Automated verbal autopsy: from research to routine use in civil registration and vital statistics systems

BMC Medicine

Ferchito Avelino¹  Agnes Segarra¹  Abdul Kalam Azad²  Shah Ali Akbar Ashrafi²  Alan D. Lopez³  John D. Hart³  Deborah Carmina Sarmiento³  Riley H. Hazard³  Mahesh P. K. Buddhika³  Khin Sandar Bo³  Hafizur R. Chowdhury³  Violoa Kwa³  Sonja Firth³  Rohina Joshi⁴ 

[1] Department of Health, Manila, Philippines;Directorate General of Health Services, Dhaka, Bangladesh;Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia;The George Institute for Global Health, UNSW Sydney, 2042, Newtown, New South Wales, Australia;

关键词: Verbal autopsy;    Civil registration and vital statistics;    Cause of death;    Bangladesh;    Myanmar;    Papua New Guinea;    Philippines;   

DOI  :  10.1186/s12916-020-01520-1

来源: Springer

【 摘 要 】

BackgroundThe majority of low- and middle-income countries (LMICs) do not have adequate civil registration and vital statistics (CRVS) systems to properly support health policy formulation. Verbal autopsy (VA), long used in research, can provide useful information on the cause of death (COD) in populations where physicians are not available to complete medical certificates of COD. Here, we report on the application of the SmartVA tool for the collection and analysis of data in several countries as part of routine CRVS activities.MethodsData from VA interviews conducted in 4 of 12 countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative, and at different stages of health statistical development, were analysed and assessed for plausibility: Myanmar, Papua New Guinea (PNG), Bangladesh and the Philippines. Analyses by age- and cause-specific mortality fractions were compared to the Global Burden of Disease (GBD) study data by country. VA interviews were analysed using SmartVA-Analyze-automated software that was designed for use in CRVS systems. The method in the Philippines differed from the other sites in that the VA output was used as a decision support tool for health officers.ResultsCountry strategies for VA implementation are described in detail. Comparisons between VA data and country GBD estimates by age and cause revealed generally similar patterns and distributions. The main discrepancy was higher infectious disease mortality and lower non-communicable disease mortality at the PNG VA sites, compared to the GBD country models, which critical appraisal suggests may highlight real differences rather than implausible VA results.ConclusionAutomated VA is the only feasible method for generating COD data for many populations. The results of implementation in four countries, reported here under the D4H Initiative, confirm that these methods are acceptable for wide-scale implementation and can produce reliable COD information on community deaths for which little was previously known.

【 授权许可】

CC BY