1.The legal context
Statistical Births and Deaths certificates are designed to allow the Directorate-General for Statistics and Economic Information to prepare key statistics on births and deaths. The Royal orders of 17 june 1999 (French or Dutch) and 14 june 1999 (French or Dutch) set out the methods for preparing these statistics on births and deaths. The Joint Community Commission is entitled to gather and treat the data on the Brussels population. The Health and Social Observatory is assigned to perform this task.
Regional Medical Officers and Municipal Officials who complete or hold the certificates are bound by statistical and professional confidentiality. This information cannot be divulged in legal proceedings.
2. The certificates
New forms are in use since 1998. There are 3 forms:
- Form I (French or Dutch): certificate for the declaration of birth for a living child. This must be completed at the birth of any living child whatever the weight at birth or length of gestation.
- Form III D (French or Dutch) : certificate for the declaration of the death of a child under one year or stillborn. This must be completed for any child that dies within its first year or for a stillbirth whose birth weight is at least 500g or whose gestational age is at least 22 weeks or whose length at birth from head to toe is at least 25 cm (WHO criteria)
- Form III C (French or Dutch): certificate for the declaration of the death of a person aged one year or over
All three forms are divided into four sections. Section A, not anonymous, is to be completed by the doctor and retained by the Municipal administration. Section B is to be filled in by the doctor and will be checked by the Municipal administration before being sent off with the rest of the form to the Regional Medical Officer at the Joint Community Commission. Section C, which contains the medical information, is to be filled in and placed in a sealed envelope by the doctor (this information cannot be accessed by the Municipal administration). It will be opened for the Health and Social Observatory by the doctor in charge. Section D, which contains anonymous administrative and social information, is to be completed by the Municipal administration.
The forms are printed by the Directorate-General for Statistics and Economic Information, which is responsible for supplying them to Local Authorities and to maternity wards. Municipal administrations are in charge of distributing the forms to doctors and hospitals within their municipality.
3.The role of Municipal administrations
Registry offices in the 19 Brussels municipalities play a key role in gathering basic data for birth and death statistics.
Officials at registry offices are responsible for completing Section D, which covers socio-demographic data for deceased persons or for parents in the case of a birth or under one year death (level of education, socio-professional situation, nationality, civil status, etc.). Depending on the quality of this data, links may be analysed between the social status or other demographic variables, and health indicators measured.
4. Data processing
The forms (Sections A, B and C) are first completed by doctors or midwives. Section C is sealed in an envelope attached to the bulletin, and then the entire folder is sent to the registry office of the municipality in which the birth or death took place.
The registry office then completes Section D. Statistical certificates are sent to the Joint Community Commission. Throughout this process, Section C (which contains the medical information) remains sealed.
The Health and Social Observatory verifies the data and contacts the Municipal administration for any corrections to the administrative data. The medical sections are opened with the permission of the Regional Medical Officer.
The various sections of the certificates are then encoded and the causes of death are converted according to the WHO International Classification of Diseases ICD-10. Since 1998, these tasks have been sub-contracted to a team at the Administration of the Flemish Community (for all certificates from 1998 to 2007 and certificates of death only for 2008) and to the non-profit organisation CEpip (Centre for Perinatal Epidemiology) (for 2008 certificates of births). These sub-contracts are subject to annual agreements between the Joint Community Commission and the bodies concerned. In collaboration with the coding officer, the responsible doctor from the Observatory checks where possible the data from Section C with the certifying doctor; if further investigations were required when the doctor issued the death certificate, the responsible doctor may also carry out further research with the Public Prosecutor to better understand the exact cause of death.
This data feeds several databases.
1. Births and under one year deaths
The births and under one year deaths are combined to produce a file containing all information on the child's birth and death.
- The database of births and under one year deaths occurring in the Brussels-Capital Region is passed to the DGSIE, which is responsible for preparing national statistics. This database is also analysed by the Observatory, enabling for example the tracking of births and deaths of non-residents of Brussels occurring in the region (flows into Brussels hospitals and maternity wards).
- The database of births and under one year deaths whose mothers reside in the Brussels Region is analysed in-depth by the Health and Social Observatory. The findings are mainly published in the Perinatal Health Indicators section of the website, in the Health profiles and in the report on Perinatal Health Indicators. Data on children from Brussels who are born or die in Vlaanderen have been included in the database since 1998; data on children from Brussels who are born or die in Wallonie are included since 2000.
2. Deaths of persons over one year
- The database for deaths occurring in the Brussels-Capital Region is passed to the DGSIE, which is responsible for preparing national statistics. This database is also analysed by the Observatory, enabling for example the tracking of deaths of non-residents of Brussels occurring in the region (flows into Brussels hospitals and care wards).
- The database for deaths of Brussels residents is analysed in-depth by the Observatory. The findings are published in the mortality indicators section of the website, in the Health profiles or in specific reports. Data on Brussels residents who die in Vlaanderen have been included in the database since 1998; data on Brussels residents who die in Wallonie are not yet included in our databases, but will be in the near future.