Estimating Cause-Specific Mortality from Community- and Facility-Based Data Sources in the United Republic of Tanzania: Options and Implications for Mortality Burden Estimates

Whiting, David R.; Setel, Philip W.; Chandramohan, Daniel; Wolfson, Lara J.; Hemed, Yusuf; & Lopez, Alan D. (2006). Estimating Cause-Specific Mortality from Community- and Facility-Based Data Sources in the United Republic of Tanzania: Options and Implications for Mortality Burden Estimates. Bulletin of the World Health Organization, 84(12), 940-8.

Reference Type:
Journal Article

Secondary Title:

Series Title:

Author(s):
Whiting, David R.
Setel, Philip W.
Chandramohan, Daniel
Wolfson, Lara J.
Hemed, Yusuf
Lopez, Alan D.

Editor(s):

Series Author(s):

Year Published:
2006

Date Published:

Journal Name:
Bulletin of the World Health Organization

Volume Number:
84

Issue Number:
12

Start Page Number:
940-8

End Page Number:

Edition:

Series Volume:

Publisher:

City of Publication:

ISSN/ISBN:

DOI:
10.2471/BLT.05.028910

PMCID:

NIHMSID:

Reference ID:
3069

Miscellaneous:

Abstract:

Objective: To compare mortality burden estimates based on direct measurement of levels and causes in communities with indirect
estimates based on combining health facility cause-specific mortality structures with community measurement of mortality levels.

Methods: Data from sentinel vital registration (SVR) with verbal autopsy (VA) were used to determine the cause-specific mortality
burden at the community level in two areas of the United Republic of Tanzania. Proportional cause-specific mortality structures
from health facilities were applied to counts of deaths obtained by SVR to produce modelled estimates. The burden was expressed
in years of life lost.

Findings: A total of 2884 deaths were recorded from health facilities and 2167 recorded from SVR/VAs. In the perinatal and neonatal
age group cause-specific mortality rates were dominated by perinatal conditions and stillbirths in both the community and the facility
data. The modelled estimates for chronic causes were very similar to those from SVR/VA. Acute febrile illnesses were coded more
specifically in the facility data than in the VA. Injuries were more prevalent in the SVR/VA data than in that from the facilities.

Conclusion: In this setting, improved International classification of diseases and health related problems, tenth revision (ICD-10)
coding practices and applying facility-based cause structures to counts of deaths from communities, derived from SVR, appears to
produce reasonable estimates of the cause-specific mortality burden in those aged 5 years and older determined directly from VA.
For the perinatal and neonatal age group, VA appears to be required. Use of this approach in a nationally representative sample of
facilities may produce reliable national estimates of the cause-specific mortality burden for leading causes of death in adults.

Keyword(s):
Population and Health Policies and Programs

URL:

http://dx.doi.org/10.2471/BLT.05.028910

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Citation:

Whiting, David R.; Setel, Philip W.; Chandramohan, Daniel; Wolfson, Lara J.; Hemed, Yusuf; & Lopez, Alan D. (2006). Estimating Cause-Specific Mortality from Community- and Facility-Based Data Sources in the United Republic of Tanzania: Options and Implications for Mortality Burden Estimates. Bulletin of the World Health Organization, 84(12), 940-8.