solution requires: – an intermediate and/or advance level of development of the VS Information System – investment to improve information system at national level – improve the Human Resource capacity – envision a high level of harmonization among levels of the Vital Statistic Information Systems, including interoperability and data exchange mechanisms among heterogeneous information systems. Pan American Health Organization 2011 2011 Content • General aspects about the document for discussion • Collection of Vital Statistics • Dissemination of Vital Statistics • Recommendations Pan American Health Organization 2011 Dissemination of Vital Statistics • It is important to recognize the tremendous progress in data and information dissemination reached by UNSD and UN Pan American Health Organization Some differences between Vital Statistics and Civil Registration for the same year Number of Birth % Number of Deaths Country UNSD PAHO PAHO/UNSD UNSD PAHO Brazil 2752401 2934829 7 1079228 1070698 Colombia 686045 719968 5 193580 196748 Guatemala 369769 369769 0 70233 67736 El Salvador 112049 106504 -5 31594 31594 Paraguay 99674 102163 2 24417 22826 Pan American Health Organization 2011 Infant Deaths % UNSD PAHO PAHO/UNSD 33713 41132 18 9250 10524 12 9042 7303 -24 947 947 0 1674 1665 -1 Why don’t conciliate the data between two different sources? Is the difference between the date of registration and date of death an issue here? Mortality Pneumonia and Influenza Seasonality - Brazil 2011 1800 1600 1400 1200 P&I Deaths 1000 800 600 400 200 0 1 3 5 7 9 11131517192123252729313335373941434547495153 Pan American Health Organization 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 For some countries VS is more complete than CR VS in Brazil has the mortality by day and CR doesn’t Mortality Data Under- registration % 2011 English Speaking Caribbean Countries ABW GUY BLZ BHS TCA DMA AIA ATG TTO VGB KNA MSR VCT SUR LCA GRD BRB BMU 0.0 5.0 10.0 15.0 20.0 % de subregistro Pan American Health Organization Source: PAHO Health Indicators, 2010 25.0 30.0 35.0 2011 Terms and definitions: in this specific case, the definition refers to Maternal mortality ratio but the title to Maternal Mortality rate Pan American Health Organization 2011 Dissemination of Vital Statistics • UNSD is disseminating and giving access to: – – Data and statistics: UNdata portal Publications and products: UN Demographic Yearbook, Population Vital Statistics Report • It is recommended to disseminates also information products as Data Visualizations • Data and Statistics should be interpreted • PAHO’s current practice on Data & Statistics dissemination is illustrated in next slide Pan American Health Organization Data & Data Visualizations Pan American Health Organization 2011 Available online at PAHO Health Observatory: http://www.paho.org Data Visualizations from PAHO Indicators 2011 From : - data to Information - information to knowledge - knowledge to actions More effective and innovative ways to communicate data and statistics. Pan American Health Organization Available at PAHO Health Observatory: http://www.paho.org 2011 Content • General aspects about the document for discussion • Collection of Vital Statistics • Dissemination of Vital Statistics • Recommendations Pan American Health Organization Recommendations • Work together with NSO to conciliate and improve Vital Statistics and Civil Registration Information systems at both international and national level • Implement a feedback mechanisms from countries • Implement more effective processes for data collection, including the implementation of data exchange services and adoption of open data exchange standards e.g. SDMX • Besides data and publications, disseminate data visualizations and analytic briefs and key messages oriented to diverse audiences • Implements web sites for dissemination with capacity for more than one language. Pan American Health Organization 2011