Quality of Mortality Statistics from Civil Registration in South Africa

Two World Health Organization comparative assessments rated the quality of South Africa’s 1996 mortality data as low. Since then, focussed initiatives were introduced to improve civil registration and vital statistics. Furthermore, South African cause-of-death data are widely used by research and international development agencies as the basis for making estimates of cause-specific mortality in many African countries. It is hence important to assess the quality of more recent South African data.

The authors employed nine criteria to evaluate the quality of civil registration mortality data. Four criteria were assessed by analysing 5.38 million deaths that occurred nationally from 1997–2007. For the remaining five criteria, we reviewed relevant legislation, data repositories, and reports to highlight developments which shaped the current status of these criteria.

National mortality statistics from civil registration were rated satisfactory for coverage and completeness of death registration, temporal consistency, age/sex classification, timeliness, and sub-national availability. Epidemiological consistency could not be assessed conclusively as the model lacks the discriminatory power to enable an assessment for South Africa. Selected studies and the extent of ill-defined/non-specific codes suggest substantial shortcomings with single-cause data. The latter criterion and content validity were rated unsatisfactory.

In a region marred by mortality data absences and deficiencies, this analysis signifies optimism by revealing considerable progress from a dysfunctional mortality data system to one that offers all-cause mortality data that can be adjusted for demographic and health analysis. Additionally, timely and disaggregated single-cause data are available, certified and coded according to international standards. However, without skillfully estimating adjustments for biases, a considerable confidence gap remains for single-cause data to inform local health planning, or to fill gaps in sparse-data countries on the continent. Improving the accuracy of single-cause data will be a critical contribution to the epidemiologic and population health evidence base in Africa.

Joubert J, Rao C, Bradshaw D, Vos T, Lopez AD (2013)

Evaluating the Quality of National Mortality Statistics from Civil Registration in South Africa, 1997–2007

PLoS ONE 8(5): e64592. doi:10.1371/journal.pone.0064592

Guttmacher Institute Reasons

In more or less routine publication of Guttmacher Institute, Legal Abortion Worldwide in 2008: Levels and Recent Trends by Gilda Sedgh, Susheela Singh, Stanley K. Henshaw and Akinrinola Bankole published by International Perspectives on Sexual and Reproductive Health, 2011, 37(2):84–94, doi: 10.1363/3708411 (link to pdf) I have found interesting reduction of Russian rating of completeness of legal abortions reporting:

For some countries, the classification of the completeness of their statistics has changed since 2003. Abortion statistics for Belarus, Canada, Cuba, Latvia, Lithuania, Russia and Tunisia were deemed complete in 2003 but incomplete in 2008.

Since now the reporting is incomplete or completeness is uncertain. This statement is based upon another statement:

The proportion of abortions in Russia that are privately performed and unreported is increasing, according to experts and published research.¹¹ 

ref 11 is Philipov D et al., Induced abortion in Russia: recent trends and underreporting in surveys, European Journal of Population, 2004, 20(2): 95–117 (link to jstore). 
(et al = E. Andreev, T. Kharkova, and V. Shkolnikov)

 + more (of Guttmacher): 

However, experts indicated that the number of unreported, privately performed abortions in this region has increased substantially, though the levels of such abortions are unknown. Informants believed that the declines in the official numbers represent a combination of real declines in incidence and a shift to unreported abortions.

Experts and informants are not indicated ;(
However known authors (D. Philipov, E. Andreev, T. Kharkova, and V. Shkolnikov) in cited paper wrote:

... finding suggests that provider statistics on abortion in Russia are a true reflection of the situation they monitor, that the observed declining trend in abortion is a real one...

They tested the idea of statistics deterioration was a couse of abortion reduction.

It seems that Guttmacher Institute authors understood their reference exactly opposite ;)