The use of cause-of-death statistics for health situation assessment: national and international experiences

About 80 countries or areas regularly report detailed cause-of-death data to WHO based on the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD). These data refer to about 35% of all deaths estimated to occur in the world, although the actual coverage may be somewhat higher due to the representativeness of data-collection schemes in countries such as China. These data are systematically validated and documented by WHO before their dissemination, principally through publication in the World health statistics annual. This article describes the collection and use of these data by WHO for assessing the global and regional health situation, and for monitoring trends in health status. In addition, several issues in the use of mortality data and the ICD for national health situation assessment are discussed, including the need for documenting the quality and coverage of cause-of-death statistics, identifying biases and evaluating mortality trends.