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SAMPLE VITAL REGISTRATION WITH VERBAL AUTOPSY

SAMPLE VITAL REGISTRATION WITH VERBAL AUTOPSY. Background, Scope, and Methodology. Central Statistical Office Zambia. What is a system of vital statistics?.

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SAMPLE VITAL REGISTRATION WITH VERBAL AUTOPSY

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  1. SAMPLE VITAL REGISTRATION WITH VERBAL AUTOPSY Background, Scope, and Methodology Central Statistical Office Zambia

  2. What is a system of vital statistics? • A system that includes the legal registration, statistical recording and reporting of the occurrence, collection, compilation, analysis, presentation, and dissemination of statistics pertaining to ‘vital events’ (live births, deaths, marriages and divorces etc) (UN, 2001).

  3. What makes up the system of vital statistics in Zambia? • Local Authorities (Traditional ?) • Registrar General’s Office • Councils • Ministry of Health • Central Statistical Office

  4. What is the current status of the system of vital statistics in Zambia? • Weak • Fragmented • Uncoordinated • Underfunded

  5. What is SAVVY? • Sample Vital Registration with Verbal Autopsy

  6. What are the general objective of SAVVY? • The overall objective of the SAVVY is to produce annual nationally representative estimates of vital statistics and mortality by cause of death. It also aims to provide reliable estimates of annual trends in the mortality rates and other indicators, through a longitudinal approach to data collection in sample areas and in the analysis.

  7. What are the specific objectives of SAVVY ? • To support and strengthen the reporting, recording, compilation, analyses and dissemination of vital statistics in Zambia; • To enhance capacity in the collection, compilation, analysis and interpretation of births and mortality surveillance data among staff in key institutions; • To contribute to the development of an effective and efficient national system of vital registration.

  8. Estimated outputs of SAVVY • Birth and death information on quarterly, bi-annual and annual basis; • Cause of death information on quarterly, bi-annual and annual basis; • Data for enhanced detailed analysis of fertility, morbidity and mortality patterns in different communities in Zambia; • Vital events data to support effective morbidity and mortality surveillance in Zambia.

  9. Which institutions are currently collaborating in implementing SAVVY? • Central Statistical Office (CSO) • The Department of National Registration Citizenship and Passports (DNRCP) • The Ministry of Finance and National Planning (MFNP) • The Ministry of Home Affairs (MHA) • The Ministry of Health (MOH) • The Ministry of Local Government and Housing (MLGH) • The Ministry of Community Development and Social Services (MCDSS) • The United States of America, Centers for Disease Control and Prevention (CDC) • The United Nations Children’s Fund (UNICEF) • MEASURE Evaluation, and • The United States Census Bureau

  10. What methodology will be used in SAVVY? • Baseline census • Verbal Autopsy • Birth registration • Update census

  11. Baseline Census • The first phase of the SAVVY system implementation will involve the conduct of a baseline census in 33 selected CSAs in Central, Luapula, Lusaka and Southern provinces. • All households within the limits of the wards will be visited and a total count of households, usual household members and visitors currently in the households will be taken • Key demographic and socio-economic characteristics of households will be collected • Information on births (children born in the last 12 months and children ever born) will be collected from women in the reproductive age group, 15-49 present in the households at the time of the census • The aim of the baseline census is to provide updated demographic and socio-economic indicators of the implementation sites

  12. Verbal Autopsy interviews (Information on Deaths) • The verbal autopsy interviews will form the core of the SAVVY system • All deaths occurring in the respective wards will be identified through Community Key Informants (CKI) • The CKI will communicate the occurrence of a death to the Verbal Autopsy Interviewer (VAI) and will facilitate an appointment for the interview at a time convenient to the household where the event has occurred. • The next of kin or any adult respondent with sufficient knowledge of the deceased individual will be interviewed using a structured verbal autopsy questionnaire. • Information about the deceased person such as age, sex, marital status, and occupation status at the time of death, education level, cause of death, history of illness and, place of death will be collected.

  13. Birth Registration • All births occurring in the respective CSA will be identified through community Key Informants (CKIs) • The CKI will communicate the occurrence of a birth to the Verbal Autopsy Interviewer (VAI) and will facilitate an appointment for the interview at a time convenient to the household where the event has occurred. • A birth registration questionnaire will be administered to the mother or father of the new born • Information to be collected include, the place of delivery, nature of birth, type of birth, sex of child, birth order, age of mother, marital status of mother, education level of mother, place of usual residence of mother and occupational status of both mother and father

  14. Census Update • A census update will be conducted 12 months after the baseline census in order to update the demographic characteristics of the population in the ward. • The aim of the census update is to update household information which might have changed since the baseline census.

  15. Use of Portable Digital Assistants (PDAs) in SAVVY • All data collection instruments or questionnaires will be programmed onto Portable Digital Assistants (PDAs) • PDAs will be used by enumerators to collect data during fieldwork • The PDAs are fitted with a Global Positioning System (GPS) to enable the collection of spatial data • The use of PDAs will help speed up the time spent on data collection and processing • The use of PDAs will eliminate the need for manual data entry

  16. SAVVY implementation strategy-Verbal Autopsy • The verbal autopsy interview will be used to ascertain cause of death from the next of kin or any knowledgeable adult with information about the deceased individual • The Community Key Informant (CKI) will use event registers to record the occurrence of a death in the community • The CKI will indicate on the ‘event register’ the sex of the deceased and age, whether the death is for an adult (15 years and older) or a child 14 years and below • The ‘event register’ will be submitted to the SAVVY field office on a weekly basis • The verbal autopsy interview will be conducted, within 14 days of the death occurrence

  17. Determination of cause of Death; Use of Nosologists • Two Nosologists are going to be used to determine the cause of death. • Using the ICD 10 each nosologist will code the VA questionnaire and come up with a cause of death. • The two have to agree on the code assigned to one questionnaire. If they don’t the a third nosologist will be called in. If all the three don’t agree, then the cause of death is not established.

  18. SAVVY implementation strategy-Birth Registration • The CKI will identify expectant mothers in the ward • Upon identification and registration, information will then be collected from the expectant mother on the current age of the woman, place of residence, birth order, antenatal attendance and Expected Date of Delivery (EDD) • Once the birth occurs, a structured interview using a birth registration questionnaire will be conducted with the mother or father • A birth record will be issued through the RGO

  19. Data Analysis • Descriptive analysis of demographic and socio-economic data collected during the baseline census will be done • Mortality and fertilityindicators will be computed for the 12 month period of observation based on data collected from verbal autopsies, birth registration and the update census • Cause of death will be determined and disaggregated by key demographic and socio-economic variables

  20. Dissemination • SAVVY results will be disseminated to all stakeholders, thegeneral public, local and international researchers • Special attention will be made in disseminating SAVVY findings to policy makers and planners in government, civil society organisations, international organisations and development cooperating partners • Dissemination will be in both hard copy and electronic formats • Dissemination of findings through scientific publication in journals will be encouraged in order to reach a wide user -audience.

  21. END OF PRESENTATION Thanks for your attention!

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