In remote areas where there are no doctors, CRVS improvements could
include family members of deceased responding to a limited number of
questions about symptoms experienced by the deceased which an algorithm
using big data samples would then analyse to record a most-likely cause
of death, Professor Lopez said. “In many cases, that algorithm can
record cause of death more accurately than a physician,” he said.
He said other technology advances could also be exploited such as
using mobile phones to transmit information about recent cases of births
and deaths. “We are on the cusp of a quantum leap in using technology
to greatly improve the availability and quality of birth and death data
even in the poorest countries”, Professor Lopez said, adding that
“mobile phones are now common virtually everywhere”.
“Indeed, accurately recording birth registration and cause of death
is vitally important to leaders around the world. To put this in
perspective, 140 countries, or 80% of the world’s population – do not
have reliable cause of death statistics. How can you influence country
and global policy and intervention programs if you don’t know the
underlying causes of illness and death?”
The first Lancet series paper looks at the current landscape of CVRS.
It highlights inconsistent record-keeping worldwide, and argues for
marked improvements in order to gather better statistics to help policy
makers make better decisions. The second paper makes the case that good
CRVS data is not only required for informing health policies, but that
it is also actually good for health. “Countries that have functional
CRVS systems report higher life expectancies and lower maternal and
infant mortality rates indicating that the availability of good birth
and death data is influencing the health policies of those nations,”
Professor Lopez said.
In the third paper, the authors monitor the development of existing
CRVS systems and its limited growth. The authors conclude that
improvements in vital statistics systems over the past four decades have
been disappointingly slow, and that rapid improvement is needed. “We
have the technology and expertise to do so”, Professor Lopez adds, “what
is missing is a clear understanding by doctors and governments of the
vital importance that vital statistics plays in a country’s
development”.
The concluding paper presents a research and development agenda for
CRVS and challenges global health and development agencies to ensure
that every birth and death is registered, and every decision-maker has
detailed, continuous and locally relevant information needed to support
policy and planning. The authors draw attention to the failures of
leadership over the past few decades asking UN agencies and development
partners to coordinate and collaborate to create a data-rich
environment, which can produce evidence-based policy that meets the
needs of a country and region.
