The road towards a better vital registration system: changes in the mortality profile, under-registration of death counts, and ill-defined causes of deaths in Brazil

This paper examines the spatial pattern of ill-defined causes of death across Brazilian regions, and its relationship to the evolution of completeness of death counts registration and the changes in the mortality age profile. We make use of the mortality database available at the Brazilian Ministry of Health Database - Datasus and Population Censuses from 1980 to 2010. We applied traditional demographic methods to evaluate the quality of mortality data for 137 small areas and correct for death counts under-registration when necessary. The second part of the analysis uses linear regression models to investigate the relation between changes in death counts coverage and age profile of mortality to changes in the reporting of ill-defined causes of death. The completeness of death counts coverage increase from about 80% in 1980-1991 to over 95% in 2000-2010 at the same time the percentage of ill-defined causes of deaths reduced about 53% in the country. The analysis suggests that efforts from the central and local governments to improve data quality in Brazil are being successful, and they will allow a better understanding of the dynamics of health and mortality transition in Brazil.