review · Pan African Medical Journal
Accurate information on the causes of child mortality is essential for setting effective health policies, yet most countries in sub-Saharan Africa lack functional civil registration and vital statistics systems. Verbal autopsy methods have become a primary tool to fill this information void. A review of studies published between 1990 and 2018 examined the validation of these techniques across the region. Physician-certified verbal autopsy emerged as the most frequently applied method. However, evaluations assessing this approach against hospital records, automated InterVA models, and expert algorithms revealed mixed and inconsistent results. Factors influencing accuracy include the local healthcare access of respondents and the reviewing physicians' familiarity with regional disease epidemiology. Despite these performance variations, verbal autopsy remains the only feasible mechanism currently available to generate child mortality data for policymakers in the region.
When national death registration systems do not function, governments cannot easily determine why children are dying. Verbal autopsies offer an alternative way to gather this vital public health data. Understanding the strengths and weaknesses of these diagnostic methods ensures that healthcare leaders recognise the limitations of the evidence they rely upon to design life-saving interventions.
The abstract does not indicate an application pathway or commercialisation opportunity, focusing instead on evaluating public health research and policy methods.
AI-generated from the published abstract. Always read the original work before citing.
Reliable data on the cause of child death is the cornerstone for evidence-informed health policy making towards improving child health outcomes. Unfortunately, accurate data on cause of death is essentially lacking in most countries of sub-Saharan Africa due to the widespread absence of functional Civil Registration and Vital Statistics (CRVS) systems. To address this problem, verbal autopsy (VA) has gained prominence as a strategy for obtaining Cause of Death (COD) information in populations where CRVS are absent. This study reviewed publications that investigated the validation of VA methods for assessment of COD. A MEDLINE PubMed search was undertaken in June 2018 for studies published in English that investigated the validation of VA methods in sub-Saharan Africa from 1990-2018. Of the 17 studies identified, 9 fulfilled the study inclusion criteria from which additional five relevant studies were found by reviewing their references. The result showed that Physician-Certified Verbal Autopsy (PCVA) was the most widely used VA method. Validation studies comparing PCVA to hospital records, expert algorithm and InterVA demonstrated mixed and highly varied outcomes. The accuracy and reliability of the VA methods depended on level of healthcare the respondents have access to and the knowledge of the physicians on the local disease aetiology and epidemiology. As the countries in sub-Saharan Africa continue to battle with dysfunctional CRVS system, VA will remain the only viable option for the supply of child mortality data necessary for policy making.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.11604/pamj.2019.33.318.16405
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
