Enhancing community death notification in Uganda using a hackathon based approach to integrate mortality surveillance...

Area of Science:

• Public Health Surveillance
• Health Informatics
• Digital Health Systems

Background:

• Uganda experiences significant challenges in mortality surveillance, with under-ascertained community deaths.
• Fragmented reporting systems across the Ministry of Health (MoH) and National Identification and Registration Authority (NIRA) lead to data gaps and inefficiencies.
• Limited interoperability between existing paper-based and digital platforms hinders comprehensive mortality data collection.

Purpose of the Study:

• To develop and integrate a harmonized community death notification workflow into Uganda's electronic Community Health Information System (eCHIS).
• To address fragmentation and improve the completeness and coordination of community death reporting through a co-design process.

Main Methods:

• A participatory qualitative descriptive study utilizing a multi-stakeholder hackathon for systems co-creation.
• Data collection through focus group discussions with Village Health Teams (VHTs) and interviews with key stakeholders.
• Analysis of qualitative data using reflexive thematic analysis and refinement through validation sessions.

Main Results:

• Identified substantial fragmentation in mortality reporting, including parallel systems and reporting duplication.
• Developed a harmonized workflow for community death notification, prioritizing feasible data capture and DHIS2 interoperability.
• Piloted the workflow in eCHIS across 17 districts, with early feedback indicating improved reporting consistency and reduced duplication.

Conclusions:

• A participatory hackathon approach successfully developed an interoperable community death notification workflow aligned with national digital health architecture.
• Integrating mortality surveillance into eCHIS presents a feasible pathway for strengthening health systems in low-resource settings.
• Further evaluation is needed to assess the impact on data completeness, timeliness, and overall national mortality surveillance performance.