Evolution of the deaths registry system in Brazil: associations with changes in the mortality profile, under-registration of death counts, and ill-defined causes of death

Abstract

This paper examines the spatial pattern of ill-defined causes of death across Brazilian regions, and its relationship with the evolution of completeness of the deaths registry and changes in the mortality age profile. We make use of the Brazilian Health Informatics Department mortality database and population censuses from 1980 to 2010. We applied demographic methods to evaluate the quality of mortality data for 137 small areas and correct for under-registration of death counts when necessary. The second part of the analysis uses linear regression models to investigate the relationship between, on the one hand, changes in death counts coverage and age profile of mortality, and on the other, changes in the reporting of ill-defined causes of death. The completeness of death counts coverage increases from about 80% in 1980-1991 to over 95% in 2000-2010 at the same time the percentage of ill-defined causes of deaths reduced about 53% in the country. The analysis suggests that the government’s efforts to improve data quality are proving successful, and they will allow for a better understanding of the dynamics of health and the mortality transition.

Adequação das informações de mortalidade e correção dos óbitos informados a partir da Pesquisa de Busca Ativa

“…The advances made by Brazil in the field ofvital statistics are widely recognized 5,7 , but the results of this research showed that our greatest challenge is to reach rural and remote municipalities that do not yet have reliable vital information. Lack of access to health care, related not only to geographic barriers but also to cultural aspects of local communities, is one of the mainimpediments to continuousquality improvement of vital statistics data 20,21 .…”

“…Particularly in the last 15 years, significant improvement in vital information was directly linked to the establishment of goals to increase coverage of mortality information in states and municipalities, the development of monitoring dashboards, the establishment of infant and maternal death review committees as well as committee to review deaths due to ill-defined causes, and the expansion of the surveillance of infant deaths and deaths among women of childbearing age 5,7 .…”

Captação de óbitos não informados ao Ministério da Saúde: pesquisa de busca ativa de óbitos em municípios brasileiros

“…Previous results using several estimation methodologies show incomplete coverage of mortality information, mainly in the North and Northeast regions of the country 5,6,17,18 . In this sense, the investigation of the local reality and the evaluation of vital statistics are important strategies for the expansion of the records and of the quality of information, as well as for the monitoring of the implemented policies 19 , which certainly contribute to identify the irregularities at the municipality level, or even in communities, and to subsidize interventions to improve the health situation 20 .…”

Incidence of hepatitis C in Brazil

“…The reason for this is that information management in Brazil's health information systems is still not performed in an orderly and systematic fashion, and any adopted initiatives are more reliable and robust in the South and Southeast of the country (40) . It is important to develop further studies and conduct ongoing assessments of the quality of the data, and to press on all administrative offi cials to improve the quality of the available information regarding health indicators in Brazil (41) .…”