Investigating the Challenges of Death Registration and Classification Program and Providing a Solution: A Qualitative Study

Background and Objectives: The distribution of causes of death indicates the distribution of risk factors for death, and is a basis of planning and intervention to reduce risk factors. The quality of the registered information has problems due to the weakness of the processes of completing and issuing the death certificate or the coding method. The purpose of this study was to explain the challenges of death registration and to provide a solution in this regard. Methods: This qualitative study was conducted in the second half of 2019 in Guilan University of Medical Sciences. The target population was the directors and experts of the death registration program. Sampling was done purposefully by counting. Data was collected through in-depth interviews using a questionnaire and simultaneous contractual content analysis to identify key themes. To ensure the validity and acceptability of the data, the participants and two research colleagues reviewed the data frequently. Results: According to the content analysis of 24 interviews, the main challenges of death registration included manpower, organizing the death registration system in the country, and death registration software system and its implementation. These themes were abstracted from 45 subcategories and 13 main categories. Conclusion: Considering the challenges described by death registration managers and experts, the main proposed interventions to improve the death registration system include recruiting appropriate staff, empowering and motivating various human resources departments, developing internal and external cooperation, increasing public participation, monitoring and continuous assessment to identify the strengths and weaknesses of the death registration system and adressing them, attention to the development of death registration software and its required infrastructure such as Internet access and equipment, attention to the multiplicity of systems, and efforts to integrate them.