**5. Conclusion**

*Contemporary Developments and Perspectives in International Health Security - Volume 1*

the number of deaths classified under the heading of ill-defined cause.

and currently Ordinance No. 1378/GM/MS of July 9, 2013 [23].

importance of correct and complete filling of this document [9].

Investments made include the regulation of data collection, flow and periodicity of information on death by means of Ordinance No. 116 of February 11, 2009 [21], and the suspension of fund-to-fund transfer in the event of problems in submitting this information, initially through Ordinance GM 3252 of December 22, 2009 [22],

In addition to these decrees, training programs for human resources and coders of basic causes are associated with the dissemination of data and technical publications, such as "Saúde Brasil," based on the use of data from information systems, thus seeking greater use of indicators of health by managers [24]. Another important initiative was the study of the active search for deaths and births in the Northeast and the Legal Amazon with the main objective of estimating the coverage of the Mortality Information System (SIM) and the Information System on Live Births (SINASC) in 133 municipalities of these regions. The statistical procedure used for data analysis allowed the estimation of infant mortality in all

Regarding the improvement of the definition of the cause of death, the program "Reduction of the percentage of deaths with ill-defined causes" was instituted in 2004, developed by the Health Surveillance Secretariat of the Ministry of Health. This program aimed to investigate deaths from ill-defined causes and establish a goal to reduce the percentage of these deaths in the Northeast region and in three states in the North region (Acre, Pará and Amazonas) to less than 10% [26]. In 2006, the National Network of Mortality Cause Verification and Death Verification Services (SVO) was created considering the need for the implementation of SVO in all state capitals and the Federal District, which should total 74 services [27] to insert these structures on the National Health Surveillance System. In addition, a new instruction manual to fill a DC from 2011 was widely disseminated and distributed, seeking greater awareness of the medical professional regarding the

The creation of Hospital Epidemiology Centers (NUHEPI), within the hospital, and the Epidemiological Surveillance Units (UVE), in Family Health Centers, as well as the implementation of the form to investigate deaths from ill-defined causes, the training of typists and coders, and awareness-raising workshops for professionals responsible for filing a DC from 2006 onwards, represented a major contribution

All measures of a legal nature, by suspending the transfer of funds from the federal fund to the municipal fund, in case of non-compliance with the rules for the collection, flow and periodicity of information on deaths, in addition to training and qualification of human resources to record and code the underlying cause and to investigate deaths by IDC through verbal autopsy, reduced the occurrence of deaths classified as IDC. According to data presented in this article, there is a pronounced reduction in ill-defined causes for the country as a whole, which proves

and the population group live and which are directly related to their health situation, that is, configuring the social determinants of health [20]. These adverse conditions cause health problems and create situations of potential risk, affecting the health of individuals and certain segments of the population. Significant differences are also observed in the organization and structuring of public services that affect, among others, the registration of vital information, whether due to lack of coverage or problems in filling out the forms related to this information. Given the situation identified in recent decades, the federal government, through the Ministry of Health, has made significant investments in various initiatives aimed at improving the quality of vital information in the country. Regarding deaths, attention has been focused on improving the coverage of deaths and reducing, to the maximum,

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municipalities [25].

to this new reality [16].

The unequal distribution of deaths according to underlying cause expresses the inequity of access to health services by the population and problems of structuring and organization of health services. The uneven geographical distribution of deaths due to this type of causes requires geographically differentiated interventions in order to reduce its occurrence. This set of problems is a major challenge for public administration to achieve an even more pronounced reduction in deaths from illdefined causes. The continuous search for improvement of health statistics necessarily involves reducing the frequency of deaths classified under this heading.
