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Dying to count: mortality surveillance in resource-poor settings

Fottrell, E; (2009) Dying to count: mortality surveillance in resource-poor settings. Global Health Action , 2 10.3402/gha.v2i0.1926. Green open access


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Reliable cause-specific mortality data constitute a crucial resource for health monitoring, service planning and prioritisation. However, in the majority of the world's poorest settings, systematic health and vital event surveillance systems are weak or non-existent. As such, deaths are not counted and causes of death remain unregistered for more than two-thirds of the world's population.For researchers, health workers and policy makers in resource-poor settings, therefore, attempts to measure mortality have to be implemented from first principles. As a result, there is wide variation in mortality surveillance methodologies in different settings, and lack of standardisation and rigorous validation of these methods hinder meaningful comparison of mortality data between settings and over time.With a particular focus on Health and Demographic Surveillance Systems (HDSSs), this paper summarises recent research and conceptual development of certain methodological aspects of mortality surveillance stemming from a series of empirical investigations. The paper describes the advantages and limitations of various methods in particular contexts, and argues that there is no single methodology to satisfy all data needs. Rather, methodological decisions about mortality measurement should be a synthesis of all available knowledge relating to clearly defined concepts of why data are being collected, how they can be used and when they are of good enough quality to inform public health action.

Type: Article
Title: Dying to count: mortality surveillance in resource-poor settings
Location: Sweden
Open access status: An open access version is available from UCL Discovery
DOI: 10.3402/gha.v2i0.1926
Publisher version: http://dx.doi.org/10.3402/gha.v2i0.1926
Language: English
Additional information: © 2009 Edward Fottrell. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: health and demographic surveillance systems, mortality, surveillance, verbal autopsy
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/1314725
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