Table 1 Sources of adult mortality data, PNG

 Civil Registration System

Civil and Identity Registry Office (CIRO)

Less than 1% registered annually

Potential source of comprehensive mortality data by age and sex

Dysfunctional system, mortality data held in departmental silos so unable to obtain meaningful and reliable mortality indicators from registered deaths

 PNG National Censuses (2000 and 2011)

National Statistics Office (NSO)

Parental survival and summary birth history (SBH) data; 89,000 reported deaths in household in last 12 months (2011)

Data on parental survival to estimate adult mortality (45q15). Summary Birth Histories (SBH) for under 5 mortality (5q0) estimation.

Household deaths have age reporting issues; hence, age-specific death rates are implausible. No father’s survival data in 2000.

 Demographic & Health Surveys

National Statistics Office

Potential source of data for adult and child mortality

2006 child survival data is of poor quality. No reliable adult mortality data.

 Health and Demographic Surveillance System (HDSS) sites (Partnership in Health Project, Hiri-West, Hides, Asaro and Karkar)

Papua New Guinea Institute of Medical Research (PNGIMR)

1,308 deaths (2009-2014)

Relatively complete recording of deaths within HDSS sites.

Deaths only from specific sites, so not representative of the whole country to enable all-cause mortality analysis

 National Health Information System (NHIS)

National Department of Health

41,405 deaths (2010–2015)

Deaths recorded from 636 health centerres and 22 hospitals

Age is not recorded in 72% of deaths limiting its usefulness in mortality analysis.

Deaths for only those accessing facilities (28%) of all deaths, not sufficient for mortality analysis.

 eNHIS

National Department of Health

2487 deaths (2015–2017)

Age recorded for all deaths, timeliness and quality of data

Reported deaths from facilities in only 5 provinces, insufficient for analysis.

Facility-based data insufficient for all-cause mortality analysis

 Discharge Health Information System (DHIS)

National Department of Health

38,303 deaths (2007–2013)

Records deaths by age and sex from all hospitals and health facilities

Reported deaths account for only 22% of all deaths, so insufficient for mortality analysis.