scholarly journals Use of verbal autopsy and social autopsy in humanitarian crises

2018 ◽  
Vol 3 (3) ◽  
pp. e000640 ◽  
Author(s):  
Lisa-Marie Thomas ◽  
Lucia D’Ambruoso ◽  
Dina Balabanova

IntroductionTwo billion people live in countries affected by conflict, violence and fragility. These are exceptional situations in which mortality shifts dramatically and in which civil registration and vital statistics systems are often weakened or cease to function. Verbal autopsy and social autopsy (VA and SA) are methods used to assign causes of death and understand the contexts in which these occur, in settings where information is otherwise unavailable. This review sought to explore the use of VA and SA in humanitarian crises, with a focus on how these approaches are used to inform policy and programme responses.MethodsA rapid scoping review was conducted on the use of VA and SA in humanitarian crises in low and middle-income countries since 1991. Drawing on a maximum variation approach, two settings of application (‘application contexts’) were selected and investigated via nine semi-structured expert interviews.ResultsVA can determine causes of death in crisis-affected populations where no other registration system is in place. Combined with SA and active community involvement, these methods can deliver a holistic view of obstacles to seeking and receiving essential healthcare, yielding context-specific information to inform appropriate responses. The contexts in which VA and SA are used require adaptations to standard tools, and new mobile developments in VA raise specific ethical considerations. Furthermore, collecting and sythesising data in a timely, continuous manner, and ensuring coordination and communication between agencies, is important to realise the potential of these approaches.ConclusionVA and SA are valuable research methods to foster evidence-informed responses for populations affected by humanitarian crises. When coordinated and communicated effectively, data generated through these methods can help to identify levels, causes and circumstances of deaths among vulnerable groups, and can enable planning and allocating resources effectively, potentially improving health system resilience to future crises.

2019 ◽  
Author(s):  
Yuta Yokobori ◽  
Jun Matsuura ◽  
Yasuo Sugiura ◽  
Charles Mutemba ◽  
Martin Nyahoda ◽  
...  

Abstract Background Over one third of deaths in Zambian health facilities involve someone who has already died before arrival (i.e., brought in dead [BiD]), and in most BiD cases, the causes of death (CoD) have not been fully analyzed. Therefore, this study aimed to analyze the CoD of BiD cases using the Tariff Method 2.0 for automated verbal autopsy (VA), which is called SmartVA.Methods The target site was one third-level hospital in the Republic of Zambia’s capital city. All BiD cases aged 13 years and older at this facility from January to August 2017 were included. The deceased’s closest relatives were interviewed using a structured VA questionnaire (Population Health Metrics Research Consortium Shortened Questionnaire) and the data were analyzed using the SmartVA to determine the CoD at the individual and population level. The CoDs were compared with description on the death notification forms by using t-test and Cohen’s kappa coefficient.Results Approximately 1500 cases were included (average age = 47.2 years, 61.8% males). The top CoD were infectious diseases, including acquired immunodeficiency syndrome, tuberculosis, and malaria, followed by non-communicable diseases, such as stroke, cardiovascular diseases, and diabetes mellitus (DM). The comparison with the CoD distribution among hospital deaths showed that the trends were similar except for DM, which was greater among hospital deaths, and malaria and accident, which were less frequent in the main CoD. The proportion of cases with a determined CoD was significantly higher when using the SmartVA (75%) than the death notification form (61%). A proportion (42.7%) of the CoD-determined cases matched in both sources, with a low concordance rate (kappa coefficient = 0.1385).Conclusions The CoD of the BiD cases were successfully analyzed using the SmartVA for the first time in Zambia. While there many erroneous descriptions on the death notification form, the SmartVA could determine the CoD among more BiD cases. Since the information on the death notification form is reflected in the national vital statistics, more accurate and complete CoD data are required. In order to strengthen the death registration system with accurate CoD, it will be useful to embed the SmartVA in Zambia’s health information system.


2019 ◽  
Author(s):  
Yuta Yokobori ◽  
Jun Matsuura ◽  
Yasuo Sugiura ◽  
Charles Mutemba ◽  
Martin Nyahoda ◽  
...  

Abstract Background Over one third of deaths in Zambian health facilities involve someone who has already died before arrival (i.e., brought in dead [BiD]), and in most BiD cases, the causes of death (CoD) have not been fully analyzed. Therefore, this study aimed to analyze the CoD of BiD cases using the Tariff Method 2.0 for automated verbal autopsy (VA), which is called SmartVA.Methods The target site was one third-level hospital in the Republic of Zambia’s capital city. All BiD cases aged 13 years and older at this facility from January to August 2017 were included. The deceased’s closest relatives were interviewed using a structured VA questionnaire (Population Health Metrics Research Consortium Shortened Questionnaire) and the data were analyzed using the SmartVA to determine the CoD at the individual and population level. The CoDs were compared with description on the death notification forms by using t-test and Cohen’s kappa coefficient.Results Approximately 1500 cases were included (average age = 47.2 years, 61.8% males). The top CoD were infectious diseases, including acquired immunodeficiency syndrome, tuberculosis, and malaria, followed by non-communicable diseases, such as stroke, cardiovascular diseases, and diabetes mellitus (DM). The comparison with the CoD distribution among hospital deaths showed that the trends were similar except for DM, which was greater among hospital deaths, and malaria and accident, which were less frequent in the main CoD. The proportion of cases with a determined CoD was significantly higher when using the SmartVA (75%) than the death notification form (61%). A proportion (42.7%) of the CoD-determined cases matched in both sources, with a low concordance rate (kappa coefficient = 0.1385).Conclusions The CoD of the BiD cases were successfully analyzed using the SmartVA for the first time in Zambia. While there many erroneous descriptions on the death notification form, the SmartVA could determine the CoD among more BiD cases. Since the information on the death notification form is reflected in the national vital statistics, more accurate and complete CoD data are required. In order to strengthen the death registration system with accurate CoD, it will be useful to embed the SmartVA in Zambia’s health information system.


2021 ◽  
Author(s):  
Tshifhiwa Nkwenika ◽  
Samuel Manda

Abstract BackgroundDeaths certification remains a challenge mostly in the low-resources countries which results in poor availability and incompleteness of vital statistics. In such sceneries, public health and developmental policies concerning the burden of diseases are limited in their derivation and application. The study aimed at developing and evaluating appropriate cause-specific mortality risk scores using Verbal Autopsy (VA) data. MethodsA logistic regression model was used to identify independent predictors of NCDs, AIDS/TB, and CDs specific causes of death. Risk scores were derived using a point scoring system. Receiver operating characteristic (ROC) curves were used to validate the models by matching the number of reported deaths to the number of deaths predicted by the models. ResultsThe models provided accurate prediction results with sensitivities of 86%, 46%, and 40% and false-positive error rates of 44%, 11%, and 12% for NCDs, AIDS/TB, and CDs respectively. ConclusionThis study has shown that, in low- and medium-income countries, simple risk scores using information collected using verbal autopsy questionnaire could be adequately used to assign causes of death for Non-Communicable Diseases and AIDS/TB


2019 ◽  
Vol 29 (1) ◽  
pp. 1-12
Author(s):  
Eva Sulistiowati ◽  
Kartika Handayani

Abstract The registration system of death and cause of death as part of a good Civil Registration and Vital Statistics System (CRVS) form the basis for planning, monitoring and evaluating development programs. Ambon City as one of the development areas for recording death and causes of death since 2010 shows results that are still under-estimated (below 7 permill). Evaluation of the implementation process is needed to find out the obstacles. The qualitative methods include in-depth interviews, Focus Group Discussion (FGD) and collecting secondary data as supporting data. The analysis is part of the Comprehensive Evaluation Study on the Development of the Death Registration System and the Causes of Death in 14 districts/cities in Indonesia in 2014, carried out by triangulation and thematically compiled. The results obtained that the system of birth and death registration in the city of Ambon is already well-organized: there are regional regulations regarding the administration of population administration even though they have not included information on causes of death; the difference in vital registration data from various agencies; limited human resources, funds, facilities and infrastructure; and public awareness to report births/deaths still low. To increase the coverage of death registration and causes of death, it is necessary: local government regulations that include the cause of death; formation of joint committees and “one data” vital statistics; Autopsy Verbal (AV) workshop/training; utilization of funds from the Regional Revenue and Expenditure Budget and Health Operational Costs optimally; cooperation with community leaders (Muhabet) and socialization to the community. Abstrak Sistem registrasi kematian dan penyebab kematian sebagai bagian dari Sistem Registrasi Sipil dan Statistik Vital (Civil Registrations and Vital Statistics/CRVS) yang baik menjadi dasar untuk perencanaan, monitoring, dan evaluasi program pembangunan. Kota Ambon sebagai salah satu daerah pengembangan kegiatan pencatatan kematian dan penyebab kematian sejak tahun 2010, menunjukkan hasil yang masih under estimate (dibawah 7 permil). Evaluasi proses pelaksanaan diperlukan untuk mengetahui kendala yang dihadapi. Metode yang digunakan kualitatif meliputi wawancara mendalam, Focus Group Discussion (FGD) dan mengumpulkan data sekunder sebagai data pendukung. Analisis merupakan bagian dari Studi Evaluasi Menyeluruh Pengembangan Sistem Registrasi Kematian dan Penyebab Kematian di 14 kabupaten/kota di Indonesia Tahun 2014, dilakukan dengan triangulasi dan disusun secara tematik. Hasil yang diperoleh bahwa sistem pencatatan kelahiran dan kematian di Kota Ambon sudah tersistem dan tertata cukup baik, ada peraturan daerah tentang penyelenggaraan administrasi kependudukan walaupun belum mencakup keterangan penyebab kematian; adanya perbedaan data registrasi vital dari berbagai instansi; keterbatasan sumber daya manusia, dana, sarana prasarana; serta kesadaran masyarakat untuk melaporkan kejadian kelahiran/kematian yang masih rendah. Untuk meningkatkan cakupan registrasi kematian dan penyebab kematian, diperlukan: regulasi pemerintah daerah yang menyertakan penyebab kematian; pembentukan komite bersama dan “one data” statistik vital; workshop/pelatihan Autopsy Verbal (AV); pemanfaatan dana Anggaran Pendapatan dan Belanja Daerah (APBD) dan Biaya Operasional Kesehatan (BOK) secara optimal; kerjasama dengan tokoh masyarakat (Muhabet), dan sosialisasi kepada masyarakat.


2011 ◽  
Vol 66 (4) ◽  
pp. 471-481 ◽  
Author(s):  
Ram B. Singh ◽  
Jan Fedacko ◽  
Viola Vargova ◽  
Adarsh Kumar ◽  
Varun Mohan ◽  
...  

2020 ◽  
Vol 10 (4) ◽  
pp. 30049.1-30049.9
Author(s):  
Flora Farivarnia ◽  
◽  
Rasool Entezarmahdi ◽  
Mohammad Delirrad ◽  
◽  
...  

Background: This article presents the most recent mortality data in West Azerbaijan Province (WAP) of Iran in 2016 based on selected characteristics, including age, sex, state of residence, and cause of death. Methods: After the local Ethics Committee approval, we obtained the data for this systematic database study from the local health registration office. The causes of death are processed following the International Classification of Diseases, tenth revision (ICD-10). The vital statistics were refined from the yearbooks of the National Organization for Civil Registration. Results: In 2016, a total of 14688 deaths were registered in the Health Death Registration System (HDRS) and 14622 in the Civil Death Registration System (CDRS) of WAP (~4% of Iran’s mortality). The Crude Mortality Rate (CMR) was 4.30 per 1000, showing an increase of 7.5% from the 2011 rate. Of the deceased, 56.9% were males, and 60% were attributed to urban areas. On average, men died 4 years earlier than women (61.2 vs 65.3 years, respectively). The major causes of death in 2016 remained the same as in 2011. Conclusion: The pattern of human mortality in WAP is comparatively consistent with the other regions of Iran except for the higher rate of neoplasms (19.6% compared to 10.7% of the country average) and the lower ratio of certain infectious and parasitic diseases (1% compared to 3.8% of the national average). There was a significant difference in registering the state of residence between HDRS and CDRS, which is highly recommended for further investigation in future studies.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. Chabila Mapoma ◽  
Brian Munkombwe ◽  
Chomba Mwango ◽  
Bupe Bwalya Bwalya ◽  
Audrey Kalindi ◽  
...  

Abstract Background Ascertaining the causes for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are not well developed or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution to determine the cause of death. We conducted a demonstration project in Lusaka District of Zambia where verbal autopsy (VA) method was implemented in routine civil registration system. Methods About 3400 VA interviews were conducted for bodies “brought-in-dead” at Lusaka’s two major teaching hospital mortuaries using a SmartVA questionnaire between October 2017 and September 2018. Probable underlying causes of deaths using VA and cause-specific mortality fractions were determined.. Demographic characteristics were analyzed for each VA-ascertained cause of death. Results Opportunistic infections (OIs) associated with HIV/AIDS such as pneumonia and tuberculosis, and malaria were among leading causes of deaths among bodies “brought-in-dead”. Over 21.6 and 26.9% of deaths were attributable to external causes and non-communicable diseases (NCDs), respectively. The VA-ascertained causes of death varied by age-group and sex. External causes were more prevalent among males in middle ages (put an age range like 30–54 years old) and NCDs highly prevalent among those aged 55 years and older. Conclusions VA application in civil registration system can provide the much-needed cause of death information for non-facility deaths in countries with under-developed or non-functional civil registration systems.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anne Abio ◽  
Pascal Bovet ◽  
Joachim Didon ◽  
Till Bärnighausen ◽  
Masood Ali Shaikh ◽  
...  

AbstractData on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Md. Toufiq Hassan Shawon ◽  
Shah Ali Akbar Ashrafi ◽  
Abul Kalam Azad ◽  
Sonja M. Firth ◽  
Hafizur Chowdhury ◽  
...  

Abstract Background In Bangladesh, a poorly functioning national system of registering deaths and determining their causes leaves the country without important information on which to inform health programming, particularly for the 85% of deaths that occur in the community. In 2017, an improved death registration system and automated verbal autopsy (VA) were introduced to 13 upazilas to assess the utility of VA as a routine source of policy-relevant information and to identify leading causes of deaths (COD) in rural Bangladesh. Methods Data from 22,535 VAs, collected in 12 upazilas between October 2017 and August 2019, were assigned a COD using the SmartVA Analyze 2.0 computer algorithm. The plausibility of the VA results was assessed using a series of demographic and epidemiological checks in the Verbal Autopsy Interpretation, Performance and Evaluation Resource (VIPER) software tool. Results Completeness of community death reporting was 65%. The vast majority (85%) of adult deaths were due to non-communicable diseases, with ischemic heart disease, stroke and chronic respiratory disease comprising about 60% alone. Leading COD were broadly consistent with Global Burden of Disease study estimates. Conclusions Routine VA collection using automated methods is feasible, can produce plausible results and provides critical information on community COD in Bangladesh. Routine VA and VIPER have potential application to countries with weak death registration systems.


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