A Rapid Assessment of Mortality Surveillance in Uganda

Abstract Background Mortality surveillance aids in identifying and addressing their causes allowing health systems to adapt and respond effectively. This rapid assessment aimed to create awareness on the state of mortality surveillance in Uganda, highlight existing gaps and provide recommendations required for an improved mortality system hence the eventual improvement of public health in the country. Methods An assessment of mortality surveillance in Uganda was conducted from November 2023 to June 2024 through data reviews and plenary discussions engaging various stakeholders in Uganda. Eight (8) workshops/meetings were conducted over a period of eight months to generate information on mortality data sources, processes of data generation and challenges affecting the system. Reports generated from the meetings and workshops were summarized and presented as descriptive narratives. Data from DHIS2 was analyzed using excel and presented using charts and tables. Results The rapid assessment of mortality surveillance in Uganda highlighted opportunities for improved mortality surveillance through the existence of various sources of data. It was highlighted that 66.9% of the death occur in communities, however, there is a major data completeness gaps where suboptimal data from the community is feed into the national health statistics database (DHIS2) to enable stakeholder analysis and utilization. Furthermore, a number of data quality issues were identified in the health facility generated data where 33% of the deaths occur. These include: data completeness where the national referral specialized health institutes do not feed their data into the national data base, late reporting and the lack of coordination and standardisation of reporting among the various partners. Conclusion The existence of structures to conduct mortality surveillance in Uganda presents an opportunity for improved mortality surveillance despite the highlighted gaps and challenges. Adoption of strategies aimed to enable the successful implementation of an efficient mortality surveillance program like: strengthening governance and operations of death reporting activities, establishing a clear definition of institutional roles and responsibilities, raising awareness and advocacy at all levels, building technical capacities, improving allocation of resources, and leveraging on shared interests by both implementing and development partners could improve mortality surveillance and the health of the population through utilisation of the generated data.