NAIROBI, Kenya:July 4 (Xinhua) — Most deaths that occur in Kenya, especially in rural areas, are not captured in the national civil registration system leaving several deaths unaccounted for.
Health experts observe that the deaths go unreported because there are no reliable systems in the areas to capture causes of deaths.
“The accuracy and efficiency of death registration in Kenya is under 50 percent. That is, only half of all deaths across the country are correctly -if at all- captured by civil registration system,” said Dr Sam Oti, a health expert from African Population and Health Research Centre in Nairobi, in an interview on Tuesday.
The situation poses a health hazard to the East African nation since concerned authorities do not get information on the causes of deaths, which if known help to save lives.
“Death without documentation for any country is big a tragedy. If we know why people are dying then we can prevent more deaths and spread of diseases,” he said.
For instance, explained Oti, if in a rural town half of all deaths among children under-five years are due to measles, then ensuring that all children get vaccinated will save a lot of lives.
“But if no one knows what is killing the children, then nothing will be done about it and this is indeed would be a tragic waste of lives and may result in a health crisis,” he added.
In Kenya, the Department of Civil Registration is tasked with death registration. However, most information about deaths is recorded in hospitals and funeral homes, through health management information system. It is estimated that as much as 75 percent of the deaths in urban areas like Nairobi are captured by the vital registration system.
However, in far flung towns for instance in Northern Kenya, less than 10 percent of deaths are captured by the system at national level. The expert suggested that to improve efficiency of capturing information on death, Kenya and other African countries should adopt verbal autopsy (VA).
This is the process of interviewing any respondent, usually a family member, close friend or neighbour, who might have accurate information about circumstances leading to the death of an individual. The interview is done by a trained VA interviewer in the community.
“Whenever a death occurs, the community alerts a trained VA interviewer. The interviewer visits the residence of the deceased and extends condolences. After this, he schedules a return visit few weeks after the death has occurred. He will return to the home and conduct the VA interview,” explained Oti, who noted the method is widely used in Asian countries.
The interviewer will focus on symptoms and signs that a patient may have experienced before death, for instance if he had high fever? And how long did the fever last? “
After the interview, the completed questionnaires are sent to medical doctors who go through each of them and by consensus, assign possible causes of death,” said Oti.
He noted that VA compares well with other methods of capturing data on death.
“Several validation studies for verbal autopsies have been published. The results indicate that VA compares quite well to other methods of capturing death information especially for major diseases of public health importance in our setting such as HIV/ Aids, tuberculosis, violent injuries, stroke, heart attack, pneumonia and diarrhoea,” said Oti.
The expert observed that Kenya, as many other African countries, cannot afford efficient death registration systems because they are expensive to set and run.
“The reason why vital registration systems are of low quality especially in the developing world is largely because they are quite expensive to set up and maintain.
Many developing countries are finding it difficult to set up vital registration systems that are comparable to what is in most developed countries,” he noted. (Xinhua)
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