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Evaluating the quality of vital statistics. UN Expert Group Meeting, 27-30 June 2011 Dr AJ Lanyon Australian Bureau of Statistics 30 June 2011. Outline. Chapter V: some comments Utility of an assessment framework and guidance tool Example: WHO/UQ HIS-Hub tool

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evaluating the quality of vital statistics

Evaluating the quality of vital statistics

UN Expert Group Meeting, 27-30 June 2011

Dr AJ Lanyon

Australian Bureau of Statistics

30 June 2011

outline
Outline
  • Chapter V: some comments
  • Utility of an assessment framework and guidance tool
  • Example: WHO/UQ HIS-Hub tool
  • Country Developmental Pathways
  • Conclusion?
chapter v comments
Chapter V: comments
  • Evaluating quality can be challenging and complex
  • Chap V currently provides comprehensive overview of different types of approaches and methods (direct and indirect)
  • Should, in general, be carried forward
chapter v comments1
Chapter V: comments
  • However:
    • elements of the Chapter are very technical and dense
    • could benefit from reference to an assessment framework that provides guidance about why, when and how to assess different elements of the quality of vital statistics
    • could consider a recommendation on how to manage revisions of data and subsequently vital statistics
example framework
Example framework
  • Work by WHO / UQ HIS-Hub across past 5 years has demonstrated value in improvement of CR and VS systems of:
    • overarching system assessment framework
    • assessment guidance tool.
  • Help to:
    • Identify strengths / areas for improvement
    • Develop feasible action plans for CR and VS system improvement.
context
Context
  • Tool developed in light of slow progress in a number of countries in strengthening their CRS
  • Framed to empower countries to develop action-based plan with the support of key stakeholders in their CR and VS systems
framework focus
Framework focus?
  • Reviewing the system underpinning the production, quality and use of birth, death and cause-of-death information
  • Not just focussed on the product or the output i.e. vital statistics
  • Did not include foetal deaths as many countries not able to collect relevant data – could be expanded to
evidence that it works
Evidence that it works . .
  • Countries who have successfully used the framework now have:
    • Strong understanding of strengths/weaknesses of their systems
    • Complete understanding of key stakeholders necessary to support effective system functioning
    • Action plan in place to achieve functional and sustainable system and quality VS
    • Intra-agency co-ordinating committee moving forward
what s in the framework
What’s in the framework?
  • Inputs – Legal framework for CR and VS systems; Registration infrastructure and resources.
  • Processes – Registration practices, coverage and completeness; Death certification and cause-of-death; ICD mortality coding practices.
  • Outputs – Data access, use and quality checks.
what s in the guidance tool
What’s in the guidance tool?
  • Comprises series of questions for each sub-component
  • Helps investigate how CR and VS systems have necessary inputs and processes in place to produce quality outputs i.e. vital statistics
  • Assists in better description of:
    • any issues or problems, and
    • possible strategies to address.
review approach
Review approach
  • Promotes establishment of an inter-agency review team
  • Required to gather relevant (specified) evidence
  • Basic assumption:
    • Buy-in of key stakeholders to process and ownership of final action plan
    • Collaboration

= KEY TO SUCCESS

component e1
Component E1
  • Data quality and plausibility checks
    • Levels of fertility and mortality
    • Causes of death
  • Asks questions like:
    • Are fertility indicators routinely calculated?
    • If so, which ones?
    • What data sources are used as the denominators to calculate rates?
    • Describe plausibility and consistency checks carried out (gives examples)
developmental pathways
Developmental pathways
  • Rapid assessment version of the tool has been applied in 26 Asia Pacific countries
  • Results help to differentiate between strength of countries CR and VS systems
  • Identified 3 broad groups of countries:
    • dysfunctional to weak systems:
    • Functional but inadequate;
    • Satisfactory (minor adjustments possible).
developmental pathways1
Developmental pathways
  • Analysis of 26 assessments
  • Cross-cutting issues:
    • Coder qualification and training alongside quality of coding
    • Routine procedures to check quality of fertility and mortality data produced
    • Certification practices
    • Lack of collaboration across government departments.
developmental pathways2
Developmental pathways
  • Analysis also re-affirmed different countries:
    • different levels of system maturity
    • different strengths, weaknesses, opportunities and threats, and
    • different developmental priorities and pathways.
  • Cross-cutting issues could be addressed through regional programmes.
conclusion
Conclusion
  • Can’t replace technical sophistication required to evaluate quality of VS
  • Can provide a framework to support countries to work through (what can be) a complex and challenging process to understand quality strengths and develop strategies to address issues.
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