Handbook for doctors

on cause of death
certification

Resources and Tools

October 2016
About this series The series serves to describe the state of CRVS
systems in partner countries and provides a baseline for
Capacity-building tools and guidelines are
comparison between countries and over time. It also
designed to influence and align civil registration
provides a preliminary diagnostic analysis for use by
and vital statistics practice in countries with
countries in highlighting areas needing improvement.
established international standards.

Other products available from the Acknowledgements

Civil Registration and Vital Statistics, This is the second version of this capacity-
Data for Health Initiative: building tool. The first version was developed
by the Health Information Systems Knowledge
Working Papers Hub at the University of Queensland (2012).

Working papers are the principle knowledge products

This tool was reviewed by Dr Rasika Rampatige,
of the Civil Registration and Vital Statistics Initiative at
Professor Ian Riley, Dr Saman Gamage, Dr Wansa
The University of Melbourne. Easily accessible, they
Paoin, Dr Nandalal Wijesekera, and Nicola Richards.
collectively form a lasting repository of knowledge
generated under the Data for Health Initiative based on
in-country experience. Working papers are intended
to stimulate debate and promote the adoption of best
practice in CRVS in partner countries and world-wide. Published by the Civil Registration and Vital
Statistics Initiative, Data for Health
The series focuses on a range of knowledge gaps, new
tools, methods and approaches, and raises and debates
The University of Melbourne
fundamental issues around the orientation, purpose and Melbourne School of Population and Global Health
functioning of CRVS systems. Generally, working papers Building 379
contain more detailed information than an academic 207 Bouverie Street
paper, are written in less academic language, and Carlton
are intended to inform health system dialogue in and VIC 3053
between countries and a range of development partners. Australia

Technical Reports
+61 3 9035 6560
Technical reports describe the methods and findings of [email protected]
CRVS activities in partner countries implemented under mspgh.unimelb.edu.au/dataforhealth
the Data for Health Initiative. The series also reports
on work in progress, particularly for large or complex
initiatives, or on specific components of projects that
may be of more immediate relevance to stakeholders.

RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

CONTENTS
Preface

Introduction 1

Legal implications and confidentiality 3

Identification data in the death certificate 4

General instructions for completing death certificates 4

Understanding the International Form of Medical Certificate of Cause of Death 5

- Sequence/chain of events leading to death 6
- Part 1 of the death certificate 7
- Part 2 of the death certificate 12
- Approximate interval between onset and death 13

Guidelines for recording specific conditions 15

- Neoplasms (tumours) 15
- Surgical procedures 15
- Pregnancy and reporting maternal deaths 15
- Hypertension 15
- Infectious and parasitic diseases 16
- Diabetes mellitus 16
- Injuries, poisonings and external causes of death 16
- Ill-defined conditions 17

Annex 1: International form of medical certificate of cause of death (WHO 2016) 18

References 19
- Primary reference 19
- Other useful references 19
Preface
Health decision-makers and planners These are generic guidelines about how
all around the world make extensive to certify the cause of death, written for
use of mortality statistics. The quality doctors and medical students, particularly in
of these statistics depends on the developing countries. They can be read and
accuracy with which individual doctors used as a separate tool, or provide the basis
fill out death certificates. Unfortunately, for training in interactive workshops. They
the accuracy of death certification is form part of a package of resources that
poor in many countries. This reduces includes a workbook of case studies and
the quality of national and international references for self-directed learning, and a
mortality statistics, and limits their trainers’ manual for running workshops.
value for health planning and policy.
These materials will be available on the
Guidelines on death certification by doctors University of Melbourne’s Civil Registration
are available but are rarely used in many and Vital Statistics Initiative’s website
countries. Busy medical doctors may not (mspgh.unimelb.edu.au/dataforhealth).
be able to reference such tools when These resources can be adapted so that
they need a quick reminder about correct they are relevant for your country.
certification procedures. This handbook is
designed to be a readily accessible resource
that doctors can consult rapidly and easily.

The causes of death recorded in the International Form of Medical Certificate of Cause of
Death are
all those diseases, morbid conditions or injuries which either resulted in or contributed
to death and the circumstance of the accident or violence which produced any such
injuries.
Twentieth World Health Assembly, 1967

The underlying cause of death is

the disease or injury which initiated the train of morbid events leading directly to
death, or the circumstances of the accident or violence which produced the fatal
injury.
World Health Organization, 1994
Introduction
This handbook aims to guide doctors The cause of death is then coded by an expert
in filling out death certificates. Death who is trained in applying the International
certification forms an important part of a Statistical Classification of Diseases and
doctor’s duties because the information Related Health Problems, currently in its 10th
recorded in death certificates helps revision (ICD-10). The ICD-10 is managed by
decision-makers determine health the World Health Organization and classifies
priorities for prevention of deaths due thousands of diseases as individual items
to similar causes in the future. and groups similar diseases together in a
meaningful way. The coded certificates are
Clinical diagnosis is the basis for then tabulated. This tabulation forms the
therapeutic decision-making. Most basis for national mortality statistics. These
patients recover, but some die. When are critical for establishing national health
the diagnosis is entered onto a death program priorities, for health planning and
certificate, it establishes the cause of policy, and to inform debate about the
death for that person. This information allocation of health resources. Good-quality
is then used in new and quite different mortality statistics are fundamental for
ways from its original use, primarily to the prevention of premature deaths. By
inform policy-makers about the leading agreement, countries are obliged to report
causes of death in their country or their mortality statistics to the World Health
district, and how these are changing. Organization. These statistics form the
basis for international health statistics and
The certificate is provided to the family who
for international program priorities. They
may need it directly to obtain permission
also form the basis for national and global
for funeral arrangements and for other legal
burden of disease estimates and for decisions
purposes, including wills and testaments.
about global priorities to improve health.
The information on the certificate is also
important for family members so that they These uses are outlined in Figure 1. In short,
know what caused the death, and are the type and the quality of health services
aware of conditions that may occur or could provided depend heavily on the accuracy of
be prevented in other family members. information obtained from death certificates.
These guidelines aim to assist you in
accurately completing the International
Form of Medical Certificate of Cause of
Death. This forms the basis of all national
and international statistics about leading
causes of death, and how they are changing.

University of Melbourne 1
 Figure 1: Use of cause of death data

Sources of data Uses

Clinical diagnosis

Therapeutic decisions

Death   Recovery

Death certificate Family – legal and other purposes

Expert coding

National health authorities National program priorities, health planning

and policy, allocation of resources

WHO and the UN family International health statistics, international

program priorities

UN = United Nations; WHO = World Health Organisation

2 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Legal implications and confidentiality
A death certificate is a legal document with Within the above limits, the doctor has a
implications and uses that vary from country duty to maintain confidentiality about the
to country. Therefore, it is important that the cause of death. This duty is to the family
death certificate is completed accurately. of the deceased person. Information in the
It may be needed to proceed with burial death certificate can be used for research
or cremation of the body. The family may purposes, as long as the deceased is not
need it to execute the deceased person’s identifiable by name or other means.
will. In countries with a coronial system in
place, a doctor may be required to report The doctor should not reveal the details of
unnatural deaths to the coronial system for a death certificate to a third party unless:
inquest or for a postmortem to be held to
they are legally required to do so
determine the cause and circumstance of
they have obtained prior consent from
the death. The process of notification will
the next of kin of the deceased.
differ between countries and doctors need
be aware of the correct process of reporting.

The doctor or the hospital will be required

to report details of the death to national
authorities such as the health department,
the civil registrar or the national statistics
office. In most countries details of the death
and the circumstances of the deceased
person are stored on a database; in some
countries these data are de-identified.

University of Melbourne 3
Identification data in the General instructions for
death certificate completing death certificates
This information is of critical importance General instructions for doctors when filling
to correctly identifying the deceased in death certificates are given in Box 1. It is
for both legal and statistical purposes. important that doctors pay attention to these
The details vary from country to guidelines because they will help coders
country but are likely to include: correctly identify and code the death.

date and place of death In most countries, coders are not medically
full name and place of residence trained, so even a small misinterpretation
sex and race/ethnicity may result in confusion and the incorrect
underlying cause of death being selected.
age
profession or occupation.

An example of a complete death certificate,

including demographic and other medical
data, is provided in Annex 1.

BOX 1: GENERAL GUIDELINES

FOR DOCTORS COMPLETING DEATH CERTIFICATES

Complete each item in order following any specific instructions given in your country.

The entry must be legible. Use black ink.

Do not make alterations or erasures. If you want to delete an entry, draw a single line
across it. Do not use correction fluid.

Verify the accuracy of identification data, including the correct spelling of the name of the
deceased, with the family of the deceased.

Do not use abbreviations.

Enter only one disease condition or event per line.

4 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Understanding the International Form of Medical
Certificate of Cause of Death
The International Form of Medical Certificate of Cause of Death (known as the death
certificate) is recommended by the World Health Organization for certification of
death in all countries. One way of looking at the death certificate is that it provides a
framework for the organisation of clinical diagnoses used for public health purposes.
Figure 2 shows the death certificate recommended by the World Health Organization.

The death certificate is divided into three sections:

1. Part 1—report sequence/chain of events leading to death

2. Part 2—other significant conditions contributing to death

3. A column to record the approximate interval between onset and death.

Before reviewing the sections in detail, it is essential to understand the following concepts:

the sequence/chain of events leading to death

the contributory cause(s) of death.

Administrative Data (can be further specified by country)

Figure
Sex 2: International Form of Medical
Female Certificate of CauseMale
of Death, Frame A: Medical
Unknowndata (WHO 2016)
Date of birth D D M M Y Y Y Y Date of death D D M M Y Y Y Y
Frame A: Medical data: Part 1 and 2
1 Time interval from
Cause of death
Report disease or condition onset to death
directly leading to death on
a
line a
Due to:
b
Report chain of events in
due to order (if applicable) Due to:
c

State the underlying cause d

Due to:
on the lowest used line
2 Other significant conditions contributing to
death (time intervals can be included in
brackets after the condition)
Frame B: Other medical data
Was surgery performed within the last 4 weeks? Yes No Unknown
If yes please specify date of surgery D D M M Y Y Y Y
If yes please specify reason for
surgery (disease or condition)
Was an autopsy requested? Yes No Unknown
If yes were the findings used in the certification? Yes No Unknown
Manner of death:
Disease Assault Could not be determined
Accident Legal intervention Pending investigation
Intentional self harm War Unknown
University of Melbourne 5
If external cause or poisoning: Date of injury D D M M Y Y Y Y
SEQUENCE/CHAIN OF EVENTS LEADING TO DEATH
Mortality statistics are based on the underlying cause of death, which is the disease or injury
that initiated the sequence/chain of events that led directly to death. For example, imagine
a person dies of a cerebral haemorrhage following a motor vehicle accident. Cerebral
haemorrhage is the direct (or immediate) cause of death—the motor vehicle accident is
the underlying cause of death. The surgeon is concerned with the treatment of cerebral
haemorrhage; the public health concern is to prevent deaths due to motor vehicle accidents
(the underlying cause of death in this case).

Case study 1 Case study 2

A 50-year-old woman was admitted to the A man dies of cerebral haemorrhage due
hospital vomiting blood and was diagnosed to secondary hypertension due to chronic
as having bleeding oesophageal varices. pyelonephritis. The chronic pyelonephritis
Investigation revealed portal hypertension. was due to outflow obstruction, which
The woman had a history of hepatitis B was due to benign prostatic hyperplasia.
infection. Three days later, she died. Figure 3 He also had a history of diabetes mellitus,
outlines the sequence/chain of events that led which had been diagnosed five years before
to her death. his death. Diabetes mellitus (Type II), which
is not in the sequence/chain of events
It is extremely important that the underlying leading to death, would have contributed
cause of each death is correctly determined to the death, and therefore should be
and accurately recorded. In this case, entered in Part 2 of the death certificate.
bleeding oesophageal varices was the
immediate cause of death. Hepatitis B was Figure 4 outlines the sequence/
the underlying cause of death. Knowing this, chain of events and contributory
the public health response is to implement condition that led to his death.
immunisation programs against hepatitis B
virus to prevent such deaths in future.

Figure 3: Sequence/chain of events leading to Figure 4: Sequence/chain of events and

the death in Case study 1 contributory condition for Case study 2

Immediate
Bleeding oesophageal varices Cerebral haemorrage Immediate
cause of death
cause of death

Portal hypertension Secondary hypertension

Liver cirrhosis Chronic pyelonephritis

Underlying
Hepatitis B Underlying Benign hypertrophy of prostate cause of death
cause of death
Contributory condition
Diabetes mellitus (Type II)

6 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

PART 1 OF THE DEATH CERTIFICATE
Part 1 of the death certificate has four lines for reporting the sequence/chain
of events leading to death; these are labelled 1(a), 1(b), 1(c) and 1(d).

The direct cause of death is entered at Part 1(a). If the death was a consequence
of another disease or condition, this underlying cause should be entered at 1(b).
If there are more events leading to death, write these in order at 1(c) and 1(d).

Important points
Always use consecutive lines starting at 1(a), never leave blank lines within the sequence
If there is only one cause of death, it is entered at 1(a)
Each condition below 1(a) is a cause of the condition above it, ie it is an antecedent cause
The initiating cause in the sequence is the Underlying Cause
The following examples are provided to highlight how a death certificate should be completed
depending on the number of events there are in the sequence/chain leading to death.

University of Melbourne 7
Case study 3
A 56-year-old man dies from acute myocardial infarction within three hours of its onset.
He did not have any other illnesses.

His ECG and cardiac enzyme levels confirmed the diagnosis.

While it is rare to only have one event leading to death, it does occur. In these cases,
cause of death would be reported at 1(a) and it would also form the underlying cause of
the death, shown in Figure 5. If more information is available in the sequence of events
leading to death, these must be reported using the lines provided at 1(b), 1(c) or 1(d).

Figure 5: A death certificate with only one cause of death reported

8 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Case study 4
A 56-year old person dies from abscess of the lung after five days, which resulted from lobar
pneumonia of the left lung (two weeks).

When there are two causes of death reported, these are written in at 1(a) and 1(b), as
shown in Figure 6. In this case, underlying cause of death is recorded in line 1(b).

Figure 6: A death certificate where two events leading to death are reported

University of Melbourne 9
Case study 5
A 23-year-old man dies from traumatic shock one hour after after sustaining multiple
fractures when he was hit by a truck. The accident happened five hours ago. Figure 7
shows a death certificate that has used three lines. These events are recorded at 1(a),
1(b) and 1(c). In this case, underlying cause of death is recorded in the line 1(c).

Figure 7: A death certificate where three events leading to death are reported

10 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Case study 6
A 70-year-old man dies from cerebral haemorrhage three days after its onset. This resulted
from secondary hypertension, which he had for the last year. The hypertension was
secondary to chronic pyelonephritis, which he had for the last two years. He had also had a
prostatic adenoma for the last five years. He also had benign hypertrophy of the prostate.

Figure 8 shows a death certificate that has used four lines. These events are recorded at 1(a),
1(b), 1 (c) and 1(d). The underlying cause of death is reported in line 1(d).

In rare situations, there could be more than four sequences leading to death. In this case,
you can add a line 1(e) and record the underlying cause of death in that line. Do not record
underlying cause of death in Part 2 of the death certificate.

Figure 8: A death certificate where four events leading to death are reported

University of Melbourne 11
PART 2 OF THE DEATH CERTIFICATE
Part 2 of the death certificate records all other significant or contributory diseases or
conditions that were present at the time of death, but did not directly lead to the underlying
cause of death listed in Part 1.

Case study 7
A 60-year-old hypertensive patient was admitted to the surgical casualty ward with severe
abdominal pain and vomiting, which had lasted for one week. She was diagnosed as
having strangulated femoral hernia with a bowel perforation. She underwent surgery to
release the hernia and resect the intestine, with an end-to-end anastomosis. Two days
after the surgery she developed signs of peritonitis and she died two days later.

In this example, the underlying cause of death is strangulated femoral hernia. Hypertension,
which is not in the sequence of events leading to death but would have contributed to
the death, should be entered in Part 2 of the death certificate, as shown in Figure 9.

Figure 9: A death certificate where a contributory condition is reported

12 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

APPROXIMATE INTERVAL BETWEEN ONSET & DEATH
The column on the right-hand side of the death certificate is for recording the approximate
time interval between the onset of the condition and the date of death. The time interval
should be entered for all conditions reported on the death certificate, especially for the
conditions reported in Part 1. These intervals are usually established by the doctor on
the basis of available information. In some cases, the interval will have to be estimated.
Time periods, such as minutes, hours, days, weeks, months or years can be used.

If the time of onset is unknown or cannot be determined, write ‘unknown’.

This is very important. Do not leave this column blank.

This information is useful for coding certain diseases and provides a check on the accuracy
of the reported sequence of conditions. Therefore, it is important to fill in these lines.

University of Melbourne 13
Case study 8
A 58-year-old man presented at a clinic with a long history of haemoptysis and
weight loss. The diagnosis was advanced pulmonary tuberculosis, reactivation
type with cavitations, perhaps of eight years duration. The patient also suffered
from generalised arteriosclerosis, probably of long duration. Directly after the
admission, the patient had an acute and massive pulmonary haemorrhage and
died about 10 hours later. The patient’s death certificate is shown in Figure 10.

Figure 10: A death certificate where the time intervals are recorded for Case study 8

14 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Guidelines for recording specific conditions
Doctors need to give as full a description of disease conditions as possible to help the
classification and coding process for each death certificate.

NEOPLASMS (TUMOURS) PREGNANCY & REPORTING

When reporting deaths due to neoplasm
MATERNAL DEATHS
try to provide detailed information about If a woman dies during pregnancy or
the tumour. This should include: within 42 days of the termination of a
pregnancy, the fact that the woman was
site of the neoplasm pregnant should be indicated on the
whether benign or malignant certificate, even if the direct cause of
whether primary or secondary (if death is not related to the pregnancy or to
known), even if the primary neoplasm childbirth. For example, the entry could read
had been removed long before death ‘pregnant, period of gestation 26 weeks’.
histological type (if known). If the death certificate includes a
If the primary site of a secondary neoplasm pregnancy check box, it should be ticked
is known, it must be stated; for example, to indicate the women was pregnant or
primary carcinoma of the lung. If the was within 42 days of delivery when the
primary site of a secondary neoplasm death occurred, if that was the case.
is unknown, ‘primary unknown’ must
be stated on the death certificate. HYPERTENSION
It is important to state whether hypertension
SURGICAL PROCEDURES was essential or secondary to some other
If death is a consequence of a surgical disease condition (ie chronic pyelonephritis).
procedures the names of the procedure
should include the condition for
which it was performed; for example,
appendectomy for acute appendicitis.

University of Melbourne 15
INFECTIOUS & INJURIES, POISONINGS &
PARASITIC DISEASES EXTERNAL CAUSES OF DEATH
If the causative agent is known, it The circumstances of death from, for
should be noted on the certificate. example, a motor vehicle accident, suicide or
homicide, is known as the external cause of
If the causative agent is unknown, write death. When death occurs as a consequence
‘cause unknown’. It is also important to of injury or violence, the external cause
include the site of the infection, if known (the circumstance of the injury) should
(ie urinary tract, respiratory tract). always be listed as the underlying cause.

DIABETES MELLITUS The external cause should be described in

as much detail as possible; for example,
The guidelines related to documenting ‘motor traffic accident’ is not sufficiently
cause of death when patient has diabetes accurate; however, ‘pedestrian hit by
is complex. Diabetes mellitus can be the motor car’ is both clear and accurate. In a
underlying cause of death, or a risk factor case of suicide, simply entering ‘suicide’
for another underlying cause of death. is insufficient; the method of suicide
As a general rule, if the patient dies from a should be entered. For example, ‘suicidal
complication of diabetes mellitus death by hanging’ is a clear description.
(ie Diabetes nephropathy) document
diabetes mellitus (Type I or II) as the In countries where a coronial system
underlying cause of death. If a patient is in place doctors may need to
dies from stroke or acute myocardial inform the coroner about deaths from
infarction, document diabetes in Part 2 as causes in this category before writing
a risk factor (other significant condition). a death certificate. These are often
referred to as unnatural deaths.

16 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

ILL-DEFINED CONDITIONS
Entering ill-defined conditions on Symptoms and signs (ie chest pain,
death certificates is of no value for cough and fever) are also considered
public health. These conditions do not to be ill-defined conditions.
provide any information for decision-
makers to guide them in designing Doctors should not report the mode
preventive health programs. of dying on the death certificate.
This includes terms such as ‘cardi-
Organ failure (ie heart or liver failure) pulmonary arrest’ or ‘brain death’.
is not acceptable as an underlying
cause of death. The disease or condition In reporting the death of an elderly
causing the organ failure should be person, the terms ‘senility’ or ‘old age’
entered as underlying if at all possible. should be avoided. If at all possible the
doctor should enter a specific cause.
Similarly, the term ‘septicaemia’ should
not be used as an underlying cause if the Where there is insufficient information to be
source of the infection (ie septic abortion certain of the cause of death, it is legitimate
or community acquired pneumonia) can be for the doctor to state ‘unknown cause of
identified. These are known as ill-defined death’. However, this diagnosis should only
conditions and should be avoided. be used in exceptional circumstances.

University of Melbourne 17
ANNEX 1: INTERNATIONAL FORM OF MEDICAL CERTIFICATE OF
CAUSE OF DEATH (WHO 2016)

Administrative Data (can be further specified by country)

Sex Female Male Unknown
Date of birth D D M M Y Y Y Y Date of death D D M M Y Y Y Y
Frame A: Medical data: Part 1 and 2
1 Time interval from
Cause of death
Report disease or condition onset to death
directly leading to death on
a
line a
Due to:
b
Report chain of events in
due to order (if applicable) Due to:
c

State the underlying cause d

Due to:
on the lowest used line
2 Other significant conditions contributing to
death (time intervals can be included in
brackets after the condition)
Frame B: Other medical data
Was surgery performed within the last 4 weeks? Yes No Unknown
If yes please specify date of surgery D D M M Y Y Y Y
If yes please specify reason for
surgery (disease or condition)
Was an autopsy requested? Yes No Unknown
If yes were the findings used in the certification? Yes No Unknown
Manner of death:
Disease Assault Could not be determined
Accident Legal intervention Pending investigation
Intentional self harm War Unknown
If external cause or poisoning: Date of injury D D M M Y Y Y Y
Please describe how external cause occurred
(If poisoning please specify poisoning agent)
Place of occurrence of the external cause:
School, other institution, public
At home Residential institution Sports and athletics area
administrative area
Street and highway Trade and service area Industrial and construction area Farm
Other place (please specify): Unknown
Fetal or infant Death
Multiple pregnancy Yes No Unknown
Stillborn? Yes No Unknown
If death within 24h specify number of hours survived Birth weight (in grams)
Number of completed weeks of pregnancy Age of mother (years)
If death was perinatal, please state conditions of
mother that affected the fetus and newborn
For women, was the deceased pregnant? Yes No Unknown
At time of death Within 42 days before the death
Between 43 days up to 1 year before death Unknown
Did the pregnancy contribute to the death? Yes No Unknown

18 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

References
PRIMARY REFERENCE
World Health Organization (2016). International Statistical Classification of Diseases
and Related Health Problems, 10th Revision, Vol. 2, 10th edn, World Health Organization,
Geneva

OTHER USEFUL REFERENCES

Core curriculum for certifiers of underlying cause of death
This curriculum can be found at http://www.cdc.gov/nchs/
data/icd9/CurriculumCertification03-08-078.pdf.

Physicians’ Handbook on Medical Certification of Death (US)

This handbook can be found at http://www.cdc.gov/nchs/data/misc/hb_cod.pdf.

Cause of Death Certification information paper (Australia)

This paper can be found at: http://www.ausstats.abs.gov.au/Ausstats/subscriber.
nsf/0/FF2D66033DF42F32CA257030007790BD/$File/1205055001_2004.pdf.

WHO online training tool

WHO has developed an online ICD-10 training tool. This interactive self-training tool helps
you to understand and use ICD-10. User-specific paths include a fast track for people such
as managers, and an in-depth training path for coders. This online tool has one module on
cause-of-death certification to help doctors learn correct death certification practices.

This training tool can be found at: http://apps.who.int/classifications/apps/icd/icd10training/.

New York City Health Department online training tool

This interactive self-training tool has been developed as a prerequisite for certifying
deaths in New York City. While specific to New York City, the concepts provided are
relevant. The training can be found at http://www.nyc.gov/html/doh/media/video/icdr/

Hawaii State Department of Health

This interactive self-training tool was developed by the Hawaii State
Department of Health. While specific to Hawaii, the concepts provided are
relevant. The training can be found at http://cod.doh.hawaii.gov/

University of Melbourne 19
Notes

20 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Notes

University of Melbourne 21
Notes

22 RESOURCES AND TOOLS HANDBOOK FOR DOCTORS ON CAUSE OF DEATH CERTIFICATION

Notes

University of Melbourne 23
In 2015, Bloomberg Philanthropies in partnership with the Australian government launched a $100 million Data for Health initiative.
Each year over 50 million people die and 65 percent of these deaths go unreported or lack a cause of death. These gaps provide
major obstacles towards understanding and addressing public health. The Data for Health initiative seeks to provide countries
with tools to better collect and use health-related data. The program will assist up to 20 low- and middle- income countries across
Latin America, Asia, and Africa strengthen data collection and data use. Countries will then be better able to prioritize, deploy
resources, shape public health policies, and measure the success of interventions. The program partners on this initiative include:
The University of Melbourne, Australia; CDC Foundation, USA; Vital Strategies, USA; Johns Hopkins University, USA; World Health
Organization, Switzerland.

Civil Registration and Vital Statistics partners:

Contact
E: [email protected]
W: mspgh.unimelb.edu.au/dataforhealth

CRICOS Provider Code: 00116K

Version: 1016_03
Copyright
© Copyright University of Melbourne October 2016.

The University of Melbourne owns the copyright in this publication, and no part of it may be reproduced without their permission.

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