Recent rapid developments in:

• verbal autopsy questionnaire design and validation
• mobile devices to simplify electronic questionnaire administration at households in remote areas and the rapid transmission of the results to a central server
• and the availability of associated diagnostic algorithms such as Smart VA, InterVA, and InSilico VA resident on central national servers that can analyse the information collected to estimate the underlying cause of death is making the use of VA in routine CRVS a potentially practical undertaking. 

By 2017 over a dozen countries will have completed demonstration scale implementations of VA as part of their CRVS system and are working to design national scale implementations. CRVS-VA systems take advantage of the popular open source Open Data Kit (ODK) approach to collecting data on mobile devices (ODK Collect), accumulating it on computer servers (ODK Aggregate) and moving on to diagnostic algorithms (ODK Briefcase).

There are currently two major platforms in use.  

• One platform is the IHME PHMRC Shortened Questionnaire that runs on any Android mobile device and can be analysed by the proprietary IHME diagnostic algorithm called SmartVA Analyze (Tariff2). This also generates cause specific mortality fractions and feeds results directly to health authorities and CRVS authorities.
• One is the WHO 2016 VA questionnaire that runs on any Android mobile device and can be analysed by all available open source diagnostic algorithms (eg InterVA and InSilicoVA as well as physician review) via a single interface called OpenVA. These generate cause specific mortality fractions and can feed results directly to the health information system such as the health sector’s DHIS2, and are made available to CRVS authorities.

For CRVS-VA systems to work there are a large number of CRVS systems level considerations to put in place. Paramount among these is the need to have a reliable death notification system to ensure that deaths occurring in communities where VA is being conducted are notified, registered and given a unique ID that will allow the eventual VA cause of death to be linked to CRVS. Modern approaches to vital event notification are now moving to mobile devices and ODK approaches thus making this a potential option. 

Read more

Automated verbal autopsy section

SmartVA:  http://www.healthdata.org/verbal-autopsy/tools

WHO 2016 VA questionaire and manual:  http://www.who.int/healthinfo/statistics/verbalautopsystandards/en/

ODK: https://opendatakit.org/

InSilicoVA: https://cran.r-project.org/web/packages/InSilicoVA/index.html

InterVA: http://www.interva.net/

OpenVA: https://rdrr.io/cran/openVA/