In Tanzania, a lack of vital information has prevented the government from addressing many urgent matters of public health. In a nation of more the 55 million people, only 8% of all deaths are assigned a cause of death (COD) that is of good, usable quality for vital statistics. Without a clear picture of the underlying causes of death among its citizens, any attempt to tackle national health challenges can often seem like searching in the dark.
Fortunately, there are many ways for the government to bridge this gap, and obtain the necessary information to make informed public health policy. For instance, 16 percent of all deaths in Tanzania occur in health facilities, which means that there is a significant opportunity to ensure that each of these deaths is assigned a correct COD. Conversely, more than 70 percent of expected annual deaths in Tanzania occur in the community.
To address this, the Tanzanian government’s Bloomberg Philanthropies Data for Health Initiative and the World Health Organization are in partnership to develop programs that are improving the prevalence and reliability of COD data both in the community and in health facilities.
To address the 30 percent of deaths that occur in health facilities, the government is establishing a system to increase the quality of medically certified causes of death in health facilities by ensuring that all certifying physicians are equipped with the necessary skills. Medical students and in-service physicians will also receive training on how to correctly issue a medical certificate of death. This topic will be incorporated into the training syllabus of clinical officers and assistant medical officers.
The updated syllabus will be used in all 60 medical schools in Tanzania starting in the 2018/2019 academic year. These colleges graduate over 10,000 students each year, all of whom will be able to apply their training in hospitals. A similar review is planned for other high-level medical universities.
To address the 70 percent of deaths that occur in communities, a recently completed pilot program for routinely reporting CODs using verbal autopsies is about to take the next step to institutionalize verbal autopsy training. Verbal autopsies are an essential component in improving the quantity and quality of COD data when deaths occur outside the hospital, often in rural, hard-to-reach areas. During the pilot program, more than 600 community deaths were reported with underlying CODs.
Through its Data for Health Initiative , Tanzania will establish a sustainable death registration system for reporting on the 92 percent of deaths whose causes have for too long remained unknown. By building a system that effectively gathers high quality mortality rate statistics, Tanzania will be better-equipped to assess and tackle its public health challenges.