Digitizing death reporting in Zambia: evaluation of a mobile-based civil registration system.

BACKGROUND

Strengthening Civil Registration and Vital Statistics (CRVS) systems is essential for generating reliable evidence to guide population health policy and planning. Routine death reporting is a critical first step toward improving data for effective health interventions in low- and middle-income countries.

OBJECTIVES

This study evaluates the operational effectiveness of a mobile electronic reporting (e-reporting) system in Zambia, assessing improvements in timeliness, completeness and data quality compared to the paper-based process.

METHODS

An implementation case study was conducted in burial offices across high-mortality provinces (Lusaka, Central, Copperbelt, and Southern Provinces) and districts in Zambia. An electronic version of Form 13, the official death notification form, was developed using KoboToolbox to capture facility and community deaths in real time. A dashboard provided real-time monitoring and analysis.

RESULTS

Over six months, the electronic platform captured 115,573 deaths that occurred between January 2021 and June 2025. The e-reporting system achieved an estimated completeness rate of 17.4% (95% CI:17.3%-17.5%), statistically significantly higher than the manual system's completeness rate of 11.9% (95% CI: 11.8%-12.0%) (chi2 = 4.01, p < 0.045). Reporting delays also reduced from an average of 6 days (manual system) to 3 days (e-reporting; p < 0.001). Completing a form electronically took an average of 4.6 minutes (median: 4.0).

CONCLUSIONS

Digitizing CRVS death reporting in Zambia improved timeliness, completeness, and data quality, enabling rapid analysis and policy response. These findings demonstrate the potential of digital platforms to strengthen CRVS, enhance disease surveillance, and support data-driven health interventions.