Mortuary-based surveillance typically collates information from three sources: postmortem reports completed by forensic pathologists, police crime incident reports and chemical pathology laboratory results. The data are an important tool to inform prevention efforts and to monitor their effectiveness, and represent an underutilised source of descriptive epidemiological information to inform our understanding of fatal violence patterns, risk factors and groups at-risk.
Following on earlier South African mortality surveillance initiatives, the current system provides a robust and simple surveillance tool that provides data that is congruent with, yet avoids the rigid confines of, the ICD10 coding system. We describe the process of consultation between participating research agencies to refine the data collection instrument, manual and automated data collection procedures and the systems institutionalisation with provincial government. The first complete non-natural mortality data for the Western Cape Province for 2007 will be presented, as well as the expected utility of these data in directing, monitoring and evaluating interventions to reduce the provincial burden of injury. The surveillance system has become a focal point of the Provincial Governments injury prevention and safety promotion efforts relating to its Burden of Disease Project. One important innovation has been the inclusion of an optional special interest variable describing fatal events that are either not readily available from ICD and other coding systems or difficult to record and analyse due to complex coding requirements. We explore the limitations of the current system and its possible improvement in line with best practices internationally.
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