Globally, an estimated two-thirds of all deaths occur in the community, the majority of which are not attended by a physician and remain unregistered. Identifying and registering these deaths in civil registration and vital statistics (CRVS) systems, and ascertaining the cause of death, is thus a critical challenge to ensure that policy benefits from reliable evidence on mortality levels and patterns in populations. In contrast to traditional processes for registration, death notification can be faster and more efficient at informing responsible government agencies about the event and at triggering a verbal autopsy for ascertaining cause of death. Thus, innovative approaches to death notification, tailored to suit the setting, can improve the availability and quality of information on community deaths in CRVS systems. Here, we present case studies in four countries (Bangladesh, Colombia, Myanmar and Papua New Guinea) that were part of the initial phases of the Bloomberg Data for Health Initiative at the University of Melbourne, each of which faces unique challenges to community death registration. The approaches taken promote improved notification of community deaths through a combination of interventions, including integration with the health sector, using various notifying agents and methods, and the application of information and communication technologies. One key factor for success has been the smoothing of processes linking notification, registration and initiation of a verbal autopsy interview. The processes implemented champion more active notification systems in relation to the passive systems commonly in place in these countries. The case studies demonstrate the significant potential for improving death reporting through the implementation of notification practices tailored to a country’s specific circumstances, including geography, cultural factors, structure of the existing CRVS system, and available human, information and communication technology resources. Strategic deployment of some, or all, of these innovations can result in rapid improvements to death notification systems and should be trialled in other settings.

中文翻译：

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没有医院的地方：改善社区死亡通知。

在全球范围内，估计有三分之二的死亡发生在社区中，其中大多数没有医生照料，并且仍未登记。因此，在民事登记和人口动态统计（CRVS）系统中识别和登记这些死亡，并确定死亡原因，是确保政策从人口死亡率和样式的可靠证据中受益的重大挑战。与传统的注册过程相比，死亡通知可以更快，更有效地向负责任的政府机构通报该事件，并触发口头尸检以确定死亡原因。因此，针对情况量身定制的创新性死亡通知方法可以提高CRVS系统中有关社区死亡的信息的可用性和质量。这里，我们介绍了四个国家（孟加拉国，哥伦比亚，缅甸和巴布亚新几内亚）的案例研究，这是墨尔本大学彭博健康数据倡议初期阶段的一部分，每个国家都面临着社区死亡登记的独特挑战。通过采取多种干预措施，包括与卫生部门整合，使用各种通知手段和方法以及信息和通信技术的应用，采取的方法可促进改善社区死亡的通报。成功的一个关键因素是使通知，注册和口头尸检访谈启动之间的流程更加顺畅。与这些国家通常采用的被动系统相比，这些流程实施了更多主动的通知系统。案例研究表明，通过实施针对一个国家特定情况的通知实践（包括地理，文化因素，现有CRVS系统的结构以及可用的人力，信息和通信技术资源），可以改善死亡报告的巨大潜力。对其中一些或全部创新的战略部署可导致死亡通知系统​​的快速改进，应在其他环境中试用。