Sanchai Techanimitvat Cirawan Matuam Third Regional workshop on Production and Use of Vital Statistics May 26–30, 2014, Daejeon, Republic of Korea

 Quality assessment and assurance in vital statistics system Topic of presentation  Overview of vital statistics system and its relationship with civil registration and health institution in Thailand.  Procedures and processes for quality assessment, assurance and reporting in vital statistics system.

 1909: Monarchy (King Rama V); Western colonization period Civil Registration System  the first registration law was enacted specified the preparation and maintenance of population registration and creation of birth and death registration.  1917 : enforced births and deaths registration throughout the kingdom

 1936: The democratic revolution Civil Registration System (Contd.)  1956 Comprehensive civil registration act  creation of a network of local registry office, acting registrars, laid down clear guidelines for the registration of birth, death, fetal death (for the first time)  increased number of registration offices spreading over the entire country

 1972 Revise civil registration act (Military government) Civil Registration System (Contd.)  1982 the Population Identification Number Project. Start of the computerized population database.  appointment hierarchy of registration authorities  laid down clear procedures for vital registration  specified types of informants place and time for registration, forms, functions, responsibility of registrars, and other requirement for registration.

MOI Central Data Processing

 National Authority: Bureau of Registration Administration Department of Local Administration, Ministry of Interior Civil Registration System  Operates and maintains the data base for the entire population of the country, and issues identity cards and household booklets

 getting free health care services  enrolling children to free education  asking for bank account. Citizen Identification Number  Citizen ID issues at the birth registration (Call 13 Digits numbers)  The numbers is needed when transact with government and many non government agencies:

Typing machine ID card 1987 – 1996 Computer Printout ID card Current Smart card type ID card Citizen Identification Card

Vital Statistic System in Thailand After Present Bureau of Registration Administration Ministry of Interior Central Registry Ministry of Public Health (MOPH) Printed Annual Vital Statistics Report National Health Security Office (NHSO) Hospitals Web Entry Birth Certifica te (Start 2010) Report Statistics back to Province Electroni c Files Data Synchroni ze Provincial Health Offices Compile, Code, Validate And Process Statistics Web Entry Death Certific ate (from 2006)

Streamline vital event data between MOI & MOPH  1996, The Ministry of Public Health has signed an agreement with the Department of Local Administration, Ministry of Interior, regarding utilization of data in the central registration database of the administration, in order to reduce redundancy of birth, death data.  The Department of Local Administration, Ministry of Interior, will send the data relevant to death of all the persons who have been registered birth, dead from the central registration database to the Office of Permanent Secretary of the Ministry of Public Health.

Death notification form (Non-hospital) with COD Death inside hospital Death outside hospital Death certificate by doctorDeath notification by village head Death registration at district office or municipality Ministry of Interior ICD-10 coding at MOPH (BPS) 40% 60% Medical death certificate form (In-hospital) with COD On-line system Electronic file transfer monthly Flow of vital even registration

Use birth dataName of users The adoption and disseminate and reference Statistical data warehouse and health statistics for search. Ministry of Public Health, National Statistical Office (NSO) To develop and analysis of surveillance reports and pregnancy and birth in adolescent. Bureau of Reproductive Health Tracking health screening newborns.Department of Medical Sciences Surveillance and monitoring project implementation. Impact of the economic crisis on health and health systems. International Health Policy Program, Thailand (IHPP) Development of statistics and indicators. Violence against women and children. Office of Women’s And Family Development Statistics on teen pregnancy, Infants weight less than 2,500 grams. Health and Socials

Thailand’ assessment process The assessment of Thailand’s CRVS system was undertaken by The Thai Health Information Standards Development Center (THIS) in collaboration with other stakeholders including - The Bureau of Policy and Strategies of the MOPH, - The Bureau of Registration Administration of the MOI, - The National Statistical Office of Ministry of Information Communication and Technology, - The international Health Policy Program (IHPP), - The National Health Security Office (NHSO), - The Institute for Population and Social Research of Mahidol University, and - The Office of the National Economic and Social Development Board (NESDB).

Thailand’ assessment process (Contd.) An initial workshop to assess the CRVS using the Rapid Assessment (RA) too was held at the THIS office on 12 July The main focus of this workshop was to conduct an initial assessment using a Thai language version of the RA tool. A second workshop was held on 14 August 2012, this time also involving participants from the Institute for Population and Social Research of Mahidol University, and NESDB. Results from the first workshop were reviewed and participants recommended conducting a comprehensive assessment.

Thailand’ assessment process (Contd.) An inaugural national CRVS workshop was held at the Miracle hotel, Bangkok, on 6 November Presentations on the upcoming “ High-level Regional meeting on CRVS in Asia and Pacific ”, held in Bangkok on 7 December 2012, CRVS concepts, “ CRVS International Situation ” as well result of Thailand’s rapid assessment result were given and discussed. There were about 50 participants from stakeholder agencies ranging from health facilities at the local level to national level policymakers and international experts from UN agencies. Minor changes to the results were adjusted.

Results and recommendations Thailand completed both a rapid and comprehensive assessment of its CRVS system in According to the results from the rapid assessment, Thailand’s system is “ Satisfactory ”, meaning “ Minor adjustments may be required in an otherwise well-functioning system ”. The main issue raised by the rapid assessment was the quality of cause of death data and the quality of coding. Amore detailed review of the CRVS system was recommended.

Results and recommendations (Contd.) Following this workshop, further discussions and reviews were held between stakeholders to reach a final comprehensive assessment result that can be used to guide the development of improvement plans.

Average score from the rapid assessment by II main areas Rapid assessment grouping areaAverage Scores Legal framework for civil registration and vital statistics2.67 Registration infrastructure and resources 3 Organization and functioning of the vital statistics system 2.5 Completeness of registration of births and deaths 3 Data storage and transmission 3 ICD-compliant practices and certification within and outside hospitals 2

Average score from the rapid assessment by II main areas (Contd.) Rapid assessment grouping areaAverage Scores Practices affecting the quality of cause- of-death data1.5 ICD coding practices3 Coder qualification and training, and quality of coding2.5 Data quality and plausibility checks2 Data access, dissemination and use3 Total Score (From 75) :65 Average Scores :2.56 Score (%)86.67

THAI HEALTH INFORMATION STANDARDS DEVELOPMENT CENTER (THIS)

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