Sunday, February 28, 2021

Deaths Data

 Only eight African countries out of more than 50 have a compulsory system to register deaths. Only Egypt, South Africa, Tunisia, Algeria, Cape Verde, São Tomé and Príncipe, Seychelles and Mauritius that have what are called functioning, compulsory and universal civil registration systems - known as CRVS systems - which record deaths. In 14 countries a maximum of only one in 10 deaths are recorded, including in Nigeria, the Democratic Republic of Congo and Cameroon. The Central African Republic (CAR) has one of the lowest performing CRVS systems on the continent following years of conflict, which is still ongoing. In 2017 only 2% of estimated deaths were registered in the country.  Over half of the countries in sub-Saharan Africa only keep handwritten death records. Certain states, such as Eritrea and Burundi, have no legal requirement to register or collate deaths at all. 

 "CRVS systems remain dysfunctional, forcing governments to rely on surveys... which by the time they are published are already outdated," says Irina Dincu, from the Centre of Excellence for CRVS systems.

In the wake of the Ebola epidemic, and now Covid-19, having an accurate picture of who is dying, from what and where, is crucial when it comes to allocating resources. This also has implications for tracking maternal and child mortality as there are children whose birth and untimely death go unrecorded.  It also means that lessons are not learnt.

"In order to help the living, we need to count the dead," UN Population Fund demographer Romesh Silva explained. Those who are missed out on the registers are often the poorest and socially excluded, he adds, and the absence of information about their deaths means that measures to deal with the causes are sometimes not taken. 

Calculating a key indicator of the pandemic's fallout - known as "excess deaths" - is impossible in most countries because of the lack of CRVS systems.

By early February, South Africa had recorded nearly 138,000 excess deaths since the pandemic began - that is almost three times the official figure given for Covid-19 deaths. To break it down: 46,200 of these people were officially recorded as having died with coronavirus and there are death certificates to prove it. This means the other 91,500 were either undiagnosed, or died as an indirect consequence of the pandemic such as delayed cancer treatment or fear of going to hospital. At the height of the pandemic in late last July, South Africa experienced 54% more deaths than was expected for that time period.

Thanks to Egypt's comprehensive registration system, it is possible to calculate that there were more than 68,000 excess deaths between May and August last year. In June, the number of recorded deaths was almost double what would usually be expected. On average, official Covid-19 deaths made up under 10% of those additional losses. But for most countries on the continent there is no way to reach any conclusions like this as the data is so sparse.

Eritrea has recorded only seven Covid-19 death to date and Burundi, just three. Nigeria has recorded nine Covid-19 deaths per million, compared to the global average of 316. Meanwhile, South Africa has recorded 827 Covid-19 deaths per million and Tunisia 659 - the two highest in Africa.

Measuring Africa’s Data Gap: The cost of not counting the dead - BBC News

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