Introduction: Establishing Qatar's comprehensive death registry system

The Ministry of Public Health in Qatar has successfully established its death registry system, aimed at gathering comprehensive and accurate data on death rates. This system plays a crucial role in formulating evidence-informed policies and programmes, as well as measuring their effectiveness. By tracking the progress towards reducing premature deaths from noncommunicable diseases (NCDs) by15%, Qatar is aligning itself with the goals set forth in the National Health Strategy (2018–2022). The data collected through this system have already led to the implementation of awareness and screening campaigns, research strategies and taxes on energy-dense drinks.

Context: Prioritizing population health

Recognizing the significance of population health in achieving its goals, Qatar's National Vision 2030 places great importance on the well-being of its citizens. The National Health Strategy (2018–2022) focuses on reducing premature death rates by 15% for cardiovascular diseases, cancer, diabetes and chronic respiratory diseases. To effectively address this issue, it is imperative to have a complete, accurate and continuous dataset summarizing death statistics. This includes a specific emphasis on deaths related to NCDs, enabling the formulation of policies and programmes to reduce premature deaths in Qatar.

Implementation of the death registry system: Enhancing reporting accuracy and collaboration 

The Ministry of Public Health has taken significant steps to establish the death registry system. Healthcare professionals have received training to accurately complete death notifications (report deaths) using both paper format and the mortuary management system, following the guidelines set by the Hamad Medical Corporation and the International Classification of Diseases (ICD-10) by WHO. These training courses, conducted by WHO experts since 2004, have enhanced reporting accuracy by emphasizing the inclusion of personal information, immediate cause of death, underlying cause of death and other relevant data. These training courses have addressed issues such as illogical sequencing, improper utilization of the mode of death instead of the cause of death, and incorrect identification of underlying causes, thereby eliminating irrelevant death data. Furthermore, forensic doctors, selected doctors and nurses from hospital wards have also undergone training on the logical composition of death notifications using WHO ICD-10 coding. The Ministry of Public Health has played a leading role, demonstrating exceptional commitment and collaborating with stakeholders including the Hamad Medical Corporation, the Ministry of Interior and other partners to ensure successful implementation of the initiative. Continuous efforts are being made to improve the quality of death notifications.

Challenges and lessons learnt: Operational challenges and positive developments

While implementing the death registry system, several operational challenges related to data sharing and transfer have been encountered. However, these challenges have paved the way for positive developments. Notably, a significant step forward has been the introduction of a unique identification number for each reported death case. This advancement allows for the comprehensive collection of death data, including deaths of Qatari citizens that occur outside the country.

Another important aspect that has emerged from this process is the need to standardize the reporting of causes of death according to the ICD-10 system. By promoting uniformity in the terminologies used, Qatar aims to enhance the accuracy and reliability of cause-of-death reporting. Efforts have been made to engage in continuous professional development, constructive dialogue and advocacy with doctors to encourage the adoption of ICD-coded cause of death data. As a result, there has been a noticeable increase in the number of well-written and clear underlying causes of death in death notifications.

However, further improvements require additional resources and capabilities. To ensure the accuracy of the collected data, a committee has been established to review and refine each death notification. This process identifies misleading coding and eliminates codes that cannot be considered as underlying causes of death. By implementing these measures, the death registry system continues to evolve, enhancing the overall accuracy of the collected data and strengthening its reliability.

Impact: Insights from the death registry system  

Data from the death registry system reveal that diseases related to the circulatory system, such as blood pressure disease, diabetes and cholesterol-related illnesses, are responsible for the majority of deaths in the Qatari population. These statistics, along with other data inputs have led to the development of new policies. Resources have been allocated to tackle the challenges posed by NCDs, resulting in various initiatives, including:

National-level NCD awareness and screening campaigns. Qatar has implemented comprehensive awareness and screening campaigns focused on diabetes and cardiovascular diseases. These initiatives aim to educate the population about risk factors, early detection and prevention strategies, ultimately reducing the burden of NCDs.

Development of a dedicated research strategy and national diabetes registry. To further strengthen efforts in combating NCDs, Qatar has developed a dedicated research strategy with allocated funding. As part of this strategy, a national diabetes registry has been established to facilitate the collection and analysis of data related to diabetes cases. This comprehensive approach enables evidence-based decision-making and targeted interventions.

Patient empowerment programmes and enhanced clinical care pathways. Recognizing the importance of patient outcomes and satisfaction, Qatar has designed patient empowerment programmes. These initiatives aim to actively involve patients in their own healthcare, enhancing their knowledge, self-management skills and engagement in the treatment process. Furthermore, clinical care pathways have been revisited and improved to ensure optimal patient outcomes and satisfaction.

Taxes and stricter laws/policies. In an effort to curb unhealthy habits and reduce the prevalence of NCDs, Qatar has increased taxes on energy-dense drinks. Additionally, the country has implemented stricter laws and policies to reduce tobacco consumption. These measures aim to discourage unhealthy behaviours and promote healthier lifestyles among the population.

Next steps: Advancing the death registry system for continued effectiveness

The Ministry of Public Health in Qatar remains committed to supporting and advancing the death registry system. As part of these efforts, the Ministry is currently developing an advanced e-learning course focused on writing the cause of death in accordance with the ICD-10 codes. This course, planned for launch in 2020, will further enhance the accuracy and consistency of cause-of-death reporting, ensuring the continued effectiveness of the death registry system.

Story originated in 2019.