Quality of the Death Certificates of Hospitals in Addis Ababa, Ethiopia: A Time to Adopt the Internationally Recommended Form

The quality of death certificates (DCs) in many countries, including Ethiopia, is often inadequate, leading to significant implications for medical, legal, and administrative processes. This study evaluated the quality of DCs issued at St. Paul’s Hospital Millennium Medical College and Ras Desta Damtew Memorial Hospital in Addis Ababa. A retrospective review of 595 randomly selected DCs from September 11, 2020 to September 10, 2021, was conducted using a standardized evaluation tool developed by the University of Melbourne. All reviewed DCs contained errors, with the most prevalent being the omission of the time interval between symptom onset and death (100%) and ill-defined underlying causes of death (72.8%). Both hospitals in this study used paper-based DCs, but neither had implemented the internationally recommended format for DCs. The high frequency of errors underscores the need for targeted training for certifiers, implementation of quality assurance mechanisms, and adoption of standardized formats to enhance the consistency and accuracy of DCs.