What are our options for mortality data collection and how can they provide HIV-specific information?

Abstract

Background: Mortality data are critical for understanding changes in population health, detecting and monitoring diseases, guiding public health responses and evaluating interventions like human immunodeficiency viruses (HIV) prevention and treatment programmes. However, in low- and middle-income countries (LMICs), comprehensive mortality data are often hindered by a high incidence of deaths occurring outside healthcare facilities and the lack of robust data systems, creating a significant knowledge gap.

Aim: This article presents methodologies for collecting mortality data, particularly in LMICs, to provide accurate and reliable information on overall and cause-specific mortality, including HIV-related deaths.

Setting: This study explore methods that may be useful in LMICs, where mortality data systems are often ad-hoc, sub-national and incomplete.

Method: Available methods were examined for collecting mortality data and report on the strengths, weaknesses and resource considerations for each method.

Results: The analysis shows that while Civil Registration and Vital Statistics is the gold standard for mortality data collection, its implementation is challenging because of differing priorities of stakeholders, infrastructural and legal barriers. Alternative methods may provide valuable data but may have limitations in coverage and resource allocation. Integrating these methods can enhance understanding of mortality data, including for HIV-related deaths.

Conclusion: Implementing a combination of mortality data-collection methods could address gaps in mortality data in LMICs. Tailoring interventions based on these data may improve health outcomes and support HIV epidemic control efforts.

Contribution: This study could be used as a resource to ministries of health, national and international public health organisations, researchers and funding bodies as it can assist countries in selecting the mortality surveillance strategy that best fits their HIV epidemic, and available infrastructure and financial resources.