Routine Health Information Systems (HIS)
Also: Health Facility Records
Routine HIS: BACKGROUND
Health information system (HIS) data on deaths are generated from health facilities including hospitals and health centres by medical professionals. Facilities compile statistics on maternal deaths and births and report these to the central level. HIS data are generally available, in some form, in most settings. However, quality can be variable and its scope is limited.
Please also see the related topic of ICD Coding
Identification of death
Medical professional/ facility records death at time it occurs.
Ascertainment of maternal/pregnancy related status
- medical professional gives cause (death certificate)
- may use diagnostic aids (e.g. pregnancy or laboratory tests)
- may use autopsy (post-mortem)
Advantages:
- on-going systems that therefore do not require special data collection activities
- can be used as a starting point for in-depth case reviews
- provides annual estimates of maternal mortality
- provides cause-specific mortality and trends
Limitations:
- community and private facility-based deaths are often excluded
- access to private facility data can be problematic
- the chain of moving data to central level is subject to problems
- not appropriate for calculation of population-based maternal mortality ratios unless close to 100% of deliveries/deaths take place in health facilities
- direction of bias in denominator/numerator is difficult to determine
- deaths that occur in emergency rooms are often missed, as are women who are “dead-on-arrival” or “discharged to die”
- may need to include record review since deaths within hospital often missed by hospital statistics
- records may not be kept
Measurement requirements:
- sub-causes need to be grouped as maternal deaths (ICD coding)
- data need to be compiled as part of hospital/health centre statistics
- need to feed into health information statistics and/or civil registration
- data on births are also needed to calculate the maternal mortality ratio (MMR) and lifetime risk (LTR)
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Routine HIS: GUIDELINES
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Routine HIS: REFERENCES
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Deneux-Tharaux, C, Berg, C, Bouvier-Colle, MH; Gissler, M; Harper, M; Nannini, A; Alexander, S; Wildman, K; Breart, G; Buekens, P (2005) Underreporting of pregnancy-related mortality in the United States and Europe. Obstetrics & Gynecology. 106(4):684-92. |
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De Sousa, MH; Cecatti, JG; Hardy, EE; Serruya, SJ (2007) Declared maternal death and the linkage between health information systems. Revista de Saúde Pública, 41(2): 1-8. |
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Graham, WJ; Hussein, J (2006) Universal reporting of maternal mortality: an achievable goal? International Journal of Gynaecology and Obstetrics, 94(3): 234-42. |
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Graham, W; Hussein J (2004) The right to count. The Lancet, 363(9402): 67-8. |
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Sombie, I.; Meda, N.; Hounton, S.; Bambara, M.; Ouedraogo, T.W.; Graham, W. (2007) Missing maternal deaths: lessons from Souro Sanou University Hospital in Bobo-Dioulasso, Burkina Faso. Tropical Doctor, 37(2): 96-8. |
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Routine HIS: ADDITIONAL RESOURCES
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