A systematic review of vital events tracking by community health agents

Erin K Nichols; Nina W Ragunanthan; Braveen Ragunanthan; Hermon Gebrehiwet; Karim Kamara

doi:10.1080/16549716.2019.1597452

A systematic review of vital events tracking by community health agents

Glob Health Action. 2019;12(1):1597452. doi: 10.1080/16549716.2019.1597452.

Authors

Erin K Nichols^{1

2}, Nina W Ragunanthan³, Braveen Ragunanthan⁴, Hermon Gebrehiwet⁵, Karim Kamara⁶

Affiliations

¹ a National Center for Health Statistics , Centers for Disease Control and Prevention , Hyattsville , MD , USA.
² b Department of Health and Human Services , United States Public Health Service , Washington, DC , USA.
³ c Department of Obstetrics, Gynecology, and Reproductive Sciences , University of Pittsburgh Medical Center Magee-Womens Hospital , Pittsburgh , PA , USA.
⁴ d Department of Pediatrics , University of Pittsburgh Medical Center Children's Hospital of Pittsburgh , Pittsburgh , PA , USA.
⁵ e Health Sciences Program , Argosy University , Arlington , VA , USA.
⁶ f School of Health Professions , Shenandoah University , Winchester , VA , USA.

Abstract

Background: Efforts to improve national civil registration and vital statistics (CRVS) systems are focusing on transforming traditionally passive systems into active systems that have the ability to reach the household level. While community health agents remain at the core of many birth and death reporting efforts, previous literature has not explored elements for their successful integration into CRVS efforts. Objective: To inform future efforts to improve CRVS systems, we conducted a systematic review of literature to understand and describe the design features, resulting data quality, and factors impacting the performance of community health agents involved in tracking vital events. Methods: We reviewed 393 articles; reviewers extracted key information from 58 articles meeting the eligibility criteria: collection of birth and/or death information outside of a clinic environment by a community agent. Reviewers recorded information in an Excel database on various program aspects, and results were summarized into key themes and topic areas. Results: The majority of articles described work in rural areas of Africa or South-East Asia. Nearly all articles (86%) cited some form of household visitation by community health agents. Only one article described a process in which vital events tracking activities were linked to official vital events registers. Other factors commonly described included program costs, relationship of community agents to community, and use of mobile devices. About 1/3 of articles reported quantitative information on performance and quality of vital events data tracked; various methods were described for measuring completeness of reporting, which varied greatly across articles. Conclusions: The multitude of articles on this topic attests to the availability of community health agents to track vital events. Creating a programmatic norm of integrating with CRVS systems the vital events information collected from existing community health programs has the potential to provide governments with information essential for public health decision-making.

Keywords: Vital statistics; civil registration; community health workers; mortality surveillance; verbal autopsy.

Publication types

Research Support, U.S. Gov't, P.H.S.
Systematic Review

MeSH terms

Birth Certificates*
Cause of Death*
Death Certificates*
Female
Humans
Male
Population Surveillance / methods*
Public Health / statistics & numerical data*
Vital Statistics*

Grants and funding

This work was supported by in-kind contributions from staff at the US Centers for Disease Control and Prevention (EKN) and by a sub-contract through Cooperative Agreement OT13-1302 with the Public Health Institute (HG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.