A multidisciplinary team from the Pan American Health Organization/World Health Organization and the National Institute for Public Health and the Environment of the Netherlands carried out a collaborative mission to Sint Maarten from 19 to 24 January 2026, focusing on strengthening systems for death certification and cause-of-death registration. The initiative aimed to reinforce key elements of the island’s public health and civil registration framework, supporting more accurate and reliable mortality reporting for evidence-based decision-making.
The mission included extensive site visits that allowed the team to engage directly with institutions and professionals involved in the mortality reporting process. At the St. Maarten Medical Center, discussions with clinical specialists and health information teams provided valuable insights into current medical and documentation practices across multiple departments involved in patient care and death certification.
Engagements were also held with leadership and technical experts from the Department of Public Health, Collective Prevention Services, private mortuary services, the Forensic Department, and the St. Maarten Police Services. These exchanges supported a comprehensive mapping of the full death reporting cycle, from certification and registration to coding and the use of data for public health surveillance and planning.
A dedicated workshop brought together general practitioners and key stakeholders to refine and validate the national process map, ensuring clarity around roles, timelines, and data flows across institutions. This was complemented by targeted capacity-building sessions, where physicians and medical examiners received intensive training on death certification and cause-of-death registration in line with WHO standards, using practical, case-based approaches.
Additional sessions focused on strengthening the skills of policy and administrative personnel, with emphasis on automated coding tools, mortality data analysis, and business process mapping to improve efficiency and institutional alignment. These efforts were designed to enhance both the technical and operational aspects of mortality data management.
The mission was supported through close collaboration between PAHO’s country and headquarters offices, RIVM, and Statistics Netherlands, reinforcing Sint Maarten’s efforts to improve the quality and reliability of mortality data for public health planning, policy development, and monitoring population health trends. By the conclusion of the mission, participating institutions had strengthened technical capacity and cross-sector collaboration, enabling death certification systems to function with greater consistency and accuracy.
Related training activities were also conducted in Saba and St. Eustatius during the following week, with plans to replicate similar missions in Aruba, Curaçao, and Bonaire in 2026. Continued regional collaboration is expected through the Dutch Caribbean Public Health Expertise Network forum, which will support strategic planning, coordination, and sustained technical cooperation, with a proposed meeting scheduled for June 2026 in Aruba.
