Development of an Indonesian sample registration system: a longitudinal study

• Published in: The Lancet (British edition) 2013-06, Vol.381 (S2), p.S118-S118
• Main Authors: Pratiwi, Endah Dwi, MD, Kosen, Soewarta, MD
• Format: Article
• Language: English
• Subjects: adults; Cardiovascular diseases; Chronic obstructive pulmonary disease; cities; Data collection; death; demographic statistics; diabetes; health care workers; Health policy; Health problems; heart diseases; hospitals; Internal Medicine; islands; issues and policy; Longitudinal studies; Mortality; necropsy; pneumonia; pregnancy; statistics; stroke; tracer techniques; tuberculosis; villages
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(13)61372-0

Abstract Background Accurate basic demographic statistics are the basis for formulation of health policies and management of effective programmes. Mortality statistics from hospitals are incomplete due to limited utilisation of hospital services (only 8% of total cases). The benefits of a well-developed vital registration system include the ability to monitor and evaluate the impact of health programmes, better quality information, and more efficient delivery of health-care services. Methods Based on the Population Administration Law (Law No. 23/2006), the mortality registration system in Indonesia has been developed and implemented systematically in 128 randomly selected subdistricts located in 103 districts and 25 cities, covering Indonesia's population of 8 million since April 2012. The efforts get financial support from the Global Fund Round 10: cross-cutting health-systems strengthening interventions to evaluate achievement of Millennium Development Goals (MDGs) 4, 5, and 6 by 2015. Findings The previous pilot registration system in Solo City and Pekalongan District showed that the data collection, compilation, and verbal autopsy procedures could be carried out in a timely and reliable way to generate annual mortality statistics. The results show stroke as a leading cause of death among adults, the continued burden from tuberculosis, diarrhoeal diseases, and pneumonia, and the growing concern of diabetes, heart disease, chronic obstructive pulmonary disease, and neoplasm. Verifications were carried out using several criteria, namely completeness of birth and death registration (using capture–recapture method), validity of reported multiple causes of death (based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision), and consistency of local data over time. Other improvement efforts include strengthening of the voluntary reporting of neonatal, infant, and maternal deaths based on cohort data of pregnant mothers. Furthermore, better coordination between the population administration and health personnel at village and subdistrict levels has improved the completeness of registered births and deaths data. The condition is also facilitated by a joint decree between the Minister of Home Affairs and Minister of Health from 2010 regarding sharing of birth and death data. Development of a similar system has been carried out in the Islands of Sumatra, Jawa, Bali, Sulawesi, Maluku, and Papua, and will cover 128 subd