The importance of cultural factors in the death registration system: the case of Turkey

Banu Akadlı Ergöçmen, Hacettepe University Institute of Population Studies
Ilknur Yuksel, Hacettepe University

Maternal mortality is an important indicator of public health and socio-economic inequalities in every community. The lack of reliable data on maternal mortality is one the major problems in most of the cases Especially in developing countries, the number of deaths as well as their medical and socio-economic causes are not precisely known and the robustness of the existing information is questionable. Since similar problems prevail in Turkey a nationwide study was conducted in 2005 (The National Maternal Mortality Study) in order to obtain valid and representative data that will help to estimate maternal mortality rates and ratios as well as providing information on improving the existing recording and reporting systems. Besides the quantitative survey, qualitative research aimed to understand the causes of under-registration of female deaths and improve the quality of recording of causes-of-death. The purpose was specisifically to understand why there is under-notification of burials in general, and of burials of women in particular. The findings of this study also aimed to provide information which would help to guide the policy makers to improve the registration system. In-depth interviews and focus group discussions were conducted with the government officials, village headman (muhtar), cemetery officials and the project teams. The interviews enabled us to see why burials of women more specifically were under-reported and understand the underlying structure and processes forming the present situation. The findings of the qualitative survey laid stress on the social and cultural factors as supplementary or as explanatory forces to understand the problematical points in the registration of maternal mortality, thus contributed to the improvement and development of new strategies to avoid the deficiencies of the system.