In the Solomon Islands, most people live and die without any official record of their existence. Only 30% of the population have birth certificates, and less than 1% of the country’s deaths are registered. In fact, doctors typically only issue a death certificate at the family’s request.
This is not just an injustice for the individual. It’s a serious roadblock to improving public health. With no standardized birth or death certificates, and no mortality database, much of the data needed to find and address public health issues is based on limited data and regional modeling.
In January, Ashley Frederes, Vital Strategies’ Data for Health Initiative Program Officer, travelled to the Solomon Islands to help bring their vital registration system up to date, and to help make sure that the people of the Solomon Islands are counted and cared for.
A key component of this program is the introduction of a new death certificate, based on the international standards established by the World Health Organization. The new form is intended to standardize the way in which deaths are recorded. Where once a person might consider “old age” a cause of death, now doctors will be trained to identify specific causes.
However, it is not as simple as creating a better document. Before the national rollout, Vital Strategies in partnership with the University of Melbourne intends to train all of the doctors in the country, including the 125 who practice at the National Referral Hospital in Honiara, and those working in the 11 smaller hospital facilities throughout the islands.
By April, all doctors will be trained in how to properly certify medical cause of death using the international standard form. From that point on, all death certificates will be compulsory medically certified.
To ensure that these new standards are maintained, a new national mortality committee will be comprised of a broad-based group of public health and medical experts, charged with reviewing any death certificates that may not be up to snuff.
When the program is rolled out, the effects will be monumental. Frederes projects that by March, 2017, the number of reported deaths will increase from 1% to 25%. That increase means a better understanding of the health problems effecting the islands. It means a stronger baseline of data to tackle these problems.
The impact will be most significant in the outlying provinces, where the mortality data is so limited that it is nearly impossible to verify the leading causes of death in the population.
While the obstacles ahead may seem daunting, Frederes is optimistic. In a very short time, the Data for Health program has helped make a significant impact in the Solomon Islands. More people are being counted, recognized and cared for.