Stakeholders’ Perspectives on Quality of Death Registration And Possibility of Introducing Verbal Autopsy Into Kurdistan Region of Iraq

Abstract

Aim : To explore stakeholders’ perspectives on the quality of death registration and possibility of introducing
verbal autopsy into the Kurdistan Region, Iraq.
Methods: Qualitative interviews conducted with 15 stakeholders from the Ministry of Health, Directorates
of Health, and Medico-legal Institutes of Erbil, Sulaymaniyah, and Duhok of the Kurdistan Region of
Iraq. Stakeholders were selected through the purposeful sampling method. Responses were analyzed using
qualitative content analysis and thematic analysis. Responses were categorized into three main categories:
strengths, gaps, and suggestions for improving the death registration in the Kurdistan Region.
Results: The strong points in favor of the current death registration were: easy and good practice, it was easy
for people to get a certificate, the existence of laws and regulations related to death registration, having a
“standard death certificate,” and follow-up and monitoring of the process of death registration at the Medicolegal Institutes. The gaps were incompleteness and inaccuracy in most of the locations, staff ignorance, no
checking of data, missing cases, no use of the data, and no standardized process for compiling data.
The stakeholders emphasized on implementing the existing rules and regulations, building staff capacity,
systematic processes for data management, and follow-up and monitoring as strategies for improvement.
All the stakeholders reported that verbal autopsy is appropriate for solving problems related to cause-ofdeath data. However, the feasibility of verbal autopsy will be a challenge for several reasons, including the
current economic crisis.