Introduction

As the sole entity responsible for Civil Registration and the National Vital Statistics Database for Jamaica, the main mandate of the Registrar General’s Department (RGD) is to ensure that each vital event (birth, death or marriage) that occurs in the country or in its waters is registered. It is also important that the vital statistics from these registrations be correct and accurate and that it be made available to the relevant persons on a timely basis. This is made possible by approximately 330 Local District Registrars and 1,400 Marriage Officers affiliated with the RGD.

In order for the vital statistics system to function optimally, civil registration must be an effective and efficient driving force behind it. The first tangible result of the change from manual to electronic methods of data storage and manipulation by RGD was the publication of the 2002 Vital Statistics Annual Report. This marked the initiation of vital statistics reporting from RGD’s electronic database.

This step was significant since prior to its advent, the data for 1995 to 2001 was prepared manually by accessing the physical registrations and compiling the data using electronic spreadsheets. In addition the majority of the procedures of compilation and production of the vital statistics were also manual. This meant that there was a greater chance of the data being incorrect and that the time for generation would also not be in keeping with the national standards.

The technological improvements at RGD, where data management is concerned, must and will continue. Coupled with this must be the integration of the efforts of all organisations that in any way play a part in civil registration.

Concerted collaboration between RGD and its various stakeholders is not a new concept, however, in the past few years specific programs geared toward this have been organised and successfully executed. Ultimately, the goal is for Jamaica’s entire national registration system to be fully functional, with very limited opportunity for a vital event that has occurred not to be registered in a timely manner.

In the past, several challenges have marred the performance of the country’s civil registration system. The timeliness of birth registration is sometimes affected in cases where the mother fails to settle hospital fees. In respect of death registrations, the delay is often due to the prolonged process which often accompanies the investigation and documentation of sudden or violent deaths. The documents needed to register these deaths are issued by the island’s Coroner’s Courts and Police Department.

Some of these inherent problems will have to be solved through legislation. Until the necessary reforms come to fruition, however, the RGD has in the interim, implemented numerous measures to help to alleviate the situation.
In respect of deaths, as stated above the RGD realises that delay in or prevention of registration is often due to either a lag in the processes in the courts or police department or simply due to a lack in the knowledge of the relatives of the deceased. These relatives are often not sufficiently informed on how to register the death or become frustrated with the process itself.

The documents needed for death registration are mentioned in detail in Types of Certification under the Deaths section of this report. Generally speaking however, sudden and violent deaths are usually registered using either a Post Mortem Examination Report, a Certificate of Coroner (Form D) or a Coroner’s Certificate of Findings of the Jury (Form E).

The RGD has initiated a collection campaign for all outstanding Post Mortem Examination Reports and Form Ds yet at the Resident Magistrates’ Courts. These documents are then checked against the existing death registrations to ensure that the specific deaths were not previously registered. Once this is established, the process of registration commences. What is different about this new registration process is that the RGD no longer waits for a relative or another person to come in with the document to initiate registration. In these cases, the Coroner who issues the document is entered as the Informant[1].

In addition to the timely capture of the data, the importance of the accuracy and correctness of the data must not be neglected. In respect of this, the greatest challenge that is presently being faced also involves death registrations, specifically the cause of death. In past reports, the ICD-10 “Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified” or (R00-R99) category was attributed to a significant number of deaths. This misleading phenomenon was also as a result of the tardiness of the Legal system with respect to death certification. Thus, many death registrations had no information entered for cause of death. Below is a table showing the number of R00-R99 cases for 1995 to 2004 (bearing in mind that a portion of these are legitimate R99 classifiable deaths).

The correction of this undesirable result is now being dealt with, however, and the high incidence of the “R99” ICD-10 code is decreasing year by year as seen previously. There are other concerns with the cause of death data provided by medical personnel and pathologists, however. In addition to the perennial problem of illegibly handwritten Medical Certificates of Cause of Death, the quality of the cause of deaths information on death certification documents are often not up to International standards. One of the common problems includes the apparent masking or failure of the reporting of the incidence of Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) for some decedents. In some cases, an unaccepted term or abbreviation for the condition known unofficially by medical doctors is cited on the document. Another challenge is that deaths caused by external causes, such as wounding, are often not specified with respect to intent (whether self-inflicted, accidental or assault). This is an increasingly important aspect of cause of death data which is poorly reported in Jamaica and indeed the Caribbean. In the near future the RGD will be intensifying its efforts to train the relevant professionals in order to eliminate the challenges as described.

The processes involved in the civil registration and vital statistics systems of Jamaica are currently in various phases of transition. It is envisioned that in the near future all these processes will individually be vastly improved and operate together both efficiently and effectively. This will facilitate a greater level of compatibility between the vital statistics produced by the country and that produced by the rest of the World.

Further improvements in the 2004 report:

For the 2004 Annual report the following are additions to the range of tables already reported on in reports for previous years:

Births

Table 6b           Live Births Registered in 2004 Showing Late Registrations by Parish

Table 8a           Live Births Occurring in 2004 by Parish of Occurrence and Live Birth Outcome

Deaths
Table 12a         Deaths Occurring in 2004 by Parish and Place of Death

Table 15n         Summary of Adult Female Deaths (5 - 100 years) by Cause and Parish of
Residence of Deceased for 2004

Table 15o         Summary of Adult Male Deaths (5 - 100 years) by Cause and Parish of
Residence of Deceased for 2004

Table 15p         Leading Causes of Deaths for All Adults (5 - 100 years) by Cause and
Parish of Residence of Deceased for 2004

In addition, a “Guide to Tables” has been included before each set of data for Births, Deaths, Marriages and Divorces for ease of reference.