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Table 4 Quality assessment of medical certificates of cause of death pre- and post-training in Peru (online system and basic training strategy)

From: Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative

AssessmentMCCODs with errors (%)
BaselineAfter online interventionAfter online and training interventionPercentage improvement after online intervention*Percentage improvement after online and training intervention*
Incorrectly completed certificates (at least one error)100.069.956.730.143.3
 Certificates with one error16.318.218.6− 11.7− 14.1
 Certificates with two or more errors83.751.738.138.254.5
Certificates with at least one major error69.053.444.022.636.2
Certificates with minor errors only31.016.412.747.159.0
Certificates with major errors     
 Multiples causes per line2.01.30.635.070.0
 Incorrect sequence of events leading to death40.325.917.935.755.6
 Illegible handwriting
 Ill-defined condition entered as an underlying cause of death52.045.438.912.725.2
 Additional information on external causes not available5.
 Additional information on neoplasms not available15.08.16.346.058.0
Certificates with minor errors
 Presence of blank lines within the sequence of events11.30.20.398.297.3
 Abbreviations used in certifying the death11.
 Absence of disease time interval96.
 Additional errors on the certificate12.713.912.6−9.40.8
  1. Total column percentages may total > 100% as a single MCCOD may contain more than one error
  2. No data available
  3. *Negative values indicate lower quality after training
  4. Category may contain minor errors