Verbal autopsy is not a substitute for medically certified cause of death. In general, it is intended for use where there is no physician, and for generating population-level data on proportions and rates of cause-specific mortality. It can also be used to support cause of death diagnosis in cases where there is little clinical information on the deceased such as dead on arrival 'DOA' cases, or community deaths where the certifying physician is unfamiliar with the deceased.
Completing the medical death certificate can be challenging in some cases, especially when death has occurred outside the health facility and where the certifying physician has no access to medical records or diagnostic tests to inform the completion of the certificate.
In some countries, physicians use automated VA (SmartVA Auto Analyze) to provide additional information so that a death certificate can be issued. This helps avoid instances where the physician refuses to certify the death because of lack of information or writes ‘ill-defined’ or ‘unknown’ as the COD. These deaths can constitute a significant proportion of all deaths in some countries.
Instituting a system for routinely applying VA methods can yield valuable diagnostic information for health policies. Automated VA techniques can be used by health personnel to interview relatives of the decedent to elicit the main symptoms experienced before death, and then apply a diagnostic tool to identify the probable COD.
While VA generates cause of death data that are generally less detailed and less reliable at the individual level than those derived using medical certification of cause of death, it can be a cost-effective means of providing useful information about the cause composition of mortality at a population level that can be used to inform health policy.