Exploring the Various Sources of Mortality Estimation in Ghana: A Scoping Review of Data Sources, Challenges, and Opportunities.

Abstract

Background: Accurate estimation of mortality is essential for effective public health planning, policymaking, and monitoring of health interventions. In Ghana, multiple data sources are used to estimate mortality, including civil registration systems, household surveys, census data, and health and demographic surveillance systems. This scoping review explores the existing sources of mortality data in Ghana, examining their challenges and opportunities. Methods: Using Arksey and O'Malley's framework, we identified peer-reviewed and grey literature from Ghana Health Service, Ministry of Health, Ghana Statistical Service, WHO, and the United Nations. We selected studies published between 2000 and 2024 that focused on mortality estimation in Ghana. Data was extracted and synthesized into key themes: data sources, challenges, and opportunities. Results: Six major data sources on mortality were identified: Civil Registration and Vital Statistics (CRVS), census data, Demographic and Health Surveys (DHS), Health and Demographic Surveillance Systems (HDSS), Facility-Based Health Information Systems (HMIS), modeled estimates from the Global Burden of Disease (GBD) and from the United Nations Department of Economic and Social Affairs (UN DESA). Key challenges include under-registration of deaths (CRVS and HMIS), recall bias (DHS, census), limited geographic coverage (HDSS), inconsistencies in cause-of-death classification (HMIS, HDSS), and lack of local geographic coverage (GBD, UN DESA, DHS). Nonetheless, benefits include longitudinal follow-up (HDSS), local coverage and ownership (CRVS, HMIS) and international comparability (GBD, UN DESA, DHS). Conclusions: Mortality estimation in Ghana is supported by diverse but fragmented data sources. Strengthening the CRVS and HMIS systems, integrating multiple data streams, standardizing methodologies, and enhancing institutional partnership are essential steps toward improving data quality and coverage. This review provides recommendations for improvement towards better quality estimations of mortality in Ghana.