Improving health facility death notification and medical certification of cause of death through digital systems integration - A case of Uganda
1
Civil registration Of Vital Statistics, Uganda National Institute of Public Health UNIPH, Kampala, Uganda
2
Civil registration Of Vital Statistics, CDF Foundation, Atlanta Georgia, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The Ugandan law mandates the notification of all deaths. In 2020, this process required presenting the death notification form, a medical cause of death certificate (MCCD) or postmortem report with identification documents of the deceased by the applicant. In 2019, Uganda adapted the use of WHO MCCD form. This was followed by digitization into the national health Information system-DHIS2. This was completed with integration and customisation of the ICD 11 API and coding tool creating the DHIS2 MCCD application/module. National MCCD ToT’s were also conducted for over 50 health workers from 16 Regional referrals and cascaded training of over 300 health workers including nurses, medical doctors and record staff from 50 general Hospitals however utilisation of the digital MCCD remained insignificant.
METHODS:
With technical assistance from data for Health Initiative-CDCF, the MoH- Division of health information restored functionality of electronic MCCD/ICD11 module through review of all data fields for validity and interoperability with existing HMIS mortality review forms in addition to a data dictionary to describing all data elements. An application Programming Interface (API) was created between the MCCD module and the national registration data base to support death notification data transfer. Training with use of the application were conducted for health workers from 22 major hospitals across the country Regular monthly online case discussions and mortality reporting performance review meetings for death notification and MCCD.
RESULTS:
Since 2020, the country has reported an annual average of 47,000 health facility deaths. Health facility death notification rates were 0 in 2020, 2% in 2021, 6% in 2022, 15% in 2023 and 57% in 2024.
CONCLUSIONS:
Digitization of the MCCD tool improved health facility death notification by 50%. More efforts are required to improve completeness and quality enhancing national public health policies in prevention of top causes of death.
The Ugandan law mandates the notification of all deaths. In 2020, this process required presenting the death notification form, a medical cause of death certificate (MCCD) or postmortem report with identification documents of the deceased by the applicant. In 2019, Uganda adapted the use of WHO MCCD form. This was followed by digitization into the national health Information system-DHIS2. This was completed with integration and customisation of the ICD 11 API and coding tool creating the DHIS2 MCCD application/module. National MCCD ToT’s were also conducted for over 50 health workers from 16 Regional referrals and cascaded training of over 300 health workers including nurses, medical doctors and record staff from 50 general Hospitals however utilisation of the digital MCCD remained insignificant.
METHODS:
With technical assistance from data for Health Initiative-CDCF, the MoH- Division of health information restored functionality of electronic MCCD/ICD11 module through review of all data fields for validity and interoperability with existing HMIS mortality review forms in addition to a data dictionary to describing all data elements. An application Programming Interface (API) was created between the MCCD module and the national registration data base to support death notification data transfer. Training with use of the application were conducted for health workers from 22 major hospitals across the country Regular monthly online case discussions and mortality reporting performance review meetings for death notification and MCCD.
RESULTS:
Since 2020, the country has reported an annual average of 47,000 health facility deaths. Health facility death notification rates were 0 in 2020, 2% in 2021, 6% in 2022, 15% in 2023 and 57% in 2024.
CONCLUSIONS:
Digitization of the MCCD tool improved health facility death notification by 50%. More efforts are required to improve completeness and quality enhancing national public health policies in prevention of top causes of death.
| eISSN: | 2654-1459 |
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