Fig. 1

Routine death reporting processes in Tonga. Dashed lines denote gaps in reporting. ^a Hospital discharge records are updated in the main hospital (Vaiola) information system. The causes of death on medical certificates of cause of death (MCCD) are coded using the International Classification of Diseases 10th revision (4th edition). ^b Medical certificates of cause of death (MCCD) are entered into the mortality database at the Health Planning and Information division of the Ministry of Health. ^c Community nursing reports are collated. ^d Legal death certificates are entered into the registry database. ^e Town and District Officer reports were not available for analysis