{"id":"https://openalex.org/W4416631472","doi":"https://doi.org/10.26633/rpsp.2025.109","title":"Informing ICD-11 implementation: applying systems thinking to assess mortality information systems in Ecuador and Trinidad and Tobago","display_name":"Informing ICD-11 implementation: applying systems thinking to assess mortality information systems in Ecuador and Trinidad and Tobago","publication_year":2025,"publication_date":"2025-11-25","ids":{"openalex":"https://openalex.org/W4416631472","doi":"https://doi.org/10.26633/rpsp.2025.109"},"language":"en","primary_location":{"id":"doi:10.26633/rpsp.2025.109","doi":"https://doi.org/10.26633/rpsp.2025.109","is_oa":true,"landing_page_url":"https://doi.org/10.26633/rpsp.2025.109","pdf_url":"https://iris.paho.org/bitstream/10665.2/69303/1/v49e1092025.pdf","source":{"id":"https://openalex.org/S4210196923","display_name":"Revista Panamericana de Salud P\u00fablica","issn_l":"1020-4989","issn":["1020-4989","1680-5348"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","scielo"],"host_organization":"https://openalex.org/P4310316868","host_organization_name":"Pan American Health Organization","host_organization_lineage":["https://openalex.org/P4310316868","https://openalex.org/P4310319664"],"host_organization_lineage_names":["Pan American Health Organization","World Health Organization"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Revista Panamericana de Salud P\u00fablica","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://iris.paho.org/bitstream/10665.2/69303/1/v49e1092025.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5000814823","display_name":"Maryam Tavakkoli","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I158937107","display_name":"Swiss Tropical and Public Health Institute","ror":"https://ror.org/03adhka07","country_code":"CH","type":"facility","lineage":["https://openalex.org/I158937107"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Maryam Tavakkoli","raw_affiliation_strings":["Swiss Tropical and Public Health Institute, Allschwil, Switzerland","maryam.tavakkoli@swisstph.ch"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Tropical and Public Health Institute, Allschwil, Switzerland","institution_ids":["https://openalex.org/I158937107"]},{"raw_affiliation_string":"maryam.tavakkoli@swisstph.ch","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5119592830","display_name":"Carmen Libertad Ballester-Otero","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I158937107","display_name":"Swiss Tropical and Public Health Institute","ror":"https://ror.org/03adhka07","country_code":"CH","type":"facility","lineage":["https://openalex.org/I158937107"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Carmen Libertad Ballester-Otero","raw_affiliation_strings":["Swiss Tropical and Public Health Institute, Allschwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Tropical and Public Health Institute, Allschwil, Switzerland","institution_ids":["https://openalex.org/I158937107"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5026083003","display_name":"Janet Miki","orcid":"https://orcid.org/0000-0002-6894-8346","observed_orcids":["https://orcid.org/0000-0002-6894-8346"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Janet Miki","raw_affiliation_strings":["Cl\u00ednica Delgado Auna, Lima, Peru"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Cl\u00ednica Delgado Auna, Lima, Peru","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048656308","display_name":"Carmen Sant Fruchtman","orcid":"https://orcid.org/0000-0002-5276-3515","observed_orcids":["https://orcid.org/0000-0002-5276-3515"]},"institutions":[{"id":"https://openalex.org/I158937107","display_name":"Swiss Tropical and Public Health Institute","ror":"https://ror.org/03adhka07","country_code":"CH","type":"facility","lineage":["https://openalex.org/I158937107"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Carmen Sant Fruchtman","raw_affiliation_strings":["Swiss Tropical and Public Health Institute, Allschwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Tropical and Public Health Institute, Allschwil, Switzerland","institution_ids":["https://openalex.org/I158937107"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091816051","display_name":"Don de Savigny","orcid":"https://orcid.org/0000-0002-6903-4722","observed_orcids":["https://orcid.org/0000-0002-6903-4722"]},"institutions":[{"id":"https://openalex.org/I158937107","display_name":"Swiss Tropical and Public Health Institute","ror":"https://ror.org/03adhka07","country_code":"CH","type":"facility","lineage":["https://openalex.org/I158937107"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Don de Savigny","raw_affiliation_strings":["Swiss Tropical and Public Health Institute, Allschwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Tropical and Public Health Institute, Allschwil, Switzerland","institution_ids":["https://openalex.org/I158937107"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5012949428","display_name":"Andrea Gerger","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210089393","display_name":"World Health Organization Regional Office for the Americas","ror":"https://ror.org/008kev776","country_code":"US","type":"government","lineage":["https://openalex.org/I4210089393","https://openalex.org/I4210105654"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Andrea Gerger","raw_affiliation_strings":["Pan American Health Organization, Washington, DC, United States of America"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pan American Health Organization, Washington, DC, United States of America","institution_ids":["https://openalex.org/I4210089393"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5043925791","display_name":"Olga Joos","orcid":"https://orcid.org/0000-0003-0335-4982","observed_orcids":["https://orcid.org/0000-0003-0335-4982"]},"institutions":[{"id":"https://openalex.org/I4210089393","display_name":"World Health Organization Regional Office for the Americas","ror":"https://ror.org/008kev776","country_code":"US","type":"government","lineage":["https://openalex.org/I4210089393","https://openalex.org/I4210105654"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Olga Joos","raw_affiliation_strings":["Pan American Health Organization, Washington, DC, United States of America"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pan American Health Organization, Washington, DC, United States of America","institution_ids":["https://openalex.org/I4210089393"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5010629599","display_name":"Avery Q. J. Hinds","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210137390","display_name":"Ministry of Health","ror":"https://ror.org/043smtf02","country_code":"TT","type":"government","lineage":["https://openalex.org/I4210137390"]}],"countries":["TT"],"is_corresponding":false,"raw_author_name":"Avery Q. J. Hinds","raw_affiliation_strings":["Ministry of Health, Government of the Republic of Trinidad and Tobago, Port of Spain, Trinidad and Tobago"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ministry of Health, Government of the Republic of Trinidad and Tobago, Port of Spain, Trinidad and Tobago","institution_ids":["https://openalex.org/I4210137390"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037347790","display_name":"Rebeca Revenga Becedas","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I158937107","display_name":"Swiss Tropical and Public Health Institute","ror":"https://ror.org/03adhka07","country_code":"CH","type":"facility","lineage":["https://openalex.org/I158937107"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Rebeca Revenga Becedas","raw_affiliation_strings":["Swiss Tropical and Public Health Institute, Allschwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Tropical and Public Health Institute, Allschwil, Switzerland","institution_ids":["https://openalex.org/I158937107"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5119093549","display_name":"Katri Kontio","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210089393","display_name":"World Health Organization Regional Office for the Americas","ror":"https://ror.org/008kev776","country_code":"US","type":"government","lineage":["https://openalex.org/I4210089393","https://openalex.org/I4210105654"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Katri Kontio","raw_affiliation_strings":["Pan American Health Organization, Washington, DC, United States of America"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pan American Health Organization, Washington, DC, United States of America","institution_ids":["https://openalex.org/I4210089393"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5045684553","display_name":"Daniel Cobos Mu\u00f1oz","orcid":"https://orcid.org/0000-0002-5920-1304","observed_orcids":["https://orcid.org/0000-0002-5920-1304"]},"institutions":[{"id":"https://openalex.org/I158937107","display_name":"Swiss Tropical and Public Health Institute","ror":"https://ror.org/03adhka07","country_code":"CH","type":"facility","lineage":["https://openalex.org/I158937107"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Daniel Cobos Munoz","raw_affiliation_strings":["Swiss Tropical and Public Health Institute, Allschwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Tropical and Public Health Institute, Allschwil, Switzerland","institution_ids":["https://openalex.org/I158937107"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.36237565,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"49","issue":null,"first_page":"1","last_page":"1"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14093","display_name":"Global Health and Epidemiology","score":0.0008999999845400453,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/icd-11","display_name":"ICD-11","score":0.8889999985694885},{"id":"https://openalex.org/keywords/mortality-information-system","display_name":"mortality information system","score":0.9290000200271606},{"id":"https://openalex.org/keywords/mortality-coding","display_name":"mortality coding","score":0.5379999876022339},{"id":"https://openalex.org/keywords/icd-10","display_name":"ICD-10","score":0.75},{"id":"https://openalex.org/keywords/business-process-mapping","display_name":"business process mapping","score":0.9179999828338623},{"id":"https://openalex.org/keywords/systems-thinking","display_name":"systems thinking","score":0.9959999918937683},{"id":"https://openalex.org/keywords/mortality-surveillance","display_name":"mortality surveillance","score":0.8579999804496765},{"id":"https://openalex.org/keywords/data-standardization","display_name":"data standardization","score":0.640999972820282},{"id":"https://openalex.org/keywords/inter-agency-information-sharing","display_name":"inter-agency information sharing","score":0.875},{"id":"https://openalex.org/keywords/digital-health-infrastructure","display_name":"digital health infrastructure","score":0.6299999952316284},{"id":"https://openalex.org/keywords/ecuador","display_name":"Ecuador","score":0.5699999928474426},{"id":"https://openalex.org/keywords/trinidad-and-tobago","display_name":"Trinidad and Tobago","score":1.0}],"concepts":[{"id":"https://openalex.org/C201305675","wikidata":"https://www.wikidata.org/wiki/Q852998","display_name":"Stakeholder","level":2,"score":0.5824000239372253},{"id":"https://openalex.org/C180198813","wikidata":"https://www.wikidata.org/wiki/Q121182","display_name":"Information system","level":2,"score":0.5717999935150146},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.5181999802589417},{"id":"https://openalex.org/C27177047","wikidata":"https://www.wikidata.org/wiki/Q269699","display_name":"Systems thinking","level":2,"score":0.4875999987125397},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.46399998664855957},{"id":"https://openalex.org/C203663800","wikidata":"https://www.wikidata.org/wiki/Q848979","display_name":"Citizen journalism","level":2,"score":0.4505999982357025},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.4108000099658966},{"id":"https://openalex.org/C133462117","wikidata":"https://www.wikidata.org/wiki/Q4929239","display_name":"Data collection","level":2,"score":0.4101000130176544},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.4043000042438507},{"id":"https://openalex.org/C98045186","wikidata":"https://www.wikidata.org/wiki/Q205663","display_name":"Process (computing)","level":2,"score":0.3995000123977661},{"id":"https://openalex.org/C145642194","wikidata":"https://www.wikidata.org/wiki/Q870895","display_name":"Health informatics","level":3,"score":0.37689998745918274},{"id":"https://openalex.org/C39389867","wikidata":"https://www.wikidata.org/wiki/Q380767","display_name":"Corporate governance","level":2,"score":0.37599998712539673},{"id":"https://openalex.org/C107645774","wikidata":"https://www.wikidata.org/wiki/Q5467169","display_name":"Human resources","level":2,"score":0.35350000858306885},{"id":"https://openalex.org/C2780984029","wikidata":"https://www.wikidata.org/wiki/Q2930198","display_name":"Stakeholder engagement","level":2,"score":0.34700000286102295},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.31769999861717224},{"id":"https://openalex.org/C121017731","wikidata":"https://www.wikidata.org/wiki/Q11661","display_name":"Information technology","level":2,"score":0.31200000643730164},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.30160000920295715},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.2962000072002411},{"id":"https://openalex.org/C66204764","wikidata":"https://www.wikidata.org/wiki/Q219416","display_name":"Sustainability","level":2,"score":0.2962000072002411},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.2858000099658966},{"id":"https://openalex.org/C2779968149","wikidata":"https://www.wikidata.org/wiki/Q8034851","display_name":"Workforce development","level":3,"score":0.2786000072956085},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.2784000039100647},{"id":"https://openalex.org/C107826830","wikidata":"https://www.wikidata.org/wiki/Q929380","display_name":"Environmental resource management","level":1,"score":0.2784000039100647},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.27790001034736633},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.27619999647140503},{"id":"https://openalex.org/C140988679","wikidata":"https://www.wikidata.org/wiki/Q7140444","display_name":"Participatory action research","level":2,"score":0.27219998836517334},{"id":"https://openalex.org/C194051981","wikidata":"https://www.wikidata.org/wiki/Q1337691","display_name":"Economic shortage","level":3,"score":0.2718000113964081},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.26600000262260437},{"id":"https://openalex.org/C107327155","wikidata":"https://www.wikidata.org/wiki/Q330268","display_name":"Decision support system","level":2,"score":0.26489999890327454},{"id":"https://openalex.org/C29848774","wikidata":"https://www.wikidata.org/wiki/Q61905","display_name":"Management information systems","level":3,"score":0.2547999918460846},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.2547000050544739}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.26633/rpsp.2025.109","doi":"https://doi.org/10.26633/rpsp.2025.109","is_oa":true,"landing_page_url":"https://doi.org/10.26633/rpsp.2025.109","pdf_url":"https://iris.paho.org/bitstream/10665.2/69303/1/v49e1092025.pdf","source":{"id":"https://openalex.org/S4210196923","display_name":"Revista Panamericana de Salud P\u00fablica","issn_l":"1020-4989","issn":["1020-4989","1680-5348"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","scielo"],"host_organization":"https://openalex.org/P4310316868","host_organization_name":"Pan American Health Organization","host_organization_lineage":["https://openalex.org/P4310316868","https://openalex.org/P4310319664"],"host_organization_lineage_names":["Pan American Health Organization","World Health Organization"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Revista Panamericana de Salud P\u00fablica","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:d12ec977dcc04c9f93464c38fb8f5e8a","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/d12ec977dcc04c9f93464c38fb8f5e8a","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Revista Panamericana de Salud P\u00fablica, Vol 49, Iss 109, Pp 1-9 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.26633/rpsp.2025.109","doi":"https://doi.org/10.26633/rpsp.2025.109","is_oa":true,"landing_page_url":"https://doi.org/10.26633/rpsp.2025.109","pdf_url":"https://iris.paho.org/bitstream/10665.2/69303/1/v49e1092025.pdf","source":{"id":"https://openalex.org/S4210196923","display_name":"Revista Panamericana de Salud P\u00fablica","issn_l":"1020-4989","issn":["1020-4989","1680-5348"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","scielo"],"host_organization":"https://openalex.org/P4310316868","host_organization_name":"Pan American Health Organization","host_organization_lineage":["https://openalex.org/P4310316868","https://openalex.org/P4310319664"],"host_organization_lineage_names":["Pan American Health Organization","World Health Organization"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Revista Panamericana de Salud P\u00fablica","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9391000270843506}],"sustainable_development_goals_aurora":[],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320319758","display_name":"Vital Strategies","ror":"https://ror.org/05mdyn772"},{"id":"https://openalex.org/F4320333249","display_name":"Pan American Health Organization","ror":"https://ror.org/008kev776"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4416631472.pdf","grobid_xml":"https://content.openalex.org/works/W4416631472.grobid-xml"},"referenced_works_count":13,"referenced_works":["https://openalex.org/W2084896036","https://openalex.org/W2123737882","https://openalex.org/W2143926494","https://openalex.org/W2332766554","https://openalex.org/W2793945673","https://openalex.org/W3010766945","https://openalex.org/W3011588960","https://openalex.org/W3095404480","https://openalex.org/W3115280303","https://openalex.org/W3145864269","https://openalex.org/W4220676773","https://openalex.org/W4319991472","https://openalex.org/W4392388706"],"related_works":[],"abstract_inverted_index":{"ABSTRACT":[0],"Objectives.":[1],"To":[2],"assess":[3],"challenges":[4,195],"and":[5,14,16,52,69,76,83,101,109,113,117,120,122,124,143,159,168,178,180,206,212,225],"opportunities":[6,149],"within":[7],"the":[8,20,23,163],"mortality":[9,187,222],"information":[10,53],"systems":[11,44,189,210,224],"of":[12,22,26,65,96,131,136],"Ecuador":[13,177],"Trinidad":[15,179],"Tobago":[17,181],"to":[18,89,191],"support":[19,161],"implementation":[21,228],"International":[24],"Classification":[25],"Diseases,":[27],"11th":[28],"revision":[29],"(ICD-11)":[30],"coding":[31],"system.":[32],"Methods.":[33],"We":[34],"applied":[35],"a":[36,43,134],"qualitative":[37],"approach":[38],"using":[39],"business":[40,213],"process":[41,67,97,214],"mapping,":[42],"thinking":[45,211],"tool":[46],"that":[47],"visualizes":[48],"workflows,":[49],"stakeholder":[50,154],"roles,":[51],"flows.":[54],"The":[55,87,174],"study":[56],"had":[57],"four":[58],"phases:":[59],"document":[60],"review;":[61],"pre-workshop":[62],"consultations;":[63],"development":[64],"country-specific":[66],"maps;":[68],"participatory":[70],"workshops":[71],"with":[72],"stakeholders.":[73],"Data":[74],"collection":[75],"analysis":[77],"were":[78],"conducted":[79],"between":[80],"May":[81],"2022":[82],"July":[84],"2023.":[85],"Results.":[86],"transition":[88],"ICD-11":[90,227],"presents":[91],"complex,":[92],"system-wide":[93],"challenges.":[94],"Analysis":[95],"maps":[98],"revealed":[99],"inefficiencies":[100],"structural":[102],"gaps":[103],"across":[104],"five":[105],"key":[106],"areas:":[107],"governance":[108],"coordination;":[110],"data":[111,146,188],"capture":[112],"standardization;":[114],"human":[115],"resources":[116],"training;":[118],"technology":[119],"infrastructure;":[121],"reporting":[123],"dissemination.":[125],"Both":[126],"countries":[127,218],"face":[128],"inconsistent":[129],"use":[130],"ICD-10":[132],"versions,":[133],"shortage":[135],"trained":[137],"coders,":[138],"reliance":[139],"on":[140],"paper-based":[141],"processes,":[142],"limited":[144],"inter-agency":[145,204],"sharing.":[147],"However,":[148],"also":[150],"emerged,":[151],"including":[152],"strong":[153],"interest,":[155],"pilot":[156],"digital":[157,201],"initiatives,":[158],"regional":[160],"through":[162],"Pan":[164],"American":[165],"Health":[166,171],"Organization":[167],"Caribbean":[169],"Public":[170],"Agency.":[172],"Conclusions.":[173],"findings":[175],"from":[176],"illustrate":[182],"systemic":[183],"barriers":[184],"common":[185],"in":[186,200,219],"transitioning":[190],"ICD-11.":[192],"Overcoming":[193],"these":[194],"will":[196],"require":[197],"targeted":[198],"investments":[199],"infrastructure,":[202],"improved":[203],"coordination,":[205],"workforce":[207],"development.":[208],"Applying":[209],"mapping":[215],"can":[216],"guide":[217],"strengthening":[220],"their":[221],"surveillance":[223],"managing":[226],"effectively.":[229]},"counts_by_year":[],"updated_date":"2026-10-01T08:54:57.152042","created_date":"2025-11-25T00:00:00"}