Brunei Darussalam strengthens capacity to improve the quality of mortality statistics

17 September 2026
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Brunei Darussalam has achieved high levels of completeness in birth and death registration, providing a strong foundation for its civil registration and vital statistics system. However, as in many countries, challenges remain in ensuring that deaths are accurately certified and coded according to international standards. Errors in medical certification of cause of death and mortality coding can affect the quality of mortality statistics and limit their usefulness for monitoring population health, identifying emerging health priorities and guiding investments in the health sector.  

Participants at the training to strengthen medical certification of cause of death, ICD mortality coding and awareness of the International Classification of Diseases, 11th  Revision.
Photo credit: Ministry of Health, Brunei Darussalam  

To address these challenges, the Statistics Unit of the Research and Development Section, Department of Policy and Planning of the Ministry of Health, Brunei Darussalam, with technical support from the World Health Organization Representative Office for Malaysia, Brunei Darussalam and Singapore and the WHO Regional Office for the Western Pacific convened a three-day training programme to strengthen medical certification of cause of death (MCCD), ICD mortality coding and awareness of the International Classification of Diseases, 11th Revision (ICD-11).  

The initiative brought together physicians, mortality coders, medical records personnel, public health professionals and other health workers to improve the quality of mortality data that support evidence-informed health planning and policy-making.  

Participants reviewing the WHO mortality coding standards and practicing applying coding rules to determine the underlying cause of death. Photo credit: Ministry of Health, Brunei Darussalam  


WHO supported the training on accurate medical certification of cause of death and ICD mortality coding for 30 hospital clinicians and public health medical officers and Brunei Darussalam’s mortality coder and potential future coders. Accurate mortality coding is essential to ensure that causes of death are classified consistently and can be compared across time and between countries. Participants also strengthened their understanding of the WHO international medical certificate of cause of death, the importance of correctly documenting the sequence of events leading to death and common certification errors that can affect the quality of mortality statistics.  

“The process of mortality certification and coding extends beyond the Ministry of Health, as the information generated is important for subsequent administrative, legal and statistical processes undertaken by other government agencies. The ANACoD3 demonstration also showed how mortality data can be analysed and translated into information for policy, which is particularly relevant from a public health perspective.” said Yang Mulia Pengiran Dr Haji Md Khalifah bin Pengiran Haji Ismail, Director General of Medical and Health Services, Ministry of Health Brunei Darussalam.  

Looking ahead, participants were introduced to ICD-11, the latest revision of the international standard for classifying diseases and causes of death. The orientation highlighted key improvements in ICD-11 and included demonstrations of the ICD-11 coding tool and WHO’s Digital Open Rule Integrated Cause of Death Selection (DORIS) tool, which supports automated selection of the underlying cause of death. Participants were also introduced to the ANACoD3 mortality analysis tool to better understand approaches for assessing and improving mortality data quality.  

BRUHIMS 2.0 offers an opportunity to incorporate structured certification and mortality coding into electronic medical records. Future strategies including inbuilt validation and verification rules, regular training and routine mortality data quality review were also discussed.  

The training is expected to strengthen quality medical certification of cause of death and mortality coding for future use to guide health planning and decision making in Brunei Darussalam.  

This activity was made possible through the generous financial contribution of the Ministry of Health and Welfare of the Republic of Korea, whose support continues to strengthen efforts across the Western Pacific Region to improve the quality and use of health information for better health outcomes.