Public Health · Psychiatry · 2 h ago
West African death registration captures a small fraction of estimated suicide deaths
A cross-sectional analysis of 16 West African countries compared WHO-estimated suicide deaths in 2021 with completeness of death registration. Under an assumption of perfect cause certification, registration systems could capture at most 6.1% of the estimated deaths across countries with available data.
- Registration could capture at most 6.1% of estimated deaths.
- Data-quality ratings were very low in 15 of 16 countries.
- Three countries lacked registration completeness data.
- Authors recommend triangulating multiple surveillance sources.
Researchers combined 2021 WHO estimates of suicide deaths and data-quality classifications with all-cause death-registration completeness data for the 15 ECOWAS member states and Mauritania. They calculated a completeness-limited ceiling for registrable suicide deaths, assuming every registered death received an accurate cause assignment, and conducted five sensitivity analyses.
WHO rated the underlying suicide data as very low quality in 15 countries and low quality in Cabo Verde; none had medium- or high-quality data. Registration counts were unavailable for Ghana, Senegal and Mali. Among the 13 countries with measurable completeness, the median was 14.1% (range 0.5% in Nigeria to 89.0% in Cabo Verde). Of 23,637 estimated suicide deaths, registration could capture at most 1,446 (6.1%); the estimate rose to 8.4% if the three countries without data were assigned the median completeness. Nigeria’s ceiling was 57 deaths, compared with 10,912 estimated.
The authors conclude that death registration alone cannot support suicide surveillance across most of the region and call for triangulation with facility data, verbal autopsy, coroner records and surveys, alongside system reforms. Estimates remain highly uncertain: WHO data quality was low or very low, and the calculated ceilings assume accurate cause certification. The analysis used aggregate country-level data and does not establish individual-level patterns.
In practice
For clinicians and public-health teams using suicide mortality statistics from West Africa, the study indicates that civil registration completeness is too limited in most countries to provide reliable surveillance on its own. The estimates suggest registration could capture no more than 6.1% of the region’s WHO-estimated suicide deaths under the study’s assumptions. These are country-level capacity estimates, not observed case counts; WHO rated source data very low quality in 15 countries, and the calculation assumes accurate cause certification. The findings support cautious interpretation of reported rates, not changes to individual clinical care.
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BMC Public Health: Counting the uncounted: suicide mortality and the limits of death registration in West Africa, a cross-sectional surveillance capacity analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.