Count
births, deaths and causes of death
An effective civil registration and vital statistics (CRVS) system is critical for tracking public health trends, planning interventions to improve population health and evaluating policy effectiveness. CRVS is the optimal system for producing fertility and mortality statistics. In addition, birth registration is the foundation of individual identity management systems that in many countries provide the proof of legal identity required to access health and other services.
Key elements
Full birth and death registration
All countries should have a well-functioning civil registration and vital statistics (CRVS) system that registers all births and deaths, issues birth and death certificates, and compiles and disseminates vital statistics, including cause-of-death data. It may also record marriages, divorces and adoptions.
Certification and reporting of causes of death
All countries should have the capacity to generate good quality, recent mortality statistics to describe levels and trends of mortality, and identify and track changes in the burden of disease in different population groups.
Full birth and death registration
Ten CRVS Milestones
The Ten CRVS Milestones framework has been developed to help policy-makers, managers and other CRVS stakeholders understand CRVS systems, capturing complexity by focusing on the 10 milestones that must be achieved in any CRVS system. Each milestone summarizes the actions that community, local and national stakeholders must take to ensure that every birth or death is officially registered and included in country vital statistics systems.
Publishers
Cobos Muñoz D, Abouzahr C, de Savigny D.
Year
2018
Handbook on civil registration and vital statistics systems: management, operations, maintenance
This handbook offers specifications and practical examples for the improvement and/or establishment of civil registration, vital statistics and identity management systems. It presents model organizational and legal arrangements, as well as ideal descriptions, processes and protocols that are considered the gold standard.
Publishers
UNSD
Year
2018
CRVS Knowledge Gateway Learning Centre
The CRVS Knowledge Gateway Learning Centre consolidates available knowledge, tools, guidelines and standards, providing countries with a convenient resource to help accelerate their CRVS improvement strategies. This Learning Centre comprises the most advanced techniques and knowledge from global experts in CRVS systems and is continuously updated.
Publishers
University of Melbourne, Data for Health, Bloomberg Philanthropies
Year
2018
CRVS eLearning Course
The CRVS eLearning course comprises 13 technical modules that aim to train policy-makers, public and civil servants, researchers, development practitioners and civil society organizations using practical tools and approaches to building and maintaining CRVS systems that are linked to identity management systems and tailored to local contexts. The World Bank Group coordinated the development of the eLearning course, with contributions from partners including CDC, UNICEF, UNFPA, WHO and D4H.
Publishers
World Bank Group
Year
2017
Civil Registration and Vital Statistics Legal and Regulatory Review: Tool and Methodology
This toolkit provides a guide for analysing existing CRVS laws to identify legal obstacles and opportunities. Even though CRVS systems should serve the same principal functions, every country has different approaches based on its legal structure, history, and culture. Countries also differ in their CRVS organization, implementation, processes, scale, partners, and capacities. This toolkit attempts to provide a standardized methodology to capture and evaluate this range of approaches and needs. .
Publishers
Vital Strategies and Global Health Advocacy Incubator
Year
2017
Training course on civil registration and vital statistics systems
The International Statistics Program has developed a training course CRVS systems to provide information to epidemiologists, statisticians, demographers, and others working in public health about vital statistics data gathered from a national civil registration system. Even though CRVS systems may differ somewhat from country to country, there are internationally accepted principles and recommendations for national CRVS systems. Accordingly, the course contains a general description of the administrative process of civil registration and fundamentals of vital statistics generated from a national civil registration system.
Publishers
Centers for Disease Control
Year
2016
Principles and Recommendations for a Vital Statistics System, Revision 3
Principles and Recommendations for a Vital Statistics System provides guidance on establishing a functioning system for collecting, processing and disseminating vital statistics; improving sources of vital statistics, primarily the functioning of the civil registration system and its components; and the role of complementary sources of vital statistics, such as population censuses, household surveys and public-health records. The document was prepared by the UN Statistics Division.
Publishers
UNSD
Year
2014
Improving the quality and use of birth, death and cause-of-death information
This rapid assessment tool consists of 25 questions to quickly evaluate the strengths and weaknesses of a country’s current CRVS system. The results of this rapid assessment can then be used to make the case for a more detailed assessment. This rapid assessment tool has been developed to accompany the comprehensive guide, “Improving the quality and use of birth, death and cause-of-death information: guidance for a standards-based review of country practices,” and countries are advised to apply it before undertaking a full review of their systems (see below). The University of Queensland oversaw the development of the tool, with financial support from the Government of Japan, WHO, and the University of Queensland
Publishers
WHO/University of Queensland
Year
2010
Strengthening civil registration and vital statistics for births, deaths and causes of death
This resource kit supports countries in planning and implementing improvements to their CRVS systems. Compiled using critically assessed materials drawn from many sources, this user-friendly resource is accessible to both experts and users with a general interest in evidence-based decision-making. The resource kit was developed by the University of Queensland, National Institute of Health Sciences (Sri Lanka), the Swiss Tropical and Public Health Institute, and the Australian Bureau of Statistics, with financial support from WHO and the Australian Agency for International Development.
Publishers
University of Queensland
Year
2013
Rapid assessment of national civil registration and vital statistics systems
This rapid assessment tool consists of 25 questions to quickly evaluate the strengths and weaknesses of a country’s current CRVS system. The results of this rapid assessment can then be used to make the case for a more detailed assessment. This rapid assessment tool has been developed to accompany the comprehensive guide, “Improving the quality and use of birth, death and cause-of-death information: guidance for a standards-based review of country practices,” and countries are advised to apply it before undertaking a full review of their systems (see below). The University of Queensland oversaw the development of the tool, with financial support from the Government of Japan, WHO, and the University of Queensland.
Publishers
WHO/University of Queensland
Year
2010
Improving Mortality Statistics through Civil Registration and Vital Statistics Systems
This document offers guidance on strategies for strengthening vital statistics in national CRVS plans, with a focus on mortality and cause-of-death statistics. The document summarizes key mortality-related indicators and describes the strengths and considerations of different data sources. It goes on to describe the best options for generating mortality statistics, proposes principles for selecting data sources, and identifies priority actions for strengthening CRVS while improving the availability and quality of mortality statistics. It concludes with recommendations on the contents of CRVS investment plans based on country starting points and capacities. The document was developed by WHO with contributions from partners including USAID, JHU, BMGF, GAVI, WBG, UNAIDS, UNICEF and TGF.
Publishers
WHO
Year
2014
Certification and reporting of causes of death
Technical package for rapid mortality surveillance and epidemic response
Revealing the Toll of COVID-19: A Technical Package for Rapid Mortality Surveillance and Epidemic Response is a technical package designed to support national governments with surveillance and response planning for COVID-19.
Compared with only using COVID-19 confirmed deaths as a measure of impact, rapid mortality surveillance generates daily or weekly counts of mortality data by age, sex, date of death, place of death and place of usual residence. The Technical Package provides a more complete picture of impact, particularly for deaths that may be indirectly related to COVID-19. This also addresses the indirect impact caused by disruptions in healthcare access and supply chains.
Publishers
Vital Strategies and WHO
Year
2020
CRVS Gateway – Resources for responding to COVID-19
The CRVS best-practice and advocacy resources are based on a combination of technical knowledge, country experiences and scientific literature.
Publishers
CRVS Gateway
Year
2020
EuroMOMO: European mortality monitoring activity
EuroMOMO is a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats.
The overall objective of the original European Mortality Monitoring Project was to design a routine public health mortality monitoring system aimed at detecting and measuring, on a real-time basis, excess number of deaths related to influenza and other possible public health threats across participating European Countries.
Publishers
Statens Serum Institut Denmark/ECDC/WHO
Year
2020
ICD-11 Coding Tool
The 11th edition of ICD (ICD–11) is the international standard for systematic recording, reporting, analysis, interpretation and comparison of mortality and morbidity data. It provides up-to-date clinical content and state of the art digital infrastructure. For the first time, ICD is fully electronic, currently providing access to 17, 000 diagnostic categories, with over 100 000 medical-diagnostic index terms.
Publishers
WHO
Year
2019
Reference guide of ICD-11 and Volume 2 of ICD-10
The reference guide and its predecessor, the Volume 2 of ICD-10, are the global standard reference for recording, coding and statistical reporting of mortality and morbidity. Both versions include the international form of medical certificate of cause of death (MCCD), instructions to physician for completing the MCCD, minimum standards for medical records, and detailed instructions in relation to age groups, live birth and maternal mortality.
The reference guide for ICD-11 includes further rules for recording and reporting for patient safety, quality, and traditional medicine. A special section provides instructions on use of the section V of ICD-11 for assessment of activity and participation in line with WHODAS.
Publishers
WHO
Year
2019
ICD-11 based automated UCoD tool
The ICD-11 based automated Underlying Cause of Death (UCoD) tool builds on and refines the rules of the ICD-10 Startup Mortality List (SMoL). The tool allows processing of both ICD-11 and ICD-10 coded data and constitutes an important step towards building an ICD-11 based automated mortality coding system in collaboration with the IRIS group.
Publishers
WHO
Year
2020
ICD-11 Application Programming Interface (APIs) and Embedded Coding Tool (ECT) in DHIS2
The ICD Application Programming Interface (API) allows programmatic access to the International Classification of Diseases (ICD) for software developers who would like to consume the ICD-API in their software. The ICD API is a HTTP based REST API which covers ICD-11 content as well as the index-based search algorithm of ICD-11. It is possible to use ICD-10 as well, but with limitations imposed by the outdated structure of ICD-10). The container version of the ICD-API can be deployed locally using “Docker” technology.
Publishers
WHO
Year
2020
ICD-FIT coding training and self-evaluation tool – Mortality module
The ICD Field Implementation Tool (ICD-FIT) is a web-based coding training and self-evaluation tool for ICD-11. In the mortality module, users practice using pre-coded code term sets extracted from cause of death certificates using the embedded ICD-11 coding tool. After completing the coding of a given term set, users get immediate feedback on their coding accuracy. The user’s code assignment for a given diagnostic term is compared with the gold standard and a summary score of the users coding performance is computed. The tool also provides a ranking of overall coding performance by users and measures the time spend by users when making the code assignment for each term.
Publishers
WHO
Year
2019
ICD-11 Training Tool and WHO Academy Course
The ICD-11 elearning Tool and the upcoming WHO Academy Course titled “ICD-11: Interactive skill training for coding mortality and morbidity data” is designed to build-up and enhance ICD-11 coding competency among the health coding workforce and other producers of ICD coded data. The tools also helps health policy makers and other health professionals who are users of coded ICD data, develop digital health solutions or decide on the implementation of ICD-11 in their health information system to develop a basic understanding of the ICD-11 content, structure and implementation benefits and requirements.
Publishers
WHO
Year
2020
WHO Application of ICD-10 for low-resource settings: The Startup Mortality List
The Start-Up Mortality List (SMoL) has been designed to be in line with the International Classification of Diseases (ICD 10th Revision) and provides a succinct, easy-to-apply summary of the ICD selection rules. The SMoL is designed to be a first step towards standardized reporting of causes of death in low-resource settings where capacity to code causes of death using ICD is low. It condenses the more than 10 000 ICD-10 cause-of-death codes into an aggregated list of 107 causes.
Internal Resources
Publishers
WHO
Year
2018
Analysing mortality levels and causes-of-death (ANACoD)
The ANACoD electronic tool provides a step-by-step approach to enable users to quickly conduct a comprehensive analysis of data on mortality levels and causes of death. The tool automatically reviews the data for errors, tabulates the information, presents the results in easy-to use tables and charts, and provides the opportunity to compare findings with those from other groups of countries.
Publishers
WHO
Year
2014
Analysing mortality levels and causes of death (ANACoDA)
ANACONDA is another option for doing a data quality assessment of mortality. The platform provides a comprehensive step-by-step framework for interrogating mortality data. Featuring a detailed guide for users, it offers a series of data checks that are based on decades of epidemiological and demographic research into mortality patterns in different populations.
Publishers
University of Melbourne
Year
2020
Integrating community-based verbal autopsy into civil registration and vital statistics
Verbal autopsy (VA) to ascertain the probable cause of death is the best alternative to generate mortality statistics in the absence of medical certification. Data collection using electronic VA questionnaires on mobile devices and computer algorithms to analyse responses and estimate probable cause of death has increased the potential for VA to be routinely applied in CRVS systems. However, a number of CRVS and health system integration issues should be considered in planning, piloting and implementing system-wide VA intervention. These include addressing the multiplicity of stakeholders and sub-systems involved, integration with existing CRVS work processes and information flows, linking VA results to civil registration records, information technology requirements and data quality assurance. This paper identifies and discusses the major system-level issues and emerging practices, provides a planning checklist of system-level considerations and proposes an overview for how VA can be integrated into routine CRVS systems.
The document was produced with multiple authors associated with the implementation of verbal autopsy in the context of country CRVS systems through the Data for Health Initiative.
Publishers
De Savigny D, Riley I, Chandramohan D, Odhiambo F, Nichols E, Notzon S et al.
Year
2017
Iris automated coding system for causes of death
Iris is an automatic system for coding multiple causes of death and for selecting the underlying cause of death. It can be used in batch or interactively. The dual aims of IRIS are to:
- provide a system in which the language-dependent aspects are separated from the software itself. Moreover, the language-dependent parts are stored in database tables and can easily be modified.
- improve international comparability. IRIS is based on the international death certificate form provided by WHO in Volume 2 of ICD-10 and the causes of death are coded according to ICD-10 rules. Updates to ICD-10 are included according to the WHO timelines.
Publishers
DIMDI Iris Institute
Year
2017
SmartVA-Analyze
SmartVA is an application that implements the Tariff 2.0 Method for computer certification of VA. It takes VA interview data as input and produces cause of death estimates at the individual and population levels. The SmartVA cause of death assignment system was designed and validated with the Population Health Metrics Research Consortium (PHMRC) Gold Standard VA database, collected as part of the PHMRC Gold Standard VA Validation Study.
Publishers
Institute for Health Metrics and Evaluation (IHME)
Year
2017
Verbal autopsy standards: The 2016 WHO verbal autopsy instrument
This questionnaire and analytical tool is designed for use in settings where deaths occur outside the health sector and medical certification of cause of death is not available in order to ascertain cause-of-death distributions in a population. The 2016 version of the WHO verbal autopsy instrument is suitable for routine use and is designed for all age groups, including maternal and perinatal deaths, and deaths caused by injuries. The tool was developed in collaboration by WHO, BMGF, D4H, CDC, JHU, UNFPA, INDEPTH Network, ICDDR, IHME, LSHTM, University of Queensland, Umea University, Ohio State University and Australian National University.
Publishers
WHO
Year
2016
Performing basic checks on cause of death data (CoDEdit)
The CoDEdit electronic tool is intended to strengthen the capacity of producers of cause-of-death statistics to perform routine data checks. The CoDEdit tool is applied at data compilation stage, and its primary purpose is to warn and flag basic gross errors, alert about possible misuse of codes and provide a data set summary.
Publishers
WHO
Year
2014
Maternal Death Surveillance and Response: Technical Guidance and information for action to prevent m
Maternal death surveillance and response (MDSR) contributes to better information for action by promoting routine identification and timely notification of maternal deaths, review of maternal deaths, and implementation and monitoring of steps to prevent similar deaths in the future. The technical guidance was developed by agencies including Canadian Network for Maternal, Newborn and Child Health, FIGO, ISA, DFID, UNFPA, CDC and WHO.
Internal Resources
Publishers
WHO
Year
2013
INDEPTH resource kit for demographic surveillance systems
In many settings where availability of data on fertility and mortality is limited, a number of health and demographic surveillance sites (HDSS) have been established that generate an ongoing stream of detailed information on fertility, mortality, causes of death and migration that can be used, for example, to evaluate the effectiveness of specific health interventions, such as the impact of distribution of insecticide-treated bednets to prevent malaria. In most instances, the sites are selected on the basis of convenience to serve as sentinel sites. However, in some countries, health and demographic surveillance is conducted in statistically sampled population clusters representative of the whole population in order to generate nationally representative statistics (Sample Registration with Verbal Autopsy or SAVVY). In both circumstances, verbal autopsy is used to generate information on causes of death. Statistics from HDSS sites can be used on an interim basis to generate national and subnational estimates of fertility and cause-specific mortality to support decision-making. The INDEPTH Resource Kit brings together best practices and experiences of a number of HDSS sites to provide detailed technical guidance, examples of all instruments and a vast array of manuals, tools, software and statistical code (such as for Stata).
Publishers
EPTH Network
Year
2008