Such financial incentives, however, are not sustainable. The ward clerk, who was responsible for recording the discharge diagnoses, seemed the best person to train to enter the medical audit data. To be sustainable, this task would need to be part of the ward clerk's job description and the audit system part of the national health statistics policy. Availability and maintenance of computers is another issue that could limit the sustainability of the system in developing countries. 3 Other issues highlighted during the study were those of coding hierarchy and diagnostic certainty.
Most anaemia is due to malaria.
Even in sophisticated centres of excellence, the final diagnosis is not always certain, and the ordering of diagnoses is debated. In developed countries, debates on bronchiolitis, wheezy bronchitis, asthma, and URTI present similar debates and overlaps. Problems with coding hierarchy cause certain diseases to appear more prevalent than they really are and for other diseases to be underestimated. It is designed to be computerised and hierarchical and is cross-referenced to all widely used coding systems. It is the most comprehensive system yet and codes diseases, symptoms, signs, procedures, treatments, and social information.