A new World Health Organization (WHO) assessment found that 21 of 40 African countries surveyed failed to notify authorities of at least 80% of deaths, raising concerns about the number of deaths missing from official records.
The findings were released on November 10 at the Africa Health Data Forum in Nairobi, Kenya. The assessment, carried out in 2024, examined how countries collect and use information about deaths, diseases and healthcare services.
“Countries have made important progress in collecting health data, but information must lead to action,” said WHO Regional Director for Africa Dr Mohamed Janabi, urging governments to make better use of the information they already collect.
Only 19 countries reported notifying authorities of at least 80% of deaths. Separately, 21 countries said they had recorded a cause of death for at least 80% of deaths that were registered. These are different measures: reporting that a person died does not necessarily establish what caused the death.
Knowing the cause matters to health workers. If deaths from a particular disease rise in one district, reliable records can help authorities investigate sooner. Missing information can make it harder to spot such patterns or decide where clinics need additional support.
The assessment also found problems with the information collected inside health facilities. Only 43% of the countries reported enough capacity to analyse health data at facility level, while just 25% said they had sufficient capacity to check its quality.
Money and planning were other obstacles. Only 18% of surveyed countries reported a dedicated budget line for health information, and 35% had an up-to-date national policy for managing such systems.
Digital technology has expanded, but the report showed that access to software alone is not enough.
WHO said 43 of its 47 African-region member states use digital platforms for routine health reporting. However, only 20% of the surveyed countries reported implementing digital patient medical records.
Rwanda’s latest national statistics offer a separate picture of the challenge. The National Institute of Statistics of Rwanda (NISR) recorded 39,355 registered deaths in 2025, representing 50.5% of the deaths estimated to have occurred that year.
That was an improvement from 46.1% in 2024, although it means the registration system still did not capture nearly half of estimated deaths.
Rwanda’s figures measure death registration completeness and should not be treated as a direct comparison with WHO’s notification threshold.
Of the deaths registered in Rwanda, 55.9% occurred outside health facilities. In rural areas, 61.3% of registered deaths occurred in communities rather than health facilities, showing why reporting cannot depend on hospitals alone.
There was also progress in how causes of death were documented. NISR reported that the quality of cause of death certification in health facilities improved from 64.7% in 2024 to 82.3% in 2025. That improvement concerns the quality of certification, not the percentage of all deaths registered.
WHO has launched a regional health-data platform to bring information from different programmes together.
The Nairobi forum, which ends on November 12, is discussing how governments can improve reporting and use those records to identify health risks and direct healthcare resources where they are needed most.
Elie GATETE
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