Africa CDC convenes meeting to discuss continent-wide mortality surveillance system

ZAMBIA—Public health experts in Southern and Eastern Africa have met in Lusaka, Zambia under the guidance of the Africa Centre for Disease Control (CDC) to discuss adopting a continental framework for strengthening the mortality surveillance system.

Africa CDC convened the meeting as part of its larger effort to build on the Continental Framework for strengthening mortality surveillance, which was officially launched in September 2022.

The continental framework aims to support countries to build routine integrated mortality surveillance systems for nationwide coverage, whilst strengthening the availability of timely and accurate data on all deaths and their causes.

During the meeting, Africa CDC shared results originating from the countries’ readiness assessment survey which was conducted across AU Member States in the last six months.

The survey mapped and identified existing capacities and gaps for implementing mortality surveillance at countries level, from infrastructure support, health informatics needs, awareness, and continued education on issues related to mortality statistics.

The findings of the survey informed discussions around the development of the countries’ specific action plans on mortality statistics.

The meeting was attended by representatives from 18 Africa Union member states, including participants from partner organizations including the Regional Economic Communities, World Health Organisation (WHO) Africa, Africa Field Epidemiology Network (AFENET), U.S. CDC, and Imperial College of London.

The meeting also held a thorough orientation on the Africa CDC continental framework for mortality surveillance, draft regional and country-specific action plans developed as well as the establishment of the regional community of practice (COP) for mortality surveillance.

The meeting was officiated by Professor, Christopher Simoonga, Permanent Secretary of the Ministry of Health in Zambia.

In a statement from Hon. Sylvia Masebo, Zambia’s Minister for Health, she read, “This gathering here today is an indication of the commitment and support of all participating member states in strengthening Africa’s public health sector, in order to achieve inclusive, accessible and sustainable public health opportunities for all Africans.”

Dr. Lul Riek, Africa CDC Southern Africa Regional Coordinator said, “We have an opportunity to advance the efforts for improving access to mortality data and strengthening capacity for evidence-based public health decisions and interventions on the continent.”

According to the American Journal of Tropical Medicine and Hygiene, low- and middle-income countries (LMICs), especially those in the sub-Saharan Africa region, lack timely data on mortality and causes of death (CODs).

In addition to that, no country in the region has a national data system that generates reliable annual national statistics on mortality and COD for all ages.

The heavy reliance by these countries on periodic household surveys and censuses to produce mortality statistics has in part led to little investment in national systems for continuous mortality and COD data collection.

However, there has been enormous progress in the collection and analysis of mortality data through household surveys.

This solution is undoubtedly a double-edged sword, whereby the mortality statistics generated are often outdated and, most importantly, are averaged over several years in the past, making them less useful for accurate assessment of health care systems outcomes.

The 2023 report also shows few national surveys incorporate modules for COD assessment through verbal autopsies (VAs).

The worst part is that all African countries have established civil registration and vital statistics systems (CRVSs) that aim for a complete recording of vital events, including births, deaths, and COD.

However, such systems are defective, and, despite recent efforts for strengthening, achieving universal completeness and quality will take resources that states are still grappling to muscle up.

Health and demographic surveillance sites also collect data on vital events, but their usefulness is constrained by their limited geographic scope making them nonrepresentative of the national situation.

The COVID-19 pandemic has led to significant loss of lives and livelihoods in Africa, and despite the over 12 million cases and over 250,000 deaths documented, the true burden of the pandemic on health systems remains unknown.

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