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The world, especially the low-income countries, lacks a viable system to register every death. The problem is conspicuous in Africa.
Just one in 10 deaths in the continent is recorded, flagged a new World Health Organization (WHO) report. Of Africa's annual average of 9,285,000 deaths between 2013 and 2018, only 921,000 were registered, the report said.
This will affect monitoring of global health outcomes since of the 18.2 million unregistered deaths across the world in a year, over 8 million or 46 per cent are in Africa.
WHO said this in its first-of-its-kind assessment of health information systems across 133 countries between 2013 and 2018, using the WHO SCORE Assessment Instrument launched in 2018.
“The SCORE report urges countries to strengthen their overall health data systems, to improve their death data registration systems and to collect more and better quality data to address inequalities,” said media baron Michael Bloomberg who is also the WHO Global Ambassador for non-communicable diseases and injuries.
The cause of deaths for nearly 92 per cent of reported deaths in African nations is not known.
Gap in birth count too
At least 28 per cent of the births across the world are not registered in a year.
Of the 36 million children born but unregistered, more than 55 per cent, or 20 million, are in the 47 African countries that WHO monitors.
Underlining regional variations in the capacity of countries to survey population health threats, it noted that in the WHO African region, only one out of 47 countries has sustainable capacity for public health surveillance.
Because of this lack of data, almost all the countries across the world faced serious challenges in counting the deaths due to the novel coronavirus disease (COVID-19). This impeded response planning, noted the WHO report released Feb 1, 2021.
No country has a fully mature health information system capable of meeting its evolving needs, the report said.
Regional disparity
WHO, in the report, flagged the difference in ‘health information system’ between high-income countries and countries in lower income groups.
For example, two of every three high-income countries have well-developed or sustainable capacities for surveying populations and health risks compared with half the countries in the lower-middle-income and low-income groups, according to the report.
While this assessment covers the period when COVID-19 pandemic did not happen, its results are quite relevant.
It addresses the commitment of WHO to support member-states in the effective collection, analysis, reporting and use of health data to achieve the sustainable development goals related to health.
Census data
Most countries maintain a census or population registry and 86 per cent conducted a census in the last 10 years, providing important baseline data for many health estimates, the report said.
But just 50 per cent of the countries provided disaggregated population projections, limiting the use of these data for regional, local-level intervention.
There is also a need to improve health statistical systems in India where the data gap is quite wide. For example, nearly 40 per cent births are not registered in Bihar, according to the SDG India Index report 2019-20 released by NITI Aayog.
Stimulus necessary
Various ongoing health programmes that were affected by COVID-19 will need better monitoring for ‘fast-tracking’ progress under the sustainable development goals.
When measurable impact is key to transforming the future of public health, it is imperative to prioritise ‘data governance’ for gathering timely, reliable, actionable health information.
There is an urgent need for funds to strengthen the health information system capacity for responding to health emergencies and tracking progress towards global health goals.