Vital Statistics Commission of Jamaica - Planning Institute of Jamaica

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Audit of Vital Registration and Vital Statistics Systems: Jamaica Exhibit A I.D. Finding 1. For Coroner’s cases, it is often difficult to obtain post mortem cooperation from families for registration information because there is no penalty for non-compliance. If there is an estate in question or a will to be probated, then the family is inclined to ensure registration procedures are completed 2. Form D, Certificate of Coroner, is obtained by the family to register a death. The form is manually logged but there is no reconciliation to registrations reported at the RGD 3. Parish Officers present to the CC to obtain all Form Ds not picked up by family members but there is no written policy or expectation. 4. CC claims that approximately 3-4 Forms D are lost per month by the RGD 5. RGD does make an effort to collect From D 6. Cause of death is not always reported correctly 7. Lack of distinction between registration data and occurrence data 8. Efforts are being made by the RGD to collect violent death information from the CC 9. Violent deaths – Form D was usually attached to the certificate but Form E was often missing 10. Law says a delayed registration is 12 months. RGD uses a three month definition 11. The MOJ’s current tracking and reporting system provides aggregate volume numbers, not the details around the causes, locations, etc. of deaths 12. MOJ systems are all manual. There are limited capabilities for evaluating backlogs and systemic problems (Data analysis is not being performed to identify systemic problems for solutions) 13. In some cases investigations of deaths have taken up to five years to be completed and the findings sent to the Coroner 14. The MOJ is in the process of installing and implementing a new information system (JEMS) to be used to track all cases in courts 15. Coders do call physicians for clarification of coding issues, but they do not use a standard set of parameters 16. Coding at the RGD is manually performed 17. The RGD database is organized according to registrations, not occurrences, but vital statistics data can be extracted from this type of database 18. LDR 19. Open air facility 20. No computerization, only paper registrations 21. Parish officers pick up the paper forms for transport to the RGD 22. Anecdotal evidence suggests that there apparently are problems in tracking peri-natal deaths, particularly neonatal deaths occurring within seven days of delivery in hospitals 23. Areas when/were births were being missed 24. C-sections 25. Weekend staffing (no ward secretary to complete a notification form) 41
Audit of Vital Registration and Vital Statistics Systems: Jamaica Exhibit A I.D. Finding 26. Fetal deaths - 50% of the time the mother does not show up to identify the body so the hospital staff do not provide notification 27. Bed availability – if no bed is available post partum, the mother may be admitted to a bed outside of the maternal ward and the information may not be gathered because the staff that do that would not round there. 28. Babies that die in the nursery – if cause of death is unknown, post mortem is performed. If the mother does not present to claim the body within 30 days, the body is buried but the birth and death are not registered (hospital 29. If post mortem takes a long time, the mother may not return to claim the body, so birth and death may not be registered 30. Born before arrival – inconsistency in applying responsibility for registering births 31. Allegations were made of impropriety with regard to requiring payments of hospital bills before birth notifications are completed 32. Births attended by certified midwifes, uncertified attendants, and physicians outside of the hospital may not be reported completely 33. There is a lack of information concerning births and deaths occurring in private hospitals and clinics 34. Lack of a robust, computerized hospital information system that allows electronic interfacing of data and minimizes manual data entry of the same information from agency to agency 35. The hospitals’ PAS has limited capabilities in terms of type of information collected and reporting capability 36. There is no electronic information system in the clinics 37. According to the RHA, data obtained from the clinics is considered very inaccurate 38. Many hospital forms provide for free-form information entry, not forced fields entry 39. By observation, MOH forms do not provide for the collection of some information required for accurate vital statistics reporting 40. Official information collection forms are the responsibility of RGD to develop and maintain 41. Births and deaths in prisons are not being reported completely 42. The RGD’s data entry standards and procedures are rigorous 43. Lack of discharge summaries was indicated by the NDMR to be a problem, but our findings did not support that indication 44. Maternal deaths – information goes to the MOH but that information is not routed to the RGD, reported out by the MOH only 45. Birth and death records are not linked – more of a security risk to prevent fraudulent use of a birth certificate 46. A manual of written policies and procedures for establishing and maintaining a patient’s medical record, including how information concerning births and deaths should be reported, was developed and issued by the MOH 42
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Vital Statistics Commission of Jamaica - Planning Institute of Jamaica

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