International Technical Assistance on CRVS
ISP is committed to playing a key role in the improvement of CRVS systems in developing countries. In addition to expertise available within CDC and NCHS, ISP and NCHS maintain multiple collaborations with CRVS partners including: The World Health Organization’s Department of Health Statistics and Informatics of the Innovation, Information, Evidence, and Research Cluster; and U.S. state vital statistics offices through the National Association for Public Health Statistics and Information Systems (NAPHSIS). Additionally, NCHS coordinates the International Collaboration Effort on automating mortality statistics. Drawing from the CRVS expertise available from these sources, international technical assistance in the form of training and demonstration projects is provided to select countries to address the unique combination of CRVS deficiencies and barriers found in each country.
Training opportunities available through ISP's CRVS improvement effort include:
- Medical certification of cause of death for physicians
- Manual coding and identification of underlying cause of death
- Use of automated software for coding and identification of underlying cause of death (IRIS)
- CRVS staff training at local and national levels
- General CRVS training (see FETP CRVS curriculum below)
Countries participating in the CRVS improvement effort include:
ISP is working with the Civil Registration Department (CRD) and the Ministry of Health to implement a demonstration project in Homa Bay County. The demonstration project aims to improve registration coverage through mobile phones and portable computer technology and to improve quality of information on cause of death through verbal autopsy. The project will incorporate community health workers and maternal and child health facilities and programs. Efforts in Kenya are being conducted with support from the Kisian Kenya Medical Research Institute (KEMRI), CDC's Field Research Station , and other CRVS partners operating in Kenya, including the World Health Organization/Health Metrics Network and their Monitoring of Vital Events through the use of Information Technology (MOVE-IT) initiative.
In collaboration with Malawi’s National Registration Bureau, the President’s Emergency Plan for AIDs Relief (PEPFAR) Malawi team has developed a proposal to strengthen Malawi’s vital statistics system, which currently lacks a full-fledged civil registration system. ISP is providing technical assistance for the project, which includes an assessment of the CRVS system, development of a strategic monitoring and evaluation plan, staff training, implementation of Sample Vital Registration with Verbal Autopsy, production of annual and quarterly publications, development of facility-level electronic Health Management Information Systems, and development of public-awareness campaigns.
ISP is conducting a demonstration project in Morocco that focuses on the region of Rabat-Salé-Zaer-Zemmour and calls for careful coordination between the Ministry of Health and the Ministry of Interior regarding their joint responsibilities for event registration and cause-of-death reporting. The Morocco project includes a review of current CRVS legislation, a review of the online death registration system, a training course for physicians on the proper certification of causes of death, verbal autopsy administered electronically using smart phones and netbooks, training on cause-of-death coding and selection of underlying cause of death, and development of a national center for coding causes of death using IRIS.
Other technical assistance has been provided in the following country:
Although a specific demonstration project has not been deemed necessary in South Africa, ISP has provided technical expertise to Statistics South Africa, the Department of Home Affairs, and the Medical Research Council in efforts to: improve completeness of death registration, identify techniques for improving the estimation of registration completeness, produce training manuals for Home Affairs staff, provide physician training on cause-of-death certification and ICD–10 coder training, improve the processing and automated coding of the death notification form, install the IRIS automated coding system, improve the analysis and reporting of vital statistics data, establish operating procedures, conduct a quality assessment of the National Population Register and evaluate the Western Cape mortality surveillance system. ISP also is providing assistance to enable South Africa to serve as a regional leader and support center on CRVS.