Evaluation of the Current Documentation of Death Certificates in the Gaza Strip

Jawad Jaber Badwan
جواد جابر سلامة بدوان
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Al-Quds University
Death certificates represent a data source that many health researchers find useful and attractive for analysis. It is an official document that declares a person is died, how we document the death certificate affect our mortality statistics which are very important. Public health policies depend heavily on the mortality indicators derived from death certificates. Because they are the main source of information about the causes of death and illness preceding death. This study aimed to evaluate the current documentation of death certificates in the Gaza Strip. Triangulated cross sectional quantitative, qualitative study was conducted in order to evaluate the current documentation of death certificates in the Gaza Strip. The instrument used in this study were reviewing death notification certificates through self constructed checklist and in-depth interview with 12 managers. Total of 256 death notification certificates from 1-7-2009 to 31-12-2009 were chosen through systematic sampling method and Epi info program. 0ut of them, 237 death notification certificates were detective, so the detective rate was 92.5%. The study findings show that for reporting of original city, 28.7% was incomplete and 37% of birth dates were improperly reported. For occupation and addresses 56% and 67.9% respectively were incomplete. For data relating to death hour and if the baby live less than 24 hours, missing of these data were 19% and 97% of the certificates respectively. The findings of the study revealed that 38% of the cause of death is not documented completely nor accurately, 100% of the certificates did not mention if the deceased was pregnant or not at time of death, 10.5% of certificates were not certified by physician completely and 11.8% of PHC registration was incomplete. Finally results show that our physicians are not trained, but familial by experience on how to complete death notification certificate and the mortality and morbidity committees within hospital are not active. The researcher concluded that there is a serious problem regarding the documentation of death notification certificates in the Gaza Strip in personal and demographic section, cause of death section, certifying physician section and PHC governorate certification section. And that due to lack of formal training, medical inexperience and perceived lack of certificate importance. The researcher recommended that continuous training for physician on the proper way of completing death notification certificate, reactivation of mortality and morbidity committees within hospitals and initiating of professional committee in the MOH responsible for querying cause of death could help in promoting better and more accurate documentation of death certificates. Also the researcher recommended for further study to investigate the effect of good documentation of death certificates on mortality statistics and health status of the population.