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The primary aim of this paper is to describe the operation, strengths and weaknesses of mortality registration systems in China.

Little is known outside of China about the characteristics of such systems and their potential application to other low-income countries.].

There remains a need to critically validate the information on causes of death, and a detailed validation exercise on these aspects is currently underway.

In general, such sample based mortality registration systems hold much promise as models for rapidly improving knowledge about levels and causes of mortality in other low-income populations.

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However, censuses and annual population change surveys do not provide routine information on causes of death, retrospective surveys could be affected by recall bias, and the child mortality surveillance system does not inform about causes of death or adult mortality.Periodic evaluations for completeness of registration are conducted, with subsequent corrections for under reporting of deaths.Results from the DSP have been used to inform health policy at national, regional and global levels.In this paper, we review the history of vital registration in China, and describe the establishment and operation of the Chinese Disease Surveillance Points (DSP) system.

We focus on vital registration because we consider it as the 'gold standard' for mortality statistics, since it provides population level data on causes of death on an annual basis.From 1990 onwards, coding was directly based on ICD – 9.

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