scholarly journals Integrating community-based verbal autopsy into civil registration and vital statistics: lessons learnt from five countries

2021 ◽  
Vol 6 (11) ◽  
pp. e006760
Author(s):  
Sonja Margot Firth ◽  
John D Hart ◽  
Matthew Reeve ◽  
Hang Li ◽  
Lene Mikkelsen ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Verbal Autopsy ◽  
Information Technologies ◽  
Solomon Islands ◽  
Health Planning ◽  
Scale Up ◽  
Governance Structure ◽  
Vital Statistics ◽  
Political Support ◽  
Funding Agency

This paper describes the lessons from scaling up a verbal autopsy (VA) intervention to improve data about causes of death according to a nine-domain framework: governance, design, operations, human resources, financing, infrastructure, logistics, information technologies and data quality assurance. We use experiences from China, Myanmar, Papua New Guinea, Philippines and Solomon Islands to explore how VA has been successfully implemented in different contexts, to guide other countries in their VA implementation. The governance structure for VA implementation comprised a multidisciplinary team of technical experts, implementers and staff at different levels within ministries. A staged approach to VA implementation involved scoping and mapping of death registration processes, followed by pretest and pilot phases which allowed for redesign before a phased scale-up. Existing health workforce in countries were trained to conduct the VA interviews as part of their routine role. Costs included training and compensation for the VA interviewers, information technology (IT) infrastructure costs, advocacy and dissemination, which were borne by the funding agency in early stages of implementation. The complexity of the necessary infrastructure, logistics and IT support required for VA increased with scale-up. Quality assurance was built into the different phases of the implementation. VA as a source of cause of death data for community deaths will be needed for some time. With the right technical and political support, countries can scale up this intervention to ensure ongoing collection of quality and timely information on community deaths for use in health planning and better monitoring of national and global health goals.

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

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 Contemporary Case Study Illustrating the Integration of Health Information Technologies into the Organisation and Clinical Practice of Radiation Oncology

2005 ◽  
Vol 34 (4) ◽  
pp. 136-145 ◽  
Author(s):  
Andrew A Miller ◽  
Aaron K Phillips
Keyword(s):  
Information System ◽  
Quality Assurance ◽  
Radiation Oncology ◽  
Information Technologies ◽  
Data Use ◽  
Design Management ◽  
Implementation Cost ◽  
Health Information Technologies ◽  
Local Solutions

The development of software in radiation oncology departments has seen the increase in capability from the Record and Verify software focused on patient safety to a fully-fledged Oncology Information System (OIS). This paper reports on the medical aspects of the implementation of a modern Oncology Information System (IMPAC MultiAccess®, also known as the Siemens LANTIS®) in a New Zealand hospital oncology department. The department was successful in translating paper procedures into electronic procedures, and the report focuses on the changes in approach to organisation and data use that occurred. The difficulties that were faced, which included procedural re-design, management of change, removal of paper, implementation cost, integration with the HIS, quality assurance and datasets, are highlighted along with the local solutions developed to overcome these problems.

scholarly journals Integrating community-based verbal autopsy into civil registration and vital statistics (CRVS): system-level considerations

2017 ◽  
Vol 10 (1) ◽  
pp. 1272882 ◽  
Author(s):  
Don de Savigny ◽  
Ian Riley ◽  
Daniel Chandramohan ◽  
Frank Odhiambo ◽  
Erin Nichols ◽  
...  
Keyword(s):  
Verbal Autopsy ◽  
Vital Statistics ◽  
System Level ◽  
Community Based ◽  
Civil Registration

Derivation and Validation of Risk Scores for Cause-Specific Mortality using Verbal Autopsy Data

2021 ◽  
Author(s):  
Tshifhiwa Nkwenika ◽  
Samuel Manda
Keyword(s):  
Verbal Autopsy ◽  
Causes Of Death ◽  
Roc Curves ◽  
Vital Statistics ◽  
Error Rates ◽  
Risk Scores ◽  
False Positive Error ◽  
Specific Mortality ◽  
Developmental Policies ◽  
Burden Of Diseases

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

Image Processing for Solar Cell Analysis, Diagnostics and Quality Assurance Inspection

2013 ◽  
pp. 338-375
Author(s):  
Michael G. Mauk
Keyword(s):  
Image Processing ◽  
Image Analysis ◽  
Quality Assurance ◽  
Solar Cell ◽  
Process Development ◽  
Low Cost ◽  
Scale Up ◽  
Image Capturing ◽  
Infrared Cameras ◽  
Primary Focus

Image capturing, processing, and analysis have numerous uses in solar cell research, device and process development and characterization, process control, and quality assurance and inspection. Solar cell image processing is expanding due to the increasing performance (resolution, sensitivity, spectral range) and low-cost of commercial CCD and infrared cameras. Methods and applications are discussed, with primary focus on monocrystalline and polycrystalline silicon solar cells using visible and infrared (thermography) wavelengths. The most prominent applications relate to mapping of minority carrier lifetime, shunts, and defects in solar cell wafers, in various stages of the manufacturing process. Other applications include measurements of surface texture and reflectivity, surface cleanliness, integrity of metallization lines, uniformity of coatings, and crystallographic texture and grain size. Image processing offers the capability to assess large-areas (> 100 cm2) with a non-contact, fast (~ 1 second), and modest cost. The challenge is to quantify and interpret the image data in order to better inform device design, process engineering, and quality control. Many promising solar cell technologies fail in the transition from laboratory to factory due to issues related to scale-up in area and manufacturing throughput. Image analysis provides an effective method to assess areal uniformity, device-to-device reproducibility, and defect densities. More integration of image analysis from research devices to field testing of modules will continue as the photovoltaics industry matures.

scholarly journals Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa

2018 ◽  
Vol 3 (4) ◽  
pp. e000833 ◽  
Author(s):  
Aaron S Karat ◽  
Noriah Maraba ◽  
Mpho Tlali ◽  
Salome Charalambous ◽  
Violet N Chihota ◽  
...  
Keyword(s):  
South Africa ◽  
Verbal Autopsy ◽  
Vital Statistics ◽  
Classification Systems ◽  
Hiv Positive ◽  
Hiv Status ◽  
Civil Registration ◽  
Art Initiation ◽  
Better Than ◽  
Hiv Negative

IntroductionVerbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods.MethodsUsing the WHO 2012 instrument with added ART questions, VA was conducted for deaths among adults with known HIV status (356 HIV positive and 103 HIV negative) in South Africa. CoD were assigned using physician-certified VA (PCVA) and computer-coded VA (CCVA) methods and compared with documented HIV status.ResultsThe sensitivity of VA questions in detecting HIV status and ART initiation was 84.3% (95% CI 80 to 88) and 91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive individuals were assigned HIV-associated CoD by PCVA, 166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5, and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze V.1.1.1 and V.1.2.1. Agreement between PCVA and older CCVA methods was poor (chance-corrected concordance [CCC] <0; cause-specific mortality fraction [CSMF] accuracy ≤56%) but better between PCVA and updated methods (CCC 0.21–0.75; CSMF accuracy 65%–98%). All methods were specific (specificity 87% to 96%) in assigning HIV-associated CoD.ConclusionAll CCVA interpretation methods underestimated the HIV-associated mortality fraction compared with PCVA; InterVA-5 and SmartVA-Analyze V.1.2.1 performed better than earlier versions. Changes to VA methods and classification systems are needed to track progress towards targets for reducing HIV-associated mortality,

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
Keyword(s):  
Community Involvement ◽  
Verbal Autopsy ◽  
Causes Of Death ◽  
Vital Statistics ◽  
Vulnerable Groups ◽  
Specific Information ◽  
Holistic View ◽  
Registration System ◽  
Social Autopsy ◽  
Humanitarian Crises

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.

scholarly journals Applications of the epidemiological modelling outputs for targeted mental health planning in conflict-affected populations: the Syria case-study

2016 ◽  
Vol 3 ◽  
Author(s):  
F. J. Charlson ◽  
Y. Y. Lee ◽  
S. Diminic ◽  
H. Whiteford
Keyword(s):  
Mental Health ◽  
Major Depression ◽  
Disease Burden ◽  
Health Planning ◽  
Scale Up ◽  
Health Benefit ◽  
World Health ◽  
Steady Increase ◽  
Linear Scale ◽  
Post Traumatic Stress

BackgroundEpidemiological models are frequently utilised to ascertain disease prevalence in a population; however, these estimates can have wider practical applications for informing targeted scale-up and optimisation of mental health services. We explore potential applications for a conflict-affected population, Syria.MethodsWe use prevalence estimates of major depression and post-traumatic stress disorder (PTSD) in conflict-affected populations as inputs for subsequent estimations. We use Global Burden of Disease (GBD) methodology to estimate years lived with a disability (YLDs) for depression and PTSD in Syrian populations. Human resource (HR) requirements to scale-up recommended packages of care for PTSD and depression in Syria over a 15-year period were modelled using the World Health Organisation mhGAP costing tool. Associated avertable burden was estimated using health benefit analyses.ResultsThe total number of cases of PTSD in Syria was estimated at approximately 2.2 million, and approximately 1.1 million for depression. An age-standardised major depression rate of 13.4 (95% UI 9.8–17.5) YLDs per 1000 Syrian population is estimated compared with the GBD 2010 global age-standardised YLD rate of 9.2 (95% UI 7.0–11.8). HR requirements to support a linear scale-up of services in Syria using the mhGAP costing tool demonstrates a steady increase from 0.3 FTE in at baseline to 7.6 FTE per 100 000 population after scale-up. Linear scale-up over 15 years could see 7–9% of disease burden being averted.ConclusionEpidemiological estimates of mental disorders are key inputs into determining disease burden and guiding optimal mental health service delivery and can be used in target populations such as conflict-affected populations.

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