Sensitivity and Positive Predictive Value of Child Death Certificates in Iran: A Cross-sectional Study

Background: Accurate information on the causes of child mortality is required to achieve Millennium Development Goal 4 (MDG4). The are used assess pattern diseases and make health policies. accuracy these statistics depends proper completion death certificates. Objectives: study aimed measure sensitivity positive predictive value (PPV) certificates obtained from hospital system (HIS) in a children's specialized Iran. Methods: This cross-sectional assessed 580 children 1-59-month-old died 2011 2018. Pediatricians identified minor major errors underlying (COD). A misclassification matrix was agreement, sensitivity, PPV using multiple pediatrician reviews. Results: HIS had 43.27% 39.37%. highest 73.33% for kidney urinary tract infections, lowest 18.18% diarrhea dehydration. accidents injuries dehydration (65.63% 20.69%, respectively). most underestimation overestimation numbers were related "respiratory disease pneumonia" "cardiac arrest", respectively. Conclusions: large proportion CODs registered inaccurately. should be with caution planning policy-making.