Differences among official statistics of mortality rates in Iran

Death indicators and causes of death are both closely associated with socio-cultural, economic, and structural factors and determinants of health, with all of which being at the core of the planning, monitoring, and assessment of intervention programs in any healthcare system (1). In Iran, the diagnosis and official registration of deaths are carried out by two independent organizations. These two organizations are medical universities, which are under the supervision of the Ministry of Health and Medical Education (MoHME), and the Forensic Medicine Organization (FMO), which is under the supervision of the Judiciary. The death registration system (DRS) managed by the MoHME suffers from several shortcomings, including inconsistency in DRS administration, the duplicate recording and misclassification of deaths, geographical misalignment, the incompleteness of records, and missing values (2). Given the shortcomings mentioned, the inaccuracy and duplication of the official statistics of the mortality rate throughout the country are probable on the part of different official sources. In this review, an outline of some of the cases with considerable differences between the mortality statistics registered by the MoHME and by the FMO has been presented. Because of the importance of death events and the respective consequences, the legislator has assigned tasks, such as the issuance of death certificates and the determining of the causes of some deaths, to the FMO, under the following conditions: a) For all cases mentioned in Table 1, a death certificate will be issued by a forensic physician. b) For the cases of death that occur less than 24 hours after the admission of the patient to the hospital, the forensic physician issues a death certificate. c) For the cases of death occurring more than 24 hours after the admission of the patient to the hospital, the hospital physician issues a death certificate after consulting with the forensic physician. Citation: Rostami M, Nazparvar B, Rezaeian Sh. Differences among official statistics of mortality rates in