Implementing an electronic death notification system in Peru
In Peru, over one in five people who die in Peru are not being counted in either the Ministry of Health (Ministerio de Salud, MINSA, 44 percent omitted) or in the National Registry of Identification and Marital Status (El Registro Nacional de Identificación y Estado Civil, RENIEC, 23 percent omitted).
Among the barriers to notification in Peru, it was identified that there were difficulties and low incentives for health facility staff and medical examiners to collect more vital events.
In 2016, with the support of the Bloomberg Philanthropies Data for Health Initiative, Peru launched an online mortality system (SINADEF).
To support the new online mortality system, two Ministerial Resolution guidelines were updated, processes among stakeholders were reviewed and updated, and notifications were collected from more sources.
Since SINADEF’s launch, over 4800 doctors received training on medical certification of cause of death and use of the SINADEF system.
The system also includes death registrations from external causes and home deaths (via the forensic institute). The database is now shared among RENIEC, MINSA and the National Institute of Statistics and Information Technology (Instituto Nacional de Estadística e Informática).
This year, the Ministry of Development and Social Inclusions will include an incentive for registration offices and health networks to implement and use SINADEF.
What impact have these changes had on the notification system?
Database available 12 months after the end of the year
40% of the database available in the same year
Limited access to information on causes of death
Dashboard for consultation of deaths and monitoring of implementation
Quality of data
Data without validation (Identification of deceased, districts, health establishments, etc.)
Links to databases (Identification of people, ubigeos, health facilities)
Quality of the causes of death
lllegible letter, the technician transcribes and reinterprets what the doctor writes, coder without training in ICD-10, codifies cause of death
The doctor writes on a device the diagnoses, coders trained in ICD-10 code the causes of death
Source: Peruvian D4H team presentation at November 2017 Technical Advisory Group Meeting, New York City