Sint Maarten Strengthens Systems for Accurate Death Certification and Mortality Reporting with support from PAHO and RIVM, Netherlands

Philipsburg, 27 January 2026 (PAHO) - A multi-disciplinary team from the Pan American Health Organization/World Health Organization (PAHO/WHO) and the National Institute for Public Health and the Environment (RIVM), Netherlands, completed a collaborative mission to Sint Maarten from 19 to 24 January 2026. The week-long engagement focused on strengthening the island's systems for death certification and cause-of-death registration, key components of a well-functioning public health and civil registration framework.

The mission began with three days of site visits that brought the team into direct contact with the institutions and professionals involved at various stages of the mortality reporting process. Visits to the St. Maarten Medical Center (SMMC) offered an opportunity to observe clinical practices and speak with specialists across departments, including internal medicine, gynecology and obstetrics, emergency care, pediatrics, maternity services, and the health information management teams.

Throughout the mission, the team also engaged with leadership and technical experts from the Department of Public Health, the Collective Prevention Services (CPS), private mortuary, and other key agencies, including the Forensic Department, St. Maarten Police Services. These discussions provided the requisite information required for the mapping the entire cycle of death reporting, from certification to registration, coding, and eventual use in public health surveillance.

Additionally, a dedicated workshop brought the Island's General Practitioners and other stakeholders together to refine and validate the country's process map, ensuring that the roles, timelines, and data flows were clearly defined and aligned across institutions.

A two-day session was also held, which focused on building technical capacity among health professionals and government staff. Physicians and medical examiners participated in an intensive training on death certification and cause-of-death registration, grounded in WHO standards and practical case-based exercises.

Parallel sessions were delivered to policy and administrative personnel, with a focus on tools that support automated coding and mortality data analysis, as well as business process mapping to improve workflow efficiency and alignment.

The mission drew on a strong partnership between PAHO's Trinidad and Tobago Country Office, PAHO Headquarters, the National Institute of Public Health and Environment Netherlands (RIVM) and Statistics Netherlands. Together, they supported Sint Maarten's continuing efforts to enhance the quality and reliability of its mortality data which supports public health planning, policy-making, and monitoring health trends that affect the population.

By the end of the mission, participating institutions had not only improved their technical capacity but had also strengthened cross-sector collaboration, ensuring that the systems surrounding death certification operate with greater clarity, consistency, and accuracy. PAHO/WHO reaffirmed its commitment to working alongside Sint Maarten and its partners to continue improving the systems that protect the health and well-being of its people.

Further, during the week of 25 January, the RIVM and Statistics Netherlands Team conducted the similar exercise of Death Certification and Cause of Death Registration Training in Saba and St. Eustatius.

It is anticipated that through the collaboration established, the mission will be replicated in Aruba, Curaçao and Bonnaire during 2026.

Additionally, the Dutch Caribbean Public Health Expertise Network (DUCaPHEN) forum will provide opportunities for strategic planning, coordination, and the alignment of core objectives. functions and continued support. This forum is proposed to be held in June 2026 in Aruba.