Health Statistics Reporting in Maldives - PowerPoint Presentation

Slide1

Health Statistics Reporting in Maldives

By: Ms.Mariyam Mohamed & Ms.Ummeedha Abdul Razzag

Ministry of Health & Gender

Republic of Maldives Slide2

I: Civil Registration and Vital Statistics (CRVS) system in Maldives

Maldives – An overviewStructure of Health System

Contents of the Annual Health Report / Maldives Health Statistics

Data compilation and Analysis

Format of Presentation / DisseminationAreas for ImprovementSlide3

MALDIVES – AN OVERVIEW

Total of 1192 islands187 inhabited islands

Population-

298,968

(Census 2006) 341848 (2014)Infant Mortality Rate – 9 per 1000 live births 2012 (The Maldives Health Statistics 2014 draft )Maternal Mortality Ratio- 13 per 100,000 live births (The Maldives Health Statistics

2014 draft

)

Under Five Mortality Rate - 11 per 1000 live births (The Maldives Health Statistics 2014 draft )Life expectancy at birth:Male: 73.0 (2012)Female: 74.8 (2012)(The Statistical Yearbook of Maldives, 2014)Slide4

Health System of MaldivesSlide5

1

CENTRAL

2

REGIONAL

3

ATOLL

4

SUB-ATOLL

5

ISLAND

STRUCTURE OF HEALTH SYSTEM (previous)

Department of

Public Health

Department of

Medical Services

Maldives Food and

Drug Authority

Indira

Gandhi

Memorial Hospital

National

Thalassaemia

Centre

Regional Hospitals

Atoll Hospitals

Health Posts & Family Health Sections

National Health

Laboratory

Health Centres

MINISTRY OF

HEALTH & GENDERSlide6

Figure 1: VRS FLOW DIAGRAM

Birth / Death Occurs

Birth Form / Death form (Triplicate copy forms)

White Copy

Yellow Copy

Pink Copy

Parent/ Guardian

Department of National Registration

(

DNR)

Island administration responsible for death registration/ Male’

Municipality

Island Councils /Atoll Council/ DNR

 Slide7

Occurrence of a birth

Occurrence of death

Fill in the birth form

Triplicate copying of the forms

Department of National Registration (DNR)

Island Office or Councils/ Male’ City Council

Fill in the death form

(death certificate)

Parent / GuardianSlide8

Island Councils

Health facilities

Atoll Councils

Database of all births and deaths in the country

Registry of all births/ deaths

Photo copy

Registry of all births/ deaths in the atoll

Ministry of Health & Gender

Registry of all births/ deaths in the island

Department of National Registration (DNR)

Records of all registered births

Records of all deathsSlide9

Photo copy

Birth

Death

Fill in the birth form

Fill in death form

Dept.

N

ational Registration Island Councils

Parent / guardian

Hospitals

Health

Centres

(

TBAs)

Foolhumas

Island Offices

Atoll Councils

Male’

Male’ City Council

Male’

Male’Slide10

Contents of the Annual Health Report / Health Statistics

NatalityMortalityMorbidity / Health ServicesHuman ResourcesHealth Care FinanceOthersMDG Indicators –incorporated within sectionsNHA – very limited baseline dataSlide11

Data compilation and Analysis

Data collected at :Peripheral Health Care facilitiesHospitals / Health Centres / Health Posts

Data compiled :

Ministry of Health & Gender – Planning and International Health Section/Health

Protection Agency/Regional HospitalsData Analysis Previously Annual Health Reports published Currently Maldives Health Statistics publishedHealth Reports to be published every five years – detailed analysis of trendsSlide12

Topics and themes covered by VS

Vital Statistics:Crude Birth Rate / Crude Death Rate / Infant mortality rate/ Neonatal Mortality Rate /Under5 mortality rate/ Maternal mortality rate /still birth rate/teenage pregnancies/mode of delivery/ cause od death / Age specific Mortality rate/etc are calculatedAnnual statistics published with gender disaggregation

Stats

are taken by locality /island /atoll

wise and gender disaggreagtedVRS is the main source of vital stats.Since VRS is complete ,Census and other surveys not used to collect vital stats ,however Census is conducted in every 5yrs Slide13

Format of Presentation / Dissemination

Maldives Health Report & Maldives Health StatisticsPublished (last one published in 2012)Printed in hard copyElectronic Form availableOn CDOn Websitewww.health.gov.mvUsed for policy making and for other purposes including for use by government and students.Slide14

Areas for Improvement

Improved Data CollectionTimely InformationStrengthened Reporting SystemStandards developedCapacity BuildingAt central levelAt Regional / Atoll LevelSlide15

Major

changes / reforms in the CRVS in Maldives during the last decadeFunctioning of CRVS

Coordination in CRVS

Topics and themes covered by Vital Statistics

Quality assessment and assurance in Vital StatisticsII: Changes / Reforms in CRVS in the last decadeSlide16

Coordination in CRVS

100% coverageICD coding1992 legislation still continues in birth registration The system will catch all the entries and get access toDNR / MoH&G Online system is hosted by NCIT Present change VRS data entry work moved to DNR in June 2011Online system functioning only in central levelSlide17

Quality assessment and assurance in VS

ICD training has given to Drs in the IGMH and coders have been trained in different regions (working in different hosps)Cause of death validation studyVRS assessment VRS completeness studyRegular checking of data in the formsSlide18

Functioning of CRVS

Triplet copies introduced in 2003 - Copies of the original forms to central level for recordsOnline system introduced in late 2009ICD coding to 4 digits introduced in 2004Birth and death forms are shared with all island facilitiesSlide19

The geographical nature of the Maldives presents difficulty in transportation and also causes delays in timely exchange of information. However, over the years the development in telecommunication has brought about positive changes to the problem but still the problem of timely exchange of information does exist. Slide20

As early as 1960s births and have been reported to the Ministry of Health through a system of registration and this can be said to be the first records in a formalized manner.

The previous death forms and birth forms did not flow from the atolls to Male’, rather a birth and death list was compiled from atolls and sent to MoHG. Slide21

Legislation pertaining to registration of births and deaths were passed and enacted in the country in 1993. The legislation entitled “Registration of Births, Birth Certification and Death Certification”, legislation number 7/92 was a turning point in strengthening the birth and death registration in the country.

Since its enforcement various efforts were made to improve and facilitate the process. the role of registration was passed later to Male’ City Councils and Island Concils in the atolls. Slide22

Establishment of a systematic reporting system with triplet copy method which ensures that a copy is kept at:  1) local registration facility (Male’ municipality and island offices 2) patient or relative and 3)

Department of National Registration. It is encouraged that a photocopy of the forms are kept at the health facility. Development of a unique serial number for each reporting form (Birth and Death) which enables tracking the reporting form and allows for follow up. Various training workshops and awareness programmes

have been conducted in the islands to familiarize with the procedure of reporting vital events. Slide23

Various training workshops and awareness programmes

have been conducted in the islands to familiarize with the procedure of reporting vital events. Procedure Manuals have been distributed to all islands and health facilities.Each and every field of the birth and death records are cross checked from the database with the manual reporting form.Establishment of Online Birth and Death system.Slide24

Data processing and records maintenance at DNR

 All the yellow copies of births and death forms received at DNR is entered to the computerized system. Cross checking is done to ensure the correctness of information and attempts are made to obtain any missing information on the forms

At the end of the year all the information entered to the system is checked against the yellow hard copy of the forms and

validated

.Slide25

There is usually a delay in getting the forms from the atolls mainly due to lack of a monitoring. Even if staff follow up and call to request to send the forms, forms will be submitted towards the end of the year which may possible to due difficulty in transportation and sending of forms.Slide26

Improvement of the years

Since 1999 there has been a lot of work done to improve the national vital registration system of Maldives.  Some of the actions that have been taken are:Establishment of a systematic reporting system with triplet copy method which ensures that a copy is kept at:  1) local registration facility (Male’ municipality and island offices 2) patient or relative and 3) Ministry of Health & Family. It is encouraged that a photocopy of the forms are kept at the health facility. Development of a unique serial number for each reporting form (Birth and Death) which enables tracking the reporting form and allows for follow up. Various training workshops and awareness programmes have been conducted in the islands to familiarize with the procedure of reporting vital events. Slide27

Improvement of the years

Procedure Manuals have been distributed to all islands and health facilities.Each and every field of the birth and death records are cross checked from the database with the manual reporting form.Establishment of Online Birth and Death system.Slide28

Thank you!