RESUMO
BACKGROUND: Vital statistics underestimate the prevalence of perinatal and infant deaths. This is particularly significant when these parameters affect eligibility for international assistance for newly emerging nations. OBJECTIVE: To determine the level of registration of livebirths, stillbirths and infant deaths in Jamaica. METHODOLOGY: Births, stillbirths and neonatal deaths identified during a cross-sectional study (1986); and infant deaths identified in six parishes (1993) were matched to vital registration documents filed with the Registrar General. RESULTS: While 94% of livebirths were registered by one year of age (1986), only 13% of stillbirths (1986) and 25% of infant deaths (1993) were registered. Post neonatal deaths were more likely to be registered than early neonatal deaths. Frequently the birth was not registered when the infant died. Birth registration rates were highest in parishes with high rates of hospital deliveries (rs = 0.97, P < 0.001) where institutions notify the registrar of each birth. Hospital deaths, however, were less likely to be registered than community deaths as registrars are not automatically notified of these deaths. CONCLUSIONS: To improve vital registration, institutions should become registration centres for all vital events occurring there (births, stillbirths, deaths). Recommendations aimed at modernizing the vital registration system in Jamaica and other developing countries are also made.
PIP: Vital statistics indicate only part of the actual prevalence of perinatal and infant mortality. Findings are reported from a study conducted to determine the level of registration of live births, stillbirths, and infant deaths in Jamaica. Births, stillbirths, and neonatal deaths identified during a 1986 cross-sectional study and infant deaths identified in six parishes during 1993 were matched to vital registration documents filed with the Registrar General. While 94% of live births were registered by one year of age, only 13% of stillbirths and 25% of infant deaths were so registered. Post neonatal deaths were more likely to be registered than early neonatal deaths. Frequently the birth was not registered when the infant died. Birth registration rates were highest in parishes with high rates of hospital deliveries where institutions notify the registrar of each birth. Hospital deaths, however, were less likely to be registered than community deaths since registrars are not automatically noticed of such deaths. Institutions should register all vital events occurring there.