Causes of death in Autonomous Region in Muslim Mindanao (Based on Analysis of Causes of National Deaths for Action)

April 18, 2018Special Release Ref No.: 2018-014

Analysis of Causes of National Deaths for Action (AnaCONDA) is a tool for checking the quality of mortality data. In particular, it will help identify probable errors, misdiagnoses and inconsistencies in the mortality and causes of death data. It is a tool jointly developed by the University of Melbourne and the Swiss Public Health Institute at the University of Basel.

41.5 percent of deaths in ARMM caused by non-communicable diseases

Deaths are categorized into three Global Burden of Disease (GBD) broad groups: Group 1 (Communicable diseases), Group 2 (Non-communicable diseases) and Group 3 (External causes). The results of 2015 Civil Registration and Vital Statistics (2015 CRVS) showed that in ARMM, 41.5 percent of deaths in ARMM were caused by non-communicable diseases (see Fig. 1). As the region develop their health systems, communicable diseases will increasingly be brought under control and the fraction of deaths due to non-communicable conditions will increase.

Figure 1. Distribution of deaths by GBD broad groups, ARMM, 2015 
Source:  Philippine Statistics Authority, 2015 CRVS

The mortality ratio of Group 2 to Group 1 in ARMM (3.5) differs significantly from the Institute for Health Metrics and Evaluation (IHME) estimates for GBD region reference value (2.6) (see Table 1). Thus, it follows that the quality cause of death (COD) diagnosis in the input data was poor due to under-reported deaths of Group 2 relative to Group 1.

Table 1. LRatio of Group 2 to Group 1: IHME estimated GBD for region and ARMM 
Source Ratio of Group 2 to Group 1 Reference Year
IHME estimates for GBD region 2.6 2010
Phil. mortality data source: 2015 CRVS 3.5 2015
Source: Philippine Statistics Authority, 2015 CRVS

37.9 percent of the remaining deaths in ARMM were unusable and insufficiently specified causes of death

In ARMM, 37.9 percent of the remaining deaths were unusable and insufficiently specified causes of death, of which 19.9 percent were unusable causes and the remaining 18 percent were insufficiently specified causes. Thus, it follows that the quality of input cause of death data in the region is poor and the utility for public policy is low.

Figure 2. Distribution of Deaths by usability, ARMM: 2015 
Source:  Philippine Statistics Authority, 2015 CRVS

Ischemic heart disease caused 10.2 percent of male deaths in ARMM

Out of the top 10 leading causes of male deaths in ARMM based on GBD list of COD, ischemic heart disease tallied as the most leading cause which were 10.2 percent of the male deaths in the region, followed by assault by firearm and hypertensive heart disease which were 9.9 percent and 5.1 percent of the regions’ male deaths, respectively. Same to the regions’ male deaths, ischemic heart disease also tallied as the most leading cause which were 8.2 percent of the female deaths in the region, followed by hypertensive heart disease and tuberculosis which were 5.4 percent and 4.0 percent of the regions’ female deaths, respectively.

Table 2 . Top 10 Leading Causes of Male Deaths, ARMM: 2015 
Source:  Philippine Statistics Authority, 2015 CRVS
 
Table 3 . Top 10 Leading Causes of Female Deaths, ARMM: 2015 
Source:  Philippine Statistics Authority, 2015 CRVS

Completeness of death reporting was the main priority action area to improve data quality in ARMM

Among all regions in Philippines, ARMM has the lowest Vital Statistics Performance Index Quality (VSPI (Q)) summary score which recorded 20.3 percent and was the only region to record “very low” in terms of VSPI (Q) classification (see Table 4). It clearly shows that the region has a poor functioning mortality data system.

Table 4 . Vital Statistics Performance Index Quality (VSPI (Q))
Components Score, ARMM: 2015
Source:  Philippine Statistics Authority, 2015 CRVS

Of all the five components in getting the VSPI (Q) of the region, completeness of death reporting has the lowest weighted score (26.2 percent). Thus, ARMM needed to strive effort in this priority action area (76 percent) to improve the mortality data quality of the region (see Figure 3).

Figure 3 .Priority Action Areas for improving mortality data quality, ARMM: 2015
Source:  Philippine Statistics Authority, 2015 CRVS
 
Technical Notes:
 
Communicable diseases is a classification of disease that can easily spread from one person to another through a variety of ways that include: contact with blood and bodily fluids; breathing in an airborne virus; or by being bitten by an insect.
 
Non-communicable diseases is a classification of disease that is not caused by infectious agents. It is a non-infectious or non-transmissible type of disease.
 
External causes most commonly are injuries due to accidents, homicide and suicide.
 
Institute for Health Metrics and Evaluation (IHME) is a research institute working in the area of global health statistics and impact evaluation at the University of Washington in Seattle. Its goal is "to identify the best strategies to build a healthier world. By measuring health, tracking program performance, finding ways to maximize health system impact, and developing innovative measurement systems, IHME provides a foundation for informed decision-making that ultimately will lead to better health globally" IHME (2011).
 
Underlying cause of death (UCOD) is the disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury.
 
Unusable causes are causes of death that are not acceptable as an UCOD.
 
Insufficiently specified causes are causes of death which can be acceptable as an UCOD but needed more information.
 
Global Burden of Diseases is a large, global collaborative study to estimate mortality and causes of death in 190 countries which is derived from ICD. GBD classifies ICD causes of death into approximately 300 specific disease and injury categories considered to be of global public health importance.
 
Vital Statistics Performance Index Quality (VSPI (Q)) is a single summary index of overall CRVS system performance. It is the composite of five dimensions of VS strength, each assessed by a separate empirical indicator. The six dimensions include: quality of age and sex reporting, quality of cause of death reporting, biologically plausible COD, level of cause-specific detail available and completeness of death reporting.

 

(Sgd) HJI. RAZULDEN A. MANGELEN, MPA, MDM
(Chief Statistical Specialist)
Officer-in-Charge
RSSO-ARMM