JMIR Publications

ABSTRACT

Background:

Mortality statistics are one of the most reliable bases for measuring the extent of health problems in a country. The quality of these statistics depends on the degree of precision of the death certificates. In Mali, despite the high maternal, infant, child, child and neonatal mortality rates, there is no single model of death certificate. Each health structure has its own model, sometimes different within the same structure. When it exists, it is poorly informed and poorly archived, making it difficult to use.

Objective:

The general objective of this work is to improve the collection and use of mortality data and more specifically to model death management, to develop an electronic death certificate, to ensure better archiving of data, to encourage the codification of causes of death in order to enable and facilitate the use of mortality statistics.

Methods:

We carried out an analysis of the existing mortality data collection and archiving system; and the evaluation of the system's limitations. This was followed by the design of a new certification system with the definition of the administrative and medical parts, the identification of the actors and their role in the process. Finally, the development of the module using the same technology as the HIS that integrates it: PHP for the back-end, CSS for the front-end and MySQL for the database. We also note the integration of the ICD-10 reference framework for information on causes of death, reason for consultation, and comorbidities. Users have also been trained in its use

Results:

After design and development, we arrived at a new model of death certificate (administrative part to be given to the parents of the deceased person and a medical part that remains in the system) and the implementation of a multifunctional death management module integrated into the HIS of the CH Mother and Child "Le Luxembourg". This management module is secure (it is accessed from a login and password), reliable (goes through several levels of validation), efficient, and thus makes it possible to: record data on the death of a hospitalized patient or a death recorded on arrival; code causes of death according to ICD-10; to issue a death certificate; archive death data; to search for a deceased patient according to his Id and to provide the actual statistics on the causes of death.

Conclusions:

The new certificate model and its management module, which uses data submitted to several correction and validation stages, makes it possible to obtain quality mortality data. This initiative could be consolidated (communication with the DHIS2) and then recommended in other health centers and should provide a basis for the emergence of texts and/or laws for the certification of causes of death in Mali.