2024 年乌干达死亡率监测快速评估

Marie Gorreti Zalwango, Caroline Kyozira, Mariam Nambuya, Martin Bulamu, Allan Muruta
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摘要

背景:死亡率监测有助于确定和解决死亡原因,使卫生系统能够有效应对。此次快速评估旨在提高人们对乌干达死亡率监测状况的认识,突出现有差距,并提出改进死亡率系统所需的建议,从而最终改善该国的公共卫生状况:方法:2023 年 11 月至 2024 年 6 月,通过数据审查和乌干达各利益相关方参与的全体讨论,对乌干达的死亡率监测情况进行了评估。在八个月的时间里,共举办了八(8)次研讨会/会议,以收集有关死亡率数据来源、数据生成过程和影响系统的挑战的信息。对会议和研讨会产生的报告进行了总结,并以描述性说明的形式提交。使用 excel 对来自 DHIS2 的数据进行了分析,并使用图表和表格进行了展示:对乌干达死亡率监测的快速评估强调了通过各种数据来源改进死亡率监测的机会。评估结果表明,66.9% 的死亡发生在社区,但在数据完整性方面存在重大差距,社区的次优数据被输入国家卫生统计数据库 (DHIS2),以便利益相关者进行分析和利用。此外,在医疗机构生成的数据中也发现了一些数据质量问题,33%的死亡发生在医疗机构。这些问题包括:国家转诊专科医疗机构未将其数据输入国家数据库的数据完整性问题、迟报问题以及各合作伙伴在报告方面缺乏协调和标准化问题:结论:尽管存在突出的差距和挑战,但乌干达存在进行死亡率监测的机构,这为改进死亡率监测工作提供了机会。采取旨在使有效的死亡率监测计划得以成功实施的战略,如:加强死亡报告活动的管理和运作、明确界定机构的作用和责任、提高各级的认识和宣传、建设技术能力、改善资源分配以及利用执行伙伴和发展伙伴的共同利益,可通过利用所生成的数据改善死亡率监测和人口健康。
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A Rapid Assessment of Mortality Surveillance in Uganda, 2024
Background: Mortality surveillance aids in identifying and addressing their causes allowing health systems to adapt and respond effectively. This rapid assessment aimed to create awareness on the state of mortality surveillance in Uganda, highlight existing gaps and provide recommendations required for an improved mortality system hence the eventual improvement of public health in the country. Methods: An assessment of mortality surveillance in Uganda was conducted from November 2023 to June 2024 through data reviews and plenary discussions engaging various stakeholders in Uganda. Eight (8) workshops/meetings were conducted over a period of eight months to generate information on mortality data sources, processes of data generation and challenges affecting the system. Reports generated from the meetings and workshops were summarized and presented as descriptive narratives. Data from DHIS2 was analyzed using excel and presented using charts and tables. Results: The rapid assessment of mortality surveillance in Uganda highlighted opportunities for improved mortality surveillance through the existence of various sources of data. It was highlighted that 66.9% of the death occur in communities, however, there is a major data completeness gaps where sub-optimal data from the community is feed into the national health statistics database (DHIS2) to enable stakeholder analysis and utilization. Furthermore, a number of data quality issues were identified in the health facility generated data where 33% of the deaths occur. These include: data completeness where the national referral specialized health institutes do not feed their data into the national data base, late reporting and the lack of coordination and standardization of reporting among the various partners. Conclusion: The existence of structures to conduct mortality surveillance in Uganda presents an opportunity for improved mortality surveillance despite the highlighted gaps and challenges. Adoption of strategies aimed to enable the successful implementation of an efficient mortality surveillance program like: strengthening governance and operations of death reporting activities, establishing a clear definition of institutional roles and responsibilities, raising awareness and advocacy at all levels, building technical capacities, improving allocation of resources, and leveraging on shared interests by both implementing and development partners could improve mortality surveillance and the health of the population through utilization of the generated data.
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