Reducing Ignorance about Adult Mortality: Improving Methods for Evaluating the Completeness of Death Registration

Christopher J.L. Murray, University of Washington
Tom Laakso, University of Washington
Julie Knoll Rajaratnam, University of Washington
Alan D. Lopez, University of Queensland

Over 40 developing countries annually report death statistics to the World Health Organization or the United Nations Statistical Office, yet their utility for measuring levels and trends in mortality, particularly among adults, remains uncertain due to a lack of confidence in the completeness of death registration. Death distribution methods have been widely applied to estimate the completeness of death registration and correct for incompleteness. However, these methods have not been extensively validated in real populations in the presence of measurement error. In this paper, we use simulated populations where we know the true level of death registration completeness to characterize the performance of the three main methods in wide use for assessing the completeness of death registration: synthetic extinct generations, generalized growth balance and a hybrid of the two.