Background: although Ethiopia has established civil registration and vital events agency for enforcing vital event registration law, majority of the deaths have not been reported and registered. Moreover, evidences on capturing the causes of death data and the actual practice in the community are not well- understood. Therefore, the present study aimed at exploring opportunities and challenges on capturing causes of death data in Ethiopia.

Methods: a qualitative study was conducted on purposefully selected 24 key informants. The key informants were individuals working in the Federal Ministry of Health (FMOH), Vital Event Registration Agency (VERA) and Central Statistics Agency (CSA), St. Paul Millennium Medical College, Zewditu and Ghandi Memorial hospitals. In addition, some of the key informants were selected from the Addis Ababa City Administration Health Bureau, Lideta Sub-City and Woreda Four health offices, as well as from Arada and Kerra Woreda Vital Events Registration offices and the community.

Semi-structured interview guide was used to collect data from August 6 to 4^th September 2018.Verbatim transcribed data were coded and analyzed using ATLAS qualitative data analysis software and the findings of the study were presented thematically. Direct quotes were used in order to represent the participants’ voice.

Results: Capturing cause of death data in Ethiopia has different challenges and opportunities. The main challenges were grouped under: system related challenges- in health and vital event registration system (leadership and management, lack of integration, problems related to coverage and access, lack of electronic recording system and resources, lack of attention and feedback, and lack of awareness). But the system has opportunities like availability of legal mandate, being part of the system’s priority agenda, and the presence of well-established administrative structure to the lower level. There were challenges related to service provision, such as value and perception related to vital event registration, lack of awareness, workload, and lack of skilled human resources and data quality. Further education, concern for data quality and motivation to support were mentioned as opportunities related to death registration service provision. In the community- deceased persons’ care taker related challenges were lack of awareness, cultural norm, and service inaccessibility and long waiting time, absence of enforcing mechanisms/ no linkage of death registration with social services. But the availability of social institutions in the community was mentioned as opportunities to strengthen the death registration system.

Conclusion: cause of death registration and notification is a complex procedure which involves multilevel and multisector performers. Challenges and opportunities related to the system, service provision and community are extremely interconnected. Therefore, working on the challenges and using the existing opportunities along with persistent awareness creation and linking death registration with other social services need to be considered as a way forward.