Myanmar: Strengthening Data

Myanmar: Introducing verbal autopsy methods to improve birth and death data registration.

Bloomberg Data for Health Initiative researchers Professor Alan Lopez, Dr Tim Adair, Sonja Firth and Nicola Richards travelled to Nay Pyi Taw, Myanmar, in early August to assist with strengthening the local civil registration and vital statistics (CRVS) system.

Improving quality of information

The visit began with Dr Adair teaching a four-day course titled Estimating the Completeness of Registration, attended by staff from the Central Statistics Office (CSO) and Ministry of Health and Sports (MOHS). Completeness relates to the percentage of births or deaths in a population that are registered. The course covered a range of concepts including the importance of routinely assessing completeness to monitor the performance of a CRVS system and improve data quality. Equipped with this new knowledge, the CSO and MOHS are now progressing with amendments to how age is recorded on birth and death registration forms.

The University of Melbourne team then led a three-day technical working group meeting with Joan Thomas and Martin Bratschi from partner organisation Vital Strategies. More than 50 representatives from the CSO, MOHS, Department of Immigration, local universities and in-country partners were in attendance. The meeting provided an opportunity for updates on CRVS activities as well as discussions regarding the Data for Health Country Work Plan, baseline evaluation, enterprise architecture maps, birth and death reporting processes, and using the verbal autopsy process for community deaths.

The country implementation team (comprising University of Melbourne and Vital Strategies staff and a Myanmar local employed by the initiative) is preparing a ministerial briefing document for submission that will summarise key decisions made at the meeting including: lessening the reporting burden on midwives by reducing the number of data variables to collect and duplicative forms to complete; adopting the International Form of Medical Certificate of Cause of Death to improve reporting on maternal deaths; and implementing a model of verbal autopsy that combines current paper-based reporting forms onto tablet.

Introducing verbal autopsy to midwives

The last part of the visit to Nay Pyi Taw involved a two-day pre-training session that introduced the verbal autopsy process to midwives. Outcomes of the training included: clarity over roles and responsibilities; discussion regarding how verbal autopsy can be integrated into the current death reporting system; and feedback on the virtual autopsy implantation plan for Myanmar.

The technical assistance program offered by the Bloomberg Data for Health Initiative is based on the best possible evidence and many years of experience in streamlining CRVS systems to make them more effective. The recent visit provided stakeholders with the opportunity to discuss options for improving and rationalising their CRVS system, ensuring it can more effectively guide policy debates in the country.