Health care professionals' knowledge and awareness of the ICD-10 coding system for assigning the cause of perinatal deaths in Jordanian hospitals

Objectives: There is a lack of studying vital registration and disease classification systems in low- and middle-income countries. This study aimed to assess health care professionals' (HCPs') level of awareness, knowledge, use, and perceived barriers of the International Classification of Diseases, 10th version (ICD-10) as well as their perceptions of the electronic neonatal death registration system. Participants and methods: A mixed method approach including descriptive cross-sectional quantitative and focus groups with HCPs (physicians, nurses, and midwives) was used to collect data from four major selected hospitals in Jordan. A total of 16 focus groups were conducted. Also, a survey, which included three case studies about the ability of nurses and physicians to identify cause of death, was completed using structured face-to-face interviews. Results: Overall, there was congruency between both the quantitative results and the qualitative findings. The majority of nurses and physicians in the four hospitals were not familiar with the ICD-10 coding system and hence reported minimal use of the coding system. Additionally, the majority of HCPs were not aware whether or not their departments used the ICD-10 to record perinatal mortality. These HCPs identified that lack of knowledge, time, staff and support, and an effective and comprehensive electronic system that allows physicians to accurately choose the exact cause of death were their main barriers to the use of the ICD-10 coding system. Conclusion: Our findings emphasize the importance of developing an effective and comprehensive electronic system which allows HCPs to accurately report and register all perinatal deaths. This system needs to account for the direct and indirect causes of death and for contributing factors such as maternal conditions at the time of perinatal death. Training IR:Ps on how to use the system is vital for the success and accuracy of the data registration process.