Improving data improving health: Verbal autopsy for health systems strengthening 

A recent event at University College London (UCL) will be of interest to those working on maternal death surveillance and response. The seminar, Improving Data, Improving Health: Verbal Autopsy for Health Systems Strengthening, was organised by the University of Aberdeen’s Centre for Global Development and UCL’s Institute for Global Health. The half-day event in October 2016 featured six speakers from the World Health Organization, Umeå University, UCL, Malaria Consortium, University of Aberdeen and the Africa Health Research Institute.

Image_quoteThe aim of the seminar was to explore how verbal autopsy (VA) and similar methods can connect communities to policy makers to improve data and strengthen health systems. Browse the links below to watch the recordings and download the slides for each presentation.

Following a round-table discussion, the speakers published a Lancet comment, the Case for Verbal Autopsy in Health Systems Strengthening (D’Ambruoso et al. 2016). Like the seminar, the focus of the piece was to explore how countries and communities can use rigorous VA methods to improve data for action, and enhance national and global understandings.

Here are the key discussion points:

  • The health systems research approach connects global health researchers with local decision-makers and service providers. The INDEPTH Network (the International Network for the Demographic Evaluation of Populations and Their Health) and Health Systems Global are examples of these groups “committed to research for action” (p.e20).
  • The World Health Organization has led the development process to standardise interview procedures and align the VA assignment of cause of death with the International Classification of Diseases. Standardising this information will help make data comparable across countries.
  • The use of mobile devices to collect information and automated tools, such as InterVA and SmartVA, to process data are practical techniques that are effective and require few resources. 
  • Drawing on the evidence of implementing VA models will inform the possibilities and barriers of using VA in mortality registration (e.g. civil registration and vital statistics, and sample registration systems).
  • In relation to VA, social autopsy is a method to capture information on the social and systemic circumstances of a death. It investigates issues related to social exclusion from the health system and systemic failures to better understand why deaths happen outside of facilities or why deaths are not registere
  • Combining VA with participatory methods can support the involvement of communities to interpret local data, generate new knowledge for action to inform service organisation and delivery, and gain learning from action.
  • There is a need to improve information systems and generate good data where deaths are currently unrecorded and health systems depend on global estimates.

The authors suggest that the use of VA can mobilise change in local communities, which in turn will contribute to global improvements.

View the recordings and download the presentations of the seminar here.

Read the Lancet commentary here.

Learn more about VA approaches and how VA models are used to capture and record maternal and perinatal deaths here.

Learn about the community-linked maternal death review project in Malawi by clicking here to watch Dr Tim Colbourn’s presentation in full, to download the Power Point presentation and to read the paper about the study.

Browse our materials on social autopsy here.

Reference

D’Ambruoso, L., Boerma, T., Byass, P., Fottrell, E., Herbst, K., Källander, K., & Mullan, Z. (2016). The case for verbal autopsy in health systems strengthening. Lancet, online publication. http://thelancet.com/journals/langlo/article/PIIS2214-109X(16)30332-1/fulltext