A Systems Approach to Improving Registration and Certification of Medico-Legal Deaths in Ghana

Fidelia A. A. Dake, Regional Institute For Population Studies, University Of Ghana
Emmanuel Opoku-Addo, Ghana Statistical Service
Omar Seidu, Ghana Statistical Service
Carlie Congdon, Vital Strategies

Vital statistics generated from a well-functioning civil registration and vital statistics serve as a source of reliable and timely data for health policy programming and planning. The United Nations recommends recording vital statistics on at least four vital events: births, deaths, marriages and divorces. In many sub-Saharan African countries, civil registration systems do not perform to acceptable international standards. Death registration is low compared to birth registration and the quality of vital statistics on causes of death is particularly poor. In Ghana, death registration coverage is about 25 percent and the quality of vital statistics on causes of death is less than 10 percent. The government of Ghana adopted a systems approach using business process mapping to analyze the challenges in the registration of medico-legal deaths. The results show a cumbersome process that burdens the family of a deceased person with notifying a death and following through with the registration process. Additional barriers such as cost and travel time to registration centers preclude the notification, creating a missed opportunity for registering, certifying, and generating vital statistics on medico-legal deaths. System challenges such as the coroner investigation process further delays and sometimes impedes the registration process.

Keywords: Data and Methods, Mortality and Longevity, Civil Registration and Vital Statistics, Health and Morbidity

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