scholarly journals Verbal autopsy in health policy and systems: a literature review

2018 ◽  
Vol 3 (2) ◽  
pp. e000639 ◽  
Author(s):  
Lisa-Marie Thomas ◽  
Lucia D’Ambruoso ◽  
Dina Balabanova
Keyword(s):  
Health Policy ◽  
Literature Review ◽  
Cause Of Death ◽  
Verbal Autopsy ◽  
Policy Development ◽  
Data Extraction ◽  
Evidence Base ◽  
Vital Statistics ◽  
Middle Income ◽  
Health Policy And Systems

IntroductionEstimates suggest that one in two deaths go unrecorded globally every year in terms of medical causes, with the majority occurring in low and middle-income countries (LMICs). This can be related to low investment in civil registration and vital statistics (CRVS) systems. Verbal autopsy (VA) is a method that enables identification of cause of death where no other routine systems are in place and where many people die at home. Considering the utility of VA as a pragmatic, interim solution to the lack of functional CRVS, this review aimed to examine the use of VA to inform health policy and systems improvements.MethodsA literature review was conducted including papers published between 2010 and 2017 according to a systematic search strategy. Inclusion of papers and data extraction were assessed by three reviewers. Thereafter, thematic analysis and narrative synthesis were conducted in which evidence was critically examined and key themes were identified.ResultsTwenty-six papers applying VA to inform health policy and systems developments were selected, including studies in 15 LMICs in Africa, Asia, the Middle East and South America. The majority of studies applied VA in surveillance sites or programmes actively engaging with decision makers and governments in different ways and to different degrees. In the papers reviewed, the value of continuous collection of cause of death data, supplemented by social and community-based investigations and underpinned by electronic data innovations, to establish a robust and reliable evidence base for health policies and programmes was clearly recognised.ConclusionVA has considerable potential to inform policy, planning and measurement of progress towards goals and targets. Working collaboratively at sub-national, national and international levels facilitates data collection, aggregation and dissemination linked to routine information systems. When used in partnerships between researchers and authorities, VA can help to close critical information gaps and guide policy development, implementation, evaluation and investment in health systems.

scholarly journals Monitoring progress with national and subnational health goals by integrating verbal autopsy and medically certified cause of death data

2021 ◽  
Vol 6 (5) ◽  
pp. e005387
Author(s):  
Tim Adair ◽  
Sonja Firth ◽  
Tint Pa Pa Phyo ◽  
Khin Sandar Bo ◽  
Alan D Lopez
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Integration Method ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Death Registration ◽  
Chronic Respiratory Diseases ◽  
Health Goals ◽  
Specific Mortality ◽  
Four Causes

IntroductionThe measurement of progress towards many Sustainable Development Goals (SDG) and other health goals requires accurate and timely all-cause and cause of death (COD) data. However, existing guidance to countries to calculate these indicators is inadequate for populations with incomplete death registration and poor-quality COD data. We introduce a replicable method to estimate national and subnational cause-specific mortality rates (and hence many such indicators) where death registration is incomplete by integrating data from Medical Certificates of Cause of Death (MCCOD) for hospital deaths with routine verbal autopsy (VA) for community deaths.MethodsThe integration method calculates population-level cause-specific mortality fractions (CSMFs) from the CSMFs of MCCODs and VAs weighted by estimated deaths in hospitals and the community. Estimated deaths are calculated by applying the empirical completeness method to incomplete death registration/reporting. The resultant cause-specific mortality rates are used to estimate SDG Indicator 23: mortality between ages 30 and 70 years from cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. We demonstrate the method using nationally representative data in Myanmar, comprising over 42 000 VAs and 7600 MCCODs.ResultsIn Myanmar in 2019, 89% of deaths were estimated to occur in the community. VAs comprised an estimated 70% of community deaths. Both the proportion of deaths in the community and CSMFs for the four causes increased with older age. We estimated that the probability of dying from any of the four causes between 30 and 70 years was 0.265 for men and 0.216 for women. This indicator is 50% higher if based on CSMFs from the integration of data sources than on MCCOD data from hospitals.ConclusionThis integration method facilitates country authorities to use their data to monitor progress with national and subnational health goals, rather than rely on estimates made by external organisations. The method is particularly relevant given the increasing application of routine VA in country Civil Registration and Vital Statistics systems.

scholarly journals A Systematic Literature Review on Water Insecurity from an Oregon Public Health Perspective

2020 ◽  
Vol 17 (3) ◽  
pp. 1122
Author(s):  
Cordelia Schimpf ◽  
Curtis Cude
Keyword(s):  
Public Health ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Policy Development ◽  
Community Education ◽  
Evidence Base ◽  
Drought Risk ◽  
Human Right ◽  
Water Insecurity ◽  
Public Health Perspective

This paper systematically reviews existing United States-based water insecurity literature with the goal of understanding the evidence base for developing public health water insecurity intervention strategies in Oregon. The authors conducted the systematic literature review using an adjusted PRISMA reporting checklist to document the review process. Results find 11 public health-related water insecurity interventions including surveillance practices and indicator and policy development. Research on water insecurity health impacts and solutions is still an emerging field. Nevertheless, state agencies perceive a risk to communities from inadequate safe water and are taking steps to assess and reduce these risks. From the review, strategies include improving water affordability, carrying out community education events, documenting drought risk and water loss, and tracking improvements in safe drinking water compliance. The review finds opportunities to take varied approaches that are community-specific, partnership-based and culturally relevant. Recommendations for Oregon include characterizing communities experiencing water insecurity, assessing community needs, tracking regional water scarcity and recognizing the human right to water in Oregon.

Research Supporting Health Policy Development: Contextualizing Evidence for People-Centred Care in Low and Middle Income Countries

2014 ◽  
Vol 3 (4) ◽  
pp. 277-279
Author(s):  
Dheepa Rajan
Keyword(s):  
Health Policy ◽  
Policy Development ◽  
Research Policy ◽  
Ground Level ◽  
Health Policies ◽  
Policy And Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level

The three areas of research, policy, and practice seem to work and interact within silos, or independent niches.  Especially for the complex task of reorienting health care and indeed, a health system, towards people-centredness, these niches at both global and country level must be broken down.  Since health policy-making is complex and non-linear, context is crucial for making research for health policies and implementation of health policies (practice) relevant.  The real measure of success is whether the evidence-informed policy has worked and produced results at ground level.  When context is so important, however, evidence (research) is only one piece of the puzzle.  Stakeholder’s views, or simply put, their opinion, is just as decisive.  This paper documents some promising examples in research and practice of bringing together evidence and stakeholder opinion, particularly highlighting a case study on Brazil as well as WHO tools for communities of practice.

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