Early detection of maternal death in Senegal through household-based death notification integrating verbal and social autopsy: a community-level case study

The article by Mosa Moshabela and colleagues in the BMC Health Services Research presents a case study of community-level surveillance in Senegal as part of the Millennium Villages Project (MVP). The mobile technology based (mHealth) platform Childcare+ was used to identify pregnancies, births and deaths. Once this information is entered into the surveillance system, this then prompts a verbal and social autopsy to be conducted. Verbal Autopsy and Social Autopsy (VASA) data was collected using a standardised tool based on the WHO’s Verbal Autopsy questionnaire but with some modifications on questions related to social contributors to mortality (e.g. accessing transport). The VASA data was collected either by hand or using a mobile device and then uploaded to a central database where a pre-set algorithm was used to calculate the likely cause of death and any contributory social factors.

The case study highlights how the routine community-based surveillance system identified inefficiencies at a tertiary level of care as the main contributor to the five maternal deaths in the area. The study concludes that mHealth data collection tools are able to detect small changes in community-level mortality in real-time, can help facilitate rapid-cycle quality improvement interventions when linked with accountability structures such as mortality reviews.