Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study
Background Verbal autopsy (VA), though imperfect, serves as a vital tool to determine cause-of-death, particularly for out-of-facility deaths, but challenges persist in integrating VA into Civil Registration and Vital Statistics systems. Objective To describe the challenges and successes of collecti...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2024.2399413 |
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| author | Monique Maqungo Nadine Nannan Beatrice Nojilana Erin Nichols Diane Morof Mireille Cheyip Chalapati Rao Carl Lombard Jessica Price Kathleen Kahn Lorna J. Martin Francois Bezuidenhout Ria Laubscher Chodziwadziwa Kabudula Tracy Glass Oluwatoyin Awotiwon Nesbert Zinyakatira Noluntu Funani Jané Joubert Debbie Bradshaw Pamela Groenewald |
| author_facet | Monique Maqungo Nadine Nannan Beatrice Nojilana Erin Nichols Diane Morof Mireille Cheyip Chalapati Rao Carl Lombard Jessica Price Kathleen Kahn Lorna J. Martin Francois Bezuidenhout Ria Laubscher Chodziwadziwa Kabudula Tracy Glass Oluwatoyin Awotiwon Nesbert Zinyakatira Noluntu Funani Jané Joubert Debbie Bradshaw Pamela Groenewald |
| author_sort | Monique Maqungo |
| collection | DOAJ |
| description | Background Verbal autopsy (VA), though imperfect, serves as a vital tool to determine cause-of-death, particularly for out-of-facility deaths, but challenges persist in integrating VA into Civil Registration and Vital Statistics systems. Objective To describe the challenges and successes of collecting a national sample of verbal autopsy interviews in South Africa to obtain the cause of death profile in 2017/18. Methods We recruited next of kin from 27 randomly selected sub-districts (10.5%) across South Africa between September 2017 and April 2018. Trained fieldworkers conducted face-to-face interviews using the WHO2016 VA instrument, with physicians certifying underlying causes of death. Feasibility was evaluated based on response rates, participation, and data quality. Results Of the total 36,976 deaths registered, only 26% were identified during recruitment, with a 55% overall response rate for VA interviews. Physician-reviewed VA data were deemed of good quality for assigning underlying causes of death in 83% of cases. By comparing cause-specific mortality fractions, physician-reviewed VA identified 22.3% HIV/AIDS and InterVA-5 identified 18.5%, aligning with burden of disease estimates, while Statistics South Africa reported 4.9% HIV/AIDS. Conclusions The study demonstrated the feasibility of using VA on a national scale, but immense challenges in identifying and recruiting next of kin highlight the importance of formalising VAs within the country’s death notification system. |
| format | Article |
| id | doaj-art-6517750a785f4c109c4c41b4514aa038 |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-6517750a785f4c109c4c41b4514aa0382025-02-05T12:46:14ZengTaylor & Francis GroupGlobal Health Action1654-98802024-12-0117110.1080/16549716.2024.23994132399413Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation studyMonique Maqungo0Nadine Nannan1Beatrice Nojilana2Erin Nichols3Diane Morof4Mireille Cheyip5Chalapati Rao6Carl Lombard7Jessica Price8Kathleen Kahn9Lorna J. Martin10Francois Bezuidenhout11Ria Laubscher12Chodziwadziwa Kabudula13Tracy Glass14Oluwatoyin Awotiwon15Nesbert Zinyakatira16Noluntu Funani17Jané Joubert18Debbie Bradshaw19Pamela Groenewald20South African Medical Research CouncilSouth African Medical Research CouncilSouth African Medical Research CouncilU.S. Centers for Disease Control and PreventionU.S. Public Health Service Commissioned CorpsCenters for Disease Control and PreventionAustralian National UniversitySouth African Medical Research Council, Parow Valley, Western Cape, South AfricaUniversity of the WitwatersrandUniversity of the WitwatersrandUniversity of Cape TownGeoSpace InternationalSouth African Medical Research Council, Parow Valley, Western Cape, South AfricaUniversity of the WitwatersrandSouth African Medical Research CouncilSouth African Medical Research CouncilWestern Cape Department of HealthSouth African Medical Research CouncilSouth African Medical Research CouncilSouth African Medical Research CouncilSouth African Medical Research CouncilBackground Verbal autopsy (VA), though imperfect, serves as a vital tool to determine cause-of-death, particularly for out-of-facility deaths, but challenges persist in integrating VA into Civil Registration and Vital Statistics systems. Objective To describe the challenges and successes of collecting a national sample of verbal autopsy interviews in South Africa to obtain the cause of death profile in 2017/18. Methods We recruited next of kin from 27 randomly selected sub-districts (10.5%) across South Africa between September 2017 and April 2018. Trained fieldworkers conducted face-to-face interviews using the WHO2016 VA instrument, with physicians certifying underlying causes of death. Feasibility was evaluated based on response rates, participation, and data quality. Results Of the total 36,976 deaths registered, only 26% were identified during recruitment, with a 55% overall response rate for VA interviews. Physician-reviewed VA data were deemed of good quality for assigning underlying causes of death in 83% of cases. By comparing cause-specific mortality fractions, physician-reviewed VA identified 22.3% HIV/AIDS and InterVA-5 identified 18.5%, aligning with burden of disease estimates, while Statistics South Africa reported 4.9% HIV/AIDS. Conclusions The study demonstrated the feasibility of using VA on a national scale, but immense challenges in identifying and recruiting next of kin highlight the importance of formalising VAs within the country’s death notification system.http://dx.doi.org/10.1080/16549716.2024.2399413cause of deathcause-specific mortality fractionscivil registration and vital statisticsverbal autopsysouth africa |
| spellingShingle | Monique Maqungo Nadine Nannan Beatrice Nojilana Erin Nichols Diane Morof Mireille Cheyip Chalapati Rao Carl Lombard Jessica Price Kathleen Kahn Lorna J. Martin Francois Bezuidenhout Ria Laubscher Chodziwadziwa Kabudula Tracy Glass Oluwatoyin Awotiwon Nesbert Zinyakatira Noluntu Funani Jané Joubert Debbie Bradshaw Pamela Groenewald Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study Global Health Action cause of death cause-specific mortality fractions civil registration and vital statistics verbal autopsy south africa |
| title | Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study |
| title_full | Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study |
| title_fullStr | Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study |
| title_full_unstemmed | Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study |
| title_short | Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study |
| title_sort | can verbal autopsies be used on a national scale key findings and lessons from south africa s national cause of death validation study |
| topic | cause of death cause-specific mortality fractions civil registration and vital statistics verbal autopsy south africa |
| url | http://dx.doi.org/10.1080/16549716.2024.2399413 |
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