Death certification status in Eastern Mediterranean Region: A systematic review

Area of Science:

• Public Health
• Medical Statistics
• Epidemiology

Background:

• Death certificates are vital for accurate morbidity and mortality statistics.
• Effective death certification relies on precise completion by physicians.
• The Eastern Mediterranean Region faces challenges in data quality for public health surveillance.

Purpose of the Study:

• To systematically review death certification practices in the Eastern Mediterranean Region.
• To assess the methodological quality of studies on death certification.
• To identify common errors and physician knowledge gaps in death certificate completion.

Main Methods:

• Systematic review of published literature.
• Searched three major databases for relevant studies.
• Included 19 studies meeting review criteria.

Main Results:

• The majority of studies reported errors in the underlying cause of death.
• Less than 25% of physicians reported receiving training on death certificate completion.
• Case complexity and insufficient training were identified as primary causes of errors.

Conclusions:

• Significant errors in death certification exist in the Eastern Mediterranean Region.
• Lack of physician training is a major contributing factor to inaccurate death certificates.
• Improving training and addressing case complexity are essential for enhancing data quality.