Population cause of death estimation using verbal autopsy methods in large-scale field trials of maternal and child health: lessons learned from a 20-year research collaboration in Central Ghana

Emerging Themes in Epidemiology

Analytic Perspective

Seeba Amanga-Etego¹  Alexander Manu²  Samuel O. Danso³  Justin Fenty⁴  Betty Kirkwood⁵  Seyi Soremekun⁶  Bilal Iqbal Avan⁶  Sam Newton⁷ 

[1] Centre for Computing, Kintampo Health Research Centre, Ministry of Health, Kintampo, Ghana;Centre for Maternal and Newborn Health, Liverpool School of Hygiene and Tropical Medicine, Liverpool, UK;Disease Modelling Research Group, Centre for Dementia Prevention & Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Liverpool, UK;Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK;Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK;School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;

关键词: Verbal autopsy;    Verbal post-mortem;    Maternal neonatal and child health;    Child health;    Neonatal mortality;    Maternal mortality;    Child mortality;    Vital registration;    Death registration;    Vital statistics;   

DOI  :  10.1186/s12982-023-00120-7

 received in 2021-10-09, accepted in 2023-01-30,  发布年份 2023

来源: Springer

【 摘 要 】

Low and middle-income countries continue to use Verbal autopsies (VAs) as a World Health Organisation-recommended method to ascertain causes of death in settings where coverage of vital registration systems is not yet comprehensive. Whilst the adoption of VA has resulted in major improvements in estimating cause-specific mortality in many settings, well documented limitations have been identified relating to the standardisation of the processes involved. The WHO has invested significant resources into addressing concerns in some of these areas; there however remains enduring challenges particularly in operationalising VA surveys for deaths amongst women and children, challenges which have measurable impacts on the quality of data collected and on the accuracy of determining the final cause of death. In this paper we describe some of our key experiences and recommendations in conducting VAs from over two decades of evaluating seminal trials of maternal and child health interventions in rural Ghana. We focus on challenges along the entire VA pathway that can impact on the success rates of ascertaining the final cause of death, and lessons we have learned to optimise the procedures. We highlight our experiences of the value of the open history narratives in VAs and the training and skills required to optimise the quality of the information collected. We describe key issues in methods for ascertaining cause of death and argue that both automated and physician-based methods can be valid depending on the setting. We further summarise how increasingly popular information technology methods may be used to facilitate the processes described. Verbal autopsy is a vital means of increasing the coverage of accurate mortality statistics in low- and middle-income settings, however operationalisation remains problematic. The lessons we share here in conducting VAs within a long-term surveillance system in Ghana will be applicable to researchers and policymakers in many similar settings.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 2

Fig. 1