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Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.

Identifieur interne : 000952 ( PubMed/Corpus ); précédent : 000951; suivant : 000953

Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.

Auteurs : Jordana Leitao ; Daniel Chandramohan ; Peter Byass ; Robert Jakob ; Kanitta Bundhamcharoen ; Chanpen Choprapawon ; Don De Savigny ; Edward Fottrell ; Elizabeth França ; Frederik Fr En ; Gihan Gewaifel ; Abraham Hodgson ; Sennen Hounton ; Kathleen Kahn ; Anand Krishnan ; Vishwajeet Kumar ; Honorati Masanja ; Erin Nichols ; Francis Notzon ; Mohammad Hafiz Rasooly ; Osman Sankoh ; Paul Spiegel ; Carla Abouzahr ; Marc Amexo ; Derege Kebede ; William Soumbey Alley ; Fatima Marinho ; Mohamed Ali ; Enrique Loyola ; Jyotsna Chikersal ; Jun Gao ; Giuseppe Annunziata ; Rajiv Bahl ; Kidist Bartolomeus ; Ties Boerma ; Bedirhan Ustun ; Doris Chou ; Lulu Muhe ; Matthews Mathai

Source :

RBID : pubmed:28141011

Abstract

Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. Methods A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. Findings A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. Conclusions The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians.

DOI: 10.3402/gha.v6i0.21518
PubMed: 28141011

Links to Exploration step

pubmed:28141011

Le document en format XML

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<nlm:affiliation>a Disease Control and Vector Biology , London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation>
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<nlm:affiliation>b WHO Collaborating Centre for Verbal Autopsy, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine Umeå University , Umeå , Sweden.</nlm:affiliation>
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<name sortKey="Fottrell, Edward" sort="Fottrell, Edward" uniqKey="Fottrell E" first="Edward" last="Fottrell">Edward Fottrell</name>
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<nlm:affiliation>g UCL Centre for International Health and Development, Institute of Child Health , London , UK.</nlm:affiliation>
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<name sortKey="Franca, Elizabeth" sort="Franca, Elizabeth" uniqKey="Franca E" first="Elizabeth" last="França">Elizabeth França</name>
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<nlm:affiliation>h Epidemiology and Health Evaluation Faculty of Medicine , Federal University of Minas Gerais, Minas Gerais , Brazil.</nlm:affiliation>
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<name sortKey="Fr En, Frederik" sort="Fr En, Frederik" uniqKey="Fr En F" first="Frederik" last="Fr En">Frederik Fr En</name>
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<nlm:affiliation>i Genes and Environment Division of Epidemiology , Norwegian Institute of Public Health , Oslo , Norway.</nlm:affiliation>
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<name sortKey="Gewaifel, Gihan" sort="Gewaifel, Gihan" uniqKey="Gewaifel G" first="Gihan" last="Gewaifel">Gihan Gewaifel</name>
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<name sortKey="Hounton, Sennen" sort="Hounton, Sennen" uniqKey="Hounton S" first="Sennen" last="Hounton">Sennen Hounton</name>
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<nlm:affiliation>l Headquarter , United Nations Population Fund (UNFPA) , New York , USA.</nlm:affiliation>
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<name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name>
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<nlm:affiliation>m MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) , School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation>
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<name sortKey="Kumar, Vishwajeet" sort="Kumar, Vishwajeet" uniqKey="Kumar V" first="Vishwajeet" last="Kumar">Vishwajeet Kumar</name>
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<name sortKey="Rasooly, Mohammad Hafiz" sort="Rasooly, Mohammad Hafiz" uniqKey="Rasooly M" first="Mohammad Hafiz" last="Rasooly">Mohammad Hafiz Rasooly</name>
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<nlm:affiliation>r Afghan Public Health Institute, Afghanistan Ministry of Public Health , Kabul , Afghanistan.</nlm:affiliation>
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<name sortKey="Sankoh, Osman" sort="Sankoh, Osman" uniqKey="Sankoh O" first="Osman" last="Sankoh">Osman Sankoh</name>
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<name sortKey="Ali, Mohamed" sort="Ali, Mohamed" uniqKey="Ali M" first="Mohamed" last="Ali">Mohamed Ali</name>
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<nlm:affiliation>x Division of Health Systems and Services Development, WHO Regional Office for the Eastern Mediterranean , Cairo , Egypt.</nlm:affiliation>
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<name sortKey="Loyola, Enrique" sort="Loyola, Enrique" uniqKey="Loyola E" first="Enrique" last="Loyola">Enrique Loyola</name>
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<nlm:affiliation>y Health Information , Evidence and Research Policy, WHO Regional Office for Europe , Kobenhavn , Denmark.</nlm:affiliation>
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<name sortKey="Chikersal, Jyotsna" sort="Chikersal, Jyotsna" uniqKey="Chikersal J" first="Jyotsna" last="Chikersal">Jyotsna Chikersal</name>
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<nlm:affiliation>z Evidence-Based Health Situation and Trends Assessment, WHO Regional Office for the South Eastern Region , New Dehli , India.</nlm:affiliation>
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<name sortKey="Gao, Jun" sort="Gao, Jun" uniqKey="Gao J" first="Jun" last="Gao">Jun Gao</name>
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<nlm:affiliation>aa Health Information, Evidence and Research Policy, WHO Regional Office for Western Pacific , Manila , Philipines.</nlm:affiliation>
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<name sortKey="Annunziata, Giuseppe" sort="Annunziata, Giuseppe" uniqKey="Annunziata G" first="Giuseppe" last="Annunziata">Giuseppe Annunziata</name>
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<nlm:affiliation>ab Mediterranean Centre for Health Risk Reduction, WHO , Geneva , Switzerland.</nlm:affiliation>
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<name sortKey="Bahl, Rajiv" sort="Bahl, Rajiv" uniqKey="Bahl R" first="Rajiv" last="Bahl">Rajiv Bahl</name>
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<name sortKey="Bartolomeus, Kidist" sort="Bartolomeus, Kidist" uniqKey="Bartolomeus K" first="Kidist" last="Bartolomeus">Kidist Bartolomeus</name>
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<name sortKey="Boerma, Ties" sort="Boerma, Ties" uniqKey="Boerma T" first="Ties" last="Boerma">Ties Boerma</name>
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<nlm:affiliation>af Classification , Terminology and Standards Unit, WHO , Geneva , Switzerland.</nlm:affiliation>
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<name sortKey="Chou, Doris" sort="Chou, Doris" uniqKey="Chou D" first="Doris" last="Chou">Doris Chou</name>
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<nlm:affiliation>ag Department of Reproductive Health and Research, WHO , Geneva , Switzerland.</nlm:affiliation>
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<name sortKey="Muhe, Lulu" sort="Muhe, Lulu" uniqKey="Muhe L" first="Lulu" last="Muhe">Lulu Muhe</name>
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<nlm:affiliation>ah Child and Adolescent Health and Development, WHO , Geneva , Switzerland.</nlm:affiliation>
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<name sortKey="Mathai, Matthews" sort="Mathai, Matthews" uniqKey="Mathai M" first="Matthews" last="Mathai">Matthews Mathai</name>
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<nlm:affiliation>ai Maternal, Newborn, Child and Adolescent Health, WHO , Geneva , Switzerland.</nlm:affiliation>
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<title xml:lang="en">Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.</title>
<author>
<name sortKey="Leitao, Jordana" sort="Leitao, Jordana" uniqKey="Leitao J" first="Jordana" last="Leitao">Jordana Leitao</name>
<affiliation>
<nlm:affiliation>a Disease Control and Vector Biology , London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name>
<affiliation>
<nlm:affiliation>a Disease Control and Vector Biology , London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Byass, Peter" sort="Byass, Peter" uniqKey="Byass P" first="Peter" last="Byass">Peter Byass</name>
<affiliation>
<nlm:affiliation>b WHO Collaborating Centre for Verbal Autopsy, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine Umeå University , Umeå , Sweden.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Jakob, Robert" sort="Jakob, Robert" uniqKey="Jakob R" first="Robert" last="Jakob">Robert Jakob</name>
<affiliation>
<nlm:affiliation>c Health Information and Statistics, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Bundhamcharoen, Kanitta" sort="Bundhamcharoen, Kanitta" uniqKey="Bundhamcharoen K" first="Kanitta" last="Bundhamcharoen">Kanitta Bundhamcharoen</name>
<affiliation>
<nlm:affiliation>d International Health Policy Program, Thailand Ministry of Public Health , Nonthaburi , Thailand.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Choprapawon, Chanpen" sort="Choprapawon, Chanpen" uniqKey="Choprapawon C" first="Chanpen" last="Choprapawon">Chanpen Choprapawon</name>
<affiliation>
<nlm:affiliation>e Health Policy and Strategic Bureau, Ministry of Public Health , Nonthaburi , Thailand.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="De Savigny, Don" sort="De Savigny, Don" uniqKey="De Savigny D" first="Don" last="De Savigny">Don De Savigny</name>
<affiliation>
<nlm:affiliation>f Public Health and Health Systems , Swiss Tropical and Public Health Institute , Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Fottrell, Edward" sort="Fottrell, Edward" uniqKey="Fottrell E" first="Edward" last="Fottrell">Edward Fottrell</name>
<affiliation>
<nlm:affiliation>g UCL Centre for International Health and Development, Institute of Child Health , London , UK.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Franca, Elizabeth" sort="Franca, Elizabeth" uniqKey="Franca E" first="Elizabeth" last="França">Elizabeth França</name>
<affiliation>
<nlm:affiliation>h Epidemiology and Health Evaluation Faculty of Medicine , Federal University of Minas Gerais, Minas Gerais , Brazil.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Fr En, Frederik" sort="Fr En, Frederik" uniqKey="Fr En F" first="Frederik" last="Fr En">Frederik Fr En</name>
<affiliation>
<nlm:affiliation>i Genes and Environment Division of Epidemiology , Norwegian Institute of Public Health , Oslo , Norway.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Gewaifel, Gihan" sort="Gewaifel, Gihan" uniqKey="Gewaifel G" first="Gihan" last="Gewaifel">Gihan Gewaifel</name>
<affiliation>
<nlm:affiliation>j Faculty of Medicine , University of Alexandria , Alexandria , Egypt.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Hodgson, Abraham" sort="Hodgson, Abraham" uniqKey="Hodgson A" first="Abraham" last="Hodgson">Abraham Hodgson</name>
<affiliation>
<nlm:affiliation>k Health Research and Development Division, Ghana Health Serfice , Accra , Ghana.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Hounton, Sennen" sort="Hounton, Sennen" uniqKey="Hounton S" first="Sennen" last="Hounton">Sennen Hounton</name>
<affiliation>
<nlm:affiliation>l Headquarter , United Nations Population Fund (UNFPA) , New York , USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name>
<affiliation>
<nlm:affiliation>m MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) , School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Krishnan, Anand" sort="Krishnan, Anand" uniqKey="Krishnan A" first="Anand" last="Krishnan">Anand Krishnan</name>
<affiliation>
<nlm:affiliation>n Centre for Community Medicine, All India Institute of Medical Sciences , New Delhi , India.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Kumar, Vishwajeet" sort="Kumar, Vishwajeet" uniqKey="Kumar V" first="Vishwajeet" last="Kumar">Vishwajeet Kumar</name>
<affiliation>
<nlm:affiliation>o Uttar Pradesh Center, Community Empowerment Lab , Uttar Pradesh , India.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Masanja, Honorati" sort="Masanja, Honorati" uniqKey="Masanja H" first="Honorati" last="Masanja">Honorati Masanja</name>
<affiliation>
<nlm:affiliation>p Ifakara Health Institute , Dar es Salaam , Tanzania.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Nichols, Erin" sort="Nichols, Erin" uniqKey="Nichols E" first="Erin" last="Nichols">Erin Nichols</name>
<affiliation>
<nlm:affiliation>q International Statistics Division , Centers for Disease Control and Prevention , Hyattsville , USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Notzon, Francis" sort="Notzon, Francis" uniqKey="Notzon F" first="Francis" last="Notzon">Francis Notzon</name>
<affiliation>
<nlm:affiliation>q International Statistics Division , Centers for Disease Control and Prevention , Hyattsville , USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Rasooly, Mohammad Hafiz" sort="Rasooly, Mohammad Hafiz" uniqKey="Rasooly M" first="Mohammad Hafiz" last="Rasooly">Mohammad Hafiz Rasooly</name>
<affiliation>
<nlm:affiliation>r Afghan Public Health Institute, Afghanistan Ministry of Public Health , Kabul , Afghanistan.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Sankoh, Osman" sort="Sankoh, Osman" uniqKey="Sankoh O" first="Osman" last="Sankoh">Osman Sankoh</name>
<affiliation>
<nlm:affiliation>s INDEPTH Network Secretariat, INDEPTH Network , Accra , Ghana.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Spiegel, Paul" sort="Spiegel, Paul" uniqKey="Spiegel P" first="Paul" last="Spiegel">Paul Spiegel</name>
<affiliation>
<nlm:affiliation>t Public Health and HIV Section , The office of the United Nations High Commissioner for Refugees (UNHCR) , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Abouzahr, Carla" sort="Abouzahr, Carla" uniqKey="Abouzahr C" first="Carla" last="Abouzahr">Carla Abouzahr</name>
<affiliation>
<nlm:affiliation>u Independent Consultant.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Amexo, Marc" sort="Amexo, Marc" uniqKey="Amexo M" first="Marc" last="Amexo">Marc Amexo</name>
<affiliation>
<nlm:affiliation>v Monitoring of Vital Events , Health Metrics Network , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Kebede, Derege" sort="Kebede, Derege" uniqKey="Kebede D" first="Derege" last="Kebede">Derege Kebede</name>
<affiliation>
<nlm:affiliation>w Health Information and Analysis , Pan American Health Organization , Washington , DC , USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Soumbey Alley, William" sort="Soumbey Alley, William" uniqKey="Soumbey Alley W" first="William" last="Soumbey Alley">William Soumbey Alley</name>
<affiliation>
<nlm:affiliation>w Health Information and Analysis , Pan American Health Organization , Washington , DC , USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Marinho, Fatima" sort="Marinho, Fatima" uniqKey="Marinho F" first="Fatima" last="Marinho">Fatima Marinho</name>
<affiliation>
<nlm:affiliation>w Health Information and Analysis , Pan American Health Organization , Washington , DC , USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Ali, Mohamed" sort="Ali, Mohamed" uniqKey="Ali M" first="Mohamed" last="Ali">Mohamed Ali</name>
<affiliation>
<nlm:affiliation>x Division of Health Systems and Services Development, WHO Regional Office for the Eastern Mediterranean , Cairo , Egypt.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Loyola, Enrique" sort="Loyola, Enrique" uniqKey="Loyola E" first="Enrique" last="Loyola">Enrique Loyola</name>
<affiliation>
<nlm:affiliation>y Health Information , Evidence and Research Policy, WHO Regional Office for Europe , Kobenhavn , Denmark.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Chikersal, Jyotsna" sort="Chikersal, Jyotsna" uniqKey="Chikersal J" first="Jyotsna" last="Chikersal">Jyotsna Chikersal</name>
<affiliation>
<nlm:affiliation>z Evidence-Based Health Situation and Trends Assessment, WHO Regional Office for the South Eastern Region , New Dehli , India.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Gao, Jun" sort="Gao, Jun" uniqKey="Gao J" first="Jun" last="Gao">Jun Gao</name>
<affiliation>
<nlm:affiliation>aa Health Information, Evidence and Research Policy, WHO Regional Office for Western Pacific , Manila , Philipines.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Annunziata, Giuseppe" sort="Annunziata, Giuseppe" uniqKey="Annunziata G" first="Giuseppe" last="Annunziata">Giuseppe Annunziata</name>
<affiliation>
<nlm:affiliation>ab Mediterranean Centre for Health Risk Reduction, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Bahl, Rajiv" sort="Bahl, Rajiv" uniqKey="Bahl R" first="Rajiv" last="Bahl">Rajiv Bahl</name>
<affiliation>
<nlm:affiliation>ac Department of Child and Adolescent Health and Development, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Bartolomeus, Kidist" sort="Bartolomeus, Kidist" uniqKey="Bartolomeus K" first="Kidist" last="Bartolomeus">Kidist Bartolomeus</name>
<affiliation>
<nlm:affiliation>ad Department of Violence and Injury Prevention and Disability, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Boerma, Ties" sort="Boerma, Ties" uniqKey="Boerma T" first="Ties" last="Boerma">Ties Boerma</name>
<affiliation>
<nlm:affiliation>ae Health Statistics and Informatics, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Ustun, Bedirhan" sort="Ustun, Bedirhan" uniqKey="Ustun B" first="Bedirhan" last="Ustun">Bedirhan Ustun</name>
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<nlm:affiliation>af Classification , Terminology and Standards Unit, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Chou, Doris" sort="Chou, Doris" uniqKey="Chou D" first="Doris" last="Chou">Doris Chou</name>
<affiliation>
<nlm:affiliation>ag Department of Reproductive Health and Research, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Muhe, Lulu" sort="Muhe, Lulu" uniqKey="Muhe L" first="Lulu" last="Muhe">Lulu Muhe</name>
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<nlm:affiliation>ah Child and Adolescent Health and Development, WHO , Geneva , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Mathai, Matthews" sort="Mathai, Matthews" uniqKey="Mathai M" first="Matthews" last="Mathai">Matthews Mathai</name>
<affiliation>
<nlm:affiliation>ai Maternal, Newborn, Child and Adolescent Health, WHO , Geneva , Switzerland.</nlm:affiliation>
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</author>
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<series>
<title level="j">Global health action</title>
<idno type="eISSN">1654-9880</idno>
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<div type="abstract" xml:lang="en">Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. Methods A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. Findings A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. Conclusions The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians.</div>
</front>
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<Title>Global health action</Title>
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<ArticleTitle>Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.</ArticleTitle>
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<AbstractText>Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. Methods A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. Findings A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. Conclusions The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians.</AbstractText>
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<Initials>J</Initials>
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</AffiliationInfo>
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