Report 2 | Underlying cause of death based on a sample of Medical Records from Public Sector Hospitals and Forensic Pathology Service Mortuaries

Executive summary

South Africa National Cause-of-Death Validation Project (NCODVP)

South Africa has a well-established Civil Registration and Vital Statistics (CRVS) system with a high proportion of deaths being registered. The quality of the cause of death statistics, however, is considered sub-optimal with a high proportion of ill-defined causes. In addition, there is extensive underreporting of HIV as an underlying cause of death.

The South African National Cause of Death Validation Project (NCODVP) was implemented by the South African Medical Research Council (SAMRC) and partners to validate CRVS cause-of-death information by linking CRVS data to data obtained from medical records (MRs), forensic pathology service (FPS) records, and verbal autopsy (VA) interviews for a national sample of deaths. The main purpose of the study was to compare the underlying cause of death from the CRVS with the highest level of information collected in the study (FPS record followed by MR and VA) so that correction factors could be estimated to derive cause-of-death profiles that are adjusted for the poor-quality information. Additionally, the study aimed to compare the medical cause of death identified from the different sources to assess their performance in identifying cause of death. The study protocol was reviewed and approved by the SAMRC Ethics Committee.   This project was reviewed in accordance with CDC human research protection procedures and was determined to be research, but CDC investigators did not interact with human subjects or have access to identifiable data or specimens for research purposes. Support was obtained from the National Department of Health (NDOH) and permissions were obtained from each provincial Department of Health and health facility included in the study.

View the complete South African National Cause-of-Death Validation - Report 2